Breastfeeding Preemie Twins

Breastfeeding Premature Twins

Breastfeeding premature babies is possible!

Multiple births often result in a preterm birth. If you give birth to premature twins you will most likely have several concerns.


Constantly worrying about the well being of her twins can be a very traumatic time. If your babies need sometime in the NICU, then you will probably be discharged before your babies.

Among many questions, one which is common:

Is Breastfeeding Premature Babies Doable?

The basic answer is YES, breastfeeding is achievable.

Preterm infants may not be able to feed straight away, instead an IV is used for nourishment and growth until their little body’s are ready to ingest breast milk. Until your twins are ready, you will need to start expressing your breast milk at by at least the next day after birth.

You can then store your breast milk for when you need it.

The Benefits of Breastfeeding Premature Babies


A women’s body is amazing, the breast milk you produce with a preterm delivery will be specially designed to nourish your preemie babies. Your milk will have extra calories, vitamins and protein which will help with weight gain and development. Another great extra that formulas do not have is antibodies that provide protection against infections, and since a premature baby has little to no immune system these antibodies are very important.


The colostrum that’s first produced before your milk comes in is like a super food and gives a boost to all newborn babies. So even if you plan on bottle feeding your twins, colostrum is a wonderful thing to give to your two infants.

How to: Breastfeeding Premature Babies


Physically nursing premature twins, that’s baby to breast, may not be possible straight away. It will depend on how many weeks gestation they are born and if there are any health issues. Preemie babies often have latching difficulties or are just not ready to nurse.


The reflex suck, swallow, breathe is established at about 32 weeks in the womb, this is vital for being able to breastfeed.


Hyperalimentation Fluids:
Preemie babies born before the 32nd week of gestation will often start off by being receiving hyperalimentation fluids through an IV. The fluids given to premature babies, who are on Total Prenatal Nutrition (TPN), contain protein vitamins, electrolytes, and lipids (a source of fat) which is fed through a separate IV.


Infants on TPN may not be given breast milk right away, due to digestion immaturity. When your infant twins are ready, they will eventually be given the breast milk you have pumped (expressed). It’s gradually introduced with less IV fluids until they are fully being feed with breast milk.


Intravenous fluids
Those who do not need TPN (total prenatal nutrition) may be given fluids containing sugar via an IV, this gives your twins an energy boost. And would probably be given pumped breast milk and/or formula specially designed for preemie babies on top of the sugary fluids.


So you may now be wondering how you give your gift of breast milk when a baby is physically not ready to nurse. Firstly a breast pump is necessary to express/pump your milk, many hospitals will have a high grade breast pump you can use during your stay. It is also a good idea to either buy or hire a one for the first few weeks at home.

4 Ways to Feed your Preemie Twins

There are 4 ways you can feed premature babies expressed breast milk (or formula), these include:


1. Feeding Tube
If your baby(s) is unable to regulate eating and breathing, then a feeding tube called a gavage tube is put directly into your baby’s tummy through the nose or mouth. This can also be use in conjunction with an IV to supplement their diet and to get their digestion system working. Medications can be given via the feeding tube.


2. Eye Dropper or Syringe
Preemie babies who have trouble with sucking and swallowing may not be able to breastfeed or use a bottle to start with. An eye dropper or a syringe (like you use for medicines) can be used and often have measurement markings. Knowing how much has been eaten can help with over or under feeding your two infants.


3. Bottle Feeding
Normal sized bottle nipples for a newborn maybe too big, you can actually get preemie sized nipples. Of course a bottle can only be used once the suck, swallow, breathe reflex has been established. So if you are determined to give breastfeeding a go, while bottle feeding at first may be necessary, it can create more difficulties when trying to nurse for the first time. This is when the finger feeding technique can be used as pointed out below.


4. Finger Feeding
Breastfeeding premature babies – If your preemie twins are having trouble latching, then finger feeding can really help with the learning process of a breastfeed latch. Have a feeding tube which fits into a baby bottle containing your expressed milk (or formula). Position the tube along the soft part of your index finger with the end of the tube to end of your finger. Gently tickle baby’s lip until you can put your finger with the tube into his/her mouth. Babies will generally start sucking and drinking. With some practice latching to breastfeed may be achieved.

When are Preemie Babies ready to Breastfeed?


As mentioned earlier the suck, swallow, breathe reflex comes at about 32 weeks gestation, as long as there are no health issues, this may be the time to gradually start breastfeeding premature babies.


Common signs are:

  • When you touch their cheek or mouth your baby’s head will turn with an open mouth
  • They are more awake and aware when feeding
  • Can suck and/or latch on to a bottle
  • Feeding seems easy and comfortable for your baby


Sometimes preemie babies will still need supplemental feeds using formula to help with weight gain and getting more nutrients in.


Need more help with Breastfeeding Preemie Babies?

The La Leche League International is place of support for breastfeeding moms, you can ask questions and find more information about breastfeeding preemies as well as breastfeeding twins.

In general to establish breastfeeding can be a learning curve, but when breastfeeding premature babies this can be more of a challenge. If nursing your twins is something you really want, stick with it. And don’t forget to ask for help if you need it.

Breast or bottle – whichever decision you take, read our indepth guide on Breastfeeding twins

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