Today’s Podcast
Episode 173 Tandem Nursing

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 Episode 173

You may have heard Jenn and I talk about the definition of tandem nursing on the last show.

There is the standard definition which is when 2 or more children of different ages who breastfeed at the same time. Both can be breastfeeding at the same time or they can take turns breastfeeding throughout the day.

I know that as an IBCLC, I should probably stick to the letter of the law, so to speak and correct moms who say they are tandem nursing their twins. They are happy. They are proud. They are doing this extraordinary act of taking care of their little ones. The last thing I am going to do is make a big stink about the correctness of the definition. I just want them to enjoy themselves and feel proud of what they are doing.

Jenn said that she had thought about tandem nursing before she even had the opportunity to do so. I would say that from talking to literally thousands of parents over the last 20 years about this very subject, not too many moms spend much time thinking about their own desire to tandem nurse. They often tell me, it just sort of happened. It seems to be something that they more or less just wind up doing, largely because it just feels right at the time. They also tell me that they have a nursing baby or toddler at the t ime of their pregnancy and they just cannot imagine purposefully weaning them. Breastfeeding has been going great. They are enjoying the nutritional and emotional benefits afforded by nursing a toddler and they see no reason to purposefully stop. They just keep going and let their child decide when they are done. If they are still nursing when the new baby comes they are more than happy to tandem nurse.

I have many moms tell me that while it was not something they planned on doing, it kind of caught them by surprise, just as it did when they found themselves nursing a baby over 1 year old. I meet so many moms who have a number, a goal in mind as to how long they will breastfeed. Common goals are: Until I return to work. For 6 months. For 1 year.

Some moms surprise themselves as they hit their goal timeline and they say that they do not know what they were thinking as there is no way, unless their baby wants to, that they would quit breastfeeding. It has become easy and convenient and they feel their baby is doing quite well. Particularly if it is before the full year is up. They realize, why would they want to switch to formula, a food that is foreign to their babies system, for the next 3 or 6 months, just because they have reached a goal. They realize that it was just a number, and one frequently put out there because of all the unknowns about breastfeeding. They had heard how hard it was or were unsure if they could combine it with work or school and at the time, they were just hoping to make it a certain time period. Breastfeeding is something planned that they were going to do as they felt it was best for their baby. However, before you breastfeed it is something that you are going to do. Many of us have no idea what it is really going to mean to us or to our babies and children.

They did not realize that it would evolve into something that was such a part of their everyday life and that it was something that they did without thinking. Lots of moms just carry on way past their goal, without really even skipping a beat, without thinking anything of it.

Then they become pregnant and now they do start thinking about it. For sure, there are moms who realize they definitely do not want to be nursing two babies at the same time. This may happen even before they start feelings the effects of their current pregnancy. Things like morning, noon or night or all day sickness, sore nipples, anxiety, backaches, growing belly… now gradually come into play. For some mothers, they actively work towards weaning their little ones in preparation for the new baby. Some babies are very easy to wean as the supply gradually decreases until they are making very little, if any milk by their 20th week of pregnancy. They can easily be distracted, are already enjoying enough other foods and liquids and are quite easy to wean. Some babies are pretty tenacious and take a lot of work to give it up even though they are not receiving nourishment and hydration at the breast. This begs the question: Why would they keep nursing if they are not getting much or a full belly. The answer is quite simple. It is serving some very good purposes usually they like the mommy time, the cuddles, the closeness, it is calming for them, it provides a gentle time out from the business of the day and it helps them drift off to sleep at night. This is Just another wonderful example of the fact that babies get so much more at the breast then vital nutrients.

Samantha, a friend of mine told me that she was in love with the idea of tandem nursing. Kind of like some of us are in love with the idea of having twins. It seems cool and romantic and a source of endless discussion. She could not wait! However, the practicality of it all…when it came right down to it… She said – No thanks! She had put herself to sleep every night with her head filled with wonderful family pictures of a newborn and a 2 year old, lovingly keeping in their own space, staying on their side of the body with their chosen breast and cuddling and holding hands with each other. This is what she wanted. This is what she needed. This is totally what she did not get.

Samantha described the first few days of nursing two kiddos as an act of supreme patience. She was so tired and her 2 year old Joshua was so demanding. She had difficulties coordinating time at breast because she found she could not do both at the same time. Joshua had to wait his turn and he was not happy with this change in his life. Her newborn Jake, seemed to be breastfeeding just fine, however, Samantha described herself as being crazy out of this world, obsessed with worry that he was not getting enough. Even though she did see the output and her breasts were pretty full by Day 5 and her newborn had that milk drunk look all the time, she still worried. While she definitely wanted to cut Joshua off, when she ventured to do so, he went wild with frustration and she just put the brakes on even trying. She described her husband as caring and helpful, however, her 2 year old wanted nothing to do with Daddy during this time.

I first met Samantha, when her newborn was about 16 days old. She scheduled a consult with me and said that she had a list of questions for me. It told her that was great. Lets get all her questions answered. Samantha was so concerned with worry that she was not able to see the beauty that was right in front of her.

I certainly did not invalidate all her feelings of worry and concern. They are hers and she has a right to them, even though I observed what I thought was a picture/textbook perfect situation. I just let her talk and talk and vent and complain and she cried some and asked many rhetorical questions. I answered some of her questions along the way, but mostly I just let her rip. Let her get everything off her chest.. yes that pun was intended.

What it really came down to is this: Samantha knew of no one else in her current or past life who had tandem nursed. She had lots of flack, lots of negative comments during her pregnancy from family and friends about the talk of tandem nursing. Interestingly enough, these seemed to highly motivate her at the time and now, these same comments were throwing her confidence down the toilet.

She talked about how hard it was to have 2 babies nursing, especially at the same time. When I saw her nursing both kids at the same time, she seemed quite relaxed to me. When I gave some suggestions about things that might make her more comfortable, she rejected each idea. Finally, I said to her – I don’t believe I have any other suggestions to offer you as far as feeding both at the same time or separately. What are some other questions or concerns that you have? She asked me: Do you think I should keep doing this if I am so uncomfortable? I said to her absolutely not. I could not help though, in the next breathe say, you actually seem quite comfortable to me. Are you comfortable? And she thought for a minute and said: Well, actually I am, but I still worry a lot.

When I asked her what parts of tandem nursing worried her, she said – well about her newborn not getting enough. But in the next breath she seemed quite proud when she told me that her newborn was already back to birthweight at 7 days old and a pound above birthweight at 2 weeks old. She was changing 5-7 fully loaded poopy diapers every day and said that the pee diapers were very, very wet. I reviewed with her what normal newborn weight gain was and average output was.

It was of no surprise to her that her baby had gained a pound more than expected and that the output was over and above what was expected. Jake was sleeping well, had his fussy times, which were minimal and otherwise seemed happy and content. Her 2

year old Joshua, had calmed down a whole bunch after the first week. He realized he could have nursies whenever he wanted, no matter what his new baby brother was doing, and he just calmed down. As a matter of fact, Samantha said that he was even better than calm. He was happiest when at the breast. She thinks he realized that after many months of dry nursing, there was all of a sudden all this food for him and he could actually drink and gulp down milk again and leave with a full belly.

I answered lots more questions from Samantha. Do you know what she realized after all this? The first week was very difficult. She found it hard getting comfortable. She did not have great family support in helping to calm and distract Joshua while working with Jake find her groove with breastfeeding. Lots of negative comments from family members. Too many telling her that since Joshua was the older brother he would take all of Jakes milk. Healing and recovering from a birth that she had quite a bit of tearing from, and sleepy and constipated from the pain meds she had been taking, it was just all pretty awful.

What she did not realize, what was right in front of her. That breastfeeding 2 babies, tandem nursing, had quickly become the norm for her. It was comfortable for her and she was definitely finding her own groove with 2. She even said to me that she loved how it afforded her 1 good afternoon nap while both kiddos slept for almost 2 hours. She had taken a bunch of really cools selfies with nursing 2 and proudly showed them off to me.
The reality is, and as silly as it sounds, Samantha was now enjoying tandem nursing, but she was so caught up with what other people were thinking and saying… all their worries and concerns, all their nasty remarks, that once she got over the hump of the early week, she did not really realize she was actually doing okay. More than okay.

She is not glossing over the difficulties of the first week. I have become quite friendly with her and I hear about all the antics of nursing 2 kiddos who are now 12 months and 3 years old and still going strong. It is easy schmeazy for her now and a normal part of her everyday life. She is now clear headed and looks back on those early days and realizes that her fatigue and her being unfamiliar with tandem nursing, allowed her to get sucked into everyone else’s drama and negativity and fears. Things actually got good and fairly easy by the time Jake was a month old and she never really looked back or questioned her decision. She was just so caught up in everyone else’s stuff that she did not realize how well it was going for her. My visit with her, was the beginning of her being able to look at her situation objectively and she started to realize that it was all good! It was going pretty well. At that point, there was nowhere else for her to go but up!

One of the first things she did after our appointment was to not listen to just me, but she started to do some of her own research. She sought out other moms who tandem nursed. She also began to journal for herself. Here are some of things she has shared with me that she learned at the time and some she has added months later. I am pleased to pass her wisdom on to you:

1. Be prepared for things to be hard at first.
2. Be prepared to not know it all.
3. Be prepared to be vigilant about learning your babies hunger and satiation cues.
4. Be prepared to track output and early weight loss.
5. Be prepared to track weight gain to ensure appropriate gain of your newborn.
6. Find at least 1 person, who will be spending significant time with you, who believes in or will at the very least support your decision to tandem nurse.
7. If you have no one close to you, join online groups and make some friends with other moms who have tandem nursed.
8. Learn the health benefits. I am not saying that you have to memorize and chant these to the naysayers. However, if you know of them, this will help boost your confidence level when telling others to nicely mind their own business. It will keep you from letting fears get the best of you.
9. Journal – how you are coordinating it all. How the babies are growing and changing with it each day., how much easier it is for you each week.
10. Take pictures. Put them on your phone and on your computer. Print a few of them and hang them up in your home. On your refrigerator. Be proud of what you are accomplishing.
Samantha also wanted me to be sure to mention this: Don’t be surprised to find out out that your toddlers stools are looser than normal for a short time. This is because the colostrum has a laxative effect, which serves a very good purpose for newborns as it binds with red blood cells and causes lots of stooling. When this happened to her toddler, it only fed into her fears as she thought that loose stools meant that he was getting sick. And if her toddler was sick and he was nursing, then he might get the newborn sick and I don’t have to tell you moms out there… our fears and anxiety can snowball quite easily!

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What do we know about the beauty of tandem nursing. Well, first and foremost, up until the last 100 years or so, breastfeeding was the most common way to feed babies. Noone thought twice about breastfeeding in public places, breastfeeding 2 babies at once, breastfeeding well beyond the first year of life. Humans have been around for a very, very, very long time and think about it. It is only in the last 100 years that people have thought twice about any of this.

Breastfeeding toddlers with a new baby in the house, is a great way to mother your toddler. The household dynamics is suddenly very different than what they had been use to. They are not getting the same attention they had before the new baby. They are still little themselves and often do not understand why mom is different with them. Or why mom left them for a few days, if she gave birth away from home. Breastfeeding your toddler is a great way to reconnect. It also provides them with comfort as well as the nutrition they get. It is well known that toddlers are picky eaters, sometimes choosing to have the same foods day in and day out, sometimes for months. What better way to ensure your toddler gets many other vital nutrients than to nurse our picky eaters. Your milk provides a large portion of the daily hydration and protein and natural sugars and Vitamins they need.

Tandem nursing is also a great opportunity to begin to teach your toddler about patience, discipline according to their developmental age. This may also be the beginning of them learning how to share. Toddlers are at a great age for falling and hurting themselves, for putting things in their mouth, for getting sick easily. The health benefits of nursing can help to reduce the times and duration of illnesses. If they do get ill, there is nothing better than human milk to help them stay hydrated and nourished.

Just like nursing one baby, the law of supply and demand will enable you to make enough milk for both of your children. Tandem nursing 2 babies of different ages, changes as time goes on. It begins to get easier and fits easily into your life as the weeks turn into months. Older ones begin to spread out their nursing times. If you are not comfortable nursing two in public, of course this is fine. Just don’t let other people’s opinions about what you are doing, stop you from doing something you really want to do. You don’t have to tell others what you are doing. The first few months you are typically spending more time at home or in private spaces, recovering from birth, than you are on the outside. When not at home, you can teach your child to wait his turn, wait until you get home. Try not to make it a bigger issue than it needs to be. You can teach him this just like you are working on teaching him anything else. Things like:

Potty training.
Waiting his turn in line.
Sharing a toy with friends.
Only 2 cookies for a snack.
No jumping on furniture
No biting

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Lori J. Isenstadt, IBCLC
Lori j Isenstadt, IBCLCLori Jill Isenstadt, IBCLC is a huge breastfeeding supporter.  She has spent much  of her adult life working in the maternal health field. Once she became turned on to birth and became a childbirth educator, there was no stopping her love of working with families during their childbearing years.  Lori became a Birth doula and a Postpartum doula and soon became a lactation consultant.  She has been helping moms and babies with breastfeeding for over 25 years.  Lori founded her private practice, All About Breastfeeding where she meets with moms one on one to help solve their breastfeeding challenges.  She is an international speaker, book author and the host of the  popular itunes podcast, All About Breastfeeding, the place where the girls hang out.  You can reach Lori by email at: [email protected] or contact her via her website:  allaboutbreastfeeding.biz/contact

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