By Ali Weatherford

Tandem nursing refers to breastfeeding more than one child at a time when they are also different ages. Feeding twins or multiples is a little different. Tandem nursing is not a common practice in our modern culture, but it happens more than a lot of people think.

Should I stop breastfeeding when I’m pregnant?

If you struggle with the idea of weaning, know that there is another option. You DO NOT have to stop breastfeeding when you get pregnant again. Especially for low risk pregnancies and for people who are able to maintain good nutrition, it does not appear to be harmful to your body or to your pregnancy to continue to breastfeed your older child. It also does not seem to negatively affect the quality of the milk that your newborn will get. The milk you make for your older baby is different, but your body is incredibly sensitive and intuitive. It will understand that there is a newborn baby needing colostrum and a different kind of milk, so it will provide it. These newborns tend to do very well, and there seems to be no difference in health and weight gain for newborns of parents who are tandem nursing.

Why tandem nurse?

If you’re successfully breastfeeding a toddler or older baby when you get pregnant again, it can be a really hard thing to consider weaning for the sake of the pregnancy and the new baby. A lot of people think it has to be done, but when things are going well with breastfeeding, it’s often not something that people want to give up. It’s excellent nutrition that is very affordable. By this time, it might also be very easy and even enjoyable for you both. The babies get very efficient, and breastfeeding can be quick and easy with no mess to clean up! When older babies and toddlers are exploring solid foods and deciding what they do and don’t want to eat, it’s especially helpful to have breastmilk as a backup. It feels good to know they’re still getting complete nutrition with breastmilk if they just play with their food or throw it on the floor today. It’s normal for older babies to explore textures and tastes when they’re starting solids, but not get much actual nutrition from it. It’s great to keep things positive and continue to offer breastmilk.

Some people get pregnant again pretty quickly after the last birth, and in this case may want to continue to breastfeed for the recommended amount of time. The current recommendation from the American Academy of Pediatrics is to provide breastmilk exclusively for at least the first six months, and to continue to offer breastmilk in addition to solid foods “for at least 2 years and beyond as mutually desired”. Many other sources have published similar recommendations. So, if you have a baby that is just a few months old, and you are trying to adhere to these recommendations, it can feel like weaning during pregnancy would be too soon for your baby.

You also might feel a very strong bond with your baby through breastfeeding, and it can be very hard to consider giving that up, especially knowing that another baby is coming and you’ll have to divide your attention. You might worry about how your baby will handle it, but it can also be really hard for the parent. People often choose to tandem nurse because breastfeeding is working very well for their family.

Some parents worry that a new baby will change their relationship with their older baby. If breastfeeding has been a point of strong connection for the two of you, it can be comforting to continue breastfeeding. That might help ease some of those worries. You and your older baby can continue to share that kind of bonding and that might help make the transition a little easier for both of you.

Tandem nursing can also help make those early days and weeks of feeding a newborn a little easier. You are less likely to experience engorgement and the discomforts that go along with that transition. The older baby can be a great help in balancing the milk supply.

Is there a downside?

Tandem nursing can be fantastic for some families, but it’s not for everyone. Some people end up feeling very tired and “touched out” when they’re trying to breastfeed a baby and a toddler at the same time. It might seem like there is always someone wanting to be at the breast. Your breasts might get sore from frequent use. And some people end up experiencing some difficult emotions. Some people feel resentment towards one or the other of their children when things feel very difficult. You might feel like you can’t give enough of your attention to one of them and resent the other for that. You might have feelings of doubt or insecurities about your ability to breastfeed two children. Some people don’t have community or family support for their choice and feel rejected or judged. There are even cases where their OB and/or pediatrician express concerns or judgments about the choice. This is usually just a lack of information on their part, and not because it’s a bad choice, but it can still feel very difficult to receive that kind of reaction from a health care professional.

Also, even though it’s not harmful, it might not be the same to breastfeed throughout your pregnancy. Your milk supply might drop in one breast or both, and the composition of the milk changes due to the hormones of pregnancy. The milk might taste different to your baby. Because of these changes, some babies decide to wean themselves. When I became pregnant with my second baby, I was still breastfeeding my daughter who had just turned two. I noticed that breastfeeding started to feel painful on one side because the supply was gone. My daughter definitely noticed that there was no more milk in that breast and would get frustrated and only choose the other. At that point, I felt ready to try weaning, and my daughter agreed. It was easy because of those changes in the milk supply, and it turned out to be the right thing for us.

How to transition away from breastfeeding

Luckily, my daughter did not struggle with weaning at all. She wasn’t nursing much at that point anyway. It was mostly a comfort and an easy way to get her ready for naps and bedtime. I offered her a little bit of juice and extended snuggles instead, and she was very happy to take it. She’s very snuggly, and juice was a special treat for her, so that’s all it took!

If things had been different, I likely would have continued to breastfeed through my pregnancy, because it was a very easy and sweet thing that my daughter and I shared. I did worry that the new baby would create more separation for my daughter and me, especially without our shared experience of breastfeeding. I worried that she would feel neglected or jealous of the new baby. Luckily, we had many months for our relationship to shift, and we still had a very strong bond when my son arrived.

When the baby came, she had mostly forgotten about nursing and it didn’t bother her as much as I thought it would that he was breastfeeding. If your older child does wean close to the time that your new baby arrives, I recommend building in some things that will help your older child with the transition:

  • Find new special bonding rituals for the two of you. Maintain those when the new baby arrives so they can see that they still have their own special relationship with you. You might start doing some infant massage at bedtime, or storytime if you haven’t done that yet. You might make a cup of sleepytime tea together and play a favorite game before bedtime, or take a daily walk around the neighborhood. My daughter loved to act out her favorite scenes from storybooks, so we did that everyday. Her favorite was pretending to be Curious George when he broke his leg and had to go to the “hoshtable” (hospital). We would wrap her leg with a scarf and put it in traction using the side of her crib.
  • If you start out tandem nursing, and then it starts to feel overwhelming to nurse both babies, it doesn’t have to be an abrupt or dramatic loss to stop breastfeeding your older child. You can gradually remove some feedings. It’s a great idea to replace that time with something else special. You can use that time to do something else that will maintain your bond. What many parents want to avoid is their older child feeling neglected or replaced by the new baby.
  • Toddlers sometimes like to be involved in the baby care, and that can help them feel included and important. You might ask them to help you when you’re feeding your newborn. They might be able to bring you a burp cloth or help hold the baby’s head or feet. They can start to understand that they have a new and very special role in the family as a big sibling.

How to tandem nurse successfully

If breastfeeding continues to go well during pregnancy and you would like to tandem nurse when your new baby arrives, here are some tips that might be helpful:

  • The more experienced baby can probably nurse well under any circumstances, but newborns are still developing their strength and skill, so latch the newborn first, then allow the older baby to latch at the other breast if you’d like to nurse them both at the same time.
    If you prefer to nurse them separately, you might set up ‘special’ nursing times just for you and your older baby when someone else can be with your newborn.
  • Make sure to feed your newborn “on demand”. It’s important for them to get as much milk as possible in those early weeks especially. They usually lose some weight at birth, and getting plenty of milk is important for their growth, and also for health concerns such as jaundice, digestive health, and immunity. Their meals should be prioritized. The older baby can nurse after the newborn and still get some milk.
  • Your older child can be fed “on demand”, but many parents decide to set up regular times to nurse the older baby. It’s a personal preference, but a schedule can be helpful for many people.
  • If you’re experiencing engorgement, it can be helpful to allow your older baby to nurse a small amount from that breast to relieve the symptoms. It can be difficult for a newborn to latch on to an engorged breast and can sometimes cause frustration and refusal. The older baby can ensure that the engorgement is relieved and that the breast is soft. This can make it easier for the newborn to get a good latch.
    If you have a very powerful milk ejection or “letdown”, a newborn might not be able to keep up with the amount of milk that is spraying out. When this happens, they can choke and gag and get upset at the breast. This can even lead to rejection of breastfeeding. If you have an older baby, you might let that baby nurse for a short time until the flow slows down, and then allow your newborn to nurse more easily.

The most important thing to take away from this is that tandem nursing is great for some families, but not for everyone. I encourage parents to listen to their own intuitions when it comes to parenting decisions like this. Tandem nursing has been done throughout our history and across many cultures, so it’s definitely something that our bodies are capable of. It can be a really good thing. It’s also true that it doesn’t work for everyone, or that it doesn’t feel right for everyone. If you feel a strong intuition to continue to breastfeed your baby and tandem nurse, you can tune out the voices that tell you it’s not healthy or wrong or weird. If someone thinks it’s unhealthy, that’s because it’s something they don’t understand. If someone thinks it’s weird, it’s just because they haven’t been exposed to it. For other people, it seems like the most reasonable and natural thing to do. I hope that you can find your own path in parenting. It doesn’t have to look like what you’ve seen before. We all have different bodies and different circumstances. There are SO many right choices!

References

Tandem Breastfeeding: A Descriptive Analysis of the Nutritional Value of Milk When Feeding a Younger and Older Child – PMC

Tandem Nursing – La Leche League GB

Pregnant and Breastfeeding – La Leche League GB

Breastfeeding During Pregnancy: A Systematic Review of the Literature