Tandem Nursing: Breastfeeding an Infant and Toddler

Breast-feeding can be hard at first. But it gets easier.  You’ve worked at it and kept with it through thick and thin. Now you’ve gotten to a great point with your little one, and she just wants to keep going, and going. Woo-hoo!

But now… you’re pregnant again!

What do you do? Keep nursing? Wean? Some mamas are ready to wean, and their little ones may even wean themselves due to changing milk tastes from the hormones of pregnancy. But other little ones nurse on, with seemingly no end in sight.

What’s a mama to do? Tandem nurse!

In this post, we’ll unpack what tandem nursing is, why you’d want to do it, and how to do it with relative ease.

What is tandem nursing?

Tandem nursing is the practice of nursing two babies at the same time. This can take two forms: nursing twins, or nursing a toddler and an older child.

It can entail a few different scenarios:

  • nursing the toddler first, perhaps to alleviate engorgement, then nursing the baby
  • nursing the baby first, to make sure he gets the most milk
  • nursing two at the same time, with one baby on each breast

It can also include what some call tri-andem nursing, or nursing three or more children at once (Can you imagine?!).

How long have women been tandem nursing?

Probably the first mention was in Roman mythology, where a she-wolf tandem nursed twin brothers, Romulus and Remus, the main characters of Rome’s foundational myth. This time period is when wet nursing was common practice. We know ancient Rome held wet nurses in high esteem, as did Victorian England (where it might be a woman with an illegitimate child who chooses to nurse).

According to Norma Jean Baumgartner in Mothering Your Nursing Toddler, tandem nursing is probably not all that common in other cultures, most of whom believe nursing during pregnancy would…

  • harm the fetus
  • turn the milk bad
  • deplete the mother

Moreover, some cultures have taboos against sex during lactation (and pregnancy), meaning the mother cannot get pregnant until her child has weaned. Tandem nursing, therefore, while not taboo itself, is something simply not done.

Benefits of tandem nursing

But tandem nursing does happen for a variety of reasons, and there are definite benefits, both emotional and physical:

  • Tandem nursing can help relieve engorgement in a mother with a newborn.
  • The older child can help manage a mom’s fast letdown (once mature milk comes in) before the newborn nurses, helping the infant not feel overwhelmed or gassy/colicky from the rush of milk to her immature digestive system.
  • Emotionally, it may help reduce feelings of jealously from the older child.
  • Tandem nursing can also bond the two children together, since it’s an activity they can do together (if you nurse simultaneously). And even if they don’t do it at same time, it’s something they share… mother’s milk.
  • It may support robust milk production in mom.
  • Tandem nursing can also help moms who feel they aren’t bonding as much with the older child due to newborn demands. Continuing to breast-feed the older child is good for a consistent bond before and after the birth of a newborn.
  • The older child continues to receive the health benefits from breast milk.

Benefits of extended breast-feeding

Truth is, breast milk is incredibly beneficial for children, even past the age of 1, when most moms are told it’s time to wean. And yet, it’s common knowledge that our immune systems aren’t fully developed until age 2, and that breastmilk is brimming with antibodies that support healthy immunity.

Breast-fed babies have lower instances of immune-related conditions like allergies, asthma, diabetes, and juvenile arthritis. Because of this, and poorer water conditions in developing countries, the WHO recommends breast-feeding a child until at least 2 years of age.

And while there aren’t a lot of U.S. studies on long-term breast-feeding, a newer study found that children who were breast-fed longer than U.S. averages had better vocabulary at age 3 and higher intelligence when tested at age 7 (according to standardized testing parameters).

Potential drawbacks to tandem nursing

Just like with everything, there can be issues with tandem nursing, but most are able to be resolved…

  • Issue: The toddler will take all the milk the baby needs—mainly, the rich, creamy hindmilk.
    • Solution: Nurse the children on different breasts, being careful to switch sides at each feeding. If you don’t feed them at the same time, put the baby on the breast the toddler last nursed on, so baby gets the rich hindmilk.
  • Issue: Mom won’t produce enough milk for baby.
    • Solution: Breast-feeding is a tight feedback loop based on supply and demand. The more baby and toddler nurse and milk is expelled, the more milk will be produced. Always nurse on demand, and don’t follow the clock or feeding schedules. Occasionally, hormonal imbalances will interfere with this process. In these situations, tandem nursing may not be the best option.
  • Issue: Moms worry about their nipples becoming too sore from so much nursing. 
    • Solution: Don’t assume you’ll have nipple dryness or pain. There are Areolar glands surrounding the nipples that secrete oil to keep nipples lubricated and protected. (Interesting to note: they also produce a smell that signals food to newborn.) If you start to have soreness issues, be sure to check your latch with a Lactation Consultant. You can also use ice packs, lanolin, and nipple cream to help with discomfort. Airing out your breasts can help (walking around bare-chested), and you can also try to cut back on toddler feedings if this helps with soreness.

What about colostrum?

You might have noticed your breast milk changing during your pregnancy. (First off, you probably saw a drop in your production thanks to progesterone, the hormone that surges in pregnancy.) Around the 6th month, your mature milk starts reverting to colostrum for your newborn. (In fact, your toddler may have had looser stool due to the bowel-stimulating effects of colostrum, which ensures that your newborn will expel all of his meconium.)

Colostrum is a very special food specifically designed for your baby’s first few days of life. It is critical that your newborn should get “first dibs” on mom’s breasts so that he gets all of the therapeutic benefits of colostrum. In fact, you might want to restrict your older child from nursing long periods or at all during this time. That’s how important the colostrum is for the newborn. It seals the gut, and provides important proteins and immune-boosting antibodies.

Once your mature milk comes in, usually a few days postpartum, then you can proceed full steam ahead with tandem nursing.

Is baby getting enough?

You can make sure your newborn is getting enough breast milk by closely monitoring his diapers and urine/feces output.

Wet diapers

According to KellyMom, a baby usually has one wet diaper for each day of life at first (1 on day one, 2 on day two, etc). Once your mature milk comes in, you should expect 5–6+ wet diapers every 24 hours. A “wet diaper” is usually about 2 TB to 1/4 cup of urine.

Dirty diapers

Similar to wet diapers, a baby should have one dirty diaper for each day of life (1 on day one, 2 on day two, etc). Keep in mind that 1 diaper may have pee and poo :). After about day 4, a breast-fed baby’s stool should be yellow, and he should have at least 3–4 stools daily that are the size of 1 TB.

Will my milk be suited for the newborn?

You have probably heard that your breast milk changes its composition as your child grows to meet his specific needs. Some moms worry that by tandem nursing, their milk will be suited for the toddler and not the newborn.

No need to worry.

As mentioned earlier, your breast milk changed during pregnancy back to colostrum to meet your newborn baby’s nutritional needs. Think of this as a milk “reset,” and your production will now follow your youngest child’s developmental needs (not your toddler’s). Mother Nature, in her everlasting wisdom, is always protecting the most vulnerable life for the survival of the species.

How does tandem nursing work?

OK, let’s get down to it. How do you actually tandem nurse?

For mamas

Well, some women prefer assigning a breast to each child for the duration of the breast-feeding relationship. Others like to rotate every other day or prefer to alternate breasts during every feeding.

Some moms will want to nurse their two children at the same time. Others will feel uncomfortable doing this, either because of the double-nipple stimulation, or because of emotional reasons such as feeling like a farm animal, feeling drained, or wanting to focus on one child at a time.

For toddlers

Some toddlers will want to nurse every time the baby breast-feeds, in which case you should plan to camp out on the couch with a glass of water and snacks in easy reach.

Other toddlers will only want to nurse occasionally; these are the easiest to manage, because you can nurse the babies separately. You may find that the toddler accepts “not now” easily, or you may find that the toddler throws a tantrum when he can’t breast-feed.

Remember, these are your breasts; your toddler is nursing not for primary nutrition, but for comfort. If you need to take a step away, for whatever reason, that’s OK!

Best positions for tandem nursing

Let’s talk about how we can latch two babies to the breast.

  • A cozy way is to nurse them both in a cradle hold, with the baby in the toddler’s lap
  • You can also try laid-back breastfeeding, where the baby and toddler both recline on the mother, their feet pointed towards her
  • You can also breast-feed one child in a cradle hold and one in a football hold
  • The toddler can kneel next to you to nurse while mom holds the newborn
  • The toddler can lean over from behind you to nurse while mom holds the newborn

What if I feel touched-out, agitated, or annoyed at my toddler?

Just as continuing to nurse your toddler through pregnancy is a personal decision, so is the choice to tandem nurse. It’s normal to feel agitated, touched-out, or tired of nursing the toddler. You may even feel fleeting resentment at the toddler for nursing at all. If you have these feelings all the time, it’s time to evaluate whether weaning might be a good choice for both of you. It’s not fair to the child to hear mama say “yes” when she really means “No!”

There are many solutions other than weaning, however.

  • You can tell your toddler “not now;” a kind “not now” opens the the door to a later “yes, you can nurse.”
  • If you’re feeling touched out, be honest and say the milkies are tired. You can also say there’s no milk right now.
  • Try not to let the toddler nurse when you feel annoyed at them, and don’t snap at them when they’re at the breast.
  • If you don’t want to nurse two babies at the same time—and some people can’t handle that feeling—be open with your toddler about it. That can help preserve nursing as your special comfort time away from the baby.
  • If you turn down your toddler, he may ask why the baby gets to nurse all the time. You can explain that the baby needs nursing as his food and water. Get silly and ask, “You don’t need nursing as your only food and water, do you? You can eat …” and list off your toddler’s favorite foods. Try to get them to chime in with some too, if they’re old enough. In fact, if you do say no, you can offer a piece of cheese or other nutritious food to your toddler instead, including a cup of milk.
  • Reading your toddler a book while you nurse may help you feel less touched out; you can also find another special activity for toddler if you need a break, such as stickers.

What if I decide tandem nursing isn’t for me?

However, if you decide to wean because you can’t get past the agitation or resentment (perfectly normal) about nursing a toddler, don’t beat yourself up. Remember that tandem nursing is a personal decision, and while it can help a toddler move through a transitional time, it’s far worse to have a resentful mother than a breast-feeding relationship.

Tips on weaning toddler

If you want to cut down on tandem nursing, there are several strategies you can take. (We have a whole post on this topic here.) Many experts and experienced moms recommend a period of three weeks after birth to allow the toddler to nurse whenever he wants.

  • After that, you can tell the toddler you’d like to nurse with only him. This should start to cut down the nursing sessions.
  • You can tell the toddler your milkies are tired or ouchie.
  • Drop one feeding at a time.
  • Offer a substitution (such as that cup of milk).
  • Tell them “later”—sometimes later never comes.
  • Shorten your toddler’s nursing session. Let them nurse up to the count of ten; this can satisfy him while keeping him from a full nursing session

There are gentle ways to wean, including cutting your breast-feeding down to once a day (you would likely pick bedtime). But don’t feel pressure to do even that. You’re the mama, and you know best.

So, what’s tandem nursing all about?

Tandem nursing is an adventure. It can be the right answer for some mother-baby-toddler triads, and not the right practice for others. There is no judgement or shame, regardless of what you and your family choose.

If you do decide to tandem, remember that as long as you let the baby nurse first during the first few days to get the colostrum, your breasts will most likely respond and make enough milk to nourish two babies. In fact, some times you may find they could feed more!

With tandem nursing, you can count on a toddler who appreciates being able to be a baby once in a while, and siblings with a closer bond than they may have had otherwise. Tandem nursing can help a mom as she’s negotiating life with a toddler and a newborn. It can help keep everyone happy, fed, and content—including mama. And that’s what tandem nursing is all about.

References

  • http://www.ncbi.nlm.nih.gov/pubmed/23896931
  • http://www.llli.org/faq/positioning.html

About the Author

Genevieve Howland is a childbirth educator and breastfeeding advocate. She is the bestselling author of The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth and creator of the Mama Natural Birth Course. A mother of three, graduate of the University of Colorado, and YouTuber with over 75,000,000 views, she helps mothers and moms-to-be lead healthier and more natural lives.

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5 Comments

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  1. I’m currently tandem feeding my 27 month old and 7 week old bubba ❤️ It’s beautiful, thou sometimes I do feel alittle touched out .
    Reading this article is very reassuring 💕

  2. Have any of you found your self pregnant and your baby only 8months old? Yes I am fully nursing day and night a d baby wearing/sleeping. I definitely don’t want to take away nutrients from my baby in my womb or my 8 month old.

  3. I never thought I would be caught in this predicament, but here I am with a 30 month old ( 2 1/2 ) who does’nt want to give up breastfeeding. I was worried that being pregnant with baby#3 and breastfeeding would harm the fetus, but this article made me feel better and not alone. I am slowly trying to wean my toddler off the breast, by telling him “their broken”. He was reluctant at first, but he is getting used to the idea. I must admit thought, when my breast feel engorged due to the pregnancy, it feels better to have him suckle for a few seconds to relieve the soreness.
    This article has given me fresh perspective, and I just might still have a toddler and newborn breastfeeding at the same time!

  4. I am on the way with my 2nd baby (6wks 5days) and still nursing my 23mos. old son..I find this article very helpful to me. Salute to all tandem nursing moms out there!!❤❤❤

  5. I absolutely love this article. I never thought I would be asking myself what tandem feeding was until I caught myself in the reality. I am planning my second child and I am still breastfeeding my 15 month old, so after reading this I feel really encouraged and excited to try it out. I have enjoyed feeding my daughter for this long and I know I can add one more. The only worry I had was about the colostrum for my newborn. Wondering if my body would still produce it even though I am feeding my toddler and it was very good news to read it did!! Mother Nature at its finest!

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