So You Want To Exclusively Breastfeed – Tips for Singletons and Multiples

Any amount of breastmilk is does incredibly things for your baby’s health, but some parents have a goal of exclusively feeding breastmilk to their children. The benefits of giving breastmilk only are numerous. First of all, breastmilk and formula are not the same. Breastmilk contains living cells, stem cells, white cells, antibodies, and immune factors that cannot be added to formula. Just as how powdered cows milk reconstituted with hot water is not the same as fresh cows milk, formula is not even close as breastmilk. That being said, thank goodness we have formula for the situations that require it. This article by Dr. Jack Newman explains in detail the differences between breastmilk and formula and is an incredibly good read.

Benefits of Exclusively Breastfeeding

  • Baby receives the best possible passive immunity from the mother which is directly catered to their particular environment and the germs found within it.
  • Baby’s microbiome develops in the best possible way. The quality of the microbiome in one’s digestive tract is known to dictate digestive and immune function, neurological and cognitive development, stress levels, and more.
  • Baby avoids any potentially risky ingredients found in formula such as aluminum and other contaminants such as glass and metal shavings. Formula is also man made and subject to human error. There have been many instances throughout history where formula is recalled for things such as arsenic and salmonella.

Jack Newman says it quite plainly, “Most women these days “cannot breastfeed” because they are undermined in their ability to do so.  Hospital routines around labour and birth, separation of mothers and babies, early introduction of bottles and poor advice from health professionals all together result in so many mothers who “cannot breastfeed” and are disappointed in breastfeeding when they should direct their disappointment at our medical system.  If they had had normal births, and good help from the beginning, most such mothers would be very successful at breastfeeding.”

This applies to mothers of multiples as well. If you can breastfeed one baby, you can breastfeed two or more. The amount of milk you make will always be equal to the amount that is removed from the breast. Period.

With all that being said, let’s move on to the tips!

Tip #1 Educate yourself about breastfeeding BEFORE giving birth
We often spend so much time preparing to give birth, but almost none preparing to breastfeed. For many parents, the birth part seems the most scary and uncertain but actually, it is only one moment in time that passes relatively quickly. The breastfeeding relationship will last months or years after birth, so it’s just as important to prepare for. If breastfeeding starts off well in the beginning, it is often easier overall than if it starts off poorly. The human body is incredible and can make up for any early mistakes, but if possible it’s much less stressful to start off on the right foot from day one. I have several posts about how to prepare for breastfeeding during pregnancy which you can read HERE and HERE.

Tip #2 Connect with a breastfeeding professional during pregnancy
Having an experienced breastfeeding support person you can call or message with while you are in the hospital is SO IMPORTANT. Even though I am a breastfeeding counselor, I still had my doula, Stephanie, on call when I had my twins in the hospital. Even though I know a lot about breastfeeding myself, it was necessary to have a support person to reassure me that everything I was doing was right. Often times in hospitals in Japan, you will receive a wide range of breastfeeding advice from the medical staff that works there. Not everyone is trained in lactation! Having someone you can trust (and who speaks your language) can be so important to your breastfeeding success. You can find out more about the breastfeeding support available in Tokyo and Japan here.

Tip #3 Let your care provider know that you plan to exclusively breastfeed
Having a conversation with your care provider about your breastfeeding goals is the first step in not only building your own confidence but also making sure you and your care provider are on the same page. Remember that YOU are your children’s advocate. YOU are the one giving birth and this is YOUR baby or babies. Being confident and strong in your decisions will get you far in Japanese hospitals. Often times, formula is offered to parents who seem like they need more rest or aren’t confident in breastfeeding yet. If you tell your care provider that your plan is “to breastfeed” not “try to breastfeed”, this will be taken seriously in my experience. I think I told every new nurse that came into my room that I would be breastfeeding and I was never offered formula. This also goes for when baby is in the nursery. There will most likely be times when the babies have to go to the nursery for some tests or checks. Make sure you explicitly say you don’t want your baby given formula while in the nursery.

Tip #4 Nurse or pump as early as possible after birth
This is particularly important after a c-section. Your breasts need to be stimulated for your milk to come in so it’s very important to put baby to the breast soon after giving birth. If it’s not possible to put them on the breast, such as with a NICU stay, then you should begin pumping soon after birth. Generally, “soon” means within the first 12-24 hours. Personally, even though I have no complications after my c-section, my babies still didn’t latch until about 24 hours after birth. It can be nerve-wracking if your babies aren’t latching yet, but don’t give up! The first milk that comes after birth is called colostrum. It is packed with the perfect nutrients for your babies and every drop should be savored even if it doesn’t look like much. If you are pumping, you can save the colostrum and give it to your babies with a syringe. Try to avoid a bottle if possible before breastfeeding is established.

Be prepared that you may be told, “your milk hasn’t come in yet, you should rest”. THIS IS BAD ADVICE. The colostrum that comes in the first couple of days is very important for helping baby pass their first stool, called meconium, preventing jaundice, and protecting them from infections with passive immunity. The colostrum you produce in the first few days may not look like much, but it is packed with benefits.

Tip #5 Have the baby/ies room in with you if possible and offer the breast or pump at least 10 times in 24 hours
Early and frequent feeding is truly the key to establishing breastfeeding and getting your mature milk to come in sooner than later. Unfortunately, not all care providers encourage parents and babies to stay together in the same room during their recovery stay. Rooming in with your babies encourages more frequent feeding and allows you to recognize their hunger cues sooner. Many hospitals will offer to let you put your babies in the nursery so you can rest. This is tricky because you will potentially be very tired after giving birth. I know I was! If you need to put your babies in the nursery so you can rest, try to limit their stay to 2 -3 hours before bringing them back to nurse them again. Only do this as much as you need because it is quite possible that they will want to nurse more than every 2-3 hours. In my three days at the hospital, I allowed my babies to go to the nursery a couple of times for 2 hours each because the epidural made me so sleepy that I couldn’t even keep my eyes open. Once the epidural was out (about 18 hours after surgery) I was able to be more alert. Attempting to breastfeed, even if baby doesn’t latch, is important as well. In the first 24 hours, I made sure to do as much skin to skin as possible and just keep trying. Eventually they both latched!

Doing skin to skin to try to get Taishi to latch

Tip #6 For multiples, start tandem nursing as soon as possible
Tandem nursing, or nursing both babies at the same time, is extremely useful in both saving you time and building your milk supply. It is especially helpful if you have one baby who is a less efficient nurser than the other because the stronger baby can trigger more letdowns, which allows the less efficient baby to still receive the same amount of milk despite being less efficient. Newborns also tend to take a longer time to nurse plus nurse more frequently than older babies, so if you nurse both at the same time you can at least have a chance for a little break in between. I tandem nursed my twins for about the first 9 months. Stimulating both breasts at once also encourages a healthy milk supply. If you are still working on the latch, it can be helpful to nurse the babies one at a time at first. But don’t be afraid of tandem nursing! It takes some practice but will make your life so much easier! I used the TwinZ nursing pillow to tandem nurse.

First time tandem nursing in the hospital. They were small enough that I could use my normal breastfeeding pillow!

Tip #7 Nurse “on demand” and not on a schedule
“On demand” means observing and responding to baby’s hunger cues by offering the breast. Newborns can seem to feed nearly constantly, which many new parents are surprised by. This is normal behavior and excellent for building your milk supply. This is a great article to read about what to expect as far as frequency of feeding. Nursing on a schedule has been shown to contribute to slow weight gain and low milk supply. If you are pumping, make sure to pump at least 8 times in 24 hours (this is every 3 hours day and night) to mimic the frequency of feeding from a newborn baby.

If you are nursing multiples, it can be more challenging and time consuming to nurse on demand because there are two babies with two different demands! A good rule of thumb is to always nurse both. When one begins to show hunger cues, you can either feed them and then the other one or ones, or tandem nurse. If you feed one and then wait a while, you will probably find yourself feeding a baby all day long. Of course, there is nothing wrong with that but it can get overwhelming at times! If your babies are or have been in the NICU, you may find that they are more “on a schedule” than babies who weren’t. That’s okay! Follow your baby’s lead. If they are naturally on the same schedule, don’t fight it, embrace it and consider yourself lucky in that regard!

Tip #8 Talk to your partner and any family members who will be involved with you and your baby/ies about your breastfeeding goals
Don’t wait until after you give birth to have a conversation about breastfeeding with the people closest to you! It’s important for your partner and/or close family members especially to be on the same page as you so that they can support you. For a parent trying to exclusively breastfeed, it is not helpful to have people near you undermining your confidence by encouraging you to give bottles so you can rest, supplement with formula unnecessarily, or even impose their own ideas about breastfeeding on to you. Your partner may have ideas about breastfeeding that are unknown to you so talking about your breastfeeding plans is crucial. Partners and family members may think that feeding the baby with a bottle is the only way they can help but that is far from true. Cooking, cleaning, changing diapers, holding and rocking the baby, taking them for walks…there are an infinite amount of things they can do that don’t involve baby feeding. You want to talk about all of this before baby comes rather than during that exhausted newborn haze, let me tell you!

After almost a year of exclusively nursing my twins, plus two years of exclusively nursing my firstborn, I can honestly say that nursing at the breast only gets easier as time goes on. Once solids are introduced and you aren’t feeding around the clock anymore, you will find that your pre-baby freedom returns somewhat. I know a lot of people don’t want to exclusively breastfeed because they are afraid of the baby constantly relying on them or maybe they have to return to work and worry that breastfeeding won’t be compatible with time away from baby. Many parents have found ways for exclusive breastfeeding to work in whatever situation they are in as long as they want to do it. As always, it is your body, your baby, and your choice. I hope this post was helpful!

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