Feeding multiple babies can be a challenge at first.

Midwives, lactation consultants (health professionals that help you with breast feeding) or community health nurses will help you.

The links in this article will provide further advice and resources. You can also ask for help from family and friends. Make sure to rest as much as you can.

When feeding multiple babies, it's important to treat each baby as an individual. Try not to compare siblings. Decisions about their feeding patterns and how they are growing depend on:

• the sex of each baby
• the weight of each baby
• when each baby was born

Many multiple babies are premature and born very small, so you may need help with feeding them.

If they are in the neonatal intensive care unit (NICU), they may be fed at first through a tube. This tube runs through the nose, and carries the milk straight to their stomach.

When feeding, using different positions, pillows and other equipment can make it easier to feed twins, triplets or other multiples. It may also be helpful to keep records of every feed, especially at first.

Breastfeeding multiple babies

Breastfeeding is a natural way to feed your baby. Breast milk contains all the nutrients your baby needs to develop and grow for their first 6 months. It is easily digested, it's convenient and it's economical. Breast milk is especially important for low weight or premature babies. This is because it also helps them to fight infection.

Your babies may not be able to breastfeed at first. You may choose to express and store your breast milk to feed them later.

Breastfeeding and expressing helps to release the hormone oxytocin. This helps bonding between mother and baby. This is especially important if you're separated from your babies for a while.

Mothers of multiple babies often worry that they can’t make enough milk. But it is possible to breastfeed multiple babies. Breastfeeding works on 'supply and demand'. The more often your babies feed (or you express), the more milk you will produce. Keep up a good supply by alternating babies between each breast.

How to breastfeed 3 or more babies

Breastfeed your babies as soon as you can. It is possible to breastfeed twins at the same time. There are different positions that can help with feeding 2 babies at once.

• You can use the 'twin football hold', with one baby under each arm.
• The 'laid back' position may be used as well. This is where you lie back and have both babies lying on your tummy.
• You can use the parallel hold as they get older. This is where both babies lie in the same direction across your body.

Your lactation consultant can advise you about different positions. You can experiment with different positions to find out what you are most comfortable with.

Some women choose to breastfeed their babies separately, especially at the beginning.

It’s important to make sure each baby is feeding well and attached properly to the breast. When a baby attaches and sucks deeply, it helps them drain the breast and it helps avoid sore nipples.

Breastfeeding 3 or more babies is a little trickier. You will have to learn how to express milk and will ideally need someone else to help you.

Focus on mastering the ability to feed 2 babies at the same time. Then, the third and/or fourth baby can be bottle fed.

Bottle feeding can be done with expressed breast milk or with formula. This can be done when you’ve finished feeding the first 2. Otherwise, someone else can feed them at the same time. Rotate the order of the babies for the next feed, to have time to bond with each baby.

Breastfeeding 3 or more babies can take a lot of time and patience. Accept all the support you can. Remember, even if you don’t breastfeed for long, some breastmilk is better than none for your babies.

Formula feeding multiple babies

Many parents of multiple babies introduce formula feeding at some stage. It may also be necessary if you don’t produce enough breast milk or if you have trouble breastfeeding one or more of your babies.

Some parents decide to use a combination of breast and formula feeding. Introducing formula feeds can affect your breastmilk supply. If you decide to stop breastfeeding altogether, it is hard to go back later.

There is a range of different formulas available. There are formulas that are suitable for small or premature babies. Follow the directions on the label and ensure to keep all the equipment sterile. Have separate, clearly labelled bottles for each baby. This way, you can keep track of how much formula they are taking.

Timing multiple babies' feeds

Feeding multiple babies is a skill that takes time to learn. It will become easier, and you may be able to feed your babies at the same time if you would like. Some mothers choose to feed them separately, especially at night.

Each baby will have their own feeding patterns. Some mothers feed the baby that wakes up first. Then, they gently wake up the next baby to feed them. But sometimes a sleepy baby may not feed so well.

An alternative is to breastfeed one baby, then use expressed breastmilk or formula for the next baby. This means that someone else can bottle feed them while you rest.

Multiple babies often have different birth weights and nutritional needs. You may need to adjust your feeding schedule to suit one or more of the babies. This is because as they grow, their needs change. You can be advised about this by your:

• midwife
• lactation consultant
• community nurse

There is no right or wrong way to time feeds for multiple babies. You will eventually find a routine that works for you, your babies and your support network.

Looking after yourself

Feeding multiple babies can be hard work, especially at first. It is normal for parents of multiples to feel constantly exhausted and stressed. Mothers of multiples are much more likely to suffer postnatal depression than mothers of single babies.

Make sure you look after yourself by:

• eating healthily
• resting whenever you can
• finding and accepting support

For more information on postnatal depression or anxiety, help and support, call the Perinatal Anxiety and Depression Australia (PANDA) helpline on 1300 726 306.

The Australian Multiple Birth Association sells equipment for feeding multiples. They can also put you in touch with other mothers in a similar situation.

The Australian Breastfeeding Association sells books and CDs on breastfeeding multiples.

For help with breastfeeding, contact your midwife or lactation consultant. You can also call the Breastfeeding Helpline on 1800 mum 2 mum (1800 686 268).