I’ve had multiples on my mind lately. Over the last few weeks, I have presented a curriculum for breastfeeding multiples classes at ILCA (the International Lactation Association Annual Conference), taught a breastfeeding class for eight families expecting twins this fall and have seen several moms and their twins in my office. Talk about seeing double!

Although breastfeeding more than one baby has similarities with nursing one, there are definite issues for the expectant mother of multiples to consider. Misinformation and poor advice abounds. So here my The Top Five Tips for Breastfeeding Multiples Prep:

Education Before Lactation
Look for a breastfeeding multiples class in your community by your second semester. If there is not one, take a general breastfeeding class. Have your partner or support person attend so they are informed too. The consummate book is Mothering Multiples: Breastfeeding and Caring for Twins or More by Karen Kernoff Gromada. Along with books and classes, the Internet has multiple (no pun!) sites for expectant parents. There’s even a site for mothers on bed rest!

Outsources and Resources
Complete your prenatal prep with locating local resources for post-partum breastfeeding assistance and household help. You will want a breastfeeding helper on speed dial! Line up names of doulas and other helpers or volunteers-ask at your doctor’s office for leads. Many areas have Mothers of Multiples groups and these ‘other mothers’ will be your lifeline! If you have other children, consider asking family and friends for extra help when you bring your babies home. When I asked my friend Denise Altman, a twin mom and IBCLC, what she would suggest as most helpful to impart, she said, “Bring meals!”

Plan B
Sometimes things don’t go as you have planned. You may have an earlier birth than due date and/or a surgical delivery, so your best laid plans can change at any time. Tour your hospital or birth center’s NICU and ask what their protocols are. Stress you expect skin to skin contact when possible after birth and breastfeeding assistance for feedings. Ask if a pump will be provided for you if needed. Have a hospital lactation consultant assist you in latching both babies prior to discharge, even though some mothers start out nursing one baby at a time. Since early milk removal is key to establishing milk supply, determine your need to buy or rent a breast pump. If you are pumping for babies in the NICU, definitely consider a rental pump.

Patience with Progress
For most new mothers breastfeeding takes practice. With premature or small babies breastfeeding is also a work in progress. Avoid expecting too much at first and protect your milk supply with extra pumping if indicated; fledgling milk supply is one of the biggest issues I see with multiples. Read these facts on nursing late-preterm babies. It is easy to get discouraged when your days are consumed with nursing, pumping, burping and diaper changes and more so if your babies are sketchy feeders. This is when it is helpful to have other mothers of multiples to cheer you on. As breastfeeding gets easier, it saves you time (and money!) so don’t raise the breastfeeding bar so high at the beginning and try to be patient.

If Mama Ain’t Happy, Ain’t Nobody Happy
Self-care is imperative if you are to function well in your new role as a mother of twins, triplets or quads. Fatigue, hormones and stress can all collide at this time. Think of the oxygen mask theory: you can’t take care of others around you until you take care of yourself. Your oxygen mask includes good nutrition, rest and moderate exercise, family and household support, and flexibility as you begin this journey. There is a purported higher incidence of post-partum depression (PPD) in mothers of multiples; talk to your midwife or doctor if you experience any signs of depression.

As you prepare for the birth of your multiples, take time to peruse the many resources available and rest assured you have a firm foundation for getting off to the best start with breastfeeding!