Tandem feeding, breastfeeding through pregnancy and beyond

Tandem feeding is one of those things that almost nobody talks about until they are in it, and then they find there is very little sensible information about what actually happens. Usually it starts with a pregnancy while an older child is still feeding, and a question about whether that is even allowed.

Feeding while pregnant

In a straightforward pregnancy, continuing to breastfeed is generally considered safe. Nipple stimulation does cause the uterus to contract, but in an uncomplicated pregnancy this is not usually a problem.

Your midwife or obstetrician may advise stopping if there is a history of preterm birth, if you have bleeding, if you are carrying more than one baby, or if you are having any complications, so it is worth raising early rather than assuming either way.

Three things usually happen, and knowing them in advance helps enormously:

• Sore nipples. Very common in the first months and driven by pregnancy hormones rather than by the latch. This is the reason most women give for stopping, and it does often ease later.
• Supply drops, often noticeably, usually around the middle of pregnancy.
• The milk changes back to colostrum in the later months, which tastes different and comes in smaller amounts. Many older children lose interest at this point.

Older children who stop

A lot of children wean themselves during pregnancy, usually because there is less milk and it tastes different. If that happens it is not a rejection and it is not your fault, and it is one of the more natural endings there is.

Some children stop and then ask to come back once the baby arrives and there is suddenly a great deal of milk again. That is normal too, and you can say yes or no. Both are allowed.

When the baby arrives

The rule that matters most is simple. The newborn comes first. They have no other way of getting milk, and your older child has food, drinks and other comforts.

• Feed the baby first, or give them one breast to themselves and let your older child have the other.
• Do not worry about the colostrum. You will make plenty for the baby even with an older child feeding. It is worth knowing that your older child may have loose stools from the colostrum for a few days, which is harmless.
• Watch the newborn's output and weight in the usual way, because that is how you know they are getting enough rather than by guessing.
• Feeding both at once saves time, but it is not compulsory. Many people feed them separately and find that easier.
• Your supply will rise to meet the demand, in the same way it does with twins. There is more in Breastfeeding twins.

The part nobody warns you about

Tandem feeding can bring up strong feelings, and they are not always the warm ones people expect.

Some women feel a wave of aversion when the older child feeds, a skin crawling, irritable, get off me feeling that can arrive suddenly and feels shameful. It is common, it is hormonal, and it does not mean anything about how you feel about your child. Shortening those feeds, setting limits on when and where, or feeding only at certain times of day all help. So does knowing it has a name and that other people get it.

Equally, some people find tandem feeding is the thing that makes the transition to two children gentler, because the older one has something familiar that is still theirs.

Setting limits is allowed

You can tandem feed and still have rules. Only at home. Only at bedtime. Only after the baby has finished. Counting to twenty and then finishing. A feeding relationship that works for you is worth more than one that follows somebody else's principle and leaves you resentful.

If you decide to stop feeding the older child, gradual is kinder for both of you. There is more in How to stop breastfeeding.

How a consultation helps with tandem feeding

The two things people most want are permission and a plan. Permission, because almost everyone has been told by somebody that they should have stopped, and it helps to hear from someone who does this for a living that what they are doing is reasonable. And a plan, usually for how to protect the newborn's feeds while keeping the older child feeling included, and for what to do about aversion if it arrives. I also check the newborn properly, with a weight and a full feed watched, because in all the busyness of two children it is easy for a feeding problem in the baby to be missed.