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Breastfeeding Multiples by Kay Hoover Reviewed by Barbara Noonan Sexton


Kay Hoover MEd and IBCLC was the keynote speaker at the recent ALCI Conference. Kay’s final session was about breastfeeding multiples.

Kay highlighted that sometimes people can frighten mothers of multiples by saying things like “Better you than me”, “Were you on fertility drugs?” or “Do Twins run in your family?”

Kay would say to these Mothers “You will have double or triple the amount of hugs. ” Focus on positive comments not on the negative ones.

(Photo:  ALCI delegates enjoying the Conference recently.)

Infertility treatments have increased the numbers of multiples from 1991 to 2016 the twinning rate per 1,000 births went from 12% to 19%. In 2016 in Ireland there were 2,363 sets of twins and 79 sets of higher order multiples.


Kay highlighted that there are many Pregnancy, birth and post- partum concerns

  • Kay stated that there is maternal, physical and emotional strain.
  • Increased risk of durgical delivery ( caesarean section ) and pre term labour,
  • Pregnancy induced hypertension increases with each baby
  • Risk of gestational diabetes increases with each baby


There are Risks with Multiples

  • Neo – natal Mortality
  • Birth – defects
  • SIDS
  • Child – abuse
  • Developmental – disabilities


Kay stated that there can be growth restrictions that affect breastfeeding

  • Intrauterine growth restriction and prematurity
  • Increased Incidence of congenital anomalies
  • Infant death is five times higher than for single infants.


Kay highlighted the importance of mothers not being afraid to ask for help from family. In one case, Kay encouraged one mother to ask her parents to stay with her for a month so that while she was breastfeeding the babies, the parents were making the meals and doing the households jobs.


Strategies for breastfeeding is very important

  • Make sure the babies can establish a milk – supply,
  • Pumping if necessary
  • Transitioning premature babies to total breastfeeding
  • Discharge planning
  1. Sometimes one baby comes home before the other,
  2. Frequently one breastfeeds better than the other at the start.


Kay stated that 60% of Twins are born preterm. When a mother pumps by her bedside nears the babies, she usually pumps more times and gets more milk. Donor milk is available in America until the mother has milk.


Kay highlighted practical tips

  • Keeping track of each baby by feeding record using different coloured paper for each baby, Individual differences in the normal range,
  • Ways to tell the babies apart
  1. Clothing
  2. Toe nail polish
  3. Bracelets


Kay also highlighted the importance of mothers getting out of the house

  1. Take one baby and leave one at home
  2. Strollers made for multiples
  3. Elastic waist band so she can go the toilet easier herself,
  4. Start saving weekly for the children
  5. Accept all help offered
  6. Remember it does get easier when the babies get older and the night feeds stop


Barbara Noonan Sexton October 2019.

Barbara received a bursary of €50 from ALCI to attend the 2019 ALCI Conference.

Further Reading


LCGB Conference April 2023: ‘Unravelling the Mysterious Milk Ejection Reflex’


ALCI’s News – Members SSD’ 23


ALCI’s Latest Bursary Form