Tandem Nursing—What Is It? Is It for You?

by Salli Gamez

Any woman who decides to ecologically breastfeed and allow her child to naturally wean many eventually face a situation she may have never considered before—nursing through a pregnancy and then tandem nursing.

Tandem nursing is when you nurse two (or more) children of different ages. This doesn’t need to include physically nursing both children at the same time, although some women do. First, let’s answer some basic questions, then we’ll look at reasons to consider tandem nursing.

Wean during pregnancy?

Can nursing cause pre-term labor? Uterine contractions are experienced when nursing while pregnant, and mothers who have a history of miscarriage or pre-term labor may find this worrisome, but there is no evidence that nursing through pregnancy causes pre-term labor. A woman who has been advised by her doctor to abstain from coitus for serious medical reasons during her pregnancy might be well advised to wean also. La Leche League’s Breastfeeding Answerbook lists uterine pain or continued weight loss by the mother during pregnancy as other reasons to wean during pregnancy. Otherwise, there seems to be little danger.

While in most cases it is safe to continue nursing, a woman should also heed her feelings: Does she want to continue? Some points a woman will want to consider include the age of the child, the child’s physical and emotional need to nurse, whether the mother is experiencing any pregnancy-related discomfort due to nursing, the mother’s past nursing experience, and the father’s feelings.

Many women are happiest simply deciding not to decide, they continue nursing and see if the child seems willing to wean. Mothers who choose this approach should be aware that toddlers often reduce to minimal levels of nursing during a pregnancy (probably due to low milk levels), which can leave mothers feeling that the nursing is so infrequent that it won’t be a problem. However, after the new birth, toddlers will sometimes increase nursing, sometimes even surpassing the new baby. This is normal. If it is expected, it does not need to be a problem.

Why tandem nurse?

Some people will say that a mother tandem nurses for her own support needs—using nursing as a refuge from a bad marriage, to keep a mother youthful, to hang on the vestiges of babyhood if she is through having children. However, most mothers who tandem nurse will tell it is because the older child still needs it. Remember, you can’t make children nurse; your child will wean when he is ready, not when you are ready.

How can you tell if tandem nursing will be right for you and your children? One of the best ways is to learn the advantages and disadvantages. Know what you like and dislike. Remember that one mom’s advantage is sometimes another mom’s disadvantage. Consider delayed fertility: some women love that; some women want another baby soon. Or bra size: some women want to be bigger and think the extra size is wonderful; some women feel they are too big already. One mother worried that her children might pass on colds to each other by nursing one right after the other, but another felt that nursing passed on immunities to the toddler and kept illness to a minimum. Who I right? With fertility and bras, both mothers are right. As far as colds go, I think it’s nearly impossible to prevent very young siblings from passing on colds whether they nurse or not.

Number one advantage

The mothers with the happiest tandem nursing experiences enjoyed the richness of this triple relationship. Tandem nursing can teach sharing: "the younger learns cooperation right from the start." One mother summed up this advantage: "They get a tangible example that I’m there for both of them. They learn to share and wait for their turn, knowing it will come."

Advantages for mom

Tandem nursing can increase the lactation amenorrhea experienced while nursing, although it sometimes doesn’t make a big difference. More simultaneous nursing may extend the amenorrhea. We know that if you use a breast pump with a double pumping attachment it will stimulate milk production better than a single attachment; perhaps using both breasts at once would have an equally strong effect on the return of fertility.

Occasionally I hear from mothers whose fertility returned earlier when nursing two children. Often there will be a likely reason such as more pacifier use, or a baby who sleeps long at night.

If tandem nursing delays the return of fertility for the mother, then it also probably decreases her risk for breast cancer. Generally, a reduction in the number of menstrual cycles in a woman’s lifetime—numerous pregnancies, late onset of menarche—will reduce her chance of pre-menopausal breast cancer. Unused or only slightly used breasts will not be as healthy as breasts that are used according to God’s design.

Some mothers mentioned losing weight as an advantage of tandem nursing. But is this true for everyone? Nine out 44 mothers felt they returned more quickly to their pre-pregnancy size when tandem nursing, including a few who felt able to eat more while tandem nursing, one said that when the nursing slows down, women should be careful or they may easily regain that weight.

In addition to these nine mothers, two mothers felt they regained their pre-pregnancy weight only slightly more quickly. However, 32 mothers found no difference at all and two mothers had more trouble losing weight. The problem is that there are several different mechanisms involved in making milk—stored fat, metabolic slowdown, calories from food—all of which operate in varying degrees in each mother. It is impossible to know whether a mother’s metabolism will slow down or whether her body will use more stored fat. No woman should tandem nurse because she thinks it will make her thin.

Disadvantages

Any mother considering tandem nursing will want to look at her support network. Tandem nursing is not always easy and lack of support or criticism can be like adding fuel to the fire. Families who did not support her decision to nurse her first baby will certainly be skeptical of the decision to nurse two. She may get support from all the places she got for nursing her first, but she should be prepared to deal with criticism. People may question her ability to nourish two children; however, the normal, healthy nursing mother can provide enough breastmilk to nourish two, three, or perhaps even four babies. And when the second baby is a toddler who is not nursing as much as a newborn, it’s easy to see that problem doesn’t really exist.

Most of the other disadvantages mentioned by mothers who have tandem nursed involve physically nursing both children at once. Many mothers opt not to do this and only them separately. Probably the main disadvantage to this method is that you can spend a lot of time nursing either on or the other. As we mentioned earlier, the older child may increase his nursing considerable after the birth. Remind yourself that this does not last forever; for example, the typical two-year-old is often down to nursing only before naptime and bedtime.

Nursing your toddler and new baby simultaneously saves time and energy, but the double nipple stimulation is also the single most challenging aspect of tandem nursing. As a result, despite the advantages of simultaneous nursing, many mothers refuse to do it simply insist that the toddler wait until after the baby has nursed.

One mother suggested that simultaneous nursing overstimulates hormones. She used to agree with mothers at LLL meetings that prolactin calms you down until she found that tandem nursing had the opposite effect on her. Could the problem be hormonal? Interestingly enough, some mothers (myself included) have observed that they are only bothered by simultaneous nursing at about the time periods returned, which would make sense if these sensations are hormonal.

Acknowledge negative feelings

What makes a mother feel this way? Perhaps nipple sensitivity is another factor—mothers who had negative experiences often mention soreness and sensitivity. Mothers who experience strong negative feelings or sore nipples during pregnancy may want to encourage weaning if it seems at all possible. A gradual weaning would seem easier on the child than a hasty and angry weaning at the birth of the new baby.

Another complaint that women are reluctant to discuss is that simultaneous nursing can cause strong feelings of sexual arousal. All the mothers I talked to about this have found it a very embarrassing and irritating experience which led them to dread, reduce and sometimes completely stop simultaneous nursing.

These are some of the reasons that mothers have decided for and against tandem nursing. Should you tandem nurse? Just because you know a happy tandem nursing trio does not mean it will work for you. Motherhood is not a competition.

You must be honest about your feelings, aware of what you can cope with, and flexible enough to change your mind it doesn’t work. You may try it and have very negative feelings. One mother advises, "Don’t do it because you think you're supermom." Another mother writes, "I went nuts trying to deny that I didn’t like the older child nursing. I would have been a happier mom, a better mom, if I had cheerfully limited the older child’s nursing from the beginning, rather than angrily allowing her to nurse on demand."

Or, you may find it a positive and enriching experience. One happy tandem nursing mom wrote, "It’s such a full feeling to have both my children in my arms nursing!"

A wise and experienced mother encourages "every women who is considering tandem nursing to listen to what her body is telling her and to ask God’s guidance as she decides how to mother her toddler. It is a very personal decision which should only be made with careful thought and prayer."

--Salli Gamez and her husband Luis have been a CCL Teaching Couple in Michigan for nine years, and Salli as been a La Leche Leader for eight years. Her most important job, however, is being a full-time mom to their four children. Salli has been tandem nursing different pairings of her children for eight years.

La Leche League International has several information sheets dealing with tandem nursing, including "Nursing Two, Is It For You?" (Publication #53), "Still Nursing?" (Information Sheet #97), "Thoughts About Weaning" (Publication #125), and "Nursing Siblings Who Are Not Twins" (Information Sheet #75). For ordering information, see La Leche League’s website.

CCL sells two books supportive of long-term breastfeeding: Breastfeeding and Natural Child Spacing and The Womanly Art of Breastfeeding. To order see CCL’s website.

Reprinted from CCL’s "Family Foundations" May-June 1997 newsletter, pages 6-7. Used by permission
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