Combination-feeding twins: Top Ten Tips


They’re cute. And oh-so-hungry.

I struggled with breastfeeding my twins when they were born. I had really wanted to breastfeed them exclusively as I knew this was what was best for them. But, as with many aspects of parenting, reality is very different from the theory. With a combination of babies with tongue-tie, dehydration and weight-loss, not to mention very painful breastfeeding for me and a shortage of milk, I ended up having to introduce formula on medical advice. I was worried that this meant no more breast milk for my babies, and therefore no more of its wonderful benefits. But introducing formula does NOT need to mean the end of breastfeeding. It is perfectly possible to combine the two, as I did in the end for seven months.  Combination feeding is little talked about, but it can create a more sustainable solution to breastfeeding twins. Without it I certainly would not have been able to continue breastfeeding mine for as long as I did.

Here are my Top Tips on how to go about it:

  1. Breastfeed one baby and bottle-feed the other at each feed 

    This was the perfect solution for me. If you top up with formula after a breastfeed it is difficult to work out how much to give, and is incredibly time-consuming. You also risk over-feeding your babies (which I did) and end up being far more acquainted with the term “possetting” than anyone should, not to mention exacerbating any colic. This way is perfect if you have help, manageable if you are alone, and enables you to measure more accurately how much your baby has fed.

  2. Start with the bottle feed 

    It takes less time than a breastfeed, so the second baby doesn’t have to wait so long to be fed.

  3. Alternate which baby receives breast milk at each feed

    This means the baby who had the formula at the last feed will receive breast milk at the next feed. The breast-fed baby will most likely get hungry sooner than the bottle-fed one, and so can be fed first with the bottle at the next feed. Making a note of which baby had which feed can help a sleep-deprived brain keep track of whose turn it is.

  4. Be prepared to be flexible

    Don’t feel that you have to stick to any rules, including mine! Each baby is different, each parent is different, and you need to find what works for you. It’s impossible, and very stressful, to be completely structured and follow recommendations to the letter. That’s true for any newborn, and doubly so for twins.

  5. Don’t feel guilty

    For a long time I felt guilty with every bottle I gave my babies. I thought I was failing them as a mother by not providing them with the best start. Breastfeeding is not a test of maternal aptitude. Yes, breast milk is ideal, but try to get used to the fact that it is impossible to be ideal in everything you do for your child. Babies don’t drink milk forever; before you know it you’ll have the headache of weaning and potty-training, and the breast/bottle question will feel like a distant memory.

  6. When giving a bottle, pretend it’s a breast

    Sounds weird. What I mean is, allow your baby to latch on to it like a nipple, rather than shoving the teat in his or her mouth. This may help prevent nipple rejection, as babies can easily get lazy and not open their mouths to latch on to your nipple if they are used to the ease of the bottle. (I did sometime lapse with this when I was trying to save time. See point 4.)

  7. Give breast milk if your baby needs a top up between feeds

    It will keep your milk supplies up, it shouldn’t over-fill one baby making their feeds too out of synch with the other. I even started giving two breast-feeds in the mornings as I had enough milk for both.

  8. Bouncy chairs are a godsend

    They can help a hungry baby wait a little more patiently while their sibling finishes a feed. You will probably still get the odd screaming-session though.

  9. Take each day as it comes

    Don’t look too far ahead. If you are struggling with breastfeeding, imagining the next few months living this way can seem nightmarishly daunting. Don’t plan how long you will breastfeed for. Think about what you can manage: “I can do one more day/week” then reassess again at that stage. Just remember, if your twins have received any breast milk at all, you are doing amazingly well.

  10. Keeping your sanity IS important

    Raising twins is a lot about logistics; trying to keep two babies with different personalities, appetites, needs, likes and dislikes on the same schedule is one of the hardest parts of being a twin parent. In the beginning this feels like an impossible task, and you may feel like you are losing your mind and your sense of self. You need to do whatever you can, cut whatever non-essential corners there are, in order to cope. That is ok. As long as your babies are being fed, burped, changed, with an occasional cuddle, you are doing brilliantly. Everything else is a bonus, including breast milk.



Read my full experience of combination feeding twins here.


4 thoughts on “Combination-feeding twins: Top Ten Tips

  1. Alison

    Thank you for this. It really has helped. I have 16 days old twins. Wanted to Breastfeed only but have started to mixed feed due to weight issues, dehydration and my exhaustion. Still feel guilty and pressured by some family so these tips have helped.


    1. perplexedparent Post author

      I’m feeling for you! You really are going through the worst part right now but it WILL get better and easier. Try not to feel guilty – I know it’s hard. I suffered a lot from guilt and it’s really not until you get through it and look back that you realise breast-feeding is not the be-all and end-all of parenting. No-one should pressure you in this – you are the one actually living and going through this. Just take it one day at a time. Very soon your twins will be smiling at you and that’s pretty special.

      I wrote about my experiences, along with the guilt, in another piece on my here (blog ) You may find it helpful to read about someone who went through what you are experiecing now.

      Let me know how you get on, and feel free to ask me anything. I’d be glad to help if I can. Hang in there, it’ll get better!


  2. Penny

    I know this post is from a good while ago now, but just wanted to thank you for the sensible and reassuring advice it contains. I currently have 3 week old twins and am finding breastfeeding exclusively incredibly exhausting – not to mention sore on the nipples! I had always said I would try not to put too much pressure on myself to exclusively breastfeed, but then the guilt of giving formula sets in. Reading this has made me feel much better about mixed feeding, if and when I choose to do it (realistically quite soon).


    1. perplexedparent Post author

      Hi Penny – I’m really pleased you found my article reassuring. Hang in there – you are going through the most challenging time at the moment, but it will get easier. Mine are 13 now!

      If you aren’t aware of them already, Twins Trust is a fantastic charity that has a huge amount of information and advice about multiples – the website is They also have a helpline called Twinline which you call even just for advice or just a chat – 0800 138 0509.

      Wishing you and your twins all the best.




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