Expressing and storing breast milk for twins or triplets

Feeding twins, triplets or more can take time, energy and practice. Expressing breast milk can give you flexibility or help when your babies aren’t ready to breastfeed.

It’s possible to produce enough breast milk for more than one baby, but everyone’s circumstances are different. You deserve support with feeding, whether you’re breastfeeding, expressing, using formula or combining these approaches.

Ask your midwife or infant feeding team for help with positioning, attachment and expressing. You don’t have to work everything out yourself.

Getting started with expressing after birth

If your babies arrive early or need neonatal care, they may not be able to breastfeed straight away. Your neonatal team can help you start expressing as soon as possible after birth.

Hand expressing is often useful during the first few days, when you’re producing colostrum, your first milk. It is normal to only be able to express small amounts of this milk, but it’s extremely beneficial to your babies.

If your babies aren’t feeding at the breast, you’ll usually be encouraged to express at least eight times in 24 hours, including overnight. Your team can help you plan sessions around your recovery and your babies’ needs. Ask for advice before reducing how often you express.

Skin-to-skin cuddles, when your babies are well enough, help you feel close and can support milk production. You might find expressing during or after a cuddle helpful.

To make expressing more comfortable:

• settle somewhere comfortable with a drink and everything you need nearby
• keep a photograph or video of your babies close if you’re apart
• try gentle breast massage before expressing
• check that your pump’s breast shields fit comfortably
• use a comfortable suction setting and ask for help if pumping hurts

Wash your hands before expressing. Clean and sterilise your collection containers and pump parts that contact milk, following the manufacturer’s instructions.

Choosing how to express and feed at home

A double electric pump lets you express from both breasts together, which can save time. Ask your feeding team about borrowing or hiring one.

If you’re expressing occasionally, hand expressing or a manual pump may suit you. Choose an approach that fits your needs and feels comfortable.

If expressing isn’t needed straight away, you can wait until breastfeeding feels established before adding regular pumping sessions. Your partner can support you through cuddles, nappy changes and practical help too.

When introducing a bottle, choose a calm moment and offer a small amount initially. Another parent or trusted adult could try offering it. Give your babies time to adjust without pressuring them.

Hold each baby close and semi-upright, keeping the bottle almost horizontal. Follow their cues, allow pauses and stop when they’ve had enough. Never prop up a bottle or leave a baby feeding alone.

Storing breast milk safely

Use sterilised containers or breast milk storage bags. Label each with the date and time, and store small portions to reduce waste.

For healthy babies at home, freshly expressed milk can be kept at room temperature for up to four hours. Refrigerate it promptly if you won’t use it soon.

In the fridge: Store milk at the back (not in the door) for up to eight days at 4°C or below. Use within three days if you’re unsure of the temperature.

In the freezer: Store milk for up to six months at −18°C or below, or two weeks in a fridge’s ice compartment.

When thawing: Defrost milk in the fridge, or in a jug of warm water if needed immediately. Use it straight away once defrosted and never refreeze it.

When feeding: Milk can be offered cold or warmed in a jug of warm water. Never microwave it. Use milk within one hour of your baby starting the bottle, then discard any remaining milk.Babies shouldn’t share bottles, due to the risk of bacteria growing from it once it’s been in contact with a baby’s saliva.

For babies in neonatal care: Follow your hospital’s storage and handling instructions, as these may differ.

Expressing can be demanding, especially alongside caring for more than one baby. If you’re uncomfortable, worried about your supply or finding the routine difficult, ask your feeding team for support.

For more information about expressing and mixed feeding, book a place on the Twins Trust online feeding course.