Tandem Breastfeeding: A Descriptive Analysis of the Nutritional Value of Milk When Feeding a Younger and Older Child

Abstract

Breastfeeding is a gold standard of feeding of newborns and infants. Tandem breastfeeding (TBF) is feeding two children of different ages at the same time. The knowledge about the composition of human milk in prolonged lactation is still scarce. Milk from tandem breastfeeding women and after weaning was examined. Milk samples were collected from 13 TBF mothers. A 24-h milk collection was done. Analyses of fat, protein, carbohydrate and energy content were performed using MIRIS. Sociodemographic characteristics of TBF mothers was done. Higher fat content, energy value and total protein concentration was found in TBFM milk during tandem breastfeeding, than in milk after weaning the older child. The carbohydrate content remained stable. The composition of breastmilk, in terms of macronutrients, changes after weaning, taking into account the nutritional requirements of the younger child. The milk of nursing mothers in tandem did not show diurnal variability in individual components. These findings suggest an adaptive role of human milk to nutrient requirements of newborn and older children. The results may support the promotion of long breastfeeding, including tandem breastfeeding.

Mothers' Experiences of Tandem Breastfeeding: A Phenomenological Study

“…According to the findings of our study, breast pain and tenderness, an increase in night breastfeeding, and related insomnia and fatigue experienced by mothers showed the points that should be supported in mothers who tandem breastfeed. Similarly, Sinkiewicz-Darol et al reported that 55% of mothers who tandem breastfed experienced fatigue, waking up frequently at night, and breast pain 9 . In another study, it was reported that only 10.2% of mothers who tandem breastfed had problems, and this problem was the feeling of tiredness caused by waking up frequently at night and not being able to rest due to constant breastfeeding 17 .…”

“…showed that feeding two children together did not adversely affect the quality of human milk, and that human milk had the content to meet the nutritional needs of both older and younger children. In the same study, it was stated that the macronutrient composition of human milk changed according to the nutritional needs of the young child after weaning the older child 9 .…”

“…While this offers the desired advantages for the newborn, it does not have negative consequences for the older child. Since the older child can get food and liquid from other sources, it is recommended that priority should be given to the younger baby in breastfeeding 9,27 . In our study, no adverse effects of tandem breastfeeding on the mother and baby were reported.…”

“…It is reported in the literature that continuing breastfeeding during pregnancy does not pose a threat to the development of the unborn baby [5][6][7] . The investigators found that the quality of human milk is not adversely affected 8,9 . Rosenberg et al (2021) found that the colostrum and mature milk of mothers who tandem breastfed were similar in protein and fat content to the milk of mothers who breastfed a single infant, while the carbohydrate content was higher 8 .…”

“…In tandem breastfeeding, the support provided by breastfeeding mothers' relatives, loved ones, and health professionals is the most important factor that enables them to continue breastfeeding 15 . However, due to health professionals' lack of knowledge, mothers who tandem breastfeed are deprived of professional support 9,16 . Healthcare professionals must be knowledgeable and conscious of this issue so that mothers who choose tandem breastfeeding can be guided correctly.…”