Breastfeeding higher order multiples: enhancing support during the postpartum hospitalization period

Higher order multiple birth (HOM) families require genuine and effective support in their quest to breastfeed their infants during the postdelivery hospitalization period. Evidence suggests that the impact of current policies and care practices on HOM breastfeeding requires careful examination. Recommendations for enhanced support include evidence-based breastfeeding of multiples practices, multiples-specific breastfeeding education for HOM families and health professionals, and establishment of an HOM breastfeeding consultation network. Equally important are coordinated breastfeeding care, development of a breastfeeding plan in partnership with parents, avoidance or minimization of maternal-infants and infant-infants separations, and added assistance to parents when the infants' discharges are staggered. The recommendations are based on the author's extensive professional experience with HOM breastfeeding and the HOM literature.