It is important to understand that your lifestyle, including your diet and other behaviors, can have an affect on your breast milk, and therefore on your baby. It’s also very important for all nursing mothers to take care of themselves so they can provide the best care to their babies. This includes getting enough rest and proper nutrition so you have enough energy to take care of your baby and avoid illness. Even though most common illnesses, such as colds, flu, or diarrhea, can’t be passed through breast milk several medications can be passed to the child and caution should always be taken. Conversely, over the years, far too many women have been wrongly told they had to stop breastfeeding. The decision about continuing breastfeeding when the mother takes a drug, for example, is far more involved than whether the baby will get any in the milk. It also involves taking into consideration the risks of not breastfeeding, for the mother, the baby and the family, as well as society. And there are plenty of risks in not breastfeeding, so the question essentially boils down to: Does the addition of a small amount of medication to the mother’s milk make breastfeeding more hazardous than formula feeding?

Remember that stopping breastfeeding for a week may result in permanent weaning since the baby may then not take the breast again. On the other hand, it should be taken into consideration that some babies may refuse to take the bottle completely, so that the advice to stop is often impractical as well. Also, advising the mother to pump her milk while the baby is not breastfeeding may cause the mother to end up painfully engorged.

Most drugs that you take will appear in your milk, but usually only in very tiny amounts because most is used by the mother’s body before it can be passed on to the child. However, some drugs can cause infants problems even in very tiny doses. Before you stop breastfeeding, make sure to check with your physican about it or switching to an alternative safe medication.

Here are a few ways you can check to see if a drug is safe to take while breastfeeding. Remember; always check with your doctor before changing your medication or breastfeeding patterns.

1. Drugs that are commonly prescribed for infants are normally safe because the amount the baby would get through the milk is much less than he would get if given directly. 
2. If a drug is considered safe during pregnancy it is commonly safe while breastfeeding. This is because the baby is getting exposed to much less drug at a less sensitive time during breastfeeding than during pregnancy.
3. Many injected drugs are not absorbed from the stomach or intestines making them safe to take while breastfeeding.
4. Some drugs are not excreted into the milk because they are too big. This makes them safe to take while breastfeeding.
5. Normally, medications applied to the skin, inhaled, or applied to the eyes or nose are safe for breastfeeding.
6. Drugs taken for local anesthesia are not normally absorbed from the baby’s stomach and are safe.
7. Caffeine is normally safe. However, caffeine tends to build up in babies’ systems because their bodies cannot get rid of it very easily. A morning cup of coffee is not likely to harm your baby, but too much caffeine can cause problems such as poor sleeping, nervousness, irritability, and poor feeding. Try using decaffeinated coffee and tea and avoid colas and other carbonated drinks that have added caffeine. Also, you should remain well hydrated with water, juice and milk while breastfeeding. This being said, there are some medications that may cause harm to your child. Be sure to review the benefits and risks with your health care provider before making any decisions.

Tips for life with breastfeeding twins:

If both babies are born healthy, talk to the pediatrician about breastfeeding them on demand. The ideal setup is rooming in with your babies. – Breastfeed them together to save precious time. This works well during the first weeks. After this you may have to breastfeed them one at a time depending on their particular hunger patterns. – If it should become necessary that the babies receive a supplement, you may want to look into other methods of feeding such as cup feeding, finger feeding, or using a spoon, medicine dropper or syringe. Bottle-feeding sometimes can interfere with lactation due to the fact that some babies develop a preference for the artificial nipple, making it harder to reestablish breastfeeding. – There are several different ways that you can position the babies in order to nurse them at the same time. One way is to place the babies in front of you with their legs overlapping, making an X across your lap. The other position is to place both babies in the clutch hold. You will need pillows at your side (and maybe one on your lap) and you will place the babies on the pillows with their legs going toward the back of the chair. Remember that if you are placing the babies in front of you, you must try to keep their whole bodies turned toward you, their chests against your chest. Their bodies must not be facing up. This is very important to avoid soreness and also to make sure that the babies are receiving enough milk. – Once you and your babies are home, you will need to take care of yourself as well as the babies. Eat healthy food, and enjoy frequent snacks (such as low-fat cheese and crackers, vegetables, yogurt and fruit). This is your chance to be able to eat a lot without gaining weight. Be sure to drink water, juices, or milk to thirst. – Try to sleep when the babies are asleep. – Use lots of pillows. There are special pillows available that help in positioning twins, or you can make a nursing pillow yourself. – Develop a plan for getting the housework and other home management tasks done. Enlist any and all available help, and carefully consider what tasks are most important to you and your family. Assign priorities along with your mate. People’s needs come first, especially babies’ needs, then comes food and clothing. – Alternate feeding each baby from both breasts. This evens out their particular needs and also gives them extra visual exercise. – Limit your visitors during the first weeks. Family members and friends who come to see the babies can help you in many ways– they can bring you meals, change diapers, give you a massage, watch the babies while you take a 15 minute walk or a shower, listen to you, etc. Don’t be shy about asking for the help you need. – Learn different positions to breastfeed. Learning to nurse while lying down may be a little tricky to learn the first few weeks, but is worth it for the added rest you will get. – Prepare “changing areas” in several different places in your home. – Be aware that many mothers of twins receive criticism from those around them who do not share their enthusiasm for breastfeeding. They may pressure you to use formula or other foods before they are needed or to wean before you feel ready. Sometimes, questions such as “Are you sure you have enough milk?” or “Isn’t this too hard for you?” are enough to lower a mother’s confidence. Your belief in your ability to produce enough milk for your babies is one of the most important factors in maintaining a great milk supply. Remember always that milk is produced on the principle of supply and demand. The more your babies breastfeed, the more milk your body will produce for them. – Don’t give babies a daily bath. Just make sure the diaper area and their faces are cleaned every day. – Make sure that you are fulfilling all the dietary recommendations for lactating mothers. You will also need to ad 400-500 calories above your pre-pregnancy needs for each baby you are nursing and an additional serving of calcium or a calcium supplement. – Drink eight to twelve glasses of fluid a day – but not more, since more may actually suppress the production of milk. – Remember that your twins have different personalities, need, and nursing patterns, and you shouldn’t try to treat them identically. It is best to keep careful records to be sure both are fed at each feeding.

The cradle position The cradle position is most commonly used after the first few weeks and gives you the most control of your baby. Your baby should be lying on his side, resting on his shoulder and hip with his mouth level with your nipple. Use pillows lifting your baby and supporting your elbows to bring your baby up to nipple height especially during the first few weeks. Support your breast while your baby’s head is on your forearm and his back will be along your inner arm and palm. When you look down, you should see his side. His mouth should be covering at least a half-inch of the dark area around your nipple. Be sure his ear, shoulder and hips should be in a straight line. As a newborn, your baby’s head and bottom should be level with each other. The cross cradle position This is a variation of the cradle position, which involves your baby being supported on a pillow across your lap to help raise him to your nipple level. Pillows should also support both elbows so your arms don’t hold the weight of the baby; they will tire before the feeding is finished. If you are preparing to breastfeed on the left breast, your left hand supports that breast in and you support your baby with the fingers of your right hand. Do this by gently placing your hand behind your baby’s ears and neck with your thumb and index finger behind each ear. Your baby’s neck rests in the web between the thumb, index finger and palm of your hand, forming a “second neck” for baby. The palm of your hand is placed between his shoulder blades. As you prepare to latch on your baby, be sure his mouth is very close to your nipple from the start. When baby opens his mouth wide, you push with the palm of your hand from between the shoulder blades. His mouth will be covering at least a half-inch from the base of your nipple. Clutch position This is an ideal position for women who have just given a Cesarean birth since it keeps the child away from your incision. It is also used in situations when the mother has a more forceful milk ejection because it allows the child to handle the increased flow more easily. For this position you should support your baby’s head in your hand and his back along your arm beside you. Your child should be facing you, with his mouth at nipple height. Your baby’s legs and feet are tucked under your arm with his hips flexed and his legs resting along side your back rest so the soles of his feet are pointed toward the ceiling. (This keeps him from being able to push against your chair.) Pillows again help bring the baby to the correct height.

Side lying position
This position puts you in a comfortable position, especially at night or when you are just feeling tired. With this position, both mother and baby lie on their sides facing each other. You can use pillows behind your back and behind or between your knees to help get comfortable. A pillow or rolled blanket behind the baby’s back will keep him from rolling away from you. The baby can be cradled in your arm with his back along your forearm. Having his hips flexed and his ear, shoulder and hip in one line helps your baby get milk more easily. Some mothers find that practicing with this position during the daytime is very helpful.

• Friendly to little ears. Ear infections are a childhood nuisance, often following on the heels of stuffy noses and colds. The middle ear fills with fluid, and eventually that fluid becomes infected, causing pain, especially in the middle of the night. Repeated ear infections, or those that go untreated, can lead to hearing loss. This is an important concern in young children, since hearing difficulties can interfere with language, and language problems can later affect reading skills. Breastfeeding protects against ear infections in four possible ways:
  1. The many germ-fighting ingredients in human milk keep harmful bacteria from bothering baby, so that stuffed-up noses and ears are less likely to become infected middle ears.
  2. Because breastfed babies are fed in a more upright position, they’re less likely to experience milk backing up through the eustachian tube into their ears; if this does happen during a breastfeeding session, human milk is less irritating to the tissues of the middle ear than infant formula.
  3. Breastfed babies have fewer, or at least less severe, colds than formula-fed babies. Fewer colds means fewer ear infections.
  4. Breastfed babies have fewer respiratory allergies, another cause of fluid building up in the middle ear, which setts the stage for bacteria to grow.
• Protects tiny tummies. Human milk excels at protecting babies from diarrhea and tummy upsets. This is important not only for individual babies but also on a global scale. Diarrhea is a leading cause of infant mortality worldwide, and breastfeeding is the simplest, most cost- effective way to protect babies from repeated bouts of gastrointestinal illness. Another way in which breastfeeding protects tiny tummies is by promoting the growth of healthful bacteria in the intestines. Intestines are healthiest when you can keep the right “bugs” in the bowels. The healthful bacteria, known as bifidus bacteria, do good things for the body in return for a warm place to live. They manufacture vitamins and nutrients and keep the harmful bacteria in check. The high levels of lactose in breastmilk particularly encourage the growth of the healthful resident bacteria Lactobacillus bifidus.
• Protects against other infection. Studies have found that breastfeeding protects against a wide variety of other diseases. Here’s a partial list:
  • Haemophilus influenzae type B
  • Pneumonia caused by Streptococcus pneumoniae
  • Meningitis
  • Infant botulism
  • Urinary tract infections
  • Cholera
  • Salmonella
  • E. coli infections
  • Respiratory syncytial virus
• Reduces risk of SIDS. Many parents are relieved to learn that breastfed babies are less likely to become victims of SIDS. There are many ways in which breastfeeding could influence the incidence of SIDS. One recent theory suggests that infants who die of SIDS may sleep too deeply and fail to awaken if they stop breathing for a moment or two, as babies often do when they’re sleeping. Breastfed babies sleep less deeply and thus may be more likely to wake up if there is a problem with their breathing. Breastfeeding’s protection against infection may also help to lower the SIDS risk. (See Breastfeeding and SIDS)
• Fewer problems with reflux. While all babies spit up a bit, some regurgitate excessive amounts of milk, because of a condition called gastroesophageal reflux (GER). Normally, the circular band of muscle where the esophagus joins the stomach acts like a one-way valve, keeping milk, food, and stomach acids from backing up into the esophagus when the stomach contracts. When it doesn’t do its job and these acids enter the esophagus, the result is an irritation that adults would call heartburn. In many infants, it takes six months to a year for this muscle to mature enough to prevent this regurgitation or reflux. GER is less of a problem in breastfed infants because breastmilk is emptied twice as fast from the stomach. It’s less likely to be regurgitated than slow-to-digest formula with its tough casein curds.

As when you were pregnant, it is a good idea to try and cut back or avoid caffeine and alcohol, as they can get into your breast milk and harm your baby phyically, or cause him to be irritable. You will be able to tell in a food substance has an effect on your baby as it may cause him to be irritable, crying or unable to sleep

Check your Iron levels
If you took a vitamin-mineral supplement during your pregnancy, you might not need one now that you’ve had your baby. Most women have depleted iron stores during a good chunk of their childbearing years, so you may be needing an iron pill. It may be a good idea to ask your doctor or midwife to see what they recommends.