What Does Tandem Mean in Breastfeeding?

There are many benefits to breastfeeding for both infants and their parents. According to a 2018 report by the National Institutes of Health (NIH), breastfeeding may lower a child's risk for allergies, asthma, obesity, and type 2 diabetes.

The length of time that a person chooses to breastfeed will depend on their preferences and those of their child. Sometimes, however, a person is still breastfeeding an older child when they have a newborn that they would also like to nurse. When a breastfeeding parent is nursing two children of different ages, it's called tandem feeding.

Parents who are not familiar with tandem feeding might wonder if it makes sense to do so, what the benefits are, and whether there are any risks to consider. Here is an overview of how tandem feeding works.

What Is Tandem Breastfeeding?

When two or more children of different ages are breastfeeding at the same time, it's called tandem breastfeeding or tandem nursing. Usually, tandem breastfeeding involves an older baby or a toddler who is still nursing at the same time that a new baby arrives.

In the case of tandem feeding, the breastfeeding parent decides to keep nursing an older child while also nursing a new baby. They might choose to nurse both children at the same time (with one child at each breast) or take turns nursing each child at intervals throughout the day.

Tandem nursing usually involves breastfeeding just two children, such as an infant and a toddler or an infant and a newborn or an older child and an infant. Sometimes, more than two children are breastfeeding at the same time, which occurs when there are multiples such as triplets.

Benefits of Tandem Breastfeeding

Tandem nursing can have several benefits, including it:

• Increases milk supply
• Reduces breast engorgement
• Reduces the risk of plugged ducts
• Promotes a bond between toddler (or older child) and new baby

Should I Tandem Breastfeed?

Each nursing parent will have to decide whether tandem breastfeeding is right for them and their children. As they are considering their options, it can help to know what major health organizations recommend.

Following are a few expert opinions on tandem breastfeeding to keep in mind.

American Academy of Pediatrics (AAP)

The American Academy of Pediatrics (AAP) recommends parents exclusively breastfeed for at least the first six months of the child's life and at least for the first year of the child’s life after introducing complementary foods. 

The AAP notes that the decision to stop breastfeeding is entirely up to the parent based on what is best for their child. Some infants will start to lose interest in breastfeeding early on (as soon as 9 months of age), while others may want to keep nursing up to age 2. 

World Health Organization (WHO)

The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life. 

According to the WHO, “After that [6 months old], babies can have food, such as thick porridge or well-mashed foods, in addition to breast milk. Children aged 1–2 years old can continue with breast milk along with their regular diet.”

La Leche League

La Leche League is an organization that supports breastfeeding and has a philosophy centered on the importance of allowing the child to self-wean at any age.

According to La Leche League, a child should gradually outgrow breastfeeding. The organization believes that the longer a child is breastfed, the better.

What Research Says

When considering whether to adopt tandem breastfeeding, you might be concerned about the nutritional composition of breast milk. Can human milk provide enough nutrition to adequately feed an older baby or child and a younger infant? 

A 2021 study examined milk from 13 participants who were tandem breastfeeding. Nutrients such as fat, protein, and carbohydrates, as well as energy content, were analyzed. 

The study reported that higher levels of fat content, energy values, and proteins were found in the milk of parents during tandem breastfeeding than in the milk expressed after the older child or infant was weaned. The level of carbohydrates remained stable. 

The study authors concluded that the "findings suggest an adaptive role of human milk to nutrient requirements of newborn and older children" and that "the results may support the promotion of long breastfeeding, including tandem breastfeeding." In short, this means that breastmilk does a good job of meeting the nutritional needs of both infants and children who are tandem nursed.

Safety Concerns of Breastfeeding While Pregnant

According to the American Academy of Family Physicians (AAFP), in a normal, healthy pregnancy, when the pregnant person has no health problems, breastfeeding poses little risk to the fetus or the pregnant person.

The AAFP report states that continuing to breastfeed into the toddler years—even with another child on the way—provides many health benefits to children, but there are also a few drawbacks that should be considered.

Downsides to breastfeeding while pregnant include:

• Sore nipples
• Fatigue
• Nausea
• Hormonal changes that can cause emotional shifts for the breastfeeding parent
• A lowered milk supply, which may lead to the older nursing child losing interest

People who are pregnant and considering whether to continue nursing an older child and tandem breastfeeding once the baby is born should take their time deciding what is right for them. In the end, there is no right or wrong decision. Rather, it’s a personal choice based on many factors that each family must make.

Frequently Asked Questions 

How common is tandem nursing?

There have not been that many studies on tandem breastfeeding.

One small study conducted in the early 1990s looked at tandem breastfeeding outcomes in 57 women. The study found that 42% percent of the children in the study continued to breastfeed throughout their mother's pregnancy and to tandem nurse after the birth of their new sibling.

When the decision is made for tandem nursing, does the older child often stop nursing during pregnancy?

Research from the early 1990s found that child-initiated weaning (when children give up nursing on their own) during pregnancy usually occurred during the second trimester as a result of diminished milk supply.

How do you tandem nurse?

Tandem nursing involves nursing two children of different ages at the same time. A nursing parent may nurse one child at each breast or separately at different intervals throughout the day.  

How do you prepare an older child for tandem nursing?

Preparing an older child for tandem nursing can involve talking about the new baby’s arrival, reading books together, and showing the child pictures.

A Word From Verywell

There are many factors and schools of thought associated with when to wean a baby or older child. In the end, it will be up to you to decide what is best for your family.

If you are considering tandem nursing, it can be helpful to seek advice from healthcare providers, such as your primary care physician, your ob-gyn, your children's pediatrician, or a nutritionist.