If the babies are small, or not sucking strongly at the breast, it may be necessary to express the breasts and give complementary feeds of expressed breast milk by cup or gavage. Although there are various other positions that can be used, the football hold is the most practical position for twins and the easiest one for the mother to use without help. In hospital, the mother will probably need assistance until she becomes practised at attaching her babies. She should have a good supply of pillows, and perhaps a footstool if sitting in a chair or on the side of the bed. At home, a couch or large bed is ideal, especially if it can be left permanently set up for feeding.
Some mothers like to use a bean bag or sit on the floor with the back supported.
A pillow under her knees or a footstool will help avoid back strain caused by leaning forward. Each baby should be placed on a side pillow with the feet facing backward and body turned toward the mother. If the babies and the pillows are correctly positioned, the mother will not need to support them totally during the feed. She will have her hands free to attend to either baby as needed. Triplets and Quadruplets Apart from the impossibility of simultaneous feeding all babies, information on breastfeeding and, in particular, breastfeeding twins, applies to triplets and quadruplets.