> I am interested in information about breast feeding with multiple births,=
> =20
> especially triplets and the role nurses play in education and support of =
> families=20
> faced with such births. I realized that many mothers may choose not to br=
> east=20
> feed because multiple infants, but I feel that with proper education and=20=
>
> instruction; breastfeeding could be performed effectively with multiple i=
> nfants.
I agree but the performance is mainly up to each baby...and nurses can play a huge role by encouraging and supporting mothers of multiples in their plan to breastfeed. And they can help provide perspective when one or more babies needs time to learn.
> A case report conducted by Auer and Gromada (1998) pointed out that=20
> complete rooming-in is possible for mothers of multiples and can increase=
> the=20
> chances of successful breastfeeding in multiple births. They also found t=
> hat=20
> the majority of higher order multiple birth women are unable to cope with=
> 24-
> hour or long stretches of rooming-in in the early days after delivery eve=
> n with=20
> family and other support. The study concluded that rooming-in should be=20=
>
> individualized based on the needs of the families with the help of lactat=
> ion=20
> consultants and home care nurse.=20
Most mothers of term or near term multiples CAN/DO room in if they have appropriate around-the-clock support, so most will need someone to relieve Dad for several hours as needed. (And can't imagine I'd ever write or let a co-writer get away with saying a majoirty couldn't cope with rooming in.) Anticipatory guidance to plan for round-the-clock physical help makes a huge difference, though. Mothers of higher-order multiples (triplets or above) are likely to have babies in the NICU, so rooming-in is not an option in those instances, although if nearer to term, there may be babies stable and with her, plus babies in the NICU. Talk about feeling pulled in many directions!
> Another study was done on enhancing support during the postpartum=20
> hospitalization period for higher order multiples (Leonard, 2002). The st=
> udy=20
> found that mothers of multiple newborns felt that the interactions with m=
> ultiple=20
> nurses could be stressful because they were unaware of their particular=20=
>
> situation. The study emphasized that it is important for lactation consul=
> tants=20
> to follow-up with parents because they may become overwhelmed or too=20
> exhausted to contact lactation support services after discharge from the=20=
>
> hospital if they run into problems.=20
> I would like to find out what guidelines/policies are set by your agency =
> to=20
> provide information or teachings on breastfeeding to mothers with multipl=
> e=20
> newborns. How many nurses are lactation consultants at your agency? Are=20=
>
> there guidelines for follow-up visits/calls and some tips or guidelines t=
> o help me=20
> support mothers in a hospital setting with multiple newborns to start or=20=
>
> continue breastfeeding?
>
At our hospital the inpatient LCs pass on the names/numbers of moms who leave with a special BF care plan, which many/most breastfeeding triads/quadrads, etc. will be on. Those in NICU are followed by the NICU LC. Also, mothers of multiples receive some related breastfeeding sheets, plus community breastfeeding-multiples-specific resource numbers, emails addresses, web sites, etc. (The resource numbers/emails are for two La Leche League leaders and mothers of twins who have a long-term LLL group for mothers of multiples only and both are LCs.)
Another source of major stress post-discharge that can be addressed via prenatal anticipatory guidance is at-home help for several weeks - months. A mother needs to be free to work with preterm/near term babies who need time to transition to breast. When trying to do it all -- babies, perhaps older children, and household tasks (and maybe a return to employment looming in a few weeks) -- breastfeeding may seem overwhelming. If really overwhelmed, partial breastfeeding is another option for this special situation. Often, though, it is the taking of two, three, four times the usual number of babies home that is the real issue. So physical household help and emotional support are needed by most MOT/MOM for quite some time -- no matter how babies are fed. And many MOT find that once everybody figures out how to breastfeed, it actually is easier 'cos it doesn't require preparation, cleaning, etc. -- not to mention how much cheaper it is! You may find some more info at my web site under FAQ...
Good luck in your studies and career!
Karen Gromada (MSN, RN, IBCLC)
www.karengromada.com/
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