HELLO! My name is Linda Kibot and I am a junior II nursing student at the 
University of North Dakota. I am currently taking a childbearing class and I 
have finished my OB nursing clinical. 
I joint the listserv a few weeks ago and have enjoyed learning about several 
topics that I learned on the OB floor and several that I did not.
I am interested in information about breast feeding with multiple births, 
especially triplets and the role nurses play in education and support of families 
faced with such births. I realized that many mothers may choose not to breast 
feed because multiple infants, but I feel that with proper education and 
instruction; breastfeeding could be performed effectively with multiple infants. 
According to Moxley and Haddon, (1999) there has been an increase in 
multiple births to approximately 30-35% in North America. This increase 
coupled with the importance of breastfeeding provides an even greater reason 
to provide parents with accurate information and anticipatory guidance on the 
subject of breastfeeding. 
Parents need to understand that breastfeeding is not only nutritional important 
but builds maternal child relationship, provides infants with emotional security, 
nurturing, physiologic and immunological protection and therefore decreases 
the chances of viral and bacteria infection for the infant (Leonard, 2002).
A case report conducted by Auer and Gromada (1998) pointed out that 
complete rooming-in is possible for mothers of multiples and can increase the 
chances of successful breastfeeding in multiple births. They also found that 
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 even with 
family and other support. The study concluded that rooming-in should be 
individualized based on the needs of the families with the help of lactation 
consultants and home care nurse. 
Another study was done on enhancing support during the postpartum 
hospitalization period for higher order multiples (Leonard, 2002). The study 
found that mothers of multiple newborns felt that the interactions with multiple 
nurses could be stressful because they were unaware of their particular 
situation. The study emphasized that it is important for lactation consultants 
to follow-up with parents because they may become overwhelmed or too 
exhausted to contact lactation support services after discharge from the 
hospital if they run into problems. 
I would like to find out what guidelines/policies are set by your agency to 
provide information or teachings on breastfeeding to mothers with multiple 
newborns. How many nurses are lactation consultants at your agency? Are 
there guidelines for follow-up visits/calls and some tips or guidelines to help me 
support mothers in a hospital setting with multiple newborns to start or 
continue breastfeeding?

Thank you for your time.
Linda Kibot, SN

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