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Subject:
From:
Karen Gromada <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 9 Jul 2009 21:16:24 -0400
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Ann, I am glad you niece has done so well and without complications. What
doesn't make sense then is WHY her babies are being surgically removed at 35
weeks vs. incubating longer. The 35 week brain is only 55-60% of what it
would be at term. (A terrific site for visualizing fetal brain growth is at
http://brainmuseum.org/development/index.html)  And ultrasound prediction of
fetal size at this point in pregnancy is notoriously off -- more so with
multiples per the lit and per the experiences of many MOT/MOM. I'm wondering
about truly informed decision making about fetal development, including
ability to coordinate sucking and swallowing (which the 35 weeker has only
recently put together) with breathing.
There are many medical
reasons why it may be necessary to deliver triplets early, but this
mother does not appear to have any
of them. (So I hope they haven't had her on so-called "preventive" bed rest,
which has no evidence behind it in if the absence of complications, such as
preterm labor, PIH, etc..) I would think everyone, including her docs, would
be rejoicing that she seems to have a good chance to get much closer to term
than 35 weeks.

The more mature these babies are at birth, the more likely each one's
ability to BF effectively -- and the less likely neos will want them on
"high-calorie" AIM or fortified EBM for gosh knows how long. At 35 weeks few
late preterms have the CNS (and often physical structure) maturity to
sustain BF for long enough to transfer adequate amounts. Multiples are no
different re: maturation than any newborns (in spite of what some docs seem
to believe) and for every extra bit of time in utero, that's less time that
will be spent having to work on transitioning 3 different babies to breast
while also pumping and supplementing (hopefully with EBM - but likelihood of
AIM exposure is increased)...

I've carried almost 15lb of baby to term with my twins. I know how
uncomfortable it gets and I understand the concern a mother feels due to
increased risks that everyone - docs, family, friends, etc
- constantly repeat and reinforce. However, "risk" only means something is
more likely to occur  - not that it will. And in your niece's case, so far
so good.

There is a MOM in my LLL group who is currently BF her 13 month old triplets
-- they were born at 34-35 wk and, after several weeks, all did transition
to full BF. They were exclusively BF after that until 7 or so months when
they indicated readiness for some solids. I know she'd be happy to talk to
this mom. Also, there are several MOM with triplets on AP Multiples -- it is
the first link under Links at my web site.

All the best to your niece and her babies...

--
Karen Gromada
www.karengromada.com/




>
>
> My niece is having triplet boys by c/s next Thursday at Baptist Hospital =
> in
> Nashville, TN. I was wondering if there is an IBCLC there who could be on=
>
> the lookout for her and help her with breastfeeding three? They will be 3=
> 5
> weeks, all over 5 pounds, but of course will be early boys and may need s=
> ome
> encouragement.
>
> Please respond to me, and I will let you know all about her. She is so
> excited and has done wonderfully. No preterm labor, no swelling, no blood=
>
> pressure problems, all in all, has been a trooper. These are natural
> triplets, no fertility drugs.
>
> Thanks!
> Ann Calandro, MSN, RNC, IBCLC
> North Carolina
>

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