Under ordinary circumstances (which pre-term triplets are not!) smart newborns are up and feeding, often cluster-feeding, at night, when the hormones are high, to drive up the supply in these intense early weeks.  So at least one milk removal is important, not just to head off mastitis but to push the supply toward the needs of three babies.  It could be her best pump of the day.  The current engorgement is so promising, but the body doesn't want to be engorged -- over time, the "inventory sitting on the shelves" for long stretches will start to slow the factory down. 

 Of course, it's easy to say such truisms, and very hard for a mother out there in the trenches, with older children to care for as well -- pumping 6 to 7 times is such an accomplishment.

One idea for helping her wedge in a nighttime pumping (stolen from IBCLC Pat Shelly) -- when the mother is going to sleep, she drinks a big glass of water (or two), and when she gets up to use the bathroom, her next stop is where the clean pump (and a cooler) is all set up and she does a pumping session as well, keeping the lights low the whole time. The natural awakening may be less disruptive to her rest than setting a jangling alarm clock for the dark hours.

Exhausted mothers, who have to pump, can use the hands-free rig, either purchased or home-made, and pile up pillows on a desk or table in front of them and lean their upper body forward and, arms up, rest into the pillows, relaxing and  closing their eyes -- both for daytime and nighttime pumps.  It's not probably the deepest sleep, but getting some rest-periods in across the day and night can only help.

Margaret Wills, IBCLC Maryland



> Date:    Thu, 19 Oct 2017 11:41:38 -0400
> From:    "Kristi Downs BSN, IBCLC" <[log in to unmask]>
> Subject: Wisdom need
> 
> Hi everyone, 
> 
> PTP-Mother of preterm triplets is having a difficult time getting up one time at night to pump which leaves her with sore breasts that are very full in the morning.  She is pumping 6-7 times per day.  She has other children at home to manage as well.  She experienced mastitis with her last child and wants to avoid this. We talked through different ideas to help her manage her supply, but if any of you have suggestions, please let me know. Thanks!
> 
>   

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