Hello!  My name is Katherine Yurkovich and I am a junior nursing student 
at the University of  North Dakota.  I am currently taking a childbearing 
class and I have just finished my OB nursing clinical.  I joined this 
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 very interested in information about breastfeeding with multiple 
births, especially triplets, and the role nurses play in education and 
support.  I realize that many mothers may chose not to breastfeed because 
of multiple infants, but I feel that with the proper education and 
instruction, breastfeeding could be performed effectively with multiple 
infants.  According to Moxley and Haddon (1999), with the increase in 
multiple births, there is a greater need to provide this group of parents 
with accurate information and anticipatory guidance about breastfeeding.  
Parents need to understand that breastfeeding is not only nutritional, but 
builds a maternal-child relationship and decreases the chances of viral 
and bacterial infections for the infant.  Many mothers believe that 
breastfeeding is a life-line to their newborn infants and provides the 
child with emotional security and nurturing (Leonard, 2002).
One study, conducted by Leonard (2000), was done on breastfeeding triplets 
in a home setting.  The study concluded that the mothers of triplet 
infants felt that the support from health care professionals, i.e. CHN 
(community health nurses), was not very helpful.  Several mothers felt 
that the CHN, although accessible and provided quality information, was 
unable to understand what it was like to have triplets.  The study, in 
conclusion, suggested that not all nurses will achieve breastfeeding 
expertise, but that it is important to have access to someone with the 
necessary skills, i.e. lactation consultant.
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 interactions with 
multiple nurses could be stressful, because they were unaware of their 
particular situation.  The study stated that it is important for nurses 
and lactation consultants to follow-up with new parents, because new 
parents may become overwhelmed or too exhausted to contact lactation 
support services after they have left the hospital if they run into 
problems. 
My questions are what your agency’s guidelines/policies for informing or 
teaching a mother with multiple newborns how to breastfeed, how many 
nurses are lactation consultants at your agency, is there a guideline for 
follow-up visits/calls, and how I can be supportive of a mother, in a 
hospital setting, with multiple newborns to start/continue to breastfeed.  

Thank you for your time!
Katherine Yurkovich, SN

Leonard, L.G. (2002). Breastfeeding Higher Order Multiples: Enhancing 
Support During the
    Postpartum Hospitilization Period. J Hum Lact, 18(4). 386-391.

Leonard, L.G. (2000, May/June). Breastfeeding Triplets: The At-Home 
Experience. Public Health
    Nursing, 17(3), 211-221.

Moxley, S. and Haddon, L.P. (1999). Focal Point to Breastfeeding:  
Teaching Breastfeeding to Parents
    Expecting Multiple Births. International Journal of Childbirth 
Education. 14(1), 1-9. 

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