Dear Lactnetters,
    I think that some very excellent points have been made.  For example, the
plan of care always has to be the MOTHER's plan of care, and simplicity is
best for everyone, especially when children arrive in multiples.  I believe
that the mother in the original post had children who were gaining well, and
who were a bit older and so were "proven" breastfeeders.
    My one caution would be, especially with younger infants, to make sure
that they are transfering milk.  Many moms are not aware that time at the
breast does not always equal milk consumption or milk making.
    Last week-end I worked with a mom who had successfully breastfed her
first three children, but who was convinced her twins weren't "getting
enough".  At first glance one would think that this busy mother of five,
experienced breastfeeder, should just get in bed and nurse these babies.
    However, while visiting with them, it was apparant that these babes could
not grasp areolar tissue once getting their mouths around their mother's
thumb-like nipples.  Once baby transferred 0.1 ounce, and the other 0.4 at a
feeding that the mother felt was "good".  If she is to breastfeed, she needs
to pump to keep up her supply while these little ones grow.  Not easy, with
five children, but what SHE has decided to do.  In her case, just nursing
more would not have increased her supply or their intake.
    Just my 2 pesos (getting ready for Acapulco :-D)

    -Debi Page Ferrarello, RN, MS, IBCLC
    Breastfeeding Resources, Inc.
    Abington, PA

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