---- Alexandra Fowler <[log in to unmask]> wrote:
> Encouragement to breastfeed is an important factor that influences nurses at work on OB and pediatric floors. Do you think there is there enough encouragement for those mothers of multiples to breastfeed?
In a word -- NO! Most expectant mothers of twins or higher multiples (MOT/MOM) receive all sorts of "you must be nuts" messages from RNs, pedis, etc. when they say they want to BF. I really don't think you want me to go off on that topic. Dr. Sheela Geraghty is in the midst of a reasearch project related to health professional attitudes/knowledge related BF and providing mothers' own milk to twins and higher multiples. Her interest came via being a mother of triplets for whom she pumped about a year. However, no colleague of hers ever suggested she might transition her babies to breast.
This topic is definitely an "easy push" button for me! A response to the "are you nuts?" question is included in the FAQ pages on my web site: www.karengromada.com/ (Working on rearranging my site, so FAQ is not as easy to find until "kinks" are worked out. But it's there still. )
> > Do you think there many hospitals that promote breastfeeding of multiples? If so what are the support systems they have in place at those hospitals?
Can't answer for others. I know it's encouraged where I work. But I'm in touch with MOT/MOM all over the globe, and support varies. Some receive tremendous encouragement and support, but many in the USA and elsewhere receive little encouragement after delivery. Some are actively discouraged. Others describe healthcare providers who were apathetic or basically "allowed" BF of multiples without actively encouraging is a bit better.
Simple encouragement is a good place for providers to start. Providing mothers with multiples-specific BF lit (suggestions) and community resources is the next step.
Anne Altshuler had some great info. Here are some additional refs that include some info related to your questions. In addition to the BF itself, maternal role attainment is quite different with multiples and it affects BF, so I added a couple of additional refs at the bottom that have to do with that...
Karen Gromada, MSN, RN, IBCLC, LLLL (LLL Cincinnati Multiples)
Refs:
Auer C & Gromada KK (1998). A case report of breastfeeding quadruplets: Factors perceived as affecting breastfeeding. Journal of Human Lactation, 14(2), 135-141.
Bowers NA & Gromada KK (2005). Care of the multiple-birth family: Part 1 Preconception and pregnancy (Nursing Module) (rev. ed.). White Plains, NY: March of Dimes.
Damato EG, Dowling DA, Standing TS & Schuster SD (2005). Explanation for cessation of breastfeeding in mothers of twins. Journal of Human Lactation, 21(3), 296-304.
Damato EG, Dowling DA, Madigan EA & Thanattherakul C (2005). Duration of breastfeeding for mothers of twins. Journal of Obstetric, Gynecologic and Neonatal Nursing, 34(2), 201-209.
Gromada KK & Bowers NA (2005). Care of the multiple-birth family: Part 2 Birth through early infancy (Nursing Module) (rev. ed.). White Plains, NY: March of Dimes.
Geraghty SR, Khoury JC & Kalkwarf HJ (2005). Human milk pumping rates of mothers of singletons and mothers of multiples. Journal of Human Lactation, 21(4), 413-420.
Geraghty SR, Pinney SM, Sethuraman G, Roy-Chaudhury A & Kalkwarf HJ (2004). Breast milk feeding rates of mothers of multiples compared to mothers of singletons. Ambulatory Pediatrics, 4(3), 226-231.
MOT role attainment refs:
Beck CT (2002a). Releasing the pause button: Mothering twins during the first year of life. Qualitative Health Research, 12(5), 593-608.
Beck CT (2002b). Mothering multiples: A meta-synthesis of qualitative research. MCN: The American Journal of Maternal Child Nursing, 27(4), 214-221.
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