Dear Mario,
We do not know the maximum milk producing capacity of the human female. We
do know women differ greatly in their ability to produce enough milk for one
baby. Women have fully and completely breastfed:
Twins
Triplets
Quads
and
Quints
Lots of women totally breastfeed twins, some triplets, a few quads, and only
one mother I am aware of provided 100% breastmilk for her quints for at least
the first 4 months. We are designed as a species to have 1 young at a time,
sometimes 2 and on rare occasions 3. Before neonatal intensive care units
came into being, larger order multiples were usually born very prematurely
and usually died. Therefore we do not seem to have evolved/to have been
created to provide for more than 2 or 3 babies.
What you should recommend is that the mother expect to provide breastmilk for
her babies, and nurse them, but that it will be unknown until she actually
does it how much milk she will make. She may need to supplement, but special
aids such as a tube feeding device used at the breast can further preserve
and enhance breastfeeding. She will need to pump if the babies are premature
or too weak to breastfeed, and may start to breastfeed them 1 at a time as
they gain the strength to do it. She will need to pump for any baby that is
not breastfeeding if she expects to maximize her milk supply. At the very
least, all of the babies can get some mother's milk, a wonderful gift.
She will need rest periods and times where she cannot feed the babies, or her
health will suffer. Some resources to help you:
Gromada KK, Spangler AK. "Breastfeeding Twins and Higher -order Multiples."
JOGNN. 1998; 27(4): 441-449.
Gromada KK, Mothering Multiples. Available through La Leche League.
Gromada K. Breastfeeding More than One: Multiples and Tandem Breastfeeding.
NAACOG's Clinical Issues in Perinatal and Women's Health Nursing. Vol 3,
No.4, 1992. 656-666.
Mead LJ, Chuffo R, Lawlor-Klean P, et al; Breastfeeding success with preterm
Quadruplets. JOGNN 1992; 21:221-27.
Mohrbacher N, Stock J. The Breastfeeding Answer Book. Revised Edition.
Schaumburg, IL: La Leche League International, 1997. pp. 317 - 328.
Noble, E. Having Twins. Second Ed. Houghton Mifflin Co; Boston.
Saint, L et al. Yield and nutrient content of milk in eight women
breast-feeding twins and one woman breast-feeding triplets. British Journal
of Nutrition 56:49-58, 1986.
Riordan J, Auerbach K. Breastfeeding and Human Lactation. Second Edition.
Boston: Jones and Bartlett Publishers, 1998. pp. 326 - 328.
Sollid, D.T., Evans, B., McClowry, S.G., and Garrett, A. (1989).
Breastfeeding Multiples. The Journal of Perinatal and Neonatal Nursing
3(1). July. p. 48.
Jane Bradshaw RN, BSN, IBCLC
Lynchburg, VA
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