> I personally know of one case where a mom had her triplets on strict
> scheduled feedings.

I think the trick is to talk to the parents about gentle scheduling with
their multiples, and let them know the signs and symptoms of adequate
feedings vs inadequate feedings.  Even with babies who are fed on demand,
we all know of some babies who were not gaining weight because they were
not demanding enough, and the parents didn't know when to wake baby and
feed them if they're not showing signs of hunger.  With multiples you have
many breastfeeding issues, #1 getting a strong enough supply  #2 getting
preemies (50% of twins are born before 37 weeks, and 90% of triplets are
premature, while 100% of quads or greater are premature) on the breast
(fixing breastfeeding) #3 getting Mom and Dad and Grandma, Aunt, Grandpa,
or hired help into a routine to number 1, care for the babies, and number
2, keep all caregivers sane and healthy.  The babies usually have frequent
weight checks with their pediatrician on at least a weekly basis during the
first month or so home from the hospital, so that any problems with growth
and feeding should be addressed before it becomes a problem.  It is so true
that some babies will not fall into whatever schedule the parents try to
put them on, or they will not thrive on that schedule.  Then, it is time to
regroup and and find another way.  In general with higher order multiples
and many twins, a routine is the best way for Mom to get a little sleep,
and have the energy to take care of and breasfeed her babies, but not
always.  There aren't many mothers of triplets or more who breastfeed for
more than a short period, and it is these families who can truly benefit
the most from breastfeeding.  Breastfeeding saves many trips to the doctor.
 Taking care of 2 or more babies is a challenge but fun, but caring for 2
or more ill infants is just hard.  Breastfeeding multiples saves hundreds
of dollars a month in formula costs.  Breastfeeding multiples saves time
and energy in not preparing and washing bottles.  Of all the mothers I know
who have successfully breastfed their triplets or more, gentle scheduling
has been the key.  Please let me know of any case studies of Higher Order
Multiples (triplets or more) who have breastfed successfully for at least 6
months on a demand system.  I would love to talk to them, and find out
their tips.

Anne Nans, RN, IBCLC
Woodbridge, VA
Breastfeeding mother to 10 1/2 month old triplets

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