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Subject:
From:
"Karen Kerkhoff Gromada, MSN, RN, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 20 Apr 2003 11:07:09 EDT
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In a message dated 4/19/03 4:37:18 PM Eastern Daylight Time, [log in to unmask]
writes:

> >There is a LOT that will be different with triplets vs. a singleton! She
> just
> >had three times the usual number of babies--most likely preterm and also
> SGA.
> >She's more likely to be initiating breastfeeding with 3 different babies
> >while recuperating from a more challenging pregnancy and likely a surgical
> >birth. Yet she still has just 24 hours in a day to do all she has to do.
> >Empathy for this very different experience helps.

I was thinking more about this yesterday to figure a way to explain how
breastfeeding more than one is sooooo different. And it occurred to me that
breastfeeding is a dance between mother and baby/child. Some babies or
mothers take to each other as natural partners almost immediately, others
need time to learn to "fit." Some have more natural ability and other are
more  clumsy or need more time to get the steps down. A baby prefers a
certain type of music, a unique rhythm. A baby needs to dance a certain
amount of time in a 24 hour period, and that period varies from baby to baby.
Eventually, though, a mother and her singleton become so in tune and move so
in sync that they adapt so quickly to each other's minor changes, such
changes go unnoticed.

When a mother has another baby or two or three, each may arrive with a
different level of ability or natural talent. (And because of prematurity and
SGA, initial "clumsiness" is more likely.) One may want to waltz, another
tango and another do disco. The mother, who may or may not be a natural
dancer herself, must adapt to each baby's steps, each baby's rhythm. She must
adapt to each dancer--often in seconds. It becomes very confusing, very
exhausting!  Each baby may want to dance a different number of times through
the day and night. Mother becomes severely sleep deprived because it doesn't
work as easily to dance with two or three via co-sleeping! Sleep deprivation
makes it that much harder to adapt to the changes in two or three babies
dance patterns, harder to adapt to changes as they occur. Harder to just keep
everything straight!

Many mothers of twins and most mothers of triplets find true cue-feeding
practically impossible to keep up with. Most will work diligently to get them
into some sort of similar routine. Obviously, that can affect breastfeeding,
milk production, mother's comfort, etc. in more ways than one, yet it appears
to be necessary for most if breastfeeding is to continue at all. Most
mothers, especially when there are more than two babies, simply cannot keep
up with so many different dancing styles!

>
> Thanks for this, Karen. I'll be following this thread with interest as
> this week I open a case with a mom expecting triplets this summer. I am
> going to be her birth educator, lactation consultant and postpartum
> doula.  She is now 29 weeks!
>
> Can you give us a little synopsis of what you consider realistic for a
> mom of triplets? The last one I worked with DID provide breastmilk for
> all three for almost 6 months.... but never did feed them at breast.


What does this mother want? What are her goals? Is she prepared for detours
and flexible enough to deal with them? Is she creating a support network,
because she's likely to ask herself every single day for months, "Why am I
doing this!"

I know mothers of triplets that fully fed them from the get-go for several
months and then continued through natural weaning with supplements and/or
solids. I know mothers who fully BF after an initial period of struggle to
breast due to the usual preterm birth and related issues--some didn't get one
or more babies to breasts until months after birth. I know mothers who
partially BF due to the previous or to maintain sanity. And I know mothers
who human-milk-fed only for many, many months. "Realistic" can be a
subjective word!

Some of this has to do with mother's short- and long-term goals. Commitment
of mother is everything. Other of it has to do with circumstances with birth
and the three unique persons incubating inside her. And we can't know about
them until they arrive.  One thing I do know is that if she's committed, if
she's patient, if she's persistent, she WILL get these babies to breast.

Karen

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