Breastfeeding Triplets

A reader shares her experience breastfeeding triplets! Enjoy this Q&A with Julie:

Tell us a little about yourself and your three children!
I am 23 years old and active duty Navy. I’ve been in the Navy for three years. I’ve been married for four years, and my husband just graduated from college in December. We were told we were expecting twins when I was seven weeks pregnant, and were ecstatic and surprised and a little scared. I experienced some bleeding a few days later, and it continued on and off for the next two weeks, so I had an ultrasound done during my first OBGYN visit, even though it was not anticipated. It was at this appointment that they told us we weren’t expecting twins, we were having TRIPLETS! The ultrasound technician told us that two babies were sharing a placenta (likely identical, although fraternal twins/triplets can have fused placentas that look like one, and only upon delivery is the fusion discovered) and the other was on his/her own. Later in the pregnancy we discovered we were having two identical boys and a little girl. My triplet pregnancy was fairly uneventful, a few trips to the ER early on, a few trips to L&D later on and many many many perinatologist appointments in between.

The babies were born at 32 weeks and 4 days, after five days of active but dysfunctional labor. Yes, I did break down and beg them to deliver these babies. And when it was clear to the doctor that the best decision was to deliver them my husband raced down I-5 to get to the hospital in time for the c-section. He made it by three minutes.

Tristan was born first, followed by Cassandra and then Ryland. Tristan and Cassandra spent 18 days in the NICU and Ryland spent 19 days there. They are now almost six months old and are very well adjusted babies for being 7+ weeks early. Tristan and Ryland weigh over 15 lbs and Cassandra is a petite little one at 12 lbs. They are so much fun and are rolling over, mimicking us, laughing at anything and everything, and I swear I heard Tristan say “addie” (daddy) the other day.

When you were pregnant, did you research the benefits of breastfeeding multiples?
Yes I did. I found the most useful resource to be the internet chat groups, where you can interact regarding your curiosities and ask questions specific to your situation. I found both a local group of moms of multiples, and a regional one for triplets and more.

What did you do to prepare yourself to get off to a good start?
I had some time to research breastfeeding while I was on modified bedrest with the babies. I found a lot of support with my local “moms of multiples” group that has an online support group/chat group. I also found a lot of support on The Triplet Connection website, which is a support group for triplets or more. There were a lot of positive and successful breastfeeding stories, as well as personal responses to questions I posted about the pumping verses feeding at the breast.

Were you and each of the babies able to breastfeed shortly after the babies’ births?
I was not able to feed the babies until five days after their birth due to the fact that I was put on magnesium sulfate to stop my contractions. I was on the magnesium sulfate for an extended period of time and the babies had very high magnesium levels. Therefore they had to wait a few days to feed them. And then they were given my expressed breast milk via gavage feeding (a tube into their noses), and then a bottle with my milk, and then about a week after their birth I was able to try and put them at the breast. I had a lot of support from the lactation department at the hospital where I delivered.

I know you are currently pumping a majority of the time. Did you pump right from the beginning to establish supply and to prepare bottles of expressed breast milk for your children?
Yes, I was very lucky to have a mother very involved in the aftercare of my delivery. Within two hours after the c-section, she had me in bed pumping. She describes me as being “three sheets to the wind” and was actually holding the pump flanges to my breasts as I was lying down on my side in bed. Then again two hours later, I was a bit more alert but still exhausted and in pain. Nevertheless, she had me roll to the side of the bed and she held the flanges and worked the machine. From there on out, for the next week, I was pumping every 1-2 hours, NEVER going more than two hours in between pumping sessions. A nurse in the NICU explained to me about pumping as much and as often as I can in the first 1-2 weeks after delivery to “lay down” as many milk producing cells as I can. I’m not sure how medically backed that theory is, but I can say that her support, encouragement, advice, and the support of my mother and husband were amazing.

Did any of you face any medical complications that affected breastfeeding?
When my babies were three weeks old, the day before two of them came home from the NICU I was in my OB’s office with a bad mastitis infection, fever of 102.5, body aches, chills, headache. I was put on an oral antibiotic and then went up to the NICU to visit the babies. Two days later, when we went back to get the third baby from the NICU and bring him home, I ended up in the ER due to the mastitis infection. It was very painful, and the pain was worse with pumping/feeding but is very necessary to promote the healing of a mastitis infection. I ended up on IV antibiotics in the ER, and was sent home on a different type of oral antibiotic than I had been given the day before. The infection cleared up in about a weak, and then pain lessened each day, but it was a very painful experience.

About a month later I ended up with another mastitis infection that required oral antibiotics and cleared up within a few days and then I experienced a third infection that landed me back in the ER. It probably would have only required oral antibiotics, but when I felt it coming on, we had been snowed in and I wasn’t able to get out of my neighborhood until 24 hours later. At that point, the only thing open was the ER and I was in enough pain that I was confident it couldn’t wait until the following morning. I was given antibiotics via an intramuscular shot and sent home to rest for a day. The worst part of the mastitis is most definitely continuing to pump/breastfeed through the infection. It was extremely painful for me for about 4-5 days each time I had an infection.

Mothers of singletons often worry–many times unnecessarily–about their milk supply. We know milk supply increases based on demand and that it’s possible (and wonderful) to breastfeed multiple babies, but I know many mothers are wondering, how is your milk supply??
Initially, my milk supply was pretty large. I am thoroughly convinced that it had to do with the pumping within hours after delivery though. And then continuing to pump every 1-2 hours for the next 1-2 weeks. I don’t have any singleton breastfeeding stories to compare it to, but I really think that’s what made my experience so successful and my supply so large. There were times, especially after I returned to work, that my supply dropped significantly. Enough that we had to pull some extras we had stored in the freezer, out for daily use. But once I relaxed in my work environment and got over the initial change of returning to work, things got better. My pumping time was also different at work than what I had been doing at home, so I just had to adjust and talk to my superiors about the importance of my pumping and the amount of time I needed to do so.

How do you manage feedings?
All weekday feedings are done with a bottle. On a few occasions, to console one of the babies, I would and still do feed at the breast. But due to working full time and having three infants to feed at once, it’s not very likely on the weekdays after an 8- or sometimes 12-hour day. On the weekends, I do my best to feed each baby at least once on the breast, just to have that bonding time. But there are weekends where that doesn’t happen. At first, I would feel really guilty about it and miss that bonding time. But as time passes, I realize there’s no sense in beating myself up over it and I can only do what I can do. Now that the babies are getting older, they are more interested in looking around and playing, so sometimes breastfeeding isn’t even on their daily agenda.

What sort of support have you received for breastfeeding? Did you attend a support group? Do you have any favorite books on breastfeeding, pumping and/or multiples?
I guess you could say that I had breastfeeding support, but I didn’t attend an actual in-person or online “breastfeeding support” session. I did however find a lot of support in chatting with other mothers on INCIID’s “babies born in October” forum (my babies were due in October) as well as my local moms of multiples club and the Triplet Connection. (INCIID’s website is www.inciid.org and is a WONDERFUL resource). (I agree!)

I didn’t do much reading about breastfeeding, so I cannot recommend any books. For me, I preferred to interact and be able to ask questions about personal situations and share my curiosities and get answers to them, which my online groups were able to provide me with.

What advice to you have for mothers of multiples?
I had many people tell me breastfeeding triplets would be impossible. For me, that just fueled my desire and determination TO breastfeed them. I would encourage mothers of multiples to talk to other women on support websites about their fears, concerns and questions. Breastfeeding was very different than I had imagined it would be. But it is so very fulfilling. Plan in advance to be pumping as well. In the end, some mothers of multiples are very successful at feeding at the breast. For other mothers, a combination of feeding at the breast and pumping is the choice that works for them. And still other moms choose to be pump only moms. Either way, your child/children are receiving that irreplaceable breast milk. I would also encourage moms to rent a hospital grade breast pump instead of buying one. I have not personally used both, but other moms have highly encouraged me to go with the hospital grade. Additionally, many insurance companies WILL pay for a breast pump or rental for a premature baby. I would recommend looking into that before the baby(s) arrive so that you have it all planned and there is no last minute running around to find what you need.

Do you have any tips for other pumping and/or working mothers?
Initially I cared about what people thought of me taking time to pump. And I realized that it was stressing me out and affecting my milk supply, and also making the whole process less than enjoyable. I realized that I am providing my children with the best nutrition possible and that as a mother, working or not, I have a right to do that. I would plan my pumping times at home so it would fit into a convenient schedule at work. For me, I’d rather be a bit engorged and uncomfortable at home while taking care of my babies and doing what I LOVE, than being in that same predicament at work and “sour” about the fact that I’m leaking and in pain and “should” be pumping but can’t. I had set in stone times that I pumped everyday, and that made it easier for my co-workers so that they could plan to have coverage for me while I pumped. Giving that schedule knowledge to everyone assisted so that I was rarely ever told that I couldn’t pump at that time. Working in a medical field, there have been unexpected situations and I can’t just drop what I am doing to pump. But at the next earliest opportunity, everyone understood (although not always happy about it), that I needed a break to pump.

If you were to do it all over again, would you do anything differently? Are you happy with your decision to breastfeed?
I would feel less guilty about taking breaks at work to pump. It’s a temporary situation and isn’t going to last forever, even the frequency and amount of time of pumping has decreased as my babies are getting older and are demanding less and eating more solids.

I am very happy with my decision to breastfeed. There were times, like my first few weeks back to work and the mastitis infections that I really wondered how long I could do this and if it was really worth it. But, I have yet to have sick children, and that’s pretty impressive for babies that were eight weeks early. And, I can’t imagine the cost associated with feeding formula to my three babies when I have breasts that produce enough milk to feed them.

How long to you plan to continue breastfeeding and pumping?
My plan is to continue until they are 9-10 months (7-8 months adjusted), and then wean down, and I imagine with my milk supply the weaning process will take a month or so. The babies are getting more active now and want to be played with together and individually, so the hardest pumping times are at home when I’d rather be playing with them than pumping. But I feel that 9-10 months will be a good time to start weaning, both for them and for me.

Thanks Julie! Congratulations on your wonderful babies and your success in breastfeeding and pumping!

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