Грудное вскармливание тройни (на англ.)
Проблемы ГВ и решенияГрудное вскармливание тройни (на англ.)
В целом положительный опыт, хотя и без недочётов. Надеюсь, кому-то пригодится, если не во вскармливании тройни, то хотя бы для воодушевшения в деле вскармливания двойни или хотя бы одного, ведь и одного многие выкормить не могут из-за незнания ГВ и неправильного настроя.
Sunday, January 13, 2008
Although my triplets are now six years old, lately I have been contacted by several Moms expecting their own triplets. It is generally assumed that it's impossible to nurse triplets. Many who would like to get discouraged by the negativity and lack of support and either give up too soon, or don't even try at all. It IS difficult - make no mistake! But it is not necessarily as difficult as one might think, and is so worth it. In response to those asking for help, I dug up the old article I wrote about it when they were still babies - good thing, too, because I can't remember much now, those days are a total blur! Here is the article as written, with the exception of the personal info I removed. I hope it can help someone else.
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I have breastfed all of my single babies (3 boys), and there was no doubt in my mind that I would do the same for this fourth child. When I found out there were three babies, though, I was not sure it could be done! I was determined to try, though, and do the best I could. Here is my story of nursing triplets.
One of the first things I did when I got home from the doctor after that first ultrasound was to call my friend, a La Leche League leader, to ask for help. She wasn't home and I had to leave a message. I turned to the book The Womanly Art of Breastfeeding and was relieved to see a chapter on nursing multiples that included information on triplets. But I still wondered. Everyone I talked to seemed to think it was impossible to nurse triplets.
I figured at the very least I could nurse one each feeding, with the others getting formula, and rotate which one got the breast. I knew I could successfully nurse one baby, so this became my minimum goal.
After awhile as I joined various e-mail lists and forums online, I learned that many women have successfully, exclusively nursed triplets and more. In the days when wet nurses were common, one woman would be in charge of feeding SIX babies! So it then became my goal to exclusively nurse my babies.
They were extremely likely to be preemies, and so it would be even more important than ever to give them Mother's milk. I "met" several women online who had been successful, and we became friends. I got advice and support from them when I needed it most. My babies were born at 32 weeks - the average for triplet births, but too early for the sucking instinct to be fully formed. They would have to be tube-fed until they learned to suckle properly.
The NICU nurses said they would like me to at least pump my milk while they were in the hospital. So a friend arranged for a hospital grade breast pump to be delivered right after the birth. A quality pump is essential!! Check with your insurance company - some will cover rental. Or tell friends and family that you need it and they can possibly gift it to you or help with it as part of your shower gift.
When I had recovered enough from the birth, the lactation consultant brought me the pump and we began. I was very blessed to have knowledgeable, supportive lactation consultants. As strange as it sounds for someone whose career is teaching people to nurse, I have heard the worst horror stories about them! Try to meet the consultants at your hospital before the birth. If they don't seem helpful, you may want to hire your own. Or look at La Leche League and try to find someone with experience with multiples, they can come to the hospital to help you get started.
I knew it would be crucial to surround myself as much as possible with support people. I don't think I could have done it without them. The babies were in the hospital for four weeks. During this time I was only allowed to actually nurse two or three times a day. I could only be there for a few feedings a day because of my other kids at home, so while I was there I would try to nurse them.
They were not very good at it! I did try some methods suggested by the LLL to avoid nipple confusion - including the use of a special tube thing (I can't remember the name) that was taped to my nipple and attached to the bottle at the other end. The idea was that they would get more milk through the tube but be practicing nursing and not end up confused by a bottle nipple. I never did get the hang of that thing and found it to be more trouble than it was worth, so I gave it up pretty quickly.
They always had to have a bottle after each "nursing" session - but I was pumping very well and they never had anything but my milk in their bottles! When they were released, they were still nowhere near nursing full time. We brought them home hoping and praying they would catch on eventually. This was a whole different ball game!
As best I can remember, here is what we did at first. I usually did NOT have help at home in the beginning; despite all the offers, they just never seemed to pan out! I just determined that for the time being, feeding babies would be my full time job (that includes getting the food and rest that I needed to nurse). I discussed this with hubby and kids so they knew what to expect - it was as if I was back on bed rest for awhile, LOL.
I would pump first if I had time (i.e. nobody screaming). This really helped to bring my supply up. The babies could always get enough milk; they are very efficient. The pump is not efficient enough to really help increase on its own, in my experience. Ideally I would pump and then wait at least 1/2 hour before nursing. Since I had to get a snack and water each time I nursed, I would do this in between to make best use of my time.
They were on a 3 hour schedule for the first month at home (until their due date had passed, per doctor's instructions). So if they were due to nurse at noon, I would pump at 11:00. When I was first pumping it would take 45 minutes or so to get a good amount. Before long it took only 10 to 15 minutes to do this. I tried to pump until I had at least 3 bottles worth, however big the bottles were at the time (Hubby got the computer to figure out their amounts based on their weight. I'm sorry I can't remember where he got this info, but your doctor can give it to you.). This way I at least kept up with their demand. Usually I could do at least 4 bottles worth.
After pumping, and before nursing, I would chug a huge glass of water. I tried to rotate who went first to nurse. Baby A got the left, Baby B got the right, and Baby C got some of each (rotating the order each time, and recording it on a chart so I could remember). I never had a problem getting more letdown. I think I really could have fed six babies easily!
As they got better at nursing they refused more of the bottle. I always bottled them AFTER nursing. If I had help I would pass the baby to be bottled and go on to the next to nurse. But even alone I never had a problem with impatience; they were always fairly willing to wait their turn (we did have our moments!) Now that I think about it, I believe that when I was alone I would choose one to nurse, and bottle the others, rotating each time. It was easy to bottle 2 at a time and I never propped bottles, though I know others do. I don't judge anyone for that, don't get me wrong. Do what you need to do. But I think they need cuddling as much as possible, heaven knows they already get less than a single baby! So do try to hold one each feeding, would be my suggestion.
I had a double nursing pillow, which was one of my most valuable baby items. I was able to stroke them and speak to them and cuddle each one. I rarely fed two at a time, though. If they would wait I thought it best to feed them separately, for the individual attention. Anyway, when C began obviously preferring the breast, I concentrated on her. She surprised me by absolutely REFUSING the bottle! Reverse nipple confusion? LOL! Since she refused the bottle I couldn't rotate her! So, at that point I would nurse her, then try at least one boy.
There were times when I thought the boys would never nurse and I would be pumping forever! After awhile I just decided to not give the bottle afterwards and see how they did. This was after the due date, as they said the babies can't really sense hunger too well before that (they were eight weeks old then). At first they got hungry again soon after, but they just got better and better. I didn't quit bottles altogether yet, but at least once or twice a day, with at least one of them, I would nurse only.
I think it was a little after Thanksgiving (age 9 weeks) that I decided to try nursing only during the day and see how it went. It took several days before it was working well; I was nursing all the time for a few days. By 3 and 1/2 months I was down to pumping three times a day. I always fed on demand during the day, no schedule. But when my body woke me up at 2:00 AM and said it's time to pump, I pumped then fed them whether they were still asleep or not. I was afraid they would wake up at 3:00 if I went back to bed!
I didn't care if they have a schedule per se, but wanted them to do things like eat and sleep at roughly the same time. So if one woke up to nurse, and the others stayed asleep, I would still get the others up to nurse. At about four months they were only getting up once at night, then when they were five months old they were mostly sleeping through the night from 8:30 to 7:00. Hooray!!!
I remember feeling like I was just feeding and pumping all day. But I really don't think I was! It would have been so much easier if I had more help. The little help I had at first was really more for my older kids (driving to and from school, etc.) But I did it! I had to take it one day at a time. My parents were a HUGE help by coming in to do the midnight feeding once I felt I could give up pumping at that hour. Hubby also got up with me for all the night feedings and eventually took over the early morning one so I could sleep through.
Eventually I had help coming in almost daily but this was long after they were off bottles. I told hubby and the kids to imagine that I was still on bed rest so I would not be able to just jump back into my former role. One of the most important things was that folks still brought dinner for the first three months. I would adivise anyone to NOT BE SHY. When people ask what they can do to help, add things like COOK ME A MEAL to that list! Don't let them think of something they can do to help, tell them, whatever you need. You will be amazed. I had friends who got their entire Ladies' Group from church to cook for me, and they didn't even know me. But they won't know what you need if you don't ask! :)
When the meals ended, now I just cook very BASIC stuff. I always loved to cook, but I am getting back into it gradually. You have to pick and choose what you can do and what can slip - whatever works for you. I was not willing to give up nursing the babies, so it was other things that got the slip.
For a mother of multiples, here is my opinion on the most important things they need help with:
- Help with feeding (bottle while they BF/pump), just make sure to WAIT till she is done with the BF and not just give the bottle. I had a little problem with that. People want to hold the babies, and they want to give bottles, and they don't realize how important it is to learning to nurse that the bottle is LAST.
- Cooking/cleaning.
- Shopping
- Laundry, etc.
- I didn't really need people to baby-sit unless I had trouble getting a nap. I took advantage of that often - "I am going to bed. Wake me when they are hungry!" LOL!
I think most people expected to play with the babies while I did the housework! I guess that would have been more help than nothing, but it wasn't REALLY what I needed.
Most people will offer to help but it's easier to actually get them to if you are SPECIFIC about what you need. I made a list of EVERYTHING I thought others could help with, and split those up into parts: Not just laundry, but doing the wash, folding, sorting. So if they could only give me 30 minutes, folding laundry was a HUGE blessing! No one really thinks 30 minutes will be helpful, so the list is great. When they ask what they can do, give them the list and let them choose!
It doesn't really take much longer to nurse them than it did to nurse one, once they got the hang of it. It did take a lot of time when I had to pump and bottle them. It took a week or so for us to get into the swing of things once we got them home - for the first 2 weeks we got up together and did every feeding together. Then one morning I woke up late and hubby told me he had already fed them and I should go back to sleep! What a blessing! I just had to be careful not to skip pumping too often so my supply didn't go down. My parents also came over to do the midnight feeding almost every night. Once I started sleeping more I felt much better.
At about 7 months the doctor was concerned because C and B were not gaining weight. For two weeks I fed them more often, including reinstating night feedings (A was still feeding at night and he was growing fine). At their weigh-in they had improved nicely. We also started solids at this time, and they got their first formula - powder mixed into their cereal to add calories. Finally a use for the free formula, LOL.
After all this, and doing some research, I would not freak out about this again. You need to look at the whole baby, not just the scale. All of them were clearly getting enough to eat. They were very happy babies, and had just the right amount of wet and dirty diapers. The charts that the doctor uses are based on the "average" baby. Bottle-fed babies will often gain weight faster for a number of reasons, one of which is that the person giving the bottle pushes the baby to finish the whole thing, while a nursing baby stops when he is full. This rapid weight gain throws off the charts for the breastfed baby!
All in all though, it was a relief when they were all gaining weight again. After a month of this I was able to stop the night feedings again and they grew like weeds! As I write this they are 8-1/2 months old. They eat two meals and a snack of solid food a day - usually cereal with fruit for breakfast and cereal with vegetables for dinner, with crackers or teething biscuits in the afternoon. They each eat about 4 oz. per meal, the size of a regular baby food jar. We still mix formula in with it to add calories. I plan to nurse them until they are 14 months old, or an adjusted age of one year. If they want to continue after that, I don't have a problem with that. I have always enjoyed nursing; it is such a special relationship with my babies. I have always been sad for it to end.
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UPDATE: I ended up nursing them for THREE YEARS! When 14 months rolled around - the goal I had set - they were going strong, growing like weeds and happy as clams. I decided that I had worked too hard to teach them to nurse, and there was NO WAY I was going to MAKE them quit! All my oldest had self-weaned and I am a big believer in that. So it should be with these, I decided. Well, they didn't stop, and didn't stop. Going, and going, and GOING!
Eventually I made rules that we could only nurse in my bedroom - this was because they developed the habit of coming up to me and lifting my shirt every time I sat down, no matter who else was in the room! So at first they could ask to go in my room, then later it was only at set times during the day. At the end we were only nursing in the morning. The older kids would get them up and they would run to my room and hop in bed with me. We moved to a new house on their third birthday and they nursed that first day, and never again, by their own choice.
The best thing about self-weaning is that there are NO side effects on the mom! If you know what I mean *wink*. I never thought I would be an extended nurser, and I am by no means militant about that. I am glad I did it, though. Although at the time I wondered if I was cheating my older kids by not being as available as I might have been, I honestly feel that it would not have been MUCH better if I had bottle fed. My older kids learned many valuable lessons during this time that I am so glad they had the opportunity to learn. They bonded more with their Dad who previously had not been as involved with their lives. The nursing was a special time for me and the babies, and Daddy and the other children were not cheated at all as they had their own ways of bonding with the babies.
Don't get me wrong - it was not easy! It took determination and diligence. Although there were many times it seemed it would be easier to bottle feed, I don't think it really would have been in the long run, all things considered!
**Feel free to post here or PM me at TC if you have any questions! Posted by 6_olive_shoots at Labels: , , ,