When feeding two or three. . .

[Barefoot Farmer]

Okay, wise multiple mamas. . . I am presently exclusively breastfeeding 2 of my 3 triplets (5 mo next week, is that possible??) and pumping for my third (he has Down syndrome and after his second hospitalization for pneumonia we have struggled and struggled to get him back to breast); I pump about 50% of what he needs (he then either gets donated breastmilk or formula). Here is the issue. . I'm not sure how long I can keep this up. About 3 weeks ago I made a decision to focus more on getting him back to breast and less on pumping; with triplets there is only so much time in the day and while it might not seem like a lot, one or two pumping sessions is one or two moments where I can be trying to get him on breast. So, I went from supplying 75% of his milk to 50%, but he went from 5 min a day on the breast to 3x 5 min a day. Success, but in small steps. The thing is that sometimes I wonder if pumping for the third is making my life more hellish, and not in just time pumping. I often wonder if I am emptying my breasts and then my other two (who are EBF) are struggling to get milk and are therefore cranky. My system has been to feed DS1 and DD off of left breast and pump right breast until about 4-5pm (witching hour), between 4pm and bedtime DS1 and DD have access to both breasts, then pump right breast before bed, use both breasts overnight, and then first thing in the morning, but right breast again, start all over.....this is the ideal situation, sometimes if DS1 or DD are super cranky I give them right breast (which needs to be pumped) to see if more milk will help; sometimes yes, sometimes no. I guess I'm just doubting that my body is really making enough for 2.5 people. I was using herbs, which I notice does increase my supply (can even pump up to 100% of DS2's milk), but it is quite expensive --we've already purchased and consumed over $500 of mother's milk plus. I just can't pour anymore money into it. I have to go with what my body can do by itself. So, I guess I asking you all -- do you think DS1 and DD are getting cranky b/c of low milk supply or me pumping off too much milk or do you think they are 4mo old and cranky because they are babies and sometimes babies get cranky? Maybe I'm just an exhausted triplet mom and need a nap? That is a definite yes. Also, if I increase my food intake (which I have no idea how that is possible b/c I am starving all the time!), will that naturally increase my supply? TIA. I know I ramble a lot; just tired.

[daisie31]

Holy moly mama! You are doing an amazing thing. I thought two was hard. Great job.
I have to say that my two are often cranky at the milk supply. More one than the other I suppose. One is a comfort nurser so if she isn't really too hungry she is happy to hang out. When they are both hungry, they are very impatient waiting for the letdown and require a second letdown to finish them off, sometimes a third if they are really hungry. It's hard to not have a second breast to off that is primed and ready. I can't imagine feeding two off of one breast, especially if they are over hungry. I would guess that is what is making them crabby. I am not sure what I would do in your situation. Can you pump about a half hour before you think they will be hungry and then let them tandem feed? Then maybe give a small bottle to the third and try the breast? Or, put the little guy to the breast with one of the others and give the bottle to one who normally gets the breast (alternating which of the two breastfeeders get a bottle) until he get the hang of it again and then just work towards all feedings at the breast? I know it's hard to think outside the box when you are tired and living the issue. I hope you find something that works for you, there has to be someone on here who will give you a great suggestion that will work for you.

Keep up the great work!

Dena

[kjoy2]

It sounds like you are doing an amazing job. Only have a bit of input, which is, YES, if you feel hungry, eating more will likely increase your milk supply. I definitely ate more nursing 2 babes than I did while I was pregnant. I think the estimate is 500 extra calories a day for mama for EACH nursing babe. So in your case, you'd want to aim for 2000 + 1500.

[Julia'sMom]

You are doing a fabulous job!! I can't even seem to make enough for two. A couple of things...I would be sure to watch the weight gain as a good indicator if they are getting enough to eat. The crankiness for mine (4 months) is not always a good indicator of feeling full since sometimes then won't even take the bottle when they are cranky. Could you let the two babes use the right breast after pumping? I know I usually have milk left that the pump won't get out and perhaps that would be enough to top them off?

Also, have you considered prescription drug for supply? I found that the cost for Reglan was actually considerable cheaper than what I'm paying for More Milk Plus but it worked wonderfully for me. (do watch for depression as a side effect, your practicioner should warn you). I'm also wondering if you were taking the tincture for more milk plus? For me, a bottle is about $15 and should last 20 days, at the recommended dosage. It's expensive, but doesn't seem like $500. I am also on brewer's yeast, which is helping and quite cheap. The cheapest thing I've been doign is really upping my water consumption. It's hard to find the time, but it's really made a difference in my supply.

Good luck, mama! Most of all, stay sane as a sane mama is worth more than a full supply of breastmilk, in my opinion. You are a superwoman!!

[dividedsky]

no major words of wisdom, just watch their weight gain. i think crankiness can be from so many things, it's hard to know. how are their weights?

you are an amazing mama. i know you're probably too tired to even think about it, but you should be so incredibly proud of yourself. what lucky babes!!

[Barefoot Farmer]

Thank you all for your responses. A couple of side notes: I avoid tandem nursing as much as possible; it is necessary at bedtime and I really try to just keep it to that. I hate, hate tandeming -- it is physically horrible for me, such a different experience than nursing single. I could never tandem w/ DS2 b/c he requires both hands and several pillows for latching. As for Mother's Milk Plus, I have to take extreme amounts for it to increase my supply. I consumed 4 of the $50 bottles in about 2 months, plus additional fenugreek, goat rue, and teas.

I am mainly trying to figure out how to manage all this, sort of fairly. Sometimes I think it is unfair that I am exclusively breastfeeding two and that DS2, because he has Down's syndrome, isn't getting 100% breastmilk. I wonder if I should give DS1 and DD occasional bottles of formula to pump off more breastmilk for DS2. But then sometimes, that seems silly and I convince myself that continuing to attempt to put DS2 on the breast is the best I can do right now and we will just have to accept that he is only 50% breastmilk; but then I think about the immunity issues and medical problems with Down's syndrome (that we are gratefully not dealing with right now) and wonder if I am making the best choice. But then it seems unfair to give DS1 and DD formula when they are breastfed all the time. . . aaarrrggghhh... I hate these dilemmas. Thoughts?

[JudiAU]

Hugs.

The only helpful thing I can suggest is maybe trying to locate extra donor milk. Seriously, you are the most awesome mama ever and when and if I have some extra milk I'll send it your way.

Also, you are SO close to what I think of the magical six month mark when you might toy with the idea of solids.

Personally, I would continue to ebf the two nurslings because that is easy (ha ha) and I don't think you would pump more if you reduced their nursing sessions. That is not at all my experience especially if you are really dependent on herbs for your current supply. The pump just isn't as good. And then I would maybe pump a little bit less and use the mental and bodily energy to try to latch the 3rd more often. 3 times a day is a terrific increase - congrats. Maybe try and get some extra donor milk or fill in with formula. Maybe dump the pumping all together and really focus more on latching. It might give your body a real break. And finally, because of the special needs, I would consider thinking of DS3's long term needs for breastmilk rather than just the short term. I've read that duration is more important than quanity and perhaps choose to prioritize his needs there.

[~bookcase~]

would it be easier to use a SNS to feed ds at the breast but with whatever top up you can get donor wise + formula? that way he's getting his top up at the breast along with b'milk and you cut out expressing?? also, tandem feeding is pants, i agree, but if you could do it a few times a day with one of the effective b'feeders for him to hitch a let down from then he can lap milk up at that time.

just abstract ideas that could get him interterested at the breast, reduce pumping time and give yopu the cuddles to maybe take away the 'fairness' aspects you're worrying about.

but 'fair' in the same month or even year! doesn't really exist with multiples imo, so go easy on yourself overall, each child will get his/her own due

and congrats for everything you have achieved mama. one day at a time

[Intertwined]

What a difficult set of decisions you're making!

If there is ANY way you can handle tandeming, I'd go for it. I HATED it but my LLL correctly encouraged me to try and fight through that reaction at least for the first six weeks since tandeming increases supply so much better than nursing seperately, more often. That's why they tell you to double pump! So if you can, I'd give that a shot. I totally feel you on hating it though. I still hate it and my twins are 2!

You're amazing. I know you're probably going to say "I don't feel amazing" because that's what I say when I'm told that. But you are. You really, really are.

[Julia'sMom]

I don't have any other suggestions. I just want to say that I bow down before your determination. What you are doing is incredible and the best gift you can ever give to your children.

[skybluepink02]

My daughter had some major feeding issues (aspirating on liquids, everything had to be thickened) so I had to pump for her. I nursed my son for a while with a horrible latch due to nipple confusion in the NICU. I ended up pumping for both because I was getting 20 minutes break every 3 hours between nursing, pumping, washing parts, feeding babies, putting babies to bed, ect. I honestly thought I was going to crack. I'm still pumping for them, but I feel sad that I didn't stick with nursing.

I would consider prioritizing breastmilk for your down syndrome son. DS people often have immune system weakness of deficiencies that make them far more likely to suffer from infections. Maybe either try to find a breastmilk supplement, or possibly give your other two a bottle a day to shift more milk towards your DS son? It's not easy balancing the needs of two or three babies, is it?

Good luck! You're doing and incredible job!

[~bookcase~]

i would be very worried that diverting more energy towards pumping will decrease overall supply and mamas vitality (if you take into consideration all the physiological 'rules' of b'milk production and the obstacles of long term pumping) and to be at 5 months and have a supply at the breast well established for the two is such an achievement, it would be a tragedy to lose that relative 'ease' iyswim.

each of us totally has to make our own risk assessment relevant to our reality and we'll make diff. choices, but i'm anxious that you don't feel panicked into a scenario that won't be sustainable long term for your health Barefoot Farmer - they are *all* going to benefit from you finding a comfortable and sustainable pattern of feeding that works for *you*

mama - i want to raise you up in confidence and power that you are doing a fine thing for all your babies and remember your own essence needs loving and nurturing too

sbp - you're doing an amazing job. i wonder why a treatment plan couldn't be found to sort the reflux?? directly, without expressing and thickening that way. it wouldn't normally be the protocol of any b'feeding specialist that has studied lactation because as you know, pumping sucks!! and takes an uber mama to stick to!!

[DiannaK]

wow beyond wow! I have no words of advice, but simply awe and blessings to you! What a wonderful momma you are!

[skybluepink02]

Originally Posted by ~bookcase~

sbp - you're doing an amazing job. i wonder why a treatment plan couldn't be found to sort the reflux?? directly, without expressing and thickening that way. it wouldn't normally be the protocol of any b'feeding specialist that has studied lactation because as you know, pumping sucks!! and takes an uber mama to stick to!!

It wasn't reflux, but an aspiration issue. She had suck issues and would breathe milk into her lungs when she ate. She had lots and lots of occupational therapy and very, very gradual weaning to get to the point where she could drink thin liquids. She still ended up with pneumonia several times because of it. The OT and doctors weren't sure if it was a preemie issue or would have happened anyways.

[Barefoot Farmer]

Thank you all for your words of encouragement. I sincerely appreciate them. Something I meant to address before, everyone has had great weight gain. Each babe gaining 2lbs or more each month since birth.

I will give it my best effort to tandem nurse DS1 and DD more to see if that boosts my supply more for when I do pump for DS2.

DS2's nursing sessions haven't been as productive as they were a week or two ago; I'm not giving up yet, just feeling a bit down that he and I don't have that nursing relationship.

As far as him having Down's syndrome and giving him as much breastmilk as possible, this does weigh on me quite a bit. I do have a friend pumping for me now, about 5 oz a day (3/4 of one of his bottles) and I pump about 50% of his needs. I am finding that my body isn't responding to the pump as much as before; I've reached that threshold; considering ordering more herbs, which I swore I would not. I was able to do 100% of all their needs until about 3-4 months old and then it just seemed that his needs weren't meeting my pumping output. *sigh*

I did toy with the idea of giving DS1 and/or DD2 some formula so that DS2 could get more bm; DS1 gets constipated with the formula (usually about 8-12 after consuming it); DD2 seems to do fine with it, but she fights the bottle crazy. . . . . .

Sorry for the continued rant., . . . I just wish I had three boobs.

[aja-belly]

i had a similar experience at almost 5 months with my twins. cash has never had an efficient suck and around 4/5 months my supply dipped enough where it just seemed like i might not be keeping up. the two things i did at this time is

1) not unlatching babies when they are doing that puny sucking in their sleep thing. it's nipple stimulation and even if they aren't emptying the breast anymore it is still helping up supply.

2) introduced some solids. i know 5 months is early when the recommended is 6, but i decided it was better than formula and it really went well. i didn't do babyfood with my older kids at all, but we did with the twins from about 5-7 months. usually once a day about 5/6pm (witching hour - when my supply seemed it's lowest). it put off a nursing session so they could really tank up before bed.

[CalaRei]

I just wanted to note that I had similar feelings when my smaller twin was moving more and more to the breast. We had been doing half bottle feedings and half nursing sessions for a while after we brought them home. I pumped like crazy and it ended up that they'd get about 2 of 5 bottles being formula a day. My bigger boy started refusing bottles at one point, so he was transitioned to breast only fairly early, but the smaller one still needed the bottles. As things went on and he got stronger, though, there came a point where I just took the leap and started nursing more, even if it seemed like he was getting more formula because I couldn't pump as much milk. By about 2 months old, we were able to wean off the formula almost entirely (they do get it if I'm not around, because I can't pump enough to have a baby sitter stash.)

I felt a lot like I had to trust that my supply would work itself out and I'm so glad I took that leap!!