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By Ellen Zagorsky-Goldberg

Sheri of Port St. Lucie, Florida, nursed her first child for almost two years. Three years later, when she discovered she was pregnant again, she had no doubts about what her feeding choice would be. Then she found out that she was carrying triplets.

Some of Ingalls's healthcare providers were very negative about even the possibility of nursing triplets. Ingalls, however, was determined to breastfeed, and her perinatologist put her in touch with The Triplet Connection. Despite a rocky start--the babies spent two nights on formula in the hospital nursery and then had terrible nipple confusion when they arrived home--Sheri's triplets breastfed happily until weaning themselves between the ages of one and three.

Ingalls and other mothers of triplets report that the most essential factors in breastfeeding success are becoming educated before giving birth about the intricacies of nursing triplets, and receiving information and support from other mothers who have successfully nursed triplets. It is crucial to remember that nursing three children at once, although more difficult than nursing one child, is possible.

Breastmilk works on the theory of supply and demand: The more you nurse or pump, the more milk you produce. Therefore, if you are nursing all three babies at each session, you will make milk for all three. If you nurse two babies and give the third a bottle of formula, you will only produce enough milk for two babies. Pumping after nursing is a great way to increase milk supply, as well as provide reserves for bottle-feeding. Some mothers of triplets have found that this method enables them to pump up to 20 ounces of milk in only 15 minutes!

Good positioning is crucial for nursing triplets. Some mothers prefer to nurse each baby individually, so that each gets "special time" at least once a day. In the interest of time, many mothers nurse two at once; the third then either gets expressed breastmilk in a bottle or nurses after the first two have finished. Since the composition and amount of breastmilk subtly change over the course of a feeding, always make sure to rotate which baby is first at the breast at each session.

If your third baby will be bottle-feeding while the others are nursing, a hands-free baby feeding system can be useful. Propping a bottle with a towel or one of the specially designed bottle holders that seem to be gaining popularity is greatly discouraged because of the very real possibility of your baby choking on the steady stream of fluid.

Many mothers recommend using nursing pillows like the "Boppy" or the "EZ-2-Nurse" pillow made by the Double Blessings company. Finding positions that work for you and your babies often requires some experimentation. You can try using the "double football" hold, where a baby is tucked under each arm, with only the babies' heads at your breasts. Or one baby can be in the football hold and the other in the cradle hold, with her body across your chest (make sure her tummy is on your chest, not facing the ceiling). You can also try the "double cradle," with the legs on each others'.

Sleeping with your babies can be a real sanity-saver. Shari Lynn-Henry Rife, of Kalamazoo, Michigan, found that putting a bedroll in the babies' room was the only thing that allowed her to get some sleep when her triplets were newborns. "When someone woke up to nurse, I would lay down, put them to breast and go back to sleep. When the next one woke up I would put the first one back in bed, put the next one on the other breast, and go back to sleep until baby number three woke up." Other families work to put the babies on the same schedule by waking all three when the first wakes.

Although it may not seem like a specific help for breastfeeding, finding people to assist around the house allows you to use your energy to make breastmilk, not dinner. Shari Rife's mother-in-law helped keep her house clean. Other mothers of triplets have received help from friends and family on everything from taking older children to soccer lessons to dropping off a casserole for dinner. As Sheri Ingalls says, "It will take all of your precious energy to feed and care for your babies. Sleep is so important and laundry isn't! Let somebody else do it!"

Relaxation and good humor will help during the early days of nursing triplets (or other multiples), since, as Rife says, "no one is going to starve if they have to wait a few minutes to eat." Education, perseverance, and mental flexibility are key to adjusting to life with triplets. Looking back, Sheri Ingalls notes, "I have to say it was very tough, but worth it."

Ellen Zagorsky-Goldberg, RN, MSN, is a pediatric nurse, freelance writer, and homeschooling mother of Batsheva (6) and Chana (4). She lives in Boston.

Originally published Feb 2012

Image: Russell Harrison