Posts

Newsletter #44: Mother’s Sharing – Breastfeeding Triplets

As told to Nabila Hanim, BMSG Staff

We have heard of mums breastfeeding twins, but rarely do we hear of breastfeeding triplets! We speak to Marie Lim*, who shares with us the highs and lows of breastfeeding her triplets, who turn 1 this year. 

*Name has been changed at mother’s request.


Breastfeeding multiple babies is not impossible but requires lots of support. [Photo for Illustration]

Q: Tell us more about yourself! What do you do, how many children/babies do you have, and how long have you been breastfeeding?

A: I’m a first-time mum of triplets. They’re about twelve months old now. My working hours are flexible and allows me to prioritise breastfeeding.

 

Q: How did you feel about breastfeeding when you discovered you were pregnant with three? Did you have any breastfeeding goals in mind then?

A: During my pregnancy I read up on breastfeeding from books, articles, and a couple of breastfeeding support groups like BMSG. I’ve always wanted to try breastfeeding despite having heard lots of horror stories from friends. I never had a specific goal in mind — I just wanted to be as prepared as I could and give it my best shot. As triplet babies are usually delivered prematurely, I hoped that giving them breastmilk would help them get stronger faster. That being said, all I had hoped for throughout pregnancy was an uneventful gestation and safe delivery.

 

Q: Tell us how you manage! What was it like at the start?

A: 
My first experience with breastfeeding took place at the recovery bay where I was being monitored post c-sect. I didn’t expect to tandem latch them at that point, so it was a pretty nice surprise.

In the hospital, the nurses would come by every 2 to 3 hours to ask if I wanted to latch the babies. It was always hard to answer because latching newborns took really long, and the third baby would get really hungry waiting. I was in a lot of discomfort and needed to rest myself. In the end, I settled with skipping the 3-4am feed and allowed myself to take breaks. The nurses would feed the babies with formula when I couldn’t latch them on myself. In hindsight, I realise they weren’t fed much because I only started collecting colostrum on Day 3 or 4.

I went home on Day 5 together with the babies and continued to struggle. Everything hurt – my abdominal muscles had separated, the wound area was sensitive, my breasts and nipples were sore and screamed all the time, etc. As I couldn’t walk properly, my husband or nanny would pass me a baby to nurse while I sat in a recliner.

Initially I’d latch one or two babies at a time and pumped after that. It was challenging as I was still tired and in pain all the time. My husband and family members were highly supportive and helped me throughout. We rotated the third baby, who would get the bottle, prioritising expressed breast milk over formula.

The key to breastfeeding triplets, just like breastfeeding 1 baby, is to get all of them latched on right from birth. [Photo for Illustration]

After 2 months, I tandem latched at almost every feed while my husband bottle fed the last baby. For the middle-of-the-night feed, all three babies would take the bottle as this allowed us to take turns to get some rest. I would pump and then sleep for 3 to 4 hours, which caused the occasional engorgement. However, I was just too tired and didn’t hear the alarms ring.

As they say, pumping is a skill. It is a skill which I honestly am still far from acquiring. I recalled doing power pumping daily for a week, trying to see if I could get enough milk to sustain a full breastmilk supply. While my supply did go up, I felt completely crushed and drained. Four months postpartum, I stopped pumping. It was killing my back. I somehow found it much harder to pump and way easier to latch. Yes, the initial 15 seconds of every latch was excruciatingly painful but once it was over, I found the actual latching experience very sweet and endearing.

I actually LOVED breastfeeding (for the most part). The initial latching pain went away eventually and latching was a lovely experience even though it still gave me backaches. When I pumped, I found it hard to get into a position that worked for the suction, my back and wound. For someone who couldn’t walk normally till 5 months postpartum, and had to rely extensively on others for the smallest of needs, I decided to accept that my babies will have a mixture of feeds.

On another level, breastfeeding also helped me understand and experience the beauty of creation. This whole world, the circle of life; we are one. It’s like the blue whale; it’s so large and majestic. It’s also a mammal and it also nurses its young! I could never be as cool as a whale, but I find it interesting that we share something in common, like breastfeeding!

 

Q: Has starting solids made it easier to nurse your children now? How is your breastfeeding routine currently?

A: We started them on solids at 7 months (actual) when they had good neck control. I was and still am worried about not having enough milk for them because they end up latching less, which makes me wonder if my supply will drop. It’s not easier per se because the logistics of solids for three is another challenge of its own. To accomplish solids prep+feed+clean, rest, diapering, latching, all within one waking period/cycle of about 2.5 hours means that everything needs to move like clockwork. If you factor in the occasional milk blister or clogged pores which requires frequent epsom salt soaks, hand expression, hot compress, etc, it can be overwhelming.

One thing to note is that our babies have been on a rough sleeping/eating schedule since they were newborns. I know that most breastfeeding mothers would suggest to fully go with the child’s cues, but for the sake of everything else, and to be able to do what we do daily, we would wake the other 1 or 2 babies at the same time for feeds.

Right now at around 12 months old, I latch in the morning around 8am, then about every 3 to 4 hours after. They go to bed at 630pm and we have a night feed at around 10pm.

Being flexible and sharing responsibilities can help mums and dads adapt to breastfeeding multiple babies. [Photo for Illustration]

Q: What are your observations about the benefits of breastfeeding on yourself and the children?

A: I found it most helpful when they were ill and managed to latch despite feeling poorly. I knew that the breastmilk would help them get better and it motivated me greatly. Personally, I also enjoyed the bonding  with the babies. My children are blessed with a father who does everything for them as a caregiver. As a mother, the only thing I could do for them that their father could not is to breastfeed them. On another level, breastfeeding also helped me understand and experience the beauty of creation. This whole world, the circle of life; we are one. It’s like the blue whale; it’s so large and majestic. It’s also a mammal and it also nurses its young! I could never be as cool as a whale, but I find it interesting that we share something in common, like breastfeeding!

I found it most helpful when they were ill and managed to latch despite feeling poorly. I knew that the breastmilk would help them get better and it motivated me greatly. Personally, I also enjoyed the bonding  with the babies.

Q: What advice would you give to mothers who are expecting twins or more, and worried about having enough to breastfeed their babies?

A: Please let others take over your responsibilities in other aspects of your life. In terms of caregiving, there’s only so much we can do. On the surface, it seems as if I’ve managed to do a lot. However, there are lots of other factors that have allowed me to breastfeed till now. I believe it truly takes a kampong (Malay for “village) to raise a child, especially for multiples. In my case, I had 2 confinement nannies in the first month after delivery. After which, we had the help of a couple of family members for another 1 to 2 months till I was able to physically handle a baby.

My husband and I are lucky enough to both have flexible working hours and have chosen to be the babies’ sole caregivers for now. We have no domestic helper and we share the majority of what needs to be done between us. Groceries are delivered by Fairprice, Amazon, or our loving parents. The floor gets a general cleaning session by the robot cleaner every other day. To keep things easy to clean and manage, we opt for a minimal interior living space and consciously declutter as we go along.

I mention the above because I feel we cannot just look at breastfeeding as the only aspect of caregiving a parent is involved in. Our habits and expectations need to be adjusted across the board. I noticed that when I started taking on work again at 5 months postpartum, the stress and further lack of sleep made my supply dip. It would be unrealistic to hope that I could still achieve the same productivity as before, with my new role as a mother considered. In the same vein, I knew that if I wanted to breastfeed, I had to prioritise my nutrition and value my rest.

According to Marie, mums need to adjust their roles with their responsibilities across the board. [Photo for Illustration]

Go with the flow, try your best, and stay flexible.

In terms of breastfeeding, I highly recommend reading up and talking to mummy friends during pregnancy. Even when armed with lots of book knowledge, the real experience still knocked the wind out of me. Thankfully, I had the support of fellow mummy friends who patiently answered my every query, listened to my virtual sobs, replied to my 2am WhatsApp spam messages while pumping. Also, I hope for every other mummy to have a partner who is equally invested in caregiving the way my husband is. It is the only way I could have survived for this long. Please try to communicate well with your family on your breastfeeding goals, ideally way in advance, such that they can have time to learn more and support you, too.

This journey is wonderful both for our babies and for us to learn so much more about our amazing bodies, not just in a physical way. It really takes a lot to sit at the dinner table with visitors, melting from a stiff c-sect binder, aching everywhere, having sharp sensations in your breasts, and trying to eat before rushing for the next feed again. I often think back to the trying initial days and smile at the bittersweet memories.

To my fellow mummies of multiples, big hugs and all the best!

Newsletter #42: Preparing to Breastfeed Before You Meet Your Baby

by BMSG Editorial Team

With greater awareness of the importance and benefits of breastfeeding, many expecting mothers want to prepare themselves for this momentous journey. But how can you actually get ready to breastfeed when you haven’t even met your infant yet?

 

Information is Power

Pregnancy often makes mamas attracted to peaceful, calm photographs of mothers breastfeeding their infants. It looks like the easiest, most wonderful thing in the world – and, of course, it can be.

However, the truth can be very different for many mothers after delivery, when your body feels as though it has been torn into two and you are battling with blood loss, pain, fatigue and hormones. Breastfeeding may look natural but it is in fact a learned skill that takes time and effort to figure out.

Yes, the truth is that many mothers may face difficulties breastfeeding in the beginning. These issues could range from flat nipples, sleepy jaundiced babies, tongue ties, extra-large breasts or nipples, or even just trying to figure out the best way to hold your floppy newborn.

Breastfeeding can be hard work but with some support and mental preparation, it can be a satisfying journey. [Credits: Lisa Matthews]

 

On the bright side, most of these problems are common ones with established solutions, and being empowered with information before you give birth can be the best way to prepare. If you know beforehand the kind of issues that many mums face, you will be less thrown off if it happens to you, and you and your partner will know that there are solutions you can employ to help make your journey a little easier.

Some ways which you can prepare yourself:

  1. Speak to mummy friends who have breastfed their children and ask them to share with you honestly what their pitfalls and problems were, and how they addressed them
  2. Join the Breastfeeding Mothers’ Support Group Facebook group and read posts as they pop up on your feed. This is an easy way for you to get a quick handle on the common issues that many mamas face
  3. Attend prenatal classes (including BMSG’s Breastfeeding 101 workshops) to find out more about the journey ahead of you and how you can make it easier for yourself and your baby

 

Knowing where to find support, including seeking comfort in other mothers, can be helpful if you are overwhelmed or just need reassurance. [Credits: Lisa Matthews]

Form Your Support Team

Although much is made about the breastfeeding mother, the reality is that we create breastfeeding families. A mother is never alone in her journey and the best way to make sure you can succeed is to ensure you have everyone on the same page.

First and foremost, it is crucial that you have your spouse on your side. It is a wonderful way to bond and prepare for baby’s arrival by attending prenatal breastfeeding classes together and understand how important the role of each parent is. 

Fathers must also buy in to breastfeeding, fully understand and support the decision to breastfeed. After giving birth, mothers are often disoriented, in pain, and may find it difficult to advocate for themselves. This is where Dad needs to step in and step up to support Mom. Be the guardian and a wall to block off unhelpful advice and unnecessary comments that may come from people who have good intentions but do not know better.

Daddies, don’t undermine your presence – mummies need you more than ever especially in the challenging early days of breastfeeding. [Stock Photo]

 

Choose Postnatal Support That Suits You

As mentioned before, being prepared is the best plan of attack. It would be useful to have the contacts of some good International Board Certified Lactation Consultants (IBCLC) whom you can speak to if you have any problems.

Many newly-delivered mothers in Singapore also hire confinement nannies to help out in the first month or more. Very often, mums hire these nannies based on word of mouth and friends’ recommendations.

However, it is really important to note that different mothers have different needs and requirements. A nanny who worked out well for your friend may not be as helpful for you if your needs are different. Therefore, if you intend to breastfeed your infant, look specifically for a confinement nanny who is fully supportive of breastfeeding and who can help you succeed. She should be up-to-date with breastfeeding knowledge and be willing to assist you as needed.

For example, while many confinement nannies try to make themselves useful by offering to take the baby at night so that you can “rest”, remember that night feeds are crucial to establish and maintain your milk supply and avoid engorgement, blocked ducts and mastitis. A breastfeeding-supportive confinement nanny can help by changing baby’s diaper at night and then passing baby to you for a feed. 

Confinement nannies and any other family member who is helping the breastfeeding mum should support the mother without imposing on her wishes. They can focus on helping mum on other mundane tasks such as changing baby’s diaper, cooking meals for her or doing other household chores to keep mum comfortable. [Stock photo]

Ditch the Pump

Many mothers are told to bring the pump to the hospital and to start pumping diligently from the beginning. Wanting to ensure they have sufficient milk supply, mums bring out their expensive dual electric pumps and go at it in the hospital room – only to be devastated and panic when they find they are getting nothing.

 In the first few days, your breasts make colostrum, a thick, rich, sticky liquid that is highly concentrated, full of protein and nutrient-dense. It’s the perfect food for your newborn and helps to fight infection, supports baby’s immune system and gut, and flushes out bilirubin through baby’s poop. Did you know that colostrum is similar to amniotic fluid? It’s the best bridge between the fluid baby has been swallowing in the womb, and the mature breast milk which he will eventually drink.

The keyword in all that information up there is “sticky”. Because colostrum is so thick and sticky, it is hard for a pump to extract it efficiently from your breast. Because your newborn baby has a tiny little belly, your breasts do not need to make a lot of it to fill baby’s tummy. Because of both these things, when a new mother tries to pump, most of the colostrum will stick to the flanges or on the sides of a bottle – wasting all that precious goodness.

Credits: Morgan Temple, IBCLC

 

 New mums expect to see a bottle full of milk when they express milk; it is what we are naturally conditioned to see. So when we look at a handful of viscous droplets sprayed all over the flange and barely covering the base of the bottle, we panic.

What is the solution? Ditch the pump and hand express instead. Massage your breasts gently in circular motions to loosen the sticky colostrum from your milk ducts. Learn how to hand express effectively and gather the droplets in a 3-5ml syringe rather than in a bottle. The colostrum can be chilled and fed to baby, which can be especially useful just in case baby has jaundice or other unexpected medical issues which may result in prolonged separation from mum. A very helpful resource to watch and learn hand expressing from is this video by the Stanford School of Medicine, which explains and demonstrates via real mothers how hand expression can be especially helpful for new mums and newborns. 

The pump is not a need as long as your baby is with you right from birth and breastfeeding well. When your milk supply is well-established, pumping may cause an oversupply. Use it wisely and only when necessary. [Stock Photo]

 

You Are Not Alone

Last but not least, remember that millions of women around the world have been where you are and come through on the other side. You are not alone, even though the nights can feel lonely. When your baby arrives earthside, cuddle that soft, sweet little infant (even when she’s bawling and angry and red in the face) and know that you have made a strong, wonderful choice to breastfeed. Hang in there Mama! We are rooting for you.

Credits: Illustration by Paula Kuka from Common Wild

 


Looking for resources for your partner? Read the following articles written by the BMSG to help dads learn how they can better support the breastfeeding mum: Role of Dads in Breastfeeding Families Part 1 and Part 2.

If you need help with breastfeeding, reach out to our BMSG volunteer counsellors by calling or sending a WhatsApp message to +65 339 3558 between 9am and 9pm daily.