18 months already?

How did my sweet, four-pound preemies become such big toddlers?

As a result of excitedly over-volunteering, I find myself with only a few minutes for this post, but as I stated last week, brief and frequent is the goal.

What are we up to, you ask?

Still nursing, and loving it! (Except when they beat on each other or me in order to get a latch position...)

Egg Decorating

O-Bear

Egg Hunting

Four SERIOUSLY handsome boys

This is how we roll; the comments about the stroller are truly endless.

Happy half birthday, sweet boys! I adore each of you!

Coming posts: "Why I Want to Have Another Baby OR My Husband Thinks I Am Nuts-o" and "What the Boys are up to These Days: the Chaos Files".

Shameless distraction!

5 month-old bottoms!

I am hoping that helped you forget the fact that I have not blogged in over a month. A funny thing happens when I stopped pumping (!) and was able to nurse instead- no more laptop time. While this was my ultimate goal, I miss reading blogs from a screen larger than my iPhone, and really miss blogging regularly. Mid-year resolution: short and sweet updates.

The boys are five months old! The nursing continues to go well- we have not used a bottle in weeks and are not looking back. I am so proud of them! They love to nurse now, and I usually have at least one baby attached to me for the better part of the day. I think they each nurse around 10 times a day- maybe more. They demand feed at night, too, which is getting out of hand (since they wake up to nurse and promptly fall asleep after latching on) but for now, it works for us.

Everyone is growing- our Cheeks is still the largest at a whopping 13 pounds! He is on the chart for his weight without adjusting for prematurity. Clearly, his nickname still fits. He has become extremely vocal about everything. He coos loudly at himself in the mirror, grunts while I get ready to nurse him, and is the first to exhibit stranger anxiety with heart-wrenching wails. Luckily, he is never with any strangers for long, but even out in the community, he can be sensitive. He has a ginormous head that we are hoping rounds out a bit soon, but at least we know his brain is a-growing.

O-Bear is also getting so big! He is definitely our snuggler. Wherever he is, he reaches for his brothers and hooks arms with them. He will settle for just gripping their sleeve or hand if necessary, but he likes to be really linked in to his brothers. Lately, he has been bucking while laying on his back, with just his head and feet on the floor and boy, can he move! He basically refuses to roll from front to back (something his brothers love to do) and settles for sucking on his hand. Our O usually has a few fingers in his mouth and drool on his shirt.

Ace lives up to that nickname! He rolled over first and is working on back to front. While his Nanna was here, he laughed out loud many times for her and will now for us, if we kiss his neck noisily. He is sort of a boob hog and will cry when he sees his brothers eating until his turn. Ace continues to be super social and loves to be worn facing out in the Bjorn, so he can see the world. He flirts with everyone, with a wide-open grin and loves new people. He reaches for and holds toys, as do his brothers, and he has showed them how to mostly get toys to their target: the mouth!

So much to write about- more coming on nursing, "leftover" embryos, multiple parenting and other adventures! For those who still read- thank you! Better posts follow... but now, I must sleep for an hour before someone wakes up to eat.

3 1/2 Months!

If I show you a super-cutie-pants picture will you forgive me for not blogging in WEEKS?

Baby A, Baby B, Baby C (Scroll down for updated nicknames)

I hope that worked! As usual, our days are so full of feedings, pumpings, changings and snuggles, but that is no excuse for an extended bloggy absence. Or for my lack of commenting, but friends, I promise I am reading and will quit it with the quiet lurker behavior.

Updates, in list form:

- I must change the babies' silly and unfitting nicknames which I assigned (after surgery and with three newborns) in the NICU. The babies will now be known by nicknames that mean something and use their first initials:

"Cheeks" is Baby A. He is CHUBBY! Possibly our most high-need baby, requiring a lot of help to settle, sleep and eat. He also has the most gorgeous grin and coos loudly, especially at his big sister. He is not a fan of being in the car and has almost required me to run red lights to avoid stopping. Did I mention the cheeks? SQUEEZABLE and chunky. His twin is O-Bear.

"O-Bear" is our Baby B. I have always called him O-Bear. He is our little fighter who had NEC in the hospital and who has recovered his weight difference to pass Baby C and almost pass Cheeks! We have a harder and harder time telling them apart as he gains so well. He eats the most and is quite dramatic. If he coughs, or coos to much, he chokes on his saliva and lots of dramatic gagging ensues. He is flirty and bats his long and curled eyelashes at everyone while tuning his head to the side and saying "ah-goooooooo".

"Ace" is Baby C. He is not a twin, but knows he is a triplet. He is patient, calm and collected. He rarely cries and smiles all day long. He has dark hair and olive skin, while the twins are fair and blonde like me and my daughter. Wait for the best part: he nurses WITHOUT a supplement after, about every 3 hours during the day. Oh, and he nurses all night, laying next to mommy. :) He also has more strength and just seems older. He doesn't have some of the other preemie behaviors that the twins have, like over extension of their bodies and weak sucks. (See more on that below...)

- We are BIG! The babies are all 11 - 11.5 pounds and growing so well!

- STILL working on breastfeeding but these boys are getting no formula! I am pumping 'round the clock to ensure the twins have milk for their supplemental bottles after nursing and at night. Hate my pump sometimes, but it has enabled me to provide for them!

- The twins were seen by a Speech Language Pathologist (SLP) and both have weak jaws/tongues and are just not ABLE to get all they need from the breast... YET! I keep up with nursing each one at each feeding, and give them my milk in a bottle if we need to. I want them so badly to be able to do it, but they are not there yet.

- I have some amazing LLL friends who are keeping me sane, and one even brings me her own expressed milk on occassion. I call them crying, frustrated and they bring me back to the fact that I am nursing TRIPLETS and that is a wonderful thing. I am the luckiest mommy ever.

- I am coming up on my Blogoversary! A year-in-review post will be coming.

The Post About Breastfeeding

Breastfeeding! I never knew what a struggle it could be to get there with these boys. I nursed my daughter until 15 months when I weaned her to try to get pregnant (insert hysterical laughter here) as I was not ovulating or having periods while nursing. So I consider myself a pretty seasoned breastfeeder and can troubleshoot a lot of latch, supply or other problems. Nursing triplets, on the other hand, was something with which I had no experience. Preemie triplets? Uncharted waters.

The knowledge and experience about nursing I had before having the boys has served me well. I know that breastfeeding is a supply and demand operation. In theory, the more you tell your body to make (through nursing and pumping), the more milk it will produce. This, unfortunately, is not the case for everyone, despite best efforts, pumping and drugs to stimulate production. I am so far, lucky enough to be able to keep up, but that could always change. For now, I drink ridiculous amounts of water to ensure I am hydrated, and take 14 Fenugreek capsules a day. This is an herb that stimulates milk supply and can be found online or at any health food store. I get mine from Amazon or the grocery store.

We are still working to get the boys all nursing from the breast their "full" feeds, which for them is about 90 cc's, or just over 3 ounces per feed, seven times per day. If they are unable to nurse the feed, we supplement with a bottle of EBM (expressed breast milk). How do we know if they got their full feed? I am CRAZY like a fox and have a rental scale. Actually, it provides us with an amazing amount of information about their nursing habits. We simply weigh them before and after nursing, and each gram they gain translates into a cc. So if they gained 60 grams during feeding, they ate about 60 cc's or 2 ounces, which is 2/3 or their feeding. Of course, sometimes they are not as hungry, and sometimes more often, and we always have a bottle ready if they are hungry.

This way of feeding, scheduling a breastfed baby to eat seven times a day, sucks (no pun intended) in so many ways. Newborns should be breastfed on demand, and usually between 10-12 times per day. Our guys are 12 weeks old, almost 6 adjusted, and really should be eating about 10 times a day still. If they did that, they'd only need to eat around 2 ounces or so at each feeding, so that is probably what is developmentally appropriate. Because there are THREE mouths to nurse, and I still have to pump 7 times per day, they cannot be demand fed most of the time. In the evenings I cue feed them whenever they are hungry since we have an extra adult home and I don't have to pump one time then. Ideally, they'd all be put to the breast all the time, all day long, but there are literally not enough hours in the day for me to do that and pump. The other problem with it is I would pump my breasts empty and then be trying to feed a hungry baby who is not the most efficient nurser, as it is.

So a schedule it is. Right now, so they get the most practice, I nurse everyone at each feeding, and anyone who is still hungry will get a bottle of EBM. When we get to where they are all nursing well, I may only nurse two at each feeding while one has a bottle in the interest of time. We've chosen to start doing "AC/PC" or before and after nursing weights with our rental scale to get an idea of how they are doing. We'd like them to nurse 70-90 cc's or 2+ to 3+ ounces at each feeding.

While my little Elephant, our non-twin Baby C is doing an amazing job, usually getting 60-90 at each feeding and often going a whole day without a supplemental bottle, the twins have plateaued. They have made very little gain on the amount they can nurse in the last couple weeks, which is so frustrating! I really hoped they'd be off of supplements by now. So each feeding we weight Baby A, nurse Baby A, weigh Baby A and then possibly give a supplement. Then we repeat that three times. After that, I pump and we begin again shortly after. This process is obviously tedious but keeping logs of AC/PC weights, how much milk we use and how much I pump is really helping us see patterns, or in the case of the twins, a plateau. Part of the frustration is the lack of consistency: sometimes our Lion will take 50 and sometimes 15- it does not seem to have anything to do with time of day, nursing order or position. Their suck is not as strong, they are not as patient to wait for my milk to let down, and they seem to be easily frustrated. To have them push away from me and then latch on easily to a bottle feels hurtful sometimes, though I know it should not.

I've had my friend and lactation consultant out, and she thinks they just need to "grow up" a bit more until they can do it. Other multiple moms have said they need to be a bit older to truly have the ability to take full feeds. Other people have suggested that the twins could have tongue tie or another sucking problem and not be able to get more. This could require occupational therapy simply a few tweaks in bottle type to help them learn to suck better. I am getting referrals from our pediatrician today to be seen at Pediatric OT units at two Seattle hospitals. They evaluate baby's abilty to suck/swallow efficiently and their overall muscle tone which plays a part in nursing. I recently discovered I know a Pediatric OT and Speech Language Pathologist (SLP) who works with preemies who are learning to breastfeed. I have a phone call set up with her this weekend and cannot wait to hear her point of view, which may be different from a lactation consultant.

That is where we are at right now- sort of in a holding pattern. I am so grateful that my babies will latch on at all, and enjoy each second of nursing them. I am truly determined to make this work, but I had not expected we'd need to persevere this long. Were it not for my completely amazing mother, who helps me with each feeding, does the dishes and laundry and bottle washing, I would not be able to do this. If it weren't for my husband who encourages me, distracts our three-year-old when I am focused on a nursing baby and doesn't mind the pump and scale rental costs, I would not be able to do this. I am lucky to even have the chance! I have also met an amazing triplet momma who is nursing her trio and she has fielded long emails from me with so much support and kindness. I have an awesome LLL leader friend, one who is on her way and totally unwavering and a great LC to consult with. This is taking a village.

You, bloggy friends, are part of the village! Please let me know if you have any ideas, thoughts or questions about this major undertaking. :)

I think it is important to add our successes over the past couple weeks:

- No one needs a nipple shield to latch on!
- Two of the babies can nurse, laying down in bed with me. Most precious feeling ever.
- They don't cry before they even start as they used to scream and flail while trying to latch them.
- Baby C PREFERS to nurse :)

Part of the problem is a complete lack of info about nursing triplets. It is different from nursing twins or a singleton, and throwing the preemie factor in there makes it even more of a unique situation. I have had limited success in gathering resources about nursing triplets, but a good (and really the only) book about nursing more than twins is Mothering Multiples by Karen Gromada. For those of you expecting babies who are interested,some of my favorite resources about breastfeeding are KellyMom, a great general breastfeeding guide; La Leche League's site which has a good tool to finding local help; and The Nursing Mother's Companion by Kathleen Huggins.

Breaking my own rule

You know, the one about no pictures? I had to show off- my babies are getting big on my milk and I am so proud! How big? 9 1/2 to 10 pounds each!



A very long, overly-detailed and obsessive post about breastfeeding is forthcoming. These babies are amazing, and I am hoping I might be able to drop a pumping session or two soon as they take more from my breast and less from a bottle. Are you on the edge of your seat or what? I am sure you'd rather be watching "American Idol" auditions than read about nursing, but STILL. It occupies my mind, breasts and time 'round the clock, so what better to write about?

I have not lost all brain cells yet...

As a result of having triplets and a preschooler and therefore little time to blog, I will give you a bullet-point update while pumping.

- The Refluxers seem to be doing better with their Prevacid! A Christmas miracle!

- I am in serious need of a diet overhaul. Apparently, sleep deprivation makes me want CARBS and nothing else, and the weight loss has stopped, leaving me with 8-ish pounds that I would like to be free of. The extra skin? We'll have to see if that ever goes away.

- As a result of above epiphany, I am going try to watch what I shove in my mouth as I walk by the kitchen while holding a baby, and get out for more walks up hill. Although I love to run, the size, sensitivity and weight of the ginormous breasts will prohibit it for a while. I am trying to squeeze in (A pun! Am not totally brain dead!) lunges and squats while holding babies. A frequently tries to imitate my lunging and only then do I realize how silly I must look to her.

- A wonderful Christmas we had! My mom and I, frequently called Martha Stewart-types, learned a hard lesson: we cannot do everything for the holidays that we usually do. I forgot to help A put out cookies for Santa, we were all wrapping gifts at midnight on Christmas eve, and I did not get to watch "Love Actually" which is a huge tragedy. What we learned? We have to let go. My house is no longer spotless and well-decorated (unless you count piles of burp-rags and pacifiers on the tables as decor) and it does NOT matter. What matters is happy and content children- four of them, not whether or not we made the marinara for the lasagna from scratch.

- The nursing/pumping adventures continue! I am working hard to keep up with my little eaters... and am constantly amazed at how much milk my body can make, and how variable my pumping output is. Frustrated post about the pump and its quirks to follow. The babies are all latching on better and taking more at each "session" but still need a bit more after sometimes. The times where they nurse themselves milk-drunk and are content are more frequent, which is awesome. I am also nursing two in a row (tandem is a three ring circus still) and having some success with that. I cannot believe how hard this is, the nursing followed by pumping followed by bottling. It sucks (Another pun!) all the time I'd have with them and their sister, but is so necessary to get where we want to be. Listening to their contented nursing sounds while they snuggle next to my skin is the most wonderful sound.

- Lastly, we are a spectacle! And neighborhood celebrities. It is rather amusing to watch cars slow down and stare at this (not liking the way my behind is looking these days! Must resist cookies.):

It should be called "Ass-id Reflux"

... because Gastroesophageal Refulx (GER) is an asshole and it makes my babies scream. Two of them, anyway.

About ten days ago, we noticed that Seal and Elephant (Babies A and C) were having a very hard time eating. At first, we thought it was just when they were nursing, but then we realized it was nursing or bottle feeding. It has never shown up in our Lion, baby B, who had NEC in the NICU, who was the "sick" one. He slurps down bottles, nurses like a champ and falls promptly back to sleep.

For the two experiencing the pain of reflux, it goes something like this:

Baby acts HUNGRY and roots around, opening mouth for a nipple of some sort. Is placed at the breast or given a bottle of breast milk, and latches on happily. Then, after a few swallows, Baby's eyes open wide and they begin to cry. Then, they make the saddest face ever and scream at the top of their lungs while arching their backs stiffly. Often, they are inconsolable, and we pace the house, holding them upright while they try to root around on our arm for some food. When we try the bottle or breast again, the whole thing usually starts over, but sometimes they've had enough of a break that they can keep eating. Sometimes, they exhaust themselves crying and fall asleep in our arms, only to wake up hungry again in an hour or so.

I talked with our pediatrician last week and she saw the babies to ensure there was not something else going on and put them on Zantac, the first line of defense of babies with reflux. (I should add that preemies are at a high risk for it, and that it often does not show up until the sixth week of life or so.) She said we'd give it a week and if it was not dramatically improved, talk about other options. Well, it got worse. The poor guys spent at least every other feeding crying so hard, while we did all the things we could to comfort them: feed them upright, give them little bits and breaks in between, hold them up after eating for about 30 minutes or more. Please keep in mind that it is usually two adults trying to manage this along with another baby and a three-year-old who would like some attention, thank you very much.

Our daughter, A, has already had a really hard time since the babies life-altering arrival (sibling post forthcoming), and she does not tolerate their crying well. Honestly, it is LOUD and stressful, and frustrating for adults, so I can only imagine how it makes her feel. When it first started, she used to ignore it, since it was for short periods, but now it can go on for an hour or more, and she often lets out the most highly pitched screams ever heard. Just in case we forgot about her, which we did not. Let's just say she is watching a lot of "Super Why" and "Sesame Street" right about now.

Yesterday, we decided to move on to Prevacid, the "big guns" in baby reflux, and hope it makes a difference. Their first dose was this morning, so we shall see if it helps. The pharmacist said we could see results in as little as a day. Their pain is so obvious, and I know that caring for one baby with reflux is challenging, without any other children or multiples in the house. I have cried with them many times.

Yet another reason why reflux is an asshole is it makes them unable to nurse when they are having a hard feeding. I have held them up in some crazy positions, which can help sometimes, but usually, I end up pacing the house with my breast hanging out, "shooshing" and trying to get them to latch on to me, a bottle, anything. The contrast between the two Reflux-y ones and Lion is that he never cries when he eats, nurses like a professional nurser, and is soothed by food. The other two are made worse by eating, which is the ultimate comfort and nourishment one gives a baby.

It is emotionally tiring to see our sweet boys suffering, and I am hoping with all hope they get some relief soon. All I want for Christmas is Reflux-Free Babies.*

*And three extra hours in each day, and exclusive nursers, and my body back. Just in case anyone has Santa's ear...

Look Who's Blogging

Hi! Remember me? I used to have endless hours laying on the couch with no one but my Bloggy friends and Wi-Fi to keep me company, and nothing to do but update my blog with frequent worries and musings. Not so with three precious newborns and a darling yet wildly jealous preschooler; the times, they are a-changing.

What do I do all day, you ask? Aside from the bit of sleeping, snacking and trying to spend some time with our daughter, I am doing two things:

... nursing (here is my view)



... and pumping.



This amazing contraption has given my babies an abundance of breast milk and allows me to pump in less time than if I didn't have a hospital grade model. I LOVE IT but sometimes, I wish the babies could take all they need without the seven times daily pumping sessions.

Without the unwavering support of my mom and husband, I would NOT be able to nurse and pump as much as I am. As of now, I make more than enough milk for the babies and have to freeze some each day, which is an awesome feeling. It takes about 30-45 minutes to work with one of the babies at each feeding and pumping is usually a 20-30 minute operation. Without my mom who does ALL the laundry and bottle washing and fixing, this would not be doable. Without my husband's commitment to breastfeeding, this would not be possible and I am very thankful to both of them. If I was alone all day or even most of the day, I would have thrown in the towel, I think. So the wonderful thing is I pump often and make a lot of milk for my boys.

The whiny, grass-is-greener thing: I wish they were ready to nurse exclusively, eat until they were full whenever they were hungry, and be able to tandem nurse. This is an unrealistic goal for many triplets at this age because despite their birth date being 6 weeks ago, they are 1 day old, adjusted, and have about the maturity of a baby born YESTERDAY. It is hard to not to rush the process and to trust that one day they will all be more efficient nursers.

I met with an amazing nurse lactation consultant from our NICU and she was incredibly encouraging. She gave me some wonderful tips on how to soothe the frantic baby who won't latch on, how to ensure they all get enough practice, but mostly, she cheered me on for the efforts and time invested and reassured me that in a few months, we should be where we want. Not only is it easier for me, but it should allow me to nurse two at once while one is given a bottle of breast milk, making it easier on the other adult here and certainly easier on my daughter. Also, less bottles to fill and wash and prepare, and less pumping for me! One of the most frustrating things is I have to go off to pump after a feeding, which is when the babies are most likely to be awake and extra cute.

As for my recovery, I was given the "green light" to exercise and the other things they "ok" at your six week visit today. I am thrilled that I can start Pilates and cardio (although these boobs preclude running!) because this body is flabby. Although I've only got 8-ish pounds to lose, the abs are stretched, the behind is saggy and I can't wait to feel some sore muscles after a good workout again. The effects of triplet pregnancy and months of bed rest need to be counteracted ASAP. I know the extra skin that is residing in my midsection needs a bit of time, but those transverse abdominal muscles better watch out- I am determined to flatten something out, and goodness knows, it will not be my breasts anytime soon.

My daughter and I brought a big box of homemade cookies and nuts that my mom and I have been working on to the nurses and doctors at our MFM clinic. We were met with lots of hugs and showed off pictures of the little guys. I spent so many weeks there, getting to know the sonographers and nurses, Dr. P and a few others, and it was bittersweet to say goodbye to them. We were all a bit teary, and we promised to bring the boys in when it is not 20 degrees in Seattle.

I remember feeling the same sadness about the graduation visit from the fertility clinic, but even more intensely because I know I will never be pregnant again. Just typing that makes me pause and swallow a lump in my throat. One would think that after a pregnancy like that, I'd be thrilled, and I am, mostly, but the feeling of my children moving inside me is one of the most magical and I will mourn the fact that I won't feel it again. Four children makes our family perfectly complete, but it is strange to know with certainty that we are finished having children since we have spent the last two years trying to bring one into the world safely. To switch from the trying-to-get pregnant mindset and the trying-to-stay-pregnant mindset to the no-more-children one is a shock to my heart, and requires some adjustment.

The boys! My love for each of them separately and the three of them together is more than I could have imagined. Their personalities are so fun to observe and without one of them, something would truly be missing. I am so thankful they are all safely here, growing and thriving.

As of last night (yes, I rented a scale):

Seal: 7 pounds, 6 ounces (CHUNK!)
Lion: 6 pounds, 7 ounces (my daughter's birth weight)
Elephant: 7 pounds, 3 ounces

Their growth is amazing everyone- all those cookies I am still eating are going to good use, I suppose. (That is what I tell myself at night when I have another biscotti.)

I promise another post within the week. What should I write about next? My mind is mush and I need prompting and direction!

1. The hardest part: my daughter with her broken heart and demon-like behavior
2. The boys' personalities and quirks
3. What our days and nights are like

I am getting good at typing/scrolling/reading while pumping, so I will try VERY hard!

Flying by the seat of my yoga pants

I cannot believe it has been so long since I've posted, but seriously... I am sort of busy around here. Life is wonderful and amazing with four children in our home! All of our boys are so very healthy and happy, and our three-year old is adjusting to the new life. My husband, mom and I are all getting used to sleep deprivation and wander around like cheerful zombies.

People have asked questions about life since our triplets' birth and I thought it might make a nice and organized blog post, since my mind is a bit mushy lately. A thoughtful narrative post will follow, most likely some time around the new year.

How is the Lion?

Our little Lion! He is an amazing boy whose body is healed, who astounded his doctor's with "the mildest case of NEC" they've seen. He managed to quickly recover, thanks to the highly skilled staff at the NICU. His seven days "NPO" (without anything by mouth) were brutal. Although he was getting IV nutrition, he cried often and his tummy was audibly rumbly. My mom, husband, mother-in-law or I always stayed the night with him while he healed. We never wanted him to feel empty and hungry and not have one of us there. While the Seal and Elephant were home (4 days before Lion), life was crazy! We only had two adults to do all the newborn preemie care and feedings and care for our daughter, while one of us was at the hospital. Thankfully, Lion was only a bit behind his brothers and after he was allowed to eat, he caught up so very quickly to them! Since he's been home, he eats like a champ with his brothers and is getting much better at nursing. He usually latches on and falls asleep, though, and requires foot-tickling and such to stay awake.

I know I will always watch him more carefully, paying special attention to his cries and behavior. I examine each diaper for traces of blood- I have no doubt this habit will go on for months. I promised him when he was in the hospital that he'd always have dessert first- he earned it during his days of being hungry. We could not be more grateful knowing that many babies are not so lucky and have major ramifications from this awful disease whose cause we know little about. Our Lion was a lucky boy, and we are so glad his body fought the infection with so much strength.

How big are the boys?

Lion is about 4 pounds, 14 ounces, Seal is 5 pounds, and Elephant is living up to his name at 5 pounds, one ounce! They've all had their first "well child" visit and their pediatrician is very pleased with each of their growth.

What is your day like?

Pull up a chair and grab a latte- this may exhaust you.

5 AM: Feed babies! My mom and I usually do this one together while my husband sleeps. It is a "super bottle" feeding where the breast milk is fortified with a preemie powder for lots of extra calories.

6 AM: Pump. I always have to wash one of my two sets of pumping parts after this. Our daughter usually wakes up in this hour, too.

7 AM: Make bottles for the day, do some sort of household chores. My mom is always on top of this, too.

8 AM: Feed babies! This time, we add vitamins and iron to a bottle of breast milk and I nurse one of the three. Depending on who is nursing, we have to give them a bit more breast milk in a bottle.

9 AM: Pump. Play with our daughter if she is not at school.

11 AM: Feed babies! A super bottle again, and I nurse one.

12 PM: Pump. Household stuff or play with A.

2 PM: Lunch for the people in the house over a month old, if we are lucky. Usually a handful of trail mix or veggies and hummus. (In fact, I just found a cashew in my bra.) We tend to graze when we feel like we might pass out.

5 PM: Feed babies! Again, a fortified bottle for two and I nurse one.

6 PM: Pump.

6:30 PM: Dinner. If we have time. We always feed A, though, so don't worry.

8 PM: Feed babies! More vitamins and iron and I nurse one.

9 PM: Pump.

10 PM: Go to bed.

11 PM: My husband and my mom do this one while I sleep unless A wakes up (as she has been) or I am needed.

2 AM: Feed babies!

3 AM: Pump.

5 AM: Return to beginning and repeat!

This is infinitely easier when we have an extra adult (besides my mom and I) so when my husband is home, it is much better, and my wonderful mother-in-law was here for a week, but for the most part, we will be on our own. My sister-in-law will be here for five days later in the week and that is the end of our "planned" helpers. Then we will be at the mercy of our friends and family who will come help feed, hold a baby, play with A or fold laundry.

How goes breastfeeding?

It is a wonderful joy to feed my babies from my body. When A was an infant, I struggled to get her to latch on, and used a nipple shield for a couple months, then nursed her for 15 months. I loved every nursing session with her and do not think I ever felt closer to her. The initial frustration of trying to get her to latch on, stay awake and eat enough so that she was not hungry again 90 minutes later felt like it would never get better. Slowly, her latch improved and she was able to eat more quickly with less fuss.

In the hospital, I was able to nurse the boys for a maximum of 3o minutes, and they were weighed before and after each feeding. Sometimes they got their whole feed, sometimes only a few CC's. Through all of it, I have pumped every three hours, around the clock, telling my body to make enough milk for three. So far, I am able to keep up with what they need, as long as I drink insane amounts of water and take Fenugreek to boost the supply a bit. It is not my favorite pastime, pumping, but I am figuring out the tricks and am usually able to pump 5-6 ounces per session, for about 40-50 ounces per day.

Trying to give each boy a good chance to nurse and help them "learn" to latch on, stay awake and take in enough are similar problems to how my daughter's nursing began. However, then I had ONE baby to teach and work with and I would put her to the breast about every 2 hours during the day. She had many more chances in 24 hours than her brothers do. I try to nurse one baby at almost each feeding (the nights I don't) and then sometimes they need a bottle of breast milk to finish. Seal could just nurse, I am convinced. He latches on without the shield and does a great job of getting my milk to let down. Lion, who does not latch well, is the most efficient eater and is usually done very quickly. Little Elephant has the hardest time latching on and gets frustrated. I just keep working with him until he is latched, but he is often wiped out after all the efforts and doesn't get much milk since he passes out quickly.

Ultimately, my goal is to nurse two at once at each feeding while the third one gets breast milk in a bottle (or formula if necessary) and right now that feels so very far away. I know it's ambitious to expect a preemie to "get it" so quickly, so I try to take heart in what both my pediatrician and lactation consultant said: That (a) they will be much stronger nursers by their due date and (b) the most important thing is to give each practice while maintaining my pumping schedule. I just expected it to come more quickly and for it to be easier to get them off of so many bottles. A very small concern compared to what can happen with preterm triplets, but it is something that is a very important goal for me. The always-wise Dr. Sears says in his “Premature Baby” book that to teach preemies to breastfeed, you need the two P's: Patience and Perseverance. I think he is right once again.


Here are a couple of pictures of our trio, settling in at home.

Snuggled in their Boppies; second favorite only to being held.



Thirty toes!

Madly in Love!

Thank you so much to my husband for being the guest blogger to let everyone know that the babies have arrived! He claims that those posts had the most comments because of his superior blogging skills, but I pointed out it could've been the news he shared: our sons are here, and they are doing marvelously!

The short version of how our boys came a few days before their "scheduled" day is that I had gone to see Dr. P for my last ultrasound and was miserable. I had woken up that day in so much pain, and had not slept in a week. The contractions were harder to control at home and I just felt off. Thank goodness my husband decided to drive me to this appointment. When Dr. P saw me she said, "Something is different!" I told her how I'd been feeling, and the boys took a while to pass their BPP's so I was worried about them. She found that I was starting to have protein in my urine and sent me over to triage for an NST.

The contractions showed up right away, and I took a hefty dose of Nifedipine after Terbutaline. They slowed for about 10 minutes and picked right back up, stronger than ever. My body was in real labor that did not want to stop, and Dr. P felt there was no need to put us all through even heavier meds, monitoring and possibly an emergency C-section, so we decided that since I hadn't eaten much, she would deliver them that night. While I was "prepped" I had regular and painful contractions and was surprised to have to recall my labor breathing from our daughter's birth. We were thrilled! And terrified!

A mad dash ensued to find a way for my mom to attend the birth while our dear friend and my brother cared for our three year old daughter. My mom arrived with many bags of things I spouted off between contractions and we all prepared to meet our sons. I looked at my husband and asked if he remembered the feeling of falling completely in love when we'd met our daughter. He said, "Of course! And we get to do it again ... " I wished I had kissed our daughter before I left the house, held her tighter for a minute because I did not know it was the last time I would see her as my only child.

All the preparations were in place and I walked into the operating room, was numbed and in seconds, it seemed, Baby A was out and screaming. I heard myself say, "OH! You are here!" and cried while his brothers emerged shortly after. I watched them all be examined, and have wonderful reports shouted from the NICU nurses and Dr. C, the neonatologist. He kept saying, "They are so healthy and beautiful!" and they all hit the four pound mark. They were taken to NICU with my husband and I was wheeled to recovery with my mom, and we stopped to see our beautiful boys being checked out further. Someone told me they all got APGARs of 9/10, and needed no help breathing. I was put into my room and after a couple of hours of begging to be let up, off my IV's and meds, they let me be wheeled in to see our little men.

They were in radiant warmers, not isolettes yet, and I was able to touch each of them, smell their intoxicating baby smell and tell them how long we'd been waiting to meet them. I started getting pretty sick from the Morphine and had to go back to my room for the night. I pumped three times that night and had the nurses deliver the colostrum to the babies even though their feeds did not start until the second day. I was very proud of having something for them already. My husband stayed mainly with our sons and my mom was in and out before she went home to see our daughter, the big sister to three.

The next day they were put into their isolettes, received IV nutrition and monitored closely. No one has needed any help or interventions- no episodes of apnea or bradycardia, no need for medications or extra tests. After that they moved to feedings through their NG tubes, and the next day from the breast! They all practiced nursing while a nurse would squirt their bit of colostrum into the corner of their mouths. Now they all are able to take a bottle or nurse a bit, though we still put their feeds down their tubes to help conserve energy. Breastfeeding uses more calories and energy than bottle feeding or getting a feed through their NG tube (a tube that runs into their tummies) so we are only allowed three feeds a day at the breast right now. It is more than I had hoped for and I am thrilled to nurse them and say they are only getting breast milk. I have been pumping about every 3 hours and am producing 30+ ounces of milk a day for them. WOO HOO!

They are currently under phototherapy lights for jaundice but their levels are down already and they'll be out tomorrow. When they are under the lights, the time they spend "out" being held or nursed is strictly limited, so no extended cuddling sessions, which we hate. We cannot wait to have them be able to look around again, without their masks (protect their eyes from the lights) and able to be kangarooed for long stretches. Their IV's should come out tomorrow also since they take all their feeds orally or through their tubes. Next steps: maintain their temperatures and get into an open crib together and take all feeds orally.

We know everyone wants to hear when they'll be home. The answer: we wish we knew! They will most likely come home in about 2 weeks or so, but it could be sooner. It could be together or staggered, they might have something come up that delays them, or they could jump ahead. We just do not know, and that is the hardest part.

The recovery from the C-section is no fun at all, but I am amazed at how much better I feel each day. I was eager to get up and walking, and managed to get myself discharged early so I could be with the babies more. The nurses could never find me since I was always in the NICU anyway, so they had the doctor discharge me. The biggest hurdles are the lack of abdominal strength and just being swollen and tired. The incision does not hurt much at all.

The side effect of producing lots of breast milk for my sons is engorgement, sore nipples and general breast pain. I kind of look like Dolly Parton, with the added ability of shooting milk across a room. I am so lucky to have a good supply, but I am sort of chained to my pumps (one at home and one in the boys' room) and it is not nearly as appealing as snuggling a little baby.

My schedule is tough, but do-able and SO worth the exhaustion. I cannot wait to see them each day but miss their sister so very much when I am away. My husband and mom spend so much time with our daughter and are both very present in the boys' care. I can't stress this enough: without "Gramma", we could not do this well!

6 am: Pump and shower
7:15 am: Leave for the hospital
8 am: Nurse the boys, snuggle for a minute, help do their "cares"
9:30 am: Pump, pack up to go home
10:30 am: Hang out at home with A
12: 30 pm: Pump, eat lunch
1:15 pm: Leave for the hospital
2 pm: Nurse the boys, snuggle for a minute, help do their "cares"
3:30 pm: Pump, pack up to go home
4:30 pm: Do something with A, help at home
6:30 pm: Pump
7:15 pm: Leave for the hospital
8 pm: Nurse the boys, snuggle for a minute, help do their "cares"
9: 30 pm: Pump and go home for the night. Discuss the plan for the evening with the nurses before leaving.
11:00: Go to bed
12:30 am: Pump
3:30 am: Pump
6:00 am: Start again!

(I may need to print this so I know where I am supposed to be!)

And now ... I must go sleep a bit. I will leave you with this cutie pie picture of our little guy getting phototherapy. I cannot wait until their masks come off and we can see their gorgeous eyes again! I will try to update more frequently, and I am sure when I buy a hands-free pumping bra that I will have much more time with my lap top. I cannot wait to share about each of their personalities and the sweet things they do as well as how AMAZINGLY their big sister is doing. (She told us she'd like an isolette from Santa for her baby dolls for Christmas.) I could also write a ten page post on the range of emotions I am feeling right now, from downright euphoria to hysteria and anxiety. Ahh, the postpartum period.



Thank you for all of the congratulations and well wishes. We are so very, very blessed and we know it. Falling in love with three precious boys is just as amazing as it sounds.