Happiest Mommy EVER

I have so much to write about our adventures in breastfeeding over the last month. For now, I just have to share with you this:

The boys are all breastfeeding on demand, without any bottles all day!



You may be wondering how they got to being able to get all they need every three hours from nursing. The answer: they didn't! I gave up on that unnatural schedule and am feeding them when they are hungry, two at a time, for hours on end sometimes. They are simply not ready to nurse every 3 hours, so I am following their lead. Today I think I nursed each about 9 or 10 times ... but sometimes it was in tandem. I do not need to pump as often, and I am having the wonderful experience spending more time with my children and less time with my pump.

There is so much less crying (by them AND me) and much more bonding time. They nurse happy, smiling and cooing. I feel the same way.

I will write a detailed post about how we came to this awesome place despite our major setbacks and roadblocks. I feel so lucky to have all the support of nursing friends, experts and other triplet moms. I have learned more about the way the body makes milk, keeps a supply and the way babies, especially preemies, nurse since the boys were born. I am one of the lucky few who can, with effort, make enough milk for all my babies.

I have not felt this good in MONTHS. It feels so frustrating to know where you want to be but not be able to get there, and that is what the last weeks have been full of. Little progress, frustration by all and lots of crying on my part. What it took ultimately, was time, persistence
(bull headedness?) and support. We are here!

Details to come if there is interest!

The boys' other favorite new pastime is touching hands.

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.):

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.