With multiples, it is important to GETTING ENOUGH MILK AT THE BREAST remember that there is no right or wrong Here are some suggestions for easing any concerns you have about producing enough breast way to combine bottle feedings and milk for more than 1 baby. breastfeedings. For example, if a Keep a record breastfeeding mother of twins uses a bottle, it is usually before she has mastered feeding Parents report that keeping a daily record of milk intake, wet diapers, and bowel movements both babies at the same time. Until then, she for each baby is very important, at least for the first few weeks at home. In general, each baby can often express milk for bottle feedings so should feed at least 8 times a day, have a wet diaper with each feeding, and have at least 1 she can get an uninterrupted stretch of sleep, bowel movement each day. or so she can spend extra time helping 1 baby Since it is difficult to remember these things for each baby, simple checklists will help you breastfeed while someone else gives keep track of them. It is a good idea to take these records along when your babies visit their the other baby a bottle. health care professional for checkups. Several parent organizations for multiple babies have Parents of triplets often elect to breastfeed 2 sample forms that they are willing to share. (See the Appendix for more information and a infants at the same time while the third baby blank breastfeeding log you can copy and fill out.) bottle feeds. Feedings by breast and bottle are rotated so that each baby receives 2 out of 3 feedings at the breast. DATE NAME DATE NAME 5/ 7/ 0 Charlie Jones 5/ 7/ 0 Jess Smith Time Feeding Weight (g) Intake Urine Stool Time Feeding Weight (g) Intake Urine Stool In 1 family, triplets were breastfed description start/finish amount description start/finish amount exclusively during the day, and were given 6:00 AM BO (MM) 2098 / 2155 2 oz. X O 6:00 AM BR 2296 / 2353 2 oz. X X bottles at night because the parents said it 7:00 AM / 7:00 AM / 8:00 AM / 8:00 AM / 9:00 AM BR 2102 2154 2 oz. X X 9:00 AM BO (MM) 2300/ 2363 2¼ oz. X O was faster. The mother used the breast pump had much more milk than 2 babies could / while her partner fed a bottle of expressed 10:00 AM / 10:00 AM / consume, and she found that it was easier 11:00 AM / 11:00 AM / milk to 1 baby. Then they each gave a bottle 12:00 PM BR (hind) 2106 2169 2 oz. X O 12:00 PM BR (fore) 2305/ 2362 2 oz. X O not to keep a schedule. She breastfed as / of the freshly pumped milk to the second 1:00 PM / 1:00 PM / and third. often as she could, and expressed extra milk 2:00 PM / 2:00 PM / for bottle feedings when her babies all slept 3:00 PM BR (fore) 2110 / 2175 2 oz. X O 3:00 PM BR (hind) 2309/ 2366 2 oz. X X 4:00 PM / 4:00 PM / Another mother elected to breastfeed her for an extended stretch of time. Each day her 5:00 PM / 5:00 PM / triplets only as frequently as she would feed breastfeeding pattern was different, and she 6:00 PM BO (F) 2114 / 2171 2¼ oz. X X 6:00 PM BO (F) 2314 / 2371 2 oz. X O found this to be the simplest approach. 7:00 PM / 7:00 PM / a single infant. So she breastfed each infant 3 8:00 PM / 8:00 PM / to 4 times a day, for a total of 9 to 12 feedings 9:00 PM BR 2118 / 2175 2 oz. X O 9:00 PM BO (mm) 2327 / 2393 2½ oz. X O at her breasts. Bottle feedings of formula 10:00 PM / 10:00 PM / 11:00 PM / 11:00 PM / were given at other times. 12:00 AM BO (mm) 2126 / 2183 2 oz. X O 12:00 AM BR 2330 / 2394 2¼ oz. X O 1:00 AM / 1:00 AM / A mother of quadruplets planned during her 2:00 AM / 2:00 AM / 3:00 AM BR 2126 / 2183 2 oz. X O 3:00 AM BR 2338 / 2395 2 oz. X X pregnancy to feed 2 babies at the breast and 4:00 AM / 4:00 AM / 2 with a bottle of formula at each feeding. 5:00 AM / 5:00 AM / However, once all the babies were home, she 64 65