IF ALL BABIES REMAIN WITH YOU in the hospital GETTING STARTED IN THE HOSPITAL With the excellent prenatal care that is Fortunately, these premature feeding Specific guidelines for starting to breastfeed available today, many twins and triplets are behaviors are temporary and will correct or for expressing your milk will depend on born after 34 weeks of gestation and weigh themselves as your babies approach their the condition of your newborn babies and at least 4½ to 5 pounds at birth. These larger expected birth dates. Until that time, you your breastfeeding goals. Whether you have premature babies are often healthy and do may need to provide some feedings of your twins, triplets, quadruplets, or even more not need to be admitted to the NICU. If this milk by bottle or another method, or use a babies, your situation will fall into one of the is true of your babies, they will remain with small, ultra-thin silicone nipple shield while SECURING A BREAST PUMP FOR following categories: you for feedings. Remember, though, that if breastfeeding. You will become aware of IN-HOSPITAL USE your babies are born 2 weeks or more before more mature feeding behaviors as your When you discuss your breastfeeding plans • All of your babies are healthy or just their expected birth date, they may not babies begin to awaken regularly, feed with your health care professionals and the slightly premature. They remain with you breastfeed as consistently, frequently, or eagerly, and take enough milk before falling lactation specialist, ask that a hospital-grade after birth, and are not admitted to the effectively as full-term babies. For this asleep. In the meantime, you will need to use electric breast pump with a double neonatal intensive care unit (NICU) reason, they may not provide the stimulation an electric breast pump in addition to collecting kit be put in your hospital room • All of your babies are premature. that your breasts need to produce enough breastfeeding to maintain your milk supply. after you give birth. You will need the They are admitted to the NICU milk for more than 1 baby. You will need BALANCING MILK EXPRESSION breast pump even if your babies are able to • One or more of your babies is in the NICU. special breastfeeding strategies for these AND BREASTFEEDING feed at the breast. If the hospital cannot You have the other(s) with you in your premature babies. To provide enough breast stimulation during provide a pump for your own exclusive use, hospital room and/or at home Although each situation will be a little the first week after birth, ideally each baby then you may want to arrange to rent an different, here are some guidelines to get you should feed actively at least 8 times a day for electric pump and take it to the hospital with started in the hospital if your premature a minimum of 10 minutes at each feeding. If you. babies are healthy and remain with you. 1 or all of your babies cannot do so, use the It is very important for a pump to be electric breast pump to “make up” for those available so that your breasts can be PREMATURE FEEDING BEHAVIORS feedings. Your priority should be to stimulated and emptied every 2–3 hours AND MILK VOLUME establish an adequate milk supply with during the first few days after your babies Healthy premature infants who do not the pump. Then you will have plenty of are born. It is a good idea to learn the require NICU admission typically do not milk by the time your babies are able to principles of how the breast pump works wake at regular times to feed, may suck feed well at the breast. Another family before your babies are born. However, weakly for only a few minutes, and may fall member can give any milk that you express you should not try to use the pump on asleep at the breast before they take enough to your babies, or it can be frozen and used yourself before you deliver, because this milk. If this is the case with any of your later. could cause contractions and bring on babies, you cannot rely on their sucking early labor. Ask a nurse or the lactation alone—especially in the early days of birth— specialist to show you how to assemble and to build an abundant milk supply. That is position the pump correctly. Make sure that because each baby is not emptying your another family member or helper knows breasts frequently and completely, and your how to operate the pump as well. You may body will not get the message that milk is need help holding the pump at one breast needed for more than one infant. while you feed a baby at the other breast. 56 57