Mothering Multiples: Breastfeeding and Caring for Twins or More!
Karen Kerkhoff Gromada, MSN, RN, IBCLC, has transformed this La Leche League International bestseller into a comprehensive collection of wisdom for today's new mothers. She offers invaluable information for parents of multiples with an emphasis on breastfeeding and attachment-style parenting and answers such questions as: What are the risks of a multiple pregnancy? What can a mother do to avoid complications and carry her babies to as close to full-term as possible? How can a mother prepare...
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Karen Kerkhoff Gromada, MSN, RN, IBCLC, has transformed this La Leche League International bestseller into a comprehensive collection of wisdom for today's new mothers. She offers invaluable information for parents of multiples with an emphasis on breastfeeding and attachment-style parenting and answers such questions as: What are the risks of a multiple pregnancy? What can a mother do to avoid complications and carry her babies to as close to full-term as possible? How can a mother prepare herself and her family for a multiple birth? Is it possible to breastfeed multiples? What does a mother need to know in order to breastfeed more than one baby? What if the babies are born prematurely? Can they still receive their mother's milk? How can a mother continue meeting her babies' needs if one or more experiences an illness or needs to be hospitalized? Are there ways to cope with breastfeeding challenges in one baby while continuing to nurse another baby? What can a mother do to comfort two or more fussy babies? How can parents of multiples get enough sleep? What kinds of clothing and equipment are needed for multiples? How can a mother adjust to the physical and emotional demands of caring for multiple babies? What about the adjustments needed by the babies' father and any older siblings? Are there ways to manage the household that will help a mother of multiples find some time for herself? What are the challenges of caring for toddler multiples?
Introduction xiAcknowledgements xiiiIt's Twins, Triplets, or More 1Twin TypesYes, It's Really Twins (or More)Health Care with MultiplesMultiple Pregnancy as High Risk: Fact and Fiction 7Maternal StressorsInfants' StressorsThink PositiveImproving the OddsMultiple Pregnancy: Caring for Three, Four, or More before Birth 11A Good DietNutrition HintsTaking Charge in Other WaysWhat to Do If... 23Signs to Watch and ReportFetal Well-BeingDiagnostic Testing during Multiple PregnancyMaternal IssuesPreterm DeliveryGetting Ready to Breastfeed Two, Three, or More Newborns 35Advantage of Breastfeeding MultiplesBreastfeeding GoalsAdditional Tools for Mapping Your RouteGetting Ready: Birth Preparation 43Preparation for BirthPregnant MemoriesGetting Ready: Preparing for Multiples 51Pediatric CareBaby Names x 2, 3, 4 +Household HelpEmployment IssuesHappy Birthday 59LaborVaginal BirthSurgical (Cesarean) BirthHospital Routines and First Stage InterventionsLabor Induction & Augmentation (Acceleration)Labor MonitoringAnalgesia/AnesthesiaSecond Stage Interventions"Assisted" Vaginal DeliveryThird Stage of LaborBeginning Breastfeeding 73During the Hospital StaySupplementing or Partial BreastfeedingBreastfeedingafter Surgical BirthOther Maternal Conditions Affecting Breastfeeding InitiationPain MedicationWhen One (or More) Cannot Yet BreastfeedMultiples in the Newborn Intensive Care Unit 85In the NICUParents' RoleWhen Babies Are SickGetting Ready for DischargeBreastfeeding in the Newborn Intensive Care Unit 95Your Milk for Your BabiesExpressing Your MilkBeginning BreastfeedingIncreasing BreastfeedingMaking Up for a Poor Start 115Keeping Babies Healthy While Increasing Milk ProductionFor Effective BreastfeedersWhen One (or More) Has a Feeding DifficultyAlternative Feeding MethodsAdditional TipsAs Each Baby ImprovesEffective Breastfeeding 129Establishing and Maintaining LactationFeeding BehaviorsTypical Feeding Patterns for Effective BreastfeedingCoordinating Feedings 137Feeding RotationFeeding Routine vs. ScheduleSimultaneous "Twogether" FeedingsGetting ComfortableOther HintsBreastfeeding Difficulties in Young Babies 151Difficulty Latching On or SuckingProblem-Solving IdeasWeight Gain IssuesWhen Mother Has a Breastfeeding Difficulty 161Sore NipplesEngorgementInsufficient Milk ProductionFlat or Inverted Nipple(s)Plugged Ducts and MastitisOverabundant Milk ProductionForceful Let-Down/Milk-Ejection ReflexMaternal IllnessAvoiding Problems During a Hospitalization 185Exploring OptionsEmergency SituationsFull and Partial Breastfeeding 191Breastfeeding DefinitionsPartial BreastfeedingFull Breastfeeding as a GoalPartial Breastfeeding as GoalHuman-Milk-FeedingBreastfeeding Multiples When Mother Is EmployedLower Milk ProductionBreastfeeding Only OneEarly WeaningEnhancing Individuality 209Attachment to Each BabyOther FactorsUnit ThinkingHelping the Attachment Process AlongComforting a Fussy Baby x 1, 2, or More! 219General CausesPhysical CausesSurvival TipsThe High Need Multiple and Maternal GuiltGetting Enough Sleep 237Sleep DeprivationEncouraging SleepSleep ArrangementsMother's Sleep StyleDad's InvolvementWhat You'll Need 249DiapersClothing or LayetteBreast PumpsCar SeatsBeddingMultiple StrollerBaby CarriersOther EquipmentEquipment Use vs. OveruseGetting Out and About 261Be Prepared for Going OutAdditional Safety PrecautionsFor Mothers Only: Adjusting to Multiples 267A New RoleDeveloping a RoutineThe Myth of the SuperMomMothers Are Not All the SameTake Care of YourselfSelf-Esteem IssuesIsolationBeating the Blues: Postpartum Mood DisordersAdjusting as a Couple 289BreastfeedingTime TogetherOlder Siblings of Multiples 297Instant CelebritiesBehavior ProblemsSibling ReactionsStreamlined Housekeeping 305Meeting Infant Developmental NeedsHousehold ManagementBreastfeeding, Starting Solids, and Weaning 313Starting SolidsSigns of ReadinessVitamin and Mineral SupplementsOrganizing MealtimeMeals Are a Social TimePicky EatersBreastfeeding Older Babies and Toddler MultiplesChanging Breastfeeding PatternsBitingNursing StrikesFor Multiples OnlyWeaningMother-Guided WeaningPartial WeaningAbrupt WeaningOlder Babies and Toddlers: Childproofing and Helpful Equipment 337Safety and Childproofing for Older BabiesHelpful EquipmentOut and AboutChildproofing for Very Mobile Toddler MultiplesBasic ChildproofingIndoor SolutionsMultiples' BedroomKitchenOutdoor SolutionsParenting Toddler Multiples 357Multiples' InteractionsToddlers' TemperamentsToddler Activity LevelsHigh Need Flip-FloppingDiscipline of MultiplesModels of BehaviorStrategies That WorkStrategies That Don't WorkOther Toddler IssuesNight WakingBrief SeparationsPotty/Toilet LearningA Need for SupportResources 385Appendix 405Photo Credits 419Index 421About La Leche League 432
