The Truth About Triplets : A risky pregnancy is only the first challenge. Just try feeding--or diapering--3 babies at once.

By ELIZABETH MEHREN

Oct. 4, 1992 12 AM PT

TIMES STAFF WRITER

SUMMIT, N.J. —

Three-and-a-half-year-old Frankie Walter has become so accustomed to the expressions of amazement he encounters on family outings that he now offers a stock response.

“Yes,” he chirps, often before those who are staring can compose themselves, “we are quite a handful.”

Such is the scene when the Walters--Frankie; his parents Deborah and Ralph; and the 2-year-old triplets, Michael, Mollie and Richard--venture out of their Victorian house here. Whether at a mall, a McDonald’s or the main street of this New York City suburb, four children under the age of 4 make them a kind of de facto road show.

Upbeat articles in women’s magazines traditionally portray the parenting of triplets as a nonstop barrel of laughs. Multiples are sometimes referred to as blessings from an especially generous God. And in photographs, the mothers always look sort of saintly and well-groomed, as if they had had their hair styled shortly before being beatified.

Deborah Walter, 37, would be the first to agree that having three healthy babies at once is a miracle. But, as she and other triplet moms point out, it is also a formidable challenge, with responsibilities and a workload no mother of children born singly could fathom.

The pressures and the demands accrue exponentially, Walter says, starting from the moment she realized that one baby-sitter just wouldn’t do the job and almost no living mortal she knew of could possibly afford two.

“It’s a triple blessing, no question about it,” she says. “But it’s also a triple whammy.”

To accommodate their brood, the Walters had to buy a new, extra-wide van. Car dealers could only roll their eyes, Ralph Walter remembers, when they showed up with four car seats. Their kitchen has an assembly-line quality, with high chairs queued up like a day-care center. Three cribs take up an entire wall of the bedroom the triplets share.

Every night after the baby-sitters have gone home, and after their children have gone to bed, Ralph and Debbie Walter sit at their kitchen table and fold laundry.

Separating socks, Ralph, a New York architect who will turn 40 on Christmas Day, says that having triplets has redefined the word normal. They are used to tripping over tricycles (four of them), and realize that many projects that they had looked forward to, such as renovation of their house, will just have to wait a decade or so.

With three 2-year-olds bobbing and babbling in a triple stroller known as The Tank, the Walters find that they are the objects of enormous curiosity and attention.

The family has become inured to what they call “triple takes”--open-mouthed astonishment accompanied by remarks so predictable the Walters have memorized them.

“Very often you hear something like ‘And I thought I had it bad,’ ” says Debbie, who returned to work at an international women’s organization in New York when the triplets were 18 months old.

“Or you hear, ‘My cousin is having twins next week, and seeing you gives us hope.’ A lot of people say, ‘What a beautiful family!,’ or ‘You’re so blessed,’ ” says Debbie. And people who don’t have the nerve to ask about fertility drugs inquire: “Do multiples run in your families?”

But mostly, the Walters hear: “Oh my God.”

That was basically the reaction of Ralph and Debbie when three heartbeats flashed onto the sonogram screen six weeks into her second pregnancy. Debbie was 35, and, like many of the growing number of mothers who are conceiving what are euphemistically known as “large multiple pregnancies,” she had taken Pergonal (a drug that enhances ovulation) to increase her chances of becoming pregnant.

Debbie had also taken fertility drugs before her first pregnancy. When Frankie was conceived after years of treatment, even the doctors were mystified about what had gone right.

So the news that she was carrying triplets was overwhelming.

“I was just stunned and overjoyed,” she remembers. “I had a hard time believing I was pregnant, much less with three babies.”

Reality set in soon enough, as her doctors bombarded her with facts about multiple births.

* Presumably because of the increased use of fertility drugs and improvements in prenatal care, the number of triplets born in this country in 1989 (the most recent year for which there are statistics) increased 17% over the previous year, the National Center for Health Statistics reports. Twin Services, in El Cerrito, Calif., says the incidence of triplets nationally has increased by 49% since 1979.

* The average gestational age at delivery for triplets is 33.8 weeks, compared to an average total of 40 weeks in a singleton pregnancy. Premature labor--labor before the 37th week of gestation--occurs in 68% of triplet pregnancies.

* Almost 90% of triplets are born weighing less than 2,500 grams, or 5 1/2 pounds. But with three such babies inside her, a woman carries an average total fetal weight of 13 to 15 pounds. Caesarean sections occur in 98% of triplet births.

* Since prematurity is common, so are developmental delays as the children grow older. Perinatal mortality--or death at the time of, or soon after birth--also occurs more often in multiple births.

“The human female is most successful when carrying only one child,” according to Dr. John P. Elliot, a perinatologist in Phoenix. Multiple gestation, says Elliot, “increases the risks of a less-than-perfect outcome.”

To Elliot, the most important thing a mother of triplets can do is “realize the seriousness of the situation.”

One option doctors often mention to parents who have conceived large multiple pregnancies is selective termination, in which some of the early gestation ova are aborted. Using selective termination, for example, a quadruplet pregnancy can be reduced to triplets, twins or even a singleton.

For the newly pregnant woman, the barrage of possibilities can be dizzying.

Debbie Walter, for example, never even got a chance to get up from the examining table before she was deluged with data.

“At the same time that I’m being told I’m pregnant, I’m being told about selective termination,” Walter recalls. “I didn’t have time to enjoy the first part before I had to start thinking about the second.”

Elizabeth Noble, the founder of the Maternal and Child Health Center in Cambridge, Mass., cautions that the very manner in which the news of a multiple birth is delivered can set the tone for the entire pregnancy.

“It’s such a bombshell, particularly where you’ve been dealing with infertility,” said Noble, who is the author of “Having Twins,” one of the main manuals of multiples. “You’re going from famine to feast.”

Noble directs much of her advice to medical practitioners. A mother should be informed that she is carrying a multiple pregnancy “while she is sitting in a chair, not standing up,” Noble says. “There’s a real danger that her knees may buckle, or that she may pass out.”

In any case, she adds, “she should not leave the doctor’s office without the phone number of another mother of multiples. It is absolutely essential that day that she knows there is support.”

Ten years ago, when Janet Bleyl of Stockton became pregnant with identical triplet boys, organized support for mothers of multiples was virtually nonexistent.

“I was completely uninformed about having multiples, and so was my doctor,” Bleyl says. The three boys, now 9 1/2 and “absolutely wonderfully healthy” were born 10 1/2 weeks prematurely, and spent several months in an intensive care unit.

When the babies finally came home, Bleyl says, “it was a nightmare. Three babies crying at once. Three babies sick at once. Three babies needing to be changed, all at once.”

A rocky first two years with Jacob, Joseph and Jonathan--”they were sick more than they were healthy”--convinced Bleyl that mothers of multiples could find comfort in numbers. In 1983, she founded the Triplet Connection, a nonprofit support service that has served as a resource for more than 7,000 families that have given birth to triplets, quadruplets or quintuplets. More by default than by design, Bleyl says, the Triplet Connection has assembled “the largest database in the world of medical information about larger multiples.”

Bleyl says the reaction of parents who learn that they are carrying triplets “varies enormously. Some are so ecstatic. Others are horrified, or scared to death.” For almost everyone in this situation, she says, “the question is ‘How, how, how are we going to get through this? How are we going to take care of all those babies at once?’ ”

In the Long Island community of Brentwood, N.Y., Maureen Boyle says her doctor was as baffled as she was in 1987 when she ballooned up early in her pregnancy. “I was so huge that my doctor assumed that my dates (of conception and projected delivery) were off,” Boyle says.

Boyle, who was 27 and who already had a 2-year-old daughter at the time, had conceived triplets spontaneously. Although she was married to a surgeon, “I didn’t know any better, so I didn’t even see a high-risk obstetrician.”

With no specialists to advise her about a group like the Triplet Connection, Boyle says the pregnancy was lonely and tense.

“We had very little support, and from everything we read, we just thought there was no way on Earth that we would have three healthy babies,” Boyle says. “I swore that if I ever knew of anyone else who was having triplets, that I would help her, and tell her what I went through.”

Boyle’s triplets--identical boys, Brendan and Patrick, and daughter Nora--came after 32 weeks of gestation. By triplet standards they were large, well over 4 pounds. But still they spent 18 days in isolettes, and both boys had lung problems.

Boyle began networking with other parents of multiples, and before long, she and six other parents had organized a group called MOST, or Mothers of Supertwins. With about 300 families nationwide, Boyle’s group focuses on issues pertaining to multiples that begin with conception and continue to school age.

“I had a really difficult time with our sort of notoriety in our community,” Boyle says. “Every other mother of every other 18-month-old could go out without lipstick, but if I went out looking less than perfect, people assumed I was coming apart. How I looked, also how I was rearing my children, became the object of great public scrutiny.”

Having survived the challenge of breast-feeding--”three babies, two breasts, two arms, you try it”--and the riotous adventure of group potty training, Boyle encountered a new set of obstacles when her children were ready for preschool. Many educators, she found, want to place children from multiples in separate classrooms. But with triplets, this is not always possible.

Her three ended up in the same preschool class. Neither the teachers nor the other students could tell the two boys apart, so after a few weeks of school, the boys began to believe that they were one child named Brendanpatrick.

“It’s three times as crazy-making, no question about it,” Boyle says. “But then there are other times when you just can’t believe these three little bodies came out of yours.”

Charlene Guasch, co-founder of M.O.M. (Mothers of Multiples) magazine, in San Carlos, Calif., contends that complications associated with raising multiples have little in common with the vagaries of rearing single children.

“You read all this material and it’s geared toward singletons,” says Guasch, the mother of 4 1/2-year-old identical twin boys. “You try to put it into practice, and it just doesn’t work.”

But if middle-class multiple mothers with access to publications like Guasch’s quarterly magazine have difficulties, Pat Malmstrom admonishes, imagine the dilemma of the low-income mother of multiples. Malmstrom, of El Cerrito, Calif., is the mother of 19-year-old identical twin girls. She is also the founder of Twin Services, a hot line and support program that makes a special effort to provide outreach for low-income families of multiples.

“You see all these ads with three beguiling little blond, blue-eyed babies, and that reinforces the idea that all multiples are affluent,” she goes on. “They aren’t.”

With all the statistics about multiples, “one tragic, but little-known fact is that families with multiple births are at nine times greater risk for child abuse” than families of singletons, Malmstrom says.

“And it’s all because the stress is so much greater.”

For Sherry Fields Tulido, a “triplet consultant” in New York City, managing the attendant pressures of bearing three babies at once has become a full-time career. Tulido begins by assuring her pregnant clients “that it really is special to have triplets, that they’re lucky and it is a miracle. I can say that, because I really mean it.”

Then she reveals her system for managing triplets--a schedule that makes Marine training look relaxed. She begins by explaining her “very strict” feeding regimen.

“I tell them that if you have three babies and feed them on demand, you’re talking about spending 21 hours a day just on feedings,” Tulido says. “Then I show them how they can do it all at once.”

Under Tulido’s tutelage, “most of my babies sleep through the night by the time they’re 6 or 8 weeks old.” For the frazzled new parents, “this means they can take a shower.”

But even with such a rigid, hyper-organized approach, Tulido concedes that “no one says it’s easy, just that it’s manageable. What I give people is information, a routine and a bit of hope.”

And discouragement often sets in, Tulido admits. “There are times when these mothers feel so personally overwhelmed, like they just can’t feed another baby or change another diaper,” she says.

“But you know what? The time comes and you get yourself up and you feed them and then it’s over--you’ve made it through another feeding, because you just don’t have a choice. You have three hungry babies.”

Tulido also reminds her clients that even with three small children, infancy flies by. “It’s so fast--before you even know it, it’s over,” she says. “When they get really stressed out, I tell them, ‘You’re not even going to remember this.’ ”

Julie Rozin of Orleans, Mass., whose triplets are almost 4, says the madness does mellow with time. “It’s like with diapers,” says Rozin. “Once it’s over you forget about it. Once you’re out of the stroller, you stop drawing crowds.

“Your house is still a terrible mess--I think that goes on forever--but you get over your embarrassment about it. You really do learn to manage.”

One thing that helped Deborah Walter as she struggled to balance the demands of a large, young family was her decision to return to work. Some prospective employers expressed doubts, “assuming that I would be very emotional and that I would go about things emotionally,” Walter says, “when in fact, I have to go about things much more rationally and objectively than I ever did.”

Others thought she would be unhappy, or that she would be unable to juggle family and a career. “There was a real sexist assumption that I would handle everything and that my husband would handle nothing,” she says. “And then there were other people who thought that I wouldn’t be up to the job, or that I shouldn’t be working, with all those children.

“But it seems to me that each side has become more enjoyable,” Walter says. “It gives me perspective, and it reminds me that my children are going to be part of the community, and I want to be also.”

While she is conducting this small soliloquy, Debbie Walter pushes the triplet stroller. Richard holds his mother’s hand and walks alongside the big rig of a stroller.

Walter remarks on how gratifying it is that all four children have such distinct personalities--Michael, “the buffoon who runs around with wastebaskets on his head”; Mollie, “tough and determined”; Richard, “the happy camper”; and Frankie, “the big guy.” Just then, a woman stops to admire the troops.

“My goodness,” she says to the children, “you must be. . . .”

Debbie Walter finishes the sentence with a smile: “Quite a handful.”

Statistics in Triplicate Number of diapers used in the Walter household: 125 a week.

* Number of loads of laundry per day: 3.

* Biodegradable laundry detergent consumed per week: one 8-pound box.

* Dishwasher loads per day: 2.

* Number of visits to pediatrician before triplets turned 1: two per week.

* Number of visits to pediatrician now (triplets are 2): two visits per month.

* Number of ear infections before the age of 1: two per month per child.

* Number of ear infections now: one per month.

* Number of potty seats in house: 3.

* Number of baby wipes consumed per week: zillions.