(Above: triplets Jerrika, Janessa and Hezekiah)

A surprise pregnancy with triplets will knock just about any mama off her feet, but it's an even bigger shock when you've already got seven other kiddos. Yup, we buried the lede—labor and delivery nurse Ashley Nieuwsma, 34, from Kansas City, MO, is a mom of ten, ranging from 4 months (the triplets!) to 14-years-old. She and her husband have no family nearby, no nannies, and yet—she's got this. (If you're out there drowning with just one babe, she also gets it: 'I always tell people I was so overwhelmed with my first couple of babies, but I've become comfortable multitasking, it doesn't intimidate me anymore.') From soothing three screaming babies at once to breastfeeding and keeping tabs on her two-year-old, here's how she's making it work.

Congratulations on your incredible—expanding!—family. Can you walk us through how your crew of 10 came to be?

I was married early, and we had three biological kids on our own. My husband and I decided to adopt two boys from Haiti, and during the adoption process we found out we were pregnant with our fourth. Five years later I had a surprise pregnancy, who is now my two-year-old daughter! I had been open to possibly having one more baby to keep her company since the rest of the kids were older, but we weren’t trying. That’s I found out I was pregnant with triplets!

Photo credit: Sara LePage Photography

You’ve given birth to a lot of babies—what’s it like to deliver three at once?

I had a very unusual labor since I delivered triplets vaginally. They were born at 34 weeks which is a great achievement for triplets. They were between five and six pounds each, which is also very large! All three were born within a five-minute window—super fast. I delivered in the OR with around 24 health professionals present...no privacy for me! I knew we were having two girls and a boy but it was just so amazing to see their little faces as they held them up one by one for me to catch a glimpse of before they were whisked away to be worked on by their NICU team. Pushing was so hard with the first one because I had no lung space and ability to bear down. I honestly thought they were going to have to do a C-section. I kept praying my way through it and didn’t give myself the option of anything else. I knew it was all on me! After the first one was born I had an assisted breech delivery with the other two and that was actually super easy!

You’ve got a lot of little mouths to feed! How has that experience been so far?

I wanted to breastfeed at least for a while when they were so little and fragile as preemies. I tried breastfeeding tandem style, doing two at once, and then the third after, but it was actually super challenging for me and I ended up preferring to do one at a time so I could use both hands. I still breastfeed all three but just part time. I tend to bottle feed with formula during the day when they’re all awake because breastfeeding one while getting up and down so frequently to tend to the other babies is very difficult. I like nursing one at a time also for bonding...it gives me time alone with each baby to look in their eyes and talk to them. They love that time and so do I. So I mainly breastfeed at night and in the mornings when I have some extra hands around to help with the other babies. Due to how much they eat, I would have to produce 17 ounces of milk every 3 hours to make enough for the triplets! So yes, formula is my friend! I strongly prefer Earths Best Organic formula because of the quality ingredients and it has better digestive support with probiotics and such. My babies were so gassy and miserable on other formulas until I switched.

Ok—what happens when all three babies are crying at once? What’s your move?

If we’re having a triplet meltdown the first thing I do is go and brew a cup of coffee while making three bottles and take some deep breaths. I’m comfortable multi-tasking—I know crying is ok, their needs are being met. So I go up to the nursery and start talking to them—'hey guys, it’s ok, mommy is here’ so they know I’m in the room, and I just pick up one baby and start bathing them. I’ve found they all calm down with a quick bath, so I just bathe babies. It’s usually done first thing in the morning and starts their day off right. While I’m with one, I’ll put the other two in their Rock 'n Plays and prop bottles with a burp cloth under their chin. Then I swap out one baby for the next—it’s like musical chairs.

Can you describe what your nights are like?

I thought the triplets would prefer to sleep together in one crib for a while but it turns out they sleep a lot better apart, they wake each other up less. So we’ve got three cribs in their nursery and a sound machine. As newborns, my husband took the 8:30pm to 2am shift, so I would sleep then (he usually did one to two feedings during that time) and then I’d be on from 2am to 8am, and they usually only got up once to eat. What I’ve found really helps with sleep training is keeping them in a super dark and quiet room—during feedings I keep the action to a minimum, I don’t talk to them. That’s really helped them to fall back asleep. After a few months of sleep training they now sleep eight-hour stretches!

What’s your best survival tip for other mamas of multiples?

You have to find out what works best for each individual baby. It’s surprising—you’d think with them all being in the womb together, they’d prefer the same routine, but they all have their own set of preferences and wishes. Our fussiest baby was super colicky and we discovered he’d only sleep on his tummy, he hates being on his back or his side. As a labor and delivery nurse, I have to recommend putting babies on their back to sleep—I even did my nurse residency project on this!—but when the rubber meets the road I put baby on his tummy. It’s not the end of the world. One baby likes the swing to calm down, the other one doesn’t care for it. They’re all different. And then there’s coffee and chocolate—I need those to survive!

What has the triplet experience been like for the other kids?

My older kids (ages 7 to 14) are so helpful—I love when they’re home from school because I’ve got baby holders! It’s interesting with our two-year-old—I think if she was an only child the triplets might have stressed her out, but because there are so many of us she’s used to the attention being split anyway—if she’s looking for someone to play with or a snack and my husband and I aren’t available, she just goes down the line and asks one kid after the next until she gets what she wants. Everyone pitches in.