I believe about 1 in 10 Miqo'te children is born such that he is assigned male? (I could be wrong there but I'm using that ratio as the example for the rest of my post for ease's sake.)
As you say, the lore naming conventions for Keepers provide suffixes for up to the 10th son. But statistically, because Keepers aren't born in a 1:1 gender ratio like humans, that means that 10th boy would have 90 sisters from the same mother.
So, then... it's more likely that for a 10th son (or, y'know, 5th son) to be born, either some of his older brothers were identical twins (allowing 2 boys to be born from 1 pregnancy - potentially placing your 5th son within the "2 or 3 pregnancies" thing), or that particular branch of the family is an anomaly in whatever it is that causes Miqo'te children to normally be born at a 1:9 gender ratio.
The fact the suffixes exist and are apparently in enough knowledge that they're a unified convention across all Keepers of the Moon suggests both that it has happened at some point, and that the occurrence is either famous or (while rare overall) common enough that it was remembered.
As you say, the lore naming conventions for Keepers provide suffixes for up to the 10th son. But statistically, because Keepers aren't born in a 1:1 gender ratio like humans, that means that 10th boy would have 90 sisters from the same mother.
So, then... it's more likely that for a 10th son (or, y'know, 5th son) to be born, either some of his older brothers were identical twins (allowing 2 boys to be born from 1 pregnancy - potentially placing your 5th son within the "2 or 3 pregnancies" thing), or that particular branch of the family is an anomaly in whatever it is that causes Miqo'te children to normally be born at a 1:9 gender ratio.
The fact the suffixes exist and are apparently in enough knowledge that they're a unified convention across all Keepers of the Moon suggests both that it has happened at some point, and that the occurrence is either famous or (while rare overall) common enough that it was remembered.