Breastfeeding Twins at Night

Breastfeeding Twins at Night

Getting Sleep:  One advantage of lying down while nursing twins.

Getting Sleep: One advantage of lying down while nursing twins.

Getting rest with a new baby in the house can be challenging . . . and doubly so when you have two (or more) new babies.  Breastfeeding twins at night is not only important but it can help you get more sleep than formula-feeding.  Here are some tips and strategies to help.

First, begin with reading this information about getting sleep with a nursing baby.

Additional sleep strategies with twins:

  1. Sleep with babies in your room
    While nursing at night, make sure to have your babies close by.  While there are pros and cons to having twins sleep in the same bed as you, you definitely want them nearby.  For some moms this means bed sharing and for others it means having a side cart or crib(s) in their room.  Either way, babies are close by and can nurse on demand without mom having to walk to another room transferring babies in and out of bed as they wake at night.  .
  2. Don’t wake the other baby at night
    As long as weight gain is good, your milk supply is strong, and your babies are nursing effectively, don’t worry if only one wakes at a time to nurse – especially at night.  Though you can nurse twins lying down, it does tend to be easier to nurse just one baby lying down at a time.  If there are ever those times when  just one baby wakes, lie on your side with your baby next to you and he can nurse and you can go back to sleep.  If the other baby wakes later, you can switch two babies out – either sliding him over or returning him to his bed and bringing the other baby to lie beside you and nurse.  The important point is to nurse on demand for each baby – but don’t worry if they don’t need to nurse at the same time.
  3. Keep everything you need nearby
    On your nightstand, make sure to keep water, a snack, music, a book, phone, iPad, remote, a diaper – whatever you might need if you are awake during the night.  Anything that allows you to rest in bed and not have to get up is helpful.
  4. Have plenty of pillows handy
    Make sure you have plenty of pillows on your bed so that you don’t have to get them from the couch or other daytime “nursing station.”  Propping plenty of pillows around you while nursing twins allows you to relax more easily and rest no matter what position they nurse in.
  5. Keep the lights low and don’t change diapers unless necessary
    You want to encourage your babies to fall back to sleep easily after nighttime feeds so make sure you don’t have lots of lights or noise around them.  Only change diapers (nappies) if it is essential.

You will get into a rhythm quickly and find ways to get rest in the most unlikely of circumstances!  Just remember, no matter how tiring it is, taking care of 2 (or more) babies is going to be exhausting no matter how they are fed.  Breastfeeding just allows a wonderful way to nurture your babies as well as allowing you as much sleep as possible with two new little bundles of joy in your home.

Breastfeeding Twins, Twice

Tara Dew HeadshotTara is a former 2nd grade teacher who now spends her days at home with the “Dew Crew,” the loving term she has given to her two sets of boy/girl twins. She is married to her high school sweetheart and they reside in NC, where she stays busy homeschooling the children and supporting her husband in ministry.

I’m excited and thankful for this opportunity to be a guest blogger today. My name is Tara and I am the proud Mommy of two sets of twins. Our first set, Natalie and Nathan, are now 6 ½ years old and our second set, Samuel and Samantha, are 3 ½ years old. I’m very grateful to be a breastfeeding Mom that was able to nurse all 4 of my children for the first year of their lives.

3But, let’s rewind back to the beginning…When my husband and I found out that we were expecting twins, we were shocked! Never in a million years did we dream that we would have twins. (Turns out that I have fraternal twins three generations up on my father’s side, and the genes were passed down to me :))

As we began preparing for their arrival, one of my biggest fears was if I’d be able to produce enough milk for them. I so desired to nurse my children, not only for the bonding and nutritional factors, but also for the economic reason: We couldn’t afford 2 in diapers AND 2 on formula! My mom had breastfed my siblings and me, so I knew that breastfeeding was what I’d love to be able to do. But, would my small-breasted self really be able to produce enough milk for not one, but two babies?

Natalie and Nathan were born at 34 weeks gestation, and were immediately taken to the NICU. I was not able to nurse them for the first few days of their life (since they hadn’t acquired the suck/swallow/breathe reflex yet). So, my first experience with “nursing” was actually with the hospital breast pump. I can remember pumping that first time and NOT GETTING ANYTHING! I was so discouraged. But the sweet nurse reassured me that this was normal: My milk hadn’t come in yet, and we were just stimulating and “prepping” my breasts for what they were created to do.

Two days later, my milk came in… And then I acquired the nickname of “Dairy Queen.” I often cried tears of joy at how my biggest fears had subsided. My body produced all that my babies needed to eat! And even when I wasn’t in the NICU, the nurses would feed my pumped breastmilk in through a small tube in Nathan and Natalie’s noses and then down to their tummies.

2When they were several days old, I was able to nurse them for the first time and though it was an unusual feeling, it was not painful for me. I praise the Lord that I never dealt with cracked or bleeding nipples, and that my body was able to produce enough milk for both babies! The only “hurt” that I had with nursing came when the kids were 2 weeks old. I developed mastitis in both breasts and felt like I had the flu with a fever! It was terrible, but cleared up quickly with medicine.

During the first few weeks of their lives, I nursed them separately in the cross-body position. They were learning how to latch correctly and stay awake for a full feeding. But after the first month, they became excellent nursers and I began feeding them at the same time. I used a double-boppy pillow, which I fondly call “my boppy on steriods” because it is so much bigger than a normal boppy. I fed the children in a “football-hold” position. One child would nurse on one side, but then at the next feeding, they would get the other side.

I fed the twins’ simultaneously until they were about 9-10 months old. By this time, they were getting more and more interested in the world around them and would “lose interest” in nursing. I found it easier to nurse one at a time at this point. They were such efficient nurses though, so feeding one and then the other didn’t cause any issues. When they were 13 ½ months old, they weaned themselves and gave up the last early morning feeding/snuggle session.

1Samuel and Samantha have a very similar nursing story, except they were born at 37 weeks and didn’t spend a day in the NICU! They were “full-term babies,” who latched correctly the very afternoon they were born and were excellent nurses the entire time! I was so blessed to be able to nurse them until almost 14 months old as well. Though nursing required a lot of dedication for that first year, I am so thankful that I was able to produce enough for them and that I was able to share that special bonding time with my children.

Mixed Feeding with Multiples

Many mothers of multiples want to breastfeed their babies but are unsure about committing to exclusive breastfeeding.  While it is completely possible for a mother’s body to make enough breast milk to nurse twins, triplets, and even quadruplets without supplementation there are many factors a mother must consider.  Weighing the pros and cons of breastfeeding multiples is important, but it is also not an all or nothing situation.  Mothers may also choose to do partial or mixed feeding with multiples. This means that some of their babies’ nutrition comes from breast milk and some from formula.

Breast milk is unique and unlike any other mammalian milk or infant formula.  Any amount of breast milk a mother is able to provide is a wonderful gift and should be celebrated.  There are multiple health benefits for both a mother and baby.  Breastfeeding will help with maternal-infant bonding – something that can be a challenge when there are multiple babies! Breastfeeding will also decrease feeding costs, visits to the doctor, time off work for illness, allergies, and health care costs both in the short and long term.

How does mixed feeding work with multiple babies?

There are several methods of giving mixed feeds with multiples:

  • Combination breastfeeding and bottle feeding
  • Combination breastfeeding and formula given via syringe, cup, finger feeding, etc.
  • Combination bottle feeding of expressed breast milk and formula
  • Exclusive nursing at the breast with an at-breast tube feeding device to supplement with formula
  • Breastfeeding with an at-breast tube feeding device and bottle top ups with formula or expressed breast milk

There are also several ways of supplementing breast milk:

  • Breastfeeding babies first then topping off with formula
  • Offering bottle as an “appetizer” then giving “meal and dessert” at the breast
  • Offering the breast to one (or more) and a bottle to one (or more) at a feed; then rotating who breastfeeds each time
  • Breastfeeding during the day (or night) and bottles the other times

There are different percentages of formula and breast milk given to babies:

  • Some mothers may start off giving majority formula but later build a strong milk supply and the majority becomes breast milk
  • Some mothers begin with a strong milk supply but allow it to decrease as they increase the percentage of formula given to babies
  • Some mothers give the majority or even all breast milk to a weaker or sick baby(s) and give formula to the stronger or healthier babies

There is no right or wrong way to provide mixed feeds to your babies.  One size does not fit all and the way a mother does this may change over time.  In fact, as her babies grow, one (or more) may take to breastfeeding more than another so a mother continues to nurse one and bottle feed another.

What are the risks of mixed feeding babies?

There are several risks to be aware of, as follows:

  • Decreased milk supply – Whenever a mother supplements her milk there is a risk of her milk supply decreasing.  This can be a slippery slope – as her milk supply decreases a baby receives increased supplementation, which cause her milk supply to further decrease until there is no more milk.
  • Nipple confusion – Babies may develop a preference for a certain feeding method – many times it is the fast flow of a bottle.  The flow of a bottle nipple is continuous whereas a baby at the breast must suck-suck-suck to have a let-down which lasts a minute or two and then there’s a pause before another let-down. Once a baby experiences the faster flow of a bottle they may get frustrated at the breast and begin to reject breastfeeding.
  • Health risks – While any amount of breast milk is a precious gift and wonderful for your baby, there are also well known and documented risks of formula.  Any amount of formula will change your babies’ intestinal flora to that of a formula-fed baby.  Any amount of formula will increase a baby’s chance of infection and illness. The more formula a baby receives the greater the chance of contracting infectious illnesses.  And, with multiples, if one baby gets sick it usually spreads to each baby.
  • Breast milk can be convenientWithout help, it can be easier and more convenient to breastfeed than give formula.  Breast milk doesn’t require mixing, heating, cleaning bottles, etc. so if mother is going to be feeding her babies it just makes sense to feed them in the most convenient way possible.  It is also a great way to multitask because breastfeeding requires touch and bonding that babies also need.  Even if mother does have help, it is many times easier for mother to breastfeed her babies and allow others to serve the breastfeeding mother.

Maximizing Your Milk Supply for Multiples

The human body is absolutely amazing it is completely possible for a mother to make enough breast milk to exclusively nurse twins, triplets, or more.  Having excellent lactation support in the early days is critical to help maximizing your milk supply for multiples.  The following are 10 strategies to help get breastfeeding your twins or higher order multiples (HOMs) off to a good start.

  1. Plan for a variety of birth scenarios
    Have a birth plan and talk with your doctor about the importance of having as natural a birth as possible.  But, also be prepared for a situation where you may end up delivering by caesarean section.  Realize that the majority of multiples come early.  Having a plan in place for whatever birth scenario will help you to initiate breastfeeding as soon as possible after.  Make sure your doctor, midwife, and birthing facility are supportive of your birth and breastfeeding goals. And talk with a lactation consultant in advance so you have a plan in place in case your babies are born prematurely and you must express your milk in the beginning while your babies are in the NICU.
  2. Initiate skin-to-skin immediately following birth 
    Skin-to-skin contact is wonderful for both mothers and babies.  It helps regulate body temperature and blood glucose levels in babies and allows a new mother’s hormones to flourish for her baby and milk supply.  In fact, did you know that each breast will specifically regulate its temperature based on each individual babies’ needs? Skin-to-skin is possible with two babies at a time, as well as after a c-section (when a mother has help supporting her babies).
  3. Allow first breastfeed to take place while babies are skin-to-skin
    Ideally, skin-to-skin contact should continue through the first breastfeed and first two hours following birth.  This is a critical time of bonding for a mother and her babies, and it can never be returned.  Delay all non-essential procedures until after this time (or have them done while babies are on mother).
  4. Room-in with your babies
    As long as your babies are not in the NICU, keep them in your room.  (And if they are in the NICU, find out if you can room-in with them and/or practice 24-hour kangaroo mother care.)  This will allow you to follow your babies’ feeding cues and nurse when they are hungry.  It gives a new mother confidence to care for her babies and helps to establish a strong milk supply.
  5. Nurse on demand around the clock
    Newborns eat all the time – at least 10-12 times every 24 hours.  It is normal to eat much more than this…even to seem to eat “all the time.”  So you can do the math – twins could mean feeding your babies 20 or more times each day!  It is important to watch your babies’ wet and dirty diapers to ensure they are taking in enough milk. It is important that they have a wide, deep latch and you are not in pain while nursing. And it is important that they seem to come off the breast satisfied – even if this “satisfaction” only lasts a short time.  Other than this, new babies spend their time and eating and sleeping.  A twin or HOMs mom will feel like all she does in the beginning is feed babies. It is okay to feed your babies separately or at the same time – whatever works best for you!  Most twin moms find that it is easiest to start off nursing them individually and then, once each baby is nursing well, nurse them together. Knowing which breast to offer and different positions for nursing twins can make all these feeding options seem less intimidating.
  6. Don’t hesitate to pump
    The first few weeks following birth is a critical time period to establish your milk supply and make sure your body gets the message that it needs to make enough milk for 2, 3, or even more babies.  If your babies are not nursing effectively at the breast, do not hesitate to pump after a feed to ensure your body makes enough milk.  An empty breast makes more milk.  If one baby nurses effectively and the other doesn’t, you will still want to pump to ensure you have an adequate supply for both babies.  (And, you can always “top-off” your baby who is not nursing effectively with your expressed milk.)
  7. Know your magic numbers
    Your goal is to ensure your body makes 750 mL of milk for each baby, within 10 days following birth. If you are expressing to build your supply it will be easier to see the amounts in the bottle. If you are breastfeeding, it is best to watch your babies’ diaper output and feeding cues.  But, if your babies are small and not nursing well, it is prudent to express following a feed.  Don’t worry so much about the amounts adding up to 750 mL/day per child since you babies are drinking your milk from the breast too (and the benefits of feeding at the breast far outweigh pumping all your milk just to see how much is in that bottle).  But, you can keep a log and see if the amounts you are expressing are going up or down – and if they are going down it is probably because your babies are taking in more at the breast . . . which is exactly what you want to happen!
  8. If your babies are in the NICU establish your supply well
    Begin pumping within the first six hours following birth with a double-electric breast pump.  Continue pumping at least eight times every 24 hours to establish your milk supply.  Also, if your babies are in the NICU, make sure to talk to the hospital lactation consultant to develop a plan to build your milk supply and then transition your babies to your breast.
  9. Have a lactation consultant that will support you
    Find out who is in your area while you are still pregnant.  Even better, have a prenatal consultation to get to know her, and develop a lactation plan for establishing a strong milk supply for your situation.  Then, after your babies are born, you will already know who to call if you have any questions or concerns.
  10. Get involved with a mother-to-mother support group
    Though qualified lactation support is essential to successfully breastfeed twins and HOMs, it is equally important to have the encouragement and support of other mothers who have been there.  Some areas even have breastfeeding support groups for mothers of multiples!

Breastfeeding Twins

Which Breast?

which-breastOnce your babies are nursing effectively most mothers of twins enjoy nursing them together when possible.  Not only does this conserve time but it also has the added bonus maintaining a strong milk supply and enhances milk let-downs if one baby is suckling more weakly at the breast.  There are several ways to go about nursing twins simultaneously: alternating breasts with each feed; alternating breasts and babies each day; or assigning one breast to each baby. Everyone mother-twin dyad is different so there is no one-size-fits-all approach. None of these approaches are right or wrong; just find what works for you and your babies and go with it.

Alternating breasts – either each feed or each day

Alternating breasts for your babies has the advantage of ensuring your baby’s eye coordination develops appropriately (so they are not always nursing on the left side for example), maintaining an ample supply in both of your breasts (in case one baby stimulates your breasts more by taking in more milk), and ensuring each baby gets adequate milk (as it is very common for one breast to produce more milk than the other).

Whether you alternate each feed or each day is completely up to you.  More twin moms prefer to alternate each day (24-hour period) simply because it is easier to remember than each feed.  However, if both babies nurse well and usually wait a little while before wanting to nurse again, changing breasts each feed is also very manageable.

Assigning one breast to each baby

Assuming both breasts have an adequate milk supply, assigning each baby a breast has several advantages as well: the baby can control the milk let-down more as the amount of milk in the breast will be what that baby needs (helping with overactive supply); it can help facilitate nursing positions if one baby has a positional anomaly such as torticollis; and it helps to minimize cross-contamination if one baby has thrush, illness, etc.

There are also several risks to this method, so it is important to be aware of them: a mother’s milk supply could be negatively impacted if one baby does not suckle effectively; a baby’s growth could falter if one breast produces less milk to the point where it is not enough for baby’s proper growth and development; or a baby could have a nursing strike if for some reason he couldn’t nurse on “his side” and had to nurse on the other.

None of the risks are enough to keep mothers from breastfeeding twins this way, they are just important to be aware of. Ultimately, if this approach works best for you, then that is perfectly acceptable!

Watch their individual feeding cues

It is also essential to remember that each of your babies is unique and it is important to listen and watch for individual cues. While it is helpful and usually possible to feed your babies simultaneously, it is rare to find two babies – even identical twins – who always want to eat at exactly the same time.  So try to also maintain flexibility in whatever plan you come up with so you can be attuned to each baby if they need to nurse at other times throughout the day.

Individual Twin Care

Having two (or more) babies is more work.  There are twice as many diapers to change, babies to dress and bathe, feed, and get to sleep. In the busyness of life with twins it can be easy to do everything as a sort of “assembly line” – when one baby is dirty, change both; when one is hungry, nurse both; etc.  Sometimes this works well, but other times it doesn’t.  Necessity often times dictates this approach. (I know when my twins were young we were living in Egypt without help or support from family. My husband would be out working and I had 2 babies and a toddler to care for.  I couldn’t clone myself and there is only so much one person can do!)  At the same time, it is important to realize that your babies are individuals and their needs might night line up congruently at the same time.

In the early days, one baby may latch well and nurse effectively while the other struggles to maintain weight at the breast.  As they grow, one may need to nurse every hour while the other is happy nursing every 2-3 hours.  One baby may sleep more during the day; the other at night.  What this can mean for a twin mom is always having at least one baby to nurse, carry, play with, or help to sleep.

Though every new mom seems to struggle with sleep deprivation, twin moms can have even greater struggles than with a singleton. Many groups for parents of multiples encourage “sleep training” and “feeding schedules,” both of which can interfere with a baby’s needs and a breastfeeding mother’s milk supply. It is important to allow your babies to be individuals and respond to their individual needs as much as possible.  So how can you watch for each baby’s needs and cues, while maintaining your sanity and not feeling like all you are able to do is nurse babies for the first year of life?!

  1. Listen to each baby.  For example, if one cries soon after nursing, rather than assuming he’s full and he must need sleep, offer to nurse again.  If one sleeps more than the other, it may be that one baby just requires less sleep – not that he needs to sleep as much as his twin.
  2. Respond to each baby’s needs. This can be challenging, especially without help and support from others.  But, responding to each baby’s individual needs can also bring a sense of calm to the chaos.  If your baby is crying, it can often be easier to nurse him again, put him in a sling, change his diaper, or meet any other need than to “train” him to fit into a routine you are attempting to create.  Babies find comfort and confidence in knowing their needs are responded to.  They don’t cry to manipulate and they haven’t read any parenting or sleep training books.
  3. Enlist help.  And accept all offers of support!  You are busy feeding your babies.  Allow everyone else to cook, clean, do laundry, take care of older siblings, shop, and serve you as you need.  You are going to be busy in the beginning.  (And this is true no matter how you feed your babies.) Twin moms need extra support that first year!
  4. Sleep near your babies.  Consider having both babies sleep together in a crib/cot by your bed or even in your bed.  But please make sure to use the safest co-sleeping strategies possible!  These include only co-bedding if you are exclusively breastfeeding, no smoking or drugs by anyone in the house, firm service, covers that are not heavy, no pets or other children in the bed, taking precautions babies can’t fall out of bed, and supportive partner.  SAFE co-sleeping either nearby or beside your babies can help to increase your sleep significantly.  No sleeping strategy is without risks, but make sure to do your research and make an informed decision as to whether bed sharing with your babies is right for your situation.
  5. Relax and try not to worry.  Remember you do have two babies and they will not always have the same need at the same time.  Just being prepared for this and accepting the reality mentally can help a mom deal with it on those days where it seems each baby’s needs are as opposite to one another as possible.  It’s okay if your babies don’t fit into the mold a book describes; it’s okay if your babies don’t sleep or eat on a schedule like your friend’s babies; it’s okay if your babies’ needs are different to one another even.  If you can relax in your role of mothering your babies, listening and responding to their individual cues, the early years of parenting twins can be much more laid back and enjoyable for everyone in the home.

Weaning Twins

Sometimes my twins sat in Bumbo seats while they ate solid foods.

Sometimes my twins sat in Bumbo seats while they ate solid foods.

Twins and higher order multiples (HOMs) have the same needs for breast milk as a singleton.  Every major pediatric association in the world recommends exclusive breastfeeding for the first six months of life with complementary solids offered alongside breast milk thereafter.  The World Health Organization recommends breastfeeding to continue for up to two years or beyond.  No matter how long you choose to breastfeed your babies, breast milk continues to have benefits for both mother and babies.

Though your babies may have been preterm, you may have struggled to build your milk supply while you were separated from your babies in the early days, and/or transitioning to breastfeeding was challenging, if you were able to overcome these obstacles and find yourself nursing your babies there will come a day when they will wean. Worldwide, taking cultural norms and values out of the equation, human babies will typically wean between the ages of 2 ½ – 7 years old.  1 This is not to say that your babies have to self-wean, or wean between these years though.

DSC03559_edited-1There are several approaches to weaning twins: mother-led, baby-led, or a combination of both. Mothers may need to wean abruptly, though if this isn’t required then it is easier on a mother’s body and for her baby for weaning to take place gradually.  Baby-led is directed by the baby and his cues, rather than directed by the mother.  Most twin moms use a combination of both approaches – with the mother watching her babies’ cues but sometimes dropping a feed when necessary. There is no right or wrong way; nursing should be enjoyable for both mothers and babies and if either of you are unhappy then the nursing relationship could cause more harm than good by forcing it to continue.

Physically, your babies need breast milk for the first year of life and if you wean before this time then your milk must be replaced with a substitute (either artificial milk or donor milk). After this time, breast milk can be replaced with foods – which could be foods that the rest of the family already enjoys.  If your babies seem to “wean” before a year, it is actually a nursing strike and you can use strategies for resolving a nursing strike to get through the situation.

It is also important to remember that your babies are individuals and it is completely normal for one baby to self-wean while the other baby continues to nurse – sometimes for months, other times for years!  Watching and responding to your babies cues in this fashion will truly allow you to meet each baby’s unique and individual needs.

Breastfeeding & Older Siblings

My daughter often nursed her babies when I nursed mine.

My daughter often nursed her babies when I nursed mine.

What to do with older siblings can be a challenge with any new baby, but especially twins.  Whereas with a singleton a mother can nurse in a sling and still do other things – such as shop, cook, or interact with other children – nursing twins means sitting down and using both hands to support each baby.  Cooking, shopping, and doing arts and crafts are nearly impossible in the early days.  Couple that with the fact that a new mom spends a lot of time nursing and it can be a recipe for chaos at home if you aren’t armed with a plan for entertaining older siblings while nursing.

Planning ahead can turn nursing times into a precious time of bonding not only with your nursing babies but also your older children.  Here are some ideas of ways to entertain older siblings while nursing your twins:

  • Have a special box of toys that can only be played with while mommy is nursing
  • Read books together
  • Play “I spy”
  • Sing songs
  • Eat a snack
  • Play dough
  • Simple art projects that don’t require your assistance…this will vary depending on age
  • Special coloring book/crayons that are only used while mommy nurses
  • Nurse outside while older children play
  • Watch a movie together

On a personal note, I really struggled with the quantity of movies I showed my firstborn in the early days of nursing my preemie twins.  I would be perfectly happy without a TV in our home and I don’t like the idea of putting my children in front of a TV as a “babysitter.”  At the same time, I was living overseas with preemie twins who needed to be fed all the time, my husband was gone throughout the day, and I had a 2 ½ year old to entertain while nursing.  Though I showed many videos, I always felt guilty.  I did try to make sure the videos were somewhat educational; we watched them together (bonding); and I just had to realize this was a period of time in our lives.  Looking back, I don’t think my daughter is any worse for the wear.  It helped us survive and now she has two best friends to play with all the time.  It didn’t develop a pattern in our home and it was nothing that I wasn’t able to change at a later time.  So, new mama, don’t beat yourself up if you watch a lot of movies during that first year while nursing twins.  Remember, it’s a phase and won’t last forever.


When Will Life Return to Normal?

64445_10100153832825061_1591475079_nWithout a doubt, every new mother of twins wonders when life will return to normal after having twins.  Usually, it’s things as basic as sleep, cook, exercise, enjoy a cup of tea without holding babies…you get the idea.  The answer is YES.  And it will be sooner than you think.

The early days, weeks, even months of a new baby, especially multiples, is an adjustment and a lot of work.  There is new life (or two) that you are responsible to keep alive.  These sweet little babies are dependent on you for everything.  You have two arms and two babies – which doesn’t leave any room to prepare a snack, cook a meal, wash clothes, do crafts with older siblings, etc.  I remember when my twins were a few weeks old thinking, “I’ll never be able to cook a meal again.”  It seems like a rather extreme statement looking back but I remember the feeling vividly.  You are completely busy taking care of these babies and there are no more arms for other necessary things.  If one baby is asleep, then you still have one baby…much easier to sling and still do some kitchen prep but invariably when they both lay down at least one will need you to hold/nurse/soothe again.

There are many ways that friends and family can support and encourage a mom of twins.  Offering to give a bottle so you can rest is not one of them.  Not only does this undermine the breastfeeding relationship, a mother’s milk supply, and a baby’s willingness to suckle at the breast it gives a mom of twins a lot more work in the long run.  Cleaning and sterilizing bottles and mixing formula takes extra time.  And if you want to give bottles at the same time there’s no way to also cuddle and hold them – something every human baby needs.  So, bottle feeding cannot also double as holding and cuddles.  All that to say, though it is hard in the beginning, and though you may wonder if you will ever be able to do X, Y, and Z again…breastfeeding is not the problem.  In fact, that might be the saving grace in helping get through those early days when, no matter how you choose to feed your babies, the fact remains you have two new babies (or more) and there is just going to be more work than if it were a singleton.

So what can you do to keep your sanity and take care of these new babies?

    1. Get a sling
      It is normal for newborns to need lots of milk and lots of cuddles.  Getting a sling can help as can learning to nurse them lying down together.
    2. Have Realistic Expectations
      Having realistic expectations of what you can do during the first few months is also important.  Not only is this not the time to paint your house or try to cook gourmet meals, it may mean sandwiches, nuts, fruit, and pre-cut vegetables are the mainstays of your diet.
    3. Accept all offers of help
      If friends and family offer to bring meal, clean your house, fold your laundry, or even sit with you and change diapers and bring babies to you as they need to nurse – graciously thank them and let them help!
    4. Babies’ sleep patterns change
      Around 6 weeks of age most babies begin to have their longer sleep at night (rather than during the day) and some will sleep up to 6 hours without waking.  Being able to get a longer stretch of sleep at night seems to do wonders for being able to take care of babies during the day.
    5. Babies develop new skills every week. A newborn really can’t do much of anything on his own.  But by 6-8 weeks old, babies can smile and begin to play on a play mat with toys above.  Now, it may only be for a few minutes, but this is a huge milestone . . . there is now something other than a person who is beginning to entertain/interact for a baby’s attention.  By 3 months, play mats and other toys will begin to be even more entertaining and pleasureable for your baby . . . and give you an opportunity to have a cup of tea, take a shower, or do the dishes :).
    6. Breastfeeding increases parent’s sleep
      Research also shows that breastfeeding increases the sleep duration of new parents by an average of 40-45 minutes!1

Each week you will most likely be able to look back and find it was easier than the week before.  Though sometimes you will take “two steps forward and one step back,” when you are able to step back and look at the big picture you will find that this is a short time that they need absolutely all of you.  Before you know it you really will be able to do these things you wonder if you’ll “ever be able to do again”!

Emergency C-Section in Egypt

Premature twin in incubator

The twins spent their first few days in an incubator in the NICU in Egypt.

To say I was excited when I found out I was pregnant would be an understatement.  I had dreamed of being a twin when I grew up and always thought I would love to raise twins. Still, I’m not sure anyone can be totally prepared to hear they are having twins! This excitement quickly turned to fear though when I realized I would have to birth twins.

I really wanted to avoid a C-section and I planned and prepared all throughout my pregnancy.  We were living in Egypt and my doctor strongly encouraged me to have a planned C-Section.  When my boys were breech and not changing positions we made plans to return to the states where my doctor was still keen to let me try to birth them vaginally.

breastfeeding premature baby

First time to attempt breastfeeding my twins – 26 hours after birth.

Fast forward to January 24th. . . I was 32 weeks, 3 days pregnant without problem. I felt great, well, except for feeling like a blue whale, but don’t all pregnant women feel large at the end?!  I was packing and preparing for our return to the states just four days later.  That morning I woke up around 8:00 a.m. and felt mildly uncomfortable in my still half-asleep state. I tossed and turned a little and remember saying, “I think I’m having a contraction.” My lower abdomen was tightening, but I figured it was just Braxton-Hicks . . .

After getting up and taking a shower, these mild contractions suddenly turned into intense labor with contractions coming almost on top of each other.   We called my doctor (who had been quite relieved when he learned we were going back to the states) and we headed to the hospital in Egypt instead.

syringe feeding colostrum

Since they were losing weight at the breast I syringe-fed my colostrum to the boys.

We arrived at 9:45 a.m. and I was already dilated to 8 cm. Since they were breech the hospital doctor wanted to prep me for a c/s but I refused. I was taken upstairs to labor and delivery and I could feel the contractions change and I had the urge to push – I knew I was now fully dilated. But, I didn’t feel a peace to work with the contractions and push those babies out without my doctor there. (I look back now and have to laugh at this scene because here I am on a bed in the hallway because the medical staff at the hospital didn’t know what to do with this foreigner who was refusing a c/s – and they didn’t know how to help me birth breech twins! We were all just waiting for my doctor to arrive.)

My doctor did arrive and said on the way he’d been thinking about it and he had decided he would give me the opportunity to birth them naturally. I was so thankful. He went and washed up and I went to the delivery room. However, when my doctor checked me his entire demeanor changed and I could sense the intense worry in his eyes. He said he had talked with the neonatologist and both really recommended a c/s.  I just didn’t have a peace to do this naturally without his support – especially since just a few minutes earlier he was okay with me trying for a natural delivery.

Syringe feeding colostrum when my newborn preemie was unable to latch on.

Syringe feeding colostrum when my newborn preemie was unable to latch on.

At this point I didn’t even have an IV so they put me under with general anesthesia.  They put the mask on my face and I was out.  They were born within a couple minutes – which makes me thankful that James and Luke still didn’t get exposed to much anesthesia.

James was born first (3 lb, 15 oz.), and then Luke (3 lb, 13 oz). They received a surfactant lung treatment since there had not been time to give steroids to me to boost their lungs before their birth. They also had extra oxygen to breath for the first 24 hours (their heads were under an oxygen bubble) and the next day they were breathing fine on their own.

We were in the hospital for six days before bringing our twins home.  (I realize that they would have probably stayed much longer had we been in the states as they were just 3 ½ pounds when we brought them home!)  You can read about my journey breastfeeding these little guys here.

Premature baby's hand

My boys were both under 4 pounds (1.8 kg) at birth.

Though this birth was nothing like I’d planned or hoped, I am very thankful they were born healthy and safe.  It is okay, and important, to grieve a birth that doesn’t go as planned.  I took comfort in knowing that I had done everything I could to prepare for a natural delivery – even to the point of buying plane tickets to another country!  I wonder sometimes what would’ve happened if I’d just pushed them out.  I do wish it hadn’t ended in a C-section but, more importantly, I am thankful they are safe and healthy.  And even though there were many “strikes” against us making breastfeeding difficult (preemies, twins, emergency C-section, not breastfeeding for the first time until 26 hours after delivery, no skin-to-skin after birth, and more) we made it.  Determination can overcome these barriers and more!