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Establishing a Night Time Routine for Newborn Twins

When should I begin to establish a night time routine for my twins?

You can begin to establish a night time routine for your twins straight after birth if you wish to do so. Some parents start from birth/the time their babies come home from hospital whilst others wait a few weeks and then introduce a routine. There are no hard and fast rules, it depends what works for you and your family. You may find that your babies set their own patterns and you can work around that. If you have other children and work commitments you may need to fit their routine around your own routine.

How do I establish a night time routine for twins?

In the early evening keep everything in the house as calm and quiet as possible, try to limit excitement and noise. This helps to set the scene and start creating a calming atmosphere. Set your voice volume to low and keep it low until morning. This helps soothe them.

Most parents set their babies routine around the following:

Bath> bottle or breast feed> burp> nappy check> cuddles> bed

(You might find that a slightly different order works better for you, that’s fine, work it round your own children and how they work best)

If a bath doesn’t wake your babies up too much (some babies get revved up by an evening bath) you could bath each baby, give them a bottle or breastfeed, burp them, check that they’re not needing a fresh nappy and pop them down to sleep. It helps if the room they’re sleeping in is not too hot or too cold, but at a nice even temperature. Use a black out blind during the summer months and all year round if you’ve got street lighting. Sometimes having a ticking clock in the room can help them to settle.

They will need after 3-4 hours and again 3-4 hours later. It may work that you give your babies a feed at around 7 pm, 11pm, 2am, 6am. There is a train of thought where you should feed on demand and another train of thought that you should feed every 3-4 hours regardless. Personally I went with them and fed on demand as I don’t see the point of listening to a hungry baby for an hour or two when I could feed him/her, meet his/her needs and then get some peace.

Managing night time feeds with twins

At first your twins will need feeding during the night time as well as during the day. In fact a new baby is likely to need to be fed every 3-4 hours (sometimes more often). Their tummies are only tiny and need refilling frequently.

IF you’re bottle feeding it can help if you get daddy to give the 11pm (ish) bottle, allowing you to go to bed for a few hours from 9ish until they need another bottle at 2-3am (ish). If you’re breastfeeding and are able to express breast milk and offer that in a bottle, again daddy could potentially offer this during the later part of the evening rather than you having to wait up. If you’re breastfeeding you could always get him to bring the babies to you for their late evening feed.

It helps if you have everything you need set up so that you’re just able to do what you need to do without putting a bright light on. I found having a spare table lamp with a night light bulb in it helped. We also had a dimmer switch on the bedroom light fitting so that I could feed them without putting on the harsh over head light or disturbing anyone else in the room. It’s a good idea to have everything you need in order to give a night time feed to hand and somewhere warm and comfortable to sit.

As your babies get bigger they are likely to go slightly longer between feeds and then get to the stage where they don’t need a night time feed (phew)

 

 

 

 

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Daytime routine

Establishing a Daytime Routine for Newborn Twins

How do I establish a daytime routine for newborn twins?

Essentially your daily routine will revolve around feeding your babies, winding them, changing them, letting them sleep and attempting to get some sleep yourself. In the early days your babies will need feeding every 2-4 hours. It helps if you can get them into some kind of routine.

There are two ways of doing this.

  1. One  way is to allow them to feed when they want feeding. If one wakes up and is hungry and you know how to feed them both together it would be worth waking the other one up and feeding him/her too so that you then (theoretically at least) get more time between feeds.
  2. The other way is to feed them at set times for example 8am, 12pm, 4pm, 8pm, 12 am, 4 am, 8am and so on (or three hourly if they’re hungrier). If you have other children to take to school you might have to impose more of a routine on them than if they were your first children and you had a freer schedule.

 

Watch your babies over a few days/weeks to see if there is a pattern developing. Do they fill their nappies before a feed, during a feed or after a feed? If it’s before, change them before the feed, if it’s after the feed, wait until after they’ve had their feed. I found having a small notebook to write down their natural awake and sleep times and when they wanted feeding and worked my twins routine around them. My twins were my first children and so I didn’t have to dash out for the school or nursery run and so could do this. If you have a nursery or school run or are heading back to work you might need to insert your babies routine into your existing routine.

Once they’ve had their feed, you’ve winded them, and changed them if necessary, put them in their baby bouncers for some awake time. If you’re doing chores around the house take your babies with you if you can. Don’t leave them unattended. As they get older you can put them on a play mat for some tummy time.

 

Make sure it’s clear when it’s day time.

During the daytime make plenty of noise. Put on the washing machine, have the radio on, use the vacuum cleaner (once your stitches have healed, of course). Talk to them even if they’re too little to understand what you’re saying. If at all possible go out for some fresh air every day it really helps to keep you sane. It also motivates you to get dressed (although getting dressed seems a bit of an additional, somewhat unnecessary task, it can help you feel human again (obviously if you’re in pain with c-section stitches etc and aren’t going anywhere then don’t do this) but if you’re otherwise well, even having a 2 minute shower will make you feel so much better.

If you would like to you could dress your twins in ‘proper clothes’ during the day time, rather than sleepsuits (babygrows), although it’s by no means compulsory to do so. Whether you pick matching outfits or not is up to you. There are some twins who love being dressed like their twin and others who hate it (whilst they’re young enough not to care either way you get to pick which path to follow)

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Recovering from the birth of twins

Time is the best healer

No matter how you’ve given birth, you will need time to recover from this. The best way to heal any scars/ tears would be to rest as much as you can. I know it’s not easy to rest when you’ve got newborn twins in the house but rest whenever you possibly can.

Do as little as you can around the house. Enlist help from those around you.

Make only light quick easy meals (or get someone else to cook) If you don’t already have a slow cooker(crock pot) , they’re a great investment as you can fill it up in a morning when you’ve got a little more energy and leave it to cook so it’s ready to dish up at dinner time.

Do the bare minimum of housework (if you are very houseproud get someone else to tidy for you). If friends come round for cup of tea and a cuddle with the twins ask them to make the tea. Don’t feel you need to jump off the sofa to start making everyone a drink. You really don’t.

In times past the only thing a mother had to do for the first ten days of the babies life was to feed and change him/her. Whilst of course these days we know that long periods of inaction is not a great idea, there’s certainly a case for spending a good proportion of your time doing just that. Spend time getting to know your babies and concentrate on establishing feeding routines and resting.

Be gentle on yourself

Don’t forget that your body has been through a lot of the last 9 months and will need time to recover. Try to eat sensible meals on a regular basis (it’s easy to ‘forget’ about yourself in the chaos of looking after newborn twins) remember to drink plenty of fluids, especially if you’re breastfeeding your twins. Having plenty of fresh fruit and vegetables and protein will help you feel better.

If you have stitches or scars ask your health team for advice as to how best to care for them.

If you have had an episiostomy (cut to the perenium during a vaginal birth) or a caesarean you will need time for your wound to heal. Your health team will advise you what you need to do to promote healing. Avoid lifting anything (including your children) until you’re feeling better.

If you’ve had an episiostomy you might find that it hurts when you pee. If this is the case try peeing in the shower whilst you flush that area with warm water. Sitting on a ring cushion might also help take the pressure off ‘downstairs’.

When can I drive after my caesarean?

If you have had a caesarean you will need to find out what your car insurance policy says about driving after a caesarean. You might have to get a certificate from your GP to say you are fit to drive again. Different countries and states have different policies so find out what applies to where you are.

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First night home

Coming Home with Newborn Twins

Your first night at home with newborn twins.

 

Finally you’re home with your twins. It can seem a little bit strange at first without the hustle and bustle of the hospital environment. If you have some help to hand encourage them to put dinner on and keep you well stocked with (non-alcoholic *sorry*) drinks and snacks to keep your strength up. If you’ve had a c-section or have any stitches you might find you need some help with lifting the babies. Don’t hesitate to ask your family to help you with anything that you find difficult like lifting etc.

Keep calm ~ it’s only twins

Try to have as quiet an evening as possible ~ ask any excited visitors to come a different day. Have dinner (hopefully someone else will have made this for you) and then start with the twins night time routine. They will need a calm environment so make sure you have your voice as low as possible, and keep other noise to a minimum.  But don’t tippy-toe about either or you’re likely to end up having to watch Eastenders with the sound off and subtitles on for the next 5 years. Don’t do it. Just don’t make more noise than strictly necessary. (Though that said my twins’ dad used to saw up logs with a chain saw under their window on a regular basis and they slept through it, somehow)

Things you need to do before they go to bed

In simple terms your babies will need to have a bath if they need one, a new nappy, a bedtime bottle, a burp and then bed. It’s up to you which order you do things in. You might find that your twins need a new nappy before you feed them, or they might decide to ‘go’ the minute they’ve finished their feed. Work round them and do whatever suits their/your needs best. (Sometimes you find that one twin does one thing and the other something else entirely. In this instance just follow their lead and give them what they need at the time)

Feeding time (again)

You will probably find that you’re up at least a couple of times in the night, babies need to be fed every 2-4 hours round the clock. They need this because their tummies are very small and if they get left for too long between feeds they may get too tired to feed properly. If you find that one baby wakes up and the other one stays asleep you have two options. If you know how to feed them together then wake them both up and feed them together. If you don’t know how to feed them together then feed the one that’s awake then after you’ve finished feed the other one. Otherwise you’re likely to get to bed and just as your head hits the pillow the other one is bound to wake up demanding a feed.

 

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Coping in Hospital with Newborn Twins

How long will I stay in hospital for after the birth of my twins?

This largely depends on you and your babies. If you’ve had a vaginal birth and your children are not needing any special care, you could potentially leave within 24 hours of having them. If you have a Cesarean it largely depends how it went and how you’re feeling after it.

Some mums stay in hospital for a day or two, maybe longer. Others stay in just 24 hours and then are released and monitored by their health team at home. It depends on what resources are available to you in your area and how you and your babies are doing. If you are unsure how long you are going to be in hospital for, ask your midwife for advice.

Establishing a Feeding Routine (see also article on Breastfeeding Twins )

Shortly after the birth you will give them their first feed. This could be by giving them a breast feed or offering a bottle of expressed milk or formula. If your babies need a fresh nappy, change them before you begin. Wash your hands, make bottles if you’re bottle feeding. Get comfortable and offer the feed. Your midwife should give you guidance as to how to breast or bottle feed and check that you’re correctly latched on if you’re breast feeding.  You might need help lifting the babies up if you’ve had a Cesarean. Newborn twins need feeding every 2-4 hours round the clock. It helps if you can feed them together. Your midwife will be able to advise you how to breastfeed your twins and help you to latch on.

What happens if they fall asleep at the breast/ during their feed?

Should they fall asleep during the feed gently wake them up again. Once they’ve had enough milk they should remove their mouth from your breast and turn their head away, or simply stop suckling. You might find that one twin/triplet finishes their feed first, it is handy to be able to put the one that has finished their feed into a bouncy chair for a few minutes whilst you finish feeding the other baby. After the feed, make sure you burp both babies by gently rubbing or tapping their upper back until any trapped wind comes up.

If you haven’t already done so, about 5-10 mins after a feed is a good time to change nappies.

Once they’ve been fed, burped, changed etc you can pop them back down into their cot.
This process is repeated every 3-4 hours (sooner if your babies are very hungry).

Whilst in hospital get as much help with feeding as possible from your midwife

Whilst in hospital get as much help with breastfeeding as you can from your midwife. If you find that your babies are always hungry, or it seems particularly painful to breastfeed, ask your midwife to check that you’re latching them on correctly. If possible ask your midwife to show you how to breastfeed them both together as this will save time during night feeds once you get home.

Coping with visitors in hospital.

It is up to you and your partner who visits you in hospital. Take as much time as you need. If you are happy to have lots of visitors (and the hospital is ok with you having them, some are keen for it to be ‘partners only’ for the first 24 hours if you’ve had a cesarean! If possible arrange it so you know in advance who is coming, so you can stagger visitors. It is very difficult when people all turn up at once!

Getting enough sleep(!)

When the babies are asleep try to get some sleep yourself. It can be really difficult getting enough sleep in the early days so every little helps. Some hospitals have an ‘afternoon siesta’ policy before visiting hour, where everyone has a lie down for an hour in the afternoons. This is a great idea. If you cannot sleep at all, please contact your midwife or doctor to see if there is anything they can suggest or give you to help.

Going Home

Once you’ve got to grips with caring for your babies, you’ve established either breast or bottle feeding and you and they are all in good health, you will be allowed to go home.

  • Before you go, make sure that someone has everything ready for you at home.
  • There needs to be enough staples like milk, tea, coffee ready to make yourself and visitors a hot drink.
  • There needs to be something easy to cook ready in the fridge/ freezer. Also having something nice to drink (that is non-alcoholic and caffeine free) would be a good idea as it’s important to keep your fluid intake up especially if you’re breastfeeding.
  • All the equipment needs to be organized and set up ready to use, in a suitable place.
  • There needs to be enough nappies to last you a few days at least, and if you’re bottle feeding enough milk formula too.

Your partner/ friend will need to bring in 

  • A blanket each for the babies,
  • Car seats (unless you’ve not got a car!)
  • Coats or cardigans for you all (depending on what season it is).
  • Proper clothes for you. Loose-ish leggings or tracksuit bottoms are ideal.
  • A suitcase or holdall to take all your belongings home in (unless you’ve kept one with you!)

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Frequently Asked Twin Questions

How long is a twin pregnancy? Around 37 weeks. Triplets 34, Quads 32 weeks.

Will I have to have a caesarean if I am having twins? Not necessarily. If you have no particular complications and at least one of your babies is lying head first down towards the end of your pregnancy you should be able to attempt labour.

Can I put my twins into their own cot/ crib/ Moses basket or should they share? This is largely up to you, how much space you have and your budget. Some twins settle better together others are perfectly fine separately. It really is up to you.

If my twins share a cot/crib how should I put them to sleep? Make sure you have their feet to the foot of the cot, so that they can’t overheat or suffocate and that you follow the guidelines for safe sleeping. The alternatives are to let them sleep both along the length of the cot with their feet to the length of the cot bars. Or place their feet to the shorter ends at opposite ends of the cot

Can my twins have their own room or do they need to stay together in the same room? 
Do whatever works for you and your family. If you have  room and want to put them in their own room this is perfectly fine. If you want to keep them together this is also equally fine. When you decide to do this depends on your individual twins. Some will be ready sooner than others. If you are finding one wakes the other one up and you have space to move one into their own room you could potentially move one.

Can I breastfeed my twins? It is possible to breastfeed twins. Ask your midwife for guidance and to make sure you’re latching them on properly if this is your first attempt at breastfeeding.
Whether you feed them together or separately is up to you. It is a valuable skill to learn to breastfeed your twins together, however it is nice to sometimes feed them separately.
Having lots of supportive pillows or cushions helps you get comfortable and your babies at the right height to breastfeed.

You might like to read Twinsonline’s Article on Breastfeeding Twins. 

Should I dress my twins alike? Again up to you really! Some Adult twins have written in to complain about being dressed the same as children!  For new babies it’s really a matter of personal choice. Some people are given lots of clothes from a singleton which don’t match so end up dressing them differently other people prefer to dress them the same. It can be easier for other people to tell your twins apart if you dress them differently. Some mums opt to give their twins the same outfit but in different colourways. I have also heard of mums assigning a particular colour to one of her twins and buying mainly that colour. As a compromise you might like to decide which way to dress your twins until they are old enough to tell you what they would prefer. I tried to dress my twins differently so that they would always have a sense of self (not saying they wouldn’t have a sense of self if I dressed them the same). They reached about age 7 and started wanting to dress the same. This phase came and then passed over. They now have very individual dressing styles and this is fine.  The only thing I would say about dressing them alike is what do you do when one of them is sick? Do you change both so they stay the same?!

Should twins always be together? No! It is good for them to get used to being separated for short periods of time right from the start. It is nice for them to spend a bit of time one on one with another adult. If there are two of you or you have grandparents or other trusted adults near by the twins could spend short periods of time one with you and the other with their other parent/ grandma / your trusted friend. You don’t have to do anything very elaborate with them, it could be running an errand, collecting a takeaway, painting, baking a cake.

Can my same sex twins be identical even if they don’t share a placenta? Yes! Around a third of identical twins don’t share a placenta, a chorion or an amniotic sac. They sometimes get mistaken for non-identical twins.

Can I have twins even if I don’t have twins in the family? Absolutely! Many people are surprised by this. It is also surprising that if you are a non-identical twin yourself you are more likely to have twins yourself. (You would assume that it would follow that twins would be more common with identical twins but it isn’t) The reason behind this is that some women are more likely to release more than one egg per cycle. Some women’s eggs are also more penetrable by sperm. Again making non-identical twins be conceived.

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Twin Statistics

Currently in the UK it is thought that around 33% of twins are Monozygotic (’identical’) and around 66% are Dizygotic (’non identical’ or ‘fraternal’)

Monozygotic Twins (normally referred to as Identical or ‘ Id’ or sometimes ‘MZ’). Mono means ‘from one’ so Monozygotic twins started off as one fertilized egg (zygote) which split in the first few days to a week or so after conception. Monozygotic twins are the same sex* and generally look very alike, hence the label ‘identical’.

Of the Monozygotic (’identical’ ) Twins 33% are Dichorionic Diamniotic (i.e. NOT sharing a placenta or an outer membrane (chorion)  This is sometimes abbreviated to DC/DA  . This occurs because the fertilized egg split before the chorion had formed, in the first 3 days after conception. Depending how close together the twins implant into the uterus, they may have a fused placenta or or may have individual placentas.

Therefore it is possible for same sex twins to be identical and NOT share a placenta or chorion or amniotic sac66% of Monozygotic Twins are sharing an outer membrane (chorion) but have individual amniotic sacs. This is known as Monochorionic Diamniotic sometimes abbreviated to MC/DA  These have split between days 3 and 9 after conception.

1% of Monozygotic Twins are sharing both a chorion and amniotic sacs. These are known as Monochorionic Monoamniotic. This is sometimes abbreviated to MC/MA Monochorionic monoamniotic twins split after day 9  will be monochorionic monoamniotic.

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breastfeeding_twins_5_c

Troubleshooting Breastfeeding Twins

Is is possible to breastfeed twins? Yes! It is possible to breastfeed twins.

Will I have enough milk? You should do, it is produced on a supply and demand basis

What if my milk doesn’t ‘come in’?

•Some mums take 3-5 days for their milk to come in.
•Talk to your midwife about it.
•Make sure they are latched on properly.
•Drink plenty and breastfeed little and often.
•Contact your local lactation advisor,
•Ask your local twins club if they have a lactation consultant or a mum of twins who would be able to help you.
•However some mums find they simply can’t breastfeed for whatever reason. If this is the case with you, please don’t beat yourself up about it. x

My breasts are sore, what shall I do? Firstly make sure that you’re latching them on properly. Ask your midwife/health visitor to help check your positioning.

You can buy soothing nipple creams, try putting damp warm or cool flannels over your breasts, use nipple shields to protect your nipples.

My breasts are sore, red, swollen and I have a temperature.If you have red, swollen breasts, nipple discharge (other than breast milk or colostrum ) a feeling of hardness in the breasts, raised temperature or other flu like symptoms please see your GP urgently as you might have mastitis.

Further Information and Help :
Association of Breastfeeding Mothers  Helpline 08444 122 949
La Leche League  Call 0845 120 2918
World Health Organisation report 
NHS Breast feeding Website
Breastfeeding Network

 

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Tips for Breastfeeding Twins

Is it possible to breastfeed twins and triplets? Yes. It is possible to breastfeed twins and triplets. Many mothers of twins breastfeed their twins or triplets exclusively and thoroughly enjoy doing so.

If you would like to try breastfeeding tell your midwife – she will show you how to breastfeed.

Your Midwife will also be able to help you with positioning of your babies and ensure that they are latched on and feeding well. She may also be able to put you in touch with your local breastfeeding group or lactation adviser. Mums at your local twins club should also be able to offer help and support.

Benefits of Breastfeeding Twins

•It passes on some of your immunity,
•It is quicker – no bottles to clean and sterilise unless of course you are offering some of your expressed breast milk
•It helps you get back to your pre-pregnancy shape more quickly
•It’s free
•Where ever you happen to be you have a feed there ready and waiting for you, dispensing at the right temperature.
•Is easier to digest than formula
•Less chance of them catching a tummy bug
•The babies are less likely to be constipated
•It is thought to help protect them from obesity, chest infections, ear infections, child onset diabetes, eczema and asthma
•It helps to protect you from breast and ovarian cancers and from developing weak bones in later life.
Will I have enough milk to feed twins/triplets?  Your body produces milk on a supply and demand basis, so the greater the demand for milk, the more milk is produced. Once breastfeeding is established you should have no need to worry about whether or not you have enough milk to go round.
I have small breasts – does this mean I won’t be able to breastfeed twins? Small breast size should not affect your bodies ability to produce breast milk.

I had a caesarean does this mean my milk won’t come in? Milk production is sparked off by the hormones oestrogen and progesterone dropping after the placenta is removed so having a caesarean should have no bearing on milk production. Once the oestrogen and progesterone levels have dropped, prolactin and oxytocin are released which allows the breasts to release milk.

What equipment do I need to breastfeed twins? Really all you need is yourself and your twins! However there are some things you can buy that can make breastfeeding more comfortable. Some mums find that a large V shaped pillow  or specially designed breastfeeding pillow to support the babies really helps, or having several pillows stacked up under both babies so that they are at the right height to latch on properly.

At least a couple of good well supporting nursing bras are also a must. Make sure you get properly measured for this so it offers maximum support and is comfortable.

Breast pads are very useful for mopping up any leakage’s from your breasts, you can either buy reusable cloth ones or disposable paper ones.

If you are going to exclusively breastfeed you will need to consider what you are going to do when you go out without your babies. If you are going to express breast milk you will need a breast pump (unless you choose to express by hand). You can either use a single breast pump or buy a special breast pump which pumps milk from both breasts at once. The choice is up to you. Both work efficiently.

If you are going to offer breast milk indirectly you will need to work out whether you would prefer to offer milk using cups or  bottles and buy either the cups or bottles and of course a bottle brush and sterilizer.

A note book is a really good idea so you can jot down who has been fed and for how long.
Having a bouncy chair to pop one twin in can also be a great help.

Some mums have found that a loose fitting t-shirt allows them the discretion needed to breastfeed twins. Having a button down shirt doesn’t really work so effectively for twins.

When will I be able to breast feed my twins for the first time? If your twins are good birth weights and not very premature, you will be able to put them to the breast soon after birth. Usually this is in their first alert or wide-awake time which normally happens in the first 30-90 minutes after the birth.
How will I know how to breastfeed my twins? Your midwife will show you how to position the babies and how to get them latched on properly. If she doesn’t show you how, then ask her to show you.

Breastfeeding, the first few days after birth. For around the first 2-3 days your body will produce a special substance called colostrum. This is a yellowy colour and made up of water, protein and minerals and is exactly what your baby needs. It also contains vital antibodies which can help protect him/her from infection. Between days three and four after birth your body will stop producing colostrum and start producing milk.

Establishing Breastfeeding with Twins. In the first few days it is a good idea to give your babies short but frequent feeds. This helps your milk come in  as breast milk is made on a supply and demand basis, so the greater the demand the greater the supply! It also allows them to get used the sucking action, enables them to feed before they are so hungry that they are too tired to manage it and enables your breasts to get used to the idea of having two babies suckling from them too.

How do you Breast feed Twins?
First Get Comfortable When you breast feed you will need either a large comfy chair, or sofa or even a double bed. It can help to have access to either the tv or some relaxing music  to listen to whilst you feed. Some mums have an audio book on the go, others watch dvd’s or a programme on the tv.

A large V shaped cushion is also really good for supporting babies on especially if you have a caesarean section in that you want to take as much pressure as possible off your abdomen. If you don’t have a V shaped cushion you could use some extra pillows stacked up so that your babies mouths are at the same height as your breasts.
Have a drink before you start breast feeding and one after you finish. It’s also a good idea to pop to the loo before you start too.At first you may need some help to pick the babies up and to place them in the correct position for breast feeding, but after a while you will be able to pick them up and latch them on without any help.

It can help for you to have a bouncy chair to hand for you to put one of the babies in should you need to for whatever reason. Sometimes one baby needs a little extra time on the breast so you could pop him/her into the baby bouncer whilst you finish off the other twin.

Relax! The more relaxed you are about breast feeding, the more milk is going to be produced. This is because the hormone Oxytocin is released more readily if you are relaxed. Having some calming or soothing music on in the background whilst you feed can help you relax.

What breastfeeding position should I use to feed my twins? How you hold your babies depends on what suits you. There are three main ways used by mums of twins.

The first is often called the rugby ball hold as it looks similar to the way you would hold a rugby ball. The babies heads are supported by mum’s hands, their bodies are supported by pillows and their feet are tucked under mums arms.

The second and third ways have the babies bodies to the front of mum, one method has both babies feet laying the same way both supported by pillows and the other method has the babies criss-crossed in front of the mother, again supported by pillows.

Which ever method you use is fine, experiment until you find one that suits you. As long as the babies mouths are positioned correctly so they latch on properly, you are comfortable and they are comfortable then they will be fine.

You need to get your babies to take into their mouth a good amount of nipple and the darker surrounding area and form a good seal round it. You should be able to see your babies suckling properly.

How can I tell if they’re latched on properly?If you are worried about whether your babies are latched on properly, ask your midwife to double check how you latch your babies on. Sometimes a little guidance from a midwife or trained lactation consultant can make a huge difference to a mothers experience of breastfeeding.

How long should I allow them to suckle for? As long as they need is the general recommendation. At first babies (particularly small ones) need a small amount of milk at a time at very frequent intervals. Some babies finish a feed in around 10-20 minutes, others especially newborns can take a while longer. A baby who has had enough may move his or her head away from the breast.

Should I swap breasts midway through the feed? There is no need to swap breasts midway through a feed as each breast is more than capable of providing what your twins need each time. You may swap breasts so that each twin has a different breast to drink from each feed, although some twin mums prefer to offer each twin the same breast at each feed. If you find one has a stronger sucking action than the other you might feel more comfortable allowing that twin to start on the opposite breast to their last feed, but really whatever works for you and your individual twins is absolutely fine.

What if they fall asleep on the breast? Newborn babies often do this, especially in the early days. If you feel that they haven’t had enough milk for this feed you could wake them up a bit by changing their nappies and then seeing if they want a little more milk. If you think they have had enough to drink then that’s fine let them sleep, put them gently into their bouncy chair or cot.
A lot of baby experts think that it’s a bad idea to let them fall asleep on the breast but sometimes babies just do fall asleep on the breast it seems a bit silly waking them up again if they have finished their milk and are full. However if they haven’t been fed for a while and you know they need a feed, you will have to wake them up to feed them.

However, if they seem unsettled after a feed it would be worth investigating if there is any other cause for their fretfulness. They can sometimes need something else such as winding, a cuddle, they may be bored, or over stimulated or tired, or may be wet or dirty, or too hot or too cold. Listening to the pitch of their cries can help as often they use a different tone of cry for different things, which given time you will be able to translate – at least some of the time!

How will I know that they are getting enough milk? You know that you are letting them suckle for long enough if they seem content after a feed. Your breasts should feel also emptier after a feed. After the first few days your babies should be having at least 6-8 wet nappies a day and look healthy and content. After the first few weeks your babies should be gaining weight at a steady pace.

Should you find that your babies are not settling well even after a full feed, are still showing signs of hunger, or are not gaining weight or do not have at least 6-8 wet nappies a day your babies may need longer on the breast. If you find that they are falling asleep or look a little tired midway through the feed it is fine to have a few minutes break, maybe change their nappies or perhaps put one in their bouncy chair for a few minutes whilst you finish the other twins feed. You can then finish the second twins feed once the first one has finished theirs. You will soon see what works for your babies.

If your babies fontanelle’s (soft spots on their heads) have a dip or a bulge, this can mean your babies are dehydrated or not well, so contact your GP.

If your breasts are sore during or after a feed you may need to make slight adjustments when latching your babies on to get them correctly positioned. Once your breasts are used to being used for breastfeeding, it should not be uncomfortable to breastfeed.

If you are at all worried about breastfeeding your babies contact your health visitor for advice. Don’t be afraid to ask for help, that is what they are there for.

How long between feeds? This depends on the individual babies – and can vary from day to day. Babies go through growth spurts and hungry days and days when they just need a little comfort. It makes sense to feed them at least every 3 to 4 hours during the day, more often if they are hungry. Some babies like to cluster feed. This is where they have several feeds in fairly quick succession often with a longer gap at the end. This happens especially in the evenings or when having a growth spurt.
See what works for each of your babies and feed them on demand. Don’t worry about not having enough milk, your body automatically produces milk when your babies need it, and the more you feed the more milk you will produce.

If you find that they just won’t settle at all or they look unwell or have a temperature contact your GP or health visitor for advice.

However if you are fairly certain that they are full and they still don’t seem to want to settle down or are crying even after a full feed then check that they are not
•Dirty or wet
•Full of wind
•Too hot or cold
•In need of a cuddle
•Bored
•Tired
•Over stimulated

If you feel they are not well then contact your GP for advice.

If you are worried they are not feeding often enough then contact your GP or Health Visitor
What about night feeds?For the first weeks your babies will need to be fed round the clock at least every 3-4 hours. They may go longer during the night after the first 2-3 months when they are able to take more milk on board at each feed during the day.

How you deal with the night feeds is up to you and your babies. Some twins naturally wake at similar times so it makes sense in this case to feed both together if you feel confident to do this, or one after the other if you prefer to feed them individually.

Should your twins not usually wake up for feeds at a similar time  and they are of an age where they still need a night feed or if they are for whatever reason likely to wake up hungry during the night, it makes sense to wake the second twin up when you have finished feeding the first one, otherwise you are likely to climb back into bed just when the second twin wake ups! If you are used to breastfeeding them both together then it is fine to wake the other twin up and feed them both together.

Whatever you do, it is important that night times are deadly boring for your twins. This means no bright lights, no talking unless absolutely necessary, no playing. Having a night light bulb in a table lamp in a far corner will provide enough light for you to see what you’re doing without making your babies be any more wide awake than strictly necessary. A dimmer switch on an over head light can also provide sufficient light, especially if you only put it on its very first click.

Will they both suck at the same rate? You may find that one twin likes breast feeding and gets a good sucking action right from day one and gets satisfied quickly where his/her twin may take a while longer to finish each feed. It is possible to work to the needs of each twin, you will get more adept at getting yourself comfortable and being able to put one twin safely down whilst you finish off the other twin.
It takes practice to get it right Breast feeding can take a little while to become accustomed to, especially if your twins are your first children. However you will quickly get into the rhythm of picking your babies up, getting ready for feeding and getting comfortable.

Feeding newborn twins  Do I have to feed them together? NO! You don’t HAVE to feed them both together. Sometimes it is very nice to be able to simply feed them one at a time. This way you can give them a proper cuddle as you feed them. That said, it is useful to  have the skill to feed them both at the same time especially when time is at a premium or for night feeds.

Is there anything else I should consider when breastfeeding twins? It is important to eat a healthy diet and to drink plenty. Always have a drink before and after feeding. Eat little and often and think carefully about what you are eating, eating foods that are nutritious is better than eating lots of fatty, sugary snacks that are full of empty calories. You will need to have around 800-1000 extra calories  per day for twins.

I am breastfeeding twins but have been given medication, is it safe?  The best way to check this is to talk to your pharmacist or GP. Always mention to your GP or Pharmacist that you are breastfeeding to be on the safe side. This also goes for natural, herbal and homeopathic remedies. Whilst many medicines are now safe for use for breastfeeding it is always wise to double check. Check the instructions in the box and if you are in any doubt, check with your GP or the pharmacist.

What happens when you are out and about? Many places are now breast feeding friendly and will offer you a comfortable place to breastfeed discreetly. It is possible to breastfeed discreetly with twins especially if you wear a baggy top or maybe a poncho or wrap if it is cold. You could breastfeed each individually when you are out but this takes longer than if you are able to feed them together. If you prefer to do them individually this is absolutely fine.

Should you go out for some time on your own, you will need to have either left a couple of bottles or cup of expressed milk in the fridge. Expressing does not take very long when you know how to do it properly. If you need help learning to express contact your midwife or health visitor, or a lactation consultant for help.

Expressed breast milk is able to be stored for up to 5 days in a refrigerator if at a temperature of 4oc or lower, or up to 6 months in the freezer. All the containers you use must be sterile. Defrost your milk in the refrigerator and warm in a jug until it is warm but not too hot. Discard any left over breast milk after each feed it does not keep after being warmed up.

Some mums offer a bottle of formula as an alternative to expressed breast milk whilst they are out.
How can I wean my babies from Breastfeeding onto a bottle/ beaker.If they are under 16 weeks old, you will need to offer them either a cup, or from a bottle. Put the expressed breast milk or formula into the bottle and if possible allow someone else to give them it!  If they are 16 weeks+ you could try weaning them straight onto a beaker, it might help to offer them a different drink like well diluted fruit juice or water from the beaker until they’re used to drinking from the beaker. Then add your expressed breast milk to it or formula depending on what you’re hoping to give them. It can help if you let another adult (for instance Dad!) offer the milk to them in the beaker, as they might decide they want your milk direct from you if they smell you!

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Teenage Twins

How can I help my teenagers through their teenage years?
You can do this by being there as a guide for them, not to judge or criticize them or to tell them what they need to do for every step of the way, but to be there as a point of reference should they need you to help them. Avoid using the ‘you mustn’t do that’ approach, as it never stops them from doing *whatever* it simply makes them not talk to you about it. If you can talk to them about things you can help them make sensible choices.

Talk to them about situations that might be happening to other people in their lives (like their classmate who is already doing *whatever*) If they can have a conversation with you about what might happen if that person continues with that particular behaviour, it is giving them the skills needed to navigate their way through their own lives, but in a non-judgemental way.
Setting clear boundaries is also key, they need to know what is and isn’t acceptable, and what behaviour you expect. If you ask them to be in for a certain time and they are late (without a good reason) then a consequence is needed. This could be ‘grounding’ them, i.e. not allowing them out or removal of privileges such as using their Xbox, PS3, computer, mobile (cell) phone etc.
They also need to know how to do things for themselves, such as how to operate the washing machine, tumble drier and iron, how to cook, how to store food correctly, budgeting, cleaning etc.
It also helps if you can provide them with regular, healthy meals, and a quiet place to study.
If at all possible give them separate rooms, so that they can study in peace, or equally play their music, games or musical instrument without directly disturbing their twin.
Help them organize their time so that they have time to study and complete homework to a suitable standard, as well as see friends, take part in sport, and find time to relax. They also need to take responsibility for organizing their school books, doing homework on time, having the correct kit for P.E., taking their musical instruments to school on the right day and practising them between lessons, and having their Food Technology ingredients on the correct day.
Understand that they not only need to learn to be separate from their parents, they also need to learn to be separate from their twin. Unless they are going to get places at the same University to study the same subject (which does happen!) or get jobs in the same company on the same floor (which also does happen!)  they are going to need to know who they are and what they want to do in life. For some twins this can be a real problem! They can be so used to doing whatever it is that their twin wants to do that they can’t be separate without feeling very lost or lonely. Some twins have put what they needed or wanted to do to one side just so that they can have the comfort of having their twin there for them. It is important that each twin reaches out for what they most value in life.
They may wish to experiment with new styles of dressing/ hairstyles which is very normal.
It is also very possible that they might not develop physically at the same rate. The slower one will catch up in good time, but it is vital to quash any teasing from either twin about their rate of development.

Should you keep teenage twins in the same class in high school?
The high school system tends to work so that the year group is divided into forms (some do this by ability and others do it by interests and who is likely to get on with who to create a community feel). Some schools use forms for pastoral care purposes only, and are not based on ability. In this instance you would have an opportunity to say to the school whether or not you want them putting in the same form. It can be nice particularly in Year 7 (first year) for twins to be together in form time, and then to be put in sets which meet their academic needs for the rest of the day. Once they have acclimatized to school life and reach year 8 they may feel comfortable to be in separate forms.
However if you or your twins feel strongly about being in separate classes from the start that is absolutely fine, just let the school know and see what they can do to accommodate this.
If your twins are well matched academically (both working at a similar level and neither being particularly brighter than the other) you may have the choice whether or not you keep your twins in the same classes for subjects. If they are not very well matched (one being distinctly more academic ‘brainier’ than the other) you will probably find that the school insists on separating them, and this is fine. They need to work at their own individual level.
At the end of the day you need to do whatever it is that feels right for you and your family.

Filling in Application forms for Twin School Admissions.
There should be a section on the application form to state any reasons you want your children to go to that particular school, it is worth mentioning in this section that you have twins (stating the other twins full name) and you want them in the same school (unless you would prefer they were separate) If you have sent your twins to school outside your normal school catchment area because you want your twins in separate classes it would be worth mentioning here too.
If you don’t get your twins into the school you prefer or only one gets into your first choice you have the right to appeal. State clearly your reasons for choosing the school and reiterate that you need both twins in the same school for logistical reasons (unless the two schools are next door to each other and dropping off and picking up are not going to cause too many problems.)
Should I send my teenage twins to separate SCHOOLS?
It is not unheard of for twins to go to separate high schools! Some do and absolutely love it. It is better to get two schools that suit the two individual twins needs, than to try to put one twin in a school that really doesn’t suit his/her personality at all!

What happens if one twin can go to Grammar school and the other one can’t?
Whilst traditional Grammar schools are now less common, there are still some in existence. These are where your child takes an entrance exam called the 11+. Only those who pass the exam will be offered a place. This can lead to a difficult situation if both take it, and only one passes or only one is academic enough to take the exam in the first place. What do you do? This really depends on your individual twins. It may be that they are happy to go to separate schools, or it may lead them to be very unhappy at the thought of being split up. The more academic one might feel happy that he/she is bright enough to get in, leaving the other one to feel deflated and unhappy.  At the end of the day you need to find a workable solution that is fair to everyone. This in itself is easier said than done. A compromise might be to get them both into a different (but equally good) school that accepts all academic levels. Or you might decide that the one that has got into Grammar should go, and the other one make the most of being at a different school.

Horrible hormones, homework, peer group pressure, of COURSE they’re going to be grumpy!
Teenage twins have several things to deal with, not only are their bodies starting to change and develop as they hit puberty, they also have extra homework and school responsibilities to handle, along with peer group pressure to try all kinds of new things (some of which you would prefer it if they didn’t try!) and hormones running riot. You will want them to keep their bedrooms at a reasonable standard of hygiene. You will find that they are naturally wanting to go to bed later on and sleep for longer in the mornings. This is because the teenage body clock is set differently to adults and children’s. There is no wonder that teenagers spend most of the time feeling grumpy.

Helping your twins go their own way in life

There are lots of opportunities for twins to make decisions about their futures during their teenage years. We need to guide them into making the right choices for them as individuals. It can be hard for each twin to decide what they (as individuals) want.
The first big decision they will have to make is what subjects to take for G.C.S.E (in the UK at least). Each twin needs to take subjects that interest them and that they are good at. This may or may not be the same subjects as their twin. They will do best at the subjects that grip them. Try to encourage them to follow their own preferences, not do the same subjects as their twin so that they can stay together.

University places and job applications can be the next big choice to be made. Again, encourage each of them to go in search of the job or course that inspires them rather than making a compromise to be with their twin.

Over their teenage years encourage them to develop their own individual style, and have their own friends. It is also ok for them to politely decline invites if they don’t want to go. This could be to parties, to a mutual friends house etc. It is ok for just one twin to go somewhere. In fact if they are confident to negotiate situations on their own this is a good thing as one day they are going to have to do this themselves without the support  of their twin. No matter how close your twins are it is a vital life skill for them to be able to do things on their own. It will seem strange for them at first when they go somewhere on their own but they will soon grow more used to it.

What happens when one twin develops physically sooner than the other?
This can happen! The best solution would be to reassure the twin who is not developing so quickly that it will be their turn soon. Also tell the other twin not to be unkind or tease them.  It can be hard for twin especially when one twin girl starts her period before her twin. They are not necessarily going to start at the same time. Make sure both twin daughters are prepared for their period starting by having sanitary towels in their school bag at all times.

Any Questions?

If you have any questions about raising teenage twins please email sarah@twinsonline.org.uk or ask a question on the Facebook Page www.facebook.com/twinsonline if you prefer your question to be anonymous please send an Inbox on Facebook and request that your question is reposted anonymously.

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