27 Sep Twin Tips… coping with the practicalities of two babies

By Anchen Verster – Registered nurse, midwife, SA Certified Perinatal Educator – SACPE, wife, mother to 4 children including a set of twins

As the Gynae moved the probe over my 12-week abdomen my husband opened his mouth to say something but the doctor, needing a few seconds to confirm his findings, silenced him. “Well,” he said, “You’re my second couple today expecting twins”. Elation and disbelief filled me. Two hours of giggling commenced (50% nerves, 50% excitement!).

At that doctor visit I was told that I was most likely to deliver the two babies prematurely given a shortened cervix. And so began 26 weeks of anxious days and fretful nights as I anticipated the premature delivery. Along with this ‘prophecy’, a fellow twin mom (her twins were 18 months and she was expecting her 3^rd baby) proclaimed that it is impossible to manage twins without two fulltime housekeepers or nannies. Given the fact that our budget didn’t even accommodate one fulltime helper I fell further into the pit of “how will we all survive”. So here’s my list of survival tips if you’re a twin mom or soon to be twin mom…. Incidentally we’ve done more than just survive, I actually enjoyed the twins and feel quite sad that they’re turning 5!

1. Make a plan. It was helpful to sit with my husband and verbalize my greatest fears about coping with 2 babies. We worked out a plan to tackle some of the anticipated challenges. For example my husband promised to be home between 5 and 7pm most nights so that he could help with supper, bath and bedtime. If he needed to work late he would start again after 7pm. The idea of that plan before the babies were born was comforting (I actually slept better at night after we decided that) and he stuck to his promise! Your plan could include asking a granny to come at a fixed time each week, using online shopping or doing your weekly shopping on Saturday or Sunday while your partner is at home, freezing some meals before the births…
2. Pace yourself. Don’t conquer the world before the babies are born. Most of us feel that we have limited time left when expecting a baby and especially multiples. We think life will end after the babies are born so we renovate or attempt new business goals or generally just wear ourselves out. The burden of sustaining two or three babies is greater on your body and thus the risk of premature delivery increases too. Don’t try and conquer the world during your pregnancy. If you have a closed office or private space at work put your feet up or lie on a mattress on the floor during breaks so that your body can benefit from some down time. If you’re home with a toddler use his nap time to lie flat and rest or catch up on admin while lying down.
3. Ignore the doom and gloom or at least try and be realistic about it. I lost count of how many people pitied me after the girls were born – both strangers and friends. Comments like “Rather you than me”, “Double trouble”, “How do you cope, I would die”. Set your own ‘new normal’ parameters. Of course life’s going to change and intensity of the work is more than with one baby but it’s do-able. I remember replying to one comment, “if I could pick out of a list of life challenges (assuming every person on earth has some or other challenge in life) I’d pick twins any day over a challenges like an incurable   illness…”
4. A bigger perspective. In the span of your 80 years of life, 6-18 months of intensity is actually very little. I know it doesn’t help to think of this in the middle of sleepless nights (believe me I know!) but when you’re planning your parenting style and you are persevering through breastfeeding hiccups it’ll help to think of how little this time is in relation to your life-span. Persevere, knowing that the intensity will ease in a few months and it’ll be worth it to look back at your twin rearing achievements when you’re 80!
5. Make use of Multiple Births Resources in South Africa such as SAMBA. They have helpful talks and get-togethers that many multiple parents have found invaluable. However, don’t confuse this resource with childbirth education classes/prenatal classes. They are not interchangeable and provide different kinds of education and support. It’s also very beneficial to get help and support from other ‘multiple moms’! Always be aware that this advice is usually not medical or backed by research so be careful what you follow.
6. It is possible to exclusively breastfeed Many moms assume that it’s not possible to provide enough breast milk for two babies and they are often encouraged by their health care providers (believe it or not!) to start supplemental formula feeds very soon after the birth. It’s much easier to ‘outsource’ some of the job of feeding if you formula feed. As I look back, breastfeeding forced me to slow down with my babies and really ‘be’ with them. As I look back those first few months were such a blur of mothering tasks, I am so thankful for the ‘forced’ hours and hours stuck on the bed or couch breastfeeding them. If you’re determined to breastfeed your twins can I encourage you in the following?
7. Set your breastfeeding goal prior to the birth. Don’t decide to “see how it goes” because it will be tough at times. These goals may include how long you would like to breastfeed for. For example one year, two years or until your babies self wean? Do you want to only give breastmilk until your babies start solid food? If you are unsure of what you’d like your goal to be then do plenty of breastfeeding research before you decide. During the 3^rd night after my twins were born they wouldn’t settle and wanted to drink every hour. I was emotional and tired and the nursing sister on duty tried to persuade me to give some formula. I waddled to the nursery still struggling with post-caesarian pain and a large ‘unpregnant’ belly and pleaded with the staff (in tears) not to give formula. We made it through that night with lots of regular feeding and then next day was better again but how easy it would have been to give that first bottle in hospital if I didn’t know exactly where I was headed with my breastfeeding goal.
8. Keep a list of names of Lactation Consultants or book an appointment prior to your hospital admission. Unfortunately unless there is a specialized staff member in the hospital you may be exposed to lots of varied advice and prodding and poking. If you book an appointment in advance you can always cancel it if things are going well.
9. Feed your babies regularly. Don’t stick to the hospitals 4-hourly rule if your babies seem to want to feed more regularly. Trust your instinct and follow their cues. The first two weeks of regular feeding can really set you up for better supply later on.
10. A breast pump is not always a necessity, but with multiples it can come in very handy. Pumping is a great way to increase your milk supply and it may help when your babies are 8 weeks or so and you want to give them some expressed milk or let dad do an evening feed while you get an early night. Breast pump hire is also an option and may be very beneficial in the first few weeks while you establish what your future pumping needs are going to be. For regular pumping with multiples it is ideal to use a pump that will do the best job in the least amount of time.
11. Don’t be pressured into feeding both babies at the same time! If you’ve breastfed before it’ll be easier to latch two babies, but if this is your first time breastfeeding concentrate on getting a good latch with each feed before you get into the rhythm of feeding both at the same time. If they’re ‘easy latchers’ then it’ll be more do-able during the first few days but otherwise wait until the latching is a bit easier. On my second day after the birth a staff member walked into the room and asked me why I wasn’t feeding both babies at the same time. I was highly annoyed, knowing she’d never tried it before!
12. Feeding on demand is ideal but this is a bit more complicated with multiples. Follow the cue of the baby who wakes first-let’s say baby A. Either wake baby B and feed them at the same time or finish feeding Baby A before waking Baby B. This is still, in essence, feeding on demand, but by demand of the first waking baby which will not always be the same baby. Alternatively give Baby A ‘main course’, wake baby B for main course then offer them both ‘dessert’ either together or apart. I found I used different techniques depending on how tired I was. If I was too tired I didn’t manage feeding both at the same time. In the first weeks each feeding session (feed, burp, change) took 90mins and they fed every 3hours so I’d have 90 minutes before the next feed began (yes during the night too!). This sounds ridiculous, but the feeding duration gets shorter within a few weeks.
13. Use your help wisely. If granny is visiting pass the first fed baby to be burped and changed to her while you feed the next baby. (Then leave both babies with granny while you catch a nap!) The workload with multiples is a bit like a sausage machine and getting tasks done quickly and effectively (using available help) can make a difference to coping. I had a housekeeper three days a week to help with the chores, but I would plan a quick admin or shopping trip while she was there and the twins were sleeping. I also met two University honours students who I paid occasionally to come and help for an afternoon. This was a great help. It also gave the students some exposure at looking after newborns and they developed a special bond with my girls which continues today.
14. Get used to some crying. I often chat to parents who never conceptualized the fact that their baby will cry or scream at times. It is abnormal and concerning to have a baby that never cries. I’m not talking about a baby that cries some and then is easily consoled. I mean a baby who doesn’t make use of their communication tool to let you know: “I’m tired”/ “I’m over stimulated”/ “I’m hungry”/ “I want to be held”. With two or three babies in the house your ‘crying threshold’ needs to be a bit higher than a singleton mom’s or dad’s. That doesn’t mean letting your babies ‘cry it out’ but it’s just not physically possible to respond immediately if you are one adult looking after 2 babies. I remember shouting from the shower to two screaming babies (on numerous occasions) “I’m coming my girls, mommy can hear you, I’ll be there soon”. Even calling to them when you can’t lift them immediately lets them know that you hear them. It’s also unrealistic to expect to meet all your regular “activities of daily living” while your babies are asleep or calm. For the sake of your own sanity there will be times you’ll have to put a fussy baby in a safe place (like a baby chair within your vision) while you finish getting dressed. That’s okay! On a few occasions our ‘colicky’ babies would scream late into the night, my husband would be at a work function and our two-year-old would be woken by a thunder storm. My husband would come home to me rocking on a chair in the dark, two crying babies on each shoulder and one crying toddler on my lap and of course the tears were streaming down my face. Thankfully those nights were the exception!
15. Keep a box of “extra’s” in the car. It becomes quite bulky carrying around extra clothing and nappies for multiples. Other than the usual nappy bag “stash” I kept an extra plastic box (just bigger than a shoe box) with extra nappies, wipes and clothing in the boot of my car. This meant I always had extras if our day out was unexpectedly long. If your babies are big on bringing up milk you can even keep an extra T-shirt or top for yourself in the box.
16. Lower your standards. Part of getting used to the complexity of 2 or 3 babies might mean a messier house, fewer ‘braais’ on weekends or social outings. If you’re a tick box person or fanatical about a spotless house it’ll ease some of the stress to lower your standards a little. Leaving the dishes till the morning might translate into 40 minutes with your partner, which is way more important. You don’t have to bath your babies every night (it’s actually better for their skin and normal flora maintenance). This might mean an extra hour of sleep for you!
17. Potty in a pram. Once we started with potty training I kept a potty in the car/ under the pram everywhere we went. It was inside a plastic bag so no-one could see but it made potty training so much easier if the potty was always available. Even if we used a public toilet it was still easier to use our own potty.
18. Enjoy your twins or triplets! It’s so easy to work the months and years away with caring for them that you don’t ever take time to enjoy them. Sit and read to them (even from a few weeks old), play with them, giggle with them. Work hard at laying down special memories (for you and them) of your double or triple blessing!

PS my twins were born at almost 38 weeks so the anxiety was wasted!