Whether you're expecting multiples or navigating life with twins, triplets, or more, you'll appreciate advice on how to survive and thrive. Here's what you need to know to get through the stages that lie ahead.

child kissing mothers pregnant belly
Credit: PhotoAlto/ Matton


Start recruiting help now, whether you'll be going back to work or staying home. "Planning for extra help is one of the greatest gifts you can provide for your babies, your other children, your husband, and yourself," says Joan Friedman, PhD, author of Emotionally Healthy Twins.

Many moms-to-be get overwhelmed thinking about the many things that are out of their control. Cathy Swan, of Lexington, Massachusetts, agonized: "Would the babies be okay? Would I deliver early?" But don't worry about what you can't control. Instead, focus on what you can, like your diet, says Nancy Bowers, author of The Multiple Pregnancy Sourcebook. Women of normal prepregnancy weight need about 2,700 calories each day, she says. "They should gain 24 pounds by 24 weeks of pregnancy, then about 1 1/2 pounds each week." Underweight women should aim to gain 45 pounds, and overweight women will want to gain between 20 and 25 pounds. Expecting triplets or more? You'll need to add 5 to 10 pounds extra per additional fetus, depending on your starting weight.

Kacey Batterton, a mother of newborn twin girls in Fort Worth, Texas, worried about getting too big. "People would say, 'You look like you're going to have that baby any day now!'" she says, "and my due date was still months away." Bowers acknowledges it may be hard to ignore unwelcome comments. "But remember that your body is doing this incredible thing -- times two or more."


Before you hang the "Welcome Home" signs, know that your babies might not be released from the hospital at the same time. Twins are almost always going to be preemies, says Kate Hall, chairwoman of Bluebirds, a nighttime infant-care agency for twins in Boston.

The March of Dimes reports that multiples make up about 3 percent of all births, yet are 20 percent of neonatal intensive care unit (NICU) admissions. Going home before your babies or leaving one behind in the NICU may not be the homecoming you imagined. But the good news is that most preemie issues (infection, feeding intolerance, respiratory distress, jaundice) are not life threatening.

Once you're all (finally!) home, expect feelings of joy, exhaustion, and everything in between. "Some days are filled with tears," Batterton says. "I have to choose between eating, sleeping, and showering, because before I know it, it's time to feed the babies again." A mother of multiples can get so wrapped up in meeting her babies' physical needs that there's no time to interact with them in other ways, Bowers says.

But bonding with two or more babies can take up most of your day, and you may find yourself wondering when you'll ever get some sleep. "That whole first month is a blur," Swan says. "I've never been that tired." Putting the babies on the same feeding pattern will help, Hall says. But that might mean you'll have to wake the babies to feed them every two to three hours. Alyssa Shaffer, of New York City, kept her twins, Nolan and Layla, on a really tight schedule: "With twins, you don't have the luxury of waiting till they're hungry." And most multiples are born prematurely and underweight, so you're constantly feeding them. Experts also say you should wake them together for daytime feedings and offer that last 10 p.m. feeding to encourage longer nighttime sleeping stretches.

Credit: Kaysh Shinn

First Year

You've emerged from the postpartum fog ready to tackle the first year. It may take six weeks or more to establish a routine as you decipher which baby needs what, and when. "Parents worry about not giving enough attention to one baby or the other," Hall says. "If one baby wants to be held constantly and the other doesn't, they feel guilty spending more time with the needier baby." But, Hall adds, your babies will let you know what they need. If you're holding your laid-back baby for feedings and interacting with him when you change his diaper, Bowers says, then you probably don't have to worry. Still, you want to get to know both babies, and there's only so much time in a day, right? Accept help, Hall says. "The first words out of a new parent's mouth should be, 'Yes, please.'" And be specific. When a neighbor asks to help, say, "How about Tuesday from 9 to 11?" Have him wash dishes and prepare bottles so you'll have more time with your babies.

Once they're mobile, two babies speed-crawling in different directions can be scary, Hall says. As one gets into the cat food, the other is behind you tipping over the trash. Have a safe place -- a playpen or bouncy seats -- where the babies can play while you're making dinner. Hire any caregivers before the babies crawl so they'll gradually get used to the kids' increased mobility.

Life with twins on the move isn't pure mayhem -- the first year holds doubly exciting firsts: smiles, laughs, steps, and words. It's tempting to compare your twins' developmental time lines, especially when one twin walks at 11 months and the other at 14. But there's a wide range of normal, and children develop at different rates. Carve out some individual time with each child, and you just might notice your "late" walker is a genius at building block towers when her brother isn't walking rings around her.

Toddler Years

At this stage, twins tend to entertain each other. "As my sons move into the toddler years, they're definitely each other's playmate," Swan says. But twin solidarity can go too far. Parents of toddler twins often feel their kids are "ganging up" on them, Friedman says. "For example, if one twin refuses to eat his dinner, the other will often do the same -- he feels power in joining the protest, testing the boundaries and vying for control, toddler style."

So how should you handle the demands, tantrums, and mood swings of two toddlers who sometimes act like a unit and, at other times, run in opposite directions? "Often the twins are craving individual attention, and their parents might not recognize this need," Friedman says. In fact, parents sometimes worry that spending time alone with one toddler will cause tremendous separation anxiety for the other. But Friedman predicts that while your twins may protest at first, they'll eventually adapt and look forward to spending their special time alone with you.

Aside from individual time with Mom and Dad, multiples also need separate playdates and the opportunity to develop their own interests. Sign one up for, say, a gym course and the other for a finger-painting class. Friedman did this for her sons when they were small, and none of the kids in either class even knew that the son she brought was a twin.

Bowers says that raising her twins is the best thing she's ever done: "Parents of twins have double the challenges -- but double the love, hugs, and kisses too."

Jon & Kate Plus 8
Credit: Kaysh Shinn

What Works in Real Life

Advice from Kate Gosselin, left, of TLC's Jon & Kate Plus 8:

  • "The most difficult part of having multiples is that we don't know what having one baby is like! We have never been able to sit and enjoy just one baby."

Advice from the Plymouth/Canton Mothers of Multiples Group in Canton, Michigan:

  • "You need a good stroller -- (we used the Graco Duo Glider LXI) -- that you can fold with one hand," notes Debra Ramsey, mom of Jason and Paige. "Also, hug your spouse once a day because he's tired too."
  • "We don't dress our identical twins the same," says Pam Gharaibeh, mom of Lessa and Ivy. "We want them to develop their own personalities. For the first six months, I put different nail polish on their toes."
  • "We never worried that one baby's crying would wake up the other -- if one started and woke up the other, we let them figure it out on their own," notes Colleen Myers, mom of Emma and Madison.

Multiples Survival Guide

Lisa Madden, mom to triplets and a singleton, lives multiple mania. That's why the Middletown, New Jersey, nurse co-founded Staying Sane, a business that provides support to couples who are expecting or who have multiple babies at home. Her tried-and-tested tips:

  • Set up circuit training. "You don't need two of everything. Put a swing, a vibrating chair, and an activity center on the floor, and move your babies along."
  • Put it on the big board. Madden wrote her triplets' names on a whiteboard, and under each she listed feedings, number of used diapers, and medications. "It's an easy, at-a-glance way to track this info."
  • Make a peace pact. Exhaustion can lead to nastiness. "If both parents are up for feedings, pledge that no one is held responsible for anything said between 11 p.m. and 7 a.m."
  • Find drive-throughs. Avoid getting out of the car to pick up dry cleaning, get coffee, etc.

Breastfeeding Multiples

Preemies can have difficulty sucking, swallowing, and breathing, which makes breastfeeding more challenging, says Bowers. But if you can persevere through the first few weeks, you're more likely to succeed. Some expert advice to help you along:

  • Breastfeed within a few hours of giving birth, one baby at a time per breast. Continue every two to three hours.
  • Once one baby is nursing effectively, try breastfeeding simultaneously (with the help of a lactation specialist and a nursing pillow).
  • If your babies can't breastfeed, start pumping milk with a hospital-grade breast pump within the first few hours after birth. Continue every three hours, and freeze the milk.
  • Once home, continue breastfeeding every two to three hours while family and friends take care of household chores.
  • Have a lactation specialist come to your house in the first few days to check the babies' positions and show you how to keep milk production up.

Originally published in American Baby magazine.

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American Baby