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Surviving Twins

Tips And Tricks For The First Few Months
(before I forget them in the mists of time)
By Our Favorite Guest Author ~ Geohde, M.D. and Mother of Twins
2008

Surviving twins? First of all, I'll state the obvious. Having newborn twins is very hard work.

Although it wasn't quite as terrifying as I had been lead to fear from all the indrawn breaths and 'Oooh-err, TWINS, eh? You're in for a shock and no mistake that everybody from friends, family and random strangers in the supermarket liked to shake their heads and dismally predict (with barely concealed glee) at the sight of my enormous waddling girth, it really wasn't easy.

At the time, I recall thinking 'this isn't so bad' because I'd manage to find seven hours of total sleep in twenty-four most days.

In retrospect it was hard, tiring work, I just didn't like admitting it (even to myself). To GET seven hours sleep, I'd have two three hour stretches overnight and perhaps a sixty minute doze in front of the TV when I intended to sit down for just a minute to watch the news after my husband came home. Otherwise I'd lose track of the days, you see.

Broken sleep for a few months sounds bearable until you realize that it doesn't really feel anything like the number of hours would suggest when it's all in bits and pieces, because it makes an utter mess of your sleep architecture. I still wake up at four am for no particular reason to this day.

Anyway, the point I am trying to make amongst my revelation that I am a ten hours a night kind of girl left to my own devices and am clearly sleep obsessed, is that newborn twins aren't quite as bad as you fear, generally speaking, but in retrospect you'll be amazed just how well you can function chronically exhausted.

Oh, and keep a diary of things you need to accomplish (down to 'bathe' and 'brush hair' if you're like myself) because your memory is one of the very first things to go, closely followed by your patience and fashion sense.

I write this piece seven months down the track, and although my fashion sense (and waist!) has recovered, my patience and my memory never returned to pre-twins levels.

So, in case any of this is helpful, I'm writing what I remember before I forget and simply resort to exploding with fits of slightly hysterical laughter when I hear of someone expecting multiples.

Surviving twins is really not so bad. Let me begin again.
Otherwise entitled, "So, you're having twins"?

Firstly, if you've not been terrified by my introductory spiel, hello! Don't go away, please? Welcome to the club.

I had my (non-identical) IVF twin girls in mid-2008, I have no formal support system and no informal one in the form of either a mother or mother in law, so I'm outnumbered by infants almost all the time. My house is clean. My children are bathed (as am I), and I manage to turn up to work three days a week. Oh, and I write about my experiences, too. There is life after multiple birth, I promise. My husband is often away or working funny hours. It's Really Not That Bad. I'll probably do it again in a year or two.

I've yet to carve my beloved spouse's eyeballs out with a blunt spoon in frustration at ever ejaculating into a cup for science (although I have fantasized about it), OR go doolally with sleep deprivation OR forget to change my underwear for three days running (although I must admit to two days on a couple of notable occasions).

If there's anything I haven't mentioned or you want to know more proper medical stuff, I'm so happy to help as I am a practicing MD. Or perhaps more usefully, browse the extensive list of resources here on Twin Pregnancy and Beyond. Information is power and knowing what to expect and being prepared for it makes newborns in multiple far, far less overwhelming.

9 Tips for Surviving Twins
(In my not-so-expert six months and counting opinion)

Yeah, I know. Like, duh, right?

I mean it. You will use a terrifying amount. You will see more poop than a proctologist at a bad day at the office. You will probably be piddled on more times than the owner of an over-excitable puppy. You will use a lot of diapers to keep those conventionally polite barriers we all like to maintain between excreta and your carpets.

Seriously. If you see the brand of local choice on sale, for godssake get them. It doesn't matter if they're size big-a**. Eventually your spawn will fit them.

Personally, being the eternal bore that I am, I spent my bedrest days in the second and third trimester online, comparing prices. I could Bore For My Nation in a cents-per-diaper competition. I can tell you to this day exactly how many cents every local brand costs per nappy.

As for which ones to get, given the options vary nation-to-nation I'll simply say that it's a bit like shampoo, i.e. above a certain threshold, all you're doing is draining your wallet without significant gain in quality.

I don't buy the too-good-to-be-true cheap-a** ones because they comprehensively suck at containing what should by rights be their job to contain, but I certainly don't buy premium. There's no need and I've got plenty of other things to spend my money on.

Oh, and for those of you who plan to cloth diaper, I do take my hat off to you. It is possible, but you'll need real commitment.

Roughly 50% of twins will make term. The other half will be premature, but not by all that much and a minority will be less than 32 weeks. You have a fairly good chance of having term babies but should be aware that it is also not uncommon for them to come a bit early. Even if you do make it to term, you're likely to find wandering about a shop physically taxing.

In other words, don't leave it until your fiftieth trimester to get the nursery ready. Apart from anything else, it sucks to go shopping for everything you forgot postpartum only to have strangers gleefully rub your newly-emptied jelly belly and ask when you're due. Yes, it happened to me. Note that "I gave birth last week" does tend to kill further conversational attempts.

I'll simply say that most commonly your twins will be nearly term or term (average is 36 weeks) and if they have any difficulty, it is likely to be with feeding only, unless they are more significantly premature (see my previous article on twin pregnancy and prematurity) . They may spend a bit of time in the nursery as 'growers and feeders' like mine did, or you may be able to take them straight home. In either case, Let The Games Begin.

If you end up bottle feeding, please don't do what I did and slay yourself with guilt. It is harder to successfully breastfeed twins than singletons. You're more tired than the average new parent because you've got two babies in your care and you need to produce twice the milk. Fatigue doesn't help milk production, and sometimes even if you're not tired your supply just won't be enough for two. Supplementing with formula essentially doubles each feed length, because you've got to do it twice.

I'm being as honest as I can about my breastfeeding experience, although it isn't entirely politically correct to admit that I gave up within two weeks. My babies are entirely formula fed.

Not to scare you, but the reality is pretty brutal with twins, it's not common to be able to keep up with the boob juice alone unless you're lucky enough to have a high supply. I had an absolutely ABYSMAL supply and at the end of the day, I was just too tired to keep it up when I got so little breast milk and I was having to make dozens of bottles a day as well as pump (neither baby would latch on to the breast by the time they came home, a side effect of their prematurity and early gavage feeding. By the time they could suck properly, they were only interested in bottles).

The logistics are that if you have to supplement with formula then you are in danger of going right from one feed to the next with breastfeed, breastfeed, bottle, bottle, pump, store, mix feeds aaaaaand start again.

What I'm saying is that despite the fact that I am very well educated in the physiology of breastfeeding, how milk is made and how to increase supply and was downing galactagogues like smarties and I so very very badly WANTED to do SOMETHING biologically right given the whole infertility and IVF conception, I still couldn't do it.

Don't beat yourself up if you don't succeed.

Conversely, if you can, that's wonderful and you'll save so much time and money washing bottles and buying formula.

BUT...
My supply was also absolute shite partly because my pregnancy was pretty awful, I have PCOS, and because my twins were just premature enough to have poor endurance/sucks so they were never at the breast - I had to try and build my primary milk supply on the pump and it just never happened.  

But give it a go, I do know a twin mum who did have a high enough supply not to need to supplement, so out of a field of the two of us that's a 50% success rate. However, the stats are that many people end up bottle feeding before their babies's age reaches the double digit in weeks. Don't feel like you've failed. 

As for types of bottles, I at first went out and brought the expensive brands. My advice now would be not to bother as the babies won't know the difference. Label consciousness doesn't start until at least thirteen. I have cheap-a** generic bottles and teats and they're fine. In fact, the fancy peristaltic nipples were too hard for my babies and I had to toss them out.  

Even if you do breastfeed your twins, you will probably pump sometimes and need some bottles. It's better to be spoiled for choice than not have enough. Start with at least twelve and if you end up bottle feeding get at least another twelve. Preferably wide neck unless your aim is superb on no sleep and fifty coffees. The narrow neck are an utter bastard to tip the feed into without spilling everywhere. That way you have about two days supply and all you have to do is chuck them in the dishwasher and run it every second day.

Unless you love your sink in ways I do not, this is MUCH better than washing them by hand. Trust me when I say you will have better things to do with your time than wash bottles. Before you use them, just pull them out of the dishwasher and sterilize them if fancy takes you in that regard. I have a microwave sterilizer that takes five-six bottles at a time, although I don't sterilize any more now that the babies are older.

On that note, if you use formula make your entire day's worth of feeds at one time. 'They' (i.e. the clever people who write on the sides of tins) do say ideally to make feeds just before you use them, but it's much quicker to make a dozen bottles at once than it is to piddle about before each feed. Especially when you're tired. They keep in the fridge just fine for a day or so. I make them by dumping the right amount of formula in all the bottles and then I fill with boiling hot water, put the lids on and shake to mix. I've only burned myself once. Moral of the story is to check the lid is on before shaking, and not by road-test. Yes, I know that this is not how they advise you to do it on the tin but if you do it the way they say on the tin with cooled-boiled water, you'll get lumpy bits and have to stir each bottle. It's a pain.

As for the volume at each feed (i.e. how much and how often should you be feeding your little lives) as a general guide your babies will take roughly 150 mls per kilogram of body weight per day over six feeds at first (but less in the first few days after birth in more like eight feeds (it's normal for babies to lose a bit of weight after they're born). So, a three kg baby will take 150 x 3 = 450mls total, i.e. roughly 75 mls a feed, which helps guide how much to make.

Obviously if they drain their bottles, they need more and if they're always leaving some you don't need to make so much. After they hit around three months of age they tend to take less than this as their growth slows down naturally at that point.

My twins were in special care for a couple of weeks after they were born and, although it was cryingly miserable to leave them in the hospital and go home alone, there was a huge silver lining...
Routine. Blessed routine.

I would otherwise not have known it was possible, but you can put them on a four hourly feeding routine. At the same time! Mine came home eating every four hours around the clock (i.e. 6am 10am, 2pm, 6pm, 10pm, 2am) - which meant that I got some quality sleep, especially if LS took the 6am feed before he went to work.

To be really honest, I used to sob at the 2am feed because it would take 45 minutes per baby and they'd puke and they were too difficult to feed to tandem feed at first, but at least I got to sleep until nearly 10am when I got back to bed at 3 to 3.30. Priceless.

As for when to expect to be able to drop the ungodly much hated 2am night-time feed, well, when you find you have to keep waking them for it give it a burl. It will take a few days for them to work it out, but once they do, they'll just take a bit more at the other feeds. Then you only have to make ten bottles a day (excitement not sarcasm, believe me). You'll also find that sooner or later you'll be able to feed then both at once rather than sequentially - it really helps if you have two good rockers/seaty things to put them in. By five-six weeks I could even prop the bottles on a rolled up towel and they could feed themselves. It now takes about 20 minutes to feed the both of them and I don't have to hold anything. I don't get vomited on nearly as often either.

Accept gifts of clothing early and often.

Although preemie sizes are great, they also only fit for a few weeks. Then they become very cute teddy bear clothing after that.

I ended up just letting my twins swim in their clothes until they got bigger with just a couple of tiny suits for public consumption for Those Who Might Judge.  

As for what to get, stuff with zips or separate tops/bottoms is the best. I initially got a load of one pieces with press studs (snaps). Those studs are so flipping annoying when nothing will line up, or you do it most of the way and then realize you skipped one, and the baby wiggles and you're tired. I ended up putting my darling spawn back to bed on many occasions with their suits completely unbuttoned because I just couldn't get it right, I wanted to cry and my hands wouldn't work properly without more sleep.

I still have press-stud flashbacks.

Check out some fun TWIN CLOTHING sites!

Yes, to state the obvious, you will be pretty tired to start with. Even though when they're newborn, they'll pretty much just sleep and eat. They'll get 20 hours sleep a day and you'll probably have four. Don't ask me why, it just seems to pan out that way 'sleep when the baby does' notwithstanding.

Mine slept best swaddled. I say use every advantage you've got while you can. As for how long you'll need to swaddle, it varies from infant to infant. Some babies are more prone to the reflexive movements that wake them up if left unswaddled than others. One of my twins was out by six weeks, the other we were still swaddling at night by three months.

Apart from nighttime, it is good to maintain a planned day wherever possible. We have a dedicated morning nap and an afternoon nap - both great times to get stuff (like blogging about how tired you are and not, say, sleeping) done, incidentally.

People (well my child health nurse) advise the sleep-eat-play sequence, but it's no big deal if you do sleep-play eat, my twins don't seem to have a complex about it, and they spit up much less that way. I care about that because I do the washing.

We put ours in two cots, but it really doesn't matter how you go about it. A bassinette (or two!) could be considered a waste of hard earned because you don't use them for very long, but if you want the babies in your bedroom they're probably good for that since they're smaller.

I got a side by side. One of the cheaper, lighter (although still pretty heavy), narrower twin strollers on the market. It fits through a standard doorway - not all of them do and this is a make or break point.

As for car seats, check your legroom, the anchor points in your car and the width of the seat bases before you buy. Yeah, I know, kind of obvious but it bears saying. Also, practice adjusting the straps before your twins are born, or you'll have that awful new-parent moment when you realize you're not actually sure how to strap a baby in properly. The same principle applies for your stroller, have a few goes at folding and unfolding it as some of them are surprisingly tricky.

We have a SUV type car and something like that is handy because the room is useful. Otherwise we'd have to take the wheels off the pusher all the time to fit it in. Not Cool In Pissing Rain. Especially if you ever misplace one when you get to your destination. I shudder thinking about that.

As for the 'et al.?' Shops may try to suck you into buying bottle warmers, room temperature gizmos etc. Resist. They're strictly optional. The microwave is fine for warming feeds, just swish before serving. If you feel warm, well it's warm and conversely if you feel cold, it's cold. No room thermometer required. Unless you want to get the gizmos, of course, then go for it. There's plenty on the market to keep you very, very poor.

I get asked all the time: "Are they twins?", "Boy and girl, right?", "Are they identical?", "Were they natural?", "Was your delivery natural?", "Ooooh you must have your hands full!", "Do twins run in your family?", etc, etc.

It all sounds pretty innocuous but it does get really grating.

Quickly.

Most of the time I now get the urge to say rude things to the rude questions. People also stare, and I've even had total strangers flip up the pram covers to verify that I have two babies in there (who were peacefully sleeping before you stuck your smelly face in, by the way Cigarette Lady In Supermarket).

I'm a bit of a shy sort, so it makes me feel like a traveling freak show. I guess I'm saying come up with answers you're comfortable with. I don't tell strangers my twins were IVF because I don't think it's their business.

Add your own 2 cents on the SILLY TWIN QUESTIONS page!

My two were born by semi-elective c-section.
Because I'd been on couch arrest for sixteen weeks, my house was an utter brothel by the time I got home from hospital. I spent several days heavy duty cleaning. At five days postpartum. Whilst I had an easy recovery, I probably wouldn't recommend it as a good time to clean your stairwell.

I guess what I'm saying is that I knocked back all the non-specific offers of help because I thought people might interpret it as not coping when what I should have said was "Awesome, I need this-and-this done". If people offer, have a list of tasks ready for them to do and let them do it. Have no pride about the help thing.

I live off a written day to day diary. It's a godsend. Otherwise I'd have no idea what month we're in, let alone that the phone is about to be disconnected because I forgot to pay the bill.

Try to leave the babies with someone and go grocery shopping without them, especially in the early days when you're stuck with only brief bits of mobility between feeds and you're tired. It's just too hard unless you're only getting a couple of things. You'll feel like you just conquered Everest without oxygen if you get out with merely your skin and a loaf of bread shopping avec spawn. When they get older, however, they like a trawl around the shops to Stare At Stuff, or at least my two nosey parkers do. Additionally, now I'm not so tired I'd consider myself unsafe to drive.

Anyway, if you're still at least reading this then either you're very patient, don't have much else on, or presumably it must actually somewhat apply to you and surviving twins. Therefore, to my remaining few companions, may I wish you good luck, best of British, a stiff upper lip and a well-stocked drinks cabinet. The last item is critical.

In final disclaimer, this merry correspondence is only based on my experience. Don't ever forget that opinions are often a bit different looking, and even if technique varies the net output can be surprisingly difficult to distinguish. Take what sounds helpful and run with those bits. Ignore the rest.

Much love, Geohde

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