Logistics

I thought I'd address some questions my friend had about the logistics of two newborns.

"One thing that I've been wondering about is the logistics of holding both babies when they're newborns and can't hold their heads up yet"

You'll often be holding one or the other, but not both. If you do need to scoop them both up, you make sure they're side by side somewhere safe, like in a crib or on the floor, or way in the middle of the bed with you absolutely right there. Then you lean over, put your hands under their bottoms and sort of push your arms up toward their heads until their heads are pretty much in your hands. It really is a scooping motion. Then you lean down further until your body is against their bodies, and then straighten, all the while holding the babies against you.

Needless to say (but I'm saying it anyway), it's not the optimal way to move newborns around. If you need to move babies from their bedroom to the family room, for example, you do it one baby at a time, always making sure you have a safe place to put them. A floor is a safe place if there are no safety hazards, other siblings, stairs to fall down, pets, etc. Other safe places are cribs, play yards, swings, infant seats...  When you're moving, one at a time is safest and using two hands is safest.

I also wonder about getting them both in and out of the car -- do I have to leave one baby in the car while I bring one into the house, then go back out and get the other one? Or will I get adept enough (and develop the upper body strength) to scoop them both up at the same time?  (I'm talking, again, when they're too little to hold their heads up; after that, I think I'll be good.)

Good question. It all depends on your particular situation. If you have a garage, you drive in the garage, close the door, and can take babies one at a time. Same with a driveway if you're in a safe neighborhood and wherever you're taking the first baby is right inside the door so you're not out of sight of the car. This also depends on how paranoid you are; I'm the queen of paranoia, but there are others who are comfortable with leisurely taking one into the house, settling him/her in a back room, and coming back to the car two minutes later without any view of the car in that time. I'm the "better safe than sorry" type.

I expect you'll have the kind of car seat for your newborns that has a base and a seat that comes out of the base. Usually people carry babies from the car in the seat; this is what I recommend. Yes, a seat and a baby are heavier than just a baby, but this gives you a lot of flexibility. You can take both babies in their seats out of the car and put them on the lawn. Now you can either carry them both to the front door, or carry them in stages, but in any case you can make sure you're not too far from either of them. You can lock up the car and get your bag before you carry babies, go back to do it, whatever. Meanwhile, they're safe in their seats and not able to get into trouble.

It's not that you can't carry babies individually without their seats, but I don't recommend it. Trying to get two babies at the same time from a car to the house without their seats would definitely be unsafe, though. How do you unlock your front door if they're not in seats? The seats can generally be carried in your hand or in the crook of your arm.

Aso depending on your situation, you could transfer the baby seats to a stroller system, roll the stroller to your door, and then move them from that into the house one at a time, of transfer the babies themselves to a stroller and do the same.

Another reason to bring the babies into the house in their car seats is you'll want to be able to do the opposite when you need to take them somewhere. You get them ready in the house, put them into their carseats, then move them to the car. You don't want to have to run out to get your car seats.

Those bouncer seats, whatever the brand or style, are invaluable for having a safe place to put a baby when necessary. Later, when they can hold up their heads, something like an Exersaucer is wonderful. We had two downstairs and one or two upstairs, all bought used at a Mother of Twins sale. Swings are good for younger babies, but some kids don't like them, so start with one.  The jumpers you put in a doorway are for babies who hold up their heads, similar to the exersaucer; they provide some variety for the babies. Again, only one of those are needed.

I would never (ever, ever) recommend a walker. Even if you don't have steps in your house, just don't do it. It allows too much mobility. Say you have a visitor who set a bag down? That bag is now within reach of a baby. Also, maybe you're careful never to take the walker anywhere unsafe, but your husband, mom, sister, whoever else is keeping an eye on the baby wouldn't think about it. I know a child who took a tumble because Daddy brought the walker onto the back porch...yeah. Luckily, the baby was fine.

I had a great play yard for my kids, the Today's Kids play yard. It looks like they don't have it anymore (except used on Ebay), but the Li'l Playzone with extensions is similar. We used this all the time once the twins got more mobile; it's also a great place for newborns if you have older kids or pets. It was my singleton's safe place as a baby -- a place where the four-year-old twins wouldn't trip over him.

Getting out and about


In the grocery store, I pushed the double stroller and pulled a cart behind me.  To do this, I really needed a stroller with a horizontal bar.  With my left hand, I grasped the bar toward the right side, and then placed my left forearm along the bar.  I was able to push and maneuver with one arm in this way, and then to pull the cart.

There are double carts and carts with benches and fire truck carts.  None of those work for little teeny babies; they need to be sitting up, holding their heads up, etc., for those kinds of things.  Also, you park in the parking lot and then…what?...leave the kids in the car and run to get the cart?  I do know a triplet mom who used to do this, but I don’t think it was optimal – she had little choice, probably.

For things like mall trips, usually everything I bought would go right under the stroller. Big baskets under your stroller are very nice to have.

Later on, as my kids walked, they had harnesses. They really will go in two different directions, and as quickly as possible; the harnesses were invaluable to me in keeping my kids safe.

There are obviously a lot of things to think about when you have twins. I remember mothers of singletons saying they'd "just" do this, or "just" do that. For example, "Oh, if he's having trouble settling down for his nap, I just pop him in the stroller!" I would sometimes say "But what about the other one?" That mother didn't have to worry about messing up the other one who was having perfectly lovely naps. Parents of twins don't "just" do anything.

You definitely will find the things that work for you and work for your babies. You'll find your stride.

Twin Peeks

 I should have some pictures of my newborn babies in here, but that would require scanning, so for now, here's a picture of them at 16 months. My son is in the pot; my daughter is behind him. Crazy children. At some point I'll add some newborn ones.

Bottles and binkies

Bottles: You do want your babies to be able to take bottles at some point, of course. Even if they have breast milk exclusively, you'll want someone else to be able to give them a bottle of pumped milk when you can't be there. So here's the skinny on bottles.

Nipple confusion: As I've mentioned, one of my twins had bottles in the NICU. This had no effect on her ability to nurse, but for some babies it might. They (the big "they," whoever they are) say that it's best to avoid bottles at first, and that's probably good advice. Know, though, that if one or both of your babies has to have bottles in the hospital, it doesn't mean nursing will never work for you. I've already mentioned the little cups they can also use to feed babies; this is something to ask about at the hospital if necessary.

Accepting a bottle: There is a time that's the "perfect time" to introduce bottles -- it's at three to four weeks of age. At that point, they shouldn't get nipple confusion from the bottles, and they're very accepting of this odd thing shoved in their mouth. More importantly, once you introduce the bottle, make sure they get a bottle at least weekly after that. Why? Because after that age, they can stop being accepting of the odd thing shoved in their mouth unless it's something they're used to.

This is advice I knew about, but ignored for my singleton. He took that first bottle of pumped milk at three weeks like a champ. Then came about a month (January, the dead of winter) where I didn't have to go anywhere and leave him, and I didn't bother with the weekly bottle thing. That child never took more than a teeny bit of milk from any source but my breast again, until he started drinking cow's milk at more than a year. Wouldn't take a bottle. Wouldn't sip from a teeny cup. Wouldn't let anyone feed him with an eyedropper. If I went out (and sometimes I did have to), it was hell for anyone left with that boy.

With twins, you're less likely to have this problem, but it's at least good to know about that and the 3 - 4 week time frame.

Types of bottles: We used Avent because it seemed they were more like mom's breast than some bottles. They were pricey, though, and tougher to find. Beyond that, some babies will take to certain bottles and not others, so you may want to get only a few bottles at first to try them out.

Binkies/Pacifiers: I don't know what the advice is nowadays on binkies. My kids had them, and I didn't think they gave them any nipple confusion. I didn't actually have any of them in the hospital, but my daughter was given one in the NICU, so we kind of went with it. When we bought them, we got the Mini-Mam, which said it was shaped more like mom (who knows?) The mini-mam also had one for younger babies and one for older babies; I liked that they realized a smaller baby might need a smaller binky.

For my son, who was so difficult to get latched on, sometimes the binky helped him latch on when he was very hungry. He'd be too frantic, so I'd put the binky in and he'd suck, suck, suck and get calmed down, then I'd grab out the binky and stuff in my breast.

My one problem with binkies was they had them for too long and I had a tough time getting rid of them. I was able at one point to limit them to just nap and bedtime, and then finally weaned them (him, really, she didn't care as much) off at about 2.5 years. I later read that six months is the perfect time to get rid of the binky, cold turkey, so that's what I did with my singleton and that worked like a charm.

I try not to judge other parents too much, but the one thing that I find really ridiculous is seeing a four year old (or older) running around the mall with a binky in his/her mouth, or talking around his/her binky. So don't let your kids do that -- if you do, look around for a gray haired lady nearby rolling her eyes; that will be me. ;)

Propping bottles: This doesn't really affect those of you who'll mostly be nursing, but I did want to mention it. "They" say to never prop bottles, and maybe that's the best advice. However, most twin moms who bottle-feed will tell you that they absolutely did prop bottles and they wouldn't have been able to make it without propping. When I watched my triplet nephews, I was told to prop bottles, and dammit, I propped bottles. How could those boys have been fed without propping? It would have been extremely difficult. There are also products to hold bottles, like bibs with holders on it, that twin parents have used with success. It's just another example of how you have to do what works for your family.

Color coding: Again, this applies more to people who bottle-feed all the time, but it's still useful. Assign bottle colors to each baby. Then when you are trying to figure out how much each baby had, you can tell, even looking at the bottles lying around. I advised my sister-in-law to do this with the triplets and I think it came in very handy.

Nursing twins -- supplementing

Effect on milk supply: If you have a singleton, I'd always advise against supplementing with formula except in cases when the doctor has told you to, and even then I'd use a cup. The theory is that supplementing with formula will lessen your milk supply. While I expect this applies to nursing twins as well, realistically you're nursing your twins so much (the demand is so great) that a little off-site supply probably won't affect your supply. It's something you want to limit, but if it helps you stay sane, do what you need to do.


I also knew moms from my MOT club who half-nursed. For each feed, one baby was nursed and one was fed formula. At the next feed, the babies would switch. It's not something I wanted to do (to me it sounds tougher than doing one or the other), but you should know that it's an option that worked for some people.


As for me, I've already mentioned that when we first came home from the hospital, the doctor wanted us to supplement with formula. I'd feed a baby and then hand him/her off to be fed an ounce of formula from a little cup of formula. Looking back on my feeding log, the first time we did this was when the kids were 7 days old and they'd generally take only about 1/4 ounce. It looks like they stopped taking any by the time they were 10 days old, so this only happened for a short time. My journal at 20 days old says "Dr. X was pretty impressed that they're being breastfed exclusively."


That didn't last that long, though. When they were 5 weeks and 2 days old, I wrote, "They are gaining good weight, but driving me crazy wanting to eat all the time. I'm not sure I have enough milk for them." I was constantly second-guessing myself; I should have said if they're gaining, I have enough milk. Bygones. In any case, at this point I decided that the final feed of the evening would be a formula feed, then we'd put the babies to bed and I'd pump so I'd have milk for other times.


Was that the right thing to do? I don't know. It seemed like a good solution at the time. It gave me a break from providing 100% of the nutrition for two babies. By the end of the day, I often felt like I couldn't possibly have anything left. It was another case of "doing what works for you" and it alleviated some of my second-guessing. It also brought in more gassiness and spitting up, and I eventually changed one of the kids to a different formula for that one feed.


A journal excerpt at three months and two days: "We're working on bedtime -- they don't get a million ounces of formula a night, nor do they get to come back downstairs to be fed more at the drop of a hat. K is getting the hang of it better, but hopefully we'll get it to work out entirely soon!" I'm kind of embarrassed at how pathetic we were at this. In our defense, it was 11 years ago and there weren't as many great sources of information on the internet at the time. Let "we can do better than they did" be your mantra.


Around that same time frame, I was realizing that we had a lot of pumped milk in the freezer, and I didn't go out that often, so we started alternating that last feed of the day when possible -- pumped milk for one baby, formula for the other.


By three months and 15 days, we started alternating the last feed of the day in a different way -- a bottle of pumped milk or formula for one baby, breastfeeding for the other.  We went on for a long time like that. It was nice to be able to give a baby two breasts. Eventually (I'm not even sure when but it was after I started feeding solids at about 7 months), the nursed baby was happy enough with one breast and the bottle baby started taking less, so I just nursed, one child to each breast, for that final feed.


If all that wordiness tells you anything, it's that you may try a lot of things to find something that works for your family. I would have love to have avoided formula entirely (as I was able to do for my subsequent singleton), but supplementing for this final feed of the day helped me avoid the stress I was feeling, being the sole source of nutrition for two other lives.

Nursing twins

Let me say right off the bat that nursing twins is tough at first. But so is bottle-feeding twins formula, according to many moms I knew in my Mother of Twins Club. I'm going to include some excerpts here from a journal I kept sporadically when my twins were babies. They were one month and four days old at the time of this entry:

Last night was a Mother of Twins meeting, the first one I went to...since I had the babies. It sounds like our life here is typical of life w/twins -- most people don't get babies in bed until at least 10 PM, and most people feed a lot from 5 PM until 10 or 11. Also, most babies are pretty fractious in the evening. A bottle feeding generally takes at least an hour a baby [remember, these are very young babies; times get shorter]. We've been finding that during the day, a bottle feed can be 30 - 45 m, a breast feed can be various lengths, anywhere from 15 m - 1 hr. But the evening feed for the 2 of them [with two of us feeding] takes all evening; say at least 8:30 - 10:30 or 11... But it does seem like we're not doing any worse than other parents of twins, and it doesn't sound like breastfeeding is making it any worse!

I know, that sounds scary. The beginning month or two is kind of scary, but all the "look at our beautiful babies" makes up for it. My point is that while breastfeeding is tough, there are a lot of advantages, and it's not like bottle-feeding your newborn twins would be a piece of cake anyway.

Maybe you can learn something from my entry, too. It seems ridiculous, doesn't it -- we just fed the babies for hours? In retrospect, maybe we should have given them a nice feed at 7 PM and put them to bed, then wake them up at 10 or 11 PM for a quiet, dark, night-time feed and then right back to bed. We were brand new parents of two babies and we were a little clueless. Do yourself a favor: read up on how to tell the difference between hungry babies and tired babies and try to do way better than we did.

Nursing pillow: I recommend a nursing pillow meant for twins. It's important that it straps around your waist.  The types I know of are the "EZ-2-Nurse Twins" pillow and the Ultra Plush Nurse EZ Twin pillow. There's a blow-up option, which I never used, that I can't imagine would be as good as the pillow.

Swapping or assigning breasts: Some people are adamant about swapping breasts each feed, that is, if Baby A is on the right for the first feed of the day s/he is on the left for the second feed. There are some advantages to this, which you can read about elsewhere, but the disadvantage is that it can be really confusing. There are times when you end up feeding them at different times (or you have a dawdling eater) and you feel like one breast didn't have time to recover. When my twins were 3 1/2 weeks old, I decided to assign each baby a breast.  They had very different eating patterns and I thought the breasts would adjust separately to each child's need. This is something that worked fine for me, so if you're having a tough time with the logistics of alternating, you may want to think about it. No matter what, make sure to mix up the positions to empty the breasts as well as possible. The position you're using will have an effect on what milk ducts are emptied.

Nursing twins in public discreetly: Honestly, while there might be some people who could nurse twins discreetly in public, it wasn't something I was comfortable with. So I used to nurse them one at a time when out at a restaurant or something. It worked because I was only out at a restaurant if I was with my parents or my husband. We'd wheel the double stroller next to the table, sit down, and I'd nurse one while looking over the menu. If the other baby needed attention, whoever was with me would keep him/her happy. I'd swap babies when I was done and they would usually be relatively happy for the amount of time we were at the restaurant.

I also heartily recommend nursing shirts. I liked the style where there were two openings in the shirt under a top layer, so you lift the top layer up slightly, position the baby and then the top layer nestles against the baby's face so your breast isn't really showing (unless baby pops off for a moment). With the two openings, if you do choose to nurse both in public, you're not showing as much, and the shirts are good for home, too.

Nursing twins - positions/logistics

Nursing positions: Google "breastfeeding twins positions" and you'll find all sorts of sites with drawings of nursing positions. Many of them won't tell you much about how to get into those positions.  It can be really tough with newborns; you may need some help, and you may end up nursing your newborns separately for a while.  It's worth looking at some of the sites you find though for the "standard" twin positions as well as a ton of information.

Lying down position for twins: After my twins were old enough to crawl to me to nurse, a friend told me about another position she used when her twins were teeny-tiny. I wish I'd known this one, but at least I can pass it on. The trick is to know that some babies are perfectly happy nursing when you are lying down and they're lying on your chest. This site has pictures, labeled the "face down lying position" and the "cross-body lying position." If you think it's one of those nursing positions born of extreme fatigue, I expect you're right.

Extrapolating this position, my friend would have one baby at her left breast with its body across her body toward her right hip. The other baby would be at her right breast with its body going back across her right shoulder. You probably could also have one baby at the right breast with its body going to your right hip and one baby at the left breast with its body going to your left hip. You could do this either lying on a big bed, maybe with some pillows around you, or on the floor, again with pillows around you. At first, you may want help with positioning babies. Eventually, if you use the "both babies straight down" position, you may be able to place them on the floor, lie down between them, and postion them yourself by rolling toward one, attaching and holding on, then rolling to the other and doing the same (while holding on well to the first one). It will take practice.

When the babies are older and can hold up their heads, crouch, etc., try lying on the floor with one baby on each side of you -- they'll crouch there and nurse. I can't recall at what age they can start doing it, but it's very easy and quick.

I've mentioned before that I didn't do a great job with getting the twins on together early enough. Looking back in my journal, I see the following entry at 17 days old: "Last Monday night/Tues am, I had them eating together on the pillow for about 6 feeds in a row. Since then, it hasn't worked so well, so I'm feeding them fairly constantly!"

Look how close I was! Six feeds in a row at a couple of weeks old?  So it was difficult! That was no reason to dump it completely for...many months. I can't believe how much time I wasted because I fed them one after the other instead of together. So my advice is to keep trying to get them on together, even if it's just once a day or once a week. Try it at different times of the day, maybe when they're not very hungry, maybe when they are very hungry...  But keep trying because at some point, you'll figure out the trick to it.  Because I didn't keep trying, it was quite a while before I did this.

General nursing advice

I thought I'd talk a bit about nursing in general first, because sometimes you need to walk before you can run. If my son had nursed as well as my daughter, I might have been able to nurse them together right away, but he was not a natural nurser. If you're a first time mom like I was, all three of you may have some learning to do.

These are tips that are especially good for one-on-one early nursing, when you're trying to help the baby learn to nurse. Once s/he's a good nurser, you don't need as many tricks. So, onward with the general nursing advice..

Take a breastfeeding class:  The more you know about nursing, the more likely you'll be successful. Most hospitals have a class you can take. Take notes and/or make sure you hold onto any handouts and refer to them when you're having trouble. They'll also probably hand out lists of where to go if you need help later; I called a volunteer on one of those lists and she was a big help with my son's latching problem.

Get your partner on board: Your husband should attend the class, too. Although you're the one who will actually nurse, your husband's attitude about nursing can help it succeed or fail. Nursing twins as a first time mom was quite difficult for me; at about 5 weeks I was thinking of giving it up, but when I asked my husband's opinion he said, "It's the best thing for them."  I decided to stick it out.  I did end up giving one formula feed a day, just to get a break; I'll speak more about that in a later post.

All advice is not created equal:  On the other hand, when I asked the pediatrician for nursing advice at a few weeks, she said "you've given them a wonderful gift," as if to say it was okay to give up, because I'd already done so much, nursing them those first couple of weeks. I get that she didn't want me beating myself up if I quit, but the gentle reminder from my husband of why I was doing this difficult thing was much more helpful to me.

Beyond that, if any of your helpers only bottle-fed, they may try to push you toward bottles.  They do mean well; their point of view may be "look how easy a bottle is; you know they got enough and everyone can help you!" If you had just one baby, I'd say absolutely not to listen to those people because you need to nurse in order to keep up your supply. Two babies changes the picture to some extent, but my point in this case is to take with a grain of salt advice that comes from someone who never nursed or didn't last beyond a few weeks.

Use the rooting instinct: If you touch the cheek (or corner of the mouth) of a young baby, s/he will turn toward that cheek with a big open mouth. Think of a baby bird waiting for that worm, but your baby only keeps that mouth open for a short time. So get the baby into nursing position, touch the baby's cheek with your nipple, and when s/he turns toward you, pull the baby toward you and stuff your breast into his/her mouth.  Note: make sure you're not confusing him/her by simultaneously touching the cheek away from your breast.

Watch for hunger cues: If your baby isn't hungry at all, s/he'll hardly pay attention to that touch against his/her cheek. Signs of hunger are a reaction to that touch as well as things like sucking on fingers, putting fingers/fists to his/her mouth... Ooh! Here's a wonderful site for hunger cues, complete with pictures! -- kellymom.  I wish I'd seen that site for my son.

Feed baby before s/he's extremely hungry: My son was extremely difficult to latch on. We finally figured out (with help) that once he was hungry, he was a very "disorganized" thinker and couldn't latch on.  I started feeding him before he was very hungry at all. He got to be a very good eater eventually, but he really needed this extra care on my part to make sure he was fed early enough so he wouldn't get frantic.

Skin to skin: Pull down your hospital gown in the hospital, or take off your shirt at home, and get baby down to his/her diaper. I'm not sure why, but the skin-to-skin contact helps the baby get things right. This helps keep the sleepy baby awake long enough to nurse, too.

Keep the sleepy baby sucking: Newborn babies are drowsy and it helps them continue sucking when you stroke their feet or their bodies.

Drink lots of water; get as much rest as you can: the rest thing is pretty obvious, probably, but the water thing may not be. Always have some water next to you while you nurse, and drink it throughout the day.

Postnatal hospital help: The nurses on the maternity ward may be able to help you with nursing. Beyond that, the hospital may have a time set up for new moms to meet as a group with a lactation consultant or they may have a lactation consultant come to the rooms. Take advantage of any of these things you can; if one isn't helpful, try the next.

Help at home: Bring in a lactation consultant, have a friend who successfully nursed come in, go online and find a nursing mothers' forum, etc. -- if you're having any problems, get help!

I'm going to add a link here to something that looks really helpful on the topic of breastfeeding: Yahoo! Health.  Anything I may not have thought to include here is probably on that site.