Twins and multiples

Multiple babies and sleep

Getting twins or multiples into a sleeping routine will help make sure everyone gets the rest they need.

A lack of sleep can be a problem for any new parent, but for mothers of multiples trying to get two or more babies into a sleeping routine, it can be even harder.

There are several reasons why two or more babies may be more difficult to get into a good sleeping routine.

Twins and triplets are more likely to be born prematurely and spend time in neonatal care, where they're used to being touched and nursed frequently. They may miss this contact and find it hard to settle when they come home.

If you're still visiting one baby in hospital, it can be hard to establish a good routine with the other baby at home.

Also:

• Premature newborn babies have tiny stomachs and need to feed every two to three hours. By the time they're four to six months old, they should generally drop their night-time feed.
• Coping with two babies is harder than coping with just one, so it may take you longer to get into a routine that suits you.
• More than one person may be caring for your babies, which can be unsettling for them, and they will take a while to get used to being handled in different ways by different people.
• You may want to comfort a restless baby faster than you would a single baby, as you are worried they may wake up their twin.

However, there are plenty of ways to encourage a good sleeping routine so that everyone gets enough rest. Try the following techniques to help twins sleep in the first six months:

• Put your babies down in a safe sleeping position, on their backs with their feet touching the bottom of the cot or Moses basket.
• Make sure they don’t get too hot, particularly if they're sharing a cot, and that blankets are securely tucked in.
• Have a bedtime routine and stick to it. This will help the babies get into a good settling routine.
• If your babies have been sleeping together, you can try to put them in separate cots if one is waking the other. You need to be flexible as one may prefer a cot while the other is more comfortable in a Moses basket. You can place cots next to each other so the babies can still see and touch each other.
• In the early days, try to synchronise night feeds so if one wakes up you can feed the other at the same time. Be prepared for one twin to sleep through before the other.
• Don’t rush to cuddle a baby if they cry. Normally, the other twin will sleep through their twin’s crying.

Can my twins sleep together in one cot?

You may put your twins to sleep in a single cot while they're small enough, either because they slept together in hospital or because space is tight. This is called co-bedding and is perfectly safe. In fact, putting twins in the same cot can help them regulate their body temperatures and sleep cycles, and can soothe them and their twin.

If you put your twins in the same cot, follow the same safe sleeping advice as for a single baby. They should be placed on their backs with the tops of their heads facing one another and their feet at opposite ends of the cot, or side by side on their backs with their feet at the foot of the cot.

If you want to use a barrier to separate your twins, use a fixed cot divider, not rolled up blankets or towels.

Because you can use a single cot for co-bedding, it can allow you to keep your babies with you in your room for longer. Having your babies in a room with you up to the age of six months is known to reduce the risk of cot death.

With triplets, you can sleep them next to each other across a cot while they're still small enough to fit. They should be laid on their backs with their feet touching the side (effectively the foot) of the cot.

When your twins are older, you may choose to put them in separate cots placed close together so they can continue to comfort each other. It's recommended that babies sleep in the same room as their parents for the first six months, but if older twins are disturbing one another, you may decide to give them separate rooms if you have the space.

 

Feeding multiple babies

Developing a routine around your babies' needs can help you cope with caring for your newborns.

Bringing your babies home with you is a cause for celebration, but it can be daunting to take on the responsibility of caring for twins or more. Looking after one newborn baby can be hard enough, but when you split your time and energy between two or more, it’s easy to become overwhelmed.

The Twins & Multiple Births Association (Tamba) advises that the best way to cope with caring for twins is to develop a routine that suits you. Think about your babies’ needs – feeding, sleeping and playing – and develop a routine around these activities that works for the whole family.

If your babies have been in neonatal care, they may already be in a routine and it’s probably worth sticking to this when they come home. However, you'll need to adapt the routine as they grow up and their needs change.

Creating a routine

Whether you breastfeed or formula feed, you'll need to create a routine that suits you and your babies. Some mothers feed both babies at the same time, some prefer to feed one after the other, while others feed on demand, whenever the babies seem hungry. 

You will need to adapt your method according to your babies’ needs. For example, if one baby is smaller and needs to feed more often, you won't be able to feed them at the same time at first. If you want, you can work towards bringing their feeding routines together as your babies grow.

If your babies are small or were premature, always follow your doctor or midwife’s advice on feeding.

If you have any concerns about your babies’ growth, you can take them to your local hospital to have them weighed to make sure they're putting on the correct amount of weight.

Feeding

Most parents take the decision of how to feed their babies very seriously. It's not only important for nutritional reasons, but feeding will also take up a lot of your time in the first few months of your babies’ lives.

While all parents choose which method of feeding suits them best, it's important not to be put off breastfeeding because you're having multiple babies.

It's possible to breastfeed twins and, in some cases, triplets. Many are breastfed until they are weaned. The advantages of breast milk for your babies are the same as for single babies.

However, as multiple babies are more likely to be born prematurely, there are even more benefits to breastfeeding. Breast milk is better for premature babies as their gut is immature and it's easier for them to tolerate and digest breast milk.

Formula feeding may be necessary in combination with breastfeeding if you have triplets or more, or you may choose only to formula feed your babies.

Weaning

When your babies are around six months old, you can begin to wean them by introducing solid foods. It's not unusual for one baby to be ready to begin weaning before the other, so let your babies dictate when you start to wean them.

Unless one of your babies has a serious infection, it's safe for them to share spoons and bowls as they will be exposed to the same germs. Even if you try to stop them from sharing, most twins will grab one another’s spoons and cups, so there isn’t much point trying to keep their feeding utensils separate.

Multiple babies: getting out and about

If you have twins or more, it's easy to feel left out of some of the activities that mums and their single babies enjoy. It’s harder to get out and about with two babies, particularly when they're very young.

It can take longer to get into a routine that allows you to attend regular baby groups or classes, and when they're older it's more expensive to pay for activities.

However, there are ways to meet other mothers and children to ensure you don’t end up feeling isolated.

Child's play

Playgroups are a great way to meet other local parents, but they can be a challenge when you have two babies. To make sure you don’t end up making a wasted journey, call first to make sure there's space for your twins in the group, and also that you will be able to get your pushchair into the building. Ask a friend or relative to come along and give you a hand.

Multiple babies and postnatal depression

Caring for two or more babies is hard work. For some women, the extra pressure of coping with more than one baby can lead to postnatal depression.

This doesn’t mean that you'll definitely get depressed after having your babies, but there are good reasons why mothers of multiple births can be more at risk.

What can cause postnatal depression?

The Twins and Multiple Births Association (Tamba) identifies some of the most common causes of postnatal depression (PND) in parents of multiple babies:

• Caring for two babies is hard. You constantly have to split your time and attention between them, and cannot give them the same type of care you would a single baby. This is perfectly natural and coping with two or more babies takes some time to get used to.
• A lack of sleep is more likely to affect mothers of multiple babies. According to Tamba, only 14% of mothers of multiples have six or more hours of sleep a night in the first year.
• Twins are more likely to be cared for in the neontal unit. It's thought that this could lead to PND. This is because, instead of being able to celebrate your babies’ birth, you're coping with worry, stress and guilt.
• Twin pregnancies are more prone to complications and the birth may be difficult too. This means you can begin motherhood feeling low and exhausted. If you had a bad birth experience, you may want to visit the hospital and go through your notes to help you come to terms with what happened.
• You may find that the reality of caring for your babies doesn’t match up to your expectations of motherhood. If your twins are the result of IVF, for example, it may be hard to discuss these feelings with relatives and friends who assume you're thrilled to have the babies you longed for.
• Mothers of multiples may envy mothers with single babies as they feel robbed of the mother-child bond that others appear to enjoy.
• Isolation can be a big problem for mums of twins, who can find it harder to get out than mothers of single babies. 
• Lack of support can be a serious problem for multiple mothers, and caring for two or more babies on your own is physically and emotionally draining.

It's important for you and your partner to be aware of the signs of postnatal depression (PND) because the faster it's diagnosed, the easier it is to treat.

Spotting signs of postnatal depression

Symptoms of PND can include:

• crying a lot
• difficulty sleeping
• thinking you’re a bad mother
• not being able to cope, and blaming yourself
• anxiety and panic attacks
• being overwhelmed by even the smallest tasks
• feeling anxious or guilty
• feeling tense and irritable
• an inability to make decisions
• poor concentration

If you have the symptoms of postnatal depression or are feeling low or unable to cope, get help as soon as possible from your doctor.