Friday, September 3, 2010

Let's Talk About Twins (Triplets, Quads, etc.) Part 1: Getting Ready for Multiples

With multiple births on the rise, we thought we would share a short 2-part series on parenting twins, triplets, and higher order multiples. While multiple births represent only 3% of all deliveries in the United States, they account for 15% of preterm births (babies born before 37 weeks gestation), 20% of low-birth-weight births (less than 5.5 lbs.) and 19 to 24% of very-low-birth-weight births (less than 3.3 lbs.) (Goodnight 2009). Although each multiple birth experience is unique, one thing is universal: there is a lot of preparation needed to get ready for this wonderful yet challenging experience. Part one of this series will provide tips for families pregnant with multiples. Part 2 will provide insights into both the mother-infant bond and the twin-to-twin bond. Let’s start with some tips for getting ready for a multiple birth in your family.

Tip 1: Form your support group early
Having a support system in place is important for any pregnancy, but it’s essential for parents of multiples. Having two or more infants to care for will be overwhelming. Recruiting your family and friends to help you during this time will take some stress off of you and give you more time to focus on your new babies.

With this new experience it may also help to enlist the support of others who have parented multiples. Signing up for a local Mothers of Twins Club ( or another similar organization could prove to be an invaluable resource for you. They offer support group meetings, newsletters and opportunities for education and networking.

Tip 2: Make nutrition a priority

Eating a well-balanced diet and getting enough calories can have an impact on the outcome of your pregnancy. Although there is a higher risk of preterm deliveries and low birth weights with multiples, the likelihood can be reduced by eating a well-balanced diet while you are pregnant. In one study, mothers eating a well-balanced diet with enough calories to support appropriate weight gain for a twin pregnancy were more likely to gain the proper amount of weight at 20 and 28 weeks gestation. They also experienced fewer complications with their pregnancies, including lower rates of low birth weight, very low birth weight, preterm births, and NICU (Neonatal Intensive Care Unit) admissions. (Goodnight 2009) Talk to your doctor or a registered dietitian to make sure you are eating what you and your growing babies need. Pregnancy weight gain goals vary depending on your pre-pregnancy weight and the number of fetuses you are carrying.

Tip 3: Prepare for your hospital experience early
Keep in mind that twins and multiples often deliver early (on average 35-36 weeks gestation for twins and a few weeks earlier for higher order multiples). (Goodnight 2009, Evans 1993) While you can’t entirely plan ahead for your birth experience, there are a few things you can do to prepare for the big day:
  • Take a tour of the hospital where you are planning to deliver. Check out both the regular labor and delivery floor and the NICU for high risk babies.

  • Talk to your doctor about what to expect when you go into labor. It is also possible that your babies will come home at different times as one baby may need to spend more time in the NICU.

  • Talk to other parents of multiples to learn about their birth experiences. Even though every birth is a unique experience, you can ask them to share any tools that they found useful or helpful.

  • Do your research: Reading books and articles (and this blog!) to learn more about what you can expect and how you can prepare for your babies will be valuable.

Tip 4: Prepare siblings & close family members too

Older siblings and other family members need to prepare for the new babies too! If you have other children, talk to them about what to expect when their new siblings arrive. Helping siblings feel connected to their new babies can make the transition easier for them. One idea is to let the older brother or sister pick out or make little gifts for the babies or make something for them. You can also give something to the older sibling from the new babies to foster a positive relationship between them (Bryan 2002). For more information about helping older children deal with your growing family, click here.

Tip 5: Give yourself time to adjust to the news

Finding out you are pregnant is big news, but hearing you are pregnant with twins or multiples can be quite an unexpected surprise and overwhelming. Take some time to mentally prepare for the new additions to your family. Talking to someone (whether it be your spouse/partner, your doctor, a friend or a counselor) can help you deal with the emotions you feel or concerns you have as they arise.

We hope this post was helpful for those of you out there who are parenting (or preparing to parent) multiples. Many of the topics we discuss in our posts, including this one, are based on comments from readers like you. Continue to let us know what you think and what questions you have! We also encourage you to share this post with any new parents of multiples in your life! Then, stay tuned next week for part 2 where we’ll discuss the art of bonding with multiples.

Next time: Multiple Births Part 2: The Art of Bonding


Bryan E. Educating families, before, during and after a multiple birth. Semin Neonatol 2002; 7: 241–246.
Evans, M. I., et al. Efficacy of transabdominal multifetal pregnancy reduction: Collaborative experience among the world's largest centers. Obstetrics and Gynecology 1993; 82: 61-66.
Goodnight W, Newman R. Optimal Nutrition for Improved Twin Pregnancy Outcome. Obstetrics and Gynecology 2009; 114, 5: 1121-1134.
The American Congress of Obstetricians and Gynecologists: (accessed 8/31/10)
The National Organization of Mothers of Twins Club: (accessed 8/31/10)

*Special thanks to Kassandra Harding for her hard work on the research that allowed us to write this post!*

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