All pregnant women should be aware of the dangers of Twin to Twin Transfusion Syndrome (TTTS). TTTS is a complication of disproportionate blood supply to twin fetuses during pregnancy. It is critical that all women have an early ultrasound to identify if they are having multiples.

World TTTS Awareness Day is an international mobilization effort created by The Twin to Twin Transfusion Syndrome Foundation to increase awareness of the #1 problem facing multiples. It is crucial for women to get an ultrasound in the first trimester to identify multiples and then to determine whether there is one placenta or two. Women must learn the warning signs of TTTS, the 15 questions to ask at each ultrasound, and the available treatment options. World TTTS Awareness Day is about empowering parents and is filled with messages of Hope, Help and Encouragement. Your babies can make it and be healthy. Don’t ever give up. Please, Get Educated, Get Ultrasounds, Ask Questions, Get Treatment and Get Involved! This day is also a remembrance day for all the babies who have had TTTS. Candles will be lit tonight across the world during the vigil and messages may also be left for your babies through lighting online candles. Please visit their websites to learn more about TTTS.

What is Twin to Twin Transfusion Syndrome?

• Twin to twin transfusion syndrome (TTTS) is a disease of the placenta (or afterbirth) that affects identical twin pregnancies.
• TTTS affects identical twins (or higher multiple gestations), who share a common monochorionic placenta.
• The shared placenta contains abnormal blood vessels, which connect the umbilical cords and circulations of the twins.
• The common placenta may also be shared unequally by the twins, and one twin may have a share too small to provide the necessary nutrients to grow normally or even survive.
• The events in pregnancy that lead to TTTS – the timing of the twinning event, the number and type of connecting vessels, and the way the placenta is shared by the twins are all random events that have no primary prevention, is not hereditary or genetic, nor is it caused by anything the parents did or did not do. TTTS can happen to anyone.

If you are pregnant, what should you do?

Get Ultrasounds

If you are pregnant, it is critical that you get an ultrasound within the first 3 months. With this ultrasound, you can determine if you are having twins, triplets, or even higher order multiples. As early as 7 weeks of pregnancy, it can be determined if you are having multiples. If the placenta is monochorionic, or single, your pregnancy is at risk for TTTS.

Ask Questions

Once you have identified that you are having twins or higher order multiples, it is imortant that you ask questions at each ultrasound. For multiples, ultrasounds should be performed more frequently than in singleton and lower risk pregnancies. Listed below are the TTTS Foundation’s 15 Most Important Questions to ask at each ultrasound.

Confirm at initial ultrasounds (preferably by 10-16 weeks)

1. Is the placenta monochorionic?
2. Are the babies the same gender?
3. Can you see the dividing membrane?
4. Is the placenta implanted on the anterior or posterior surface of the womb?
5. Do the twins’ umbilical cords each have the normal 3 blood vessels, or does one of them have 2 vessels?
6. Are the umbilical cords fully attached to the placenta?

Questions to ask at weekly ultrasounds (16 weeks to delivery)

1. What is the largest vertical pocket of fluid for each baby?
2. Can you see the bladder of the donor baby?
3. What are the weights of the babies in grams? (every 2-3 weeks)
4. Are the dopplers normal for both babies?
5. Is the heart of the recipient baby enlarged or thickened?
6. Does the recipient baby have hydrops?
7. What is the measurement of your cervix, is it long and closed or thinning or dilated?
8. Is the smaller baby growing at the same rate?
9. What is the fundal height?

Read the explanations for these questions at the TTTS Foundation’s website.

PLEASE, get an early ultrasound to determine if you are carrying multiples. If you are pregnant with twins or higher order multiples, PLEASE ask the questions provided by the TTTS Foundation. It could save your babies’ lives. If you are diagnosed with TTTS, or would like more information, please contact the TTTS Foundation for help, information, and support.

When having twins, you should plan to complete all your preparations before your 30^th week of your twin pregnancy. 

• Twin pregnancies experience a much higher rate of bed rest than singleton pregnancies.
• Twin pregnancies experience a higher rate of pre-term labor.
• If you manage to make it into or through your 3^rd trimester, you will very likely be so tired that you will not be able to accomplish much on your to-do list.

 Tasks you can (and should) complete before the 30^th week of pregnancy

• Nursery setup

The most important piece of equipment for your nursery is a crib. It is not necessary to get two cribs immediately, as you may wish to have your twins share a crib at first.  Twins often take comfort from sharing a crib.

• Stock the freezer with meals 

Whether you make meals ahead and freeze them, use a service where you prepare 30 days of meals in advance, buy pre-made warehouse meals, or schedule family and friends to bring meals — you will not regret being prepared in this way. When your twins arrive, you will be so relieved to have meals at the ready.

• Organize your help schedule

 When expecting twins, many will offer help. Our tendency is to say thank you, but then never to bring it up again. You must resist this tendency! Practice accepting offers of help. Think about what types of help you are willing to accept. When friends and family offer to help, be prepared to tell them specifically how they can help.  Try using a “care” calendar.  These online calendars allow you to list your needs and facilitate sign ups for help. Don’t be shy — you’ll be needing help.

• Get your equipment basics

 As we mentioned earlier, your most critical equipment need is your crib. Don’t go too overboard and purchase everything you’ll need to raise your twins into adulthood. Just focus on the needs to cover the first 3 months. You’ll have time later to purchase additional equipment and supplies for the next stage.  The second most important piece of equipment is your stroller. For your first stroller, we recommend a Snap ‘N Go, or convertable system that allows you to put your infant car seats into the stroller.  This will save you headaches when your twins are sleeping soundly and you don’t have to remove them from their car seats to put them into the stroller.

• Prepare birth announcements and thank-you notes

This is a great time review styles for birth announcements and thank-you notes. Pick out the layout and shop around for prices. Prepare as much of the information in advance as possible. You can even address envelopes so they will be ready to personalize and pop in the mail.

Completing your preparations before the 30th week will give you peace of mind as you move into the final weeks of your twin pregnancy. Enjoy this time as you prepare for your little ones.

Copyright 2011 – Kathryn Whiteley / TwinParenthood.com

Having twins is life changing. Every day brings new joys and challenges. Recently going back to work has made me reflect fondly on the things I most love about having twins. I miss my sweeties!

10 things to love about having twins

1. MoM to MoM Connections
   As soon as you’re pregnant with twins (or triplets, or more), you’ve got an instant connection, and instant bond with other MoMs (Mothers of multiples). No one “gets it” like  another mother of multiples — except maybe a dad of multiples.
2. Built in Playmate
   Parents of singletons spend a good chunk of time entertaining thier kids. Its not that parents of multiples don’t, but after a couple years of intense parenting, we deserve a little bit of a break.
3. The Twin Bond
   Twins form a fantastic bond that is a joy to see. They are each others greatest comfort in life, and become bff’s. There are exceptions to prove the rule, but mostly twins have a connection that non-twins will never fully understand.
4. Rock Star MoM/Dad
   You have a built in ice breaker with strangers — even when you don’t have your twins with you. And, you can’t go out with twins and not be stopped and asked a ton of questions. Most of the time, this is really great. But not always. That’s why this one makes both our best and worst list.
5. Consolidated Effort
   Raising kids is tough. The first couple of years with twins is really tough. But as they get older, you can consolidate your child rearing effort. Combined birthday parties, combined potty training, and two kids on the same sport teams, for example, can begin to ease your parenting burdon.
6. Sharing Clothing
   Having extra clothing of the same size has saved us on more than one occassion. And it makes for putting clothing away in the dresser and closet much easier, too.
7. Singles Now a Breeze
   On those rare occasions that you are caring for just one baby, it is amazing how easy it seems. One of our favorite mantras is “It’s all relative”. That is, having one baby is tough and makes for sleepless nights. And yet, when you’ve had two, caring for one seems like a breeze.
8. Twin Discounts
   Many stores offer discounts when buying for twins. Often, these discounts are not advertised, so don’t be afraid to ask.  And when you’re shopping, if you can’t decide between two items, you can just buy them both!
9. His & Hers
   Each parent has an extraordinary opportunity to bond with their sweet babies. There is never a shortage of opportunities to care for your babies.
10. Double Hugs, Kisses, & Love
    Having twins is truly a double blessing.  Nothing more to say.

copyright 2011 – TwinParenthood / Kathryn Whiteley

TwinParenthood is pleased to turn over this space today to guest contributor Cori (of Cori’s Big Mouth) to bring us a nanny’s guide to finding the perfect twins (or more) nanny. Cori is currently a nanny to triplets, and a previous nanny to many sets of multiples including quadruplets & quintuplets.  We hope you will enjoy this valuable insight into finding the right twins nanny, from a great multiples nanny, Cori.

Picking the Right Twins Nanny for Your Family

One of the first things, that expectant parents think of – well after  that initial shock of finding out you’re expecting multiples has worn off – is how are we going to do this? 

Is mom going to work?  Stay home?  Can we do this alone?  Daycare?  Nanny?  There are so many options to pick from, but what’s right for your family?

Hi!  My name is Cori and I am a nanny who has personally known Kathryn for many years through her local twins group.  I was excited and honored when Kat asked me to write a guest-post for TwinParenthood on my experience as a nanny.  I have spent the last 11 years as a babysitter and/or nanny for many families of multiples, including quadruplets & quintuplets.  I’ve  spent the last 3.5 years with a family who has BBG triplets. 

What Type of Nanny is Right for You?

That’s the first thing you need to ask yourself.  Are you looking for a post-partum nanny to help when you bring home new babies?  Or are you planning on going back to work and will need full-time long term childcare for your children?  Or, maybe you just want help a few hours a day to get things done or take a nap?  Well, you’re in luck; you can find help for any of those types of childcare needs.

Mothers Helper: A mother’s helper is a great option if you just need a few hours a day a couple times a week.  If you want to just to get stuff done around the house or nap, a 12-year-old girl is the perfect person.  They really want to babysit but aren’t quite old enough to be left alone, plus they’re cheaper.  If you want to be able to leave the house then I recommend finding a high school student to come over a couple afternoons a week.

Post-Partum Nanny: Is hired to help you the first few weeks to months after your babies come home.  They support you in caring for your babies, give you tips, and of course give you rest.  They aren’t long term, though. They last a short time, and then move on to another family.

Nanny: Is a person who comes to your home and cares for your children.  They will follow your instructions, ways of doing things, etc.  Your children get to stay in their own environment.  Nannies tend to work on a 1-year contract, with a hope that she’ll be a great fit and will stay for many years.

When to find a Nanny?

Early In Your Twin Pregnancy

If you know early on in your pregnancy that you are going to need a nanny, I highly suggest you start researching and finding someone while you still have the time and energy.  If you find a nanny you love, it’s nice for them to get to be a part of the remainder of your pregnancy.  They get to know you, your spouse, other kids, etc.  Plus, they can help you prepare for the pending arrival of your little ones.  If your babies are born premature, they will probably spend time in the NICU – your nanny can also spend time with your babies in the NICU, getting to know them and their schedules, working with the nurses to learn to care for preemies along with you.  Makes a much smoother transition when the babies come home and you go back to work.

I had this wonderful opportunity in this job I’m in now.  I was hired when the mom was about 20 weeks along.  I helped them get things ready for the triplets, gave tips and advice, and was right there with her, holding our breath that she would make it to the high risk pregnancy milestones.  I then got to spend a lot of time with the babies while they were in the NICU, which was a really special experience.

After Delivery of your Twins

If you’ve already had your babies, or are going back to work when your kids are older, don’t panic there’s still hope for you.  By now, you have an idea of what type of care your kids need and are in search to find the right person to fit the mold.

Where to Find Your Multiples Nanny?

Anybody (and I mean anybody) can be a nanny.  Don’t get me wrong, there are great nannies out there, but keep in mind, it takes a special (and possibly crazy) nanny to take on a family with multiples.  As you know multiples take a lot of work and a lot of multitasking.  Many nannies aren’t comfortable and/or capable of handling the stress and extra work that comes with more than one baby.  That’s fine, it doesn’t mean they’re not good nannies, they just aren’t the right nanny for you.

The best way to find a great nanny is through your local twins group, friends and family.  Talk to other parents, get names and information.  Once a great nanny is found, she is likely to be known by many families and passed from family to family.  Word of mouth is the best way to find the right nanny for you.

How Do You Know this Nanny is Right?

Before Delivery

If you haven’t had your babies yet, and think you’ve found the right nanny get to know her.  Befriend her.  I’m not just talking about an interview; I’m talking getting to know her as a person.  Invite her over for dinner.  My jobs that I have had a genuine friendship with my employers have been the best and longest lasting.  Think of your nanny has an extension of your family.  You’re going to be spending a lot of time with her, so you really need to like her as a person, and not just as a childcare provider.  You’ll know quickly if she’s the right choice for you.

After Delivery

It’s okay to have a trial period.  Hire the nanny on a short term basis, for a week or two.  That will give you time get to know each other and see how she interacts with your children and if she meets the expectations you have.  You’ll know quickly, if she’s the right nanny.  If the trial period passes and you’re happy, hire her for a long term position.  If the fit wasn’t quite right, that’s okay; you can try again and aren’t committed to one person.  Don’t settle for a certain nanny; try until you find the right one.

So there you have it – A Nanny’s Guide to find the perfect twin nanny.  I think the most important thing to remember is don’t settle for a certain nanny, the perfect one is out there.  Good luck in your search.

Be sure to check out Cori’s blog at Cori’s Big Mouth, or connect with her on Twitter @cori_shelley.

All pregnant women should be aware of the dangers of Twin to Twin Transfusion Syndrome (TTTS).  TTTS is a complication of disproportionate blood supply to twin fetuses during pregnancy.  It is critical that all women have an early ultrasound to identify if they are having multiples.

World TTTS Awareness Day is an international mobilization effort created by The Twin to Twin Transfusion Syndrome Foundation to increase awareness of the #1 problem facing multiples. It is crucial for women to get an ultrasound in the first trimester to identify multiples and then to determine whether there is one placenta or two. Women must learn the warning signs of TTTS, the 15 questions to ask at each ultrasound, and the available treatment options. World TTTS Awareness Day is about empowering parents and is filled with messages of Hope, Help and Encouragement. Your babies can make it and be healthy. Don’t ever give up. Please, Get Educated, Get Ultrasounds, Ask Questions, Get Treatment and Get Involved! This day is also a remembrance day for all the babies who have had TTTS. Candles will be lit tonight across the world during the vigil and messages may also be left for your babies through lighting online candles.  Please visit their websites to learn more about TTTS.

What is Twin to Twin Transfusion Syndrome?

• Twin to twin transfusion syndrome (TTTS) is a disease of the placenta (or afterbirth) that affects identical twin pregnancies.
• TTTS affects identical twins (or higher multiple gestations), who share a common monochorionic placenta.
• The shared placenta contains abnormal blood vessels, which connect the umbilical cords and circulations of the twins.
• The common placenta may also be shared unequally by the twins, and one twin may have a share too small to provide the necessary nutrients to grow normally or even survive.
• The events in pregnancy that lead to TTTS – the timing of the twinning event, the number and type of connecting vessels, and the way the placenta is shared by the twins are all random events that have no primary prevention, is not hereditary or genetic, nor is it caused by anything the parents did or did not do. TTTS can happen to anyone.

If you are pregnant, what should you do?

Get Ultrasounds

If you are pregnant, it is critical that you get an ultrasound within the first 3 months.  With this ultrasound, you can determine if you are having twins, triplets, or even higher order multiples.  As early as 7 weeks of pregnancy, it can be determined if you are having multiples.  If the placenta is monochorionic, or single, your pregnancy is at risk for TTTS.

Ask Questions

Once you have identified that you are having twins or higher order multiples, it is imortant that you ask questions at each ultrasound.  For multiples, ultrasounds should be performed more frequently than in singleton and lower risk pregnancies.  Listed below are the TTTS Foundation’s 15 Most Important Questions to ask at each ultrasound.

Confirm at initial ultrasounds (preferably by 10-16 weeks)

1. Is the placenta monochorionic?
2. Are the babies the same gender?
3. Can you see the dividing membrane?
4. Is the placenta implanted on the anterior or posterior surface of the womb?
5. Do the twins’ umbilical cords each have the normal 3 blood vessels, or does one of them have 2 vessels?
6. Are the umbilical cords fully attached to the placenta?

Questions to ask at weekly ultrasounds (16 weeks to delivery)

1. What is the largest vertical pocket of fluid for each baby?
2. Can you see the bladder of the donor baby?
3. What are the weights of the babies in grams? (every 2-3 weeks)
4. Are the dopplers normal for both babies?
5. Is the heart of the recipient baby enlarged or thickened?
6. Does the recipient baby have hydrops?
7. What is the measurement of your cervix, is it long and closed or thinning or dilated?
8. Is the smaller baby growing at the same rate?
9. What is the fundal height?

Read the explanations for these questions at the TTTS Foundation’s website.

PLEASE, get an early ultrasound to determine if you are carrying multiples.  If you are pregnant with twins or higher order multiples, PLEASE ask the questions provided by the TTTS Foundation.  It could save your babies’ lives.  If you are diagnosed with TTTS, or would like more information, please contact the TTTS Foundation for help, information, and support.

Whether you plan to breastfeed or bottle feed your babies, expecting parents of twins with an older child often worry about how they can keep their child occupied while they feed twin newborns.

Take the time to explain to your first born that new babies need to eat frequently. They are putting all of their energy into growing right now, so they can be a little bit boring at times, too. If you are able and choose to breastfeed, explain what it is all about — your child will be curious.

Don’t be afraid to ask your older child for help while you are feeding — bring things to you that you’ll need, and help burp the babies by patting them on the back. Being included and involved helps your older child to adjust and to feel needed.

A little advance planning can go a long way to keep things running smoothly for your older child, your twins, and you.

1.  Special Activity Basket.
Well before your 30th week of your twin pregnancy, begin gathering items for a “special activity” basket. The basket can be brought out for your child to choose an item to play with while you feed your twin infants. You can choose to allow your child to keep the new play item after the feeding session is over, or you can replace the item into the basket and put the basket away until the next session.  Both strategies have some advantages.

Putting the item back will help to retain the “specialness” of the items in the basket. You may find that your child has a particular interest in one thing when they choose that item over and over again. But, be prepared for the inevitable melt downs when the item is taken away and put back to the basket. This can be a learning opportunity for your child.

Having this special activity basket will encourage your toddler to look at feeding times as a positive experience rather than a negative one that diverts the attention of mommy & daddy.  This basket will be especially helpful for the first several weeks — until your little one becomes accustomed to the process and learns that a little independent play is required.

Ideas for items for your special activity basket:

• New toys
• Crayons
• Coloring Books
• Stickers
• Play Dough (and accessories like muffin tins, jello molds, cookie cutters)
• Puzzles
• Match box cars
• New videos
• Books
• Felt boards
• Coupons for watching a special video or tv show
• Jobs your child can help with (this is a treat for them), like dusting or hand washing dishes

While you can use the special activity basket as your primary strategy, you won’t want to go to the basket for every feed. It will be important to keep the “Special Activity Basket” fresh and perceived as a special treat. With that in mind, it is helpful to decide on a schedule for which feedings you will use the basket and which you will use other strategies.

2. Snack or Meal Time.
One or two feedings for your twins can coincide with a snack time for your toddler or preschooler. Plan ahead and have the snack prepared in advance. You can put out crackers, cheese, sliced apples and such to allow your toddler to help herself, or contain your child in their high chair to keep probing hands away at a safe distance.

3. Reading Time.
Another feeding could be designated as “reading time”. Again, planning ahead is key. Pick out a book that will hold your child’s interest and ask him to help by turning the pages. You might choose to have a “special” book that is only read during feeding time — to add to the feeling that your older child is special, too.

4. Story Time.
Wait… didn’t we already cover this? Nope. These are stories without the book. Kids love it when parents make up stories — especially when you incorporate your child and other family members into the story. Ask your child to contribute to the story, too. “What should happen next?”

5. Screentime.
While it is important to limit screen time, an occasional educational video or tv show — when it is planned within the context of an enriched environment — can be a sanity saver. Don’t feel guilty about it. One of our favorite TwinParenthood mantras is “You do what you have to do.”

6. Game Time.
Imagination Games are great to play during feeding time.  Here are some ideas to get you started.

• Animal Actors. Have your child act like a… bear, dog, cat, lion, etc.
• I Spy. This can occupy a young child for quite a while. “I spy something red… you’re getting hotter/colder… etc.”
• Mini scavenger hunt. Plan ahead, and draw pictures on little slips of paper and place your clues around the house. One clue leads to the next and so on. For example, the first clue might be a picture of a specific ball. At the ball, you’ll place the next clue, maybe a firetruck. At the firetruck you place a picture of a puzzle, and so on. Make sure you make the hunt long enough, but easy and age appropriate or else you’ll get sucked into helping!
• Word or Counting Games. Have your child bring out all of their stuffies (one by one) and organize them into a zoo in the living room. Then, have your child return them, one by one, to the bedroom and put them into the toy box or crib — Count them up as you go.

7. Location change.
Often times, just a change in location is enough to ensure your child is happy and occupied. Keeping toys segregated to specific areas of the house help with this strategy. The basement toys stay in the basement, the family room toys stay in the family room, etc.

8. The Entertainer.
Have another adult or older child play with your child. It can be very nice to hire a teenager from the neighborhood to come be mother’s helper for an hour after school each day. This can be a special time for your child and a break for you.

9. Adventure Train/Airplane/Bus.
Set up some chairs to create a vehicle and have your child sit down as the driver. Tell him to close his eyes and imagine taking a trip. Where would he like to go? Describe the scenery, describe things that happen along the way. When you arrive at your destination, have your child continue the action by gathering objects from this special place. A ball can be a coconut. A postcard can be a notice for a party. Help his imagination to soar.

10. New “Twin” Dolls.
Getting new “twin” dolls and caring for the new babies (the dolls) can be very comforting to your child. Have your child shadow you and she pretends to feed her infants, too.

As with all things in life, balance is key. Identify the strategies that work best for you, those that allow you to bond with your infants and maintain that special relationship with your older child, too.

Have you used any of these strategies? What else has worked for you?

copyright 2010 – TwinParenthood / Kathryn Whiteley

Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women — including those who are carrying twins, according to guidelines released this week by The American College of Obstetricians and Gynecologists (ACOG).  This is great news for women expecting twins.  Previously, VBAC was not recommended for women carrying twins although there were no conclusive studies to suggest that twins posed a higher risk. 

In fact, VBAC was often not recommended for many women, and the rate of C-sections in the United States had risen significantly over the past four decades.  In the 1970′s, the C-section rate was about 5%, but by 2007, it was up at a whopping 31%.  One reason for the increased rate of C-sections was due to insurers, doctors, and hospitals opting for a repeat C-section rather than attempting a trial of labor after cesarean (TOLAC).

TOLAC and VBAC do present some added risk.  If uterine rupture occurs (between 0.5% and 0.9% of the time), it is an emergency situation that can cause serious harm to a mother and babies.  For this reason, TOLAC and VBAC should only be undertaken in a hospital where an emergency C-section can be performed in the event of complications.

Patients and doctors will need to work together on a case by case basis to determine if TOLAC and VBAC are appropriate.  New moms having twins should do their research and come prepared for a discussion with their OB/GYN about the possibility for VBAC with twins if that is their desire.  Patients who encounter doctors that won’t even consider VBAC for a twin pregnancy should consider moving to another doctor.  While there may be very valid reasons why a VBAC is not appropriate for your particular twin pregnancy, you should expect your doctor to cover those reasons with you in detail rather than rejecting the option out of hand.

These new guidelines will provide women expecting twins with more options than were readily available previously.  And when you’re having twins — your options are often limited and out of your control.  So bringing back options is always a good thing.  And reducing the number of “automatic” C-sections is a good thing.  Hopefully these guidelines will help to reduce the overall number of C-sections being performed in the United States.

Source:  The American College of Obstetricians and Gynecologists, “Ob-Gyns Issue Less Restrictive VBAC Guidelines“, July 21, 2010.

Copyright 2010 Kathryn Whiteley — TwinParenthood.com

Can you feed twins at the same time?

Absolutely! However, it doesn’t work out for everyone, so it is best to keep an open mind about how feeding will go.

• “Tandem Feeding” just means feeding both at the same time, this could be breastfeeding, bottle feeding, or a combination of those.  But in most articles tandem feeding refers to breastfeeding more than one baby at a time. 
• Sometimes one infant will have feeding issues or other medical problems that prevent that baby from breastfeeding, while the other baby may breastfeed like a champ.
• Sometimes moms will feed one baby and then immediately follow with the other because a helper is not available or for some reason tandem feeding doesn’t work out.
• Some families choose to breastfeed one baby while another adult bottle feeds the other baby — then with the next feeding, the babies are swapped. This gives both caregivers an additional opportunity to bond individually with each baby.

I’m having trouble getting the hang of tandem breast feeding – is it worth it?

As we said earlier, it doesn’t work out for everyone, so it is best to keep an open mind about how feeding will go. Don’t beat yourself up if it doesn’t work out for you. There are many circumstances that may prevent you from tandem breastfeeding. Only you can decide if it is worth it to continue attempting to tandem breast feed.  Some of the benefits include:

• Tandem breast feeding can cut the feeding time almost in half
• Some moms report an added closeness between the babies as a result of tandem breastfeeding
• Breastfeeding saves on bottle washing and prep time

Tips for tandem breast feeding

• Practice with a lactation consultant present
• Until you get the hang of it, don’t attempt to tandem feed if you’re alone
• Use a helper to get the babies positioned and to help with burping
• Try to practice at least once a day
• Use pillows! Lots of them
  • Use a double nursing pillow for resting the babies (these are horseshoe shaped, stiff foam pillows that will support two babies at the right level and position for breast feeding). Many twins moms recommend the EZ2Nurse pillow.
  • You may need several pillows under the sides of the double nursing pillow
  • Use a pillow behind mom’s back for support
• Try out different tandem breast feeding holds to determine which works best for you.
  • One way that works well is the “football” or “clutch” hold. One baby tucked under your arm on each side with their legs sticking out towards the back of the chair.
  • Another tandem position is to place the babies in front of you with their legs criss-crossing over each other.
• If one baby is better at breastfeeding than the other, get that baby settled first before adding the second baby

If I don’t tandem feed, how can I deal with two hungry, howling babies at the same time?

The trick here is to cue in to early hunger signals and begin feeding the hungrier baby before either baby gets too hungry.  These early cues include:

• Finger or fist sucking
• Nuzzling into your arm or chest
• Opening and closing of the mouth or smacking
• Moving the head back and forth

If feeding is delayed so that the waiting baby is overly hungry, you can attempt delay or distraction techniques. These include: 

• Use of pacifier
• Placing the baby in a bouncer or vibrator chair
•  Toys
• Offering your (clean) finger for the baby to suck

Twin Tandem Breast Feeding Best Practices

• Keep track (chart) your babies’ feeds (time started, which breast L/R)
• Switch your babies’ assigned breast with each feed
• Practice tandem feeding daily for the first several weeks before making any decisions to discontinue tandem feeds
• Watch for early hunger signs and begin feedings early
• Drink 8 – 12 glasses of water daily (too much or too little can impact milk supply).

Having twins and multiples means more of everything — including morning sickness. The majority of all pregnancies experience nausea to some degree, and that increases with each additional baby in the mix.  The severity of the nausea is also increased with each additional baby.

Pregnancy nausea is usually attributed to the increased hormones during pregnancy. Many of these hormones are produced by the placenta. So, when there is more than one placenta (as in many twin pregnancies), more of these pregnancy hormones are produced — causing increased nausea.

“Morning Sickness” can occur at any time of day, but is often associated with the morning because it can be more strongly felt with an empty stomach. In addition, a twin pregnancy can put more pressure on the tummy — increasing nausea.

One little trick to help with this is to keep crackers or a banana at your bedside. When you get up in the middle of the night to use the bathroom (as pregnant twin mamas often must do), eat a little bit. It is healthy for you and your babies — and will help reduce the morning nausea.

Increased nausea is one of many signs that you might be having twins.

Do:

• Eat small meals often
• Take a nap and get plenty of rest
• Learn your particular triggers and avoid those foods and smells that increase your nausea
• Dress in layers so you can peel off if you get too hot (feeling too warm increases nausea)
• Drink lemonade, eat watermelon, or something with ginger — as these help reduce nausea
• Exercise (but talk to your doctor about the amount and type that would be appropriate for your twin pregnancy)
• Eat salty potato chips
• Consult with your doctor — keep your doctor informed of your level of nausea (too much naseua can indicate a problem)
• Eat healthy with lots of protein

Don’t:

• Do not drink a large amount of fluids with meals
• Do not lie down after eating
• Do not skip meals
• Do not cook or eat spicy food

While morning sickness in a twin pregnancy can be more severe and can last longer into the pregnancy, it is survivable — as is just about everything twin related.  Take it one day at a time, and your little sweethearts will be here before you know it.

Did you or do you have morning sickness with your twin pregnancy? Any tips for coping?

Copyright 2010 Kathryn Whiteley — TwinParenthood.com

Many new parents having twins, triplets or more wonder and worry if they should hire someone to help care for their twins in the first several weeks or months. Based on my own experience and the results of several surveys conducted by TwinParenthood.com, the resounding answer is YES.

• Yes! If you can easily afford to hire help for the first several weeks, you will not regret doing so
• Yes! If you can’t easily afford to hire help, but can scrape together money to hire help, you will not regret doing so

Still, many twin parents will tell you that hiring someone to help you with your twin infants’ care is not strictly necessary — especially if you have volunteer help.

Volunteer help can come in many forms. It may be family that come to stay with you, or it may be a church or neighborhood community that rallies to your aid. Our previous article, Twin Baby Shower Gifts that Provide Real Help for Mom, gives some great advice about how to incorporate volunteer signups into your twin baby shower. 

But, not everyone has a support network to step in. So, hiring help makes sense. Once you have decided to hire help, the next question quickly arises. 

Should we hire help to care for our twins during the day or night?

Day:  Typically you’ll get more for your dollar during the day if you hire someone for daytime help with your twins because you can hire someone that is willing to do more than strictly baby care (fix lunch, do dishes or wash bottles, for example).  And, daytime help is typically less expensive than night help.

Night:  Getting at least one 4 hour uninterrupted sleep stretch can make a huge difference in your physical and mental well being. If you don’t have at least 3 caregivers in your rotation, you will have difficulty being able to achieve at least one 4 hour stretch of uninterrupted sleep. If you are not able to schedule this in without paid assistance, then you should hire night help.   

What type of help should we hire?

The type of help you will need depends a lot upon your particular situation, your financial reserves, and how much volunteer help you will be receiving. If money is unlimited, you can hire several types of help to cover all the bases: a post-partum doula for right after the babies are born, a night-nanny for the first 3 – 4 months, a day time nanny and a housekeeper.  Unfortunately, the reality is that most of us can’t afford all of that.

Regardless of what type of help you decide on, you should interview your candidates to ensure they have experience with newborns. Experience with twins is nice, but not strictly necessary.

Doula:  A post-partum doula has special expertise with newborns and mother care.  A doula is usually more expensive than other types of care. Doulas are often available for over-night care.

Nanny: A nanny may live in or out, but typically a nanny works only for you – in your home. A nanny is usually considered an employee of the household (and thus, you will usually need to pay vacation and holidays, and consider the tax implications). Nannies responsibilities often include additional tasks such as laundry, dishes, and other light housework. Be sure this is discussed prior to hiring your twins’ nanny.

Night-Nanny: A night nanny is a nanny that works at night.  Often they try to rest when the babies are sleeping, but may do some household tasks such as emptying the dishwasher or folding laundry – again, be sure to negotiate this prior to hiring.

Au Pair: An au pair is a foreign national on a work visa for a 1 year term. They live in your home and are paid a small salary, room & board, and travel & insurance expenses. Typically, they are required to take some kind of coursework (which you will need to make accommodations for in their schedule). Keep in mind that an Au Pair is not a 24 hour caregiver although they live in your home.

Daycare Providers: This is usually in someone else’s home or facility and your babies will not be the only ones receiving care. Daycare providers must be licensed.

Baby Sitter: Not always, but often a baby sitter is used on an irregular, as needed basis. Baby sitters also do not usually perform extra tasks such as light housework.  The term “baby sitter” is often used as an over-arching word to describe anyone who provides child care.

Mother’s Helper: Typically the least expensive of all options. A mother’s helper can be a high school student that comes over after school to help with housework and baby care. Usually a mother’s helper does not take on full responsibility for caring for the babies – but assists with mother present.

Housekeeper: One option not often considered is to hire a housekeeper who will take care of the house, the dishes, the bottles, the pump, cleaning the bathrooms – all of the things that you will not have the energy to do.  It is easy to become resentful of your twins’ caregiver who is spending sweet cuddle time with your babies while you are off doing household chores.  Wouldn’t you rather pay someone to do the things you don’t want to do, while you dedicate your time to your twinfants?

All of the options available for the early weeks of care with your twinfants often seem overwhelming. But, don’t be tempted to put it off, to “wait and see” what you’ll need. To be on the safe side, you’ll want to plan, interview, and hire your caregiver before reaching your 35th week. If you are very unsure and expense is an issue, start with hiring a part-time housekeeper or mother’s helper.

Bottom line, you will not regret having the help. 

What did you do in the early weeks or months?

Copyright 2010 Kathryn Whiteley — TwinParenthood.com

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