Breastfeeding twins has many advantages for both the mother and baby.

Breastfeeding strengthens the baby’s immune system and reduces the incidence of Sudden Infant Death Syndrome (SIDS). It is also a great way for mother and child to bond.

Breastfeeding twins can seem overwhelming to a new mom, but thousands of new mothers successfully breastfed their twins every day.

These tips will help you to be successful from day one.

1. Get a Lactation Consultant

As soon as you arrive in your Postpartum room after giving birth, ask to see the Lactation Consultant. As a mother of twins, you will be a priority for her.

She will sit with you and teach you exactly how to get each of your babies to latch correctly onto your breast. Learning how to do this from the very first feeding is important.

If your babies do not latch correctly, breastfeeding twins can be painful and your babies will not be able to feed efficiently.

That is the number one reason responsible for issues with breastfeeding twins.

Nowadays all Lactation Consultants receive training on teaching mothers how to breastfeed twins, so she will be able to help you with different positions and issues particular to twins.

2. Find a Lactation Consultant in Your Area

Before giving birth, you may want to find a lactation consultant in your area, so you can make an appointment to see her once you have been released from the hospital. Many will come out to your home to continue to help you after you leave the hospital.

3. Get in a Comfortable Breastfeeding Position.

The position is very important when breastfeeding twins. There are many positions mothers prefer when breastfeeding twins and there is no one right way.

The positions for breastfeeding twins should allow you to relax your back and neck. Your posture of choice should allow easy digestion while the babies suckle.

You may find a number of positions helpful at different times. The goal is to try different positions until you find the ones that work best for you and your twins.

4. Get a Comfortable Breastfeeding Pillow

Get a special breastfeeding pillow designed for twins.

The My Brest Friend Supportive Nursing Pillow For Twins 0-12 Months, Plus-Size is the most useful breastfeeding pillow for twins.

It is soft and provides plenty of room for both babies. The strap is also awesome, as it keeps the pillow in place while you move your twins around and help them latch on correctly.

Colors: Light Green (Pictured), Dark Grey, Light Grey, Fireworks, and Black and White

Lowest Price: Amazon.com

Price: $58.04- $67.99

5. Wear Easy Access Nursing Tops and Nursing Bras.

In the beginning, you will find soft, comfortable 2-in-1 nursing tops with built-in bras to be extremely useful. While you are learning how to nurse twins and your twins are feeding to often, you will find yourself constantly needing to expose your breast to feed. These tops also make it simple to breastfeed both twins at the same time.

Caramel Cantina 3 Pack Women’s Nursing Cami Built-in Bra is a great 2-in-1 soft tank top and nursing bra. You can wear it by itself or under another loose top. It comes in many sizes and colors, thus matching everything. You will want to buy at least a few packs of these because in the beginning, milk will leak and babies will spit up on you.

Colors: Black, White and Charcoal (3 Pack), Navy, Burgundy and Teal (3 Pack), Black (3 Pack)

Lowest Price: Amazon.com

Price: $36.99 (Pack of three)

Having plenty of comfortable nursing bras is also important. When your milk supply is first coming in and your twins are learning how to breastfeed, it will messy. You will find yourself often needing to change your bra. You will also need to wear a bra all the time in the beginning because your breasts will leak milk.

Therefore, you will want to have comfortable bras you can wear all day and night.

The 3 PACK Full Bust Seamless Nursing Maternity Bras with Extenders & Clips is the perfect nursing bra bundle.

We recommend you buy at least three of these packs to get started. The extender will be great right after you give birth before you lose your pregnancy and while your milk supply is adjusting. The clips allow you to connect the two straps in the back to hide them when wear tank tops or other sleeveless shirts.

Colors: Black, Pink & Nude (3 Pack), Nude (3 Pack), Black (3 Pack), Black, Grey & Nude (3 Pack)

Lowest Price: Amazon.com

Price: $36.99 (Pack of three)

6. Start with One Twin at a Time

As a new parent or one who is having your first pair of twins, it is advisable that you start gradually, with a twin at a time to the breast.

Once each twin is latching properly and you feel comfortable, start trying to feed the other twin at the same time.

Be patient with yourself and know you will master breastfeeding twins at the same time. It is a skill like any other and simply requires practice.

7. Use a Breastpump Only When Necessary

Before you consider using a breast pump, be sure it is needed.

Mothers panic, saying their breasts don’t produce much milk and they are afraid they are not making enough for the twins.

it takes a few days for your milk to come in. The most effective way to establish a strong milk supply is to latch them properly and encourage your twins to feed often.

The woman lactation process actually generates more milk with the demands placed by the suckling mouth(s). Breast pumps are just not as effective at expelling milk from the breast.

In the early days, encourage your twins to breastfeed often. These early days will determine how much milk your body makes. It is a supply and demand system established during the first days. That is also why learning how to latch your twins on is so important from the beginning.

So, before you go for a pumping aid, be sure you need it.

When it is time to begin pumping, we recommend you use the Medela Pump in Style Advanced Double Electric Breast Pump with On the Go Tote.

It is an awesome all-in-one system.

Medela is the most well-known and recommended brand on the market. All of their products come with a lifetime warranty and their service department is excellent.

While the bag this breast pump comes with may not be your first choice, this bundle is a great deal and has everything you will need to immediately begin pumping.

Lowest Price: Amazon.com

Price: $190.93

8. Alternate the kids to the breast

Each of the twins might have different appetite and sucking behavior.

Therefore, alternate which twin feeds from each breast with every feeding. A great way to remember which twin fed from each breast is to wear a simple bracelet or hair tie on your wrist. Assign the hair tie to Twin A. After you have completed breastfeeding your twins, move the hair tie to the other wrist. This will tell you that Twin A should feed on that breast during the next feeding.

9. Get Rest

You need as much rest as you can get.

When your newborn twins are sleeping, you should sleep, as well.

Ask friends and family members to keep up with the daily tasks around the house.

In the early days, your task is to heal your body from birth, breastfeed and care for your new twins. That is a full-time job. Everything else can wait.

10. Ask for Help

Neighbors, friends, co-workers, and family are great helpers in the early days. Don’t be afraid to ask for help.

Hiring a Postpartum Doula is also an excellent choice.

Postpartum Doulas can help you care for your newborn twins, clean your house, cook and help organize the help of others in your life.

11. Eat and Drink Frequently

Think of your body as just recovering from running a marathon.

Labor is exhausting and you have lost a lot of blood. Now you are trying to make food for two little people.

Allow yourself to eat foods you are craving. Your body may need more salt, protein or fats to recover.

In the early days, we drank lots of Ensure High Protein Nutrition Shake with 16 grams of high-quality protein, Meal Replacement Shakes.

We loved them because they did not contain milk and thus did not need to remain refrigerated. We kept them on our nightstand and drank them during the night when we woke up hungry.

Product Details:

Flavors: Chocolate, Strawberry, and Vanilla

Price: $31.94 for 24 8oz Bottles

Lowest Price: Amazon.com

Drinking lots of water is one of the best ways to ensure your body will produce enough milk.

Breast milk is composed of 90% water.

During birth and for days after giving birth, your body will lose a lot of blood. Blood is composed mostly of water. Therefore, you will likely be extremely dehydrated.

One of the biggest factors that will affect your milk supply in the early days is your water intake. This is a crucial time as your body is figuring out how much milk to make for your twins. If you are severely dehydrated in the early days, your body will not establish the correct amount of milk supply.

You will probably notice that soon after you begin breastfeeding your twins you will become thirsty. The oxytocin that your body releases during breastfeeding is responsible for triggering your thirst. This is your body’s natural way of ensuring that you are getting enough water to make breast milk.

As soon as you can, begin rehydrating your body. This can easily be done simply with water. During breastfeeding one baby, you should drink an extra quart, or 32 ounces, per day.

12. Start Preparing Before Your Twins Arrive.

Preparation is key. Create a plan now to ensure you will have all of the tools and people in place when your twins arrive.

Don’t be afraid to ask for help. People who love you will want to feel needed and your twins will benefit from it, as well.

The post 12 Tips for Breastfeeding Twins appeared first on TWINS Magazine.

There are a few things you can do to prepare for your twins and ensure that you will be successful at breastfeeding them.

You CAN Breastfeed Your Twins

When I was pregnant with my twins, friends and even nurses would take one look at my breasts and my small physique and say, “There is no way your little body will be able to make enough milk to feed twins! You should stock up on formula now!”

I felt defeated before I had even begun.

However, I was determined to master breastfeeding twins and so I decided to learn everything I could about breastfeeding and get a plan in place for the day my boys arrived.

I am pleased to say my little 130lb body (when pregnant) gave birth to two healthy little boys and I breastfed them for 20 months.

The reason I was so successful was in large part to these 10 tips. While many well-meaning people will complicate breastfeeding, it is a very innate, natural action and one you can expect to quickly learn and feel comfortable with.

1. Use a Breastfeeding Pillow Designed for Feeding Twins.

My Brest Friend Supportive Nursing Pillow For Twins 0-12 Months, Plus-Size was the most helpful tool of all. It is soft and provides plenty of room for both babies. The strap is also awesome, as it keeps the pillow in place while you move your twins around and help them latch on correctly.

Colors: Light Green (Pictured), Dark Grey, Light Grey, Fireworks, and Black and White

Lowest Price: Amazon.com

Price: $58.04- $67.99

Amazon Rating:

2. Wear Easy Access Nursing Tops and Nursing Bras.

In the beginning, you will find soft, comfortable 2-in-1 nursing tops with built-in bras to be extremely useful. While you are learning how to breastfeed your twins and your twins are feeding to often, you will find yourself constantly needing to expose your breast to feed. These tops also make it simple to breastfeed both twins at the same time.

Caramel Cantina 3 Pack Women’s Nursing Cami Built in Bra is a great 2-in-1 soft tank top and nursing bra. You can wear it by itself or under another loose top. It comes in many sizes and colors, thus matching everything. You will want to buy at least a few packs of these because in the beginning, milk will leak and babies will spit up on you.

Colors: Black, White and Charcoal (3 Pack), Navy, Burgundy and Teal (3 Pack), Black (3 Pack)

Lowest Price: Amazon.com

Price: $36.99 (Pack of three)

Amazon Rating:

Having plenty of comfortable nursing bras is also important. When your milk supply is first coming in and your twins are learning how to breastfeed, it will messy. You will find yourself often needing to change your bra. You will also need to wear a bra all the time in the beginning because your breasts will leak milk.

Therefore, you will want to have comfortable bras you can wear all day and night.

The 3 PACK Full Bust Seamless Nursing Maternity Bras with Extenders & Clips is the perfect nursing bra bundle.

We recommend you buy at least three of these packs to get started. The extender will be great right after you give birth before you lose your pregnancy and while your milk supply is adjusting. The clips allow you to connect the two straps in the back to hide them when wear tank tops or other sleeveless shirts.

Colors: Black, Pink & Nude (3 Pack), Nude (3 Pack), Black (3 Pack), Black, Grey & Nude (3 Pack)

Lowest Price: Amazon.com

Price: $36.99 (Pack of three)

Amazon Rating:

3. Have Plenty of Breast Pads and Nipple Cream on Hand.

When your milk first comes in and your twins begin breastfeeding twins, your body may make more milk than your twins will need. Often, mother’s of twins find their breasts leak a lot in the beginning.

Breastpads will absorb the leaking milk and keep wet stains from appearing on your clothing.

There are two main types of breast pads new mothers can choose between: disposable and reusable.

Disposable breast pads are intended for one time use. Reusable breast pads can be washed and reused.

Lansinoh Nursing Pads, 4 Packs of 60 (240 count) Stay Dry Disposable Breast Pads are by far the most well-known and most absorbent breast pads. We suggest you buy them in bulk because you will use quite a few during the first few months.

Lowest Price: Amazon.com

Price: $28.48

Amazon Rating:

If reusable breast pads seem to be your preferred choice, the Organic Bamboo Nursing Pads (14 Pack)+Laundry Bag & Travel Bag bundle is a great choice. Reusable breast pads will end up saving you a lot of money, but you must be willing to do some extra laundry.

Lowest Price: Amazon.com

Price: $12.99

Amazon Rating:

When you and your twin babies are first learning to breastfeed, the babies often do not latch properly. This can cause you nipples to become sore and sometimes cracked. By keeping your nipples lubricated with a good nipple cream, they will heal more quickly and help you and your twins quickly experience the joys of nursing.

We have found Motherlove Nipple Cream Certified Organic Salve for Sore Cracked Nursing Nipples to be the best and safest on the market. It is 100% organic and cruelty-free in their testing practices. It is all natural and doesn’t need to be washed off before breastfeeding.

Lowest Price: Amazon.com

Price: $10.40

Amazon Rating:

4. Use a Quality Breast Pump

One of the items moms of twins should invest in is a hospital grade breast pump. Even if you are not planning on bottle feeding your twins in the beginning, a breast pump may be needed if one of your twins needs to stay in the hospital after birth or if you want to increase your milk supply.

The Medela Pump in Style Advanced Double Electric Breast Pump with On the Go Tote is an awesome all-in-one system. Medela is the most well-known and recommended brand on the market. All of their products come with a lifetime warranty and their service department is excellent.

While the bag this breast pump comes with may not be your first choice, this bundle is a great deal and has everything you will need to immediately begin pumping.

Lowest Price: Amazon.com

Price: $190.93

Amazon Rating:

5. Meet with a Lactation Consultant as Soon as Your Twins are Born.

As soon as your twins are born, you will be moved into a postpartum room. That is when you should immediately ask to see a Lactation Consultant.

The Lactation Consultant will help you learn how to hold each twin, get them to open their mouths wide and latch properly. By getting this teaching during your very first feeding, you will save yourself from pain and frustration. While you may feel extremely excited about breastfeeding your new babies, we highly recommend, you wait for the Lactation Consultant.

Generally, as a mother of twins, she will try to come see you as soon as you arrive in your room. She will sit with you and warmly walk you through the process of breastfeeding your twins.

Throughout your stay, we suggest you ask the Lactation Consultant to periodically observe you while you breastfeed each of your twins.

During the first days, be patient with yourself and your babies as you all learn together.

Before leaving the hospital, the Lactation Consultant should provide you with the number to a consultant in your area. You can also look up Lactation Consultants in your area here.

6. Master Breastfeeding One Twin at a Time.

When you are first learning how to breastfeed your twins, we recommend you feed them one at a time until they are both latching on correctly. This usually takes 4 or five days.

The Lactation Consultant will help you know when you are ready to begin feeding your twins at the same time. While you may feel motivated to quickly begin feeding them together, it will be much easier if you take your time and focus on each individual twin first. You will have many amazing months of feeding them at the same time.

6. Learn to Breastfeed Your Twins Together.

As soon as you feel comfortable feeding each of them individually, it is time to learn how to breastfeed them at the same time. This might seem difficult at first, but it will save you hours each day while your twins are eating every few hours.

When your twins are first born, they will sleep often and very soundly. In order to get them on the same schedule, we let the first twin to awaken determine when to feed them both.

When one twin wakes up hungry, gently wake the other one as well. It may be difficult at first to get the second one to wake up, but once they are both awake, offering them each a breast. Almost always, they will both feed.

If you continue to wake the second twin up when the first one is hungry, you will quickly get your twins on the same schedule. It will be an amazing feeling when this process begins to become easy. You will get more sleep and your breasts will both be emptied at the same time.

As your twins get older and begin to develop head control, breastfeeding them becomes even easier. The early days of breastfeeding are the hardest, but going slowly and taking the time to use proper techniques and practices will benefit you immensely in the future.

7. Drink Lots of Water to Maintain Your Milk Supply.

Breast milk is composed of 90% water.

During birth and for days after giving birth, your body will lose a lot of blood. Blood is composed mostly of water. Therefore, you will likely be extremely dehydrated.

One of the biggest factors that will affect your milk supply in the early days is your water intake. This is a crucial time as your body is figuring out how much milk to make for your twins. If you are severely dehydrated in the early days, your body will not establish the correct amount of milk supply.

You will probably notice that soon after you begin nursing your little one you will become thirsty. The oxytocin that your body releases during breastfeeding is responsible for triggering your thirst. This is your body’s natural way of ensuring that you are getting enough water to make breast milk.

As soon as you can, begin re hydrating your body. This can easily be done simply with water. During breastfeeding one baby, you should drink an extra quart, or 32 ounces, per day.

When breastfeeding twins, you should drink an additional 64 ounces of water each day.

In the early days, breastfeeding can take a long time. It will be hard for you to get up to get yourself water during long stretches of time. Always have a glass or a bottle within arms reach so you don’t have to sit there thirsty until everyone is done nursing.

8. Take Natural Supplements if You need to Increase Your Milk Supply.

Milky Way Natural Breastfeeding Supplement for Lactation Support is formulated to help the body naturally increase your milk supply. Their advanced formula contains super-effective herbs, such as fenugreek, alfalfa, fennel, nettle, milk thistle and more. of all the natural supplements intended to increase milk supply, this has the most complete blend.

Lowest Price: Amazon.com

Price: $22.90

Amazon Rating:

Another excellent way to increase your milk supply is by drinking tea specially formulated to help your body make more milk. Pink Stork Lactation: Smooth Vanilla Nursing Support Tea -Organic Loose Leaf Tea is a delicious choice that tastes great hot or cold.

Lowest Price: Amazon.com

Price: $11.99

Amazon Rating:

In summary, breastfeeding twins will be one of the most rewarding and bonding experiences of your life. While you await the arrival of your babies, you may begin to feel worried that you will not be able to breastfeed them. That is normal.

The 8 tips I have outlined above will help you to prepare for your twins and begin breastfeeding them with confidence from the very beginning.

By purchasing the items above and preparing to immediately reach out to the lactation consultant in your hospital, you will begin the journey of breastfeeding your twins with confidence.

The post 8 Simple Tips for Successfully Breastfeeding Twins appeared first on TWINS Magazine.

Breastfeeding twins is an incredible way to ensure your twins health and can be done.

There it was again–another look of disbelief. Melinda’s confidence dipped a little lower with each look or thoughtless remark: “You’re not going to nurse twins, are you?” or “You’ll have your hands full enough without nursing.” Already exhausted from a lack of sleep–it was hard to get comfortable at night–Melinda was especially vulnerable to negative remarks. Melinda’s concerns–sleep and milk–are not unlike those of thousands of other mothers who eventually find nursing twins one of the most rewarding experiences of their lives. In the beginning, however, the reality–sleep, milk production, emotions and a dramatic change in lifestyle–can be overwhelming.

“When I was breastfeeding my twins, I felt like I had my shirt off 24 hours a day,” recalled Jean Dosdos, a breastfeeding support volunteer through the West Palm Beach Mothers of Twins Club in West Palm Beach, Fla. “I know how frustrating it can be for new moms of twins, and that’s why I volunteer. I know it’s a tremendous help to have that support and encouragement. Otherwise, new moms would quit trying after two or three weeks.”

The Proper Technique for Breastfeeding Twins

Breastfeding Twins is simply a skill you must learn to do correctly.

As soon as your twins are born, you will want to have a Lactation Consultant come in to your hospital room. She will show you how to properly hold each twin, position his or her mouth around your nipple and latch properly onto your breast.

The first steps to successfully nursing twins are to seek out supportive family, friends and an encouraging Pediatrician; get accurate information; and turn a deaf ear to negative remarks.

Talk to other mothers who are nursing twins a couple of months older than yours. Join a Mothers of Twins club and attend La Leche League meetings before your delivery.

Carol Huotari, accredited La Leche League leader and an international board certified lactation consultant, said that commitment is essential to successfully breastfeeding twins. “A migratory field worker pumped her milk three times a day in the bus and the other workers laughed at her, but her commitment was strong and her twins were the healthy ones who didn’t have ear infections.”

Set Goals to Ensure You Will Be Successful at Breastfeeding Your Twins

“Are you going to nurse exclusively for six months? A working mother may supplement with bottles. Think it through and decide what will work in your life,” Huotari advised. Success is defined differently for every mother.

Be Patient with Yourself While You are Learning How to Breastfeed Your Twins

While still in the hospital, talk to a Lactation Consultant about your goals, concerns and lifestyle.

Ask that she be there when you first nurse and ask for a home visit if you have preemies.

Contact your local Lactation Consultant Organization to schedule home visits.

The Lactation Consultant in the hospital will guide you through the first sessions.

These are the learning times for you and your twins. Your newborn twins are trying to latch on and you are establishing your milk supply.

“With twins in the football hold position, you can really watch what they are doing with their mouth,” Huotari explained. As they grow you may find more comfortable positions.

Preemies may take a little longer to latch on since their sucking instinct may not be fully developed. In that case, you may need to pump your breasts to get the milk flowing.

You Will Have Enough Milk to Breastfeed Your Twins

When your twins latch on well and nurse effectively, your milk supply will quickly build.

It is a case of demand and supply. The greater the demand, the more milk you supply. Expect to nurse your newborn twins about 10 to 12 times in a 24-hour period.

Until your twins learn to latch on, it may be a good idea to nurse them one at a time.

“It really helps mothers to individualize their twins and see who’s who. Each baby has a different nursing style,” Huotari said.

Know Which Twin Nursed When and on Which Breast

Whether you continue to nurse them individually or simultaneously, you do it you need to be organized about it. Keeping track of who nursed first and at which breast helps you know how they are feeding.

Each of the twins might have different appetite and sucking behavior.

Therefore, alternate which twin feeds from each breast with every feeding. A great way to remember which twin fed from each breast is to wear a simple bracelet or hairtie on your wrist. Assign the hairtie to Twin A. After you have completed breastfeeding your twins, move the hairtie to the other wrist. This will tell you that Twin A should feed from that breast during the next feeding.

“I breastfed my 30-month-old triplets, Sammy, Hope and Emma. One of the three is still breastfeeding, one weaned at 13 months, the other at 24 months,” said Sheri Ingalls of Port St. Lucie, Fla.

“To keep my milk supply up, I nursed the babies on demand through the night. It also alleviated some of my concern over the babies getting enough to eat. During the day, the babies had to be on a schedule so that I could ensure that each one had the opportunity to be first–which was the easiest let-down–and last, which was the longest time on Mommy. If I allowed them to nurse on demand all the time, Hope would have nursed all day and left the smaller ones with nothing.”

Sleep When Your Twins Sleep

Allison Berryhill of Atlantic, Iowa, found nighttime nursing to be a way of life during her twin boys’ most milk-dependent months. “With newborns, I reclined in a pillow-piled Lay-Z-Boy, each boy to a breast, attached for the night. I did not get long, uninterrupted hours of slumber, but I was no more sleep-deprived than during the final months of pregnancy when few positions were comfortable.”

Sleep becomes the top priority–after establishing your milk supply and feeding your twins.

The rule for mothers of twins is sleep when your twins sleep.

You’ll get more rest if you can learn to nurse lying down in bed and if you set up a comfortable “nursing station” for the days.

Whether it is a Lay-Z-Boy or a comfortable sofa, you need room to prop plenty of pillows and a footstool for your feet. On a table within easy reach have a telephone, diapers, a notepad for jotting down who nursed first and where, and a snack and a beverage.

A well-arranged nursing station means you won’t have to hop up once you’re settled and you will be more rested.

You Must Take Care of Yourself Before You Can Care for Your Twins

If you become fatigued your ability to keep a positive outlook while coping with the ups and downs of nursing twins diminishes.

You must take care of yourself first.

That means sleeping as much as possible, eating right and drinking plenty of fluids each day.

The number one piece of advice new mothers of twins offer expectant mothers is to get help with the household chores and cooking.

But housework may have to wait. Cooking is something others do for you.

Only you can nurse your twins.

Sleep deprivation and neglecting your basic care just opens the door to depression.

About 10% of women have postpartum depression the first year, but with mothers of twins the figure jumps to 25%, according to Huotari. When you are home and alone with your babies, you can quickly feel isolated and overwhelmed.

Be sure you have a friend to talk with, one who understands the special demands of multiples.

Don’t Give Up

Regardless of how much support you have and how well you prepare mentally, the reality of your new job can be an emotional seesaw and the adjustment definitely takes time.

Huotari offered some sage advice: If you feel like giving up, stick with what you’re doing for three days and then see how you feel. Remember, tens of thousands of nursing mothers say joy does come out of the early chaos.

Sheri summed up: “Don’t listen to other people, not even doctors, when they tell you it can’t be done. You can make enough milk. You can get some sleep. You can have a life! Don’t give up if it’s tough at first, because after your babies are bigger and getting more milk in a shorter period of time, it’s a breeze.”

BREASTFEEDING FAQs

How can I tell if my twins are nursing effectively?

Most newborns breastfeed 10 to 12 times per 24-hour period. They nurse for 15 to 30 minutes at a feeding and swallow after every one or two sucks. A baby who is having difficulty getting enough to eat will not latch on properly, may want to nurse inordinately long and will not swallow often.

How do I know if my babies are getting enough to eat?

After the first couple of days, they saturate six to eight diapers per day and have from three to five bowel movements.

With multiples, it is helpful to keep notes on who nursed at which breast, for how long, and the number of wet and soiled diapers. An electronic scale help your confidence.

Once your milk and their weight gain are established, tracking the nursing schedules and diapers is not essential.

Why are my twins suddenly starving all day and night?

Growth spurts occur periodically; the first may come as early as 10 to 14 days after birth. The next one may surface around four to six weeks and another one around three months.

Prop your feet up and nurse, nurse, nurse on demand. Your milk supply will quickly catch up with your twins’ needs. If, however, you respond with supplemental bottles, your milk supply may not increase to meet the rising demand.

Can I nurse my preemies in the NICU?

Babies develop the ability to swallow when they are 11 to 16 weeks in utero.

The ability to suck follows a few weeks later. The ability to coordinate both actions and breathing comes later still. If your babies are very low birth weight, you may have to express your breast.

Expect to pump for a total of 100 to 120 minutes a day. The NICU will watch for signs that your preemies are ready for nutritive sucking.

The post Breastfeeding Twins: It Can Be Done! appeared first on TWINS Magazine.

But continuing to live my life this way began to exact a toll on my physical and emotional health.  I got pneumonia when the boys were one year old, and I had a fever that continued for more than a year.  Then I began to awaken at three o’clock every morning, unable to get back to sleep.  When the alarm went off, I would lie in bed exhausted, feeling a sense of despair and dread, wondering how I could face another day.

That dark mood began to permeate every aspect of my life.  At one point, I remember crying almost daily during my long commute to pick the boys up from daycare.  I waited, hoping to “snap out of it.”  Yet the sadness continued.

Finally, I summoned the courage to ask my doctor for a referral to a therapist.  Asking for help and admitting that I suffered from depression represented a giant step for me.  With the help of a gifted therapist and a course of antidepressant medication, I began the process of emerging from my depression.  This involved making some logistical changes in our daily routine in order to reduce stress, as well as trying to understand and change the negative “self-talk” that fueled my depression.

Our boys are now almost 6 and life seems much easier than when they were babies.  In retrospect, I can see that there were several core “myths” that contributed to my depression and robbed me of my ability to enjoy those early years with our new family.  I share these core myths along with the realities, as I now see them, with the hope that other new mothers of multiples might read them and discover ways to be gentler on their own self.

MYTH #1

You should always feel lucky and blessed to be the mother of twins.  Our culture still romanticizes motherhood, perpetuating the myth that being home with infants or young children is always joyful and easier than being out in the “real” world.  Therefore, being home with two babies as once must be “twice the joy”.  How many times have strangers stopped you on the street and confessed “I’ve always wanted to have twins.  I think it would be so much fun!”  The message I got from society was that I should feel joyous, but in those initial months at home with our babies, I felt mainly exhausted and overwhelmed.  I concluded, therefore, that I must be a bad (or at least, inadequate) mother.  I could no longer see or appreciate the creative ways I was managing to love and care for two babies at once.

REALITY

You can love your twins unconditionally and feel blessed to have two beautiful babies.  However, you do not always have to love trying to meet the physical and emotional needs of two babies simultaneously, nor always rejoice over the way your life has so drastically changed.  Caring for two babies at once is one of the hardest things you may ever do in your life.  And no one else, unless they have multiples of their own, can understand what it really feels like.  Any reasonable person would at times feel exhausted, overwhelmed, and vulnerable to depression when faced with a relentless stream of diapers, feedings, and months of sleep deprivation.  Expect to feel a wide spectrum of emotions once your twins arrive.  You are not alone in your experience: Studies have found significantly high rates of chronic exhaustion among mothers of young twins (76% versus only 8% among mothers of singletons) and rates of depression ranging from 30% to 50% (three to five times the rates among mothers of singletons).  We typically think of postpartum depression (PPD) as having its onset within three months of childbirth.  However, experts on PPD now emphasize that women are at increased risk for depression for up to three years after giving birth.

MYTH #2

Taking time for yourself is selfish and means you’re not taking care of your family.  One of the most difficult things for mothers of multiples is to take time for ourselves.  Especially when our babies are little, they have so many physical and emotional needs that require our attention.  In my case, I had a supportive and involved husband who did his best to give me some breaks.  However, the guilt and ambivalence that I experienced when I did take time away from our babies made the psychological costs of nurturing myself too high.

REALITY

“You cannot give from an empty cup.” And you can’t replenish your cup unless you take a break.  Taking some time for yourself (to simply take a walk or have coffee with a friend) is important, not only for your well-being but for your babies as well.  A recent study of mothers of very young twins found that mothers who asked for help and were less exhausted were much more sensitive and responsible for their babies’ individual needs.  Of course, the reality is that any dedicated “Mommy Time” is extremely limited and therefore, precious. Protect it fiercely and spend it only on activities that you truly enjoy or with people who delight and nurture you.

MYTH #3

Each individual decision I make about how I raise my twins is critically important to their future well-being.  Making the wrong decision could be devastating.  As mothers, we are faced with a never-ending stream of choices regarding the care of our children: Breastfeed or bottle feed?  Return to work or stay home?  The list seems endless.  Unless we are careful, we can begin to expend too much energy worrying about making the “right decision,” losing sight of the bigger picture with respect to the good jobs we do as mothers.

REALITY

The decisions you make about caring for your twins deserve careful consideration.  But it is the sum of all your decisions and the daily interactions with your children that matter the most.  Trust yourself.  No one knows your twins better than you do.  If it turns out that a decision was not the best one, in the long run, you will know that and will have even more information under your belt to draw upon the next time you’re faced with a difficult decision.

I know now that the love I have for my twins is like an iceberg.  The tiny, exposed tip of the iceberg represents the day-to-day decisions: one crib or two, same classroom or separate?  But those decisions are supported by the unseen, massive body of the iceberg, comprised of all the loving interactions, attention, and care I have given our boys.  I know that it is the powerful base of the iceberg that shapes and nurtures them in the long run.

Raising twins is a unique challenge and it is hard work.  Don’t make your job even harder by letting these or other myths about motherhood rob you of your ability to see just how creative and capable you are. While some days will feel harder than others, there should also be some days when you can find ways to nurture yourself and take pleasure in the things you do. 

If these good days begin to disappear, especially if you notice other symptoms of clinical depression such as difficulty sleeping or eating, feeling sad, worthless, or hopeless about the future, don’t hesitate to seek professional help.  Asking for support during times of stress is not a sign of weakness, but rather a testament to how much you value and treasure your children, your family, and yourself.

The post The Myths of Motherhood appeared first on TWINS Magazine.

“When I was breastfeeding my twins, I felt like I had my shirt off 24 hours a day,” recalled Jean Dosdos, a breastfeeding support volunteer through the West Palm Beach Mothers of Twins Club in West Palm Beach, Fla. “I know how frustrating it can be for new moms of twins, and that’s why I volunteer. I know it’s a tremendous help to have that support and encouragement. Otherwise, new moms would quit trying after two or three weeks.”

Find support
The first steps to successfully nursing twins are to seek out supportive family, friends and an encouraging pediatrician; get accurate information; and turn a deaf ear to negative remarks. Talk to other mothers who are nursing twins a couple of months older than yours. Join a Mothers of Twins club and attend La Leche League meetings before your delivery. A lactation consultant can administer a healthy dose of facts and the wisdom of experience.

Carol Huotari, accredited La Leche League leader and an international board certified lactation consultant, said that commitment is essential to successfully breastfeeding twins. “A migratory field worker pumped her milk three times a day in the bus and the other workers laughed at her, but her commitment was strong and her twins were the healthy ones who didn’t have ear infections.”

Set goals
Knowing your goals is part of the commitment. “Are you going to nurse exclusively for six months? A working mother may supplement with bottles. Think it through and decide what will work in your life,” Huotari advised. Success is defined differently for every mother.

It takes time to learn
While still in the hospital, talk to your lactation consultant about your goals, concerns and lifestyle. Ask that she be there when you first nurse and ask for a home visit if you have preemies. She will guide you through the first sessions; they are the learning times for you and your babies. Your newborns are trying to latch on and you are establishing your milk supply. “With twins in the football hold position, you can really watch what they are doing with their mouth,” Huotari explained. As they grow you may find more comfortable positions.

Preemies may take a little longer to latch on since their sucking instinct may not be fully developed. In that case, you may need to pump your breasts to get the milk flowing.

You will have milk
When your twins latch on well and nurse effectively, your milk supply will quickly build. It is a case of demand and supply. The greater the demand, the more milk you supply. Expect to nurse your newborn twins about 10 to 12 times in a 24-hour period.

Until your twins learn to latch on, it may be a good idea to nurse them one at a time. “It really helps mothers to individualize their twins and see who’s who. Each baby has a different nursing style,” Huotari said.

Know who nurses when and where
Whether you continue to nurse them individually or simultaneously, you do it you need to be organized about it. Keeping track of who nursed first and at which breast helps you know how they are feeding.

“I breastfed my 30-month-old triplets, Sammy, Hope and Emma. One of the three is still breastfeeding, one weaned at 13 months, the other at 24 months,” said Sheri Ingalls of Port St. Lucie, Fla. “To keep my milk supply up, I nursed the babies on demand through the night. It also alleviated some of my concerns over the babies getting enough to eat. During the day, the babies had to be on a schedule so that I could ensure that each one had the opportunity to be first–which was the easiest let-down–and last, which was the longest time on Mommy. If I allowed them to nurse on demand all the time, Hope would have nursed all day and left the smaller ones with nothing.”

Sleep when your twins sleep
Allison Berryhill of Atlantic, Iowa, found nighttime nursing to be a way of life during her twin boys’ most milk-dependent months. “With newborns, I reclined in a pillow-piled Lay-Z-Boy, each boy to a breast, attached for the night. I did not get long, uninterrupted hours of slumber, but I was no more sleep-deprived than during the final months of pregnancy when few positions were comfortable.”

Sleep becomes the top priority–after establishing your milk supply and feeding your twins. The rule for mothers of twins is to sleep when your twins sleep.

You’ll get more rest if you can learn to nurse lying down in bed and if you set up a comfortable “nursing station” for the days. Whether it is a Lay-Z-Boy or a comfortable sofa, you need room to prop plenty of pillows and a footstool for your feet. On a table within easy reach have a telephone, diapers, a notepad for jotting down who nursed first and where, and a snack and a beverage. A well-arranged nursing station means you won’t have to hop up once you’re settled and you will be more rested.

Nurture yourself
If you become fatigued your ability to keep a positive outlook while coping with the ups and downs of nursing twins diminishes. You must take care of yourself. That means sleeping as much as possible, eating right, and drinking quarts of fluids each day.

The number one piece of advice new mothers of twins offer expectant mothers is to get help with the household chores and cooking.

But housework may have to wait. Cooking is something others do for you. Only you can nurse your twins.

Sleep deprivation and neglecting your basic care just opens the door to depression. About 10% of women have postpartum depression the first year, but with mothers of twins the figure jumps to 25%, according to Huotari. When you are home and alone with your babies, you can quickly feel isolated and overwhelmed. Be sure you have a friend to talk with, one who understands the special demands of multiples.

Don’t give up
Regardless of how much support you have and how well you prepare mentally, the reality of your new job can be an emotional seesaw and the adjustment definitely takes time. Huotari offered some sage advice: If you feel like giving up, stick with what you’re doing for three days and then see how you feel. Remember, tens of thousands of nursing mothers say joy does come out of the early chaos.

Sheri summed up: “Don’t listen to other people, not even doctors when they tell you it can’t be done. You can make enough milk. You can get some sleep. You can have a life! Don’t give up if it’s tough at first, because after your babies are bigger and getting more milk in a shorter period of time, it’s a breeze.”

BREASTFEEDING FAQs
How can I tell if my twins are nursing effectively?
Most newborns breastfeed 10 to 12 times per 24-hour period. They nurse for 15 to 30 minutes at a feeding and swallow after every one or two sucks. A baby who is having difficulty getting enough to eat will not latch on properly may want to nurse inordinately long and will not swallow often.

How do I know if my babies are getting enough to eat?
After the first couple of days, they saturate six to eight diapers per day and have from three to five bowel movements. With multiples, it is helpful to keep notes on who nursed at which breast, for how long, and the number of wet and soiled diapers. An electronic scale helps your confidence. Once your milk and their weight gain are established, tracking the nursing schedules and diapers is not essential.

Why are my twins suddenly starving all day and night?
Growth spurts occur periodically; the first may come as early as 10 to 14 days after birth. The next one may surface around four to six weeks and another one around three months. Prop your feet up and nurse, nurse, nurse on demand. Your milk supply will quickly catch up with your twins’ needs. If, however, you respond with supplemental bottles, your milk supply may not increase to meet the rising demand.

Can I nurse my preemies in the NICU?
Babies develop the ability to swallow when they are 11 to 16 weeks in utero. The ability to suck follows a few weeks later. The ability to coordinate both actions and breathing comes later still. If your babies are very low birth weight, you may have to express your breast. Expect to pump for a total of 100 to 120 minutes a day. The NICU will watch for signs that your preemies are ready for nutritive sucking.

The post How to Succeed in Nursing Multiples appeared first on TWINS Magazine.

Now, fast forward to the moment you find out you are expecting twins (or more), and that idealistic vision you had just created for you and your one baby has now suddenly changed. Now you are facing the real possibility that you may have to forget about all your home-birth plans and you may even be told you will have to have a cesarean or C-section delivery.

Having twins can definitely take its toll on your body and then add this to having a C-section surgery, and you will soon discover that it may be more challenging and take longer to recover than you initially thought! Here are some tips to help you speed up your recovery process so you can spend less time sore and tired, and more time bonding with your new twin babies:

1. Walk, walk, walk

You will be encouraged to get out of bed at least a couple of times the day after your surgery – or even on the day of surgery – to walk. Don’t try getting up by yourself. The nurse should be at your side the first few times you do get up and walk. In the meantime, get the blood going in your legs by wiggling your feet, rotating your ankles, and moving and stretching your legs.

Personally, I have had three C-section deliveries and I can remember that even walking to the bathroom seemed almost impossible at first, but moving around is important for your recovery, so you need to push through so you will be ready to take on caring for infant twins. It will also help your circulation and make it much less likely that you develop blood clots. What’s more is that it will make your bowels less sluggish, which will help you feel a whole lot more comfortable a lot sooner. For these reasons, you’ll be encouraged to walk each day. Try to take your walks a short time after you’ve taken pain medication – when you’re likely to feel more comfortable.

2. Get plenty of rest

A C-section is major surgery. Just like with any other surgery, your body needs time to heal afterward. Expect to stay in the hospital for three to four days after your delivery (longer if there are complications), and give your body up to six weeks to fully heal. This is where you need to enlist lots of family and friends to help you with chores and laundry when you and your babies come home. I am sure you have already heard people say, “Rest when your babies rest!” This is so important, especially if you are recovering from surgery. The household “to-do’s” can wait, and even taking just a few moments to rest throughout the day can be extremely helpful for you and your postpartum body.

3. Manage your pain

Ask your doctor what pain medicines you can take, especially if you’re breastfeeding. Depending on the level of your discomfort, the doctor might prescribe a pain reliever or advise you to take an over-the-counter NSAID (Advil, Motrin) or acetaminophen (Tylenol). In addition to pain medicine, you can use a heating pad to relieve discomfort at the surgical site. In any case, don’t be shy about asking your nurse for more medication if you’re uncomfortable. You don’t need to suffer in silence, and the longer you wait to ask for the medication you need, the harder it will be to manage your pain.

4. Listen to your body

Be sure to take extra care getting around while you heal, so avoid going up and down the stairs as much as possible. A good idea is to keep everything you need close by, such as diaper changing supplies close to you so that you don’t have to get up too often. It’s also important not to lift anything heavier than your babies and certainly do not try to hold both of them in their car seats at one time, until you feel stronger, because you do not want to risk tearing your incision. Ask for help as much as possible and whenever you have to sneeze or cough, hold your abdomen to protect the incision site. It could take up to eight weeks for you to get back into your normal routine. Ask your doctor when it’s okay to exercise, go back to work, and drive. Also, wait to have sex or use tampons until your doctor gives you the green light.

5. Wear loose-fitting clothing and underwear

You’ll want to avoid putting too much pressure on your healing scar, so it’s best to either wear underwear a size bigger or you can buy special knickers that fit over the area to make it more comfortable while you are healing.

6. Beware of a good laugh

Laughing normally feels good, but not necessarily post a C-section. You can be more comfortable when laughing, coughing, and even pooping if you hold a pillow to your abdomen. This will help your core muscles from aching. Anything that puts pressure on the abdominal area will probably be painful at first, but you’ll feel a bit better day by day. Be sure to use your hands or a pillow to support your incision when you cough, sneeze, or laugh.

7. When to call the doctor

You’ll probably feel some soreness in the incision and you may have bleeding or discharge for up to six weeks after the C-section. That’s normal. But the following symptoms warrant a call to your doctor because they could signal an infection:

• redness, swelling, or pus oozing from the incision site
• pain around the site
• fever of more than 100.4 degrees Fahrenheit
• bad-smelling discharge from the vagina
• heavy vaginal bleeding
• redness or swelling in your leg
• difficulty with breathing
• chest pain
• pain in your breasts

Also call your doctor if you feel sad and your mood never seems to lift, especially if you have thoughts of hurting your babies. Finally, if you have a friend or sibling who went through a C-section, try not to compare yourself to her. Every woman’s experience with this surgery is different. Focus on your own healing right now and give your body the time it needs to get back to normal.

The post 7 Tips on Recovering from a C-Section appeared first on TWINS Magazine.

Like every parent of multiples, I wondered how difficult would be for me to persuade the powers-that-be that my children would be best served if they were together in the same classroom. I felt more confident knowing I had a secret weapon in my portfolio to strengthen my hand for negotiations that day-just in case. I want to share my secret with you.

First, some background: My twins have been at a Montessori school for the last three years-the first two-and-a-half together, and this past six months apart (a trial period we agreed to after two years of arguing with their teachers). Although they have flourished in both environments, they have repeatedly mentioned how much they miss each other when they’re separated.

In a new school, with new friends to make and a new environment to which they must acclimate, my husband and I believe a particular blessing of twinship is for them to have each other-being physically close together-until we parents agree they can be apart for their own reasons.

In writing this, I wish to argue not that all twins should be together all the time, but that parents who disagree with the decisions of a school system regarding their children need only know the path to take with the school to get what they want. I feel fortunate to live in Oklahoma-one of only two states having legal standards for schools that require deference to parental choice in the placement of multiple-birth children.

Jack and Emma will be in the same class next year, and no fight erupted in the effort to place them there. For those of you who live elsewhere, your experience can be discouragingly different-you may be told that your multiples will be separated because it is supposedly “in the twins’ best interest.” And you may feel there is little you can do to change the minds of the teachers and administrators-indeed, some parents of multiples have been told to consider home schooling if they wish to try to control their children’s education

Many of us agree legislation would be helpful, and I have personally endorsed Kathy Dolan’s efforts in this regard (to see a copy of the letter I wrote Kathy, visit her website at http://www.twinslaw.com/Welcome_to_Twinslaw.com_Where_the_twin_bond_is_celebrated_and_protected_under_law!.html

However, in the absence of legislative help, all is not lost. While you may not have control, there is always room for negotiation. And if you level the playing field by knowing what the educators know, you may well succeed.

Educators, like doctors, are expected to follow certain guidelines when taking care of your loved ones. These standards or guidelines are not intended to be applied blindly if there is evidence that following them would be harmful to a specific person in a specific situation. Guidelines exist in an effort to unify the ways in which we do our jobs. Guidelines for educators are created by a federal government task force (the Educational Research and Improvement Council-ERIC) and funded by the Office of Educational Research and Improvement of the U.S. Department of Education, covering topics ranging from how to create fair tests to how to acclimate home-schooled children into higher education.

These guidelines are published on the Internet (at www.eric.ed.gov) and are available to educators across the country.

Just as all doctors are expected to know what the Journal of the American Medical Association is, all teachers and administrators should be familiar with the ERIC Digest and know that it exists and contains guidelines for assisting them in providing an appropriate educational environment for all of our children.

Many educators seem to have forgotten the ERIC Digests—or never knew they existed—because these men and women are often arguing a position to you that is in direct opposition to their own guidelines, which say—wait for the shocker here—that parents often know what is best for their children, and that placement of twins together should be allowed unless certain circumstances exist!

If you have children nearing school age, you would benefit by going to the site above and printing out these guidelines for yourself, putting them in your “Important Information” folder along with your twins’ immunization records. Be prepared to “share” them with your local school principal when enrolling your children in school.

This is especially important if you believe your district will be less than eager to adopt your assertions about your children’s needs to be in the same classroom. You will then be prepared to argue from a position of increased strength by asking the educators to agree to follow their own guidelines when teaching your children.

In brief, the guideline says that parents and teachers should ask themselves a few questions when considering the appropriate placement of multiples, namely:
• Are the twins, by the age of five, able to make and sustain friendships independently of one another? If so, they can be placed together if the parents wish. If not, separation should be considered on an “experimental” basis to allow this to begin.
• Do classmates or teachers constantly compare the twins, leaving one to feel negatively toward school? If so, separation could be considered. ?(In my opinion, a frank discussion with a teacher who is making comparisons is warranted to eliminate his or her unhelpful behavior).
• Are the twins consistently disruptive when they are together (and have attempts to change their behavior failed?) If so, separation may be important to preserve the rights of other children to learn successfully.

• Does a female twin “over-mother” her male sibling? If so, separation may help the boy develop independent behaviors and improve his learning.
• Does a female twin “over-mother” her male sibling? If so, separation may help the boy develop independent behaviors and improve his learning.
• How will separation affect twins who are used to leaning on each other for academic and social support, especially in preschool and early elementary education? A balance must be found between twins being overly dependent upon each other and twins being separated before they are able to cope adequately.
• Is there a social or health concern that would compound the stress of separation on the twins? For instance, if one twin has disabilities and leans on the other one, or if the parents are separating or divorcing, placement together may be in the best interests of the children.
• Finally, if the twins are school-aged, what do they want? The guidelines recognize that children have a right to their opinions and that those should be taken into account along with all other available information when the decision is made.
• And most interestingly, ERIC recognizes the importance of gaining the agreement of the parents:

“Placement decisions should also take into account the views of the parents…If parents disagree on the best course of action, teachers may want to listen carefully to each, make suggestions for them to consider, invite them to observe their children in the classroom, and suggest a short-term experiment of separating or keeping the twins together. During that time, the twins can be closely observed and evaluated by teachers and parents. In this way, the school personnel and the parents can address the issue as a team focused on the long-term best interests of the children.”

So don’t sell yourself short when it comes to directing the education of your children—your opinion matters most, and you have always known it. Remember that if your children turn out poorly, nothing else you have ever done matters.

The people who have the greatest interest in your children’s final outcome are you and your children, not the people who went to school to learn to teach them. They may love children and be dedicated professionals when it comes to educating children, but ultimately, those who teach will only be with your children for about nine months or less, after which they move on to another group of kids.

Advocate for your twins just as you did while you were pregnant with them—ask the tough questions, demand answers from the professionals, and be willing to participate with them to improve your children’s educational experience. Ask to be part of a team with your kids’ educators, neither insisting that they be “the boss” of the educational process nor agreeing to be relegated to the sidelines.

And keep the ERIC guidelines in mind—you never know when you might need them again to help you find answers when talking to the other members of the team. Best wishes for a successful school year—see you on the playground!

Bio/Byline: Dr. Rachel Franklin, a board-certified family medicine physician in Oklahoma City, is the mother of 4-year-old twins and the author of Expecting Twins, Triplets and More: A Doctor’s Guide to a Healthy and Happy Multiple Pregnancy (St. Martin’s Griffin 2005), available at www.TwinsMagazine.com (Twins Bookshelf, Pregnancy and Expecting Books). She posts advice on the TWINS Magazine Message Board forums “Pregnant with Multiples?” and “Postpartum.” Visit her Web site, www.AskDrRachel.com

The post Breaking the Barriers: The Secret to Controlling Your Twins School Placement appeared first on TWINS Magazine.

Most people realize that there is a percentage of women who experience feelings of sadness after they deliver their baby or babies. The reality is that many people have no idea of the severity and complexity of life with PPD. 

In fact, there are a number of discouraging myths that keep many women from seeking help when they experience the signs of depression after delivery.  

In this article, we will look at what postpartum depression is, why it occurs, debunk some popular myths, and talk about how to get help for you or someone you love.

Postpartum depression does not have to derail your experience as a new mom of multiples. 

What is postpartum depression?

There is not one single underlying cause of PPD. Instead, experts believe that there is a myriad of contributing factors that lead to developing this form of clinical depression. 

Postpartum or perinatal depression affects as many as 1 in 7 women. It is so common that it is the most common complication of childbirth. 

Who is most likely to develop postpartum depression?

PPD can affect any woman. It strikes women who experience easy pregnancies, as well as, those with difficult pregnancies. First-time mothers and mothers who have one or more children can also experience PPD. It doesn’t matter if a new mom is married or single, and things like income, age, ethnicity, culture, and education make little difference in your risk of experiencing depression after birth.

One group of women who are at a higher risk of suffering from postpartum depression are moms of multiples (or MoMs). MoMs are much more likely to develop PPD than moms of singletons. While not all twin moms will experience symptoms, they are at an increased risk. 

What are the risk factors for postpartum depression?

• A change in hormone levels after childbirth 
• Previous experience of depression or anxiety 
• Loneliness, not having close friends and family around
• Family history of depression or mental illness 
• The stress involved in caring for a newborn and managing new life changes
• Having a challenging baby who cries more than usual, is hard to comfort, or whose sleep and hunger needs are irregular and hard to predict
• Having a baby with special needs (premature birth, medical complications, illness) 
• Lack of family support
• The health consequences of childbirth, including urinary incontinence, anemia, blood pressure changes, and alterations in metabolism
• The physical changes during and after pregnancy
• Other emotional stressors, such as the death of a loved one or family problems
• Financial or employment problems 
• Caring for twins, triplets, or higher-order multiples 
• Isolation and lack of social support
• Changes in the sleep cycle 

Difficulties with breastfeeding might also be linked to PPD. New moms who have difficulty breastfeeding in the first 2 weeks after delivering their babies have a higher risk of PPD 2 months later, according to a study at the University of North Carolina in Chapel Hill. 

What is the difference between baby blues and depression?

Many new moms confuse their own postpartum depression with the less serious “baby blues.” Baby blues happen when moms feel more melancholic than is typical for them after delivering their infant. As hormone levels drop, moms can feel moody, sad, tired, and generally “blue.” This is very different from PPD. 

Unlike the baby blues, PPD doesn’t go away on its own. It can impact a mother’s ability to care for her newborn. The symptoms are much more debilitating and longer-lasting. Any mom who is concerned about how she is feeling should talk to their doctor in order to stay aware of what is going on. 

How prevalent is postpartum depression?

Rates of PPD in singleton pregnancies

According to a report and statement issued by the U.S. Preventive Services Task Force, 8.9 percent of all pregnant women and 37 percent of new mothers experience clinical depression in the months before or after giving birth. Less research has been done on new fathers, but some studies suggest that about 10 percent of dads may also experience postpartum depression. For half of the women diagnosed with PPD, this is their first episode of depression. 

Rates of PPD in twin pregnancy

Moms of multiples experience PPD at a higher rate than singleton moms. Researchers have not yet isolated whether these higher rates are due to physical etiology (such as higher levels of hormones) or the additional stress of caring for two newborns. 

A 2009 study, published in the journal Pediatrics found that new MoMs were 43 percent more likely to have postpartum depression than were mothers of singletons. While not all moms of multiples will develop PPD, it is important for these MoM’s and their families to be on the lookout for potential symptoms.  

Recognizing the signs of postpartum depression

In theory, it sounds like it would be fairly simple to identify and treat PPD, right? 

The reality is that after delivering newborn twins, in the sleep-deprived newness of parenting, things can get muddy. MoM’s often think their sadness or anxiety will go away. They often blame their feelings on exhaustion. Understanding the signs of PPD can help to tease apart normal postpartum blues with true depression. 

What are the symptoms of postpartum depression?

The warning signs are different for everyone but may include: 

• A loss of pleasure or interest in things you used to enjoy
• Fear of not being a good mother 
• Eating much more, or much less, than usual
• Anxiety — all or most of the time 
• Fear of being left alone with the baby 
• Racing thoughts 
• Feeling guilty or worthless, including blaming yourself 
• Excessive irritability, anger, or agitation 
• Sadness, crying uncontrollably for very long periods of time 
• Difficulty sleeping, beyond the typical new parent lack of sleep
• Disinterest in the baby, family, and friends 
• Difficulty concentrating, remembering details, or making decisions 
• Thoughts of hurting yourself or the baby (seek help immediately if you experience this symptom).

What to do when you suspect postpartum depression?

If you suspect someone you love may be suffering from any form of postpartum depression, anxiety, or even blues – the first thing to do is talk about it. Many moms don’t even realize what is going on. In many cases, it is the loved ones that first recognize the symptoms. 

However, if you are feeling any of the earlier noted signs of PPD, talk to your doctor right away. There is no need to suffer in silence. PPD is treatable!

Fighting the stigma of postpartum depression

Despite the mountains of research surrounding postpartum depression and dialogue that is opening up, many women still feel a stigma when it comes to PPD. There are a number of myths that keep many people in the dark about the realities surrounding postpartum depression. 

Debunking the myths

Myth #1: Moms who have PPD don’t bond with their babies

Truth: Moms with PPD love their babies just as much as moms who do not have PPD. Depression is in no way a sign that a mom will not bond with her baby and love her twins the same as any other mother.  

Myth #2: You can only get PPD if you had a previous mental illness

Truth: While women with a history of mental illness (specifically a mood disorder) are slightly more likely to develop postpartum depression, any new mom can experience it regardless of health history. What’s more is that MoM’s who have experienced a mental illness in the past, are not necessarily going to develop PPD.  

Myth #3: Symptoms show up right after birth

Truth: In many cases, moms will not experience the symptoms of PPD for weeks (or even months) after giving birth. In some cases, women can display signs during the last stage of pregnancy and some won’t develop until as much as a year after delivery. Typically, the condition develops within 4 to 6 weeks after giving birth, but it can sometimes take several months to appear.

Myth #4: PPD will go away on its own

Truth: PPD is a serious condition that requires treatment. It often will not subside on its own and may require a combination of therapy and medication to alleviate the symptoms. Many new moms wait in hopes that the symptoms will retreat on their own, but inevitably prolong their negative feelings. 

Myth #5: Moms with PPD cry nonstop

Truth: Postpartum depression can take many forms. While some moms of multiples will be tearful, others will experience PPD as isolation, anxiety, or withdrawal. A woman does not have to cry around the clock to be experiencing PPD.  

Seeking help for postpartum depression

If you experience these symptoms during pregnancy or after delivering your babies you should talk to your doctor. Also, if you recognize any of these signs in someone you love, encourage them to talk to a medical professional. Many women delay seeking treatment for PPD and suffer in silence for much longer than is necessary. 

Too few women seek help for postpartum depression

In a survey published in the Journal of Psychiatric Practice, parents of twins or other multiples reported experiencing the most difficulty during the first three months of their babies’ lives. The study included 244 parents of twins and other multiples (including 197 mothers and 44 spouses or partners), asking about parents’ mental health during the postpartum period. 

They found that, although 48 percent of the study participants had struggled emotionally after their babies were born, very few got help. Many parents reported that with caring for multiple babies at once, finding childcare, and the financial stress of finding a therapist, often felt like another burden.

Coping strategies

In addition to psychological interventions and medication, there are a number of things new moms can do to help cope with the stress of parenting two babies. Using some or all of these coping skills in the face of PPD can help improve outcomes and manage symptoms. 

1. Get some exercise. Okay, maybe you aren’t ready to hit the gym but simply taking a walk, going for a bike ride, or even a few minutes of dancing with cranky babies can go a long way. 
2. Make time for yourself. While finding a few quiet moments for yourself may seem impossible, they are so important. Make sure to take a break and focus on yourself. Take a shower, talk to a friend on the phone, meditate, or do anything that makes you feel like yourself again. 
3. Stay on top of your diet. This point covers two important aspects. First, if you are breastfeeding make sure you are getting enough calories. Second, be sure you are making good food choices that will fuel your tired mind and body. 
4. Get your rest. This is probably the most laughable on our list. Once you are done chuckling at our suggestion, read on. We realize that adding an extra hour of sleep to your day is highly unlikely, remember that rest is more than sleep. A 20-minute power nap, meditation, or mindfulness and just a micro-break a few times each day can help keep you going. 
5. Connect with people. One of the biggest sources of melancholy new moms report is feeling isolated. Long hours spent just you and your babies can be an isolating experience. Connect with friends or family or join a Moms of Multiples group near you. 

Despite the growing body of information about postpartum depression and its impact on moms of multiples, there is still a gap that needs to be bridged. Too many women are left untreated and suffering in silence. The more information moms-to-be and new moms have, the more they can understand what is going on. 

Postpartum depression is a real diagnosis and is very treatable. Be on the lookout for the signs and symptoms. If you or someone you love are experiencing any, be sure to talk to a medical professional right away. There is no need to suffer in silence.  

Resources:

American Psychological Association – What is postpartum depression & anxiety?

Journal of Psychiatric Practice – Perinatal Mental Health Treatment Needs, Preferences, and Barriers in Parents of Multiples

Journal of the American Medical Association – Prenatal and Postpartum Depression in Fathers and Its Association With Maternal Depression

Medical News Today – What to know about postpartum depression

National Public Radio – Mommy Mentors Help Fight The Stigma Of Postpartum Mood Disorder

National Public Radio – Pssst: Parenting Twins Can Be Depressing

Obstetrics and Gynecology – Early breastfeeding experiences and postpartum depression

Pediatrics – Multiple Births Are a Risk Factor for Postpartum Maternal Depressive Symptoms

Postpartum Support International – Depression During Pregnancy & Postpartum

US Preventative Services Task Force – Perinatal Depression: Preventive Interventions

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