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Preparing for Twins or Multiples Before Birth

Key takeaways: About 60% of twins are born preterm, according to ACOG. Recommended timing of birth depends on whether twins share a placenta. Plan for possible NICU care, early pumping if needed, two safe sleep spaces, two car seats, and plenty of help at home.

Expecting twins or more means extra planning. Here’s how to prepare for their arrival.

Types of Twins

  • Dichorionic: each baby has its own placenta.
  • Monochorionic: twins share a placenta. These pregnancies need closer monitoring because of complications like twin-twin transfusion syndrome.
  • Monoamniotic: twins share a placenta and amniotic sac (rare, highest risk).

When Twins Are Usually Born

ACOG recommends delivery timing for uncomplicated twin pregnancies:

  • Dichorionic-diamniotic twins: 38 weeks 0 days to 38 weeks 6 days.
  • Monochorionic-diamniotic twins: 34 weeks 0 days to 37 weeks 6 days.
  • Monoamniotic twins: 32 weeks 0 days to 34 weeks 0 days.

Many twins are born earlier than planned.

Preparing for NICU Care

  • Tour the NICU.
  • Ask about steroids if early birth is likely.
  • Plan for pumping if babies can’t breastfeed right away.

Feeding Plans

  • Breastfeeding twins is possible; many parents also combine breast milk and formula.
  • Consider meeting an IBCLC before birth.
  • A twin nursing pillow can help with tandem feeds.

Gear

  • Two safe sleep spaces. Co-bedding twins in the same crib isn’t recommended by the AAP.
  • Two rear-facing car seats.
  • A double stroller.
  • Feeding and diaper logs to track each baby.

Support at Home

  • Line up help for the first weeks.
  • Plan meals.
  • Look for local or online multiples groups.

The Bottom Line

Twins often arrive early. Plan for NICU care, feeding support, two of each safety item, and lots of help.

Want more support for your baby’s first year? My book, From First Breath to First Birthday, is available on Amazon.

Sources

  1. American College of Obstetricians and Gynecologists. Practice Bulletin No. 231: Multifetal gestations: twin, triplet, and higher-order multifetal pregnancies. Obstet Gynecol. 2021;137(6):e145-e162.
  2. American College of Obstetricians and Gynecologists. Committee Opinion No. 831: Medically indicated late-preterm and early-term deliveries. Obstet Gynecol. 2021;138(1):e35-e39.
  3. Moon RY, Carlin RF, Hand I; Task Force on Sudden Infant Death Syndrome; Committee on Fetus and Newborn. Sleep-related infant deaths: updated 2022 recommendations for reducing infant deaths in the sleep environment. Pediatrics. 2022;150(1):e2022057990.

This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.

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