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Raising and feeding twins

11-minute read

Key facts

  • Breast milk is the best nutrition for babies and it is particularly important for twins, who might be smaller than other babies.
  • Sometimes one or both of your babies will need to supplement their feeds with expressed breast milk or formula.
  • You might prefer to feed twins at the same time if you can, or you might choose to feed them one at a time, especially in the early days when you are first learning.
  • There are many ways to position twins while you are breastfeeding, and your preferred position is likely to change as they get bigger and older.
  • Your twins’ bond may be very strong — even before they are born, twins touch, hold and hug each other.

How do I manage a sleep routine with twins?

A good sleeping routine is important for you and your babies. If your twins are born prematurely, they might spend time in neonatal care. The noise and frequent handling that babies experience in hospital can affect their sleep routine. You can help them develop a good routine by including massage and music into their sleep routine, and setting up good sleep patterns.

In the early stages, you may want to have both twins sleep in the same cot, particularly if this was done in neonatal care. However, it’s a good idea to be flexible about it. For example, one baby might be comfortable in a cot and the other might prefer a bassinette.

Keep twins safe while they sleep in the same cot:

  • Place the babies’ head-to-head, at opposite ends of the cot. If the twins are sleeping side-by-side there is the risk of one twin accidentally covering the face of the other, interfering with their breathing.
  • Do not use bedding (sheets and blankets) — Use safe sleeping bags, or swaddle the babies separately.
  • Move babies to their own separate cots when they show signs of being able to move around.

Sometimes one twin is settled and the other is not. The settled twin usually gets used to the unsettled one and won’t wake up. If both twins are unsettled, if possible get someone to help you.

Always follow safe sleeping guidelines for both babies. The Australian Multiple Birth Association also has information on settling and routine. If you can get your babies into a good sleep routine, you can use that time to catch on sleep for yourself.

How do I feed my twins?

Breast milk is the best nutrition for babies, and it is particularly important for twins, who might be smaller than other babies. You can produce enough breast milk to feed more than one baby.

You can tell if you are producing enough breast milk by watching your babies’ behaviour. Newborns who are getting enough milk feed at least 8 times in a 24 hour day, have 4 to 6 wet nappies a day and produce soft, mustard coloured poo. They also bring themselves off the breast when they have finished their feed, generally are content and look healthy.

Starting to breastfeed twins might be a challenge if you are unwell or exhausted after birthing your twins. Newborn twins usually need small frequent feeds, because they can’t stay on the breast for a long period.

It is tempting to allocate one breast to each baby, but it's best not to. Babies will grow and develop better if they feed on both breasts. Swap your babies from one breast to the other at each feed to help you balance your milk production, especially if one baby has a much stronger suck.

If your babies are premature and/or small, they might have a weak and ineffective suck. This might cause a delay in breast milk production. Sometimes one or both of your babies will need to supplement their feeds with expressed breast milk or formula. You might be advised to do this if they are not gaining weight well, or if one baby is smaller or weaker than the other. Check that your babies are putting on the correct weight with your doctor, lactation consultant or early childhood nurse, and discuss with them if you have any concerns.

Giving your babies expressed breast milk in a bottle can be important if they need supplemental feeding. There are many different ways to express breast milk, and it’s important that you find the one that’s right for you. Speak to a lactation consultant about the different pumps that are available, how to express milk, and how often you should supplement. You can help improve your milk flow by trying to relax, using gentle massage on your breast and by thinking about your baby while you express.

Any amount of breast milk is good for your babies. If you can’t exclusively breastfeed, or don’t want to, you can use mixed feeding (breastfeeding and formula) or full formula feeding.

Time management

It’s up to you if you feed your twins together or separately. For some people, it makes sense to feed twins at the same time. You might also choose to feed babies one at a time in the early days, when you are first learning how to breastfeed.

Feeding at the same time: When one baby wakes up for a feed, wake the other baby. This will help you to have as much time as possible between feeds to rest or sleep. To do this, you might need help at feeding time to position or support your babies.

Feeding one after the other: If you don’t have support at feeding time, or if one or both babies are small, it can be hard to get both to the breast with a good attachment. In that situation, you might want to feed one baby at a time. You can decide to change to feeding your twins together later on when you are ready.

How do I hold my twins when breastfeeding?

There are many ways to position twins, depending on their age and size. There is no ‘right’ way, so you can choose whichever position works best for you and your baby. Some examples are shown below.

The twin football hold involves placing one baby under each arm.

The laid-back position is where you lie back and lie both babies on your tummy.

The parallel hold can be used as your babies get older. This is where both babies lie in the same direction across your body, meeting at a right angle.

The front ‘v’ hold is where you hold your hands in your lap, and each baby leans against one arm. Your babies’ heads will be supported in the crook of your elbow.

A useful piece of equipment is a twin feeding pillow, which was developed to help twins feed together. These firm pillows create a supportive surface and make it much easier to latch babies to the breast.

Illustration showing different positions for breastfeeding twins.
Illustration showing different positions for breastfeeding twins.

Your doctor, lactation consultant and early childhood nurse can give you advice relating to positioning, pillows and equipment to make feeding your twins easier.

What is the ‘twin bond’?

Even before they are born, twins touch, hold and hug each other. The bond can be very strong and you might even feel left out. It’s important to accept this, while knowing you will still be a significant person in their lives and you will have your own special bond with each of them.

If you have other children, you might notice that their behaviour gets worse for a while.

They might have tantrums, be aggressive towards the twins, go backwards in their development or withdraw. It is important you have one on one time with your other children, so they don’t feel left out.

Twins might also feel sibling rivalry with each other. While it was good to bond and share a womb as twins, it’s a whole different story to share a toy or a parent as a toddler.

How do I get out and about with my twins?

You may find it harder to get out and about with your twins, than other parents who have single babies. It helps to be organised by making sure the nappy bag is well stocked with nappies, wipes, formula or expressed milk and a change of clothes. You might also need plenty of help and support from friends and family to get out.

Is there anything I should do before my twins start preschool?

Some twins who were born early have problems with their hearing and eyesight. It is good to know if there are any problems like this before your twins start preschool and school.

As newborns, your twins would have probably had the newborn hearing test, which picks up any hearing problem at an early age.

Pre-schoolers should have a health check when they are turning 4. Your local GP can do this.

Some twins who were born early have problems with their language or communication. Talk to your doctor if you have any concerns.

How do I prepare my twins for school?

Before your twins start preschool it's a good idea to give them some practice playing with other children. They may be used to keeping each other company but it is very different in a classroom with other children.

Pack their lunches and have them eat outside under a tree. A story hour or a craft session at your local library or community centre teaches them to sit quietly in a group, and these activities are free. You can also join a playgroup, which can be good for babies as well as their parents or carers.

Taking your twins to the local playground lets them have fun on different play equipment and lets them meet and play with other children. This all helps them get ready for preschool.

Same or different classroom?

Many parents of twins find this a difficult decision. This is a very personal decision for you, your twins and your family. If your preschool is small, you might not have a choice as all 3-year-olds may be together in one class.

If you have a choice of separate classes, think about whether your twins depend on each other or easily make friends with other children. Are there any family issues like divorce that may affect their ability to cope separately? You can talk to the school and see what they think as well.

Resources and support

Support is important. As soon as you learn you are having twins, it's a good idea to seek support from your partner, family members and/or professional organisations. Remember that family and friends often want to help, but don’t know exactly what you need. Don’t hesitate to suggest practical ways they can help support your growing family. You can remind them that you’re getting less sleep than usual, and that you may be tired, sore, moody or emotional after birthing twins.

The Australian Multiple Birth Association provides information on feeding and sleep guidelines for multiples.

The Australian Breastfeeding Association also provides information on how to feed twins.

Read more on our Feeding multiple babies page, including how to cope with triplets and more.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

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Last reviewed: January 2023

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