Multiple Births - The Endless Party
BWS - 13
Contributed by Dr. Eleanor Womack
A baby is a precious blessing, a tender gift wrapped in joy and wonder. And when that blessing comes in the form of twins, triplets, or more, your heart overflows with multiplied love. Yet, alongside that overflowing joy comes an added measure of care and effort. It’s simple math—no, perhaps it’s more like the magic of multiplication!
Parenting always calls for thoughtful planning and gentle organization, but this becomes all the more true with multiples. It tends to do so when the unexpected arises in pairs or even trios. Where parents of a single baby might learn from one mistake, parents of multiples often face their challenges in multiples, too. But take heart because the same holds true for your triumphs—each success is magnified, each joyful moment multiplied.
In our home, we’ve always seen parenting our triplets as a celebration of life that never quite stops. When our three boys were tiny preemies, needing to be fed every three hours, we turned those midnight feedings into cherished moments of togetherness. The "feeders" would gather in the same room, sharing stories, jokes, or simply the warmth of each other’s presence. Even at 3:00 a.m., we were buoyed by our shared commitment, knowing that each feeding was more than a task—it was a time to bond, to laugh, to make memories in the most unexpected of moments.
From the earliest days, children are deeply attuned to your spirit. If you see their care as a heavy burden, they will feel that weight, too, and the days will seem long and weary. But if you approach each moment as an adventure with wonder and patience, your children will meet you there, filling your life with the sweetness of each stage. Every day, every smile, every small triumph is precious beyond measure.
Bringing Them Home
Pregnancies with multiples often come with the tender challenge of prematurity. In the early days, you may find yourself caring for tiny babies who need extra medical attention. It’s possible your little ones may spend time in the Neonatal Intensive Care Unit (NICU), where they receive the nurturing care they need to grow stronger. Some of your babies may come home one at a time as they reach safe milestones, such as gaining enough weight or developing the ability to feed on their own. There may even be monitors that come home with them, like apnea or heart monitors, offering you the reassurance that your child is breathing steadily.
Cribs: In the beginning, your babies will be small and won’t be moving around much. It’s perfectly fine to let two or even three babies share a crib, snuggled close to each other. It’s a sweet and safe arrangement while they’re tiny, but as they grow and wiggle, giving them their own space is important. This ensures that they don’t unintentionally become a risk to one another as they start to move more freely.
Diapers: With triplets, you’ll find yourself changing between 24 and 30 diapers a day, making diapers a notable part of your budget. You have options, of course, and it’s a good idea to weigh them carefully. Cloth diapers may seem like the more affordable choice upfront, especially if you’re washing them yourself. However, the time and effort required for constant laundry can be significant, and cloth diapers tend to increase the chances of diaper rash because babies can’t go as long between changes. With their lower absorbency, cloth diapers often lead to more frequent changes, which can be tricky when you’re already trying to keep track of who’s been changed and when.
Disposable diapers, while more costly, offer a level of convenience that can bring peace of mind. Babies are less likely to feel uncomfortable if a wet diaper goes unnoticed for a short time, and it’s easier to keep up with their needs when you have so much else to manage. Some families find that using a commercial diaper service provides a middle ground—offering savings over disposable diapers while also sparing you the time and effort of washing cloth ones. While you will have soiled diapers waiting for pickup, a diaper service might be a helpful option for some. I personally lean toward disposable diapers, but every family’s situation is unique. If a diaper service works for you and helps keep your little ones comfortable and dry, it could be a wonderful solution and save you some costs along the way.
Finding Help
As I gently guide expectant mothers of multiples, I often see one common misstep: trying to take on this beautiful yet demanding journey all on their own. Families often find themselves on a tight budget, and hiring help seems out of reach, so Mom and Dad set out with the noble intention of managing everything themselves. But, my dear friend, please don't make this mistake. You cannot, and should not, try to do it alone.
The good news is you don’t need to spend money to receive the help you need. There are many heartfelt alternatives. Extended family members are often more than willing to step in, mainly when your babies are settled into a routine of eating and sleeping. Schools in your area—high schools, colleges, seminaries, or yeshivas—often offer classes in child development, and your home could become an excellent, hands-on learning environment for kindhearted students and their teachers. Places of worship, like churches and synagogues, are filled with caring people who would love to lend a helping hand—you need only ask.
If one or more of your little ones come home with medical monitors, you might even qualify for in-home nursing care, potentially provided through state assistance. To explore this, contact the social worker in your hospital's neonatal intensive care unit or speak with your pediatrician. They can guide you toward helpful resources.
When someone offers to help, always say, “Yes, please!” Keep a daily planner handy to assign a specific time and task to those kind souls who offer assistance. Whether it's caring for your babies or tackling household chores, such as laundry or picking up groceries and prescriptions, every little bit helps. Don’t hesitate to delegate. Asking for and accepting help is one of the best ways to preserve your peace of mind and savor the joy of raising multiples.
Feeding Multiples
Are you thinking about breastfeeding? Many mothers of multiples can breastfeed, but ultimately, the right decision is one that you and your babies will make together. Your ability to breastfeed may depend on a variety of factors, including your babies' maturity at birth, whether they require care in the NICU, whether you had a Cesarean section and the number of babies you’ve had. While mothers of twins often find more success in breastfeeding, mothers of triplets may face additional challenges. If your babies come home with you immediately, establishing a breastfeeding routine will be easier.
As mentioned in Chapter Four, mother’s milk is a remarkable gift. It is a complete and perfect source of nourishment, easily digested and packed with the ideal balance of proteins, fats, and essential antibodies that help to build your baby's immune system. Even if your babies are in the NICU and you don’t plan to breastfeed directly, you might consider providing them with milk using an electric breast pump. Many pediatricians recommend this, and insurance companies often cover the cost of pump rentals while your baby is in the NICU. Premature babies, in particular, benefit greatly from the antibodies in breastmilk. But please, never feel guilty if breastfeeding isn’t possible for you. Formula-fed babies can grow up strong and healthy too.
Each of your babies will have their own unique preferences. While you may plan to breastfeed all of them, one or more might prefer the bottle over the breast. Some mothers successfully breastfeed their multiples on a rotating schedule—one baby may have a bottle while the others nurse. Other moms can produce enough milk for their babies, even triplets. An excellent electric pump can be incredibly helpful in maintaining your milk supply for multiples. You may find that after feeding one or two babies, you can pump enough to feed the others by bottle. Once breastfeeding is established, it can become a wonderfully smooth process, but it may not start out that way—especially after the stresses of a high-risk pregnancy. Be gentle with yourself, and seek guidance from a professional lactation consultant. Breastfeeding multiples may not come naturally, and asking for help is okay.
If your babies are born premature and have low birth weights, they may sleep almost constantly. They might even sleep through diaper changes, baths, and feedings. Premature babies often respond to stimulation by retreating into sleep, and it's important not to fight this natural response. Focus on feeding them the best you can, but don’t try for more than 30 minutes every 2½ to 3 hours. From the start of one feeding to the beginning of the next, no more than 3 hours should pass. Try to feed and burp each baby for about 30 minutes, then let them rest for the remaining 2 to 2½ hours of the cycle. Even if a baby only takes in a small amount of milk or spits up, stick to this schedule. If your baby spits up 10 minutes into a feeding, gently try again until the 30 minutes is up.
Monitoring your babies' hydration is important in caring for newborns and premature infants. Each baby should have 6-8 wet diapers per day. If you are breastfeeding, this is a helpful sign that they are correctly latched and receiving enough milk. However, keeping track of wet diapers can be tricky with multiples. Even simple details can slip through the cracks in those early, sleep-deprived postpartum weeks. To make things easier, write everything down. Keep your Healthy Baby Growth charts near the changing table and update them regularly. You might even color-code them, assigning each baby a different color, making tracking their progress easier.
As your babies grow and mature, feedings will become smoother and quicker—you may even finish feeding each baby in under 30 minutes. Sticking to a feeding, wake-time, and nap-time routine for each baby is important. When one baby wakes at night to feed, gently wake the others and feed them all together. However, if one baby wakes early from a nap, resist the urge to feed them right away. Instead, check their diaper, soothe them, and help them learn to self-soothe and fall back asleep.
Sleep For Multiples
Sleep is essential not only for your little ones' happiness but also for your peace of mind, especially when caring for multiple. With newborns—particularly small or premature babies—it’s easy to become focused on how much they’re eating, how often, and whether they’re gaining weight consistently. My husband and I applied the PDF (Parent-Directed Feeding) principles from the very beginning with our triplets, and we’ve encouraged many parents of multiples to do the same. The real key to growth and healthy weight gain is sleep. A well-rested baby will eat well, but a tired, overstimulated, and sleep-deprived baby will cry, fuss, nurse poorly, and often spit up.
You might worry that if your babies don’t take a full feeding, they’ll wake up hungry before their next scheduled feeding. I certainly had that fear! But, more often than not, they wake up rested and ready for their next meal. The surprise is that well-rested babies tend to eat more effectively. By focusing on sleep, you’re setting them up for better digestion and stronger, more successful feedings.
As your multiples grow, they will settle into their own wakefulness and sleep patterns. In the early days, they may fall asleep during feedings, or they might even stay asleep throughout. As they get older, they’ll still get drowsy after eating, but with a bit of gentle stimulation, you can keep them awake for playtime before their next nap. It’s essential to incorporate some independent playtime during their wakeful moments. When naptime arrives, your babies might show signs of sleepiness by becoming fussy or complicated to soothe or seem cheerful and wide awake. Either way, put them down awake. With multiples, it’s not practical to rock each baby to sleep every time. Instead, your little ones need to learn the valuable skill of self-soothing. This is a crucial part of their development and will help them navigate stress and sickness as they grow. If they learn to sleep on their own early in life, they’ll turn to sleep as a source of comfort when they’re tired, rather than becoming more stressed by crying.
If your babies have been sharing a room since birth, they will likely learn to sleep through each other’s cries. There’s no need to separate them when one is fussing. If one baby has a particularly hard time settling down, you can go in every 10 minutes to offer gentle reassurance—a pat, a quiet word, or a quick diaper check. Your role is to guide them toward self-comfort but not to stay long enough for them to fall asleep in your arms. The goal is to lay them down awake so they can learn to fall asleep independently without rocking or patting. It can be challenging, especially with multiples, but it’s a skill worth cultivating for both you and your babies.
Establishing a consistent feed-wake-sleep routine is key. Changing diapers and putting three babies down for a nap can take 15-20 minutes. One common pitfall is allowing your babies to fall asleep in activity chairs or swings during wake time. It’s understandable—you may be trying to juggle household tasks, answer a phone call, or tend to another baby’s needs, only to find that the others have dozed off sitting up. While it’s great that they can fall asleep on their own, they must do so in the right place—their cribs. If this happens frequently, they may struggle to learn how to self-soothe in their cribs. Plan ahead when you can, and put your babies awake in their cribs whenever possible. That way, when they do fall asleep sitting up, it will be a rare exception, not a habit.
One of the most frequent questions I hear from parents of multiples is, “Our babies are about four months old and feeding every four hours, but they’re not sleeping through the night. Why?” My advice is to stick to a strict 3-hour feeding schedule during the day while encouraging sleep at night. Often, I get a call just a few days later with reports of a “miracle”—one or all of the babies are now sleeping 8 hours at night!
The first rule of nighttime sleep is this: Don’t be tempted to stretch out the time between daytime feedings until your babies are sleeping at least 9-10 hours at night. They need those regular, 3-hour feedings during the day not only to meet their nutritional needs but also to help them distinguish between night and day. A consistent 3-hour daytime routine will achieve both.
As your babies continue to grow, another delightful challenge will arise. Between six and nine months, your little ones will begin to discover each other. That’s when the fun really begins! While they won’t wake each other up by crying, they may wake each other up with giggles and playful antics. They’ve found built-in playmates! To help manage this, you can place quiet toys in their cribs after they’ve fallen asleep so the early risers can play without disturbing their siblings.
It’s also important to teach your multiples to stay in their cribs until you give them permission to get out. This is a valuable skill for all babies, but with multiples, there’s an added safety concern. An unsupervised toddler can be a potential danger to their sibling. We taught our triplets that they couldn’t get in or out of their cribs without help, and by using a small stepladder when needed, we reinforced the idea that climbing in and out was impossible without assistance. They stayed safely in their cribs until after their third birthday, with no unauthorized climbing adventures.
Routine For Multiples
The routine for each baby should remain consistent, but with multiples, their feeding and sleep schedules may vary depending on several factors. How many babies are there? How many caregivers? Are you breastfeeding? Each baby should have a pattern of feeding time, waketime, and naptime, and it’s important not to change that order. The only exceptions are late-night feedings, which skip waketime, and premature babies who may not yet be ready for waketime due to neurological immaturity.
If you have triplets and are often the only caregiver, you may choose to stagger their schedules to make things more manageable. For example, you might begin with Baby A at the top of the hour, finish feeding after 30 minutes, and then move on to Baby B, while Baby A enjoys some waketime nearby in a bouncy seat. In the next hour, Baby C wakes up to feed, and Baby A is ready for their nap. Once all three babies are fed, you'll have about 1½ hours before the cycle starts again. With two caregivers, two babies can be fed at the same time, making things a little smoother.
When you have additional help, keeping all the babies on a similar schedule becomes easier. With two helpers, all three babies can be fed simultaneously. Since babies eat at different paces, you may notice a fast eater and a slower one. Once you figure out who eats the quickest and who takes a bit longer, you can set up a system where one helper feeds the slow eater while another feeds the fast one and the baby in-between. For breastfeeding moms, you can nurse two babies at once while a helper bottle-feeds the third.
Waketime for Multiples
In the early weeks, you won’t need to worry too much about waketime, as your babies will mostly be sleepy, but soon enough, they’ll begin to stay awake after feedings and show curiosity about the world around them. A reclining upright seat is a wonderful place for these early waketime moments, allowing your baby to observe and move their arms and legs while also staying upright to help reduce spit-ups. These seats are also useful for later stages, such as bottle-feeding or introducing solids, but always remember to supervise your baby when seated.
You don’t need three of everything for waketime activities. Babies typically lose interest in an activity after 10-20 minutes, so rotating playstations works well. You might have one baby in a wind-up swing, another in a playpen with a rattle, and the third in a bouncy seat playing or spending time with you. Every 15 minutes, rotate the babies to the next activity, offering them new experiences and keeping things engaging.
Individual time is key to keeping multiples happy. They need moments of independent play each day, and just as important, they need one-on-one time with Mom and Dad. It’s natural to think of multiples as a unit, feeding, changing, dressing, and bathing them together to maintain a sense of order. While this ensures everyone’s needs are met, structuring their waketime to include individual play can break the routine and make each child feel special. For instance, leave two of the babies with a helper or spouse and take one for a stroll or read a book to just one while the others enjoy independent play.
As your little ones grow into toddlers, they’ll face the challenge of always having a sibling nearby, sometimes grabbing at toys or competing for attention. A playpen can be a special refuge for them, offering a space where they can explore and play without interruptions. It’s one piece of baby gear you may want multiples of! Having their own playpen gives each baby some personal space, and it also provides a much-needed break for you—whether to answer the phone or prepare a meal, knowing they are safely occupied. Start introducing playpen time around three to four months, beginning with just 10 minutes a day and gradually increasing the time. By the time they’re one year old, they should be able to enjoy independent play in the playpen for at least 40 minutes.
A Word To Husbands
The heart of a harmonious family life lies in a strong, loving relationship between husband and wife. This central bond shapes every other relationship in the home, either positively or negatively. Nurture it, protect it, and make it a priority! Your strength as a parent is deeply connected to the strength of your partnership as a couple. This is especially true when raising multiples, which is why it is so vital for Dad to be an active presence at home. Your wife can only truly listen, share, and enjoy time with you if she feels your support and encouragement.
In many ways, your wife takes on the role of primary caregiver—she is the chief feeder, diaper-changer, bather, and teacher to the little ones entrusted to both of you. She carries the weight of these responsibilities without pause, often with little or no downtime, needing to remain calm and steady 24 hours a day. This constant demand for her energy is essential because she makes critical daily decisions for your babies. The more you cherish, serve, and support her, the more you’ll see the rewards of a calm, composed mother and peaceful, secure children. A little bit of your love and help will go a long way toward building a joyful, loving family.