After the shock of learning you’re expecting multiples starts to fade, it’s likely your mind will start to process the unknowns. “How will the car seats fit in my car?”, “Do I really need double of everything?”, and then nervously, “What if they come early and need NICU/SCU care?” I remember clearly having these concerns with both of my sets of twins!

In an ideal world, all twin pregnancies would reach that magic 36-38 weeks, and the likelihood of NICU (Neonatal Intensive Care Unit) time at this gestational point is very low. According to the March of Dimes, however, the average gestation for twins is 35 weeks and for triplets it’s 33 weeks. This means that even though it’s not fun to think about, preparing for the possibility of some involvement with the NICU is a good idea. If you’ve had complications arise, addressing some of the following areas will be even more important.


There are a few things you can do to prepare your home for the possibility of spending time away from your babies while they receive care. Many of these things aren’t a bad idea to tackle even if your babies are full-term!

Fine-tuning your budget, and setting things up to run themselves as much as possible is very helpful. If your monthly bills are automatically drafted out of your bank account, take a look at the next few months and make sure all of the withdrawal dates work well with your incoming funds. Or perhaps now is a good time to get set up on an automatic payment service! If you prefer to pay bills manually, pre-writing checks and placing in addressed, stamped envelopes will save you time and energy later on. Even if it’s a bill that you need the specific amount written on the check, you can fill everything else out and leave that part for later.

There is also a lot you can do in the kitchen to save time with cooking and meal preparation later on. As you approach your second trimester, consider making double portions of meals you are making anyway, and stash them in a freezer for later. Preparing a few large batches of cooked proteins can make for easy meals later; shredded chicken, grilled chicken, browned ground beef or turkey, etc., can all be defrosted and added to veggies and a starch (think stir-fry, pasta dishes, enchiladas, etc) for almost instant meals.

Are you a new or expecting parent of Twins? Join our renowned Expecting Twins class or Breastfeeding Twins and Newborn Care with Twins class local to you or webinar online!


If you want to breastfeed, it can be daunting to think about how it can be done with two premature babies. I assure you, it can be done! The road may be trickier, but you will reap the rewards once you and the babies get the hang of it. And of course, the benefits of breastmilk are even more important for babies born early.

Mothering Multiples by Karen Kerkoff Gromada was a great resource for me. The author was very realistic in her conversation about the journey of breastfeeding multiples. Plan to pump every 2-3 hours around the clock until your babies are strong enough to latch on their own. Look into what your health insurance covers for lactation supplies – most cover a pump for personal use, but many also cover a hospital-grade pump (a must when pumping for preemies) for rent.

A good pumping bra will be your best friend. Having some pumping log sheets printed would also be a great idea. If you prefer, there are also apps for your phone which help track all of the details. When my babies were in the NICU, I found keeping a log very motivating with my efforts to increase supply.

And of course joining our online Breastfeeding Twins class, a live class dedicated to teaching you all you need to know with ongoing support from the IBCLC/Mother to Twins herself.

Getting to Know “Your” NICU

This area is especially important if you have had some complications arise that have increased your chances of needing the NICU. It’s a good idea to make a visit beforehand. Start with verifying where the closest hospitals which have a NICU are in relation to where you live. If you haven’t already, check with your doctor to see if he or she delivers at that hospital. When I was newly pregnant with our first set of identical twin boys, I didn’t really think about whether the OB I had chosen delivered at a hospital with a NICU. When we encountered some complications, switching to another obstetrician connected to a hospital with a NICU became necessary. It was tricky to say the least, dealing with insurance and file transfers, and then getting to know new doctors. I wished I had chosen more carefully to begin with.

Most NICU’s will let high-risk mothers come in, meet with a neonatologist, and tour the unit. This is a great time to ask questions like, “Do you have Lactation professionals on staff or available to parents?”, “What are your visitation policies?”, “Do you allow siblings into the unit?”, “Do you have any facilities where mothers can stay with their babies?”, or if not, “What kind of resources are nearby for families who live long distance?”, “What are the typical ratios of nurses to babies?” and anything else you feel is important. Knowledge is power! If you feel educated about the NICU your babies will potentially stay, it will give you an additional level of comfort!

When you Have Older Children at Home

When my first set of twins arrived at 30 weeks, I was ‘fortunate’ enough to be able to spend as much time as I wanted at the NICU by their bedside. I didn’t experience the feeling of being pulled in two directions like many of the other parents I met who had babies in the unit and children at home.

Then came my pregnancy with my second set of twins. I was terrified of what I would do if they came early as well. How would I balance myself between two children at home, and two at the hospital? To prepare for the possibility, I spoke with our part-time childcare provider at the time and made sure she was on board to pick up extra hours if need be. I made laminated “cheat sheets” for family members who would try to help out with the boys’ schedule, meal ideas for each meal of the day, details of our routines, phone numbers and names of doctors, friends, neighbors, and other important people. The idea is to set up as much outside help for your older children as possible, so you can be with your babies.

Things to Consider Buying

There are quite a few products that would be helpful to stock your home with (whether you end up needing the NICU or not!) … Paper products, cleaning supplies, pretty much anything that is not perishable. If you’re anything like I was, you’ll never wash or sanitize your hands as much as when your babies are in the NICU. Even if you have full-term babies who come home right after birth, it would be a good idea to stock up on hand sanitizers, nice hand soaps, and heavy-duty hand creams.

Healthy, on-the-go snacks are another lifesaver in the early days after the babies arrive. Trail mix, nutritional bars, individual peanut butter containers to use with crackers or apple slices. Try making these Energy Bites, which are delicious and taste just like Lara Bars and are easily prepared up to months ahead when stored in the freezer. I kept a stash of non-perishable snacks in my tote bag I brought to the NICU every day, as well as in the bag that contained my pump at home.

Another item I found invaluable at the NICU was a nursing robe such as this one from Pink Blush Maternity. Having this robe in the hospital after delivery was great if I needed to cover up whenever a doctor came in. It was also perfect to wear whenever holding the babies skin to skin. Make sure the robe very soft and stretchy – you want to be able to place both babies on your chest, and have enough room to wrap it around all three of you. Look for one that is pretty and feels luxurious, and you’ll enjoy this special time that much more!


We are all different when it comes to how we prepare for life-changing transitions. Some mothers want to consider every possibility and have plans A, B, C, and so on, while others choose winging it with positive thoughts as their preferred route. However, with 50% of twins born early, it may be helpful to look at these suggestions during your second and third trimester. Many blessings as you continue down this incredibly life-changing journey!

About the Author

Lindsay Castiglione LC, TLC’s Pre & Postpartum South Carolina Associate, is the mother of two sets of twins, an identical five year old boy set, and a three year old boy/girl set. Lindsay’s twin pregnancies were profoundly different; her older boys had complications requiring delivery at 30 weeks and a 7 week NICU stay. But her younger set had no complications and were born perfectly healthy and full term at 38 weeks. Breastfeeding was very different for each set, but equally as important, and her varied experiences motivated her to become a Certified Lactation Counselor in 2015. You can contact her at for more information on our South Carolina services.