Any mama who’s expecting twins probably has the same fear. Will my twins end up in the NICU?
Not all twins end up in the NICU, but it’s more common for multiple birth pregnancies to be premature and require extra medical attention.
Here’s what you can expect with NICU twins.
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My NICU Twins
31 weeks and 6 days.
That’s how many weeks pregnant I was when my identical twin girls were born.
Just over 8-weeks before my due date.
It was so early, and yet, in the neonatal intensive care unit, it wasn’t.
They were just over 3 and 4 pounds, and when I remarked how tiny they were to a nurse, she told me that compared to a lot of other babies, they weren’t that small.
Their combined weight was over a full pound LESS than my singleton, but compared to micro preemies, they were huge.
Their time spent in the NICU was entirely uneventful.
They were breathing on their own when they were born (most likely because I had a steroid shot to help with lung development).
They had no episodes or health scares.
They just needed to learn to drink milk on their own and regulate their body temperatures.
So, while there was nothing traumatizing that happened during their NICU stay, the experience was far from being
It’s a time that I think back on and all I remember is guilt, stress, anxiety, worry, and fear. Once it became time for them to come home, all of these feelings escalated.
How was I going to take care of them without a team of medical experts by my side?
How would I know that they were safe?
How on earth would I be able to take care of both of them, and my two-year-old… all by myself?
Bringing not one, but two, premature babies home was a lot of work. I think it’s something that all twin parents would be really nervous about.
Despite my nerves and fears, it was overall a relatively smooth experience.
Note About NICU Twins: You Might Not Take Your Twins Home on the Same Day
Before we get started on the actual coming home part, it’s important to note that NICU twins don’t always get dismissed on the same day.
It is actually more common to bring one baby home before the other.
One of our twins was ready to come home a day before her sister, and I asked the nurse what the possibility was that we could delay her homecoming a day so that she could come home with her sister.
I was told that once the babies were cleared to go home, that there was no way the insurance company would continue to pay for their stay.
We were lucky that it was only a difference in one day.
Bringing Home Preemie Twins: Driving
Home from the NICU
I was really nervous that my girls would be too small for their car seats. When you are shopping for your car seats, make sure that the ones you purchase has a low weight limit.
Twins have a higher chance of being born prematurely, and you want to make sure you’re prepared!
Rest assured: they will not let you take them home until they pass the car seat test.
They looked so tiny in their car seats, but I was confident and tried not to be too nervous because we had approval from the NICU staff that they were secured in their car seats.
Bringing Home Preemie Twins: Visitors
I know everyone will want to see your babies.
It is OK to tell them they have to wait.
I repeat: it is OK to tell people they have to wait!
If it is cold and flu season and you aren’t comfortable having people in your home immediately, that is your right.
When you are comfortable having visitors, there are things you can do to minimize the spreading of germs.
How We Handled Visitors
- Shoes: I asked that guests remove their shoes and leave them by the door.
- Coats: We kept our coats in the garage, and had an empty coat rack by our front door. When guests arrived, we made sure that they hung their coats on the coat rack instead of on the back of a couch where a pesky germ could jump off.
- Cellphones: Phones are huge germ transmitters. I asked that visitors leave their phones put away. If they wanted to use their phones to take pictures, I had them first thoroughly wipe the phone down with an antibacterial wipe, and then wash their hands when they were done.
- Sickness: It’s common sense, but I still reminded everyone who visited that if they had recently been sick or around someone who was sick that they needed to reschedule.
I probably seemed extreme and overboard to some people, but I followed the directions we were given from the NICU.
Premature babies don’t have fully developed immune systems for quite some time and a simple cold could put them right back in the hospital.
Bringing Home Preemie Twins: Sanitizing and Germs
You don’t have to be overly crazy with sanitizing and cleaning if you are staying home most of the time and not having too many visitors.
Shoes and Coats
When we came home from something, we left our shoes and coats in the garage. This included when my husband came home from work every day.
He would then go upstairs and change his clothes and wash his face and hands.
Theo wasn’t in school at the time, but if you have school-aged children, I highly recommend that you have them change their clothes as well as wash-up when they get home from school.
I don’t typically clean with chemicals, but you better believe that I busted them out during this time in our life.
I didn’t do it daily (hello, newborn twins, no time for that!), but I definitely hardcore cleaned after we had visitors.
I diffused OnGuard, an essential oil that helps to purify the air and boost immune support diffusing through our house daily.
I used antibacterial wipes at the end of each day (or at least most days!) on things that were most frequently touched such as door knobs and light switches.
I’d make sure to completely wash my hands after touching the harsh chemicals because so there was no risk of them getting on my babies.
Bringing Home Preemie Twins: Feeding
Feeding premature babies is a LOT of work. Since they are so small and don’t have much strength, it can take them a long time to eat.
Breastfeeding Versus Bottle Feeding Premature Twins
When I was pregnant with my twins, my plan was to breastfeed them, as I had a successful journey breastfeeding my singleton.
Sure, breastfeeding twins would be a bigger challenge, but it was something I wanted to do.
Unfortunately, that wasn’t in the cards for us. Breastfeeding is much more work than taking a bottle for premature babies.
They didn’t have the strength to exclusively nurse, and I was already pumping, bottle feeding, and taking care of a
After a few tries, I gave up on the dream of breastfeeding.
At this point, I had been through so much that breastfeeding wasn’t as important to me anymore.
All I cared about was that they were healthy and thriving.
If breastfeeding is incredibly important to you, I believe you can do it.
I know many, many preemie moms who have had successful breastfeeding journeys.
Just know that it will take time, and a lot of work. Your best bet is to have a lactation consultant come out once you are home.
You Will Need a Bottle Warmer
Haha, I know it’s kind of funny that this gets a heading.
I like to be very minimalist. I don’t like buying the latest and greatest fancy gadgets that aren’t truly necessary.
My singleton had about one bottle of breastmilk per day while I was at work.
We didn’t have a bottle warmer and gave it to him straight from the fridge.
He didn’t care at all.
Well, they warm their bottles in the NICU, and giving premature babies a cold bottle can be a shock to their system.
I had this lightbulb moment one day during the girls feeding at the NICU when I realized on snap, I definitely need to get a bottle warmer! My preemie babies can’t have cold bottles!
This bottle warmer can fit two bottles and doubles as a bottle sterilizer. It’s a great price and has fantastic reviews!
As I mentioned above, I was exclusively pumping and feeding my girls bottles of pumped breast milk.
To help them gain weight, our pediatrician had us fortify their bottles by adding a small amount of high-calorie formula into their bottles of breastmilk.
To fortify a formula bottle, simple use a higher ratio of formula to water.
We had strict guidelines from our pediatrician as to how to do this and I don’t recommend doing it without consulting with your pediatrician!
These are the preemie nipples that we used for bottles. They don’t fit on regular bottles, but that’s OK because you won’t use them forever.
We used them with bottles that we brought home from the NICU.
Washing and Sanitizing Bottles and Pump Parts
Since your premature babies don’t have fully developed immune systems, they are at a higher risk for infections.
It is so so so important that their bottles are properly washed and sanitized!
The easiest way is to put them in the dishwasher at the end of every day on the sanitizing cycle.
You can also use micro-steam bags to sanitize them in the microwave. I would usually do this at least once a week just to ensure everything was really
A final option is to use an electric steam sterilizer. I have no experience with these, but the one I linked has great reviews and is affordable.
Invest in a Hands Free Pumping Bra
If you’re exclusively pumping, or doing a combination of breastfeeding and pumping, a hands-free pumping bra is a MUST.
Related Posts on Feeding Premature Twins:
Bringing Home Preemie Twins: Medical Care
My twins didn’t need an extra medical care once they were dismissed from the NICU, but they were monitored pretty closely.
Expect Extra Appointments
We had an appointment with their pediatrician two days after Margo came home, and one day after Josie came home.
After that appointment, if I remember correctly (and let me be very clear, it’s all kind of a huge blur!) we went at least once a week for a month to monitor their growth.
Social Worker/Nurse Visit
We had a visit from a nurse shortly after we were dismissed to make sure we were handling everything well at home.
This might be dependent on the state you live in, but it’s pretty awesome.
I probably could have used that as
We also had a social worker come out to visit a few times to check in on things.
To be honest, our transition was pretty smooth, and even though I had twins, I had that second-time mom confidence.
I didn’t feel as if I needed someone checking in on me, but I’m glad the service is there because I’d rather have too many people checking on me than not enough.
Bringing Home Preemie Twins: Sleep
Safe Sleep for Premature Babies
Night time was the only time that I ever felt slightly panicked or “Omg I can’t believe they let me take these teeny tiny babies home!”
Every time I had those panicked feelings, I reminded myself that the NICU staff was overcautious and would not send the babies home if they weren’t ready.
So, if you’re feeling these panicked feelings, remind yourself of the same thing.
Be alert and aware and cautious; follow the advice from your pediatrician and the NICU doctors, but rest assured that your babies are ready to be home.
You will need a safe place for your babies to sleep.
The AAP recommends keeping babies in your room for the first six months, but we always put our babies in their rooms right away.
Our bedroom shares a wall with the nursery, and I can basically hear them breathing through the wall. I do not do well… at all… with babies sleeping in my room.
The only time I struggle with anxiety is when I have a baby in my room.
I asked a nurse in the NICU if it was OK to put them in their rooms despite it being against the recommendation, and she assured me that it was fine.
She pointed out that they had been in the NICU for 3 weeks with 0 episodes and that if we all got better sleep with the babies in their own room, that was what mattered.
Do what feels right for you. I’m definitely not implying that putting babies in their room immediately is the right way or the only way.
It’s the way that worked for us.
Wherever they are sleeping, make sure that it follows safe sleep recommendations. Don’t use a docatot, rock n play, or put your babies in the same sleeping device.
Swaddles will be your best friend. They will keep your preemies nice and cozy, and prevent the startle reflex that can wake them up.
It’s the perfect stretchy material, and allows babies to stretch and have some movement, without startling awake.
The HALO Sleepsack is what we used for the first month or so. It technically says that it’s for babies 6 pounds and up, but it adjusts by velcro and worked for our twins.
Related Posts on Twin Sleep
Bringing Home Preemie Twins: Schedule
Keep Them On the Same Schedule as the NICU
My twins were on a 3-hour schedule in the NICU.
Every three-hours they would get their feeding. Their first feedings were from a feeding tube, and then they graduated to bottles.
It’s important for them to eat every 3-hours to maintain their blood sugar.
However, eating is exhausting for them, especially when they’re learning how to take a bottle or breastfeed.
I was told by the NICU staff that feeding them too close together would actually burn more calories than they were taking in because of how hard they have to work at eating.
When we took our twins home from the NICU, we kept them on the exact same schedule. They were used to it and happy on it, so there was no point in switching it up.
Ask the Nurses to Transition Your Twins to a Schedule That Works at Home
Actually, about a week before the girls came home, they were on different schedules by half an hour.
The NICU nurses asked me if I wanted them to transition them to eating at the same
My husband and I both agreed that feeding them at the same time would be best for our family.
We never regretted that decision!
If your babies are on a schedule that doesn’t work for your home life, talk to the NICU staff to see if they can help ease the transition before the babies come home.
For example, let’s say that the NICU has your twins eating at 8:00, but you know you need to leave at 8:00 to bring your older children to school.
I mean, first of all, please, for the love ask for help with that!
But, second of all, your babies will most likely be on a 3-hour schedule for many, many months.
You will eventually probably need to take your older kids to school, so why not ask the NICU staff if they can make their first feeding at 7:00 AM.
This way, there is no need to struggle through a transition at home.
Related Posts on Twin Schedules and Preemies
Don’t Compare NICU Twins to Full Term Babies
Having had both a full-term singleton and premature twins, I can tell you that it is completely different.
You can’t compare the two experiences.
You will feel like you have a newborn forever. Your preemie won’t start smiling, waving, or cooing on the timetable of a
Rest assured, sweet mama friends. By the age of 2, your preemie will be mostly caught up developmentally.
Josie and Margo are now 3.5 They are HEALTHY and THRIVING and HAPPY.
Their time in the NICU and transitioning home is all but a blur now that I look back on and think holy moly, that was hard, but we made it through!
Look at these happy girls with their big brother! NICU graduates!