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The birth is over and whatever form it took – natural or surgical, leisurely or sudden – your babies are launched in to the outside world. Well done. You will all be recovering from the experience, as well as learning a lot in a short time about what newborns need.
A lot of what happens next will depend on how straightforward the pregnancy and birth have been.
Support on the ward
If all is well then your babies will be with you beside your bed. You may need help from staff or your partner to care for them, especially when both need feeding at the same time. This can be tricky if partners and family are expected to leave after visiting hours.
Be sure to ask staff to help. Some mothers of multiples also recommend talking to the paediatrician,senior midwife or matron and getting permission for partners to stay after hours. That way, if anyone complains you can quote a higher authority.
You may be able to have a private room in which to get to know your babies. If you or they have trouble sleeping, ask if the babies can share a cot. You may also be able to get a member of staff to mind babies while you sleep.
What if my babies need neonatal care?
Around 40 percent of multiples need some extra help in hospital after the birth. This is known as ‘special’ or ‘neonatal’ care.
The Special Care Baby Unit (SCBU) is staffed by paediatricians, specially trained nurses and midwives. If babies need more intensive care, they may go to the Neonatal Intensive Care Unit (NICU). Keep in contact with your babies, visiting them as soon as possible after the birth, even if you have to do this from your bed or a wheelchair. Try to help in their care as far as you can; nurses will be able to show you what to do.
Babies often spend only a few days in special care, but this will depend on why they were admitted. Special care can help babies by:
• maintaining their body temperature inside an incubator (usually without clothes). They may have a temperature monitor fixed to their skin.
• giving help with breathing by a ventilator. Some babies need oxygen, while others may suffer from apnoea (they occasionally forget to breathe). To be on the safe side, many babies in SCBU sleep on apnoea alarm mats, which cause an alarm to beep if movement stops. They go off very easily and can cause false alarms.
• feeding by intravenous drip or through a feeding tube (which runs through the nostril and down the throat, and is taped into place on the cheek).
The nurses will understand how fearful parents may feel and how alarming some of the equipment looks. Don’t be afraid to ask what it’s all for: they will be happy to reassure you and explain what’s going on.
When you are in the unit, try to concentrate on your own babies and not what is going on around you. It is very normal to hear alarms and monitors and for there to be wires around your babies. It may all seem overwhelming, but there is still plenty you can do as parents to help your newborns.
Skin to skin contact, also known as ‘kangaroo care’, can calm babies and help develop an attachment. It also helps with breathing, heart rate and speeding up recovery. It can also stimulate babies to latch on and breastfeed when they are ready to do so. Tuck your baby or babies inside your shirt against your skin in the kangaroo position. You will need to ask for help to pass your second baby to you, or you and your partner may enjoy alternating babies.
It is possible and you are encouraged to breastfeed premature babies, although you may have to initially start by expressing breastmilk and feeding it through a small tube into the nose or mouth.
Sometimes one or more babies are transferred to a different hospital because of a lack of places. This can be very distressing. Do make sure that you know the reasons why your baby/ies have to be moved. Contact Tamba if you are concerned that hospital policy rather than a medical reason is behind the decision to split your babies between different hospitals. We may be able to help. You can also ring Tamba’s freephone helpline Twinline on 0800 138 0509. This confidential listening service is staffed by volunteers who are parents of multiples themselves and have had training in the issues that can affect a multiple birth. Twinline is open every day of the year from 10am-1pm and 7pm-10pm.
To find out more about your babies’ care in the neonatal unit, download Tamba’s Parent’s Guide to Neonatal Care.
What if only one baby needs special care?
Most hospitals try to keep multiples together until they are discharged, even if only one baby needs special care. This makes it easier for the parents to visit and care for the babies.
If only one of your babies goes into neonatal care, it is difficult to share yourself between them, especially if you have other children. Each of your children needs you to spend time with them. Only you can tell which compromise best suits your family.
If only one of your babies is sick, it is a good idea to spend plenty of time with the sick baby too, and to take photographs of the babies and family together.
How do I feed babies in neonatal care?
Because of its antibodies and nutritional balance, breast milk is best, particularly for small or premature babies. However, you will need plenty of support to help you initially express breastmilk and then move to breastfeeding your babies in neonatal care. Ask if your hospital has a feeding advisor or lactation consultant who can help you.
If you are breastfeeding, the staff should provide you with a screen you can draw around yourself for privacy. If the babies cannot suckle at the breast, but you are expressing breast milk for them, the hospital should be able to offer you a private room and an electric breast pump. (If not, breast pumps are available to hire from the National Childbirth Trust and a variety of other sources).
In some units, babies are fed expressed milk by cup instead of by bottle. If you want to breastfeed later, this approach may prevent some problems with latching on.
If you are tube-feeding the babies, a nurse will show you what to do. Simply put you check that the feeding tube is correctly in place, then you gently introduce the required volume of expressed breast milk or formula milk into the tube.
Babies don’t need to be fed if they are on a drip, although you may need to moisten their mouths with cooled boiled water. Often, babies who have been tube-fed for a long time do not like either the breast or the bottle, and it can take a lot of patience to get them feeding by these methods.
You can learn more about breastfeeding newborn twins, triplets or more by downloading Tamba’s guide Breastfeeding More Than One.
Follow the links to find out more about coming home, feeding, bonding, sleep and co-bedding, concerns and development.
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