As a twin mom whose twins were born at 35 weeks, I had the experience of my twins going to the Neonatal Intensive Care Unit (NICU) and the experience of one twin coming home while the other twin had to stay in the NICU for longer. In this post, I am sharing what to expect and how to handle it if your twins end up in the NICU based on my personal experience.

Why Would Twins End Up in the NICU?

It is more common for twins to arrive early before their due date when compared with a singleton pregnancy. The further away from the due date a baby is born, the more likely for the baby to have to spend time in the NICU. Typically, if your babies arrive before 37 weeks gestation you should prepare for the possibility of a NICU stay.

Additionally, twins share the womb. It’s possible their growth can be impacted and they might be smaller than average for the week of pregnancy they are born. These two factors are the biggest contributors to twins being more likely to go to the NICU after they are born.

Do All Twins Go In the NICU?

No, all twins do not have to go to the NICU. I think it’s important as an expecting twin parent to be prepared for this possibility, but it is not guaranteed that your twins will end up there (which is good news).

Can I Have One Twin in the NICU and One Not?

Yes! This happened to our family. I bring this situation up because it’s important to also be prepared that this could happen.

One twin might be ready to go home with you, while the other baby needs to spend more time at the hospital. It’s not an ideal situation, but being aware of this possibility will help you better deal with it, if it does happen.

What To Expect When Twins Are In the NICU

If your twins need to go to the NICU after birth, it can feel overwhelming, but knowing what to expect can help you feel more prepared. Here’s a breakdown of what you can expect if your twins are in the NICU.

NICU Environment

The NICU may feel intimidating at first. There will be incubators, monitors, IVs, and a lot of medical staff. The lights may be dimmed to protect the babies’ developing eyes, and the room will have constant beeping from monitors.

Your Twins’ Care

Your twins will be closely monitored with sensors tracking heart rate, oxygen levels, and breathing. If they have trouble breathing, they may need oxygen, a CPAP machine, or a ventilator. If your babies are too small or weak to breastfeed or bottle feed, they may get nutrition through a feeding tube or IV.

Premature babies may need help with temperature regulation. In this case they will be placed in an incubator to help them stay warm. Other times, babies may need antibiotics to treat infections (this was the case for one of my twins) or phototherapy for jaundice.

Some things you might find helpful while your twins are in the NICU or for when they first come home include this Newborn Twins Daily Tracker or this Twin Feeding Log.

Parent’s Role

As far as visiting your twins, some NICUs have set visiting hours, while others allow 24/7 access. You’ll be encouraged to do skin-to-skin contact (kangaroo care) when possible.

If you plan to breastfeed, you may need to pump for your twins (this is what I did) and have milk given through a tube or bottle. Finally, the NICU staff will update you regularly. Don’t hesitate to ask any and all questions about your twins’ progress and care.

Length of NICU Stay

The length of stay depends on why your twins are in the NICU. Premature babies often stay until they can breathe, eat, and regulate their body temperature on their own. Some twins may have different needs and as previously discussed, one might be discharged before the other, which can be emotionally challenging.

Emotional Impact

It’s completely normal to feel scared, anxious, or even guilty. NICU stays can be a rollercoaster of progress and setbacks. Connecting with other NICU parents or a support group can help. At the end of the day, hang in there and know this setup is temporary.

Before we move on, you might be interested in these FREE Twin Pregnancy Checklists. You can get them now by clicking the button below.

Twin pregnancy checklists including baby registry, hospital bag, & trimester mockup image.

Tips for Navigating the NICU with Twins

Here are my top tips for surviving a NICU stay with twins.

  • Learn About the NICU – Familiarize yourself with the equipment, procedures, and staff roles.
  • Pack a NICU Bag – Set up a bag to bring back and forth with essentials like snacks, water, a phone charger, a journal, and comfortable clothing for skin-to-skin time.
  • Track Progress – Keep a notebook or app for tracking medical terms, updates, and milestones.
  • Be Patient – Each twin will have a different journey and progress at their own pace.
  • Kangaroo Care – When possible, do skin-to-skin contact for bonding and to help regulate your babies’ temperature and breathing.
  • Pump & Store Breast Milk – If breastfeeding, start pumping early to establish your milk supply. NICU staff can help with storage and feeding. There will likely be pumping rooms at the NICU too. Check out these Pumping for Twins Schedules & Logs for even more help.
  • Give Yourself Grace – NICU stays are emotionally draining, take it one day at a time.
  • Build a Support System – Don’t hesitate to lean on family, friends, and NICU parent groups.
  • Celebrate Small Wins – Every milestone, like gaining weight or breathing independently is progress!
  • Prepare for Going Home – Learn about any special care your babies might need after discharge.
How to navigate twins in the NICU Pinterest pin.

If your twins go to the NICU, hang in there during this stressful time.

Having a baby, let alone two babies in the NICU is not fun. However, when you are expecting twins it is a very realistic possibility that your babies might have to spend some time there.

It’s important to understand this could happen, so you are not in shock if it does. Additionally, understanding what a NICU stay might be like will also help you navigate this period of time with your newborns. Good luck – and if you have any questions comment below!

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