expecting twins

Pregnant with twins: What to expect

Being told you are expecting multiples is a big surprise! Clinical Practice Development Co-ordinator Ann Bowers at The Coombe explains what to expect.

Discovering you are pregnant with more than one baby can lead to a roller coaster of emotions: surprise, fear, joy, bewilderment to name but a few. You may feel daunted by the extra risks and responsibilities that come with a multiple pregnancy and birth, however it is important to remember that you are not alone. There are lots of people who have been through a multiple pregnancy and healthcare professionals who have cared for parents of multiples will be there to support you on this amazing journey. Use the time before the arrival of your babies to research all you need to know about caring for yourself for your infants – especially the practical issues such finding out what happens at a multiple birth to sleep routines and feeding.

Pregnant with twins: What to expect

Mother of twins Catherine Rafferty shares her tips.

Forget about the housework; if someone offers help…take it! Just concentrate on feeding your babies; you won’t have time for much else especially at the start. Try get into the swing of feeding tandem and you will soon learn babies that feed together sleep together! Invest in a twin pillow can be used to tandem feed both by breast. Tap into local support groups even on Facebook if you cannot get out. Cuidiu and Irish Multiple Births Association (IMBA) are great.

Types of multiples

Fraternal twins:

All pregnancies begin when a sperm fertilises an egg to form a zygote. Sometimes two eggs are fertilised by two different sperm forming two zygotes, in other words ‘twins’. These twins are called fraternal or dizygotic twins (meaning two zygotes). Each fraternal twin will have their own umbilical cord and own placenta. Fraternal twins are like having two pregnancies at the same time. They may look similar or completely different.

Identical Twins:

A single fertilised egg (zygote) that splits in the days after conception forms genetically identical twins known as monozygotic. These twins are of the same sex and will usually look very similar to each other. There are different types of identical twins. Some identical twins split soon after fertilisation and will have their own individual placentas. Some will split after they attach to the wall of the womb therefore they share a placenta. A very small number of twins who split later will share a placenta and an inner sac, called an amnion – however they will have separate umbilical cords and are called monoamniotic twins. Triplets and quadruplets may develop as a result of combinations of fraternal and identical twinning.

Looking after yourself

1. Diet and nutrition:

Taking care of yourself during your pregnancy starts with good nourishment. Eating a healthy, varied diet rich in iron, protein, vitamins and minerals is vital. Anaemia, in particular iron-deficiency anaemia is more common in multiple pregnancies. This can cause tiredness, fatigue, pale complexion as well as shortness of breath. Your doctor or midwife may recommend a pregnancy supplement. Keep well hydrated by drinking water, as this helps you feel more energised and is important for keeping a healthy urinary system. Slow burning foods such as wholegrain rich foods like vegetables, beans, oats, brown rice and pasta will help to keep you feeling full for longer and keep your blood sugar levels stable. Eating your meals slowly and while sitting upright may aid digestion and reduce heartburn.

2. Keeping active:

When you are expecting more than one baby, you will also be carrying extra weight in the form of placentas, amniotic fluid and extra maternal fluid. A multiple pregnancy will put more pressure on your joints, which may cause discomfort and backache towards the third trimester. Gentle exercise can ease tension and aid your muscle tone. You may find that exercise may help to relieve backache and constipation, while also helping you to sleep better.

Pregnant with twins: What to expect

Low-impact sports such as walking and swimming can be enjoyed by most women. Remember to start slowly and if you feel unwell or if you are in pain, stop! Due to the added weight of pregnancy, your pelvic floor muscles get weaker. Weakened pelvic floor muscles can lead to urinary incontinence and reduced sensitivity during sex. Pelvic floor muscle exercises can keep your pelvic muscles strong. Try to attend a physio class in your hospital to learn how to do pelvic floor muscle exercises correctly. Do these exercises daily throughout your pregnancy and beyond to maintain a healthy pelvic floor.

3. Emotional wellbeing:

A multiple pregnancy can cause a mixture of emotions from fear of the unknown to joy at the prospect of seeing your babies. Added to this are the extra pregnancy hormones and physical changes that can leave you feeling overwhelmed. These are normal emotions. Do not be afraid to discuss your feelings with your partner, they may be feeling a bit overwhelmed too. Support groups such as the Irish Multiple Births Association (IMBA) provide guidance and information for parents during pregnancy and after the arrival of your babies.


One of the most common complaints during a multiple pregnancy is extreme tiredness. Your body works extremely hard during a pregnancy and during a multiple pregnancy it must work even harder. In a singleton pregnancy, blood volume increases by nearly 50%, however, in a twin pregnancy your blood volume will increase by nearly one 100%. This means that your heart will need to work much harder to pump all of this blood around your body. As a result, your blood pressure will generally drop and your pulse rate will rise during a multiple pregnancy.

It is common for pregnant women, in particular women expecting multiples, to feel faint when lying down due to the pressure of the uterus. Most women will find it more comfortable to lie on their side. This may be necessary for scans and any other procedures requiring a pregnant woman to lie down for a considerable amount of time.

Pregnant with twins: What to expect

Deborah Hughes-Mulcahy, mother of twins Emma and Anna shares her experience and advice.

I found out I was pregnant at five weeks after ten years of trying for a baby. To say my husband and I were overjoyed is an understatement! I suffered from morning sickness the whole way through my pregnancy and I had bleeding (caused by a subchorionic hematoma) up until 20 weeks of pregnancy. Apart from all this, my pregnancy was problem free. I had a planned C-section at 36 weeks plus five days, which went very well and my two daughters were born – Emma 4lbs 12oz and Anna 4lbs 9oz. They are 14 months now and doing really well.

Anna is deaf in one ear, which was found at her newborn screening. But she seems to be okay and is picking up speech very well, so she’ll be continually assessed. I would recommend that parents with multiples join the IMBA Facebook page. You can ask anything at any time, no matter what time of the night and you’ll get an answer! Also, accept help from any one that offers, even if you think you don’t need it! And I know it’s hard, but do look after yourself. I recently attended an emotional wellness course that was run by IMBA and I learned some great tips on how to stay on top of my mental health.

Twin facts

In 2011, the latest figures available from the ESRI, Ireland reported the highest fertility rate of any of the 27 EU countries, at 16.2 births per 1,000 population. The twinning rate for 2011 was 18.1 per 1,000 maternities, compared with a twinning rate in 2010 of 16.7 per 1,000 maternities. Multiple births in 2011 included 1,319 sets of twins, 28 sets of triplets and 1 set of quadruplets.

Pregnant with twins: What to expect

Patrica Allen-Garrett, mother of two and a half year old Daniel and Alannah shares her story.

Daniel and Alannah were born on the 28th of December – 10 weeks early. Daniel was 3Ib 4 oz, while Alannah was an even tinier 1Ib 9 oz. We had been monitored very closely from 21 weeks, as there was a big growth deferential between the two babies. My team at Holles street discovered at a routine antenatal appointment that the blood flow had reversed for Alannah, so I had to go up to theatre that day for a C-section.

My consultant had warned me from 23/24 weeks that I could be faced with an early delivery – so I was somewhat prepared for this. The team in Holles Street were amazing, Daniel was in NICU for five weeks while Alannah was in for seven weeks. Luckily, they were born with no complications – the only issue was that they were small. I expressed milk for them as they were too tiny to latch on. In terms of the early days with the twins, I would recommend that support is key. I was lucky to have my husband at home with me to help out. I also have some great friends who were a brilliant support to me during those early weeks.

I developed postnatal depression but I managed to come through it – it’s important for mothers to know that if they feel like they are dipping and can’t cope that the help is out there. Take all the assistance that you are offered and make sure you look after yourself. Eating well and getting enough sleep are vital and reaching out to people is important too. I kept a big white board up on the kitchen wall, which outlined all of babies’ feeds and sleeps. This really helped me to stay on top of things. And one great tip is to give your visitors a job. Let them make their own tea! The twins are now doing really well and are a pair of happy little chatterboxes!

Is it possible to breastfeed twins?

Breast milk is made on demand, the more you feed the more milk you make. By feeding your babies on demand, your babies will get enough milk. In the beginning, you may find it easier to breastfeed one baby at a time. Once you gain confidence with positioning and latching your babies to the breast, you can try feeding them at the same time. Take any help that is offered from family and friends to allow you to get rest and concentrate on feeding your babies.

Find out more about breastfeeding twins.

For further information:

The Irish Multiple Births Association (IMBA) is a charity that was founded in 1996 by parents of multiples. IMBA is managed by volunteers who are all parents of multiples themselves.


Tel: 01 874 9056

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Help! I’m expecting twins
Expert tips for breastfeeding twins


Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….


Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.