Attachment Parenting Twins: is it possible?
If you have used a gentle, responsive, child-led approach to parenting previous children or this style resonated with you before you discovered you are expecting more than one baby, will you need to reconsider now?
I use the term Attachment Parenting, as coined by Dr William and Martha Sears while using the Continuum Concept as a guide to raising their family. It is one approach to a more child-focused approach than the typical mainstream Authoritative type. However, this style of caring for children now goes by many names and all are reflected in this article.
Choosing to practice this way of parenting is not about painstakingly adhering to a list of Dos and Don’ts, though it is often mistaken to mean exactly that. Rather, it is about how you see the parent-child relationship and using techniques to enhance natural bonding and build a secure attachment. Many of the practices we support are synonymous with Attachment Parenting however they are not essential. As long as alternatives are approached with the philosophy in mind, you can still be the type of parnt you choose to be, even if some of the tools in your toolbox need to look a bit different.
Breastfeeding
One significant part of Attachment Parenting is breastfeeding - ideally exclusive breastfeeding for the first six months and child-led weaning after two years or more. However, the challenges for parents birthing more than one baby include barriers to breastfeeding often well beyond their control. While the intention to breastfeed might be strong, the circumstances may prevent initial goals being viable.
Babies born prematurely are gestationally less-prepared to breastfeed. Establishing milk production may partly or fully rely on the mother expressing her breastmilk. The earlier the babies, the longer the commitment to pumping milk .Babies in NICU have less wriggle room than full-term, healthy babies and can medically require milk to be fortified and/or supplemented. This is hopefully done using donated human milk but might also include infant formula use in the short or long-term.
In Australia, around eight per cent of babies are born prematurely (before 37 weeks gestation) every year. Most babies who are premature are born between 32 and 36 weeks gestation, and almost all of these babies grow up to be healthy children.
The chance of survival depends on the baby’s degree of prematurity and birth weight. A full-term pregnancy is said to last between 37 and 42 weeks.
Two thirds of babies born at 24 weeks gestation who are admitted to a neonatal intensive care unit (NICU) will survive to go home. Ninety eight per cent of babies born at 30 weeks gestation will survive.https://www.betterhealth.vic.gov.au/health/healthyliving/premature-babies
Your breastmilk is uniquely designed for your babies needs. The milk of mothers whose babies are born prematurely is different to the milk those same mothers would produce at full-term. So every drop you can give them in the vital early days matters. However, Australian premature and sick babies are increasingly able to access donor milk from milk banks.
Going home with multiples can be a daunting experience and, if you have been exclusively pumping breastmilk, you might find the demands of caring for your new or expanded family mean bottle feeding continues to be the primary or pre-dominant method of feeding. If this is the case, how you bottle feed can be important. Wherever possible, babies should be held while feeding and given the focus and attention of the person giving them milk. Propping babies and feeding them two at a time will inevitably be necessary at times but do aim for the mother especially to spend as much time skin-to-skin while bottlefeeding, to enhance her milk production. Right after doing so can be a good time to pump, making the most of raised oxytocin levels.
If you have helpers coming to your home, direct them toward giving practical support in the household rather than sitting enjoying snuggles with your babies. Anyone can do the laundry or wash the dishes but parents need the opportunities to sit and feed, bond and be in physical contact with each baby as often as possible.
Babywearing
Parents who choose an Attachment Parenting approach carry their babies most of the day held against their chest in a baby carrier. While specially designed twin carriers are available, not all can be used from birth and many babies born prematurely need to wait a while before meeting the size considered safest to begin. So how do you compensate or modify your babywearing plans?
It helps to remember that babywearing isn’t a goal in itself, rather a tool to facilitate a close physical connection while an adult goes about their day. If you have support when you bring your babies home, then the ideal scenario is you do the things which can only be done by you and you outsource everything possible. Practicing Kangaroo Mother Care at home while sitting comfortably and relaxing is a great substitute for babywearing with small or premature babies yet to reach the recommended stage.
Once your babies are big enough, aim to carry each one for at least part of each day. You can alternate days or alternate times, whatever works for you. You might even feel comfortable leaving one baby sleeping at home with a carer while you walk around the block wearing the other. Or place one in the pram while the other is in the carrier. When there are two of you in the house, wear a baby each. Grandmothers will quickly work out the techniques, especially if you all learn how before the babies arrive. Your partner might enjoy carrying one baby in the evening when they get home from work, leaving you to settle the other baby or practice self-care while dinner reheats.
As your babies grow, your options increase - and so does the load! If you plan to wear two babies at once, get the okay first from your doctor or physiotherapist. Your back, abdominal muscles and pelvic floor have already done a massive effort so make sure they are good to go before you hit the walking tracks!
Co-sleeping
If a Family Bed is part of your life, or part of your plans, this is one area where compromise will be needed, at least for a period of time. While bed-sharing, when practiced with safe sleep guidelines in place, is very much a part of Attachment Parenting practice, there is no getting around the potential risks for babies born prematurely or those not exclusively breastfed. Indeed, there is no data looking at the impact of direct feeding versus expressed breastmilk feeding for the protective aspect of breastfeeding against SIDS. You might need to give up the idea of bed-sharing with your babies, even if sharing the parental bed is the most practical space-saving option for your home. Side-car arrangements for more than one baby in a room already struggling to accommodate a Queen or King sized bed might be a challenge to even the recmmended room-sharing for the first 6 months or more. It might well be back to the drawing board for this one!
Options to consider might include adults sleeping in separate rooms, with the babies sharing a room with the mother, herself sleeping in a single or double bed for the time being. If you have a room set aside for the babies, this could be the most practical option. That doesn’t mean the other parent gets the nights off, it means the new family game might be called musical beds, as everyone sleeps in the best sleep space for them in the moment.
Parents sitting up to bottle feed or breastfeed are the most vulnerable to falling asleep in dangerous environments like sofas and armchairs. This is an issue both day and night and parents of more than one baby are particularly vulnerable to fatigue. There will be times where a risk assessment needs to be done: is it safer to lie down and breastfeed the babies, even if that means falling asleep with them, rather than sitting up to feed them and risk falling asleep and one or more babies slipping into a dangerous position? Only you can make such decisions, based on your individual circumstances.
Images: https://www.basisonline.org.uk/co-sleeping-image-archive/
Responsive Feeding. Cue Feeding. Feeding on Demand. Baby-led Breastfeeding
The elephant in the room when it comes to talking about gently parenting more than one baby is the issue of routines and schedules.
Breastfeeding works best when it is a direct supply and demand feedback loop between baby and breast. Optimal breastfeeding practice is keeping mother and babies close around the clock so subtle feeding cues can be recognised and responded to, day and night, with minimal delay. Babies breastfeed according to need, not the clock and variations between frequency and length of feeds are adapted to by the mother, with periods of cluster feeding typically occurring late afternoon and early evening, while night feeds are recognised as an integral part of maintaining milk supply and meeting babies needs.
It goes against everything I know and believe for babies to be put on schedules for sleep and feeding. You can read why elsewhere on this website. I abhor sleep training and know the damage done to mothers milk supply when breastfeeding is regulated by the clock. If your goal is to breastfeed until natural term, introducing schedules is a barrier to meeting that goal.
So, if you feel the same way, then as soon as your babies come home from hospital, any routines put in place due to their prematurity must be left behind. Many parents of babies who have been in NICU or SCN have been directed to feed their babies every three hours or every four hours but not had the reasons effectively explained. Pre-term babies sleep a lot because that is how they are programmed for life in the womb. They need to be woken for feeds as they might otherwise go too long between feeds. Babies beig fed by bottle need daily volumes divided into equal amounts fed at regular intervals because the adult is determining feed times and volumes.
Healthy full-term babies will wake and feed increasingly in the weeks after birth. They will feed as many as twelve or more times in a 24 hour period. Once premature babies reach 40 weeks gestational age, we should anticipate this typical behaviour from them and even celebrate that all is well! But adhering to routine feeding established in hospital will often lead to reduced milk production, poor weight gains and recommendations to increase or introduce supplements of infant formula. Triple feeding is the most demanding and unsustainable method of feeding newborns and should only ever be a short-term approach.
Instead of a clock-based regime of timed feeds, restricted feed lengths and scheduled sleep and nap-times, breastfeedig is most successful when a flexible daily rhythm is applied instead. This might look like:
Morning:
Activity time - babies are most likely to settle easily and sleep longer. This is a time to do essential household tasks like laundry, meal preparation, and basic cleaning. A good time for a walk with the pram, some simple post-natal exercise or visits from helpful people (avoid unhelpful people who just add to your workload!)
Afternoon:
Recovery time - babies are less likely to settle easily and sleep for shorter periods. This is the time to rest, relax while feeding or contact napping and do tasks like online shopping, bill paying or catching up on emails on your phone. Longer naps can be shared by lying down to breastfeed and resting once babies are asleep. Decline visitors at this time of day unless they can do household tasks independently and make you cups of tea without asking.
Evening:
Bedtime - cluster feeding is likely and babies are least likely to sleep out of arms. This is the time to eat meals prepared earlier in the day or from the freezer, prepare for night feeds and go to bed early to feed lying down. Partners can share the load by taking responsibility for bathing, nappy changing and settling babies so the mother can focus on breastfeeding and rest.
Overnight:
Nighttime parenting includes multiple waking and feeding, unsettled periods and disturbed sleep. If breastsleeping is appropriate for your family, take opportunities to do so with one or both babies.
I’m not going to sugar-coat this. There are barriers here which might include the following:
You already have an infant aged three or under
You have children who need to get to and from daycare, kindergarten, school or extracurricular activities
You have an unsupportive partner, one who works away from home, one who works shift work or none at all
Your family are not close enough to help, are critical of your parenting choices or are elderly and not able to help practically.
You have to return to the paid workforce, run a business or live with disability or mental health issues
Your have one or more older children with special needs, your new babies have special needs associated with prematurity
You have financial barriers to accessing services like lactation consultancy, breast pump hire, cleaning services etc
I am yet to met a parent of twins or triplets who were not exhausted by the experience. I was going to add “for the first …” bu couldn’t think of an end time. There is no way around it, this is physically and mentally demanding. You might see a strict routine as giving you some control over the uncontrollable. Nobody is going to judge you if you do, least of all me. But if you want to try a child-led approach of responding to your babies individual needs day and night, you will certainly have my respect and you will reap the benefits long-term. Intensive parenting in these early years is possible and rewarding.
Crying
It might help to be prepared for the typical increase in crying during the 6-12 week (adjusted age) period when all human babies (and, curiously, some other mammals as well) spend time each day crying for no apparent reason. This crying has been labelled as colic for hundreds of years, without any evidence to support its origin is gut pain. Whatever its cause, this crying period is not caused by anything you are or are not doing. It is not related to milk production and while some babies experience reflux, this crying is not related to that. What it IS is relentless and all-consuming. Experiencing this crying stage with two or three babies is overwhelming.
“Scientists decided to look at different animal species to see if they go through this developmental stage. So far, all breast feeding animals tested do have a similar developmental stage of crying more in the first months of life as human babies do.”
Reach out for all the practical help you can access during this stage. Focus on supporting your babies rather than trying to cure them: they will resist calming and settling techniques, may seek the breast but not behave satisfied and seem tired but unable to fall asleep. They look like they must be in pain, screwing up their face, drawing their legs up and arching their back - yet there is nothing apparently wrong medically.
Female brains are wired to react to the sound of a crying baby by taking sympathetic action to soothe and calm the baby, identify and resolve the cause. Male brains respond differently.
Researchers asked men and women to let their minds wander, then played a recording of white noise interspersed with the sounds of an infant crying. Brain scans showed that, in the women, patterns of brain activity abruptly switched to an attentive mode when they heard the infant cries, whereas the men’s brains remained in the resting state.
This might be helpful to know if your partner reacts differently to your crying babies. You might need to have a conversation at a time when your babies are sleeping or another adult can watch them and discuss how this crying is affecting you, especially if you are the primary caregiver spending time alone with your babies. Problem solving is not so much about stopping the crying but coping with the impact of the crying. Parents of singletons become overwhelmed by one crying baby: living with two or three is incredibly challenging.
