If you are about to have twins, don’t worry. You won’t be the only one. In the U.S, about three of every 100 pregnant women give birth to twins or triplets, according to statistics from the Mayo Clinic in Rochester, MN. And by many accounts, twin pregnancies are on the rise. As a result, growing numbers of parents will be faced with the challenges of raising twins.

While it is true that twins can bring double the joy, parenting twins can also require double the work – at least initially. The key is to be prepared.

“This is survival mode,” says Atlanta-based pediatric nurse Jennifer Walker, RN, coauthor (along with Laura Hunter) of The Moms on Call Guide to Basic Baby Care and the mother of twins. To better prepare yourself, here are seven things that many new moms and dads may not know about parenting twins.

“It’s hard enough with a single baby, but when you have newborn twins, things have to be on a schedule,” Walker says. “You want to get the babies on the same feeding and napping schedules. They will eventually learn to adapt.” (You won’t if the newborn twins are not on a schedule!)

“If you breastfeed, you can feed both babies at the same time with one twin on each breast, but it takes great coordination and patience,” Walker tells WebMD. “I personally did not like the way it felt.”

She recalls that breastfeeding her newborn twins felt like she was balancing two bobbing heads. The solution? “I breast-fed one and bottle-fed the other,” she says. “I would sit down on the floor while breastfeeding one infant, while the other infant lay on a pillow in front of me or on my side with a bottle, so the whole feeding experience would take me 45 minutes – total.”

“Newborn twins can certainly remain in the same crib initially,” Walker says. “If they sleep better when they know the other is close by, crib-sharing can last up until they move into their childhood beds.”
Many parents may make the switch to two cribs when the twins begin to roll, bump into one another and wake each other up, she says.
While one crib is fine, two car seats and a double-stroller are absolute musts for newborn twins.

Newborn twins are more likely than singletons to be born early and underweight. “Preemies often do have more respiratory issues because their lungs may not be as developed as babies born at term,” explains Alan Rosenbloom, MD, a New York City-based pediatrician. This doesn’t mean that both premature newborn twins will have respiratory issues, however. “If you have two premature twins born at 32 weeks and one needs a breathing tube, this twin may be more likely to have respiratory issues down the road than a twin who had slightly more mature lungs and only needed some oxygen via a nasal cannula.”

“Twins are like all siblings in that they certainly get each other’s illnesses,” says Rosenbloom. “If you have a contagious infection, the risk of a twin sibling getting it is just as good as if another person in the same household had that infection,” he says. Parents of newborn twins may consider separating the two if one comes down with a contagious illness right after birth. “Mobility is less of an issue early on, so if one twin has chickenpox, for example, you can separate them and let the healthy twin stay somewhere else to minimize their risk,” he says. “You can’t reduce the risk to zero, but you can control it better.”

Encourage the differences between twins and never compare twins to one another, says mom of twins and developmental pediatrician Randye Huron, MD, the chief of the section of developmental pediatrics and the director of the Institute for Child Development at the Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center in New Jersey. “Most children do have their own strengths and weaknesses, and twins are no exception,” says Huron. “My daughter loves ballet and art, and my son likes sports. I encourage the differences to minimize competition and comparisons,” she tells WebMD. “Never say, ‘Your sister is behaving, so why aren’t you?’”

Separating the twins eventually is also helpful. “It is in their best interest to be separated and get their own group of friends,” she says. Separate time with parents and separate play dates encourages independent decision-making.

“Young twins are easier to raise, have each other to play with, and sleep better than singletons once they turn two,” says Manju Monga, MD, the Berel Held Professor and the division director of maternal-fetal medicine at the University of Texas Health Sciences Center in Houston, and the mother of twins.