Many parents find developing a routine extremely valuable. Babies and toddlers respond well to a routine as it allows them to make sense of their world and know the difference between night and day.
Why establish a routine for your twins or triplets?
The purpose of a routine is to help parents and children predict what is coming next. If you have the same routine when feeding, putting them down for a nap or to bed at night, this familiarity will mean your babies come to expect it and are more accepting of it. It will also help to regulate their body clock, also known as their circadian rhythm, so they should be easier to settle to sleep.
However it's important that as parents you don't feel you can't go out just because of a routine. The routines you establish should give you confidence and allow you to go out, as you know exactly what the babies will need at different points during the day so you can be prepared. For example, you can plan to leave to get somewhere during their first nap and have that nap in the car or pushchair.
Developing routines for your twins or triplets
It is important to remember that routines should be flexible and reflective of your baby's needs. It is much easier to implement a routine if it is developed around your babies' cues. This is often why families with more than one baby find it takes a bit longer to develop a routine as you have more than one baby's needs to take into account.
How do routines change as twin or triplet babies grow?
Routines need to change and develop with the babies' age and stage of development, for example a routine for a 3-month-old would be very different to a routine for 10-month-old. We've provided some things to think about but it is important to remember that every baby is different. It is also worth bearing in mind if your babies were born prematurely, you should be guided by their corrected age rather than their actual age.
You often hear the new born stage being referred to as the fourth trimester. This is your opportunity to really build the bond with your babies. Make the most of those newborn cuddles and really start to get to know each of your babies individually. During this stage the most important thing is to make sure they are feeding well and often.
I didn't need to be so obsessed once we brought them home to get them into a sleeping routine. Young babies need time before a routine can work. Wished I felt more relaxed about spending more time simply hugging them - but I didn't want to interrupt the routine I was trying to instil ... It's tricky with the whole routine thing, as obviously it's important for triplets, but the focus of the routine at the beginning is really more on the feeding. I just assumed that I needed to do the same with sleeping. But a sleeping routine didn't really start to work until they were around four months old.
A newborn baby's body clock is not developed and they have no sense of day and night, their sleep and wake pattern is simply governed by hunger and other needs. Try to help them differentiate between night and day by exposing them to light and fresh air during the day, interact with them, don't minimize noise around the house and encourage more daytime calories by ensuring they feed every 3-4 hours. At nighttime, keep the lights as low as possible during feeds, use a quiet voice or whisper, avoid playful interaction and use blackout blinds if you have them.
This can be an extremely demanding time for parents, especially when one parent has to return to work. You need to come up with a way to cope through these early weeks when the babies are not very happy to wait and when tandem feeding is often a challenge due to the size and weight of the babies. Thankfully, there are a number of ways you can make things easier:
- Accept offers of help: even if people can’t help you through the night, take any useful help throughout the day. People can take them out for a walk in between feeds so you can get some rest (remember, the housework will wait!). If people offer to do some shopping or cook some meals then take it.
- Encourage the babies to feed one after the other, when one wakes up, feed that one and then wake the other babies up in turn. Once you feel they are feeding well you may be able to tandem feed, but this isn’t easy especially if they were born prematurely or at a low birth weight. It does become easier the bigger they get, so don't put too much pressure on yourself.
- Work out a strategy with your partner or support network for how you will get some sleep. Some families take it in shifts, for example one parent may go to bed and sleep from 7pm-1am and then swap. This may mean that the babies stay downstairs rather than go upstairs to bed in the early days, but you can still make the environments different, for example dimming the lights and keeping interaction to a minimum in the night so they can start to make sense of what is night and day.
- Alternatively, some prefer feeding together as this means it can be done quicker and everyone can get back to sleep.
- Either way, having everything to hand is essential so that you can do the caring in as short a time as possible. "Be organised and stick to a routine! Whiteboards are amazing and help other people understand the routine. They are useful to note who was fed, how much and whether they have had a wet or dirty nappy as it's easy to forget. And in case of sickness it might be needed to advise a health professional."
- Newborn babies don't need a bath every day. Don't put pressure on yourself to develop a bedtime routine in these early days. Using the day and nighttime cues is a good start and as they move into the next stages then bedtime routines will become easier to establish.
If you have spent time in NICU or SCBU you may have a feeding pattern which we would encourage you to try and stick with. Discuss with the nurses on the ward how you want to try and work a feeding routine at home and they may be able to help you get the babies in to this schedule if it suits all their needs.
It is important to remember that even though this newborn phase is incredibly demanding with two, three or four babies at once, it does come to an end. Being prepared before your babies come home with help from family or friends organised and all your equipment ready is a big help.
Three to six months
As the babies are moving out of the newborn phase you will have started to get some smiles and more interactions from them. You will notice they have more awake time through the day and you will be starting to introduce some play time as well. Your routines should reflect this and we would expect that the babies will need a nap every 1.5-2.5 hours.
It is advisable that you don't feed your babies to sleep at this stage - this can mean that they establish a feed to sleep association and come to rely on it to sleep and in between their many sleep cycles during the night. If you can start to encourage a feed when they wake up, rather than just before they are due a nap, it also means they should be able to take a decent feed as they aren't tired. WAKE-FEED-PLAY-NAP and repeat throughout the day is a good pattern to establish. We hope during this stage that they can go a bit longer between feeds (no more than four hours between feeds during the day). They may have 6-7 feeds in a 24 hour period (breastfeeding may be more regular if you are feeding on demand).
This is a great age to start to develop a bedtime routine if you haven't already. It doesn't need to be complicated or long but you start to do the same things at around the same time every evening. You don't need to incorporate a bath for each baby every night especially if you are having to do the bedtime routine on your own regularly.
Here is an example bedtime routine you may like to adapt to your situation:
- About 30 minutes before bedtime, have everything ready to get them changed in to bedtime clothes. You can bath one or more of the babies or think about bathing one each night. The babies who aren’t bathed still come into the room and get changed, washed (top and tail) and nappy change. This is also a good time to give them some no nappy time and opportunity to kick about.
- Dim all the lights and give bedtime bottle. You can also start to introduce a very short bedtime book before you put them into their cots. If you find they're falling asleep whilst taking this bedtime bottle, you may want to consider doing a split feed, half their bedtime bottle before their bath and the other half before they go into their cot. The smaller volume at this time can prevent them falling asleep whilst feeding therefore preventing the feed-to-sleep association.
- Put them into their baby sleeping bag and then into their cots awake but drowsy and say your good night sleep phrase. You may then need to soothe them and help to resettle as required.
Night feeds are also still very normal at this stage but may have reduced naturally. You may only have one late evening feed and then one more before the morning.
Six to twelve months
You will notice that your babies are starting to be able to stay awake a little longer between their naps and will start to move towards three naps a day - one in the morning, a longer lunchtime nap and then a cat nap in the late-afternoon to get them through to bedtime. The late-afternoon nap is notoriously difficult and it can be easier to take them for a walk at this time if it fits in with your schedule and have this nap in the pram. This late-afternoon nap will be dropped as they move to two naps a day.
Get into the habit of putting your babies in their cots awake so they associate them as being a nice place to go. You may find they need some help in soothing and it's fine for you to cuddle them and get them to a drowsy state before you put them down. You might find that one of your babies is better at this and others may need a bit more encouragement.
Here are some tips for self-soothing:
- Try to avoid your babies getting overtired.
- You may find your babies are not able to nap for long periods of time. When they stir, try and resettle them (especially during the longer lunchtime nap), but if they are resistant then get them up and make the most of the one-to-one time until the others wake up. You may find some of your babies are able to stretch their naps longer before the others and may be able to move to two naps earlier than the others.
- Shushing and patting is really effective when trying to get babies to settle in their cots. Look at the layout of your room, can you reach two of your babies at once in their cots to help them to settle?
- Put the babies who are more difficult to settle nearer the door so that if you need to enter the room you don’t disturb the better sleepers as well.
- You may find that moving one or more baby into a separate room or in with you if they are really struggling can help make you feel less anxious about them waking the others up and allow you to encourage more self-soothing.
- White noise or lullabies in the room can help to break the silence and prevent startling with sudden noises. Just be aware anything you use needs to be constant and stay on throughout the night.
Your babies may still be needing night feeds during the early part of this stage and you will also be weaning them. Weaning is an exciting time but can also mean juggling bottles, meals and naps, which doesn't leave much time for anything else.
You may start off by introducing one meal about 30 minutes after a milk feed, at a time of day that is the least stressful in your household. By the time you get to 12 months they will be having three meals a day and will have dropped some of their bottles. It is totally fine if not all your babies are ready to be weaned at the same time, you can start one or two first. You may be interested in attending our weaning webinar for further information about this and the general weaning process.
Twelve months plus
Your babies will be having three meals a day and potentially just one long nap during the early afternoon. This routine will now be fairly set for the next year as they move into toddlerhood.
If you still feel you are having issues with their sleep then there is further advice available in our sleep online course. It may also be that your little people are becoming more head strong and begin to display some behaviours that are less desirable. Our behaviour online course includes useful tips and advice for dealing with this stage of their growth.
As your toddlers start to become more independent and want to take further control of many aspects of their lives there will be more challenges along the way, but lots of fun at the same time.