Table of Contents
Title Page
Copyright Page
Why I Wrote This Book
How This Book Works
What Is My Background
CHAPTER 1 - Pregnancy
#1: Congratulate Yourself and Celebrate!
#2: Remember You Are Not Alone
#3: Don’t Worry About All the Horror Stories
#4: Find Out If Your Twins Are Identical or Fraternal
#5: Take Steps Early to Know If Your Twins Share a Placenta
#6: Get the Results of Every Test You Undergo
#7: Tell Your Doctor What You Fear the Most
#8: Build an Experienced Medical Team
#9: Lie Down on Your Side as Much as Possible
#10: Negotiate a Long Maternity Leave
#11: Let Your Own Home Get Messy, But Keep Your Baby’s Home Sparkling Clean
#12: Don’t Go on a Diet
#13: Bond with Your Unborn Babies
#14: Keep a Pregnancy Journal
#15: Remember That Humor Can Help Overcome All Obstacles
CHAPTER 2 - Delivery
#16: Ask About Delivery Options Early
#17: Be Alert for the Signs and Symptoms of Preterm Labor
#18: Don’t Worry About Having a Picture-Perfect Delivery
#19: Take Lots of Pictures
#20: Ask for a Private Room
CHAPTER 3 - The Neonatal Intensive Care Unit
#21: Visit the NICU During Your Second Trimester
#22: Learn Some NICU Lingo
#23: Feel Free to Cry
#24: Remember These Are Still Your Beautiful Babies
#25: Cuddle Like a Kangaroo
#26: Find Out the Benchmarks for Going Home
CHAPTER 4 - Sensible Shopping
#27: You Don’t Have to Buy Two of Everything
#28: Pace, Not Waste
#29: Look for Bargains
#30: Shop Online If You Can’t Go Out
#31: Put Safety First
CHAPTER 5 - Staying Organized
#32: Be Sure You Can Tell Your Twins Apart
#33: Maintain a “Twin-Driven” Schedule
#34: Keep a Separate Journal for Each Baby
CHAPTER 6 - Feeding and Dressing Twins
#35: Be Open to Different Nursing Techniques
#36: Feed Solids That Are Convenient and Developmentally Appropriate
#37: Dress Them Alike If You Want To
#38: Consider Going Green
CHAPTER 7 - Sleep (or Lack Thereof )
#39: Divide and Conquer
#40: Snuggle Them Close, But Snuggle Them Safely
#41: Teach Healthy Sleep Habits
CHAPTER 8 - Crucial Survival Tip
#42: Make Doctor Visits Productive for You and Your Babies
#43: Get All the Help You Can
#44: Don’t Let Crying Stress You Out
#45: Aim for Fairness, Not Equality
#46: Make Time for Talk
#47: Make Time for Play
#48: Don’t Forget the Older Siblings
#49: Make Time for Yourselves
#50: Share Your Experience with Novice Mothers of Twins

More Praise for Twins 101
“When I found I was having twins, I searched for books that would be able to give me research- and experiential-based information, and there was nothing out there until Twins 101.”
—Eileen Andrade Kitching, M.S., C.C.L.S., child life director, University of California, Irvine; mother of twins
“Twins 101 is filled with practical advice and insights that will be welcome reading for all parents expecting or raising twins.”
—Henry Lee, M.D., neonatologist, Stanford University
“This book contains high-yield, easy-to-read tips, making it convenient for busy, on-the-go parents of multiples. Dr. Le-Bucklin demystifies the NICU and familiarizes readers with medical jargon that can be overwhelming to new parents. Nobody could have been better qualified to write this book than Dr. Le-Bucklin as a pediatrician and an amazing M.O.M.”
—Henry J. Legere III, M.D., Brigham and Women’s Hospital, Boston; pediatrician and author, Raising Healthy Eaters: 100 Tips for Parents
“This is a fantastic reference for any parent who has twins or multiples. This book provides exceptional insight for parents of twins that can relieve stress and anxiety in a fast-paced life.”
—Eric D. Schultz, D.O., M.P.H., pediatrician, Duke University Medical Center


To all the mothers who have guided me on my parenting journey
and to all the mothers of twins to come.
May this book connect us as parents of multiples.
May the priceless wisdom of veteran mothers find its way
to blessed new mothers through this book.

Writing this book has been much like raising twins: at once challenging and thrilling. In the end, you know you have achieved something unique and wonderful. And you realize that you could not have accomplished any of it without the help of so many generous supporters along the way.
First, I thank all the mothers who have so kindly and graciously guided me through my ongoing journey as a mother of twins. I could not have written this book without their insight and wisdom.
My deep appreciation to Alan Rinzler, executive editor at Jossey-Bass, for being such an amazing literary mentor and believing in me as a writer. Alan, I am honored to have had the opportunity to work with you! Thank you to publisher, Paul Foster, for his support of this book. Thank you to all the staff at Jossey-Bass who helped with the editing, production, and marketing of this book, including Nana Twumasi, Beverly Miller, Carol Hartland, Jennifer Wenzel, Jeff Puda, Beverly Butterfield, Paula Goldstein, Sophia Ho, Michael Onorato, and Susan Geraghty. Thanks to Shii McDuff for taking photographs for the book.
Special thanks to Kimberly Douglas, Angela Sun, and Anh Tran for their insightful quotes and tips. Thanks to Alan Greene, Cheryl Greene, and Elise Proulx for paving the way for me to write this book.
I want to acknowledge the chair of my department at the University of California, Irvine, Feizal Waffarn, for his support, especially during my pregnancy. Thank you to Donna Peach, Margaret Zimmerman, Brinda Singh, Carla Busto, Carolyn Moser, Jodi Richardson, Kirat Malhi, and Jennifer Lai for keeping the residency running smoothly during my pregnancy and thereafter.
Thank you to Bich-Van Tran, Manuel Porto, Deborah Wing, Jack Sills, and Cherry Uy for providing exceptional medical care to me and my twin daughters, Faith and Hope. Thank you to all the nurses and other great doctors at the University of California, Irvine Medical Center who forever touched our lives with their kindness and brilliant clinical expertise.
I am deeply grateful to all our relatives and friends for their support, prayers, cooked meals, and free babysitting. Special thanks to my siblings and their spouses—Anh-Tuan Le, Linhsan Le, Jessica Le, Luke Dalfiume, Anne Le, Hong-Van Le, Jason Tuffs, Tasha Le, and Gustavo Delgado—for being like second parents to our children.
Thank you to Langdon and Rose Bucklin for their love, humor, and support. Thank you to my father, Tung Van Le, for giving me a passion for science and for always encouraging me to pursue my dreams. My wholehearted appreciation to my mother, Ngoc-Dieu Nguyen, for her steadfast love and immeasurable generosity in caring for me and my children.
A heartfelt thanks to my dear husband, Chris, who has been not only the love of my life but also a true friend and wonderful partner in parenthood. To my lovely children Hannah, Faith, and Hope, thank you for your never-ending smiles, hugs, and patience. You are the most amazing children, and I thank God every day for you.
Faith and Hope, your mere existence is a miracle. You are such survivors! You remind me that anything is possible with faith and hope. I love being a mother to you, and I am truly “doubly blessed” by you. Thank you for being the inspiration for this book.
Khanh-Van Le-Bucklin
October 2008

On a sunny February afternoon in Orange County, California, I decide to entrust my children, a pair of seven-month-old twin girls and their three-year-old sister, to their father while I take a break—a short drive to the local department store on a quest to replenish our dwindling supply of baby wipes and diapers.
A couple of spots down from where I park, a petite blonde woman merrily pushes a double-stroller up to her black Suburban SUV. Two adorable boys dressed alike in orange T-shirts chat with each other while sitting tandem in their double-stroller. I surmised that they were about three years old. And no doubt about it, they were . . . twins!
Intrigued, I watch as the woman purposefully parks the stroller alongside the car and steps on the stroller brakes—true signs of an experienced mother of twins. I remember the time I parked my twins in their stroller in back of the car and took one girl out—then saw with horror that the stroller started sliding backward toward the street. Did I move fast!
This veteran mother quickly transfers one twin out of the stroller and into the car while managing to keep a watchful eye on the other. She hands one boy a toy to keep him occupied while she lifts his brother into the car. Closing the second-row passenger door, she then proceeds to begin loading the huge stroller and some shopping bags into the trunk of her car.
As I marvel at the efficiency and fluidity with which she cares for her children, I walk by and say, “Your children are adorable! I have three children, and two are twins.”
Her face lights up. “Twins! What a trip!” Instantly the other mother of twins and I bond over our experience as parents of multiples. “How old are they?”
“Seven months,” I reply. “I can’t wait until they are your children’s age. You handle them so gracefully!”
“Thank you!” She smiles. Encouragingly she continues, “I’ve had a lot of practice. When they are young, it can be really tough, but it does get a lot easier.”
“I hope so!” I exclaim. “They are so much fun, but they are so much work!”
“I know!” she says. “What kept me sane was keeping them on a schedule. It’s really important to keep them on a schedule.”
“I’m so glad you said that!” I sigh in relief. “You hear so much these days that we’re supposed to let our babies make their own schedules, and that may be okay for one kid at a time, but it doesn’t work for me. I couldn’t get any rest or sleep with infant twins on random schedules.”
“Absolutely!” she says. “It’s not the same with twins. My boys are three, and I still have them on a schedule!”
I listen eagerly as she graciously offers more advice while packing up her car.
“When they get older, try making an entire room where they can hang out safely by themselves. When our boys started to crawl, we took all the furniture out of the living room and made it a big playroom. Then we didn’t have to go crazy trying to keep them out of trouble.
“And make sure you have time to yourself. I’m glad to see you are out by yourself right now. I went batty until I realized that I needed time to myself to reenergize.”
Just then the two cute boys poke their heads out from behind the back seat and holler in synchrony, “Mom! We’re hungry!”
“I better let you go,” I say. “Thank you so much for all your great advice!”
Liberated by her last tip, I decide to enter the department store and shop guilt free. Not half an hour into my shopping trip, a very pregnant woman in a motorized shopping cart nearly runs me over in the infant clothing section.
“Oops,” she says. “I’m so sorry. I’m really not used to this contraption. My doctor says I have to use it to keep the twins from being born too early.”
“Congratulations! I have twins at home. What a coincidence!” I exclaim. An immediate connection forms as we laugh over how many people we nearly injured driving the motorized shopping cart around tight corners.
As we talk, she hesitantly inquires, “How are your twins? Are they okay now?”
I see her sweep her hands protectively over her abdomen, and I say, “My twins are doing great! They were born premature and had some problems in the beginning, but they’re seven months old now and doing fantastic.”
“That’s so great to hear!” she says. “I’ve been really worried about this pregnancy.
“Do you like being a mother to twins? Is it doable?”
“Definitely!” I answer. “It’s so much work from pregnancy onward, but every bit of it is worth it. You’re going to love being a mother to twins.”
“I’m really excited,” she responds, “but I’m so nervous. I have a teenage daughter, and I haven’t cared for a baby in years. And now, two of them at once! Oh my gosh.”
“You’ll do great.” I try to reassure her, touching her lightly on the arm. “Every twin mother I’ve spoken to has said that she was surprised and proud of her ability to step up to the challenge. The fact that you care this much is a great sign of how wonderful a mother you’re going to be to your twins.
“How many more weeks do you have to go?”
“Another month or so,” she says, looking pretty exhausted. “It’s really hard to be on bed rest for this long.”
“I know!” I reply. “I remember how hard it was to literally lie in wait for the due date to come.”
Having recently been in the same situation, I share some advice and words of encouragement. “One thing that kept me motivated was remembering how good it was for my babies for me to rest. When you’re not up and about, lie down on your side as much as possible to increase blood flow to the babies. For moral support, you can perform a Web search to find and then join online community discussions with other mothers on bed rest. Bed rest can sometimes be difficult, but shopping with a motorized cart like this is a great way to get out while sticking to your doctor’s prescription to stay off your feet. Believe me, you are much more talented on that cart than I ever was!”
She laughs and thanks me for my advice. “Thanks so much for talking with me!” she says appreciatively. “I feel so much better knowing someone has been through the same thing and everything worked out well for her in the end.”

Why I Wrote This Book

An unspoken sisterhood exists between mothers of multiples. The instant they meet, they are bonded by a shared understanding of the joys and challenges of parenting multiples. They want to encourage each other. They freely admit their mistakes as they relate their experience for the sake of the other mother. Novice mothers attentively seek advice while more veteran mothers graciously impart it. This spirit of sisterhood and sharing provided the inspiration for writing this book.
My personal journey with twins began with two unusually solid blue lines on a pregnancy test strip. Two stripes, you’re pregnant. One stripe, you’re not. I knew the routine from my prior pregnancy with my then two-year-old daughter.
What made this test different was an unusual clarity to the blue stripes considering that the test was done at least a week before my period would have arrived. I remember with my first daughter that we could barely tell if there was a second line. But with this test, the two blue lines emerged quickly and solidly, indicating that my pregnancy hormone level was surging. In retrospect, my hormone level was unusually high because I was pregnant with twins.
Seven weeks into my pregnancy, I started spotting. An ultrasound to evaluate the bleeding surprised both me and my obstetrician when two little bodies appeared on the screen. I couldn’t believe I was pregnant with twins!
As the weeks passed, I continued to have regular ultrasounds to monitor the health of the twins. With amazement, I saw the babies transform from two tiny white masses on the screen into two fully formed babies. There were many challenges along the way, but before I knew it, I was on the laboring table giving birth. What started out as two beautiful blue stripes on a pregnancy test culminated in the birth of two beautiful girls, Faith and Hope. Parenting them has been a learning and rewarding experience.
From the day I found out I was pregnant with twins, I knew I was embarking on a special journey. Mothers of multiples openly share what they have learned from their experiences because they understand that parenting twins can be very different from rearing singletons. I am writing this book to guide others on the unique and fantastic adventure of raising twins.
Although this book specifically addresses twins, many of the tips also apply to parenting triplets and other high-order multiples. I hope these tips provide a source of help and inspiration to parents and other fortunate caregivers of twin babies.

How This Book Works

Parents of twins are busy people. We don’t have any spare time to sit down and read a book from beginning to end like a novel or history book, so I designed this book to suit the active lifestyle of a parent of multiples.
Instead of long, time-consuming chapters, I have organized the book into fifty brief, easy-to-read tips plus boxed sections containing twin facts, innovative hints, and insightful stories. This book provides a wealth of information in increments that accommodate your schedule. Busy parents of twins can easily read one tip at a time during the brief pauses in their day. In the middle of the night when you need answers, you can refer to this book for quick ideas and solutions.
The first fifteen tips offer instruction for maintaining a healthy twin pregnancy. During pregnancy, the care required for twins differs from that of a single baby. Specialists and tests that one may never consider in a normal single pregnancy become crucial in a twin pregnancy. Women pregnant with twins can also maximize the health of their babies by eating appropriately, bonding with their unborn babies, and learning how to cope with the unique challenges of a twin pregnancy.
The date of delivery is the day every mother looks forward to, and a twin pregnancy requires preparing for that day far in advance. Tips 16 to 20 address the key questions mothers with multiples have about their anticipated delivery. How do I know I am in labor? Can I deliver vaginally? Where will I deliver? Who will be there when I deliver? This information prepares mothers for the experience of birthing multiples while providing ideas for how to make the experience pleasurable and memorable.
For most families, the homecoming immediately follows the delivery of twins. However, some baby twins may be born premature and require time to grow in the hospital prior to coming home. A special hospital ward, the Neonatal Intensive Care Unit (NICU), provides a temporary home for these babies. Tips 21 to 26 address families whose babies require care in the NICU.
At last, the babies are ready to come home, and caring parents want to buy everything they can to make both parents and babies comfortable. It’s very easy to waste an enormous amount of money on this pursuit. Tips 27 to 31 provide practical advice on how to avoid shopping pitfalls and to save money while meeting the needs of twins.
Raising twins means double the work—and double the blessings. At first, the work seems more challenging than anyone could ever imagine. However, in Tips 32 to 50, you will find easy, parent-tested ways to simplify your child care duties. From feeding to dressing to sleep-training twins, Tips 32 to 50 offer ideas for making these daily activities fun and easier to do.

What Is My Background

The collection of fifty tips in this book is a result of experience gained through my two degrees, my M.D. (doctor of medicine degree) and my M.O.M. (Mother of Multiples degree).
As a physician, I am no stranger to giving advice on the care of twins, so many of the tips provided in this book originate from my medical training in pediatrics. I earned my medical degree in 1998 from the University of California, San Francisco. Following medical school, I completed my pediatric residency training at Stanford University. It was at Stanford where I first provided medical care to twins and high-order multiples. I have enjoyed caring for multiples ever since.
My career has been devoted to teaching others how to care for children. I have over fifteen years of experience in health education. Currently I direct multiple aspects of patient and physician education at the University of California, Irvine (UCI). I oversee the education of medical students, future pediatricians, and other health care providers through my roles as pediatric electives director, pediatric residency program director, and pediatric continuing medical education director.
In addition to teaching health care providers, I enjoy interacting personally with parents and promoting child health through my job as a faculty pediatrician at UCI. I also have over eight years of experience as the senior medical content editor for a popular pediatric Web site, DrGreene.com. In this role, I help deliver parenting advice to a massive number of families nationwide.
When I became pregnant with twins, I wanted to read everything I could on twins. Not surprisingly, I found that the majority of information I needed was not on standard bookstore shelves but in medical books and journals.
As a physician, I was thankful for the access I had to these medical resources. However, I quickly realized that what parents of twins really need is a book for them—a book that has all the information available to researchers and clinicians but in a form that parents can quickly read and easily grasp. For this book, I have used my medical background and personal experience to translate current research and medical knowledge into useful information for parents of twins.
Although my medical degree certainly helped me to write this book, being a mother of twins is the most important way I have learned to appreciate the many trials and joys of parenting twins. I discovered some of the tips I share in this book through troubleshooting challenges on my own. Other tips are derived from the collective wisdom of veteran mothers before me. Every mother of twins deserves a special degree. In the world of multiples, this degree is called the M.O.M. degree. I earned mine from the “University of Caring for Faith and Hope.” Without this degree, I could not have written this book.
As a physician, a common question I receive from parents is, “What would you do if you were in my shoes?” When it comes to twins, I can enthusiastically answer, “This is what I would do, not only because I am a doctor but because I have been in your shoes.”


003 #1: Congratulate Yourself and Celebrate!

My eyes stared at the black-and-white image on the screen. Seven weeks pregnant and spotting, I held my breath as my obstetrician performed a fetal ultrasound to look for signs of life. I knew the statistics: if she found a heartbeat, the chances of survival for the baby would be over 90 percent.