When One Twin Comes Home First

Why it happens

Twins born at the same moment are not the same baby. One may be smaller, one may have had a harder time with breathing, one may take longer to learn to feed. Twins Trust says babies move between different neonatal units as they get stronger, and that one baby may go home before the other, which can feel very emotional.

Discharge is decided per baby against the same criteria: Twins Trust says the team will check each baby is feeding well and can keep a normal temperature in a cot, and will usually ask you to bring car seats in so staff can check the babies sit safely in them. One twin meeting those criteria before the other is not a failure by anyone.

What it actually feels like

Twins Trust names the feeling precisely: you may feel pulled between home and hospital. Its advice after a neonatal stay describes parents feeling torn between their babies when one needs more care, and finding it hard to juggle feeding, medication, appointments and everyday tasks.

There is also a quieter version of it, which is guilt in both directions at once. Guilt for enjoying the baby at home. Guilt for wanting to be at the hospital. Guilt for wanting to be nowhere. None of that means you are handling it badly.

What the unit can do

Twins Trust says your neonatal team will help you plan how to manage the split, and that you can usually bring the baby who is at home in with you when you visit. That is the single most useful sentence for anyone in this situation, because most parents assume the opposite and stop asking.

Other things worth asking your unit about: whether it has parent accommodation or a room you can use during the day, what its visiting arrangements are for siblings, whether the babies can be nursed together if the second baby is nearly ready, and whether there is an outreach nurse who could support the baby at home.

Twins Trust says most neonatal units offer outreach or community support once babies are home, with nurses who can help with discharge planning, answer questions, arrange home visits and check feeding, weight gain and medication. That service usually starts with the first baby's discharge, not the second's.

Feeding across two places

If you are expressing, you are now doing it in two locations on two schedules. The NHS says you can express breast milk for a baby in neonatal care, that a fine tube can be used to give it, that hospitals may have breast pumps you can use, and that milk can be frozen and given later. It adds that when you go home you can express milk for the nurses to give while you are away, and that there is no need to worry about how much you produce because every bit helps.

Practical things that make it survivable: ask for a pump you can use at home as well as on the unit, label and date everything, and ask the unit exactly how it wants milk transported and stored. Ask an infant feeding specialist to look at your plan. NICE NG137 includes an infant feeding specialist in the enhanced team available for referral in a twin or triplet pregnancy, so this is a referral your team can make.

Neonatal Care Leave and Pay

Twins Trust says you may be entitled to Neonatal Care Leave and Pay, describing it as one week of leave and pay for every seven consecutive days your babies are in hospital, up to a maximum of 12 weeks, taken in addition to maternity leave. It says that if your maternity leave has already started when your babies go into neonatal care, you can take your neonatal leave afterwards, and that if your babies are admitted at different times you may be able to claim for each baby separately.

That last point is specific to multiples and easy to miss. It is worth raising with your employer or HR early, with dates, rather than working it out at the end.

Practical arrangements that help

Keep one bag permanently packed for hospital visits. Set a fixed time of day you will be on the unit so staff know when to expect you and can save updates for then. Ask for a daily phone update at a set time so you are not calling repeatedly. Accept lifts, because parking and public transport with a newborn is the part that quietly exhausts people.

Twins Trust's advice on asking for help is to ask early rather than waiting until you feel overwhelmed, to be specific about what you need, for example meals, laundry or help getting to appointments, and to keep a short list of who to call for medical questions, emotional support and practical help.

When they are finally both home

The reunion is often less straightforward than expected. Twins Trust says coming home can feel worrying as well as relieving, that you may feel anxious when monitors are no longer in place, check your babies often, or worry when they sleep for longer, and that sleep can be disrupted for a long time, especially with more than one newborn while you are also recovering yourself.

The babies also have to get used to each other's noise and to a household routine built around one of them. Give it weeks rather than days.

Looking after yourself

Twins Trust says anxiety, low mood and intrusive thoughts are common after a premature birth or neonatal stay, especially when caring for more than one baby, and that your GP or health visitor can share information about local support including perinatal mental health teams, who can discuss treatment options with you.

If you are having thoughts of harming yourself, or your thoughts feel frightening or unreal, contact your GP, midwife or NHS 111 the same day. Reaching out early is the point at which this gets easier, not the point at which you have failed.