Q. My six-week-old twin boys, who were born three and a half weeks early, have put on weight well, but can be quite sleepy by day. This seems to be affecting their nights. They are still waking twice in the night around 2am and 5am. The amount taken at 2am can vary between 2-4ozs. When they wake at 5am and again at 7am they are never very hungry. We also find that they take a large feed at 5/6.15pm, which means that the 10pm feed can be quite small.
I have tried two ways to deal with the 5am waking: the first way is to try to settle them with a dummy without feeding them, which takes some time; the other way is to split the feed between 5am and 7am. Neither approach seems to improve their interest in feeding at 7am. During the day they are very slow to feed, sometimes taking up to an hour each.
A. To help the twins sleep for one long stretch in the night, it is important that they take a take a good 10pm feed. To ensure that this happens, give them the larger part of their split 5/6.15pm feed at 5pm, and a smaller feed at 6.15pm. Begin to wake them at 9.45pm and ensure they are well awake before you start to feed them. Take them into a well-lit room with gentle background noise. Once they have taken as much milk as they want, let them have a quiet kick until 11/11.15pm. Change their nappies and offer them a top-up feed before settling them back to sleep.
If the twins have fed well at 10/11.15pm, they should be able to get to 2.30/3am before they need their next feed. Although it can be tempting to feed and settle them quickly at this time, it is better to spend some time ensuring they are properly awake, so that they will take a full feed and will hopefully go through to nearer 6/7am in the morning.
Even if the twins are still swaddled, make sure they are tucked in well at night as kicking the covers off is another reason, apart from hunger, that tiny babies tend to wake up earlier in the night. Use a cotton sheet spread lengthways across them and tuck at least six inches each side under the mattress. Secure the sheet by rolling up two hand towels and tucking them down between the spars of the cot and the mattress.
As your babies were early, you may find that they need more sleep than the routines recommend. Do not be in a hurry to push them on to the next routine, as this could lead to overtiredness, which will create another set of problems. Try to aim for getting the babies sleeping until between 2/3am, then feeding well and settling them back until 6/7am. By taking one step at a time and not attempting to push them too quickly, they will be much more likely to start to sleep longer at night naturally.