What Premature Twins Teach You

What happens when your twins arrive much earlier than expected? Twin mom Laura shares about her journey with premature twins born at 29 weeks.

In this episode of the Twiniversity Podcast, Natalie talks with Laura Liepold, a registered dietician and mom of identical twin boys, about what it was really like to deliver her twins at 29 weeks and 4 days, navigate a long NICU stay, and figure out feeding when nothing about the experience looked simple.

Laura’s boys were born after signs of twin-to-twin transfusion syndrome, also known as TTTS, appeared suddenly during a routine appointment. From there, everything moved quickly. She went to the hospital, received steroid shots, delivered by C-section, and then began a NICU journey that lasted 63 days for one twin and 86 days for the other.

But this episode is not just about prematurity.

It is about feeding.

It is about pumping.

It is about bottles, breast milk, thickened liquids, sideline feeding, calorie recipes, NICU numbers, and the emotional weight of trying to do everything right when your babies are tiny, fragile, and still learning how to eat.

Here are some of the biggest takeaways from this episode for parents of twins, parents of preemies, and anyone trying to understand what NICU feeding really looks like.

(Or you can watch the full episode below!)

1. Premature birth can shift everything in an instant

Laura shares that finding out she was pregnant with identical twins was an exciting shock. Because identical twins do not run in families, she was not expecting to see two babies at that first ultrasound.

Like many twin parents, she tried to manage the panic by learning as much as she could. She found the Twiniversity Podcast while pregnant and listened to episode after episode to prepare herself for what might be ahead.

That preparation mattered. When her pregnancy suddenly changed at 29 weeks, some of the words and procedures were not completely foreign. She had already heard about TTTS. She knew other moms had received steroid shots. She had some idea of what an early delivery could involve.

But even when you know things intellectually, living through them is different.

Laura explains that when she was sent to the hospital, she was initially in denial. She hoped they might monitor the babies and send her home. Instead, it became clear that one baby was under too much distress, and the safest option was delivery.

2. NICU feeding starts long before bottles or breastfeeding

When people think about feeding babies, they often picture nursing, bottles, burp cloths, and late-night feeds. NICU feeding can look very different.

Laura explains that in the earliest days, her babies were not simply taking bottles or going to the breast. Their feeding journey started with getting their bodies ready to tolerate nutrition at all. As a registered dietician who had spent time in a NICU rotation, she understood things like parenteral nutrition, where babies receive nutrients through an IV.

That background helped her understand what was happening medically, but it did not remove the emotional reality of seeing her own children go through it.

She talks about one of her babies being stuck at only a tiny amount of milk and trying to tolerate that over a long feed. She also describes the fear that can come with getting a premature baby’s gut started and watching the care team monitor every sign.

For parents listening, this part of the episode is helpful because it gives language to something many NICU families experience but may not know how to explain.

Feeding your premature twins is not always about “will they take the bottle?” Sometimes it starts with:

• Can their gut tolerate this?
• Are they breathing safely?
• Are they getting enough calories?
• Are they digesting?
• Are they aspirating?
• Are they strong enough to coordinate sucking, swallowing, and breathing?

That is why NICU feeding can feel so intense. It is not just feeding. It is medicine, growth, safety, and survival all layered together.

3. Breast milk can become a source of purpose in the NICU

When your babies are in the NICU, so much is out of your control. The monitors, the alarms, the rounds, the feeding plans, the breathing support, the discharge timeline – all of it can feel like it belongs to the hospital.

But pumping became one way Laura felt she could actively support her babies.

As a dietician, she explains that breast milk for premature babies can be different from milk for full-term babies. It may be higher in calories, protein, and fat, and it also provides antibodies and digestibility benefits. In the NICU, breast milk can also be fortified to give premature babies even more of what they need.

Even if you entered your twin pregnancy with a relaxed “fed is best” mindset, the NICU may suddenly put a very strong emphasis on breast milk. And that can feel like a lot of pressure.

But in Laura’s story, pumping was also something she could hold onto. It gave her a job. It gave her a sense of contribution. It helped her feel like she was doing something for her boys when so much else was being handled by the medical team.

4. Triple feeding is simple in theory and exhausting in real life

Triple feeding can quickly become unsustainable, especially with twins. Triple feeding usually means:

1. Feeding at the breast
2. Giving a bottle afterward
3. Pumping to maintain supply

With one baby, that can already be a lot. With twins, it can become an entire full-time operation.

Laura originally hoped that pumping would be temporary while her boys were in the NICU. She wanted to directly breastfeed her twins eventually. But as oral feeds began, one of her babies was taking much more from the bottle than from the breast. Since her goal was to get the babies home from the NICU as soon as possible, bottles became the practical choice.

Then, once one baby was home, she tried direct breastfeeding again. But because he still was not getting enough from the breast, she had to nurse, bottle feed, and pump. And she still had another baby in the NICU.

That’s the tricky part about triple feeding. It’s not impossible, but it can quietly take over every minute of your life.

And when you are also managing NICU visits, pumping schedules, bottles, recovery, sleep deprivation, and another baby’s medical needs, it can become too much to sustain.

5. Sometimes the feeding plan you wanted is not the feeding plan your babies need

Laura shares that she ultimately exclusively pumped for the first year of her twins’ lives. That was not exactly the original dream.

She wanted to breastfeed directly. She hoped bottle feeding might be something they could use temporarily and then move away from. But one baby needed thickened liquids, which meant direct breastfeeding was not an option for him at that time. Looking back, Laura also realized she may have had feelings about breastfeeding one twin and not the other.

Feeding her premature twins wasn’t just nutritional. It brought up struggles with fairness, guilt, grief, comparison, pressure, and identity.

And yet, Laura is also clear that she is proud of what she did. Her babies received breast milk. They were fed. They grew. She adapted.

Her story is proof that sometimes success looks like releasing the picture you had in your head and building a new system that actually works for the babies in front of you.

6. Thickened liquids and feeding therapy can make feeding even more complicated

One of Laura’s twins had a more difficult feeding journey. After weeks of trying bottles, nipples, and different approaches, he had a swallow study that showed he was silently aspirating. That means some liquid was going into his lungs instead of down the esophagus.

Because of that, he needed thickened liquids. This changed everything.

At that stage, he was too young for thickened breast milk, so he had to switch to infant formula thickened with oatmeal. That helped him become more comfortable eating and helped his intake improve.

This part of the episode is important because many parents do not realize how specialized preemie feeding can become. It is not always as simple as choosing breast or bottle.

And for those with premature twins, feeding is often not just a parenting task. It becomes a medical routine you have to learn, repeat, track, and adjust.

7. Sideline feeding is another skill preemie parents may have to learn

Laura also talks about sideline feeding, which many preemie parents are taught in the NICU.

Most people are used to picturing a baby being bottle fed in a cradle position. But for premature babies, that position can be difficult. They may not yet have the strength or coordination to keep their airway open comfortably while feeding.

Sideline feeding can help, but it is not intuitive. Laura explains that because it is such a specific technique, it limited who could help feed the babies. Her husband became great at it, and her mom spent time learning it too, but it was still another layer of training and responsibility.

This is a practical takeaway that deserves more attention. When a baby comes home from the NICU, parents are not just “bringing the baby home.”

They may be bringing home:

• A feeding position people need to learn
• Special bottles or nipples
• Fortified milk recipes
• Thickened liquid instructions
• Pumping schedules
• Medical follow-ups
• Feeding therapy
• Anxiety around oxygen, swallowing, and intake

That is why support matters so much. NICU parents are often doing highly specific care at home while everyone else thinks the hardest part is over.

8. Systems are survival when both babies have different feeding needs

Once both babies were home, Laura and her husband had to build systems to keep all the logistics running smoothly.

Because she was pumping, Laura would batch her breast milk into a larger container, then prepare bottles once or twice a day. But the twins were not on the same calorie recipes, so she could not simply make one batch and give it to both babies.

One baby needed one amount of formula added to breast milk. The other needed a different amount. One needed different nipple sizes. One had thickened liquids. There were different bottles, different colors, different shelves, and different buckets.

Laura used practical systems to keep everything straight:

• One baby’s bottles went on a specific shelf
• Colored lids helped separate bottles
• Hospital basins became labeled wash buckets
• Different nipple sizes were kept with the correct baby’s supplies
• Milk was prepped ahead of time so no one had to figure it out at 3 AM

When feeding is complicated, you cannot rely on memory alone. Especially not in the middle of the night. Especially not when you are exhausted. Especially not when two babies have two different plans.

A system is not overkill. It’s what keeps everyone fed safely.

9. Having one twin come home first can be both helpful and hard

Laura’s twins did not come home from the NICU at the same time. One came home after 63 days. The other stayed until day 86. That meant Laura had one baby at home and one baby still in the NICU for about 3 weeks.

She shares that at first, she was excited. Having one “free baby” who was not attached to cords sounded like it might make the NICU easier logistically. And in some ways, it did.

But as the days stretched on, bringing one baby back and forth to visit his brother became exhausting. The gap between the two discharges was not just a few days. It was more than three weeks.

This part of the episode captures the complicated reality of split discharge for twins. It can be a relief, a learning curve, and it’s emotionally and physically draining.

Parents may feel guilty leaving one baby at the hospital. They may feel stretched between two places. They may feel grateful and devastated at the same time. The episode does a good job of making space for both truths.

10. Coping sometimes means focusing on what you can control

When Natalie asks Laura how she coped emotionally, Laura says that much of the processing came later, through therapy.

At the time, she focused on what she could control. She showed up every day for her boys. She pumped. She did skin-to-skin. She and her husband tried to make sure each baby got hours of skin-to-skin time in the NICU.

That is such a strong takeaway for NICU parents: You may not be able to control when your babies come home. You may not be able to control every feeding issue. You may not be able to control every alarm, every test, every round, or every setback But there may still be things you can do:

• Show up.
• Pump if that is part of your plan.
• Ask questions.
• Hold your babies when you can.
• Learn the feeding techniques.
• Build the systems.
• Accept help.

Or even: let yourself process later if survival mode is all you can manage right now. Sometimes that is enough.

11. Medical knowledge does not make it less emotional when it is your baby

One of the most interesting layers of this episode is Laura’s professional background.

Because she is a registered dietician and had NICU experience, she understood many parts of the feeding journey that might feel confusing or scary to other parents. She understood IV nutrition. She understood calorie needs. She understood fortification. She understood some of the clinical language.

But she is very clear that knowing the information did not make it easy. Because this time, it was her own children.

That is a powerful reminder for any parent who thinks they “should” be handling things better because they work in healthcare, know a lot, have done research, or understand the terminology.

Knowledge helps. But it does not erase fear, grief, or the shock of seeing your own baby struggle. And it does not mean you are not allowed to need support.

12. The hard phase can become part of the story, not the whole story

Near the end of the episode, Laura shares that her boys are now 13 months old and doing well. They are crawling, getting into everything, eating table foods, and becoming happy, active little boys.

That does not erase what happened.

But it does create distance.

She describes the NICU and feeding struggle as a hard phase that now feels more like a separate life.

That is one of the most hopeful parts of the conversation. Not because it wraps everything up perfectly, but because it reminds parents that the NICU chapter is not necessarily the whole book.

There may come a day when the bottles, the thickened liquids, the calorie recipes, the pumping parts, the swallow studies, the alarms, and the long drives back and forth feel less immediate.

There may come a day when your babies are eating cake at a birthday party and you suddenly think, how did we get from there to here?

Listen to the full episode

To hear Laura’s full story, including her premature twin delivery, TTTS diagnosis, NICU feeding journey, triple feeding experience, exclusive pumping, thickened liquids, sideline feeding, and life after the NICU, listen to the full episode of the Twiniversity Podcast.

Want to read more articles about premature twins or the NICU? Check out these articles too!

• When Did Your Preemies Hit Developmental Milestones?
• What if My Preterm Twins Need a Preemie Feeding Tube?
• NICU Resource for Parents of Multiples

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