Having twins is an exciting but challenging experience for new parents. While singleton babies typically stay in the hospital for 1-2 days after birth, twins often require a longer hospital stay of 2-5 days on average. The length of the hospital stay depends on several factors related to the twins’ health and care needs.
Why twins usually stay longer in the hospital
There are a few key reasons why twins tend to stay in the hospital longer than singletons after birth:
- Earlier gestational age at birth – Twins are often born prematurely before 37 weeks gestation. The earlier the twins are born, the more medical monitoring and specialized neonatal care they may need in the hospital.
- Lower birth weights – On average, twins are smaller than singletons at birth. Lower birth weight babies may have trouble regulating their body temperature, blood sugar, and breathing on their own, requiring a longer hospital stay.
- Feeding difficulties – It can be challenging for new parents to learn to feed two babies at once. The hospital staff helps establish breastfeeding and makes sure the babies are able to feed properly before discharge.
- Jaundice – Jaundice, or high bilirubin levels, is more common in twins. Phototherapy treatment is usually done in the hospital for a few days to treat high jaundice levels.
- Infection risk – Twins are at higher risk of developing infections compared to singletons. Doctors monitor for signs of infection and make sure the babies are healthy before discharge.
While singletons may go home within 24 hours of vaginal birth, twins often stay 2-3 days or longer to ensure they are feeding well, maintaining their temperature, and have no complications from their birth.
Typical hospital stay by gestational age at birth
The earlier twins are born, especially if they are preterm, the longer their average hospital stay will be. Here is an overview of the typical newborn hospital stay for twins based on gestational age at delivery:
|Gestational Age at Birth
|Typical Hospital Stay
|Full term (37+ weeks)
Twins born very preterm at 32-34 weeks may spend 2 weeks or longer in the neonatal intensive care unit (NICU) as their lungs, brain, and other organs continue developing. Twins born closer to full term at 35-36 weeks often stay 1-2 weeks in the hospital with specialized transitional care before they can be discharged home.
Factors impacting length of stay
While the gestational age at birth is the biggest factor for hospital length of stay, there are other influences on how long twins stay after delivery:
Method of delivery
Twins born by unplanned C-section usually stay 3-5 days, which is 1-2 days longer than a vaginal birth. Planned C-sections may have a slightly shorter stay of 2-4 days.
Twins with very low birth weights under 2500 grams (5.5 pounds) often need specialized neonatal care for 2-4 weeks. Heavier twins over 2500 grams can usually feed well and go home after just 2-3 days.
Any health problems like respiratory distress, infections, jaundice, or low blood sugar can prolong the hospital stay for closer monitoring and treatment. Generally healthy twins without complications can go home sooner.
If the twins have trouble breastfeeding or bottle feeding, the hospital staff works on feeding skills and nutrition before discharge. Twins with a strong sucking reflex and ability to feed usually go home earlier.
First-time parents need training on caring for two newborns, including feeding, diapering, bathing, and telling the babies apart. More time is spent educating new parents before bringing twins home from the hospital.
How parents can prepare for bringing twins home
To help make the transition from hospital to home go smoothly, parents of twins should:
- Set up the nursery with two cribs and double the supplies before the birth.
- Arrange for help from family or postpartum doulas after the hospital discharge.
- Take infant care classes focused on twins to build confidence.
- Ask about forwarding medical records to the pediatrician for follow-up care.
- Inquire about breast pumps and lactation support to establish breastfeeding.
- Discuss any concerns with the neonatal or obstetric medical team before bringing the twins home.
Having a strong support system and plan for caring for two newborns makes the transition home less stressful. Many parents find combining bottle and breastfeeding allows for sharing duties with a partner or caregiver. Meal prep and house cleaning assistance also keeps the focus on bonding with the babies.
Outpatient follow-up care
After discharge from the hospital, twins need close outpatient follow-up care to monitor their health and development. Typically, twins will have follow-up doctor’s visits:
- 24-48 hours after discharge
- 5-7 days after discharge
- 2 weeks after discharge
- 1 month after discharge
Premature twins and those with medical complications may have even more frequent visits to check weight gain, feeding tolerance, jaundice levels, and general health. Having a pediatrician experienced in caring for twins is extremely helpful for getting questions answered after the hospital stay.
Early intervention services
Twins who were born preterm, have very low birth weights, or have medical complications may qualify for early intervention services after hospital discharge. These services include:
- Physical therapy – For improving muscle tone, strength, and motor development
- Occupational therapy – For enhancing coordination, feeding, and self-care skills
- Speech therapy – For working on communication, oral-motor, and swallowing skills
Early intervention can help get twins back on track developmentally and is often covered by health insurance depending on the child’s needs. The neonatal care team will make recommendations and referrals before the twins are discharged from the hospital.
The typical newborn hospital stay for twins ranges from 2-5 days on average, with longer stays of 1-4 weeks for preterm or very low birth weight twins requiring neonatal care. Multiple factors impact the length of the hospital stay including gestational age at delivery, delivery method, birth weights, health complications, feeding abilities, and parent education. Preparing the home environment, arranging postpartum help, scheduling pediatrician visits, and accessing early intervention services can help ease the transition when bringing twins home. With supportive medical care and parental preparation, twins can thrive after their stay in the hospital.