Dr jen, It seems you are on top of it! <<Aside from the obvious concerns about prematurity, small for gestational age issues, what things do I need to watch for in the early days? >> These are the most important concerns. i would recommend she keep a diaper diary becoz it may be confusing to keep track of who did what. I like these babies to be weighed in a couple days. She might consider having a breastpump on hand "just in case" since the babies are premature. I think another big concern will be just supporting the mother becoz with twins feeding alot and 2 other children, mother will be quite busy. so she needs alot of help so that she can eat/drink/rest/establish her bf and supply. Many moms have help in the very early days (like first week) but then the helpers evaporate. Help her with good positioning and attachment to breast, esp when feeding both together, so as to avoid nipple trauma and pain. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA _________________________________________________________________ Add photos to your messages with MSN 8. Get 2 months FREE*. http://join.msn.com/?page=features/featuredemail *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html