Archive for the ‘Family’ Category

Sep

A Practical Guide for Parents of Twins

Posted by: Erikson in Family

Welcome back!

In the last post, I have show you an introductory about twins. This time let’s share more about guide for parents in handling twins and their uniqueness.

How Do We Care for the Twins at Home?

Hopefully, you have already prepared for this moment, have met other parents of twins, bought equipment, and read books. (Check the booklist at the end of this file.)

Fatigue is the main cause of depression in new parents. Dad, friends, or relatives can help in housekeeping. Mom will tire if she waits on the grandparents or visiting relatives who are playing with the twins.

By necessity, the father of twins should be an active parent. Happily, most fathers enjoy their involvement. He can change diapers, feed bottle-fed babies, bring the kids to mom, keep house, and cook.

Feeling tied down is a problem. We recommend using babysitters as early as you want. Infant bonding won’t be harmed. It might be a good idea to hire an occasional babysitter just so mom can nap.

Transportation is a chore. Two infant car seats are mandatory. Over-the-shoulder baby-packs are convenient for walks. A twin stroller allows one parent to walk the twins.

Infant Feeding

Demand feeding, in which the infants feed according to their individual patterns, is time consuming and tiring. Modified demand, in which the first baby who is awake is fed and then the second baby is awakened for feeding, is reasonable. Simultaneous feeding of the babies together is possible, if both are good feeders.

Breast-feeding has many advantages: it provides optimal nutrition and infection-fighting factors; it comes "premixed" in unbreakable "containers." Breast-feeding twins is possible and pleasant. Be confident, you can do it.

Suggestions :
1. Nurse babies in the hospital to develop your milk supply.
2. Assign one baby to one side – each breast produces its own milk.
3. Satisfy your increased appetite, eating a balanced diet and drinking plenty of fluids.
4. Positions – see figures.
5. Have plenty of rest in between nursings.

Bottle-feeding suggestions
1. Feed infants individually to ensure maternal-infant touching.
2. If you decide to feed simultaneously, alternate holding one twin with the other lying close by.

Fussiness

Crying grates on both twins and parents. Try feeding, holding, or putting fussy twins in a swinging chair, or driving them in the car. If all their needs are met, let them cry in the isolation of their room – they have energy to release. It doesn’t reflect poorly on you. Remember the Jewish saying, "It is better that a child should cry than its parents."

How Do My Twins Compare with Nontwins in Size?

At birth, typical monozygotic twins weigh less than 98% of nontwin newborns (singletons). Dizygotic twins weigh less than 90% of singletons. The weight difference between singletons and twins significantly decreases in the first three months and disappears by the time they are eight years old. The height differences reduce dramatically in the first year and disappear by eight years. At birth, monozygotic pairs differ more in size than do dizygotic twins, but become more similar as they grow. Monozygotic twin-to-twin blood transfusions and birth defects in one twin may account for their size differences; the passage of time erases these differences. In contrast, dizygotic twins differ more as they grow.

The First Year

Differences and similarities will soon become apparent in their physical and emotional makeup. They will physically explore each other around three months. Later, they’ll hug, wrestle, and fight over toys. Mom and dad will welcome their growing independence in feeding and sleeping through the night.

Intelligence

Intelligence (IQ) test results have shown no real differences between twins and singletons. Many studies show that twins from educated, understanding, and stable families are at least as intelligent as singletons. In addition, we believe that twins have the advantages of developing outgoing, comfortable personalities.

Twins tend to have more speech difficulties than singletons. Twins start to talk later than singletons and stutter more often. Idioglossia or twin language may be spoken. This is a unique language understood by the twins but not by others. These speech patterns may be caused by the large amount of time twins spend together. All of these speech problems can be treated. The children’s doctor will check their development and hearing. If the twins speak clearly when they speak in English, parents can simply handle the problem by responding only when they speak clearly, reading books aloud with them, and increasing their contact with other people. Sing to the babies and repeat nursery rhymes to them whenever you are within ear shot and the babies are awake.

Toddlers

Safety

Twins cooperate. What one does not think of the other will. You can not watch two children at the same time. We recommend completely child proofing all open rooms. Lock the other rooms with child-proof knobs or latches. You can enjoy the humor of their tricks knowing that they are safe.

Fighting

Some fighting is to be expected, but it may get intolerable. Do not take sides, just separate them. Remove the toy involved or allow each a certain amount of time, for example, five minutes, to play with the toy. Children behave badly to get attention, for power, and for revenge. Understand the reason. Biting is common, and you should immediately discipline the aggressor. Twins enjoy cooperating also. It is fun watching them make up and laugh together.

Clothing

Dissimilar clothes establish identity and allow identification for safety. However, infants are not harmed by wearing look-alike clothes. Later, try different clothes or at least vary colors of identical prints. Allow them to choose their own clothing and keep them in their own separate drawers.

Toys

Sharing is fine to some extent, though toddler-aged children need to learn the meaning of possessions before they can learn to share. Therefore, children their age need some of their own possessions. Monozygotic twins share more but all toddlers are self-centered by nature. We suggest labeling his or her possessions with each twin’s name. Use a timer to alternate time for playing with a popular toy. Buy a toy with many pieces, such as building blocks, to allow sharing. Twins learn to share earlier than singletons and thus become good playmates with other children.

Pre-school

The closeness of twins may make them timid with others. They may have confidence as "we," shyness as "I." Friends may choose a favorite twin, or the twins may dominate playmates. However, friendships are important. You should encourage each twin to take separate outings with his or her own friends to assist individualization. Nurseries will also offer you a free period.

Lying can be a problem. A monozygotic twin may escape being caught when he or she misbehaves because both twins look alike. One solution is to dress the twins differently. Twins are special and sometimes spoiled. One or both may misbehave. We suggest rewarding positive behavior more than disciplining for negative behavior. Tailor the reward or punishment to the individual child’s needs.

Jealousy is usually not a problem with monozygotic twins. Dizygotic twins may compete for parental attention because of personality differences. Be attentive to individual needs and discuss the child’s feelings with him or her.

Decision making should be fostered at an early age to promote individualization.

The twins will overhear others ask, "Are they twins?" or they will be called by their sibling’s name. It is best for twins and parents to correct people calmly.

The twins will build a close and supportive relationship. They will become less dependent on parents – happily for all concerned!

Age 6 to 12 Years

In this age group, continue to accentuate individual attributes and encourage different pursuits.

School

Kindergarten may be the twins’ first separation from each other. Separation may be difficult for identical twins and welcomed by fraternal twins. Classmates accept both kinds of twins quickly as twins but not as individuals. Earlier separation trials will ease the anxiety. Some separation is good, promoting independence by preventing comparison of achievements and friends. It helps speech and discourages twin-foolery in class.

Teachers need to support the twins in this difficult transition. School achievement may fall but should return to normal after several months. Avoid one twin failing a grade and losing self-esteem. When adjusted, the twins should socially flourish because of their practice in accommodating each other.

Hospitalization

Hospitalization of one twin leaves two lonely children. Give more attention to both children and allow frequent telephoning and visitation.

Parties

Take the uninvited out for a special occasion. Plan separate birthday parties with friends of each. Try birthday parties in the same room, different rooms, or on different days as seems suitable.

Teens

Teen twins share joys, sorrows, and the family car! They understand each other’s thinking and can counsel one another. Puberty may accentuate differences in physical and emotional growth. When that happens, privileges and responsibilities should be divided out to each according to his or her maturity.

Conclusion

Check the helpful references below and meet other parents of twins. Now, take a deep breath. Relax. Enjoy.

Bibliography
References
Theroux, R.T. and Tingley, J.F. The Care of Twin Children: A Common-Sense Guide for Parents. Center for Study of Multiple Births, Chicago, lllinois, 1978.
Noble, E. Having Twins. Houghton Mifflin Co., Boston, 1980.
Abbe, K.M. and Gill, F.M. Twins on Twins. Crown Publishers, Inc., New York, 1980.
Keith, D.M., Mclnnes, S., and Keith, L.G., Ed. Breast-feeding Twins, Triplets, and Quadruplets: 195 Practical Hints for Success. Center for Study of Multiple Births, Chicago, Illinois, 1982.
La Leche League International. The Womanly Art of Breast-feeding (Revised). Franklin Park, lllinois,1981.

1 Comment

Aug

Twins : An Overview

Posted by: Erikson in Family

Are you twins ? Or do you have twins in your family ? Or are you expecting twins babies ?

Congratulations! As a parent or prospective parent of twins, you will experience special joys and challenges. Most twins experience a special emotional bond between each other. On the other hand, parents should assist twins in developing a completely individual identity.

Definitions
There are Identical Twins and Fraternal Twins.
Identical Twins are also called Monozygotic (Mz), meaning one egg. Their genes are identical. They are always of the same sex.
Fraternal Twins are called Dizygotic (Dz) or two egg. They share approximately 25 percent of their genes, as do any two brothers or sisters. One-half of fraternal twin pairs are boy-girl, one-quarter are boy-boy, and one-quarter are girl-girl.

Biology
You may be asking, "Why did we have twins?" No one else in your family may have had twins. If you have fraternal twins in the family, you may ask, "Why did we have identical twins?" To answer these questions, let’s talk about the biology of twins.

How twins are conceived ? This can occur in one of two ways:

The more common way (which accounts for two-thirds of cases) is for the two different sperm to fertilize two different eggs, resulting in what is called a Dizygotic (DZ) twin gestation. These twins are often called fraternal twins.

In this type of twinning each twin has its own sac of amniotic fluid and its own placenta (afterbirth). Dizygotic twins have two sets of membranes surrounding their amniotic fluid sacs (one inner amnion layer and one outer chorion layer), and therefore they are known as Dizygotic (diamniotic, dichorionic).

Each embryo has its own amnion and chorion. After the birth of your twins, your obstetrician may be able to tell if the twins are monozygotic or dizygotic from the membranes around the placenta.

In about one-third of twin pregnancies, one sperm fertilizes one egg, but this splits into two embryos resulting in what is known as monozygotic (MZ) twins. The two-cell mass passes down the Fallopian tube and attaches separately or together in the womb. These twins are often referred to as identical twins since they have the same genetic material.

The developing embryo is surrounded by a sack of two layers of thin tissue called membranes: an amniotic membrane (amnion) and around that a chorionic membrane (chorion) (see figure). Approximately one-third of MZ twins look just like fraternal twins on prenatal ultrasound since there are two separate amniotic sacs and two separate placentas. However, in two-thirds of identical twins, each twin has its own amniotic sac but shares a common placenta.

This type of MZ twinning is called monochorionic, diamniotic since there is an inner layer surrounding the amniotic sac of each twin, but there is only one common outer layer (chorion) surrounding both of the sacs. This type of twinning occurs in approximately one in 360 pregnancies. Monochorionic twins are at higher risk for complications since they share a common placenta.

Less than 1 percent of identical twins (about one in 2,400 pregnancies) will have one amniotic sac and one placenta for both twins. This type of twinning is referred to as monochorionic, monoamniotic twinning. These twins are at very high risk for loss of the pregnancy due to entangled umbilical cords.

If the zygote splits early (1 to 3 days after fertilization), each embryo will have a separate chorion and amnion. The later the zygote splits after ovulation, that is at 4 to 8 days, the greater the likelihood of the embryos sharing one chorion. If the zygote splits after 8 days, the amnion may also be shared. But if the zygote splits after 14 days, the twins may be joined together at some part of their bodies and are called conjoined or Siamese twins.

Frequency
A couple has a 1 in 80 (1.2%) chance of delivering twins; monozygotic twins occur in 1 out of every 250 births (0.4%) and dizygotic twins in 1 in 170 (0.6%) in the U.S. A woman who is herself a fraternal twin has a 1 in 10 (10%) chance of delivering twins. If she is an identical twin she has only a 1 in 170 (0.6%) chance of delivering twins. A mother of twins has a 1 in 20 (5%) chance of delivering twins again. A father who is a twin has the same chance of fathering twins as a nontwin father.

Cause of Twinning
The cause of monozygotic twinning is unknown. Less than 20 families have been described with an inherited tendency towards monozygotic twinning. (People in these families have a nearly 50 percent chance of delivering monozygotic twins!) Some evidence suggests that the environment of the womb causes the zygote to split in most cases.

Dizygotic twins are slightly more likely in Blacks, in women between 30 and 40 years old, in tall and heavy women, in women who conceive soon after stopping birth control pills, and in women who have had several previous pregnancies. Women who have been taking fertility drugs have the greatest chance of multiple births, a 10 to 20 percent or 1 in 10 to 1 in 5 chance.

How Do You Know You’re Having Twins?
The pregnant mother of twins first hears the statement "I bet you’re going to have twins," from family members who have had twins. The twin pregnancy causes earlier occurrence of pregnancy symptoms such as nausea, frequent urge to urinate, swelling, and weight gain. Fetal movement may be so increased that some mothers say they must have an octopus inside. The obstetrician may feel two different heads or note an increasing fundal height beyond that which is expected for dates. An ultrasound test can safely confirm the suspicions. Advance notice allows the parents time to prepare emotionally and practically for the twins’ birth.

Parental Adjustment before the Birth
Parents may worry even more than usual knowing that twins are on the way. Delivery complications occur more frequently in twin births than nontwin births, including premature (early) delivery and small birth weight. While her doctor can advise her, the expectant mother is the only one who can make the daily commitment of rest and proper nutrition to insure optimal health of the twins.

If you know in advance that you are expecting twins, now is a good time to meet other parents of twins for emotional support and practical advice. A chapter of the Mothers of Twins Club (MOTC) may exist in your community. You will need to buy various items in duplicate before the babies arrive: two bassinets or cribs, 1 twin stroller (the face-to-face type allows easy passage through doors), two baby chairs, clothes, and so forth. Dad hopefully will have time off around the delivery. In addition, have a friend or relative to help with housework when you come home from the hospital.

Prepare your other children for the new arrivals. Let them get used to their new bed and send them to preschool well before the babies arrive. The older children will have enough change to deal with in their new twin siblings.

Birth
The birthing process is more complicated with twins, so it’s unlikely that your obstetrician will advise alternative birthing centers. Vaginal delivery is often possible, especially when the babies are in the head-down position.

Just a few words about birth defects. Happily, Siamese twins occur rarely, about 1 per 100,000 births and can easily be detected by prenatal ultrasound. Monozygotic twins have a somewhat higher risk of having birth defects, so your obstetrician will make a point of checking the placenta to determine whether your twins are monozygotic or dizygotic.

Your pediatrician or family doctor will examine the twins carefully to make sure there are no birth defects. If one twin is significantly larger than the other, the physician will check the blood counts. Sometimes one monozygotic twin transfers too much blood to the other, leaving the first twin anemic and small and the second ruddy and large. This can only happen to monozygotic twins, and only when they share chorions. That’s why the term "identical" can be misleading, since monozygotic twins may differ because one of them has a birth defect or there may be a difference in their blood quantity. Bowed legs and bent ankles may occur in twins due to the crowding in the womb. However, these problems usually disappear completely as time passes.

The chances are that your birth will not have serious complications.

Are My Twins Identical or Fraternal?
We believe that it is important to answer this question correctly at birth and not just guess it. If it’s known that newborn twins are monozygotic, the physical exam must be especially careful, since monozygotic twins who differ in size may have birth defects. Identifying monozygotic twins at birth is important because it can improve medical care throughout life. For example, if one monozygotic twin develops a disease such as diabetes or epilepsy, the second twin has a higher than average chance of getting the same disease and should be carefully checked.

Also, twin behavior is different in monozygotic compared to dizygotic twins. Knowing the specifics is important in parenting. Identical twins have closer relationships than fraternal. They cooperate more. Fraternal twins develop their individuality easier because of clearer physical, emotional, and genetic differences.

It is possible to determine whether your twins are monozygotic or dizygotic. This is best done after you’ve delivered and are still in the hospital. If the sexes differ, the twins are dizygotic. If they’re the same sex, the obstetrician, after carefully examining the placenta, will send it to the pathologist for detailed study. If there is only one shared chorion, they are monozygotic twins. If there are two chorions, then they may be monozygotic or dizygotic, and a simple blood test can be done to compare blood cell groups, for example, A, B, O, and others you may not have heard. Many laboratories can do this relatively inexpensively. If red blood cell groups differ, then the twins are dizygotic.

Other characteristics can determine zygosity (monozygotic vs dizygotic): fingerprints, teeth imprints, electrocardiogram. However, these tests are difficult and are less accurate than the blood tests. Detailed comparison of physical characteristics may be fairly accurate. For example, in one study, where mothers reported that their twins looked like two peas in a pod, these twins were identical, based on blood types.

Can you recognize the name of the twins correctly ?