Lynda Haddon

Keeping the Couple in A Relationship After Multiples

Posted by Lynda Haddonon November 4, 2012September 16, 2017in General Prenatal Info, Prenatal Education2 Comments

Your relationship after multiples: A new baby brings emotional and financial challenges, new routines, loss of sleep, and so much more to a relationship. Even more complex issues are added to to a relationship after multiples. Once a diaper has been changed and a baby fed, burped and soothed, we aren’t finished – it needs to be done again, and possibly again and again. It is estimated that every time we add a baby to the mix, we are adding a baby and a half’s worth of work.

Parents try hard to meet the needs of the new babies, the house, make meals, do laundry, grab a shower, a quick bathroom visit at an opportune moment and fit in some much-needed sleep. As parents juggle work outside the home and the physical, mental, emotional and financial demands of 2, 3 or 4 new little ones, their relationship, can be pushed aside and virtually ignored. Without meaning to, the martial relationship is often one of the last items parents tend to as it falls victim to the “parenting relationship.” Sleep deprivation is HUGE with multiples and escalates the “cranky” factor. After the kiddies are seen to, it takes effort to remember to look after a spousal relationship too.

Remember to take care of your relationship, even as you are working on your parenting techniques. When parents LOOK AFTER themselves and each other, the children have the benefit of two happier, healthier adults who are important role models. Always taking a back seat or leaving the spousal relationship to fend for itself negatively affects the whole family. An important lesson is taught when we show the kids by example how to look after their parents’ relationship.

Things that can help. Advice from parents of multiples:

Before your babies arrive, look around for some multiple-birth-specific classes in your community and sign up for them as soon as you know you are having multiples. Both parents need to attend.
Connect with other parents of multiples. Learning from those whom have specifically walked the walk is extremely helpful.
Line up help before the babies arrive in a form that will work for you. Some choices are: a nanny during the day, during the night, live-in or live-out. One family had each grandmother stay for 3 weeks each after their babies’ arrival. The 6 weeks of extra hands and experience made it easier to establish routines and get some much-needed sleep.
It is important for each parent to be actively involved in the children’s’ care. Don’t wait to be asked to get involved.
Recognize that each of you may have a different way of doing a task. Appreciate the different skills that you each bring to the role of parenting and baby care and allow each other to complete the task in your own style. Many parents have expressed their pleasure at watching their partner redefine him/herself as a parent.
If there is an issue between you, communicate. Don’t assume the other can read your mind about what tasks need completing or anticipate exactly what needs to be done. Speak clearly to each other, e.g. “Could you please help change babies?”
Plan time for each other on a regular basis. Plan a regular Date Night when grandparents or a local teen can come to sit for a couple of hours. It doesn’t have to be huge, a trip to the coffee shop or walk around the block by yourselves could work, but the important thing is that it is just the two of you. It could be that you stay home to watch a movie, cuddle, talk, share a glass of wine and a pizza or foot/back rubs.
Even when out together, expect to talk about the kids. It’s okay because you are a team, discussing what works, what doesn’t seem to be working, or concerns you might have about eating, sleeping habits and such. The good news is that the discussion occurs on your own terms and cements your desire to be the best parents you can be.
It can be a challenge to communicate about parenting styles with three toddlers running in different directions. Be prepared to have to deal with the present and talk about parenting styles at another opportunity.
If you can afford it, get help to complete some tasks around the home, e.g. cutting the grass, shoveling the snow, cleaning the house, perhaps grocery shopping. Some of the tasks can be done by older neighbourhood children, or place a notice at your local high school or library to find an available teenager whom would like to make a little extra money. Having someone else, even in the short term, assist with these tasks, allows you to focus on the babies and each other.
If it is felt that your relationship is really suffering, consider professional counseling. It might be covered through one partner’s expended health benefits, and if not, this medical expense can often be deducted at Income Tax time as a health care benefit. Don’t wait to seek appropriate help until it is too late.
It’s amazing how quickly out of control things can get when one parent doesn’t know the ground rules set out by the other parent and the kiddies learn pretty quickly to play one parent against the other creating havoc and perhaps an argument between the parents. If necessary, check with each other and present a unified front to the children.
As one couple shared: Yes multiples can stress a marriage especially if the relationship is not solid in the first place. A relationship takes a lot of work, commitment, unconditional love and each parent giving 110%. Teamwork is essential.

Getting through those initial days and weeks can be a challenge, especially as the sleep deprivation builds up and fuses shorten. Keeping a supportive eye on each other is essential to ensure that the love, trust, respect and companionship that brought you together in the first place is not misplaced. Things will improve as the kids become more independent and sleep through the night. Promise!

For even more information, check out the results of Multiple Births Canada’s Survey Multiples and Impact on Couple Relationships on their Web Site at www.multiplebirthscanada.org.

Health Canada Warning Regarding Use of Crib Bumper Pads and Baby Quilts

Posted by Lynda Haddonon November 3, 2012September 16, 2017in Clothing & Equipment, Prenatal EducationLeave a comment

Health Canada recommends in their “Crib Safety” fact sheet that crib bumper pads never be used. This position is supported by the Canadian Paediatric Society, the American Academy of Pediatrics and The Canadian Foundation for the Study of Infant Deaths. The rationale behind this statement is that crib bumper pads, and other products such as quilts, duvets, sheepskins, pillows, stuffed toys, and position maintaining devices, affect the flow of fresh oxygen around the infant and can also pose a smothering hazard if the child’s face is in close contact with them.

Article reprinted with permission from The City of Ottawa.

The American Academy of Pediatrics, in their position paper, hypothesis that certain infants may have a maldevelopment or delay in maturation in a part of their brainstem involved in ventilatory response, chemosensitivity and blood pressure responses. When these infants become compromised (physiologically) during sleep (perhaps from overheating or lack of oxygen as a result of being in contact with or too close to one of the above listed products, or a combination), they are not able to arouse themselves enough to prevent hypoxia and death. The re-breathing of air may in fact be a contributing factor.

Multiple births- bumper Crib bumper pads were first introduced many years ago as a method of protecting infants from head entrapment in unsafe cribs where the slats were too far apart. Since 1986, cribs are manufactured with slat widths that are impossible to get an infant’s head trapped in. Therefore, the bumper pads are no longer necessary.

As well, many years ago when bumper pads were first used, infants were dying as a result of SIDS, but the research as to why this was happening was not as advanced as it is today, and researchers had not yet discovered the link between bumper pads and re-breathing or decreased air flow. Luckily, we have that information today from a vast body of scientific research, and it is very important that we convey this information to parents who question the recommendations.

Parents will also often comment that if they do not use bumper pads, their infant’s hands, feet or legs will get stuck in the slats. This in fact can also happen with the use of bumper pads, as baby’s can get their feet, legs etc. lodged in between the slats either above or below the level of the bumper pad. Although it is possible for the infant to get their hands, leg, etc. caught in between the slats, this event will not result in any serious injury. In fact, the infant will either dislodge the body part themselves, or will make a noise so that the parents can respond and help to remove the part. On the other hand, the risk with bumper pad use is much more serious and can in fact result in the death of the child.

It is also important for parents to be reassured that the risk of sustaining a bruise or injury to the head if the infant rolls into the side of the crib s next to non-existent. The force that would be required to cause such damage is not possible for an infant to produce.

Lynda’s Note: I used to have website addresses here for further information but due to the fact that it is very difficult to keep up with changing web site locations and addresses, I have removed them since they change so often. Please Google “bumper pad use, risks” or anything else you can think of to find current resources.

Useful Multiple Births Definitions

Posted by Lynda Haddonon November 2, 2012August 25, 2017in Prenatal EducationLeave a comment

Now that you are pregnant with multiples, you will be hearing many different terms, diagnoses, or ‘name calling’ by the healthcare professionals, local support chapter, perhaps in your multiple-birth prenatal class or in the resources you have been reading and researching.

We have included a list of multiple births definitions and the most commonly used names and phrases you might hear. Whenever you have not clearly understand any of the feedback you have received, don’t be shy. Speak up and ask for clarification on anything and everything you don’t understand.

Multiple Births Definitions

Amnion:
Inner lining of sac containing the developing fetus.

Amniocentesis:
Removal of a portion of amniotic fluid, either to test for chromosomal abnormalities that could indicate Down Syndrome or other disorders, or to relieve polyhydromnios.

Cesarean Section (C-section):
Surgical method of childbirth in which a woman’s abdomen and uterus are incised and the baby is delivered transabdominally.

Chorion:
Outer lining of sac containing the developing fetus.

Conjoined Twins:
Monozygotic twins where separation into two individuals is incomplete so their bodies are joined together at some point.

Cryptophasia:
The secret language of twins.

Diamniotic Twins:
Twins who have developed in separate amniotic sacs. These twins may be either dizygotic or monozygotic.

Dichorionic Twins:
Twins who have developed in separate chorionic sacs. These twins may be either dizygotic or monozygotic.

Dizygotic (Or dizygous) Twins:
Twins formed from two separate zygotes. Commonly known as “fraternal twins.”

Embryo:
The developing baby during the first eight weeks of pregnancy.

Embryo Reduction:
See Fetal Reduction.

Epidural:
Anesthetic injected in a space at the base of the spinal cord.

Fetal Reduction:
The reduction of the number of viable fetuses/embryos in a multiple pregnancy (usually within a higher order multiple pregnancy) by medical intervention.

Fetus Papyraceous:
A fetus which dies in the second trimester of pregnancy and becomes compressed and parchment-like.

Fraternal Twins:
See Dizygotic Twins.

GIFT:
Gamete Intrafallopian Transfer – assisted conception method.

Higher Order Multiples:
Triplets, quadruplets, quintuplets or more.

Identical Twins:
See monozygotic twins.

IVF:
In vitro fertilization and embryo transfer – assisted conception method.

Intrauterine Growth Retardation:
Impeded or delayed fetal development and maturation due to genetic factors, maternal disease or fetal malnutrition caused by placental insufficiency.

Monoamniotic Twins:
Twins who have developed in a single amniotic sac. These twins are always monozygotic.

Monochorionic Twins:
Twins who have developed in a single chorionic sac. These twins are always monozygotic.

Monozygotic (or monozygous) twins:
Twins formed from a single zygote. Commonly known as “identical twins.”

Multifetal Pregnancy Reduction:
See Fetal Reduction.

Multiple Pregnancy:
A pregnancy with more than one fetus.

Neonatal Death:
A death within the first four weeks after delivery.

Neonatal Intensive-care Unit (NICU):
Hospital unit containing special equipment for the management and care of premature and seriously ill newborns.

Oxytocin:
Hormone prescribed to stimulate contractions in order to induce or augment labor and to contract the uterus to control postpartum bleeding. Pitocin is a trademarked name for oxytocin. Oxytocin also causes contractions within the breasts which squeeze the milk down the ducts to the nipples so the baby can feed.

Placenta:
Vascular organ through which fetus receives oxygen, nutrients and antibodies to infection and excretes carbon dioxide and waste products.

Premature/Prematurity:
Delivery before 37 completed weeks of pregnancy.

Prolactin:
Milk-producing hormone released by the pituitary gland in response to a baby’s sucking.

Polyhydramnios:
Abnormal condition of pregnancy characterized by excess of amniotic fluid.

Preclampsia:
Abnormal condition of pregnancy characterized by the onset of acute hypertension after the twenty-fourth week of gestation.

Preterm:
See Premature.

Selective Fetocide:
The medical destruction of one or more fetuses in a continuing pregnancy.

Selective Reduction:
See Fetal Reduction.

Singleton:
Child born from a nonmultiple pregnancy.

Stillbirth:
A baby born at 20 weeks gestation or later, who shows no sign of life.

Superfecundation:
Conception of multiples as a result of two acts of sexual intercourse in the same menstrual cycle.

Superfetation:
Conception of multiples as a result of two acts of sexual intercourse in different menstrual cycles.

Toxemia:
Hypertensive disorder of pregnancy including presence of bacterial toxins in the bloodstream; also called preclampsia.

Trizygotic:
Fetuses formed from three separate zygotes.

Twin-to-Twin Transfusion Syndrome (TTTS):
A condition in which blood from one monozygotic twin fetus transfuses into the other fetus via blood vessels in the placenta. Can also occur among monozygotic multiples in a higher order multiple pregnancy.

VBAC:
Vaginal birth after cesarean.

Vanishing Twin Syndrome:
Unexplained loss of one multiple fetus during the first trimester, despite the survival of other(s).

Zygosity:
Describing the genetic makeup of children from a multiple birth.

Zygote:
Fertilized egg.

Occipital Plagiocephaly

Posted by Lynda Haddonon November 1, 2012September 16, 2017in First Six Weeks, Postnatal EducationLeave a comment

Two of my triplets (they are aged 8 weeks) have flat spots on one side of their heads. How did this happen? What can we do about it?

While the rate of Sudden Infant Death Syndrome (SIDS) has greatly decreased since parents and caregivers have followed recommendations to put babies to sleep on their backs (“Back to Sleep” programme), another issue has come to the fore.

Babies who lie for long periods of time in one position, can develop flat areas on their heads. It is well known that babies skull bones are very soft until about one year of age.

Further, multiple birth babies can be at a greater risk for occipital plagiocephaly (and/or torticollis) due to “stacking” in the womb, i.e. the lower baby may be engaged in the birth canal with one, two or more babies above it.

The combination of increased pressure from above that lower baby combined with gravity, can place a lot of pressure on the lower baby’s head and neck. In addition, prematurity and supine sleeping (i.e. placing a baby on its back to sleep) increase the liklihood of there being a risk of a flat spot occurring on the baby’s skull.

What is Occipital Plagiocephaly of Positional Orgin?

“Occipital Plagiocephaly” is a medical term for the flattening of one side of the back of the head, often caused by lying with the head in the same position. A flat area may develop very quickly or over several months.

Visually, your child may have one ear that is shifted forward of the other and may also have facial changes, e.g. forehead protrusion or cheek protrusion in more severe cases, on the flat side of the head.
Head Shapes (looking down from above at the top of the baby’s head)


Normal head shape		Positional plagiocephaly

What can I do if my baby(ies) has a flat area on her head?

With proper positioning encouraged by the parents, the baby’s head shape usually quickly improves on its own. When a flattening of the head is noted, or you notice that your baby(ies) has a strong preference for always turning to the same side, it is important to take some action to rectify the situation.

After discussion with and agreement by your doctor, the following are some ideas for you to try to keep the baby off of the flat side:

Make sure that your baby(ies) is placed off of the flat area at all times. This can be accomplished by placing a small, rolled up blanket under your baby’s shoulder, on the same side as the flat area. This will help keep the baby’s head turned away from the flat side. Make sure that the baby’s underside arm is out so that there is extra protection against the baby accidentally rolling on its tummy.
Babies tend to look towards the door while lying in their cribs (as they wait for a parent to appear). Move the crib often to change the view of the door. Move toys and mobiles around and away from the flat side of his head. This will encourage your baby(ies) to look towards the toys. You could also regularly change the ends of the bed when putting your baby(ies) to sleep.
When holding, feeding or carrying your baby(ies), make sure that there is no undue pressure placed on the flat side.
With the new style of baby seats that go from table to car to stroller frame, your baby(ies) can potentially end up spending long periods of time sitting in the same position thereby increasing the chances of a flat spot developing. Be aware of this danger and avoid long periods where your babies may remain sitting in the same position.
Provide your baby(ies) with lots of SUPERVISED play on their tummies. This helps build and strengthen neck, shoulder and arm muscles. Appropriate toys can be used to encourage tummy and side lying play.
Provide lots of SUPERVISED time to play in a sitting position and in an ‘exersaucer’ as soon as each baby has achieved good head control.
Pay attention to bottle-feeding. It isn’t necessary to change a baby from side to side once the spot has been noticed, but the person feeding the baby(ies) will need to make sure that there is no undue pressure placed on the flat spot. For prevention of a flat spot occurring, change your baby(ies) from side to side at each feeding.
If you notice that one or more of your babies has difficulty turning her head(s), she may require some neck stretching exercises. Consult your physician who can refer you to appropriate physiotherapists, if this is the case.
For the best results, positional therapy needs to be started before the baby(ies) is four months old.

How do flat areas occur?

Before Birth:

One or more of your multiple birth babies may be born with flat areas on their heads due to lack of space to change positions in the womb.
One multiple birth baby may be engaged in the birth canal while the other(s) is “stacked” on top, putting pressure (gravity) on the lower baby’s head and neck.

After Birth:

As newborn skulls are very soft and malleable to help ease the baby through the birth canal, it is not unusual for newborn babies to have an unusual shape to their heads, due to the pressure of birth. This will generally rectify itself by about six weeks after birth.
However, some babies show a preference for sleeping or sitting with their head turned in the same position for the majority of time.
Some babies may have the additional problem of torticollis, a neck muscle problem, that prohibits them from properly turning their head to another position.
Premature babies have softer skull bones.

Does having Positional Plagiocephaly cause problems for my child?

In the majority of cases, having a flattened area will not affect a baby’s brain growth or mental development. When the hair grows in, it will cover the flat spot and it will not be visible. However, if there are visual changes in the baby’s appearance, i.e. one ear may be shifted forward of the other one, on the same side as the flattening, this can make a difference cosmetically with perhaps reduced perceived attractiveness and there is a potential for teasing and/or rejection amongst peers.

What do we do if positioning doesn’t help?

If positioning exercises do not help, it may be necessary for your child(ren) to wear a helmet(s). Your physician will guide you, if this is the case. Each case is different and each child unique but you may count on your child(ren) needing to wear a helmet for six to eight months from when it is initially recommended.

To Sum Up

It is possible that more than one of your multiples may show signs of occipital plagiocephaly.
With routine change of baby’s head position right from birth, the problem can be prevented;
With early recognition and treatment after birth or at two to four months of age, positional therapy may be all that is required in the majority of cases;
Only in the more severe cases will the use of a helmet be indicated.

Definitions

Occipital Plagiocephaly: a one-sided occipital flattening that results in marked skull asymmetry.
Torticollis: shortening of the neck muscles on one side of the neck, making it difficult to turn the head. Rectified by stretching exercises.
Uterine Constraint; Uterine Packing; Stacking: All of these terms may be used to describe the positioning of multiple fetuses within utero. I have chosen to use ‘stacking’ in this text.

Additional Resources

Najarian, S.(1999). Infant Cranial Molding Deformation and Sleep Position: Implications for Primary Care. Journal of Pediatric Health Care, 13, 4, 173-177.
Neufeld, S. and Birkett, S. (1999). Positional plagiocephaly: A community approach to prevention and treatment. Alberta RN, 55, 1, 15-16.

Websites

www.plagiocephaly.org/about.htm

Adapted from a pamphlet prepared by: The Children’s Hospital of Eastern Ontario, Ottawa and from: “Your Baby’s Head Shape”. 1999. The Alberta Infant Cranial Remodelling Program – Stollery Children’s Health Centre (CHA) and Alberta Children’s Hospital (CHRA)

With guidance and input from Karen Dube, Nurse Practioner/APN, Ottawa, Ontario.

Possible Risks for Mom of a Multiple Birth Pregnancy

Posted by Lynda Haddonon November 1, 2012August 25, 2017in Pregnancy, Prenatal Education1 Comment

Question: I am pregnant with multiples. What are the possible risks to me carrying multiple babies?

A usual part of every young person’s fantasy is envisioning their future, future job, car, house, partner and possibly children. While the majority don’t necessarily envision having twins, triplets or more, multiple births are a definite possibility. Several factors weigh in when considering whom will have multiples: the age of the mother when she conceives (women over 35 years old are more like to spontaneously conceive multiples); if Mom already has had several children; if multiples run in your family; or if fertility assistance was used to help you get pregnant. If none of these situations describe you, consider the fact that multiples start with someone, so why not you?

A multiple birth pregnancy is automatically called “high risk”. While this term generally has a negative connotation, it is also a security blanket, so to speak, for parents expecting multiples. Mom is followed more closely, can expect more ultrasounds, blood tests, fetal monitoring, has different nutritional needs than if she was carrying one baby, can expect a greater number of visits with her doctor and may be referred to obstetrician to deliver the babies, all in the wish to ensure a happy, healthy outcome to this multiple birth pregnancy.

While any pregnant woman might experience some concerns during her pregnancy such as gestational pregnancy diabetes, anemia (water retention and subsequent swelling), vaginal bleeding, preeclampsia (rise in blood pressure, sudden weight gain, water retention) and kidney infection, there remain other possible concerns in a multiple pregnancy and the following looks at some of these possibilities. The goal is to look at each topic and to familiarize yourself with some of the warning signs. An immediate call to your doctor enables early detection of any concerns and ensures timely and appropriate treatment. They are not listed in any particular order.

NOTE: This information is not intended to replace expert medical advice. If you have any concerns about any aspect of your pregnancy, PLEASE CONSULT YOUR DOCTOR IMMEDIATELY.

While some women may experience slight bleeding within the first few days after the fertilized eggs have implanted, it can be heavier with multiples. This bleeding is completely normal and is often mistaken for a light period before the pregnancy is confirmed. More serious bleeding later in the pregnancy may signal a miscarriage. With multiples, the risk of miscarriage before the 20th week of pregnancy is slightly higher than with a singleton. There is also a slight chance that one or more of the fetuses could miscarry (see Vanishing Twin) and the pregnancy continue with the healthy delivery of the remaining baby or babies.

As compared to a singleton pregnancy, many women report increased nausea and vomiting in the initial stages of the pregnancy, as well as feeling extreme fatigue. Much of this is due to the vast amount of hormones that are raging through Mom’s body as the babies are establishing themselves. Many women state that they generally begin feeling better after the fourth month. As in a singleton pregnancy, for some women nausea can last for the duration of the pregnancy. In the third trimester, fatigue is a common complaint as is the inability “to get comfortable” and “to get a good night’s sleep”. The increased baby load and the awkwardness of the size and shape of Mom’s abdomen, makes it a fatiguing load to carry.

Incompetent Cervix

A possible reason for bleeding early in the pregnancy is a condition in which the cervix spontaneously and painlessly opens early in the pregnancy. This is believed to be the cause of many second-trimester miscarriages. When detected early enough, an incompetent cervix can be sutured closed. For a mother pregnant with multiples, early detection is essential due to the increased pressure on the pelvic floor as her babies grow. Of course the higher the number of babies she is carrying, the earlier and greater the pressure on her cervix. It is not unusual for Mom to be put on bed rest and/or be required to spend some time in a tilted bed (tredelenburg position), with the lower body elevated above the head, relieving pressure on the pelvic floor.

Placental Problems

This is the most common reason for complications and bleeding after the 20th week of pregnancy. A condition called abruptio placenta occurs when the placenta partially detaches from the uterus before delivery. This may result in some bleeding and some abdominal pain.

With placenta previa, the placenta can implant low in the uterus, partially or completely covering the cervix. Placenta previa presents as painless bleeding and because the placenta is covering the cervix, a c-section may be necessary. This situation is more common in multiple pregnancies owing to the increased number and/or size of placentas present.

Iron-deficiency Anemia

The majority of women pregnant with multiples eventually develop iron-deficiency anemia, a condition characterized by low levels or iron in the red blood cells which carry oxygen to the tissues. The risk increases with each additional baby that is carried, particularly if you had low or borderline iron reserves before becoming pregnant. Symptoms include fatigue, light-headedness, pallor and shortness of breath. If untreated, anemia can adversely affect the babies’ growth, as well as increase your own risk for complications both during the pregnancy and after the birth. Because of the risk of iron and/or folic acid deficiency, the doctor may prescribe supplements in order to ensure that deficiency will not be a problem for Mom and her babies.

Gestational Diabetes

Common in women who are over the age of 30 years, overweight or have a family history of diabetes. Expectant mothers of multiples develop this kind of gestational diabetes two or three times more often than Moms carrying singletons. Gestational diabetes will clear up after birth.

Intrauterine Growth Restriction

Multiples usually grow slower than single babies while in utero and, additionally, do not always grow at the same rate as each other. This can be a result of unequal sharing of the available maternal nutrition. Depending upon nature’s distribution of the maternal nutrition available, the babies may therefore grow at different rates. Such a discrepancy can be revealed through ultrasound and may be evident quite early in the pregnancy.

Preeclampsia

Characterized by a rapid rise in blood pressure, the presence of protein in the urine, sudden and extreme weight gain and swelling of the hands and face from fluid retention. While this condition occurs in about one out of ten singleton pregnancies, it occurs in nearly one in three multiple gestations. It typically occurs in the second half of pregnancy. Bed rest is usually the recommended treatment. Severe cases may require hospitalization and medication will be given to lower your blood pressure.

Preterm Labour

A major concern in a multiple pregnancy. This is probably the most common concern that anyone pregnant with multiples might face. Approximately 50% of twins, 90% of triplets and virtually all quadruplets are either preterm or of a low birth weight. Among infants born prematurely, nearly one in ten do not survive. Although the majority of premature babies do very well, they are at a somewhat higher risk of a variety of medical problems, some of which are lifelong. These can include hearing loss, vision problems, developmental disabilities and delays. The more premature the babies are, the more severe the complication could be: e.g. cerebral palsy. Discuss with your doctor the signs and symptoms of premature labour. Both you and your partner need to be fully aware of the signs and symptoms of premature labour as well as the appropriate course of action to take should you feel that you are experiencing preterm labour.

Extended Bed Rest

It is common, but is not always the case, for Moms expecting multiples to have to spend some time on bed rest. This can be at home, with bathroom privileges and maybe going to the table for meals, or it can be on hospital bed rest with no privileges but to stay in bed. Bed rest at home may be helpful for those families with other young children at home, but those with young children, the doctor may insist on hospital bed rest so that Mom will actually rest. Bed rest can be prescribed when there is a danger that she may go into preterm labour or if she is showing some signs of physical stress. Bed rest and subsequent monitoring of Mom and the babies, may allow the situation to calm down and when (if) things are settled after a week or so, Mom may be permitted more activity.

For Moms expecting triplets, quadruplets or quintuplets there is an increased chance that some of the time will be spent on bed rest. When bed rest is prescribed, this takes pressure off of the cervix, helps to reduce strain on your heart, improves blood flow to the kidneys, which helps to eliminate excess fluids, increases circulation to the uterus thus providing additional oxygen and nutrients to your unborn babies. Further, it minimizes blood levels of catecholamines, the stress hormones that can trigger contractions and conserves your energy so that more of what you eat goes directly to promoting the babies’ growth.

The Disadvantages of Bed Rest

Bed rest may present an increased risk of blood clots. In some cases of extended bed rest, doctors may prescribe injections of heparin, a blood thinner, to lower the risk of blood clots. Prolonged inactivity may highlight or exacerbate heartburn, constipation, leg swelling or backache. Your doctor can provide some suggestions to alleviate some of your concerns. Inactivity may decrease your appetite and as you can appreciate, this will impact on your babies’ development. An extended period of bed rest could pose some financial difficulties with the loss of an income which you can ill afford. Bed rest can be boring and even very difficult for women who are used to being active and on the go.

An extended period of bed rest may affect your muscles. One mother had a massage therapist come to the hospital a couple of times in order to help keep her muscles in shape. It can be difficult to move about properly after the babies’ birth if your muscles are even somewhat atrophied.

It is important to keep in mind why bed rest has been recommended and that the longer your babies stay in utero, the healthier they will be at delivery and the sooner they can go home with you. Bed rest is a time to read, keep a journal, speak on the phone with family and friends, knit or crochet. See the time on bed rest as a “Count Up” to a healthy birth and healthy babies. Some parents may view bed rest as a time to worry, but keep in mind that the babies are growing and this time on bed rest is important to assist them in getting the best possible start to life. Bed rest requires giving up control and allowing others to do for you. Some women have difficulty with being dependent upon others. (See Web Site Page on Bedrest for more ideas.)

Depending upon how long the pregnancy continues and the number of babies Mom is carrying, there is a spectrum of outcomes that she might, to some degree, experience:

Foot size may change after the pregnancy. As the babies grow, the continued pressure on Mom’s feet may cause a change in foot size as the foot settles to accommodate the additional weight size. A foot size change will not reverse itself after the birth.
Change in body shape. Mom’s body will probably change, i.e. thighs and upper legs will thicken to better support her expanding abdomen. This may or may not right itself with exercise after pregnancy. There will be an expansion of the rib cage. As the babies slowly develop under the rib cage, it expands and after birth, does not always return to its original shape.
Due to increased hormone changes, it is not unusual for moles that were normally flush with the skin to appear to “grow” during the pregnancy. This apparent “growth” will disappear after the pregnancy.
Hair may be luxurious and healthy during the pregnancy and then, for sometime after the birth, fall out in handfuls and/or become limp and not hold any curl. This will rectify itself over time (3-4 months) after birth. This potential hair loss is attributed to hormonal changes and can occur with any pregnancy, not just with multiples.

As the pregnancy progresses and the babies grow, keeping your balance can be a cause for concern. Mom’s enlarged and extended abdomen changes her centre of gravity and it is important to be very careful about maintaining your balance, especially when going down the stairs or when it is slippery outside. Late in my own pregnancy, on a wonderful Summer day, I turned quickly and my tummy kept going, while I did not. I landed flat on my face but did manage to get my arms around by stomach before I fell. The fact that I was laying on my arms didn’t permit me to push myself upright. Luckily it was the weekend and my husband was home. He heard my yell as I went over and rushed to help. Another Mom reported falling down the stairs at 16 weeks pregnancy as her twins were both lying to one side of her abdomen and therefore her balance centre was off. Always hold the railing when descending the stairs.

Some Moms have reported that due to positioning within the womb, a baby may lie on arteries or nerves to her lower extremities. This can be quite uncomfortable and limit Mom’s mobility until the baby moves and then the discomfort usually corrects itself.

Knowing ahead of time what might occur permits us to take quick, timely appropriate action in order to rectify the situation. While many of the above possibilities may not happen to you, it is wise to be informed and able to make the best possible decision based on your individual situation. Knowledge is power.

Bibliography

Twins, Triplets and More: Their Nature, Development and Care, by Elizabeth Bryan, London, Multiple Birth Foundation, 1995
When You’re Expecting Twins, Triplets or Quads by Dr. Barbara Luke and Tamara Eberlein, Harper Perennial, 1999
Double Duty, by Christina Baglivi Tinglof, Contemporary Books, 1998
The Art of Parenting Twins by Patricia Maxwell Malmstrom and Janet Poland, Ballantyne Books, 1999
Multiple Blessings, by Betty Rothbart, Hearst Books, 1994

Additional Resources

If you have further questions about risks during pregnancy, please visit askanob.com.

Expectant Mom Tips, Multiple Births Canada Fact Sheet
You’re Having Multiples, Multiple Births Canada Fact Sheet
Twin Care: Prenatal to Six Months, Multiple Births Canada
Finding our Way, by Triplets, Quads, Quints Association, 2001
This article was written with grateful input and assistance from:
– Dr. Elizabeth Bryan, Multiple Births Foundation, London, England
– Dr. Karen Fung Kee Fung, Ottawa, Ontario, Canada

Suggested Reading List for Parents Expecting Twins, Triplets and More!

Posted by Lynda Haddonon October 31, 2012August 25, 2017in General Prenatal Info, Pregnancy, Prenatal EducationLeave a comment

Forever Linked: A Mother’s Journey Through Twin to Twin Transfusion Syndrome, Erin Bruch, Philatory Ink, 299 pages, $14.95US, ISBN 13: 978-1-936519-02-6

Twin-to-twin transfusion syndrome (TTTS) is a disease of the placenta and can affect monozygotic (identical) babies, including within triplets or more when there are monozygotics. It has a spectrum from mild to severe and if left untreated, can result in death for one or both babies, or put in jeopardy the complete pregnancy for triplets or more.

Erin Bruch explains what TTTS is, how it can happen, the need to have the diagnosis as early as possible in a multiple-birth pregnancy, about managing it and what it feels like for the parents and families to go through, sometimes with the loss of one or both babies. In addition, 21 mothers’ stories of their twin pregnancies are followed from finding out their babies had TTTS, the worry that knowledge carried, through their births and outcomes. Bruch has included a drawing of what a TTTS placenta might look like. It is a helpful visual in understanding what is happening with the babies and why their struggle with TTTS can be a life and death matter. I also find both the cover pictures to be important visuals of what the babies go through with their unequal sharing within the womb.

If your babies have or had TTTS and if you like first hand accounts, this is definitely a must-read book.

Twice the Love, compiled and edited by Susan H. Heim, in collaboration with TWINS Magazine, 2007, ISBN 1-891846-31-0, 208 pages, $13.95 US

Includes 82 stories from families with twins and more, and in some cases singletons as well. It is well worth the read. Pick it up and open it anywhere to enjoy entertaining stories, tales, joys, challenges, and adventures that belong to families with multiples. Or if you prefer, Heim has chosen to group the stories by subject, e.g. Becoming a Family, Trials and Triumphs, Mischievous Multiples (no kidding!). You are not alone in your journey and the bonding that goes on with other families with multiples in this delightful book proves it!

It’s Twins: Parent-to-Parent Advice from Infancy Through Adolescence, Susan M. Heim, Hampton Road Publishing Co. Inc., 2007, ISBN 13: 978-1-57174-531-6, 306 Pages, $17.95 US

From the first few weeks through to 17 years, Heim covers many of the bases parents could expect to face and she doesn’t shy away from the tough discussion such as when bottle feeding is best for you and your twins. Two of my favorite Chapters addressed the advantages and disadvantages of being twins when the kids have reached adolescence. Even if you haven’t reached that stage yet, here are some thoughts for you to prepare yourselves. Another nice touch is each section has Points to Ponder with writing space for the reader to address those topics which are pertinent to them.

I liked that this book addresses the whole spectrum of raising multiples and did not just focus on the early weeks, months and years. Birthday party planning is important as is encouraging them to play with others, but so is dominancy, disabilities, when they mature at different rates, college – together or separate? and my favorite certainly as expressed to me by other parents with monozygotic (identical) multiples, the Old “Switcheroo.”

I found this book uplifting, informative, thoughtful and I wasn’t beyond laughing out loud at some points from understanding and having “been there, done that.”

Emotionally Healthy Twins: A new philosophy for parenting two unique children, by Joan A. Friedman, Ph.D., 2008, Da Capo Press Books, soft cover, 245 pages.

I am SO excited about this book! There, that’s off my chest. For anyone expecting or raising multiples, this book needs to be on their recommended reading list! There are several very good books which focus on the early (and intense) years of raising multiples. Friedman’s book addresses the early years’ challenges and explores the parenting scenario beyond, into the multiples’ young adult years and does so with insight and personal knowledge.

As someone working with multiples and their families for over 2 decades, I was pleased to note that Friedman encourages parents to look beyond their multiples’ unique bond and to focus as well on what makes them individuals. Every child, even if they arrive more than one at a time, needs and deserves the chance to discover his or her unique potential, and have ample opportunities to nourish and develop their individualities. Parents set the tone in their multiples’ development and Friedman asks them to honestly evaluate their contribution to encouraging their twins to become self-sufficient. Friedman provides several examples of twins whom have flourished within their “twinship” but floundered or were impeded when they needed to separate from each other. Her messages are some that every parent raising multiples needs to hear.

Friedman is a twin herself and has twin sons and 3 singletons, so she has many support bases covered. This book is an important addition to the reading resources for anyone raising their multiples.

Womb Mates: A Modern Guide to Fertility and Twinning, by Gary D. Steinman, and Christina Verni, 2007, Baffin Books Publishing, 121 pages, soft cover

Any couple looking into infertility treatments to assist them in getting pregnant would benefit from reading this book before they begin their treatments. It thoroughly sets the stage for such families to understand the chances of them conceiving at least twins, how that might happen and the many possible ramifications. Dr. Steinman describes, in easy to understand language, how twinning occurs (the controllable and uncontrollable factors) and explores such topics as the risks of a multiple-birth pregnancy for the mother and babies and the different types of infertility assistance. Important issues for prospective parents to consider.

Healthcare and related professionals, researchers as well as some parents could get a lot out of this book. In other words, this book is very technical. I don’t think that it would be as valuable to parents who desire to learn how to get their babies on the same schedule or how to deal with sleep deprivation, for example. For most parents looking for ideas and answers in handling their new families, this is not a book I would recommend.

Nevertheless, this book belongs on the shelf of anyone involved with teaching multiple-birth prenatal classes, doulas, midwives, lactation consultants and those wanting to better understand how to better meet the needs of their clientele.

One and the Same: My Life as an Identical Twin and What I’ve Learned About Everyone’s Struggle to Be Singular, by Abigail Pogrebin, Double Day, 2009, hardcover, 275 pages, $26.95 US; $33.00 Cdn.

I’ve read a lot of books about multiples, and this one I could not put down. It is one thing to raise multiples and address the unique challenges, joys and pleasures of doing same, but quite another to be a multiple. In her research, Pogrebin has not only drawn on her experiences and journey with her monozygotic sister, but interviewed a plethora of well-known experts in the field of multiples (many of them being multiples themselves) as well as speaking with many sets of multiples across the U.S. In addition she attended the International Society of Twins Studies Conference in Belgium to gather more data and attended the annual Conference of Twins held in Twinsburg, Ohio. As most of us in-the-know are aware, this Conference is a melting pot for multiples from all over the world.
What follows is a riveting, entertaining, informative, insightful and educational journey which is MUST read not only for multiples themselves, but also for the parents who love them. Pogrebin presents the many nuances of being a multiple, some complicated, some simple, how multiples are “entangled” and how both parties will usually attempt to seek individuality within their multipleship and when (e.g. marriage). And some can’t see themselves apart, even for a moment. In addition, she explores the unique circumstances around when one dies and what that event can mean for the survivor.

I could not put this book down, really. For anyone involved with multiples in any form, this book is definitely the crème de la crème!

Blender Baby Food, Nicole Young and Nadine Day, 2005, Robert Rose Inc., 189 Pages, $19.95 Cdn., $18.95 US, softcover

For parents wishing to make their own baby foods or wishing to have some fun choices to offer toddlers, this book is a must have! It is broken down from when babies need to begin solid foods through 12 months and older and includes suggested meal plans for each age. There are 125 delicious recipes included for babies beginning solids, with hints and tips in the margins on how to “upgrade” each recipe for older children.

The authors begin with steps on how to recognize when your babies are ready to begin solids, address food consistency at each age and stage, answer safety with food issues (such as with eggs), choking hazards, storing, freezing and thawing prepared foods and offer a list of the equipment you can expect to use when preparing your own baby food. There is even a section covering salt, sugars and The Picky Eater. It couldn’t be easier.
Another great point – it’s a Canadian book!

The no-cry potty training solution: gentle ways to help your child say good-bye to diapers, Elizabeth Pantley, McGraw Hill, 2007, 174 pages, softcover, $12.95 US, $16.95 Cdn.

Here are two goals which can bring joy to a parent’s heart: “sleeping through the night” and “toilet trained.” For the latter, Elizbeth Pantley has scored again with her newest book on potty training. It isn’t unheard of for parents to find themselves in unpleasant, close enocunters of the potty-training kind when trying to train their toddlers. It doesn’t have to be so and Pantley gives us suggestions, not the least of which is to recognize the signs of each child’s readiness to be trained. If they are not physically ready and able, training can quickly move to a battle of wills, with no winners insight.

Right at the beginning, Pantley sets out a Readiness Quizz so that we know what signs of readiness to look for in our children. She addresses topics such as keeping it natural, making it a game, getting to the bathroom quickly (kids tend to leave it to the last second and when they say they “need to go,” time is of the essence), bathroom safety, how to teach your child to wipe properly and wash their hands afterwards.

There is a chapter on bed-wetting which is extremely helpful. Bed-wetting is more common with boys and during the night, the kidneys may not be sending appropriate messages to the brain to signal the need to go and/or the bladder is not fully developed enough to go through the night. Bed-wetting can sporadically last for years, or not. She provides constructive ways to handle bed-wetting and to help keep your child dry, without them losing their self-esteem in the process. Pantley even includes some suggestions for toilet training children with special needs.

While her book focuses on training singleton toddlers, there reference about training twins and more. She gives us notice that our children may not be ready to train at the same time – and haven’t we heard that before in other contexts! – and reminds us not to compare them regarding successes and failures – yet another common theme for parents with multiples. Each child having their own potty ensures that when the time is right, there will be no waiting in line for a turn and perhaps subsequent accidents.

While toilet training is long-past with my own children, I really appreciated Pantley’s easy writing style, identifying the challenges and offering suggestions, and positive approach to a topic which can be a challenge for parents as well as toddlers. She takes the pain out of it all for everyone and if your children are nearly ready to toilet train, this is one book you don’t want to miss reading.

Your Premature Baby: the first five years, by Nikki Bradford, 2003, Firefly Books, 208 pages, $19.95

An excellent Canadian book offering detailed information regarding your premature baby. Why does premature birth happen?; What can you do?; how a premature baby may behave (looking at the body language of a premature baby), how the hospital can help, bringing them home, and feeding a premature baby are some of the topics covered in detail. The photographs of these special babies are simply fabulous. This book would be a great resource for those with a premature baby.

Expecting, twins, triplets, and more: a doctor’s guide to a healthy and happy multiple pregnancy, by Rachel Franklin, M.D., M.O.M.* (*Mother of Multiples), 2005, St. Martin’s Griffin, N.Y., 221 pages, $14.95 U.S.; $21.95 Canadian, ISBN 0-312-32823-0

Read my full review of this book

Dr. Franklin has a light-hearted, easy to understand writing style, generously laced with humour. Her book takes you through each stage of the pregnancy. She includes Chapters on learning the news “…and What To Do About It”, she addresses issues you might expect to face in each trimester of your pregnancy, focusing on nutrition, exercise, and preparing for the babies. .

Mothering Multiples: Breastfeeding Twins, Triplets or More by Karen Kerkhoff Gromada from La Leche League

Covers every possible breastfeeding topic, with good photos and is very encouraging to breastfeeding mothers. Lots of other topics of interest to multiple birth parents.

Raising Multiple Birth Children – A Parent’s Survival Guide, by William and Sheila Laut, 1999

I haven’t yet read this book by parents of triplets but it has come highly recommended to me. Includes practical tips for getting organized, baby gear you will need, coping with sleep deprivation (I like it already!), gift ideas, funny stories (we can always use those) and more!

When You’re Expecting Twins, Triplets or Quads by Dr. Barbara Luke and Tamara Eberlein, 1999, Harper Perennial

Twins From Conception to Five Years by Averil Clegg and Anne Woolett, 1983, First Ballantine Books

Multiple Blessings by Betty Rothbart, 1994, Hearst Books

The Art of Parenting Twins by Patricia Maxwell Malmstrom and Janet Poland, 1999, Ballantine Books

Finding our Way: life with triplets, quadruplets and quintuplets, Web Com Canada 2001

Double Duty, by Christina Baglivi Tinglof, 1998, Contemporary Books

The Joy of Twins and other multiple births by Pamela Patrick Novotny, 1994, Crown Trade Paperbacks

Twins: Pregnancy, Birth and the First Year of Life by Connie L. Agnew, Alan H. Klein and Jill Alison Ganon, 1997, Harper Perennial

Twins, Triplets and More, by Elizabeth M. Bryan, St. Martin’s Press, N.Y.

New Father Book by Wade F. Horn and Jeffrey Rosenberg, 1998, Better Homes and Gardens Books

Feeding Your Baby the Healthiest Foods by Louise Lambert-Lagace, 2000, Stoddart Publishing

The No-Cry Discipline Solution, Elizabeth Pantley, due for release: June, 2007, McGraw Hill, softcover, 235 pages, Expected price $16.95US

Elizabeth Pantley has, thankfully, added another book to her “No-Cry” series. This latest one offers discipline solutions for toddlers and children, aged 2 to 8 years. All types of potentially difficult situatons are covered such as bedtimes, tantrums, not brushing teeth, hitting, bitting, meal times, inappropriate language use and more. She covers not only what the child might be feeling but also the parent’s feelings. A very helpful section looks at anger, what it means, possible triggers and how our own anger can affect the situation and sometimes make things worse. Pantley offers useful suggestions on keeping one’s own emotions in check, turning the situation around with distracting methods (make a song out of what you want done, use humour) and offers appropriate consequences when or if necessary.

My favorite section has to be Part 4: Specific Solutions for Everyday Problems.

When my girls were small (twins and a singleton 22 months their elder), I just didn’t have time to read psycyologically-based, drawn-out solutions for situations which generally had one child, one adult and the general message “follow this advice and all will be well.” Yeah right! Not in my house where the parents were outnumbered by little ones feeding off of each other’s behaviour. I needed quick, helpful, supportive feedback with several possible suggestions to consider in turning things around. Flying by the seat of your pants and/or “learning as you go” doesn’t always equal good parenting skills.

Pantley clearly and concisely states a situation, for example Sibling Fights. Each begins with a story from a frustrated parent. Pantley asks us to Think About It (in this case Sibling Fights) and addresses what such fights can mean for the child. She then offers step by step ideas on What to Do and, perhaps more importantly,What Not to Do. Pantley cross-references to other areas of the book for additional suggestions. In this case, Biting Other Children; Bossiness, Hitting, Kicking and Hair Pulling; Playtime Behaviour. Most topics are covered in two pages, making it quick and simple to grab the book (topics are alphabetically listed), peruse the appropriate area, absorb some techniques and get back to the home situation, all in a timely fashion. That’s my kinda guide!

If you have kids aged 2-8 years, this book is a must have. I hope that Pantley will soon add a “No-Cry Discipline” focused on preteens and teens.

NOTE: Don’t just limit yourself to books on multiples. There are some wonderful books on babies out there and here are a few examples:

What to Expect When you are Expecting
Dr. Spock’s Book – describes childhood diseases and incubation periods
The Mother of All Pregnancy Books, by Ann Douglas – an all-Canadian guide
Secrets of the Baby Whisperer, by Tracy Hogg with Melinda Blau

DVD Reviews

Fascinating DVD regarding conception and gestational journey of Twins, Triplets and Quads. A must view for parents, grandparents, researchers, healthcare professionals and any one else with an interest in multiples.

Check it out at: http://www.rocketrights.tv/womb/multiples.php?
PHPSESSID=15b23a92713177aa2c4be1065cfc2eb4

Your Babies’ Journey: Twins, Triplets, Quads, approx. 100 minutes

This amazing DVD out of the UK will no doubt be very well received not only by parents (and grandparents) expecting multiples but also by the healthcare professionals who look after them. The photography, graphics and sonagrams lets the viewer into the womb to watch the babies’ growth, development and interactions. It’s breathtaking and I was glued to the screen throughout. I found myself jettisoned back to my own pregnancy and was thrilled to observe what our girls were doing prior to their delivery. This fascintating documentary is an important and enlightened resource for anyone with an interest in multiple-births.

If I were to comment on anything, two little things stood out: l) Society often refers to vaginal birth as “natural birth.” Does that make a necessary c-section an “unnatural birth?” I think not. A “natural birth” is, in truth, any birth that ensures a healthy Mom and baby(ies), and that includes a c-section. Many families whom need to have a c-section feel guilty about having to do so and by changing our vernacular, we could make a positive difference. And 2) I would have liked to have heard more direct references to the fathers and their roles. Two parents are ideal in any parenting situation and this is partiacularly true in the case of multiples. Dad, an important part of the parenting equation, is almost completely absent from this otherwise stunning DVD.

Adult Multiples

Posted by Lynda Haddonon August 31, 2012August 25, 2017in Photo GalleriesLeave a comment

Growing up as a twin, triplet or higher order multiple can be a special, rewarding, and unique journey. There are likely many experiences you share that are unlike those of singleton siblings. You have probably also faced some interesting challenges along the way.

While reading each other’s stories can be exceedingly eye-opening and informative, a welcome alternative is photo sharing. Photo sharing is a great way to connect with other adult multiples.

Take a look at our collection of photographs featuring adult multiples.

Vintage Multiples

Posted by Lynda Haddonon August 31, 2012August 25, 2017in Photo GalleriesLeave a comment

Check out our collection of Vintage Multiples!

Vanishing Twin and Multifetal Pregnancy Reduction: New Reproductive Technologies, New Losses

Posted by Lynda Haddonon August 30, 2012August 25, 2017in Lynda Weighs In, Pregnancy, Prenatal EducationLeave a comment

There are two types of losses which, in my opinion, are often overlooked, not only by family and friends, but also by many professionals, including medical practitioners, therapists and grief counsellors. Those two losses are Vanishing Twin and Multifetal Pregnancy Reduction.

For reasons which can be understood, although debated, one can see why they might be marginalized (it’s an early loss…, “you hadn’t yet had time to bond with your child(ren)” or “at least you still have one [two]”). However judging by the number of e-mails I receive from families with questions, disbelief, concerns and aching hearts, I think, as a society, we need to take a hard and long look at how we are supporting (or seemingly not supporting) families experiencing such losses.

Vanishing Twin (VT) is a surprisingly common situation, certainly judging by how many questions I receive (it’s the most hit-on article on my site). Even as a young girl, I can remember a couple of my Mom’s women friends saying something like, “It’s the strangest thing; I’ve been bleeding but the doctor tells me I’m still pregnant.” In hindsight and prior to the advent of ultrasound, I bet some of these women experienced VT. Not knowing that they did might indeed be their story, and they continued on with their lives, thankful for their healthy baby.

In the messages I receive, parents narrate their stories, desperately looking for hope regarding the empty sac and asking “over time will there be a baby in it?” Then there is the worry about the effect of VT on the health of the remaining embryo(s). Because ultrasounds are regularly performed at 5-8 weeks, we learn very early that we are pregnant and with how many. Hence, to learn by 10-12 weeks the situation has changed dramatically is devastating to many families. Doctors, ultrasound technicians, grief counsellors, friends, family all need to realize that the loss of these much-wanted children is two-fold: first there is the loss of a baby, and then there is the loss of unique parenting experience. Passing off an early loss as “at least you still have one” is not the way to comfort anyone and only adds to the confusion and disappointment these parents feel while also depriving them of a right to safely talk about their feelings.

Multifetal Pregnancy Reduction (MFPR) is very complicated and in a recent 10-day period, I was contacted by six families facing reduction or who had just gone through it and were comfortable with their decision, and one who deeply regretted the decision and felt pressured to reduce or chance losing the whole pregnancy. Here too, anyone coming in contact with families facing reduction needs to be in tune with the emotional strain, possibly lasting a life time, of having to decide to reduce. Yes, a reduction offers a better chance to having healthy survivors; yes, a reduction improves the physical stress on the mother, and yes the brain tells us a reduction makes rational sense in so many instances. None of this can be repudiated, but it isn’t just the brain making this decision; the heart is very much involved too and will not be ignored. The heart is already in love with the babies within and wants desperately to believe that the pregnancy will continue to deliver healthy 3, 4 or 5 infants.

In some cases, it will and things work out, and sometimes things don’t work out so well for one or more of the babies. There is the emotional strain of the decision: Am I a killer of my baby(ies)? How will I ever tell the others? When do I tell them? Do I tell them? My babies are already bonded in utero, how will a reduction affect the survivors? All difficult questions and parents need informed guidance and support in finding solutions which will work for them.

MFPR is not a topic that can be easily discussed with family or friends. The decision is usually made by the parents in conjunction with professionals and peer strangers who are located on the internet (e.g. other families experiencing or looking at reduction, caring support people and organizations who guide them along the rocky path). Parents can feel very isolated, frightened and alone in making a decision which bears such significant and life altering impact. If the discussion to reduce does include family members or friends, then it is no longer a “secret” and telling the kiddies of their origins takes on a new urgency so that parents have control over how and when the children are told.

There are no easy answers but one thing is for sure and that is these grieving families need society’s support, comfort, and understanding in a non-judgmental way. They are mourning their losses and like any grieving individual, deserve a safe place to do so, with caring people all around them who do not minimize or de-legitimize their loss. It is the least we can do.

By Lynda P. Haddon, Article copyrighted.

Multiple Births Canada
www.multiplebirthscanada.org

Multiples are Individuals Too

Posted by Lynda Haddonon August 30, 2012August 25, 2017in Lynda Weighs In, Postnatal EducationLeave a comment

In 2007 Oprah had a show focusing on multiples. There was a delightful family with sextuplets who shared the challenges of raising six babies at one time. The family was obviously full of love and delight with their family, yet they also provided honest feedback on the difficulties and exhaustion they faced with their unique family. They have two older children to add to the mix.

Oprah also interviewed 28-year old triplet men whom had an interesting background and achievements whose father died unexpectedly when they were 10 years old. They have two older brothers and their mother raised her five sons on a teacher’s salary after their father died. She focused on three places her children should always be: at home, in school or in church. Get this: all five sons are lawyers and achieved top of their class marks, not only in high school but university as well! It is thrilling to hear of the achievements of this special and unique family, under challenging circumstances.

So here’s my but. One cannot take away from this single mother’s love and devotion to her children, especially under extenuating circumstances. And the love of the sons (one older brother and the mother were also present) towards their mother was very evident. So what was bothering me? It took me a little while to figure it out.

Parenting multiples is a challenge. With two or more babies arriving at once and struggling to meet their needs, it is difficult to find time for one-on-one and let alone learn the unique characteristics, desires and interests of each child as an individual. Some of us have other children too, making quality individual time all the more difficult to schedule.

What stood out for me was that at age 28, these young men are a unit. As they explained, they were always in the same class, graduated high school top of the class, two were Valdictorians. They admitted that they were never sports minded. They went to the same university, all taking Law, in the same classes and graduating top of their class. They were pleased to note that they try to meet three times a week for lunch. They were dressed in spiffy suits, looking very similar, and while two were wearing black shoes, one was wearing brown. I was excited to see this obvious bit of individuality. No one spoke of dating, girlfriends or wives.

I’m not trying to tell people how to live or even make a judgment regarding their choices but in this particular case, I was left feeling sad about the lack of any expressed individuality (beyond shoe colour) of these three bright men. I believe that part of a parent’s responsibility, and particularly those of us with multiples, is to honour their birth bond while encouraging and nurturing individuality. Such balance is essential to a child’s well-being. I was left with the impression that the men and their relationship as it stood, precluded their need or desire to look outside their relationship for any other relationship comfort or connection. In other words, they received all of their connection and safety within their own relationship and hence had no need to look elsewhere. I admit I do not know this family other than what was portrayed on the show.

As can happen with multiples and the media, this “unit” of 3 persons was celebrated and acclaimed, I felt not as much on the merit of their individual achievements, but primarily on their merits as being triplets. This is dicey because what they have each achieved is something any parent would be proud of, yet once again, the public has not appreciated these multiples as individuals but mainly as triplets. Because they have been continually presented as a package to the public, it is their “package” that has been celebrated rather than whom they are as individuals. I believe they were recognized firstly as triplets rather than bright, capable, highly achieving individuals. I also believe that parents call the shots on how their children are perceived. It is the responsibility of the parents, or parent, to encourage their multiples in every aspect of their lives, including the nurturing of their individuality.

One of the beauties of having multiples is the factor of built-in playmates, something quite different from raising a singleton child when parents actively seek community situations where their singleton can learn to socialize, share and take turns. The failure to encourage our multiples to reach outside of their unique situation and embrace something else, be it activities, interests or individual friends, robs them of a chance to learn to live and adapt to the world outside of their relationship. Parents needs to be aware and take appropriate steps that each of their multiples is given a chance to shine alone. If not, they can be robbed of an opportunity to grow and develop as individuals, and that would be such a shame.

April, 2007