Occipital Plagiocephaly

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.

occipital-plagiocephaly-helmetBabies 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)

original head shape positional plagiocephaly
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

  1. It is possible that more than one of your multiples may show signs of occipital plagiocephaly.
  2. With routine change of baby’s head position right from birth, the problem can be prevented;
  3. 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;
  4. 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

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.

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

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.

Loss of a child in utero

After two and a half years of trying, in April 2002, we conceived twins through IVF/ICSI. I had moderate OHSS* so the first month or so took a bit of a toll but we were so excited to be having twins. I had some mild bleeding at 5 & 6 weeks but the doctors believed this was associated to the progesterone I was taking as part of the IVF treatment. At 7.5 weeks it was confirmed that we were having twins.

At 13 weeks we had a nuchal translucency scan** as we did not want to have an amniocentesis (which were advised to do due to my age – 35 yrs). The reason for not wanting the amnio was we did not want risk losing the babies. Twin A had a great measurement of less than 1mm but Twin B had a measurement of 3.2mm, and this situation combined with my age, showed a high risk for chromosomal abnormalities. Even after this news we decided not to do an amnio and that we would look to Level II ultrasound for tentative diagnosis.At 16 weeks we had another scan and it seemed that Twin B had Hypoplastic Left Heart Syndrome, a situation where the left side of the heart does not develop. At 19 weeks, we had another scan and this diagnosis was confirmed. It was also determined that Twin A was a girl – Catherine, and Twin B was a boy – Marcus.

At 22 weeks we went in for a fetal echocardiogram followed by an appointment with the Pediatric Cardiologist. Unfortunately Marcus had died between my OB appointment the week before and the scan. We were aware that there was a high chance that Marcus could die in utero but you have to hope. Three days later I was admitted to hospital and put on bedrest due to a disease I have called adenomyosis. This is like endometriosis but it is only in the uterine muscle and during pregnancy it can cause severe pain when the uterus grows, plus the uterus is enlarged. They did a transvaginal ultrasound 3 days later and found my cervix had shortened and was only 1cm long Consequently, I was put on full bedrest. At 24 weeks, Marcus’ water broke and I was put on intravenous antibiotics. At 25 wks, 2 days I went into premature labour due to a uterine infection, from Marcus’ water breaking. At 12.29am the next morning, just squeaking into the next day, Catherine was born followed by Marcus at 12.30am. Catherine was intubated and taken to the NICU, though not before we heard a couple of little cries from her.

In recovery the hospital staff brought Marcus to us and we had the Chaplain name and Bless our precious little Angel. Afterwards we held him and said goodbye. This is something that meant so much. I needed to hold my much wanted little boy, as did my husband. The nurses took photos of us with Marcus plus photos of just Marcus, as well as little footprints. These were given to us in a beautiful memory box along with the clothing that he had worn. The hospital also gave us a beautiful urn in a box with Raphael angels on. We had Marucs cremated and put his ashes into this beautiful urn. Next Spring we will scatter his ashes on a small island that we love. The pain is always there but I believe that Marcu is watching over his sister and giving her strength to survive being such an early baby.

My advice for those who endured such a loss would be remember that your baby is yours and if you want to hold and see him/her you make enough noise until they bring him (them) to you. Be prepared for the fact that they may not look like the beautiful baby you want them to, but the most important thing is to say goodbye. I miss being pregnant as while I was pregnant I still had my son with me. But all things must come to end and we must move on. I hope that you are able to find strength if you are going through a stillbirth or birth loss. Just remember it does get better. I believe I am lucky to have had Marcus with me for 22 weeks and to still have her sister to love and hold. We will raise her to know about her special twin brother.

Gina in Canada

*Ovarian Hyperstimulation Syndrome (OHSS): is a side effect that can occur during infertility treament with ovulation inducing drugs. In these cases, the ovaries are very sensititve for these drugs and respond with growth of multiple follicles. Symptoms of this syndrome may include ovarian enlargement, accumultion of fluid in the abdomen and gastrointestinal disorders (nausea, vomiting, diarrhoea). Severe cases of PHSS are however very rate (1-2%). In case of multiple follicular growth there is also a risk of multiple pregnancy and sexual intercourse is therefore prohibited. OHSS can be very painful because of the swollen ovaries. (Source: www.ferti.net/library/faq/tretment-5.asp)

**Nuchal translucency scan (NTS): is the swelling just under the skin at the back of the fetal neck. It is important because if the fetus has a greater-than-normal amount of swelling at the back of the neck, there is a high likelihood that the baby will have Down Syndrome or a major heart problem or both. For greater detail on NTS, please visit www.obgynsono.com/nt.html.

One Extraordinary Birth (Six Days of Labor, 33 hours between births, two healthy babies)

Part I: Once Upon A Choice

It wasn’t that I set out to be an enthusiastic proponent of homebirth.  As a matter of fact, I hadn’t thought much about what kind of a birth experience I would like to have until I got pregnant.  Somehow when I found out that I was carrying a baby (or what turned out to be two babies in my case), it became clear that it was my greatest desire to allow these children to enter the world in the most sacred, peaceful, loving way that I could imagine.  The more people gasped in disbelief of the possibility of having a natural home birth with twins, the more I wanted this experience to be the first gift I gave to my children.  This is my tale of the miraculous labor and highly unusual births of my twin boy and girl, Zaanti and Miela.

When I was 6 months pregnant we relocated to Southern California and I began looking for prenatal medical care there.  Most women have already chosen their doctor and figured out a birth plan by then, so I was a little concerned about being able to find the right prenatal care.  Moreover, I had been reading books about birthing written by midwives, yoga teachers and psychologists and was really considering having a homebirth with a midwife.  In the stories about homebirths the women went through amazing vision quests, discovering their own strength and softness and molding into the divine feminine.  I wanted one of those experiences where I came to a seemingly insurmountable mountain, scaled it, and then I did it again and again.  I wanted to bond with my partner Francis and feel the primordial creative force coming through us as we journeyed together with our babies through the transition from the unseen world into the material world. And I wanted to feel everything, yes, everything…the joy, the fear, the pain…. I wanted to feel what millions of women have gone through since time began.  And nowhere in this vision of mine did I see bright lights, hospital gowns, being hooked up to an IV and immobilized, being told what to do and when to do it, etc…

I faced resistance from some friends and acquaintances after sharing with them my desire of giving birth at home, so I stopped talking about it except with a few select friends who were supportive and encouraging. Francis and I had to put aside the naysayers’ words about the impossibility of a vaginal delivery, the hopelessness of finding a midwife when I was seven months pregnant, of birthing drug free, etc.

Miraculously, I found a wonderful OB/GYN who agreed to do my prenatal appointments and be a backup doctor for my homebirth.  Now I just needed to find a midwife willing and capable of safely delivering my precious twins at home.  This proved to be no small feat, but where there is a will, there is a way.  After speaking with a dozen doulas (birth assistants) and midwives, writing emails to every Southern California birthing center, and talking to anyone and everyone who knew anything about giving birth naturally, I finally found an amazing midwife who has delivered 14 sets of twins and over 500 singleton births.  We drove 3 hours to meet with Brenda and at that first appointment I knew that I found the person who I trusted enough to be the first one to touch my babies.  She was mama earth embodied: nurturing, grounded and serene.  Moreover, being a midwife is truly her calling: she is passionate about giving women like me a choice in how we brought our children into the world.  After weeks of searching for a midwife, I knew she was the one we’ve been looking for!

I was so grateful and relieved to have all the birth plans finalized.  At 36 weeks, we went in for a routine appointment with the doctor found out that Zaanti (Baby A – the first one in position to come out) was footling breech and Miela (Baby B) was vertex.  She said that she no longer felt comfortable being a backup doctor for a homebirth and strongly suggested that I schedule a C-section at 38 weeks.  My heart tightened. My throat narrowed.  I felt as if I was breathing through a tiny straw, getting just enough air to get by.  Tears welled up and I told myself to be composed enough to thank the OB/GYN for her opinion, tell her we’ll think about it and go process this news at home.

As soon as we left the office, I became hysterical, and Francis had to physically hold on to me so that I didn’t fall.  This news was so sudden and so directly opposite of the birth experience we had been wanting that it was difficult to digest.  It was at this time that I worked through and accepted that what I can control is setting a clear intention of following my own Wisdom; the rest was out of my control so I needed to surrender to the events as they unfolded.  Whether it was a C-section or a vaginal birth, I wanted it to be conscious and with a conscience.  Francis and I decided to gather some more opinions before we chose to either schedule a C-section, plan for a hospital delivery after going into labor or continue with our intent to birth at home.

I have spent almost a decade practicing and teaching yoga, meditated for countless hours, participated in a 10-day silent meditation retreat, but nothing even came close to what happened in the week after that last OB/GYN appointment.  I entered a period of the most intense spiritual living so far in my life.   I meditated, prayed, journaled, spoke with every ‘expert’ I could on the topic, and even consulted with a psychic.  But mostly I listened.  Not to the outside, but to the inside.  I closed my eyes wide open to the internal compass leading to a birth that honored me, Francis and the babies.

When I spoke with our midwife about the news, she didn’t seem concerned.  Brenda had delivered many breech babies, even breech twins and two footling breeches.  In the spirit of full disclosure she told me that she had one footling breech baby that died, but after the coroner’s report came out it was clear that it had nothing to do with the positioning of the baby during the birth.  I asked Brenda if she would need extra assistance during the birth or if this latest development changed anything.  She said no, that I can always have an extra midwife or doula, but that is not necessary and is up to me.  I felt reassured and comforted by her confidence that nothing is out of the ordinary in the babies’ positioning.  If I had no physical symptoms and if I  put all my trust in the Source of Life within me, I knew all will be well with the homebirth.

I connected with a gynecologist who has been practicing for 42 years and he told me that before they started using ultrasounds routinely they delivered babies in all kinds of positions, and doctors back in the day knew how to deliver healthy babies in a variety of presentations.  He was not concerned about the footling breech position, but mentioned that with twins it was usually the second twin that had difficulties.  He suggested that I wait to go into spontaneous labor and then bring my midwife to the hospital to help with the delivery. I also emailed a doctor who is a vocal supporter of midwives and he wrote back a very caring email saying that even though he felt the birth may be safe, his knowledge of western medicine and liability reasons mandated him to advise me to birth in a hospital, probably through a scheduled c-section.

One of the midwives I spoke with told me that if she were having twins, she would trust Brenda above anyone and everyone she knew and that as long as Brenda, Francis and I felt comfortable still proceeding with a homebirth, then there is no reason not to.  She explained to me in detail that a baby who had a foot sticking out can tuck it back in at any moment and vice versa.  And since babies change position all the time, it is more likely that I would have a breech than a footling breech baby.  What shocked me is that my gynecologist didn’t explain that to me.  She seemed to think that if Baby A was footling breech now, he may be footling breech in two weeks when she wanted to schedule a C-section.  If it is possible that the babies may still shift position, why would I have my babies cut out of me two weeks early?  Hmmm, my internal compass was starting to really lean in the direction of the homebirth.

What sealed the deal in our decision was speaking with a psychic.  I never felt the desire to speak to a clairvoyant before, but I wanted to explore all of my options so I spoke with her for about half an hour.  She exclaimed: “No wonder you intuitively feel like you don’t want to go to the hospital!  I have a vision of you having more complications than usual and being totally unconscious in a hospital setting”   Whoa, that sent a chill down my spine.  Who wants to be unconscious while you have two newborns wanting to be held by their mommy?  On the other hand, who wants to lose a baby?  I asked her if she saw me losing a baby or having complications if I were to birth at home.  She said that one of the babies might take a few moments to find its breath, but that besides that she saw two healthy happy babies.  I cried when she said that. It is not that I thought she could see the future, but her words really resonated with me.  I was (and still am) willing to go through any lengths to have healthy and happy babies.  To me, that meant staying away from unnecessary interventions and allowing the animal in me to give birth in a natural and instinctual way.  I believe that homebirth is not for everyone, but so is the case with hospital births.  I would love to see our culture moving in the direction of having lots of birthing options easily available so that a woman could choose the option that feels safest for her.

Ultimately, Francis and I had a heart to heart and, being the amazing partner he is, he said that he trusted whatever decision I felt was best, but that he felt most comfortable with a homebirth with Brenda.  We agreed that we would try everything in our power to turn Zaanti (baby A) around and barring any health complications we wanted to labor at home.  I saw a chiropractor who performed the Webster technique to help turn Zaanti vertex.  A couple of days later I saw an acupuncturist for the same purpose.  The night after my acupuncture appointment there was so much movement in my lower abdomen that could have signaled Zaanti turning down.  For better or for worse, I never had a chance to confirm what position he was in for sure because I went into labor the next day.  Either way, all of my contemplative practices clearly pointed me in the direction of keeping the initial plan of homebirth, while still covering all bases by pre-registering at a local hospital in case I needed to go there.

Part II: Zaanti’s Birth

On Monday of my 39th week of pregnancy, my water broke.  I was so excited I could hardly talk when I called Francis and told him to hurry home. Then I called the midwife and told her to hurry because I thought I may deliver the babies before she had time to make the 3 hour drive. After all, my mom’s labors were both very quick.  Well, Brenda arrived and my contractions were still mild at best.  I had called my mom in the Bay area after my water broke and told her that I will call her when the babies have arrived.  However, my mom was so excited that she left work and drove straight to Southern California.  After she arrived, my labor slowed down so much it was almost non-existent.  Brenda said: “Babies come at their own time” so I just needed to be patient and to let nature do its job.

Tuesday came and went and Brenda stayed with us to monitor me.  I was taking lots of Vitamin C and Echinacea in order to prevent any infection since that is a concern after the water breaks.  The babies heart-beats were both great and it seemed that Zaanti was making his way down.  So Brenda, Francis and I prayed, meditated, waited, and waited and waited.  By Tuesday evening I knew something was off and I spoke to a therapist in Germany named Kim.  She is a friend’s therapist and as many people in my life, she appeared at the perfect time and was a vital resource for me during labor.   Kim told me what I knew in my heart was the truth: having my mom there slowed down my labor because I was focusing on my mom and picking up her nervous energy and therefore I wasn’t directing my attention to tuning into my body and communicating with the babies and.   Francis and I agreed that we needed to get my mom out of the house and I was nervous about asking her to leave.  However, I was a mother now, and my unborn children needed me to place their needs (and my own) above my mother’s.  This was one of the lessons I learned: now I had my own primary family to take care of and therefore everyone else needed to take care of themselves.   Francis managed to explain to my mom that we love her and understand why she would worry about me and the babies, but this was not what we needed in the house.  My mom was wonderful and understood that the best way that she could help me now was to go to a local hotel and hope for the best.

After she left on Wednesday afternoon, my contractions got steadily stronger and by Thursday afternoon I was in full active labor. It has been such a journey to get the opportunity to labor at home that I hadn’t even thought about what it would actually be like to go through contractions without any pain medication.  I was so grateful to feel every contraction and every movement in my body, but I certainly reached a point when I was starting to doubt if I could do this.  After about 14 hours of active labor, I told Francis and the midwife that I wasn’t sure I was cut out for this birthing thing.  I knew from my Bradley (husband-coached birth) classes about transition phase and it was pretty obvious that I was at that place of total doubt, and feeling terrified that there is no point of return: these babies had to come out one way or another! Francis kept reminding me how strong I was and how this was going to pass. Brenda prayed over me and assured me that I am no different than any other woman and that I can do this. They trusted in me and that helped me trust in myself.

By midnight I was almost fully dilated.  I had been in the kiddie pool Francis set up in the bedroom and needed to go to the bathroom.  When I was on the toilet I finally felt the urge to push.  I was enjoying pushing in that position, but Brenda asked me to lie down so she could have access to our breech firstborn.  I lay down on the floor and immediately the pain became unbearable.  The only thing better than feeling the doubling-over pain of the contractions was the doubling-over pain of pushing.  After a few pushes Brenda said: “Reach down and feel your son’s balls.”  This got me laughing and as I reached down I could feel teeny tiny little testicles.  I thought to myself: “This is one ballsy guy!”  After another push, Zaanti’s butt came out and Brenda adjusted him so that he would slide out in the next couple of pushes.  I felt so much trust in Brenda and in the holiness of the moment, I never felt any doubt that Zaanti would come out perfectly healthy.  Finally I gave one last push and Zaanti’s head came out.  After a total of 21 hours of sacred, pain-transcending, mountain-moving, roaring labor Zaanti was born at 1:45 a.m. on September 17th, weighing 5lbs 6 oz.

Brenda put him on my chest and I was in awe of his tiny face.  His eyes were wide open and he looked me right in the eyes.  The Love-Joy-Ecstasy I felt in that moment was indescribable…  Then he lifted his eyes up and looked right in Francis’s eyes.  Brenda said that in her 20+ years of catching babies she has never seen a baby make direct eye contact on the day of his/her birth.  At that moment, I could palpably feel how special this boy was.   I was instantly bonded to this tiny creature and felt as if Francis, Zaanti and I were moving in an ecstatic dance, looking at each other in turns, feeling our bodies close, breathing deeply and syncing the beat of our hearts.

This is the time when most women relax and enjoy the time with their baby.  I had one more in me though!  Thank goodness my friend Susie flew out from San Francisco and arrived a few minutes after Zaanti’s birth.  She is a mother of two who gave birth at home and was a tremendous support for me during the pregnancy and labor.  It was her therapist in Germany that has been helping me.   As much as I wanted to keep cuddling with Zaanti, I let Susie care for him and just bring him in for feeding and cuddles.  I knew I had to focus on my little girl Miela coming out.  The thought of going through another skin-ripping delivery was frightening.  But I knew that if I could do it once, I could do it twice.

Part III: Miela’s Birth

As soon as Zaanti came out, my attention split into two places and has remained that way since.  One part of me was with Zaanti and the other with the unborn fetus in my belly.  I kept checking in, wondering if contractions will start again.  A few minutes passed after the first birth and nothing.  I kept holding Zaanti and now another 10 minutes passed.  I got cold so I climbed into bed.  At this point it has probably been about 30 minutes and I asked Brenda if she could check me again and see what was going on.  Miela’s heartbeat was steady and strong; I was dilated about 8cm, but had no contractions.  I ate an enormous meal that was waiting for me and started to feel incredibly tired.  It was already around 4am so Brenda suggested that I sleep a little and call her when the contractions recommenced.  Francis and I cuddled up together and slept a few hours.  I woke up a bit anxious for Miela to come out, but I was still strongly feeling a divine presence around me and felt very connected to my Inner Wisdom.

I took a walk, kept putting Zaanti on to nurse, ate, prayed, meditated and waited.  It was tough for me to wait and allow the process to unfold.  That was certainly one of the major gifts that these births have brought me – learning patience and allowing things to take the time they need.  I ended up speaking with Kim in Germany again and she put me in an amazing frame of mind, welcoming this journey just as it was and connecting with Miela and asking her what she needed from me.  It was very clear that there are two of us going through this birth and Miela had just as much of a role as I did.  And this girly girl was so comfortable in the womb that she was in no rush to come out!  At a certain point in the afternoon Brenda discovered that Miela had decided to play around since she had so much room – this lady went transverse (sideways) on me!  This was the one and only time I had a hint of panic.  I knew that transverse babies could not be delivered vaginally and I certainly did not feel that I had come so far just to have a c-section with the second birth.  I turned within and searched for an intuitive guidance, and it became clear that I needed to use my resources and try everything I can to turn Miela around and give birth to her at home, unless there was any danger and we needed to rush to the hospital.

Having problems gives us the opportunity to experience the joy of coming to a solution.  As I again connected with Kim in Germany, I instantly felt that I tapped into Spirit through her.  She asked me to have Brenda check Miela’s heartbeat, estimate her positioning and find out if one of the placentas was blocking the cervix.  Indeed that seemed to be the case.  Then Brenda left the room and Kim guided me into a sort of trance.  I entered a hyper awake state, completely lucid, but surreal.  Kim and I worked together to connect with Miela, to encourage her to turn head down.  I did certain hand movements over my belly and visualized what I wanted to happen.  I imagined Miela and me together arranging the perfect space for her to turn and come out easily and effortlessly.  I was in such a place of trust, felt so present, so aware of the physical and non-physical, that I may as well have been high.  I’ve always said that I’m not interested in drugs because I am high on life and this time I was really living it!

And it worked!  When Brenda came back in the room about 30 minutes later it was game on – the placenta had moved out of the cervical opening and Miela was in a vertex position and making her way down!  I was still dilated 6-7cm.  Apparently Brenda could feel contractions happening, but I couldn’t really feel them.  Whew, what a difference from the day before with Zaanti’s excruciating labor.  Like this, I could give birth all day long!

A few hours passed and Zaanti finally started breastfeeding.  Evening turned into night and my contractions started getting stronger.  In the early morning on Saturday, the contractions kept growing, but Miela was still not descending enough to push so I asked Brenda to break my water.  I was getting tired and I was ready to stop walking around with the cord to Zaanti’s placenta sticking out a few inches between my legs. But most importantly, I wanted to hold both of my babies safely in my arms and kiss the bejesus out of them.  So Brenda did the one and only intervention during the entire birth process.   Around 9am she used some kind of a midwife tool to break my water.  Within minutes my contractions got real strong, real fast.  All of a sudden I remembered what it was like to have waves of pain come crashing over, but this time I knew how to relax into the sensations, allowing them to wash over me instead of fighting them.  And it helped that I was too exhausted to even care about the discomfort!  Soon, I felt the urge to push and after only a few pushes, Miela was born at 10:45am, 33 hours after her much older twin brother. She weighed 6lbs 6oz, a whole pound heavier than her brother, even though they were the same length.  Healthy, pink, chubby baby was squirming and screaming in my arms.  My heart was overflowing with so much love for this amazing creature who taught me so much already.  That’s when I finally released more fully than I ever thought possible.  I cried out in intelligible howls, holding Miela tightly to my heart, shaking and wailing.  I did it!  WE DID IT!  My children were both here.  They were healthy, beautiful and with all their parts in place.  We were at home.  I was in MY bed.  I was a champion!  I felt such a flood of emotions come over me that I think only Francis understood what I was saying because he was also floating in the Love-Joy-Beauty that surrounded us.   I’ve had an evolving spiritual relationship with God/Spirit/Source, but at that moment it was clear: I was touching the Unnamed and it was holding all of us in its divine bliss.

The last thing left to do was birth the placentas.  Once they came out I intended to encapsulate them and take them for hormonal balance, nutrients and milk production.  Brenda checked the placentas and came to the bed exclaiming: “Zaanti is a miracle baby!”  It turns out that he had a huge blood clot between his placenta and cord.  That was why he wanted to come out early and it also explained why he was a pound less than Miela.  This boy was so smart to break his water and signal to me that he needed to get out.  Luckily, the blood clot did not affect him adversely as both of the babies had high Apgar scores.   Miela, on the other hand, was as comfortable as could be and was in no rush to leave the womb.  I already knew that they are their own people, with different personalities, but now I tangibly felt how unique they each are.  And they’ve got separate birthdays to prove it!

Part IV: Happily Ever After

This miraculous birth passage certainly would not have been possible without all the amazing people who came to support us during this time.  Although there were many that did not believe in our endeavor, the ones that trusted us showered us with their love and faith.   I am so grateful for our lay midwife Brenda Capps who went above and beyond the call of duty by staying with us the whole six days and monitoring me and the babies closely the entire time.  She is truly an earth angel!  I am also incredibly grateful to the therapist in Germany, Kim Hutchinson, who was an inspirational and transformative guide for me during this birth.  My friend Susie Small was also instrumental in our experience and to her I am forever indebted. Moreover, countless friends and family members were keeping us in their prayers and wishing us well.  I am certain that their positive thoughts tremendously helped us in our birth journey and for that I am eternally grateful.

In the end, this unbelievable birth experience taught me so many wonderful lessons and has been the gift that keeps on giving.  I learned to allow things to blossom at their own pace; just as an apple seed will take its own sweet time to become an apple tree.  Patience was never a virtue of mine, and I used to think that sitting back was being idle.  Now I feel that while it is essential to hold a strong intention, it is just as important to relax and enjoy the journey while it meanders.  I now recognize more clearly that I am not in control and that I don’t need to try to fix things or figure them out all the time.  I have grown to appreciate uncertainty and trust that the old proverb about everything happening for a reason really is true.

Another wonderful lesson has been to discover that there was a well of knowledge within me that was richer than any outside source.  Had I relinquished my internal compass to experts, I would have had a very different birth experience. Had I ended up in the hospital, there were at least three instances during my labors that would have resulted in a C-section.  Moreover, I would not have had the opportunity to build confidence in my intuition and my ability to manifest things that seem virtually impossible.  It is amazing to live life recognizing that there is a sage inside of me and being able to communicate with this wisdom.  I now viscerally feel an internal guidance that helps me make decisions, both big and small.  I am convinced that everyone has their own guru inside and if they take the time to listen and then find the courage to follow this guide, they will be living a life of truly limitless and unimaginable proportions.  If I can create this kind of a birth, what else can I create in my life?  Truly, all things are possible – for me and for you!

The victory I felt as a result of this extraordinary birth experience was incredible… and necessary… because now I needed to manage breastfeeding and caring for these two angels.  That is another story within itself that I will share with you another time.  All you need to know is that we are still breastfeeding 9 months later and are all healthy and thriving!

A day in the life of a mother of twins

Hi everyone, hope you are all doing well! Since I never have time to talk on the phone anymore, here’s a long update email. I can’t believe I’m telling you that our babies are already two months old – amazing. They are doing just great. Brandon is now wearing 3-6 month clothing for the most part, and Cara is starting to fit nicely into her 0-3 month clothes. Brandon is approx. 10.5lbs and Cara is approx. 9.5lbs. Although their weights aren’t much different, Brandon is thinner and longer which means he needs bigger sizes.

We are hoping to get some portraits taken this week (could be an interesting juggling act!) and the babies will be having their first vaccinations on Monday. We are very thankful that we did manage to find a wonderful pediatrician who agreed to take us on – poor guy had no idea what he was getting into!. (Not sure if it’s the case in Newfoundland/Labrador, but here it’s very hard to find doctors taking new patients – almost impossible.)

Cara is now starting to really focus on things around the nursery and she often holds our fingers and sometimes grabs our clothes while we feed her. Brandon is still our lively boy who just desperately needs food the minute his eyes open. He is always looking for the next source of food and I had a good laugh yesterday when he was lying next to Cara in her crib and he managed to latch onto her cheek! She got a slurpy kiss that she wasn’t expecting!! He did a sweet little cooing noise and grinned at a picture on the wall that Aunt Barbara made this morning – his first coo! Cara is getting more smiley all the time, and thankfully she continues to be patient and relaxed. She really enjoys the swing.

Yesterday Keith and I managed to get out for breakfast and get through the entire meal with both babies sleeping. Woo hoo! Babies get tons of attention when we are out. At first this was thrilling for me, but already I find myself sometimes pulling down the sun shades on their stroller so that we can get in and out of stores without too many people stopping us.

Since Grandma and Poppy left last weekend, we’ve hired a nanny named Tiffany to help me out during the day. She’s a part-time university student. She’s really nice and is great at helping out whenever and wherever needed – she seems to be enjoying getting to know the babies and dogs. I must admit that although I first thought I could easily do this myself, I really appreciate the second set of hands and being able to run a few errands during the day that would otherwise have to be done when Keith’s at home.

That’s all for now- Cara’s waking up and Brandon is asleep on my chest… so time to do another switcheroo!

Tracy

Delayed Speech or Autism?

Hi my name is Laurie. My husband is a twin and I am a twin. He has a twin sister and I had a twin sister who died 5 days after birth. Neither my husband nor I are monozygotic twins. We have dizygotic twin boys who are very different. One is more talkative and the other is very laid back.

A pediatrician recently said that there was a possibility that the laid back twin may be autistic. We are in a speech play group to help him with his words. It has been a wonderful experience and we feel that he doesn’t have autism but rather speech delay, as his brother has always been the one to ask for things and lead the way. Austin (the talker & and first born) will ask for a cookie and Colton (the laid back one) will automatically get one as well. Because he doesn’t have to ask for it, he doesn’t get to practice his verbal skills.

Colton is doing much better now we realize how to assist him with his verbal skills and he will continue to improve. My husband (David) and I have decided not to send Colton to be assessed. We feel that if there are problems, that a few months more of waiting and encouraging him will not hurt him. The Speech Pathologist feels that we are doing everything we need to be doing and in her professional opinion, if he is Autistic, it is a very mild case.

I would love to chat with other mothers in the same position. The boys turned two years old in April of 2002. I can’t stress enough how important a schedule is with newborn twins. Please e-mail me at ajpcdw@msn.com.

Laurie, Fort Frances, Ontario