Potty training… Now or later?  My husband and I agreed to delay answering that dreaded question until we heard from the experts.  Marriage and family therapist Nonie Bradley and certified parent educator Sherry Ittner, parents themselves, team-teach parenting classes in Southern California, including one on potty training, which they break down into six helpful steps.  And with potty training, as with much in the lives of twins, it’s two steps forward and one step back.

1)  Readiness

Each child is unique in this process.  “A key element,” Ittner says, “is bladder control: Is your child having longer intervals between diaper changes?”  Typically, girls show readiness between the ages of 2 and 2 ½ and boys by the age of 3.  That was the experience for Diane Aiken, of Encinitas, California, mother of boy/girl twins.  “My daughter had bladder control right away.” Aiken says, “But my son is taking a little longer.”  While the readiness of your child is primary, parental readiness should not be overlooked.  Aiken agrees, “One morning I woke up and decided I was ready to start the potty training process and we began.”

Bradley stressed the importance to parents of “owning their feelings” towards potty training because children are highly intuitive and often reflect their parents’ feelings.  “Get real clear on your attitudes before starting the next step, preparing,” Bradley cautions.

2)  Preparing

The preparing stage can start as early as 18-months because you are simply introducing the idea of using a potty.  Shop around and purchase a potty but, as Ittner suggests, “Introduce the potty gradually by letting your child explore.  Ask them if they want to sit on the potty, but if they say ‘no’, quit.  You and your child are still becoming comfortable with the idea and preparing for the next phase.

“At 18-months, a child learns through observation and imitating others, so parents and siblings are encouraged to model the behavior,” Ittner explains.

“Blake and Brent were much more interested in standing and going potty like their big brother than using the smaller potty,” says Shawn Homan, mother of fraternal twin boys in Oceanside, California. Twins can also model behavior for each other.  They see their twin use the potty and don’t want to be left out, so they try, too.  “The time involved in potty training twins,” Homan admits, “wasn’t cut in half, but it was much easier.”

3)  Step By Step

Even after preparing the groundwork, parents tend to fall into the trap of questioning their children.  “Do you want to stop wearing diapers?”  Instead, Joanna Cole, in her book Parents Book of Toilet Teaching, advocates making positive statements such as, “We think you are ready to stop wearing diapers and start using the potty.”

As with preparing your children and letting them explore the potty, underpants should also be gradually introduced.  It is important not to rush the process.  Set a date with your children and make positive statements.  Tell them:  “We are going to go shopping for some new underpants.”

“Include your child.” Cole recommends.  “Let them select their underpants.”  Also, be sure to buy underpants that are big enough to pull up and down easily.  Your twins will need about a dozen pairs each—in preparation for accidents.  After your twins select their underpants, don’t hide the new pants in a drawer.  Let your twins admire themselves in the mirror with their new underpants.

Kelly O’Connell of Seal Beach, California, recalls: “It was a big deal going to buy big boy underpants and big girl panties for my triplets.”  O’Connell laughs as she recalls, “The excitement didn’t end at the store—they showed them off to everyone!”

Next, lead them to the potty.  Use a positive statement, such as “Remember, you’re not wearing diapers now, so you’ll have to use the potty.”

As we discussed, however, you can lead a child to the potty but you can’t make him go.  Bradley recommends that parents relax and not panic.  Be ready for accidents and remind your child of the potty for the “next time.”

4)  Night Dryness

“Night dryness” develops later in most children because they are still working on control during the day.  Until your child has fewer daytime accidents and has developed greater bladder control, use a diaper for naptime and during the night.

Eventually, when your child is ready for a diaper-free night, prepare yourself.  Double-sheet the bed, avoid any drinks for your child one hour prior to bedtime and leave the potty in an accessible area.

5)  Learning Period

Potty training can be frustrating for parents because they are learning new techniques to teach their child, according to Bradley and Ittner.  From showing them how to pull down pants to friendly reminders like, “Let’s go potty.” Potty training is an entirely new arena for most parents.  Accordingly, Bradley advises that accidents will happen, with minor setbacks and periods of regression for the child and parent.

6)  Parental Attitudes and Behaviors

Bradley and Ittner stress the acceptance of feelings.  “Frustration or perfectionism,” Bradley says, “are feelings you wouldn’t want to transmit to your child.”

Parents and children are learning and developing new skills with each other.  Bradley reminds everyone, “Be gentle with yourself and your child.” Whether the topic is positive discipline or potty training, Bradley and Ittner encourage “firm and kind” parenting.  “Be kind out of respect for our children and firm out of respect for ourselves,” Bradley explains.

When a problem arises between parents on the “how-to-potty” approach, Bradley encourages parents to privately discuss the matter away from the children.  One approach is to use a code word that signals to your partner the need to talk.  One couple in one of their potty training classes offered their code word of “Bob” which stood for “Back off Buddy,” when a potty training issue arose. Most of the couples reported that jointly they form the “firm and kind” parenting approach, but individually each parent tended to be closer to one spectrum than sharing both characteristics.  While one tended to be firm, the other leaned towards being kind.

Bradley acknowledged the gifts both types of parenting offer.  A “firm” parent brings the gift of structure and boundaries and a “kind” parent bring the gift of love and patience.  Children need both these gifts.  “Create the balance of structure and boundaries, within an atmosphere of love and patience, and the children will thrive,” Bradley stated.

Since attending this class, my husband and I have been able to turn the question, “Potty train now or potty train later? Into a positive statement…  “We think now is the time and, in the team approach to potty training, unity works.”

Mary Billiter Thomas lives in Oceanside, California with her husband and identical twin boys.

The post Six Steps to Potty Training Your Pair appeared first on TWINS Magazine.

Breastfeeding twins is an incredible way to ensure your twins health and can be done.

There it was again–another look of disbelief. Melinda’s confidence dipped a little lower with each look or thoughtless remark: “You’re not going to nurse twins, are you?” or “You’ll have your hands full enough without nursing.” Already exhausted from a lack of sleep–it was hard to get comfortable at night–Melinda was especially vulnerable to negative remarks. Melinda’s concerns–sleep and milk–are not unlike those of thousands of other mothers who eventually find nursing twins one of the most rewarding experiences of their lives. In the beginning, however, the reality–sleep, milk production, emotions and a dramatic change in lifestyle–can be overwhelming.

“When I was breastfeeding my twins, I felt like I had my shirt off 24 hours a day,” recalled Jean Dosdos, a breastfeeding support volunteer through the West Palm Beach Mothers of Twins Club in West Palm Beach, Fla. “I know how frustrating it can be for new moms of twins, and that’s why I volunteer. I know it’s a tremendous help to have that support and encouragement. Otherwise, new moms would quit trying after two or three weeks.”

The Proper Technique for Breastfeeding Twins

Breastfeding Twins is simply a skill you must learn to do correctly.

As soon as your twins are born, you will want to have a Lactation Consultant come in to your hospital room. She will show you how to properly hold each twin, position his or her mouth around your nipple and latch properly onto your breast.

The first steps to successfully nursing twins are to seek out supportive family, friends and an encouraging Pediatrician; get accurate information; and turn a deaf ear to negative remarks.

Talk to other mothers who are nursing twins a couple of months older than yours. Join a Mothers of Twins club and attend La Leche League meetings before your delivery.

Carol Huotari, accredited La Leche League leader and an international board certified lactation consultant, said that commitment is essential to successfully breastfeeding twins. “A migratory field worker pumped her milk three times a day in the bus and the other workers laughed at her, but her commitment was strong and her twins were the healthy ones who didn’t have ear infections.”

Set Goals to Ensure You Will Be Successful at Breastfeeding Your Twins

“Are you going to nurse exclusively for six months? A working mother may supplement with bottles. Think it through and decide what will work in your life,” Huotari advised. Success is defined differently for every mother.

Be Patient with Yourself While You are Learning How to Breastfeed Your Twins

While still in the hospital, talk to a Lactation Consultant about your goals, concerns and lifestyle.

Ask that she be there when you first nurse and ask for a home visit if you have preemies.

Contact your local Lactation Consultant Organization to schedule home visits.

The Lactation Consultant in the hospital will guide you through the first sessions.

These are the learning times for you and your twins. Your newborn twins are trying to latch on and you are establishing your milk supply.

“With twins in the football hold position, you can really watch what they are doing with their mouth,” Huotari explained. As they grow you may find more comfortable positions.

Preemies may take a little longer to latch on since their sucking instinct may not be fully developed. In that case, you may need to pump your breasts to get the milk flowing.

You Will Have Enough Milk to Breastfeed Your Twins

When your twins latch on well and nurse effectively, your milk supply will quickly build.

It is a case of demand and supply. The greater the demand, the more milk you supply. Expect to nurse your newborn twins about 10 to 12 times in a 24-hour period.

Until your twins learn to latch on, it may be a good idea to nurse them one at a time.

“It really helps mothers to individualize their twins and see who’s who. Each baby has a different nursing style,” Huotari said.

Know Which Twin Nursed When and on Which Breast

Whether you continue to nurse them individually or simultaneously, you do it you need to be organized about it. Keeping track of who nursed first and at which breast helps you know how they are feeding.

Each of the twins might have different appetite and sucking behavior.

Therefore, alternate which twin feeds from each breast with every feeding. A great way to remember which twin fed from each breast is to wear a simple bracelet or hairtie on your wrist. Assign the hairtie to Twin A. After you have completed breastfeeding your twins, move the hairtie to the other wrist. This will tell you that Twin A should feed from that breast during the next feeding.

“I breastfed my 30-month-old triplets, Sammy, Hope and Emma. One of the three is still breastfeeding, one weaned at 13 months, the other at 24 months,” said Sheri Ingalls of Port St. Lucie, Fla.

“To keep my milk supply up, I nursed the babies on demand through the night. It also alleviated some of my concern over the babies getting enough to eat. During the day, the babies had to be on a schedule so that I could ensure that each one had the opportunity to be first–which was the easiest let-down–and last, which was the longest time on Mommy. If I allowed them to nurse on demand all the time, Hope would have nursed all day and left the smaller ones with nothing.”

Sleep When Your Twins Sleep

Allison Berryhill of Atlantic, Iowa, found nighttime nursing to be a way of life during her twin boys’ most milk-dependent months. “With newborns, I reclined in a pillow-piled Lay-Z-Boy, each boy to a breast, attached for the night. I did not get long, uninterrupted hours of slumber, but I was no more sleep-deprived than during the final months of pregnancy when few positions were comfortable.”

Sleep becomes the top priority–after establishing your milk supply and feeding your twins.

The rule for mothers of twins is sleep when your twins sleep.

You’ll get more rest if you can learn to nurse lying down in bed and if you set up a comfortable “nursing station” for the days.

Whether it is a Lay-Z-Boy or a comfortable sofa, you need room to prop plenty of pillows and a footstool for your feet. On a table within easy reach have a telephone, diapers, a notepad for jotting down who nursed first and where, and a snack and a beverage.

A well-arranged nursing station means you won’t have to hop up once you’re settled and you will be more rested.

You Must Take Care of Yourself Before You Can Care for Your Twins

If you become fatigued your ability to keep a positive outlook while coping with the ups and downs of nursing twins diminishes.

You must take care of yourself first.

That means sleeping as much as possible, eating right and drinking plenty of fluids each day.

The number one piece of advice new mothers of twins offer expectant mothers is to get help with the household chores and cooking.

But housework may have to wait. Cooking is something others do for you.

Only you can nurse your twins.

Sleep deprivation and neglecting your basic care just opens the door to depression.

About 10% of women have postpartum depression the first year, but with mothers of twins the figure jumps to 25%, according to Huotari. When you are home and alone with your babies, you can quickly feel isolated and overwhelmed.

Be sure you have a friend to talk with, one who understands the special demands of multiples.

Don’t Give Up

Regardless of how much support you have and how well you prepare mentally, the reality of your new job can be an emotional seesaw and the adjustment definitely takes time.

Huotari offered some sage advice: If you feel like giving up, stick with what you’re doing for three days and then see how you feel. Remember, tens of thousands of nursing mothers say joy does come out of the early chaos.

Sheri summed up: “Don’t listen to other people, not even doctors, when they tell you it can’t be done. You can make enough milk. You can get some sleep. You can have a life! Don’t give up if it’s tough at first, because after your babies are bigger and getting more milk in a shorter period of time, it’s a breeze.”

BREASTFEEDING FAQs

How can I tell if my twins are nursing effectively?

Most newborns breastfeed 10 to 12 times per 24-hour period. They nurse for 15 to 30 minutes at a feeding and swallow after every one or two sucks. A baby who is having difficulty getting enough to eat will not latch on properly, may want to nurse inordinately long and will not swallow often.

How do I know if my babies are getting enough to eat?

After the first couple of days, they saturate six to eight diapers per day and have from three to five bowel movements.

With multiples, it is helpful to keep notes on who nursed at which breast, for how long, and the number of wet and soiled diapers. An electronic scale help your confidence.

Once your milk and their weight gain are established, tracking the nursing schedules and diapers is not essential.

Why are my twins suddenly starving all day and night?

Growth spurts occur periodically; the first may come as early as 10 to 14 days after birth. The next one may surface around four to six weeks and another one around three months.

Prop your feet up and nurse, nurse, nurse on demand. Your milk supply will quickly catch up with your twins’ needs. If, however, you respond with supplemental bottles, your milk supply may not increase to meet the rising demand.

Can I nurse my preemies in the NICU?

Babies develop the ability to swallow when they are 11 to 16 weeks in utero.

The ability to suck follows a few weeks later. The ability to coordinate both actions and breathing comes later still. If your babies are very low birth weight, you may have to express your breast.

Expect to pump for a total of 100 to 120 minutes a day. The NICU will watch for signs that your preemies are ready for nutritive sucking.

The post Breastfeeding Twins: It Can Be Done! appeared first on TWINS Magazine.

“When I was breastfeeding my twins, I felt like I had my shirt off 24 hours a day,” recalled Jean Dosdos, a breastfeeding support volunteer through the West Palm Beach Mothers of Twins Club in West Palm Beach, Fla. “I know how frustrating it can be for new moms of twins, and that’s why I volunteer. I know it’s a tremendous help to have that support and encouragement. Otherwise, new moms would quit trying after two or three weeks.”

Find support
The first steps to successfully nursing twins are to seek out supportive family, friends and an encouraging pediatrician; get accurate information; and turn a deaf ear to negative remarks. Talk to other mothers who are nursing twins a couple of months older than yours. Join a Mothers of Twins club and attend La Leche League meetings before your delivery. A lactation consultant can administer a healthy dose of facts and the wisdom of experience.

Carol Huotari, accredited La Leche League leader and an international board certified lactation consultant, said that commitment is essential to successfully breastfeeding twins. “A migratory field worker pumped her milk three times a day in the bus and the other workers laughed at her, but her commitment was strong and her twins were the healthy ones who didn’t have ear infections.”

Set goals
Knowing your goals is part of the commitment. “Are you going to nurse exclusively for six months? A working mother may supplement with bottles. Think it through and decide what will work in your life,” Huotari advised. Success is defined differently for every mother.

It takes time to learn
While still in the hospital, talk to your lactation consultant about your goals, concerns and lifestyle. Ask that she be there when you first nurse and ask for a home visit if you have preemies. She will guide you through the first sessions; they are the learning times for you and your babies. Your newborns are trying to latch on and you are establishing your milk supply. “With twins in the football hold position, you can really watch what they are doing with their mouth,” Huotari explained. As they grow you may find more comfortable positions.

Preemies may take a little longer to latch on since their sucking instinct may not be fully developed. In that case, you may need to pump your breasts to get the milk flowing.

You will have milk
When your twins latch on well and nurse effectively, your milk supply will quickly build. It is a case of demand and supply. The greater the demand, the more milk you supply. Expect to nurse your newborn twins about 10 to 12 times in a 24-hour period.

Until your twins learn to latch on, it may be a good idea to nurse them one at a time. “It really helps mothers to individualize their twins and see who’s who. Each baby has a different nursing style,” Huotari said.

Know who nurses when and where
Whether you continue to nurse them individually or simultaneously, you do it you need to be organized about it. Keeping track of who nursed first and at which breast helps you know how they are feeding.

“I breastfed my 30-month-old triplets, Sammy, Hope and Emma. One of the three is still breastfeeding, one weaned at 13 months, the other at 24 months,” said Sheri Ingalls of Port St. Lucie, Fla. “To keep my milk supply up, I nursed the babies on demand through the night. It also alleviated some of my concerns over the babies getting enough to eat. During the day, the babies had to be on a schedule so that I could ensure that each one had the opportunity to be first–which was the easiest let-down–and last, which was the longest time on Mommy. If I allowed them to nurse on demand all the time, Hope would have nursed all day and left the smaller ones with nothing.”

Sleep when your twins sleep
Allison Berryhill of Atlantic, Iowa, found nighttime nursing to be a way of life during her twin boys’ most milk-dependent months. “With newborns, I reclined in a pillow-piled Lay-Z-Boy, each boy to a breast, attached for the night. I did not get long, uninterrupted hours of slumber, but I was no more sleep-deprived than during the final months of pregnancy when few positions were comfortable.”

Sleep becomes the top priority–after establishing your milk supply and feeding your twins. The rule for mothers of twins is to sleep when your twins sleep.

You’ll get more rest if you can learn to nurse lying down in bed and if you set up a comfortable “nursing station” for the days. Whether it is a Lay-Z-Boy or a comfortable sofa, you need room to prop plenty of pillows and a footstool for your feet. On a table within easy reach have a telephone, diapers, a notepad for jotting down who nursed first and where, and a snack and a beverage. A well-arranged nursing station means you won’t have to hop up once you’re settled and you will be more rested.

Nurture yourself
If you become fatigued your ability to keep a positive outlook while coping with the ups and downs of nursing twins diminishes. You must take care of yourself. That means sleeping as much as possible, eating right, and drinking quarts of fluids each day.

The number one piece of advice new mothers of twins offer expectant mothers is to get help with the household chores and cooking.

But housework may have to wait. Cooking is something others do for you. Only you can nurse your twins.

Sleep deprivation and neglecting your basic care just opens the door to depression. About 10% of women have postpartum depression the first year, but with mothers of twins the figure jumps to 25%, according to Huotari. When you are home and alone with your babies, you can quickly feel isolated and overwhelmed. Be sure you have a friend to talk with, one who understands the special demands of multiples.

Don’t give up
Regardless of how much support you have and how well you prepare mentally, the reality of your new job can be an emotional seesaw and the adjustment definitely takes time. Huotari offered some sage advice: If you feel like giving up, stick with what you’re doing for three days and then see how you feel. Remember, tens of thousands of nursing mothers say joy does come out of the early chaos.

Sheri summed up: “Don’t listen to other people, not even doctors when they tell you it can’t be done. You can make enough milk. You can get some sleep. You can have a life! Don’t give up if it’s tough at first, because after your babies are bigger and getting more milk in a shorter period of time, it’s a breeze.”

BREASTFEEDING FAQs
How can I tell if my twins are nursing effectively?
Most newborns breastfeed 10 to 12 times per 24-hour period. They nurse for 15 to 30 minutes at a feeding and swallow after every one or two sucks. A baby who is having difficulty getting enough to eat will not latch on properly may want to nurse inordinately long and will not swallow often.

How do I know if my babies are getting enough to eat?
After the first couple of days, they saturate six to eight diapers per day and have from three to five bowel movements. With multiples, it is helpful to keep notes on who nursed at which breast, for how long, and the number of wet and soiled diapers. An electronic scale helps your confidence. Once your milk and their weight gain are established, tracking the nursing schedules and diapers is not essential.

Why are my twins suddenly starving all day and night?
Growth spurts occur periodically; the first may come as early as 10 to 14 days after birth. The next one may surface around four to six weeks and another one around three months. Prop your feet up and nurse, nurse, nurse on demand. Your milk supply will quickly catch up with your twins’ needs. If, however, you respond with supplemental bottles, your milk supply may not increase to meet the rising demand.

Can I nurse my preemies in the NICU?
Babies develop the ability to swallow when they are 11 to 16 weeks in utero. The ability to suck follows a few weeks later. The ability to coordinate both actions and breathing comes later still. If your babies are very low birth weight, you may have to express your breast. Expect to pump for a total of 100 to 120 minutes a day. The NICU will watch for signs that your preemies are ready for nutritive sucking.

The post How to Succeed in Nursing Multiples appeared first on TWINS Magazine.

Sherene Silverberg, a marketing consultant, who lives with her husband, Marc, in Norfolk, Virginia, was thrilled to learn one August that she was pregnant for the first time and carrying twins.

Then the stories started.

“It seemed every person I met insisted on telling me a horror story about twin pregnancy, about someone they knew who had a long bed rest, terrible complications, or a premature delivery,” says Silverberg. “I became very fearful that my babies would end up in the neonatal intensive care nursery.”

In fact, multiples are often born prematurely (before 37 weeks’ gestation). “For every additional baby inside the womb, you can deduct three and a half weeks off of your due date,” says Dr. John Elliott, director of maternal-fetal medicine at Good Samaritan Hospital and a partner with Phoenix Perinatal Associates, in Phoenix, Arizona. Twins typically arrive at 36-1?2 weeks, triplets at 33 weeks.

Babies born prematurely are at risk for medical and developmental problems, but “the majority of babies who are born between 34 and 37 weeks have fewer and milder problems,” Dr. Elliott says.

Besides premature birth, “any complication that can happen with a singleton is two times as likely to happen with twins,” says Dr. Elliott. Of primary concern is preterm labor. Mothers carrying multiples are also at increased risk for preeclampsia (high blood pressure that only occurs during pregnancy). Twins are at higher risk for birth defects, too.

The Power of Positive Thinking

Though these statistics are disheartening for mothers-to-be, like Silverberg, Dr. Elliott and other perinatal health experts say there is much a woman can do to increase her chances of delivering healthy babies. One of the most important of these is having a positive attitude: “If you tell a woman that she is not going to succeed, it can negatively affect the outcome,” says Dr. Elliott. “But if you give a woman confidence that she will succeed, you’ll see better results.”

A case in point is Silverberg’s experience. “Hearing those awful stories and reading books about all the bad things that could happen during my pregnancy really messed up my mind,” she says. At sixteen weeks, Silverberg began experiencing mild contractions, which she believes were caused by all the worry and stress. She began seeing a therapist, who helped her focus on the positive and less on the negative, and the contractions stopped.

Silverberg continues to keep her spirits up throughout her days in waiting by listening to relaxation tapes and meditating several times each day. You can also keep a diary of your pregnancy progress, or a journal of your feelings. To stay upbeat, some women practice saying frequent positive affirmations, such as “My babies will arrive healthy and strong.”

Deciding on a Doctor

Finding the right doctor is critical. “Women carrying multiples need to make sure their pregnancy is being treated as a multiple pregnancy, not a singleton pregnancy, and that their practitioner is aware of the special issues concerning multiples,” says Dr. Gila Leiter, assistant clinical professor at Mt. Sinai School of Medicine, in New York City, and author of Everything You Need to Know to Have a Healthy Twin Pregnancy (Dell, 2000). “It’s a warning flag if your doctor says he or she is not going to treat your twin pregnancy any differently.”

You may choose an obstetrician/gynecologist (look for one with experience in multiples) or a perinatologist, a doctor who primarily focuses on high-risk pregnancies. Midwives typically do not care for twin pregnancies. Ask your doctor or hospital if there are any prematurity prevention programs in your area. Some larger communities offer clinics that specialize in multiple births, too.

When choosing your doctor, consider these questions:

• Is it a solo or group practice? Weigh the pros and cons. You’ll get one-on-one attention in a private practice, but your doctor may cancel appointments during deliveries, or even be on vacation when you go into labor. In a group practice, you probably won’t see your primary doctor at every appointment, but all the physicians who may deliver your babies will know your medical history.

• What access does your doctor have to sonography?

• Twin pregnancies typically require frequent ultrasounds.

• How will your doctor monitor this pregnancy? Ask for specifics regarding frequency and content of appointments, and what tests and procedures may be needed.

• What hospital is your doctor affiliated with? You may need a hospital with a nursery that can handle very premature babies?

• Will you be able to call your doctor with concerns and questions (not just emergency calls)? Make sure your doctor welcomes you as part of your medical team.

A Change of Pace

Experts say reducing the stress in your life can also help you carry your twins longer. “I tell women that if they are going to have successful pregnancies, their first job is to be an incubator; anything else they can fit into their lives is a bonus,” says Dr. Elliott.

One of the first things Jennifer Shearin, an automotive engineer, in Rochester Hills, Michigan, did when she found out she was expecting twins at 19 weeks was reduce her workload and notify her employer that she’d probably be going on temporary disability (which she did at 24 weeks).
“I was concerned about how we’d handle finances when the disability payments ran out, but I also knew I needed to eliminate some stress in my life for my babies,” says Shearin. She and her husband, Will, managed money concerns by eliminating “recreational shopping,” delaying the purchase of a new car, and cutting back on dining out.

When her blood pressure went up late in her pregnancy, Shearin rested more, napped frequently, and avoided anything strenuous, such as grocery shopping. Her babies, Emma and Olivia, were born four and a half weeks before their due date, but without any long-term health problems.

Most doctors do not prescribe bed rest as preventative treatment; however, bed rest at home or in the hospital may be prescribed if you experience complications, such as preterm labor. “A lot of studies say bed rest doesn’t work to prevent preterm birth, but bed rest is useful in high-risk situations in helping to decrease uterine activity and to get pressure off the lower uterine area,” says Dr. Leiter. (For more on bed rest, see What To Do If You’re Sent to Bed.)

Nutritional Needs

Since twins often arrive preterm, it’s important for you to gain weight early in your pregnancy. “It’s been well studied that a mother’s good nutrition and proper weight gain increases the birth weight of a baby, and the higher the weight at birth, the better a baby does,” says Dr. Leiter, who gave birth to twin girls more than a decade ago.

But gaining weight can be a challenge for multiple moms who often experience excessive nausea and vomiting. To reduce nausea, Dr. Leiter suggests consuming products with ginger (ginger ale, ginger tea, and ginger preserves) in small amounts (too much ginger may be harmful). Also, try eating dry crackers and cereal and drinking flat noncaffeinated soda. Consult your doctor about other methods to reduce nausea, including hypnosis, “relief bands” that stimulate acupressure points on the wrists, and medication. To maintain calories, eat frequent small meals throughout the day and stay hydrated by drinking water and juice.

You’ll also need to make sure you get the most nutrition from the food you do consume. Two essentials in your diet should be protein (red meat, rice and beans, nuts, and dairy products) and calcium (four glasses of milk per day or the equivalent). Ask your doctor or a dietitian for nutritional guidelines and if supplements might be needed. “Nutrition is not a minor issue during a multiple pregnancy,” says Dr. Leiter. “Women need to seek the advise of an expert.”

Silverberg knows the importance of eating well for her babies. She avoids soda and artificial sweeteners, and prepares all meals from scratch. “I believe that everything I eat and do impacts these two little souls,” says Silverberg. “It’s such an awesome responsibility, and I plan on doing as good a job as I possibly can.”

Amy E. Tracy is the author of The Pregnancy Bed Rest Book(Berkley Trade, 2001). Visit her Web site at www.pregnancybedrest.com

The post Carrying Twins to Term appeared first on TWINS Magazine.

As a psychologist working with twins, I have found that twins express a wide range of ideas about twinship and individuality. Some confess to believing that, separated, they are less than a whole human being, and together they are an unusually powerful human being. There is also a frequent theme of “good” twin and “evil” twin as if in their separation one became the embodiment of good and the other of evil. Some twins report a fear that parents confused their identities as newborns, and that they will never know who is really who. Some describe their twin as the other side of them. Still, others say that when they want to be by themselves it really means they want to be with their twin.

In developmental psychology and psychoanalysis, we learn that separateness and difference between self and other is a slowly evolving understanding. According to this premise, we all begin life as a whole, undifferentiated from others, knowing no demarcation of self and other. As we develop psychologically, we come to understand that we are indeed differentiated and split off from what we once were a part of.

When some people see identical twins, they may have an uneasy feeling that stems from an unconscious memory of not being fully differentiated. They may recognize a wish to be able to exist as an individual and yet not do so. In other words, in twins, people can see the possibility of eliminating the pain and loneliness of individuality while still remaining individual. This potential may explain the world’s fascination with twins. Even twins themselves feel this fascination.

An identical twin told me the following story. She was in a beauty shop where she saw a set of identical twins sitting side-by-side under the hairdryers talking to each other. She watched them with fascination and had the thought, “I wonder what that feels like.” Then she remembered that she was an identical twin. What she felt was the longing that all people experience to be back in a time prior to the existence of separation and loneliness, to be one with another person. Because twins shared the same womb before birth and before psychological separateness, I believe they can feel this longing infinitely more intensely than non-twins.

One of the most widely circulated photos in the last few years tenderly demonstrates that the twin bond is formed in the womb. A 1995 article in the Worcester Gazette (Mass.) entitled “The Rescuing Hug,”* described twins born prematurely and put in separate incubators, a standard practice. Three weeks after birth one of the twins was in critical condition; the nurses were unable to stabilize her and feared she would die. With the parents’ consent, they put the twins together in one incubator. The healthy twin snuggled up to the sick twin and wrapped her tiny arm around her sister. Within minutes the sick twin’s blood oxygen rates were the best they had been since she was born.

How these–or any twins–move from a “we” position to an “I” position is a primary task of childhood and sometimes adulthood. It is a difficult task for any human being, and exponentially so for twins. Through repetitive interactions with our environment, we begin to discover who we are by separating ourselves out from the rest of the world. The primary separation is from mother.

For twins and triplets, however, the process is complicated by the fact that they must learn to distinguish themselves from a constant companion. To the extent that they appear identical, the task will be that much more difficult. This process begins around 6 months of age. Parents discover that a baby who previously would let many people hold him will no longer do so. We call this “stranger anxiety” and it implies that the baby has begun to separate people, including himself, from others. Interestingly, psychological researchers have found that often between the ages of 6 and 10 months twins seem to become highly aware of each other while being averse to gazing at each other. It is as if in this time of initial separation and individuation the presence of one so similar to oneself is somehow troubling.

If parents treat twins as a unit, it can hinder the process of attaining an individual identity, even for infants. To the extent parents can experience and treat their multiples as individuals, the greater will be their children’s ability to experience themselves as individuals. The more individuated each multiple is, the more stable his or her relationship will be throughout the trials of life. Developing as an individual is not a threat to the twin bond, but contributes to the health of the twinship.

How parents help twins and triplets develop their own identities must be done on a child-by-child basis. No one answer is right for all twins. I have many stories from twins I’ve worked with in psychotherapy who describe severe trauma from being separated. I also have many stories of twins suffering trauma from not being separated. Parents must evaluate the individual situations. Regarding wearing the same clothes, sharing birthday parties, having play dates together, and so on, look at the twins as individuals and explore, with their help, what is in each one’s best interest. While we don’t necessarily accept their judgment as final, considering their wishes certainly increases the possibility of making healthy decisions for twin children.

Most of the twins I have worked with express the feeling of being a twin as a blessing, regardless of the complications involved. They point out that they have a head start on human relationships. In helping twins become healthy individuals, secure in their own identities, and able to form satisfying and fulfilling relationships with others, we teach them to balance unity and separation. Ultimately, they can enjoy being close with another person in a way that is never experienced by a non-twin and satisfies an intense longing in the human condition.

The post Am I an I or a We: Helping twins to be individuals appeared first on TWINS Magazine.

Like every parent of multiples, I wondered how difficult would be for me to persuade the powers-that-be that my children would be best served if they were together in the same classroom. I felt more confident knowing I had a secret weapon in my portfolio to strengthen my hand for negotiations that day-just in case. I want to share my secret with you.

First, some background: My twins have been at a Montessori school for the last three years-the first two-and-a-half together, and this past six months apart (a trial period we agreed to after two years of arguing with their teachers). Although they have flourished in both environments, they have repeatedly mentioned how much they miss each other when they’re separated.

In a new school, with new friends to make and a new environment to which they must acclimate, my husband and I believe a particular blessing of twinship is for them to have each other-being physically close together-until we parents agree they can be apart for their own reasons.

In writing this, I wish to argue not that all twins should be together all the time, but that parents who disagree with the decisions of a school system regarding their children need only know the path to take with the school to get what they want. I feel fortunate to live in Oklahoma-one of only two states having legal standards for schools that require deference to parental choice in the placement of multiple-birth children.

Jack and Emma will be in the same class next year, and no fight erupted in the effort to place them there. For those of you who live elsewhere, your experience can be discouragingly different-you may be told that your multiples will be separated because it is supposedly “in the twins’ best interest.” And you may feel there is little you can do to change the minds of the teachers and administrators-indeed, some parents of multiples have been told to consider home schooling if they wish to try to control their children’s education

Many of us agree legislation would be helpful, and I have personally endorsed Kathy Dolan’s efforts in this regard (to see a copy of the letter I wrote Kathy, visit her website at http://www.twinslaw.com/Welcome_to_Twinslaw.com_Where_the_twin_bond_is_celebrated_and_protected_under_law!.html

However, in the absence of legislative help, all is not lost. While you may not have control, there is always room for negotiation. And if you level the playing field by knowing what the educators know, you may well succeed.

Educators, like doctors, are expected to follow certain guidelines when taking care of your loved ones. These standards or guidelines are not intended to be applied blindly if there is evidence that following them would be harmful to a specific person in a specific situation. Guidelines exist in an effort to unify the ways in which we do our jobs. Guidelines for educators are created by a federal government task force (the Educational Research and Improvement Council-ERIC) and funded by the Office of Educational Research and Improvement of the U.S. Department of Education, covering topics ranging from how to create fair tests to how to acclimate home-schooled children into higher education.

These guidelines are published on the Internet (at www.eric.ed.gov) and are available to educators across the country.

Just as all doctors are expected to know what the Journal of the American Medical Association is, all teachers and administrators should be familiar with the ERIC Digest and know that it exists and contains guidelines for assisting them in providing an appropriate educational environment for all of our children.

Many educators seem to have forgotten the ERIC Digests—or never knew they existed—because these men and women are often arguing a position to you that is in direct opposition to their own guidelines, which say—wait for the shocker here—that parents often know what is best for their children, and that placement of twins together should be allowed unless certain circumstances exist!

If you have children nearing school age, you would benefit by going to the site above and printing out these guidelines for yourself, putting them in your “Important Information” folder along with your twins’ immunization records. Be prepared to “share” them with your local school principal when enrolling your children in school.

This is especially important if you believe your district will be less than eager to adopt your assertions about your children’s needs to be in the same classroom. You will then be prepared to argue from a position of increased strength by asking the educators to agree to follow their own guidelines when teaching your children.

In brief, the guideline says that parents and teachers should ask themselves a few questions when considering the appropriate placement of multiples, namely:
• Are the twins, by the age of five, able to make and sustain friendships independently of one another? If so, they can be placed together if the parents wish. If not, separation should be considered on an “experimental” basis to allow this to begin.
• Do classmates or teachers constantly compare the twins, leaving one to feel negatively toward school? If so, separation could be considered. ?(In my opinion, a frank discussion with a teacher who is making comparisons is warranted to eliminate his or her unhelpful behavior).
• Are the twins consistently disruptive when they are together (and have attempts to change their behavior failed?) If so, separation may be important to preserve the rights of other children to learn successfully.

• Does a female twin “over-mother” her male sibling? If so, separation may help the boy develop independent behaviors and improve his learning.
• Does a female twin “over-mother” her male sibling? If so, separation may help the boy develop independent behaviors and improve his learning.
• How will separation affect twins who are used to leaning on each other for academic and social support, especially in preschool and early elementary education? A balance must be found between twins being overly dependent upon each other and twins being separated before they are able to cope adequately.
• Is there a social or health concern that would compound the stress of separation on the twins? For instance, if one twin has disabilities and leans on the other one, or if the parents are separating or divorcing, placement together may be in the best interests of the children.
• Finally, if the twins are school-aged, what do they want? The guidelines recognize that children have a right to their opinions and that those should be taken into account along with all other available information when the decision is made.
• And most interestingly, ERIC recognizes the importance of gaining the agreement of the parents:

“Placement decisions should also take into account the views of the parents…If parents disagree on the best course of action, teachers may want to listen carefully to each, make suggestions for them to consider, invite them to observe their children in the classroom, and suggest a short-term experiment of separating or keeping the twins together. During that time, the twins can be closely observed and evaluated by teachers and parents. In this way, the school personnel and the parents can address the issue as a team focused on the long-term best interests of the children.”

So don’t sell yourself short when it comes to directing the education of your children—your opinion matters most, and you have always known it. Remember that if your children turn out poorly, nothing else you have ever done matters.

The people who have the greatest interest in your children’s final outcome are you and your children, not the people who went to school to learn to teach them. They may love children and be dedicated professionals when it comes to educating children, but ultimately, those who teach will only be with your children for about nine months or less, after which they move on to another group of kids.

Advocate for your twins just as you did while you were pregnant with them—ask the tough questions, demand answers from the professionals, and be willing to participate with them to improve your children’s educational experience. Ask to be part of a team with your kids’ educators, neither insisting that they be “the boss” of the educational process nor agreeing to be relegated to the sidelines.

And keep the ERIC guidelines in mind—you never know when you might need them again to help you find answers when talking to the other members of the team. Best wishes for a successful school year—see you on the playground!

Bio/Byline: Dr. Rachel Franklin, a board-certified family medicine physician in Oklahoma City, is the mother of 4-year-old twins and the author of Expecting Twins, Triplets and More: A Doctor’s Guide to a Healthy and Happy Multiple Pregnancy (St. Martin’s Griffin 2005), available at www.TwinsMagazine.com (Twins Bookshelf, Pregnancy and Expecting Books). She posts advice on the TWINS Magazine Message Board forums “Pregnant with Multiples?” and “Postpartum.” Visit her Web site, www.AskDrRachel.com

The post Breaking the Barriers: The Secret to Controlling Your Twins School Placement appeared first on TWINS Magazine.

Most people realize that there is a percentage of women who experience feelings of sadness after they deliver their baby or babies. The reality is that many people have no idea of the severity and complexity of life with PPD. 

In fact, there are a number of discouraging myths that keep many women from seeking help when they experience the signs of depression after delivery.  

In this article, we will look at what postpartum depression is, why it occurs, debunk some popular myths, and talk about how to get help for you or someone you love.

Postpartum depression does not have to derail your experience as a new mom of multiples. 

What is postpartum depression?

There is not one single underlying cause of PPD. Instead, experts believe that there is a myriad of contributing factors that lead to developing this form of clinical depression. 

Postpartum or perinatal depression affects as many as 1 in 7 women. It is so common that it is the most common complication of childbirth. 

Who is most likely to develop postpartum depression?

PPD can affect any woman. It strikes women who experience easy pregnancies, as well as, those with difficult pregnancies. First-time mothers and mothers who have one or more children can also experience PPD. It doesn’t matter if a new mom is married or single, and things like income, age, ethnicity, culture, and education make little difference in your risk of experiencing depression after birth.

One group of women who are at a higher risk of suffering from postpartum depression are moms of multiples (or MoMs). MoMs are much more likely to develop PPD than moms of singletons. While not all twin moms will experience symptoms, they are at an increased risk. 

What are the risk factors for postpartum depression?

• A change in hormone levels after childbirth 
• Previous experience of depression or anxiety 
• Loneliness, not having close friends and family around
• Family history of depression or mental illness 
• The stress involved in caring for a newborn and managing new life changes
• Having a challenging baby who cries more than usual, is hard to comfort, or whose sleep and hunger needs are irregular and hard to predict
• Having a baby with special needs (premature birth, medical complications, illness) 
• Lack of family support
• The health consequences of childbirth, including urinary incontinence, anemia, blood pressure changes, and alterations in metabolism
• The physical changes during and after pregnancy
• Other emotional stressors, such as the death of a loved one or family problems
• Financial or employment problems 
• Caring for twins, triplets, or higher-order multiples 
• Isolation and lack of social support
• Changes in the sleep cycle 

Difficulties with breastfeeding might also be linked to PPD. New moms who have difficulty breastfeeding in the first 2 weeks after delivering their babies have a higher risk of PPD 2 months later, according to a study at the University of North Carolina in Chapel Hill. 

What is the difference between baby blues and depression?

Many new moms confuse their own postpartum depression with the less serious “baby blues.” Baby blues happen when moms feel more melancholic than is typical for them after delivering their infant. As hormone levels drop, moms can feel moody, sad, tired, and generally “blue.” This is very different from PPD. 

Unlike the baby blues, PPD doesn’t go away on its own. It can impact a mother’s ability to care for her newborn. The symptoms are much more debilitating and longer-lasting. Any mom who is concerned about how she is feeling should talk to their doctor in order to stay aware of what is going on. 

How prevalent is postpartum depression?

Rates of PPD in singleton pregnancies

According to a report and statement issued by the U.S. Preventive Services Task Force, 8.9 percent of all pregnant women and 37 percent of new mothers experience clinical depression in the months before or after giving birth. Less research has been done on new fathers, but some studies suggest that about 10 percent of dads may also experience postpartum depression. For half of the women diagnosed with PPD, this is their first episode of depression. 

Rates of PPD in twin pregnancy

Moms of multiples experience PPD at a higher rate than singleton moms. Researchers have not yet isolated whether these higher rates are due to physical etiology (such as higher levels of hormones) or the additional stress of caring for two newborns. 

A 2009 study, published in the journal Pediatrics found that new MoMs were 43 percent more likely to have postpartum depression than were mothers of singletons. While not all moms of multiples will develop PPD, it is important for these MoM’s and their families to be on the lookout for potential symptoms.  

Recognizing the signs of postpartum depression

In theory, it sounds like it would be fairly simple to identify and treat PPD, right? 

The reality is that after delivering newborn twins, in the sleep-deprived newness of parenting, things can get muddy. MoM’s often think their sadness or anxiety will go away. They often blame their feelings on exhaustion. Understanding the signs of PPD can help to tease apart normal postpartum blues with true depression. 

What are the symptoms of postpartum depression?

The warning signs are different for everyone but may include: 

• A loss of pleasure or interest in things you used to enjoy
• Fear of not being a good mother 
• Eating much more, or much less, than usual
• Anxiety — all or most of the time 
• Fear of being left alone with the baby 
• Racing thoughts 
• Feeling guilty or worthless, including blaming yourself 
• Excessive irritability, anger, or agitation 
• Sadness, crying uncontrollably for very long periods of time 
• Difficulty sleeping, beyond the typical new parent lack of sleep
• Disinterest in the baby, family, and friends 
• Difficulty concentrating, remembering details, or making decisions 
• Thoughts of hurting yourself or the baby (seek help immediately if you experience this symptom).

What to do when you suspect postpartum depression?

If you suspect someone you love may be suffering from any form of postpartum depression, anxiety, or even blues – the first thing to do is talk about it. Many moms don’t even realize what is going on. In many cases, it is the loved ones that first recognize the symptoms. 

However, if you are feeling any of the earlier noted signs of PPD, talk to your doctor right away. There is no need to suffer in silence. PPD is treatable!

Fighting the stigma of postpartum depression

Despite the mountains of research surrounding postpartum depression and dialogue that is opening up, many women still feel a stigma when it comes to PPD. There are a number of myths that keep many people in the dark about the realities surrounding postpartum depression. 

Debunking the myths

Myth #1: Moms who have PPD don’t bond with their babies

Truth: Moms with PPD love their babies just as much as moms who do not have PPD. Depression is in no way a sign that a mom will not bond with her baby and love her twins the same as any other mother.  

Myth #2: You can only get PPD if you had a previous mental illness

Truth: While women with a history of mental illness (specifically a mood disorder) are slightly more likely to develop postpartum depression, any new mom can experience it regardless of health history. What’s more is that MoM’s who have experienced a mental illness in the past, are not necessarily going to develop PPD.  

Myth #3: Symptoms show up right after birth

Truth: In many cases, moms will not experience the symptoms of PPD for weeks (or even months) after giving birth. In some cases, women can display signs during the last stage of pregnancy and some won’t develop until as much as a year after delivery. Typically, the condition develops within 4 to 6 weeks after giving birth, but it can sometimes take several months to appear.

Myth #4: PPD will go away on its own

Truth: PPD is a serious condition that requires treatment. It often will not subside on its own and may require a combination of therapy and medication to alleviate the symptoms. Many new moms wait in hopes that the symptoms will retreat on their own, but inevitably prolong their negative feelings. 

Myth #5: Moms with PPD cry nonstop

Truth: Postpartum depression can take many forms. While some moms of multiples will be tearful, others will experience PPD as isolation, anxiety, or withdrawal. A woman does not have to cry around the clock to be experiencing PPD.  

Seeking help for postpartum depression

If you experience these symptoms during pregnancy or after delivering your babies you should talk to your doctor. Also, if you recognize any of these signs in someone you love, encourage them to talk to a medical professional. Many women delay seeking treatment for PPD and suffer in silence for much longer than is necessary. 

Too few women seek help for postpartum depression

In a survey published in the Journal of Psychiatric Practice, parents of twins or other multiples reported experiencing the most difficulty during the first three months of their babies’ lives. The study included 244 parents of twins and other multiples (including 197 mothers and 44 spouses or partners), asking about parents’ mental health during the postpartum period. 

They found that, although 48 percent of the study participants had struggled emotionally after their babies were born, very few got help. Many parents reported that with caring for multiple babies at once, finding childcare, and the financial stress of finding a therapist, often felt like another burden.

Coping strategies

In addition to psychological interventions and medication, there are a number of things new moms can do to help cope with the stress of parenting two babies. Using some or all of these coping skills in the face of PPD can help improve outcomes and manage symptoms. 

1. Get some exercise. Okay, maybe you aren’t ready to hit the gym but simply taking a walk, going for a bike ride, or even a few minutes of dancing with cranky babies can go a long way. 
2. Make time for yourself. While finding a few quiet moments for yourself may seem impossible, they are so important. Make sure to take a break and focus on yourself. Take a shower, talk to a friend on the phone, meditate, or do anything that makes you feel like yourself again. 
3. Stay on top of your diet. This point covers two important aspects. First, if you are breastfeeding make sure you are getting enough calories. Second, be sure you are making good food choices that will fuel your tired mind and body. 
4. Get your rest. This is probably the most laughable on our list. Once you are done chuckling at our suggestion, read on. We realize that adding an extra hour of sleep to your day is highly unlikely, remember that rest is more than sleep. A 20-minute power nap, meditation, or mindfulness and just a micro-break a few times each day can help keep you going. 
5. Connect with people. One of the biggest sources of melancholy new moms report is feeling isolated. Long hours spent just you and your babies can be an isolating experience. Connect with friends or family or join a Moms of Multiples group near you. 

Despite the growing body of information about postpartum depression and its impact on moms of multiples, there is still a gap that needs to be bridged. Too many women are left untreated and suffering in silence. The more information moms-to-be and new moms have, the more they can understand what is going on. 

Postpartum depression is a real diagnosis and is very treatable. Be on the lookout for the signs and symptoms. If you or someone you love are experiencing any, be sure to talk to a medical professional right away. There is no need to suffer in silence.  

Resources:

American Psychological Association – What is postpartum depression & anxiety?

Journal of Psychiatric Practice – Perinatal Mental Health Treatment Needs, Preferences, and Barriers in Parents of Multiples

Journal of the American Medical Association – Prenatal and Postpartum Depression in Fathers and Its Association With Maternal Depression

Medical News Today – What to know about postpartum depression

National Public Radio – Mommy Mentors Help Fight The Stigma Of Postpartum Mood Disorder

National Public Radio – Pssst: Parenting Twins Can Be Depressing

Obstetrics and Gynecology – Early breastfeeding experiences and postpartum depression

Pediatrics – Multiple Births Are a Risk Factor for Postpartum Maternal Depressive Symptoms

Postpartum Support International – Depression During Pregnancy & Postpartum

US Preventative Services Task Force – Perinatal Depression: Preventive Interventions

The post The Truth About Postpartum Depression appeared first on TWINS Magazine.

First, we received some beautiful pictures of all of your twins reminding us how thankful you are for your children. Keep them coming, we love to see your twins, triplets and beyond!

One of our readers commented “I am so thankful for Twins Magazine! When my twins were little babies almost 25 years ago, I submitted a penpal request through the magazine, and found my best buddy, twin mom (name omitted for privacy)! It was another 20 years before we actually met in person, but I am forever grateful for Twins magazine for bringing this wonderful lady into my life! 

Needless to say, that one made our day!

We also had some of our social media friends remind us how thankful they are to be alive and to have their families.

Twins Magazine editor and twin mom, Kristen told us, “I am so thankful for the tribe of people who keep my family functioning. It really does take a tribe and I am truly blessed by mine.”

This Thanksgiving we at Twins Magazine want to tell you how thankful we are for all of you, our readers and your families. You are all a blessing!

Happy Thanksgiving,

The Twins Magazine Team

The post What Are You Most Thankful For? appeared first on TWINS Magazine.