The Great Book of Twins and Multiples

Contents

Acknowledgements

Foreword

Introduction

1. The phenomenon of the multiple pregnancy 

• Pregnancy of twins
• Identical or fraternal, how can you tell?
• Pregnancy of triplets
• Pregnancy of quadruplets
• Pregnancy of 5 or 6
• Influence of genetics

2. The multiple pregnancy

• A unique experience
• Dealing with the news
• Is it a special pregnancy?
  • Pregnancy of twins
  • Pregnancy of triplets
  • Medical check-ups
  • Putting on weight
• Antenatal classes
• Prenatal-tests
  • The ultrasound
  • Amniocentesis and Chorionic Villus Sampling

3. Fertility treatment

• Stimulating ovulation
• Artificial insemination
• Is it possible to avoid a multiple pregnancy?
• Multi-foetal Pregnancy Reduction
• How do you take a decision?

4. The first trimester of the multiple pregnancy

• Nausea
• Fatigue
• Growth of the uterus
• Blood loss
• Breast pain
• The need to urinate
• Dizziness and fatigue
• Constipation
• The importance of good nutrition
• Maternity clothes

5. The second trimester of the multiple pregnancy

• Anaemia
• Backache
• Groin ligament pain
• Blood loss
• High blood pressure
• Pre-eclampsia and the HELPP-syndrome
• Oedema (fluid retention).
• Proteins in the urine
• Carpal Tunnel Syndrome (CTS)
• Gastric acidity
• Stretch marks
• Twin-to-Twin Transfusion Syndrome
• Treatments for Twin-to-Twin Transfusion Syndrome
• Symptoms of Twin-to-Twin Transfusion Syndrome

6. The third trimester of the multiple pregnancy

• Resting
• Haemorrhoids
• Varicose veins
• Insomnia
• Shortness of breath
• Tachycardia
• Leg cramps
• Itching
• Contractions
• Symptoms of contractions
• Can I still travel by plane?
• Sexual intercourse during the pregnancy

7. What is the pregnancy like for the father?

• Prenatal contact with the babies
• Changes in the partner

8. Prenatal bonding

• The babies’ movements
• Hormonal influences between the sexes in the womb
• Prenatal contact between the babies

9. Birth of twins

• Where should the birth take place?
• The babies’ position
• Special situations
• Symptoms that announce the delivery
• Admission to hospital
• Stages of labour
  • Dilatation of the cervix
  • Transitional labour
  • Expulsion
  • Birth and delivery of the placenta (s)
• Caesarean delivery
  • A planned Caesarean delivery
  • An unexpected Caesarean delivery
  • Recovery after a Caesarean delivery
• Advice for protection of the belly

10. Giving birth to triplets

• The biological origin of the babies
  • The foetal position of the babies in the uterus
  • The experience for the mother
  • Who is who?
  • Post-partum for a mother of triplets

11. Premature births

• Can premature birth be avoided?
• Symptoms of possible premature birth
• The hospital
• The incubator and its function
• Together in the incubator
• Physical needs of a premature baby
• Warmth
• Oxygen
• Nutrition
• When can the babies leave the hospital?
• The relationship with the babies
  • The parents’ emotions
  • And then they arrive home
• How does a premature baby develop?
• Stimulation of a premature baby

12. Nutrition

• Breastfeeding
  • Advantages and disadvantages
  • A personal choice
  • Stimulating breast-feeding
  • Do they get enough nutrition?
  • Night feeding
  • Positions for simultaneous nursing
  • Breastfeeding triplets
  • Uses of a breast pump
  • The importance of good nutrition
• Problems with breastfeeding
  • Not enough milk
  • Pain in the breasts
  • Inflammation of the breasts
  • Allergy to milk
  • Breastfeeding after a Caesarean delivery
  • Breastfeeding quadruplets
  • Weaning
• Bottle feeding
• Feeding schedule

13. At home with the babies

• Advice on how to reduce stress
• Building a relationship with each baby
• Help at home and lack of privacy
• Postnatal depression

14. 0 – 6 months

• Sleeping
• Should they sleep together or apart?
• The babies’ rhythm
• Sudden infant death syndrome (SIDS)
• Crying
• Who do you comfort first?
• Bronchiolitis or the VRS virus
• Taking the babies outside
• Economical aspects
• How do the parents experience this period?
• The mother’s recovery

15. 6 – 12 months

• Mealtimes
• Crawling and safety at home
• Speaking
• Girl-boy twins
• Visits to the a paediatrician
• Stranger anxiety
• Sleep
• How to tackle parents’ exhaustion?
• The twins’ relationship 
• The couple’s relationship  

16. 1 – 2 years

• Motor skills development
• Development of speech
• Discovering the sense of "me"
• Learning to share
• Kissing and biting
• Tantrums
• Safety at home
• Starting to set the rules
• Toys: the same or different?
• The importance of routine
• Eating
• Illnesses
• A different treatment for each child
• The grandparents

17. 2 – 4 years

• The "no" phase
• Motor skills development
• The identity of each child
• Empathy
• How do I teach them rules?
• Their relationship: Love and hate
• "This is mine!"
• The pacifier and other comforting objects
• Kindergarten
• In the same class?
• Painful divorces
• The invisible friend
• Copying each other
• Jealousy
• Learning to use the potty
• Discovering sexuality
• Sleeping problems
• Different sleeping patterns
• Dividing attention

18. 4 – 6 years

• The special unique relationship between twins
  • The unique relationship between triplets
• A block against the parents
• The twins’ relationship with their siblings
• School
  • Advice for twins in the same class
  • Advice for twins in  different classes
• Development of language
• Competition
• Aggression
• Hyperactivity
• Solutions for hyperactivity
• The difficult task of raising 2 or 3 children of the same age
• A relationship under stress
• Typical day to day problems of living with twins
  • Three children instead of two
  • Lying to get attention
  • Switching behaviour
  • Snitching
• The influence of birth order
• Sharing a room
• Their birthday
• Their contacts outside the family

19. 6 – 12 years

• School
• Shyness
• Competitiveness
  • ‘You love him more than you love me!’
• Fighting
  • How do triplets interact?
• Jokes and insults
• Nurture or nature?
• How to keep a good relationship with each child
• Education to independence (of each other)
• Other problems
  • Their birthday
• Their intellectual development
• Their physical development
• Their hobbies

20. 12 – 18 years

• Physical changes
• Change in the relationship with their parents
• The twins’ relationship with each other
• Day to day problems
• Who am I?
• Crushes and relationships
• Secondary school
  • In the same class
  • In different classes
  • Different schools
  • Exam stress

21. 18 years and ……………….

• Finding your own way
  • The couple effect
  • Discovering your own identity
• Being apart for periods of time
• Choosing a profession
• Their relationships with the opposite sex
• The adult twins’ relationship 
• Positive and negative aspects of being a unit
• Competitiveness
• Twins who do not get on well
• Are we identical or not?
• Changes in DNA
• Does telepathy exist?
• Unexplainable experiences
• Did we raise them well?
• Growing old together

22. The place of twins in the family

• The oldest sibling and the twins
  • The arrival of the babies
  • Advice to help the jealous sibling
  • When jealousy comes later
• The twins and a younger sibling

23. Daily schedules of different families

• Schedule 1
• Schedule 2
• Schedule 3
• Schedule 4

24. Difficult situations

• One of a multiple is handicapped
• One parent families
  • Talking about a divorce with the twins

25. The death of a twin

• During pregnancy or around birth
• The influence of the death on the surviving twin
• Death of a twin during childhood
• Death of a twin during puberty
• Death of a twin during adulthood

26. Scientific studies about twins

• Studies by Francis Galton
• Different surroundings, similar characters
• The research goes on

Glossary

Bibliography

Useful adresses

Alphabetical index

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