When Baby Makes Three -- or Four or More

When expectant parents hear the news

Susan: As soon as we found out, we proudly announced the news to our family and friends, and my identity changed in an instant. I was defined differently by other people. First it was "she's the one having twins," and then after they were born "she's the mother of twins," as if that was the most significant thing about me. The truth is, it did become my identity. Caring for Cara and Lewis was more than a full time job, and I didn't lift my head for three years.

Foster: We were adjusted to the idea of having twins, but when we found out there was a third child we were stunned. Then we went through a few stages. We became excited and then we broadcast the news to everyone we knew. But when the reality sank in we realized that it was going to be tough going—the pregnancy was high risk, the birth might take a long time, even getting the right equipment, arranging for extra help, and then all the extra expenses. We see-sawed between feeling excited and sheer terror.

Types of multiple births

Twins can be

• identical or monozygotic—a single fertilized egg divides into two separate but identical babies

• fraternal or dizygotic—two eggs fertilized by two sperm; no more alike than siblings (more common)

• Supertwins or twins+ refer to triplets or higher-order multiples who can be identical or fraternal

How is being a parent of twins or twins+ different from being a parent of one child?

Parents of twins or supertwins unanimously declare that the most critical difference is time. The care and feeding of more than one child at a time severely taxes the capabilities of two adults, and just having the time and energy to get through the day becomes the number one issue. According to Julie, a mother of twin infant girls, You don't get the chance to establish any priorities. There's simply no time left over to do things like clean up the kitchen, it's always open and in action. Vacuuming the living room becomes a luxury.

New parents of multiples need support, as much as they can get, from family, friends, and paid caregivers, when possible, for both physical and emotional reasons.

Having a baby changes parents' lives in many ways. Having more than one baby at a time makes the changes even greater. Although all parents are faced with lots of decisions, parents of multiples are faced with extras. In addition to the usual choices—breast or bottle feed; stroller or carriage; stay-at-home or back to work; nanny or day care; move or stay put—parents of multiples have even more to think about. Here are some special issues:

Twins or supertwins are not a package deal. Their individuality should be encouraged

Dennis, a father with a sense of humor, liked to dress his twin boys the same and then shuffle them around interchangeably to see if relatives could tell them apart. The game might be fun for the grownups, but it's not a good idea for the children.

• Right from the start it is important to help each child establish his/her own individual personality. Children are born with different temperaments, or ways of reacting to new people or things, which can be observed even in infancy. Not all twins or twins+ have the same temperament. Most will be easy-going, have regular sleeping and eating habits, adapt easily to new situations, and will be generally even-tempered. But some may be shy and need time to adjust, and others may be more difficult and have trouble settling down and getting used to routines. Each child has his or her own patterns of strengths and weaknesses.

• Give each child some one-to-one time. Individual time, even if short, acknowledges each child's particular interests.

• Talk with each child separately. Twins often communicate with each other in non-verbal ways and their verbal language may develop later than singletons. Another reason that twins may acquire language slowly is that they have fewer opportunities to converse with their parents, who must divide their time between several children.

• Individualize birthdays by giving presents, even birthday cakes, chosen according to each child's interests. Don't expect multiples to share and enjoy the same toys.

• Respect the closeness of twins and supertwins but create opportunities for them to play with other kids. Let other parents know it's okay to invite one and not the others.

• Create a special space for each child. If they share rooms, provide different drawers or chests or storage places for clothing and for individual toys and possessions.

• Don't forget the plus side of being a multiple. Nicky, an adult, reflects on her childhood as a twin: There's nothing like being born part of a group to encourage sharing and getting along with others.

Some Pitfalls—Avoid

• giving similar or rhyming names (Micky/Nicky; Jason/Jared/Jerry) which de-emphasize their individuality.

• identifying them by simplistic labels, such as "she's the cute one; he's the big one; he's the quiet one; she's the good eater." One should not be the reference point for the others.

• referring to them as a unit, such as "the twins, the triplets, the gang."

• giving them directions as a group, such as "It's time for everyone to go to bed, you all have to play outside." Try and communicate separately with each one.

• dressing all the same. Although they may look cute and elicit admiring comments, different clothes will accentuate their individuality.

• making them feel special just because they're twins; seeing themselves just as twins limits their individuality.

Special issues for twins and supertwins

Separation is a process that all children experience and that re-occurs throughout life. For the first two months of life, an infant is barely aware of the outside world. Gradually the infant becomes aware of him or herself as a separate person. According to Dr. Eileen Pearlman, an identical twin and a specialist in twins and twin parenting, "It's between 5 to 6 months old when they start becoming aware that there's someone else there and that the mirror image is not themselves, it's another person." Twins and supertwins may be different even in the womb; one may be more active or one may be larger. But they've had to adjust to each other, and so "they must not only learn to separate from their mother, but also from each other. Little by little, they become more and more aware of themselves as being separate." Dr. Pearlman notes also that "twins have each other as a transitional object." A transitional object may be a blanket or a teddy bear or a diaper, which soothes and comforts the baby even when the mother is not there. "Twins do a lot of soothing and comforting for each other." Starting with their togetherness in the womb, they learn to share and to be in a relationship with others.

Sleeping: separate or together? Parental decision to separate the infants or keep them together in one crib often depends on whether the hospital has separated or kept them together. Having them in one crib can make life easier for parents, but gradual separation is usually advisable. Many parents report that when the children get older they may start the night in separate beds, but they're often in the same bed in the morning.

School: separate classes or together? The decision rests on the individual situation. It's not advisable to separate children before they're ready, which depends on how self-sufficient they are and if they've had other social contacts apart from each other. Some twins, such as girls and identical twins, tend to be more attached to each other. For some, the separation should take place gradually; they might start pre-K and Kindergarten in the same class, and then attend different classes in first grade. Some educators believe that separate classes are preferable in that they promote independence, discourage clinginess, and encourage new friends. Separate classes avoid comparisons by teachers and other children, especially if one child does better academically. On the other hand, same class placement has advantages. Most twins work well together and get security from each other. If one teacher is involved, it's easier for parents in terms of homework; however separate conferences should be scheduled for each child. The decision is best made by cooperation between school and family.

What about other children in the family?

Older children in the family could be involved right from the start. During pregnancy they can help choose equipment and clothing for the new babies, and they can later be involved in their care. When the infants are greeted with fuss and attention by parents, relatives, friends, and even casual onlookers, parents can remind visitors to acknowledge all the children, not just the new ones. Encouraging the older children to spend time and talk with each twin separately emphasizes each child's individuality and reinforces an older sibling's role as part of the caring team. Although it may be hard to find the opportunity, parents should spend some individual time with the older siblings.

Parents' expectations

Parents' experiences with an older child may affect their expectations about the way they expect their twins or supertwins to interact.

I thought I had some control over my life, but my twins taught me humility, said Susan, mother of three. I had a wonderful relationship with my daughter Kim, who was three when her twin brothers were born. Kim spoke very early; she was very verbal and we enjoyed reading books together and talking about them. I expected Evan and Lewis to be similar, but much to my surprise, they were quite different. Neither of them was interested in sitting quietly and looking at picture books. They were both action-oriented; they enjoyed running around and bouncing off each other. It took quite a bit of adjusting on my part.

Parents' experiences with an older child may affect their expectations about the way they expect their twins to interact.

First aid for parents

Fatigue, lack of personal time, preoccupation with the care of the children and, for some families, financial stress are the special demands of parenting multiples. For many, joining a support group and spending time with other parents of multiples to discuss specific concerns and solutions is often helpful.

References and Recommended Reading

"Challenges of Parenting Multiples." (2006) American Society for Reproductive Medicine.
www.asrm.org

"Parenting Multiples." www.KidsHealth.org (Nemours Foundation)

"Twins: Taking Care of Two." American Academy of Family Physicians.
www.familydoctor.org

Pearlman, E. (2000). Raising Twins: What Parents Want to Know. New York: Harper Collins

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