Understanding Families of Twins and Multiples— Health and Developmental Perspectives

1. Understanding Families of Twins and Multiples—Health and Developmental Perspectives A “Product” but Really a “Process” Dana M. Cox University of Massachusetts Boston IPMHPCP Fellow

2. Special Project: * Extensive review of literature and the internet * Developed a Resource Guide for early childhood professionals * Hitting a few “Road Blocks” in my own journey * Developed my own Early Childhood Health and Development Internet Site http://childhealthanddevelopment.wordpress.com * Project ready for what’s next…truly integrating the “lenses” of IPMH, illuminated by all of you!

3. My Story

8. Developing a Resource Guide • Summarizing the vast amount of information, (primarily focused as “advice” for parents), statistics and research into a useful format for professionals • How to “hold” and integrate my own experience, and cultural values, while respecting and even “admiring” those of others. • Vision to create hope and a “village” for families in today’s world • Appreciate twins for what they are teaching us about the research and sciences that make up IPMH

9. Twins Types 1-Identical -- monozygotic(one zygote) -- twins form when a single fertilized egg splits into two genetically identical parts. 2- Fraternal -- or dizygotic (two zygotes) -- twins develop when two separate eggs are fertilized and implant in the uterus. 3-Scientists have theorized a third, hybrid type called polar body twinning.

10. MONOZYGOTIC TWINS * Constant incidence of 1:250 births. * Not affected by heredity. * Not related to induction of ovulation. * Constitutes 1/3 of twin 70% are diamniotic monochorionic. * 30% are diamniotic dichorionic. * Always same sex

11. MonocygoticDivisions • First 72 H  two embryos, diamniotic, dichorionic and two placenta or single fused placenta. • 4-8 days  two embryos, diamniotic, monochorionic. • About 8 days after fertilization  two embryos, monoamniotic and monochorionic. • Divisions  clearage is incomplete and conjoined twins result.

12. DIZYGOTIC TWINS * Most common represents 2/3 of cases. * Fertilization of more than one egg by more than one sperm. * Non identical, may be of different sex. * Two chorion and two amnion. * Placenta may be separate or fused.

13. Supertwins…

14. Key Twin Issues in Infant-Parent Mental Health * Cultural Aspects: - Good or evil • - Individuation—Promoting individuality vs twin-ness/ Collective-ness • * Parental Stress/ Mental Health Issues * Twin Myths: misunderstandings about the nature of twinning

15. In the Beginning—Pregnancy and Childbirth * Signs of Twin Pregnancy * Working Toward Healthy Pregnancies with Multiples

16. High-risk Aspects of Multiple Birth * Prematurity * Low BirthWeight * Complications Specific to Identical Twinning -Twin to Twin Transfusion Syndrome (TTTS) -Selective Intrauterine Growth Restriction (SIUGR). -Cord Entanglement -Conjoined twins

17. Issues in Parenting Multiples in Infancy and Toddlerhood * Fatigue and Lack of Sleep * Connecting/Bonding/Attachment  * Logistics of Care Giving and Feeding Routines * Impact on the Family * Breastfeeding * Parenting—Guidance, Limit-setting

18. Multiples in Preschool and Beyond * Supporting Social Emotional Development both as Individuals and Part of a Group of Multiples * Twin Discrimination * Twin Relationships with Each Other  * Educational Needs School Placement –Together or Apart

19. Resources to Support Families with Multiples • Books • Journals • Internet Sites • National Resources & Support Groups • Local Mother’s (Parent’s) of Twins Clubs • Research: Twins have contributed much to psychological research.

20. Thank you! Twins Talking