Foreword

Article Outline

• Copyright

Editors note: The editors are delighted that a “mother of multiples,” Melissa Courts, agreed to write the Foreword for this issue.

Raising twins is a challenge. It seems that such a conclusion would be foregone, but it’s difficult to comprehend just how complicated parenting multiples can be until you have experienced it. It’s like the first time you fishtail next to a semi in a blizzard and you suddenly realize that practicing in a simulator was a lot easier. With nearly 20 years of professional experience in early childhood, I was confident that I was well-equipped for parenthood. When we learned that we were having twins, I bought a few more books, gained a few more pounds, and doubled the gift registry. I was prepared to care for two babies but, like many new twin moms, I wasn’t prepared to do so while experiencing extreme sleep deprivation, postpartum depression, and social isolation.

Despite a plethora of parenting books and web sites, there is limited reliable information available to parents and professionals regarding raising multiples. Cookbook approaches fail to take into account not only the wide variation among families, but the individual differences among twins. In addition, some guides are strictly anecdotal without reference to research or recommended practices. In this monograph, Langkamp and Girardet have created a desperately needed resource which not only presents the most relevant findings regarding the health and development of twins and higher order multiples, but also offers excellent practical information that families need. As pediatricians and mothers of twins, the authors have thoroughly captured the range of issues faced by parents of multiples and their health care clinicians.

Parenting twins can bestow great joy, but can also bring a host of stressors. As the authors of this monograph describe, families with multiples may struggle with issues related to preterm birth and long-term disabilities. Breastfeeding twins (especially preemies) can be logistically challenging on one’s own. The increased cost of purchasing multiple cribs, car seats and other expensive items can tax a family’s budget. In addition, couples who find themselves working different feeding shifts around the clock often have little time to connect with each other.

Parents quickly find themselves looking for support systems. Traditional sources, such as grandparents and friends, can share topic-specific recommendations, but may not be able to address issues specific to twins. Conventional advice (“Sleep when the baby sleeps”) may be more frustrating than useful. New parents have limited time to consult specialized books or attend meetings of other twin parents. Primary health care clinicians, however, are in the unique position of being a trusted source of information, a respected authority to validate parenting decisions and one of the few professionals to have ongoing contact with families during the critical early years.

This document can serve as an excellent guide to supporting the families that clinicians serve. By being not only more knowledgeable of the research regarding multiples, but also more aware of the issues families face, clinicians can offer extensive support through the medical home. Key roles include the following:

•Providing developmental information and monitoring child health. Parents who are concerned about their children’s development may be relieved if developmental milestones are discussed in terms of preemies’ corrected ages. Parents of multiples may also need to be reassured that their nontraditional techniques are appropriate for their situation.

•Monitoring the mother’s health, especially for potential signs of depression, and making referrals. It is quite possible that a new mother will see her child’s clinician four or five times in the year following birth, during which time a stressed mom may not see her own primary care clinician.

•Validating mothers’ needs for additional support. Many new mothers of twins may have difficulty accepting help in caring for the babies, feeling that they should be able to handle it on their own. Health care clinicians can make a significant difference by simply encouraging parents to make a list of three things people could do to help and to refer to it when help is offered. Remind parents they need time for themselves. You can also grant permission to let low priority responsibilities slide. What new parents wouldn’t be delighted to tell visitors that their twins’ pediatrician advised them that sleeping was more important than vacuuming?

•Offering practical advice and links to community resources. Ask the local Mothers of Twins Club to provide their brochure or contact information and make it available during visits. If possible, have a list of family support resources (e.g., health insurance, child care, counseling, etc.) to share with parents who need assistance. Consider giving a brief presentation or serving on a roundtable at a local meeting for parents of multiples.

Please read this monograph in detail and share it with colleagues. It is, quite simply, everything parents of multiples want (and need) their children’s primary care clinician to know about twins.