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Twins

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The following information aims to help you to understand more about twins and offers some ideas about how to care for them. Most of the information also applies to triplets and other multiple births.

Contents

Once you have found out that you are expecting twins it can very exciting. It can also be scary as you think about how you will manage two babies at once.

How are twins formed?

Identical twins (or monozygotic twins)

  • Identical twins happen when a single sperm fertilises an egg, and then, at a very early stage, the fertilised egg divides into two and starts forming two babies.
  • Identical twins have the same genes, so they are the same sex.
  • Some of these twins have their own separate placenta (afterbirth) and sac to grow in the mother’s uterus (womb) but many share the same placenta and sac.
  • Monozygotic twins may be quite different sizes at birth, but they become more alike with time. They are often hard to tell apart when they are older.
  • Identical twins do not usually “run in families” and it is not known why monozygotic twins occur.
  • Identical twins happen about once in every 250 live births.
    father and twins

Non-identical twins (or dizygotic twins)

  • Non-identical twins are also sometimes called fraternal twins. They happen when two separate eggs are fertilised by two different sperm so that two embryos (the beginnings of a baby) are formed.
  • Each has its own separate place in the uterus and separate placenta and sac.
  • They may be the same sex or different sexes.
  • Dizygotic twins are often similar at birth, but they become less alike as they get older, as do other (different age) brothers and sisters.
  • Dizygotic twins are more likely to happen when there are twins in the mother’s family, or if the mother has been having fertility treatment. If a mother is a non-identical twin, she has about a 10% chance of having twins herself. (A mother of twins who is not a twin herself, has about a 5% chance of having another set of twins). If the father is a twin, this does not make it more likely that the parents will have twins.
  • About two births in every hundred are dizygotic twins. There has been a rise in the number since the use of fertility treatment has become more common.

Siamese twins (or conjoined twins)

  • Siamese twins are extremely rare.
  • They are twins who come from the same egg (monozygotic) but the embryo does not separate completely to form two separate babies.
  • This means that the babies are joined together in some way. Some can be separated by an operation without too much difficulty. In other cases they share vital organs and cannot be separated without the death of one or both twins.

A vanishing twin

With ultrasound being done early in pregnancies, it has been found that many more pregnancies start as twin pregnancies (up to 5% at 12 weeks), but one of the babies stops developing. The other baby develops normally.

Knowing if twins are monozygotic or dizygotic

Usually your doctor will work out whether your twins are monozygotic or dizygotic soon after the birth. If they are different sexes they are definitely dizygotic. Monozygotic twins are more likely to have some physical problems at birth, and also more likely to have similar health problems when they are older – so it can be useful to tell if they are identical or not. Since monozygotic twins can look very different at birth, the doctor may have the placenta very carefully examined, or do blood tests.

Pregnancy and birth with twins

  • Some of the problems (complications) with pregnancy, such as ‘morning sickness’ and weight gain may happen earlier with twins.
  • Twins may be born earlier than single births, and the babies may be smaller.
  • The babies may be born vaginally, especially if both babies are in a head-down position, but a caesarean section may be a safer way of delivery for some twins.
  • There are more health risks for newborn twins, but usually the risks are similar to the risks for single babies of the same weight.
  • Some twins will be born prematurely, and they may develop breathing problems, and need special care, or intensive care for a while.
  • Sometimes one monozygotic twin will be much smaller than the other, because the placenta was not equally shared. This baby may have some health problems at birth, but usually the smaller baby will have caught up in size within 6 months.

Preparing for twins

It is important to prepare your mind as well as your body for the twins’ arrival.

  • Once you know you are having twins it is a good idea to start thinking about them as separate individuals so you can get to know them.
  • You can start building your relationship with your babies by getting to know their movements and their position in the womb. You can also use ultrasound pictures to share your experiences with the babies' father.
  • You might feel emotionally and physically drained by the changes happening to your body. It is important to share these feelings with your loved ones. This helps them to start sharing the care.
  • mother and twinsRead as much as you can about twins and how to care for them.
  • If you get offers of help – accept! You may feel uncomfortable about this at first. Every bit of help you get will help you to build a better relationship with your babies. People like to be helpful. You could, for example, accept help with cleaning, ironing, shopping or with preparing food.
  • Freeze some meals in advance for times when you need them after the birth.
  • In the first few weeks while you are getting settled you may need a lot of help. This is a good time to plan for your partner, a family member or family friend to be available to help out.
  • Plan what you are going to do about nappies. A nappy service or disposable nappies may be helpful.
  • Because twins often come early, plan to go to your antenatal classes a bit earlier than usual to make sure you can complete them. Your midwife or doctor will be able to help you with this planning.
  • If you have other children at home, particularly very young children, think about how you are going to prepare them for the new babies. Our topic 'Second baby' may be helpful.
  • There is a topic 'Twins and more' on our Kid's Health site which may help.

Breastfeeding twins

Because breastmilk supply increases with extra demands, most women can breastfeed twins well. This can mean much less work compared to preparing and giving formula.

  • Because of the extra challenges of feeding two babies, it might help if you get in touch with your local breastfeeding association, a lactation consultant or your local branch of the Multiple Birth Association before the birth of your babies. Your midwife or community child health nurse will also be able to give support.
  • Breastfeeding has many advantages. It provides the best food for babies and it helps prevent some common infections.
  • Make sure you get as much rest as you can and remember to eat nutritious meals.
  • You can feed the babies together or separately. Feeding both babies at once can give you more time to get some rest in between feeds. You may want to feed separately some of the time so you get more chance to get to know each baby.
  • Have a look at our topic 'Breastfeeding - more about breastfeeding' for information about breastfeeding twins and about feeding premature babies.

Bottle feeding twins

  • If you are bottle feeding your babies, it is a good idea when you can to feed each baby separately, as this separate closeness and touching helps encourage bonding with the baby. If you try to feed them together you will find you are holding the bottles, not the babies!
  • Have a look at our topic 'Bottle feeding - feeding your baby with formula'for more information.

Caring for twins at home

Note: If you can manage getting a bit of extra help in the house after the babies are born this can be a great help – even if you have to go without something else.

Resources

South Australia

  • Parent Helpline 1300 364 100.
  • Child and Family Health Services nurses - call 1300 733 606 for an appointment
  • South Australian Multiple Births Association
    Ph: 8364 0433 Monday to Thursday 10am to 1pm
    http://www.communitywebs.org/samba/ 
  • Multiple Births Coordinator, Women's and Children's Hospital 8161 7520 (Can provide information and support to parents in all areas of South Australia.)
  • Multiple Births Coordinator, Flinders Medical Centre 8204 4296 (Tuesdays only, 10.30 to 2.30).

Australia

References and further reading

Bowen, C. (1999). 'Twins development and language'
Retrieved from http://www.speech-language-therapy.com/mbc.htm on (11/06/2010).

Gromada KK and Hurlburt MC. 'Keys to parenting multiples'. Barrons Educational Series, 2nd Ed. 2001.

Simpson L and Paviour A. 'More than One'. Simon and Schuster, Australia, 1994.

Corrigan A. ‘Parenting Twins’, Australian Multiple Birth Association, 1995.

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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