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What Are the Biggest Signs You’re Having Twins?

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TwinStuff
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twin pregnancy

Some women just know that they’re going to have twins.

You might have had a dream, or a strong, defined sense that you’re carrying more than one child. Twins might run in your family, or a perceptive aunt or sister might have told you that twins are on the cards. It might even just be a general feeling that comes from knowing your own body, how you feel and what’s going on. But what are the actual signs you’re having twins?

A lot of women aren’t so lucky, and they go through the first few weeks or months of pregnancy blissfully unaware that they’re soon to be the parents of a pair of beautiful babies.

So how do you know? Can you tell whether you’re having twins, even before your first scans? Just what are the signs and symptoms that you’re pregnant with twins?

So What Are the Signs You’re Having Twins?

There are a lot of classic symptoms for twins, which are all generally down to the increased levels of Human Chorionic Gonadotrophin Hormone, or hCG, which is the pregnancy hormone that causes all of the wonderful (and maybe not so wonderful…) changes that come with falling pregnant.

A lot of twin pregnancy symptoms are actually the same as for regular pregnancies, just stronger, or ‘more’ than you’d expect for someone as far along as you might be, so if this is your first time, just go with it and wait for your scans to confirm what you might already suspect.

As you read down this list, remember that pregnancy affects every woman differently, and you might experience some, all or even none of the below symptoms as you go through the different stages.

Symptoms For Twins

Being Bigger Than Expected

This is the one of the first signs you are pregnant with twins that the majority of women will experience, and the one that will probably push them into suspecting that they might be carrying twins. After all, it is an incredibly noticeable sign!

If you’re experiencing bloating that makes you look further along than you are, parents or friends have commented along those same sort of lines, or you just feel like you’re getting bigger faster than you’d have expected, then it’s possible you’re carrying twins.

Doctors and midwives will also normally measure your fundal height (the distance between the top of your pubic bone and your uterus) when you go for check ups. If this distance is further than expected, it’s a possible sign of a multiple pregnancy.

There are multiple reasons why this might happen, though, so don’t get excited if you’re a little larger than you have been with past pregnancies or than you expected to be. It’s not a sure fire sign of twins.

Twin pregnancy

Extreme Nausea

Heavy duty nausea aka morning sickness, is one of the classic early signs of twins, which can come even if you’ve been pregnant without any nausea before. This can also manifest as a really strong aversion or intolerance to particular foods, much earlier than you’d expect these sorts of things to happen.

Tender Breasts

When you’re carrying twins, it’s common to experience extremely tender breasts, which can be so severe they’ll hurt at even the slightest touch or pressure, to the point that even wearing bras can become uncomfortable. If this affects you, it might be worth switching to bandeau style tops or crop tops for support until this dies down again.

Urinary Urgency and Incontinence

Needing to pee much more often. Whilst needing to urinate more is a classic early sign of pregnancy, when you’re carrying twins it will be even more intense.

An unfortunate side effect of pregnancy is incontinence. Because of the weight and pressure that you’re carrying, most of it over the bladder, there’s increased strain on you down there, so shocks like sneezing, exercise and heavy laughter can cause leakage. Obviously, with twins you’re going to be carrying even more weight, making this more likely.

Severe Exhaustion

A lot of women already struggle with feeling tired when they’re pregnant, from a combination of hormones, stress, and simply having to carry extra that they’re not used to, making everything you do harder.

With twins, this can escalate to the point of complete and utter exhaustion and fatigue, sometimes to the point that making it through the day can be a struggle. The likely explanation is the increased demand for nutrients and blood oxygen your twins need, so make sure you get enough rest and you’re eating a healthy, balanced diet.

Unexplained Uterine Cramping

If you experience uterine cramping that’s not combined with any blood loss, you could be having twins. This is because the uterus is having to expand quicker than usual, which puts increased strain on the round ligaments that hold and supports everything down there.

Fluttering or Pounding Heartbeats

You might feel like your heart is pounding or working harder than usual. And you might be correct. Because your heart will have to pump larger amounts of nutrient and oxygen rich blood to the uterus, it’s going to be working harder than usual, which will obviously have physical effects.

The Mood Thing

Mood swings, unstable, uncontrollable moods and being far more prone to tears are always normal symptom of pregnancies, but in twin pregnancies the symptoms are usually going to be far stronger and more intense, because of the higher concentration of hormones that cause this symptom.

So remember, if you are experiencing mood swings and heavy ups and downs, don’t despair. It’s normal. Just do what you can to ride with it, make sure your significant other is aware of what’s going on, and if you have to, see your doctor.

Out of Place AFP Test Results

During your second trimester, you should have an alpha feroprotein test. This detects the levels of a protein your baby’s liver produces, and can be a possible way to catch birth defects and other things early.

Abnormally high readings can indicate you’re having twins, because of course there’s going to be around twice as much of this protein being produced.

Elevated Levels of hCG

Like we said right at the start, one of the major signs of twins is a if you have higher levels of the pregnancy hormone and your blood levels change quicker than expected.

Even this isn’t a foolproof sign, though, because sometimes even singleton pregnancies have higher levels. As always, it depends entirely on you and your body. But this is a pretty good indicator.

How to Actually Confirm The Symptoms of Twins

The most reliable, and one of the only ways to confirm that you’re carrying twins is an ultrasound, so if you think you might be having twins, wait until your ultrasound to confirm it. If you’re sure you’re having twins, but the ultrasound only shows a singleton, then don’t worry. Sometimes ultrasounds will only pick up one embryo, especially if it’s an early ultrasound performed only a few weeks in.

It’s also possible to confirm that you’re pregnant with twins by hearing separate heartbeats on a Doppler fetal monitor.

Bear in mind both of these methods can miss or overlook the signs that you’re having twins. It’s really unlikely, but it can happen!

So if you’ve got your heart and mind set on twins and all the signs are pointing to you having two babies on the way, but all your scans are showing one, then don’t worry! It’s possible you’ll have a surprise coming when it’s time to pop. The second baby is sometimes missed in the early ultrasounds. 

Bear in mind that twins are more likely if:

  • You’re older, especially if you’re past the age of 30
  • You’re taller or heavier than average
  • There is a history of twins in your family
  • This isn’t your first pregnancy
  • You’ve had fertility assistance to conceive
  • You’re of particular descent or lineage, for example, African American

So if you have any of these signs, or so does anyone you know, it’s possible! Remember that the best way to confirm that you’re carrying twins, even if you’re 99% sure and have the strongest feelings, is an ultrasound scan, so until then just keep your fingers crossed!

Did we miss anything? Have you experienced any of the signs you’re having twins, or know anyone who has? Is there anything in particular that made you realise you were going to have twins? If so, we’d love to hear from you. Feel free to tell us all about it in the comments below.

Best Double Jogging Stroller for Active Parents

By
TwinStuff
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best double jogging stroller reviews

In our active lives, it’s hard to find time to exercise without having the best double jogging stroller. When there are two babies to look after, it’s near impossible to find the time to exercise without them. That’s why we keep hearing about ways to exercise with our babies. It’s the growing thing, from mother and baby classes to jogging options using a stroller specifically designed to help you with the task. It’s great. You get your exercise, and the babies get to go with mommy on something she loves and some fresh air into the bargain.

Then you’ve got to consider that the more active the parents are, the more active a child ends up being, and considering we all want the best for our children, it’s good to get habits like these ingrained early.

But buying a stroller to go jogging brings with it a whole new host of problems. That’s why it’s important to know what the options are, so you can make an informed choice and guarantee you buy the best stroller you can. Here are our reviews with a neat comparison table followed by the features that actually matter. 

Best Double Jogging Stroller Comparison

Product

Features

Durability

Our Rating

BOB Revolution Pro Duallie Jogging Stroller

4.5/5

4/5

 

Baby Trend Expedition Double Jogger Stroller

4/5

4/5

 

Baby Jogger 2016 Summit X3 Double Jogging Stroller

3.5/5

4/5

 

Thule Urban Glide – Double Jogging Stroller

4/5

3.5/5

 

The Features That Matter

When you’re looking to buy a double stroller for runners and joggers, you’re really looking for two things.

First, you need a stroller that’s going to be comfortable for you when you’re jogging.

twins stroller jogger

Second, you need a stroller that makes sure your two babies are as comfortable as possible, especially if you’re going off road or longer distances.

There’s quite a few things that can make a major difference for you and your children, including:

The Wheels and Suspension

If you’re buying a stroller specifically to use when jogging, then the type of wheel and the suspension your purchase has will make an absolutely huge difference.

Bear in mind any shocks will be absorbed by the wheels and suspension first. If you buy a stroller with a sub par suspension system, or hard, rigid wheels then any bumps you go over will be transmitted straight up through the frame into your arms, and more importantly, into any passengers!

High end strollers have air filled wheels, similar to wheels you’d find on a mountain bike. They also tend to have suspension systems already built in, which can normally be adjusted. What this means is you can make sure that you have the right ride for you and your children, every single time, no matter where you’re going.

Seats and Straps

We’ve all been on long plane journeys and been wildly uncomfortable, whether it was because we didn’t have enough leg room or the person next to us refused to give us any space on the arm rest.

Now imagine being placed in a chair like that, but not being able to get up and out of it if you want to.

That’s why it’s so important to make sure that the seats are as comfortable as possible. In general, especially if you tend to run over rougher ground or trail run, then deeper seats are better. It’s also worth having a look to see how adjustable seats are, because we all know how our kids can be. One twin might like to lie back and relax, staring at the clouds, whilst the other wants to see everything and everyone ahead.

Most importantly though, is padding. Jogging strollers tend to have seats with a lot of extra padding to make sitting in them whilst you run over bumps and make turns extra comfy, so if you’re looking at a stroller with no padding and it’s advertised for jogging, get suspicious!

It’s also worth checking the safety harness before you buy. Most strollers have decent harnesses, but strollers equipped for jogging can sometimes have better harness designs that are safer and more comfortable on rougher terrain.

The Handlebar and Brakes

The first thing to say is, make sure your handlebar is a comfortable height! Have you ever gone for a run holding your arms above your head? No? Good, because that would be crazy. But you can imagine how uncomfortable it would be, right?

Most good strollers have adjustable handlebars that can be set to multiple different heights, for even the tallest and shortest amongst us.

You’re also going to want a handlebar with a decent amount of padding. This doesn’t matter so much when you’re just walking around town, but when you’re running you’ll come to appreciate that extra layer of protection on your hands. Trust me, after a long run pushing two babies in a 30lb stroller, your hands will be feeling it enough!

Whilst we’re talking about handlebars, it’s also worth discussing brakes. Seems like a weird segue, but a lot of jogging strollers have hand brakes that are mounted on or near the handlebar, as well as a footbrake.

If you can, it’s worth buying a stroller with an easily accessible hand brake, because they are so much easier to use when you’re moving than foot brakes, and you only need one loose rock or slippery big of ground for accidents to happen. If it ever does, you’ll be happy you had your brakes in easy reach.

Like on cars, the best types of brakes are drum brakes. What this means is the brake clamps down all the way around the axle, putting force on every part and stopping you faster. Again, these are worth looking out for, especially if you regularly run on rough or loose ground.

Canopy and Storage

If you’re out jogging, it’s fair to say you’ll experience bad weather, unless you’ve somehow learned to control it. (If you have, please share the gift. Imagine every summer’s day being hot and never having to go on holiday again!)

Now you might be able to deal with a bit of rain, but your children probably won’t, especially because they’re sitting down low and leaning into it.

That’s why a decent canopy is important. It blocks everything, rain or shine. A good canopy will have excellent coverage of the seats, probably has a viewing window, and if it does, the window will definitely be UV resistant.

Whether it’s hot and stuffy or cold and miserable, nothing makes a quick stop off better than a snack and drink. Plus all that running can cause nature to call at the most inopportune moments, so strollers with large amounts of secure storage space are always appreciated.

When you’re looking for storage on a stroller designed for jogging, deep or easily sealed pockets are a welcome addition. Nothing worse than having to double back because a bottle bounced out whilst you ran.

Durability

Finally, it’s worth talking about durability. After all, there’s no point in buying a stroller, and shelling out a lot of money for something that’s going to fail after a few weeks.

When you’re checking how tough your stroller is, focus on the areas that see the most use, like the wheels and seats. It’s these areas that are going to be taking the brunt of the force when you’re running, and a little bit of extra toughness here, like double stitched linings, goes a long way!

Top Double Jogging Strollers

BOB 2016 Revolution PRO Duallie Stroller

Pros

  • Handlebar can adjust to any height needed
  • You can set the wheels and suspension for any surface
  • Drum brakes stop this in seconds
  • Great storage options

 

Cons

  • A little heavier than some strollers

In my opinion, this is the single best double jogging stroller out there. It’s got so many options that are perfect for the amateur jogger and the kids, that make sure that every run is as comfortable and easy as possible, for all three of you.

First off, the handlebar is massively adjustable, with nine different levels, as well as being padded, which makes it incredibly comfortable even on longer jogs.

It’s got hand activated rear drum brakes, like the kind you’d find on a sports car, which stop it effortlessly. On top of that, the wheels are large and air filled, so they take impacts and keep everyone going with the least amount of fuss.

For the little guys inside, there’s a top quality suspension system to keep them comfy, plus all the normal things you’d expect to see, as well as a really decent all weather canopy that comes down low to cover everything that’s needed.

Plus, it’s a really high quality stroller anyway, with all the mod cons like a really easy two stage breakdown that can even be done one handed, loads of storage space and easily accessible pockets! There’s no real downsides, except that it’s a tiny bit heavier than some lower quality strollers.

But if you’re looking for the most convenient stroller to take on your runs, the amount of features and sheer quality on offer here means this is the one you should choose.

Baby Trend Expedition Double Jogger Stroller

Pros

  • So easy to push
  • Individually reclining seats are a nice touch
  • 5 point harness belts are comfy and safe

 

Cons

  • No hand activated brake
  • Wheels sometimes need adjusting

Lightweight, really easy to push and manoeuvrer, and surprisingly budget friendly. The Baby Trend Expedition is a really good stroller for city and suburb use, as it’s air filled bicycle type tires run incredibly smoothly on side walks.

But don’t let that make you think it won’t also go all terrain. Even though it’s a lightweight stroller, the frame is robustly built so it gives a really smooth ride for even the smallest passengers. Another huge bonus on this front is the five point harness, which is adjustable in multiple ways to fit any occupant.

Being able to recline each seat by itself is a huge bonus, as is the canopy, which is incredibly versatile. No matter what it’s like out there, your kids are going to be safe, from rain, wind or sun!

There are a couple of smaller issues, but nothing that derails the whole thing. Sometimes the wheels need a little bit of adjustment to run smooth, but that’s easily fixed. I also don’t like foot activated brakes on strollers meant for jogging, just because it can be a little harder to hit.

Overall though, there’s a lot here to love, and this is definitely our number one budget friendly jogging stroller.

Baby Jogger 2016 Summit X3 Double Jogging Stroller

Pros

  • Really great ride. Wheels and suspension are top quality
  • Seats are so comfortable
  • Canopy is huge and covers everything

 

Cons

  • Non-adjustable handlebar
  • Wheels sometimes get into a bit of a wobble until you stop moving

Another high quality jogger manufactured by Baby Jogger, this stroller is specifically designed to be used whilst running or jogging, and comes with a whole suite of features that are excellently placed and well thought out.

Firstly, the ride is exceptional, with heavy duty air filled wheels, a powerful, adjustable suspension system and reliable hand brake that will stop this dead in seconds.

It’s also really comfortable for the kids inside, with two deep seats that are both individually adjustable, and a huge all weather canopy that can be pulled all the way over for complete coverage.

All told, this is very similar to our top choice, which isn’t a bad thing, as the BOB Revolution Pro is a fantastic jogging stroller. Given the option, I’d still choose that one, but for one reason only. This stroller doesn’t have an adjustable handlebar, so for particularly short or tall women, it could be uncomfortable to use. Apart from that, it’s absolutely fantastic, but if you’re going to buy it, make sure you can comfortably hold on to the bar.

Thule Urban Glide – Jogging Stroller Double

Pros

  • Small, light and easy to move
  • Really great ride, deals well with rough ground
  • Lovely little touches like magnetic canopy windows

 

Cons

  • Wheels can occasionally stick
  • Smaller seats

In terms of rough ground, I think this is the stroller you want to use on all terrain out of our list. With its huge wheels, both in size and how far apart they are, the ride is smooth and incredibly comfortable no matter what you’re rolling over.

The front wheel can be locked for smoother terrain, which is really simple to do. Plus there’s a built in, high quality suspension system that keeps the little ones bump free.

For such a large stroller, it’s surprisingly easy to move, and everything about it is simple and easy to use. There’s some lovely touches too, like the fact that the canopy windows are magnetic rather than studs, so you can literally just reach over and snap them up or down in one go.

There are a few minor issues that prevent this being the best, though. The front wheel can sometimes stick and takes a little wobbling to get it moving again, the foot brake is really loud, so might wake light sleepers, and worst of all, the seats are a little smaller than average, so larger or older children might struggle.

Don’t let that put you off though. These are all really small problems, (even the seat thing, it’s not as bad as it sounds) and everything else about this stroller is absolute quality.

Baby Trend Navigator Double Jogger Stroller

best baby trend double jogging stroller

Pros

  • Storage tray design is genius
  • Comfortable, individually adjustable seats
  • Easy to set up and put away

 

Cons

  • Can be hard to steer around corners
  • It’s huge

Another Baby Trend product, another great jogging stroller. This one has all the same creature comforts and technology to keep the little ones safe and comfortable on your jobs, including twin padded reclining seats and a smooth, easy ride with big, air filled tyres.

But it’s the little touches for mommy that make the difference. Like the storage tray. It’s got twin cup holders, which are pretty standard, but it’s also got a covered storage tray to keep everything safe, and the best touch, built in MP3 speakers. That means you can plug your phone straight into this and have music whilst you run, without having to wear headphones and lock yourself away from the world, and your babies!

So why is this not rated higher than the Baby Trend Expedition? Simple. It’s a huge stroller, and for some reason the designers decided to put a pair of wheels on the front of this, instead of the single rotating wheel you normally see.

This makes it handle like a tank. It’s amazing in straight lines, but getting it round sharp corners will test every ounce of your strength. Apart from that one thing though, this is a fantastic jogging stroller that any mom would be proud to own.

Bringing It Together

Now that you’ve read through the list, you should already have an idea of which best double jogging stroller is best for your needs. But as long as you buy something from our top choices, you can relax, because you know that you’re soon going to be the owner of a great stroller!

Do you regularly take your little ones on jogs with you? Did you find these reviews helpful? Any tips for dealing with sudden showers, bumpy roads or even grizzly little ones? We’d love to hear from you, so let us know in the comments below what you think.

7 Different Types of Twins

By
TwinStuff
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2
different types of twins

Twins are getting more and more common, with the rate of multiple births getting higher and higher. In fact, in 2001 the amount of twin births raised to more than 3% for the first time in history!

 Most people think there are only two different types of twins, but did you know there are actually seven?

There’s a lot of reasons why twin births are occurring far more regularly. There’s the fact that women are having children older that they used to, which can increase the chances more than one egg will be released into the womb at a time.

There’s the advent of assisted reproductive techniques, which can cause the ovaries to produce more than one egg per cycle.

Previous pregnancies can increase your chance of conceiving twins, and finally there’s also heavy genetic and racial components to having twins. In fact, certain tribes in Africa have as much as a 1 in 20 chance of having twins!

twins on a wagon

So What Are the Different Types of Twins?

When it comes to twins, there are two ‘standard’ types, and a whole bunch of rarer occurrences that crop up every now and then.

Most of these are occasional events, but some are so rare that you’ve probably never heard of it, let alone going to have this type of twin!

Fraternal Twins

This is one of the ‘normal’ types of twin that people think about when you say twin. It’s caused when two eggs are released and manage to both be fertilized by separate sperm at the same time.

Because both children come from different eggs, they’re non-identical twins, and they’re going to be as different as any two brothers or sisters usually are.

This means they can look completely different, act different, and be different in any conceivable way that any two normal siblings could be.

The chance of fraternal twins is actually genetic. Some families are far more likely to have twins than others. It’s passed down by an individual gene that the mother holds, so if a few people in your family have fraternal twins, it might not be just down to chance!

Learn more about fraternal twins here.

Identical Twins

Out of all the types of twins, this is what people normally think of when you say twin. Two children with 100% the same genetics, both born from the same egg.

There’s an incredibly high chance that identical twins look almost exactly the same. Hence the name identical. It sounds obvious to even say this, but it turns out that there is a minor chance that identical twins look very different.

A pair of twins born recently in England are genetically identical, but one has blue eyes and pale skin, and one is darker skinned with brown eyes!

Identical twins also don’t have to have the same sort of personality. It’s a common misconception that twins are identical in every way. But any mother of identical twins will tell you that, even though they look completely alike, they can be as different as chalk and cheese!

Identical twinning happens when one egg is fertilized, then splits into two during the first few days of pregnancy.

As of yet, no one knows what causes the egg to split this way, but considering that twins are getting far more frequent, and the science of twins is understood more every year, it could only be a few years until we know exactly what causes twins!

Learn more about identical twins here.

Mirror Image Twins

This is a type of identical twin where the egg splits, the same as it normally does, but far later in the fertilization process. Around one quarter of identical twins are mirror image twins.

A mirror image twin is exactly what the name says. Both twins are like reflections of each other, to the point that they will even favor different hands for writing and sports!

Mirror image twins have exactly the same DNA, and usually have identical or incredibly similar fingerprints.

Sometimes one of the twins even has situs inversus, a harmless but strange disorder where the internal organs are on the other side of the body from where they normally are! 

So yeah, if you’ve ever had an urge to recreate Freaky Friday with your own family, mirror image twins are where it’s at.

Half Identical Twins

This can also called polar body twinning. This is caused when an egg splits before fertilization occurs, and then each egg goes on to be fertilized by a different sperm.

Because of this, the twins share all of their mother’s genes, but only half of their father’s, so share 75% of their DNA.

Because they share a few traits with identical twins and a few with fraternal twins, they’re generally called half identical twins.

Superfetation

This is a rare occurrence when a pregnant woman falls pregnant again!

This can happen, but it’s incredibly unlikely. It’s literally caused when a woman falls pregnant on one menstrual cycle, then has another menstrual cycle, and the second egg is also inseminated in a separate instance of intercourse, weeks apart.

Superfecundation

This is an even rarer occurrence when a woman releases two eggs during her cycle and has more than one lover, and each egg is fertilized by sperm from a different father.

Because they share the same mother but two fathers, this literally means you are pregnant with twins who are also half siblings, and they’re growing together in the same womb!

Mixed Chromosome Twins

This is possibly the rarest type of twin possible, with less than 25 recorded cases worldwide.

It’s the result of the fusion of two eggs, which were fertilized by two different sperm. This produces individuals with different sets of chromosomes.

Some of the people born this way even have multiple blood types, or potentially even both male and female chromosomes!

What Does This Mean for You?

It doesn’t really matter which of the twin types you have. Just consider yourself blessed to be born with two beautiful babies rather than just one.

As long as your children are healthy and happy, nothing else matters. And if you’re interested in having twins, whilst there’s a few ways you can increase your chances, you’re better off just trying to conceive naturally and hoping you get lucky!

Which types of twins do you guys have? Have you noticed any quirks or peculiarities with your twin bundles of joy?

We’d love to hear all your twin stories, so let us know in the comments below or join our community and post your story there!

Mirror Twins: Causes, and What It Means for Your Family

By
TwinStuff
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9
mirror twins
Identical ginger twins looking at each other in studio

Have you wondered why some twins who look so identical to each other are so completely opposite? Or looked at two children who seemed identical, but there was something unique about each one that you just couldn’t put your finger on?

It turns out that there might be a scientific reason for it!

They might be something called ‘mirror twins’ or ‘mirror-image twins,’ a phenomenon that scientists have only recently started to look into.

Even more shockingly, it turns out that as many as 1 in 4 identical twins could actually be mirror image twins, without even realising it.

But what does this mean? What is a mirror twin, and how are they different from normal identical twins?

twin crib

What Causes Mirror Image Twins?

Normal identical twins are caused when a single fertilised egg splits between the fourth and eighth day into two identical embryos, then each embryo goes on to grow into a healthy baby.

Because both babies come from the same fertilised egg, each twin has the same genes, so they end up growing up ‘identical’.

However, for these twins, it’s thought that the egg splits later, between days nine and twelve, and this somehow causes the twins to act as mirrors of each other.

Are you expecting twins? Are you the new parent of twins? Join our community here and join the conversation.

How Are Mirror Twins Different From Identical Twins?

Whilst normal identical twins are, well, identical, mirror image twins look the same, except reversed. Like you’re looking at them in a mirror.

It can be physical, with simple things like hair parting different ways or moles and birthmarks appearing on opposite sides.

It can manifest as one twin being right handed and the other being left. (Which is really common, by the way, so if you have identical twins who are differently handed, they might be mirror twins!)

It can even come through in really odd ways. One pair from the UK both lost their first tooth at about the same time, and they both lost one of the same type of tooth, an incisor. Except one girl lost her bottom left tooth, and the other lost her bottom right!

In the most extreme cases, one mirror twin will have internal organs in different places! Their heart and vein structure will be flipped, as if their entire body has been reversed! Thankfully, whilst this is a bizarre syndrome, it’s not harmful in any way!

Mirror Image Twins With Mirror Image Personalities​

For some reason, many also have mirrored personalities.

For example, the twins we mentioned earlier who both lost a tooth at the same time? They’re described by their parents as ‘the quiet one’ and ‘the lunatic.’

This is pretty normal. Another pair, even though they’re a little older now, realised they were mirror twins in the middle of a college psychology class. For their whole lives they’d wondered why they were so alike in looks but but so far apart in personality, and now they knew!

Finally, these twins shared all of the usual signs. One was left handed, the other was right, they both needed braces when they were children, but their tooth placements were a reflection of each others, but when it came to personalities, both kids couldn’t have been more different.

One girl, Erin, describes herself as the quiet one, and this is something she loves, as it’s one obvious way that they’re different, whilst her sister Ash is incredibly outgoing and will talk to anyone, no matter where they are.

But this doesn’t happen every time. In this book on twins, written by recognised behavioural specialist and twin expert Dr Nancy Segal, two twins who were separated at birth and only met for the first time after 39 years were found to have a huge amount of similarities, far beyond what could be coincidence!

For example, both twins suffered from tension headaches. Weird, but something you can understand. But both twins also bit their fingernails, even as adults. Both smoked, and even smoked the same brand of cigarettes! Both shared hobbies, and as a finale, even though neither of them knew the other, both liked the same sort of holidays, and regularly took holidays on exactly the same beach in Florida! If that’s not a signifier of the special bond twins can share, I don’t know what is!

It’s not just interesting, though. This phenomenon is incredibly helpful to scientists studying genetics, because of the way mirror image twins manifest the same things, but on different sides of their bodies.

This proves that there’s a massive genetic component to things like personality, likes and dislikes. On top of that, because they share tooth placement and even little things like where and when wisdom teeth come through, it means things like that are written into our bodies when we’re first conceived!

By studying twins, it enables scientists to work out exactly what is and isn’t determined by our genetics, and work to cure the things that aren’t helpful, like diseases and even cancers! All because of twins!cute twins

What Does This Mean For You And Your Twins?

If you’re having identical twins, there’s a pretty good chance that you might be lucky enough to have mirror twins!

They are nothing to concern yourself about. In fact, it’s just another way for your twin treasures to be unique.

It can also be helpful. For example, if you have them and one starts teething early, you can be pretty sure the other one will too. This will carry on all their lives, and it means you can use one as the gauge for the other. Obviously, both of your children are going to be individuals, with their own unique likes and dislikes, but it’s a good start to go on, and more than most new mothers get, especially the first timers out there!

The only real issue, and this is something we’ve heard multiple times, is working out who is who, especially when they’re a little way away from you! It might be worth investing in color coded clothes or unique hair decs now!

Have you been told you’re going to have mirror twins? Maybe you’re already blessed enough to have a set in your life? Either way, we want to hear your story in the comments below!

Twins In The Womb: 4 Fascinating Facts About Twins Before Birth

By
TwinStuff
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1
Fundal Height Twins

In any pregnancy, but particularly in a twin pregnancy, a lot of development is taking place in your womb. The womb provides a secure place for the babies to grow that is conditioned to meet their needs. There, babies grow from embryos to fully formed infants, responding to pokes, prods, sounds and even the food you eat. Let’s look specifically at twins in the womb.

How Are Twins Formed During Fertilization?

Twins develop when one zygote – a fertilized egg – splits into two parts, forming identical twins, or when two eggs are released and fertilized separately, resulting in fraternal twins. Twin pregnancies are full of new challenges and fascinating facts that make them different from singleton pregnancies in more ways than one. Let’s take a closer look at four fascinating things that take place for twins in utero.

  1. Sense of Touch

Twin babies first develop their sense of touch at around seven gestational weeks, at which point in time their mouths become able to feel sensation. About two weeks into your second trimester, your babies’ heads will become more sensitive to touch. Later on in your pregnancy, your babies will be very aware of touch, responding to pressure applied to your baby bump.

  1. Sense of Hearing

Around the start of your 5th month of pregnancy, your babies will start being able to hear sounds. At first, the sounds will be very indistinct to them, muffled by their fluid surroundings as well as the sounds made by your stomach and heartbeat. Toward the end of your pregnancy, your babies will begin responding to external sounds with movement, especially words and phrases that have been repeated when talking to them in utero throughout the pregnancy

  1. Sense of Smell

Though it may seem hard to imagine, your babies will be able to smell the things you smell as well as what you eat via the amniotic fluid that surrounds them. Though it doesn’t seem to affect babies in any notable way, the scent is an important sense to them after birth and is what enables them to identify their mother.

  1. Intrauterine Twin Bonding

As twins develop together, studies have shown that they form a social bond that includes reaching out for one another and touching each other, a demonstration of the inherent impulse to make contact with other humans. This early bond may explain why twin babies are often extremely close, even developing their own imperceptible languages as they grow.

Twin Pregnancy: Development Process

In the National Geographic documentary by In The Womb, they assessed the development of twins in the womb, explaining the growth process of twins in utero to fully formed baby. Around 12 or 13 weeks, twin babies take on a more human appearance, and their head and body size becomes more proportional. The first ultrasound happens around this time, and the presence of one or multiple placentas can help a tech identify whether a woman is having identical or fraternal twins.

Reactions to Stimulus in Twins

Later in pregnancy, 3D ultrasounds have shown that babies respond with facial expressions to the ministrations of those manipulating their position in womb. Babies may frown and make unhappy faces in response to the pokes, prods and nudges of doctors trying to get them to move around.

how early can twins be detected

Twins Born Holding Hands

In one case, twin girls born in the rare condition of both a shared placenta and amniotic sac emerged from the womb holding hands. This beautiful moment was unusual to capture, but not a far cry from the norm from twin babies, who rely on a sense of touch to get to know their sibling from early in the developmental process.

A Lifesaving Hug

In another case, twin girls were born premature, and one twin was barely hanging onto life after a few weeks. Doctors and nurses made the unprecedented choice to put the healthier twin in her sister’s incubator, where the healthy twin wrapped her arm around her sister. This eased her breathing and helped to restore her vital signs to a normal level. Over a decade later, both girls are still healthy. Did you know we have our own forum? and ask questions, meet other parents, and join in the discussion.

Reaction to Womb-like Environments

Very young twin babies sometimes react to environments that mimic the womb by curling up against their twin just as they did in that small space. One video demonstrated that twin babies carefully submerged in warm water with their faces exposed to air snuggled with one another and slept, inevitably due to the similarity the situation shared with the conditions from when they were twins in the womb.

How To Conceive Twins Naturally

By
TwinStuff
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1
pregnant woman

The reasons may vary, but many couples hope to conceive twins. The main reason is to have siblings that can grow and support one another. Another reason is the desire to start building a family sooner than later.

I Want to Have Twins

The possibility of multiple births occurs in a little under three percent of all U.S. births annually. But science has discovered there are things you as potential parents can do to increase the chances of having twins.

The following information is about having twins naturally and does not factor infertility treatment.

What are Your Chances of Having Twins?

Take a look at the following list. The more factors that apply to you or your significant other, the greater the chance you may have twins.

  • If there are already twins in the family, especially on the mother’s side, you have a greater chance of having multiple babies.
  • Women who have already had multiple pregnancies dramatically maximize the chance of having twins. This is seen in large families of at least 12 children. Often, these families have sets of twins and triplets.
  • Studies show that people of Asian and Hispanic culture are less likely to conceive twins. People of African descent have the greatest chance of having twins.
  • Waiting to have a child can impact twinning. Women who waited until they were in their mid-30s were twice as likely to have twins.
  • Being well nourished — even overweight — increases the chance of twin conception. Research implies women with a BMI of 30 boosts, or higher are more likely to have twins.
  • This is something you have no control over, but taller women are more likely to have twins than women of the same age who are of average height or shorter.
  • A female twin has a greater chance of having twins.

Is Age a Factor to Have Twins?

Yes, age does appear to matter. While older women are less likely to get pregnant in the first place, statistics show they are more likely to have twins. Women between 40 and 45 are between seven and 17 percent more likely to have twins. This data falls in line with the idea that women who have already had children are more likely to have twins.

What Type of Twins am I More Likely to Have?

In general, the average woman has a one in 350–400 chance of having identical twins. Those chances increase based on the above criteria.

It’s estimated that a quarter of identical twin births are mirrored twins. Not many people are even aware of this rarity. Mirrored twins are exactly what it sounds like, twins that have reversed characteristics.

One will be left handed, the other right. A birthmark on one twin’s shoulder will be on the opposite shoulder of the sibling. There has even been bizarre physicality like opposite teeth and reversed skeletal features.

Fraternal twins happen once in 60 twin births.

Some Truths About Having Twins

Even taking into account factors listed above, overall, the odds of any women having twins is about the same.

  • There is no such thing as twins skipping a generation.
  • There is no scientific evidence to support the idea that a diet high in dairy foods, meat, and milk — especially during ovulation — increases the possibility of twinning. (More on this later.)
  • There is no research to support the idea that therapies like naturopathy, acupuncture, chiropractics, aromatherapy or flower essences increase the likelihood of conceiving twins. Those who believe otherwise may have simply been the recipients of a happy coincidence.

Can a Sexual Position Increase Twinning?

You can find a ton of information that implies a sexual position can influence the possibility of having twins, but it’s more hopeful hype than anything.

Remember; twins are the result of (i) the woman releasing two eggs at the same time and then being fertilized by sperm or (ii) a fertilized egg splitting in two.

In other words, the factors that create twins will be in place before even beginning sex. Ergo, the position should not have any impact on the outcome.

What Can I Do to Increase My Chances of Having Twins?

Folic Acid Can Help

A study in Australia uncovered a correlation between women that conceived twins and folic acid supplements. According to the research, women who consumed folic acid before getting pregnant had a 40 percent or greater chance of conceiving twins.

Unfortunately, there are also studies that contradict those results. But folic acids are still a good idea for pre-pregnancy. As a supplement, they can prevent neural tube defects.

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Continue Breastfeeding

If you already have a child, continue breastfeeding. A study concluded that women breastfeeding were nine times more likely to conceive twins compared to women who were not breastfeeding.

Birth Control

If you were on birth control pills and stopped to conceive, this may be the best time to make a pair of babies. The body of a woman that’s been taking the pills for at least six months has to wait for her hormones to begin regulating themselves, as opposed to the pills controlling them.

There can be up to eight weeks for the system to correct itself. For twinning, the medical community considers this a benefit as too much hormone stimulation can cause ovaries to release an extra egg early in anovulatory cycle or two. This means a greater likelihood of conceiving twins.

Consume Dairy

Despite our argument above, there are as many studies that support consuming dairy products as there are that shoot it down. It is a fact that vegans and vegetarians are significantly less likely to have twins, which implies meat may play some part in twin conception.

So the argument becomes is a regular diet of milk and dairy derived from hormone-treated cows a factor in twinning? We don’t know. We would suggest you continue your regular diet and hope for the best!

Eat Wild Yams

Speaking of diet, wild yams has a chemical that appears to overstimulate ovaries. This can result in more than a single egg release during ovulation.

This data derives from a study done in a small town in Nigeria where the birth of twins was four times greater than the rest of the world. Researchers could only conclude diet played the greatest part, especially a cassava root the townspeople ate regularly, or wild yam.

Have More Children

Build your family. Remember, larger families are more likely to conceive twins. That means, based on pure math, the more children you have, the greater your chances.

What are the Odds of Having Twins?

Twins of any type – 1:40Spontaneously fraternal twins – 1:60Identical twins – 1:2402nd set of identical twins – 1:62,500Two sets of fraternal twins – 1:5If mom is fraternal twin – 1:20-25Conjoined twins – 1:60,000

Twins in Australia – 1:66Twins in UK – 1:72Twins in Canada – 1:89Twins in Japan – 1:166Twins in Nigeria – 1:22Twins if using Clomid – 1:5

Odds of Having Twins by Ethnicity

White under 20 – 1:66White between 20 & 24 – 1:50 (1997)White between 25 & 29 – 1:39 (1997)White between 30 & 34 – 1:31 (1997)White between 35 & 39 – 1:27 (1997)White between 40 & 44 – 1:23White between 45 & 49 – 1:6White between 50 & 54 – 1:3Black under 20 – 1:54Black between 20 & 29 – 1:33Black between 30 & 39 – 1:28Black between 40 & 49 – 1:38Hispanic under 20 – 1:80Hispanic between 20 & 29 – 1:56Hispanic between 30 & 39 – 1:39Hispanic between 40 & 49 – 1:42

​

What are the Odds of Having Triplets?

Having triplets in U.S. – 1:517Spontaneously conceived triplets – 1:8,100White under 20 – 1:6,800White between 20 & 29 – 1:1,100White between 30 & 39 – 1:350White between 40 & 49 – 1:290Black under 20 – 1:3,600Black between 20 & 29 – 1:1,600Black between 30 & 39 – 1:740Black between 40 & 49 – 1:570Hispanic under 20 – 1:5,100Hispanic between 20 & 29 – 1:2,200Hispanic between 30 & 39 – 1:810Hispanic between 40 & 49 – 1:700

Having Twins is Still Up to Chance

Understand that we don’t get to pick our family. At the end of the day, the natural conception of twins borders on nothing less than miraculous.

While fertility treatments are certainly an option, but naturally, the twinning process is completely random.

When the times comes, instead of lamenting not having the twins you craved, bask in the idea you are getting ready to share your love with someone that’s going to need you for their entire lives.

Twins in School: Should My Twins Be in the Same Class?

By
TwinStuff
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4

As a mother of nine-year-old fraternal girl twins, I have found my association in both the local chapter and the regional chapters of a mother of twins’ group to be invaluable.

One of the themes that I consistently hear repeated is “Should we seperate twins in school or not?” A really interesting question from an educational psychology perspective. The issue of twins at school is an ongoing one. Let’s dive into this issue:

Should Twins be Separated in School?

Coming from the perspective of both a mother and a former elementary school teacher, I respond, “There is no simple answer. It depends upon the children and the school situation.” I think this decision is an individual one that must be made after evaluating several questions including:

  1. At this stage in their development are your twins extremely dependent on each other or do they easily make friends and play with different children.
  2. Are there any extenuating circumstances going on at home, such as a family illness or divorce, that would make you twins function easier by staying together or apart?
  3. Is there a situation at the school, such as a teacher or grouping of children that would make a particular classroom environment better for your children if they stayed together?
  4. What are your child’s thoughts on the subject? Are they looking forward to a separation or dreading it?

In the decisions I have made about my girls placement I have considered and weighed the responses to each of these questions each school year. I would like to tell you my experiences in hopes that they will both answer questions and raise new questions.

maternal vs fraternal twins

When my girls began pre-school I requested (okay, close to demanded before I wrote out the first check) that they stay together. I had been working outside of the house since the girls were 5 weeks old, but had previously left them with first a nanny and then in a home daycare environment. This was there first pre-school experience, and even though they weren’t nervous, I was. I felt the adjustment would be easier for them if they stayed together. And, somewhat selfishly, I felt more at ease knowing they would be together and looking out for each other.

When it came time to enroll them in kindergarten, everyone in our family was looking forward to separate classrooms. My girls are quite different both in physical appearance and temperament. They were ready for time apart, and the transition into separate classrooms came easily. They both made new friends and flourished.

Before the start of first grade, I observed the different first grade classrooms, spoke to parents for input, and decided to not only keep the girls separated, but went one step further by selecting which teacher I thought would be best for each girl based upon the girls’ abilities and temperaments. Prior to the end of kindergarten I wrote a letter to the principal stating the reasons for my preferences.

At the start of first grade I was pleased to learn my requests had been granted. Again, both girls flourished in their separate environments. But, there was one factor I had not considered. At this stage, both of my girls were academically advanced. For whatever reasons the school administration decided to take a group of six of the most advanced first graders and put them all in the same classroom. One of my daughters was part of this group. The other one would have been as well, but was not in this classroom because she was a “twin”. Throughout the year the girls were constantly comparing activities, and I was constantly shielding questions such as “why are her spelling words harder” and “why does she get to learn that.”

Prior to the start of second grade I spoke to the principal about classroom placements for second grade. To complicate matters, our school was converting to a year-round schedule. We live in an area of Southern California that is rapidly expanding. Because of overcrowding, a year round schedule was being implemented, allowing for two classrooms of each grade per track. So, with only two classrooms to choose from, my choice was narrowed down to “together or not!”

I voiced my concern that one of my daughters not be left behind academically just because she was a twin. I stated that in the best of worlds, I wanted them separated, but if this core academic group were kept together in second grade, I would request that both girls be in the same classroom. I was assured that the grouping would be dispersed between the two classrooms and that the girls would be separated.

And, here comes, rule #1: Know who does what, when you place a request with your school administration. Although I spoke with the principal, it was the vice-principal who made up the class list.

And, rule #2: Place your request in writing!

And, rule #3: Understand requests are just that. There is no guarantee that your request will always be accommodated.

At the start of second grade, my husband and I took the girls to school, only to view the class list to find they were in the same classroom. As I viewed the list, I realized that the core group, as well as some other academically advanced students from the other first grade class, had all been kept together and reasoned that was why the girls were together.

Surprise! As I took them to meet the teacher she announced, “R” will not be in my class. I have had her moved to the other classroom because our policy is not to have twins together”. I took my daughter to the other class, but knew I was not done with this issue. I remembered a workshop I had attended at a twin convention on this very subject. I can only speak for California, but I would venture to say that this would apply to other states as well. In the workshop, the presenter informed us that even if a school states a particular policy regarding twin placements, there are no laws or written policies. If you are presented with this statement, ask to see the policy in writing.

Knowing something about school dynamics, I decided to wait a few weeks to see how the girls were doing in their classrooms before approaching first the teachers and then the administration. It quickly became evident that their curriculum varied greatly. I spoke with “R”‘s teacher. I assured her that it was not personal, but that I was concerned about the differences in the two curriculums. Having had time to assess the children she said that she was facing a dilemma because she would either have to put my daughter in her own reading group or place her with children who were not yet at her reading level, which could slow down her progress.

At that point, both the teacher and I approached the principal. When he looked into the matter, we all agreed that it would be best to place “R” back in her sister’s class. The principal then approached the other teacher about keeping the girls together.

At the first parent conference, the teacher said to me “this is working out much better than I had expected. There is no problem with them being together. They are so different that nobody would even know they were twins!” By the end of second grade the teacher even suggested that the girls be kept together in third grade.

The transition to third grade was smooth as both girls entered the same class and did well. At the end of third grade, I had a conversation with the vice-principal. I reiterated that if the children were grouped academically, that I did not want the girls separated solely based on the decision that they were twins.

As we are in a year-round setting, the girls recently started fourth grade. My girls have been placed in the same class even though the school has dispersed the fourth graders between the classes regardless of their academic levels.

During my initial meeting with their fourth grade teacher she stated “I don’t know what your reasons are for keeping the girls together, but at some point you may want to have them in separate classrooms.” I quickly recited the “Reader’s Digest version” of “why”. And, it may very well be that the girls will be separated next year. As that time approaches I will weigh the different factors and make that decision.

Twins At School: Closing Thoughts

After speaking with so many parents of multiples, I can say that many of us have faced the same decisions. I think it is helpful to keep an open mind on this issue. Understand that you may not be able to make long-term decisions about the separation issue because the variables change with each new encounter. Know that you can approach the school staff with your input. And, for those of you with greater multiples, realize that the decisions are even more mathematically complex!

What do you think about twins at school? Are you for or against separation? Let us know in the comments below.

What are the Ideal Weights For My Twin Babies During the Pregnancy?

By
TwinStuff
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9
twin fetal movement
Start feeling around for that first fetal movement!

As you progress through your twin pregnancy, you’ll likely receive many updates from your doctor through ultrasounds and other methods on the weights of ‘Baby A’ and ‘Baby B’.

As you gestate, the weight of your baby twins will differ slightly from each other. The weights of the twins will also depend on the status of the mom as well as her lifestyle. However, when you reach 30 weeks, it is important to note that your babies should be around 3 lbs.

When Are Twins Usually Born

If your twins’ weight is lower than that, your doctor will assess the situation and determine the cause and solution. You may be prescribed to eat more or take additional supplements. Your babies will also be checked for any nutritional deficiencies.

Regarding your babies being overweight, your concern should be directed at the baby’s nutritional intake. Some genetic issues may cause babies to become overweight in utero, but it is rare, especially in cases of twins.

How Can You Ensure That Your Babies Are At the Right Weight Bracket?

There is no assurance that you can control your twins’ weight, but your obstetrician will do their best to advise you on the best possible scenarios you can execute.

They may encourage you to eat more, eat less of certain food products, or put you on a strict diet that will benefit you and your babies.

It is important to check with your doctor every time you have concerns, especially about your twin’s weight. This includes factors such as:

All of these will affect your weight, so it is best to ask for advice before changing anything in your routine. Don’t worry because when you choose the right doctor, they will be with you all the way, guiding you and helping you whenever you have questions about the weight and size of your twins.

What are the Ideal Weights For My Twin Babies During the Pregnancy

While the twin baby weight chart below indicates average gestational weights for a singleton pregnancy, your twins are likely to be close in weight to the chart below if they measure at the intermediate levels – our unofficial surveys of TwinStuff community members have similar weights of the singletons’ figures shown below.

What are the Ideal Weights For My Twin Babies During the Pregnancy?

Gestational Age

Weight (gm)

Weight (lb/oz)

   

8 weeks

1.0 gm

0.035 oz

9 weeks

3.0 gm

0.11 oz

10 weeks

5.0 gm

0.18 oz

11 weeks

12.5 gm

0.44 oz

12 weeks

20 gm

0.7 oz

13 weeks

40 gm

1.4 oz

14 weeks

60 gm

2.1 oz

15 weeks

90 gm

3.2 oz

16 weeks

120 gm

4.2 oz

17 weeks

170 gm

6.0 oz

18 weeks

220 gm

7.75 oz

19 weeks

275 gm

9.7 oz

20 weeks

330 gm

11.6 oz

21 weeks

395.5 gm

13.9 oz

22 weeks

460 gm

1 lb

23 weeks

555 gm

1 lb 3 oz

24 weeks

655 gm

1 lb 7 oz

25 weeks

750 gm

1 lb 10 oz

26 weeks

850 gm

1 lb 14 oz

27 weeks

975 gm

2 lb 2 oz

28 weeks

1100 gm

2 lb 7 oz

29 weeks

1260 gm

2 lb 12 oz

30 weeks

1420 gm

3 lb 2 oz

31 weeks

1585 gm

3 lb 7 oz

32 weeks

1750 gm

3 lb 14 oz

33 weeks

1915 gm

4 lb 3 oz

34 weeks

2080 gm

4 lb 9 oz

35 weeks

2250 gm

4 lb 15 oz

36 weeks

2420 gm

5 lb 5 oz

37 weeks

2660 gm

5 lb 14 oz

38 weeks

2900 gm

6 lb 6 oz

39 weeks

3075 gm

6 lb 12 oz

40 weeks

3250 gm

7 lb 2 oz

 

The baby weight chart above was taken from ‘Ultrasound in Pregnancy: A Book for Parents and Parents-To-Be’ by Dr. Applebaum. The table is just meant to be an average weight and should not be construed as medical advice of any type.

The final authority on the proper weights of your babies should always be your OB-GYN doctor.

 

What is TTTS – Twin to Twin Transfusion Syndrome?

By
TwinStuff
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0

Twin to twin transfusion syndrome (TTTS), also known as Feto-Fetal Transfusion Syndrome (FFTS) and Twin Oligohydramnios-Polyhydramnios Sequence (TOPS)) is a complication of disproportionate blood supply, resulting in high morbidity and mortality. It can affect monochorionic multiples (mono mono and mono di), that is, multiple pregnancies where two or more fetuses share a chorion and hence a single placenta.

TTTS is a very serious complication affecting approximately 15% of identical twin pregnancies.

Monochorionic  vs  TTTS Twins

source: Ritesh Mahajan, Radiologist at Mercury Imaging Centre Chandigarh

Twin to Twin Transfusion Syndrome

TTTS is a disease of the placenta. It affects only monozygotic (“identical”) twins sharing a single placenta. As the placenta develops, the blood vessels form in such a way that vessels from one umbilical cord connect up with vessels from the other. This causes a sort of “short circuit” between the babies. It can create a transfusion situation where one baby does not have an opportunity to process fluid coming to it because the fluid immediately gets sent over to the second baby.

TTTS Definitions

Samantha and Alexis were monitored for signs of TTTS.

  • Recipient: The baby that is receiving the extra blood from the placenta, due to the transfusion syndrome
  • Donor: The baby that is receiving less blood as a result of the transfusion syndrome
  • Stuck Twin: The donor twin will appear stuck to the wall of the chorionic sac on an U/S. This is because there is little or no amniotic fluid inside the baby’s amniotic sac and the dividing membrane has shrink wrapped to the wall. The membrane separating the twins can be difficult or impossible to find when the donor baby is completely stuck to the wall of the sac.
  • Hydrops: Water droplets that form in the recipient baby’s body tissue as a result of organs being overworked
  • Amniocentesis: The procedure employed for the periodic draining of amniotic fluid from the sac of the recipient in order to balance the pressure between the babies
  • Septostomy: The intentional rupturing of the dividing membrane between the babies; this creates a Monoamniotic pregnancy (see Monoamniotic below).
  • Fused Placenta: When the placentas of fraternal twins form close together in the womb, it is possible for them to grow into each other. On an ultrasound, they are almost indistinguishable from a single placenta. Even post-birth biopsy can not always enable doctors to distinguish a single placenta from a fused placenta.
  • Monoamniotic (MoMo): Some identical twins share both the chorionic sac and the amniotic sac. This is an uncommon configuration for identical twins and has many risks associated with it. TTTS patients are sometimes misdiagnosed as Monoamniotic since in both cases there is no visible dividing membrane (see Stuck Twin above).

Stages of Twin-to-Twin Syndrome

  • Stage I TTTS: Less then 2 cm of amniotic fluid around the donor and greater then 8 cm of amniotic fluid around the recipient
  • Stage II TTTS: Same as Stage I without any visible bladder in the donor baby.
  • Stage III TTTS: Same as Stage I (atypical) or Stage II (classic) with critically abnormal Doppler readings.
  • Stage IV TTTS: Same as Stage III with visible hydrops
  • Stage V TTTS: One or both babies have died

How is TTTS Identified?

Often, the first sign of TTTS is a “stuck” twin. This is caused by one baby not receiving enough placental blood to make much, if any, amniotic fluid. The membrane separating the babies will shrink wrap the baby to the side of the amniotic sac. Doppler ultrasound can also detect uneven or unbalanced flow within the two cords. Other signs are a weight and/or size differential of 10%-20% between the twins. Often, the mother’s belly can grow so quickly that it could measure 24 weeks one day and 40 weeks 4 days later.

Internal Indicators

  • Same sex babies (must)
  • Single placenta (not fused)
  • Size discordance (typically >15%)
  • Amniotic fluid measurement difference: less than 1 cm around donor; greater than 10 cm around recipient
  • Significant difference in cord Doppler readings
  • Hydrops in recipient (water forming in body tissue)

External Indicators

  • larger then normal uterus for gestational age of twins
  • one baby is felt kicking while the other is not

When Does Twin-to-Twin Syndrome Happen?

TTTS can strike at any time during the pregnancy. Usually, a first trimester occurrence of chronic TTTS is fatal and there is nothing mother or medicine can do about it. No one has proven it yet, but it is suggested and stands to reason that there are probably lots of parents who never know that there were twins growing in there before the babies pass on and begin to be absorbed back into the womb.

Second trimester chronic TTTS is very problematic because any invasion of the womb could trigger pre-term labor, which would be fatal at this point. The babies are too small to deliver and too big for re-absorption. Current procedures give these twins a fighting chance where, even just a few years ago, little chance existed.

Third trimester chronic TTTS is perhaps the easiest to deal with. In this case, the babies are viable outside the womb, so, if things get too bad, the option to deliver is real.

TTTS Frequently Asked Questions

In this Video Dr. Ahmet Baschat, Director of the Johns Hopkins center for Fetal Therapy answers the most common questions about Twin to Twin Syndrome.

  • How common is TTTS?
  • When is a mother typically diagnosed with TTTS?
  • What happens if it goes untreated?
  • How is twin to twin transfusion syndrome typically treated?
  • What are the risks of this procedure?
  • What can a patient expect after this procedure?
  • Is there any special follow up required after the birth of the twins?

Twin to Twin Transfusion Treatment Options

  • Reduction amniocentesis
  • Septostomy (also known as microseptostomy)
  • Selective laser ablation of the placental anastomotic vessels
  • Selective cord coagulation

There’s Always Hope

A diagnosis of TTTS is a shock to parents who have been joyfully expecting an uneventful pregnancy. Like many medical mysteries, the cause and development of TTTS is not yet fully understood by even the leading doctors in the field of TTTS research, but more and more is being learned every day. Huge advances in the ability to analyze and diagnose TTTS have been made over the past couple of years.

New laser techniques pioneered by Dr. Quintero (Tampa) and Dr. De Lia (Milwaukee) are showing amazing success when compared to more traditional methods of combating the disease and there are several programs around North America and Europe that are currently working hard to understand the syndrome better so that a better treatment plan can be.prescribed.

Unfortunately, most doctors practicing today were trained before these advances were known, and the currently available statistics on TTTS do not reflect the most recent successes, either. As a result, few doctors are actually current on the newest techniques for diagnosing and treating the disorder, and this results in some less than accurate assessments of the babies’ chances of survival. 

Until the general medical community is familiar with the advances in the field, and the literature reflects the newer, more positive statistics, patients may need to, advocate for themselves and their babies and look a little harder to find the right course of action for them. There are new procedures and protocols available today to improve your babies chances of surviving TTTS. 

What Can You Expect

First of all, I want to stress that because of different combinations of cross-connecting and different sizes of those vessels that do cross-connect, this disease can show up in a very wide number of ways. As there is little that can be done in the early stages of the pregnancy, I will try to focus more on second and third trimester cases.

It is not uncommon for a TTTS pregnancy to be mistaken for Monoamniotic (MoMo) early on, if the donor baby is not receiving excess blood right from the beginning. The diagnostic clue is that the donor baby will be “stuck” to the wall of the womb and will move its limbs little, if at all, during the ultrasound reading. It may also be difficult to detect the donor baby’s bladder through ultrasound, if TTTS has progressed far enough.

Each ultrasound visit should include a Doppler reading of the blood flow in the cords and other places. In the cords, differences in flow should be measured and noted and, if possible, the number of vessels that are functioning in each cord should be determined. This can give you an idea about placenta share and it can be a supporting clue in a TTTS diagnosis.

If TTTS is allowed to progress without intervention, the recipient baby may begin to experience a hardening of the heart. This is caused by 2 factors: 1) the amount of blood being processed (since this baby is getting its own supply plus some of its sibling’s) and 2) the thickness of the blood. This hardening of the heart can progress to a point where heart failure occurs. Should heart failure begin, water drops, called hydrops, will form in the recipient’s body tissue. This will usually precede the demise of the baby by only a couple of days, if that many. However, should TTTS be corrected by any method, (such as amniotic fluid reductions, surgery or birth) before it has advanced to far into this stage, the heart will usually correct itself as it grows.

Anemia is the biggest problem for the donor. If left untreated, TTTS-driven anemia will be terminal for the donor baby. Again, if intervention corrects the transfusion syndrome, then the anemia will correct itself.

What Can You Do Now?

The first thing you should do upon receiving a TTTS diagnosis is find out the answers to the following questions, if possible:

  • What is the gestational age of the babies?
  • Are they same gender? (Even if you do not want to know the babies’ genders, you NEED to know if they are the same, whatever they are)
  • Is there a single, shared placenta? (Ask if there is any previous evidence of there having been two placentas; this may help identify a fused placenta)
  • What is the size difference between the babies?
  • What is the fluid level around each baby?
  • Are hydrops present?

The second thing you should do is schedule a second opinion. This is no reflection on your doctor’s abilities. Twins occur about once in every sixty pregnancies. Monozygotic twins account for about one third of these twin pregnancies, and TTTS occurs in an unknown fraction of the monozygotic twin pregnancies. Some OBs can go their whole careers without diagnosing a single TTTS case. Most see only a handful throughout their careers. There have been a lot of advances in diagnosis and treatment over the past 5-8 years, but not every OB will be familiar with the syndrome or the advances in treatment. Since doctors do not see it often, they may not feel compelled to spend much time keeping up to date with it. It is always my recommendation to get a second opinion from one of the leading experts in the TTTS field. One good thing about the second opinion here is that it does not require a second trip to the doctor. Doctors can review the U/S results remotely. You need only get in touch with the two doctors’ offices and they will transfer the information. In many cases, contacting one or the other is enough, as long as you supply all of the necessary contact information.

TTTS progresses rapidly once it begins showing its ugly head. Often, the prognosis is grim. Due to the low occurrence of TTTS in the population, and the newness of some of the treatment plans, it could be a number of years before the statistics available to most doctors accurately reflect the growing success rate of the new medical procedures. Most doctors currently believe that, when left untreated, chronic TTTS diagnosed before week 25 is so close to 100% fatal that survival odds are almost negligible. You may be told that you have, at best, a 5-10% chance of taking even one baby home some day. Most parents are devastated. When parents finds out that a child is on the way, they begin preparing emotionally and logistically. When they find out there are 2 babies on the way, they often go into overdrive and double their commitment to the pregnancy. It is difficult enough to come to terms with the fact that it is twins; to deal with the prospect of the imminent loss of both can be devastating.

The third thing you should do is find hope. Seek out someone who has traveled the road of TTTS.  I cannot encourage you strongly enough to get in touch with someone who has walked this road ahead of you.. Thanks to the various new techniques, TTTS patients enjoy a tremendous and rising success rate, and talking about this with someone who has experienced it, and hearing their success story, can be tremendously reassuring and empowering. Today, with proper treatment, there is a lot of reason for hope.

TTTS Survivor Stories

 

In this book Erin Bruch shares the powerful and heart wrenching story of how her most blessed event became her greatest trial when her unborn twins were diagnosed with TTTS. She shares her personal reflections, the nature of this disease, current treatments, and the practical and emotional advice for families facing the diagnosis.

This concise guide describes the etiology, diagnosis and treatment of TTTS. Divided into six sections, the book begins with the history of the condition, then the basics, clinical features and diagnosis, to the most recent advances in its management and related ethical issues

Resources for Help and More Information:

TTTS Foundation The only non profit organization in the USA dedicated solely to TTTS. Provides support by e-mail and phone. Provides a comprehensive book on TTTS to newly diagnosed TTTS patients via the mail. Provides other support on a case by case basis. Some information regarding TTTS.

http://www.tttsfoundation.org

Fetal Health Foundation A 501(c)(3) non-profit charity that provides factual medical information on fetal syndromes, provides unconditional support to families dealing with these syndromes, provides advocacy and awareness around fetal syndromes and provides research grants funding new treatments and technologies.

http://www.fetalhealthfoundation.org/

If you have anything to share about twin to twin transfusion syndrome, please leave a comment below.

Whether to Separate the Twins in School and When

By
TwinStuff
-
17
Separating Your Twins In School

First, apparently I have a blog here. I know you couldn’t tell based on recent inactivity. D’oh. I offer no excuses (because you twin moms know all of my reasons already) and only apologies. But I’m back today with a topic that is affecting us right now and that I know many twin parents have also struggled with.

To Separate or Not to Separate

We’ve been very fortunate that our ID twin daughters have always been extraordinary playmates and friends.

Alexis and Samantha are two sweet, enthusiastic, imaginative little girls who, if given the choice, would spend every waking moment playing pretend together. They often get in “trouble” with mom and dad for trying to extend that play into the nighttime hours. I really only mind a little bit because, if I am being honest, I am *totally* jealous of them.

Samantha and Alexis after a hairdressing session.
Samantha and Alexis after a hairdressing session.

My husband and I decided many years ago that we would separate Lexi and Sam in school some time during early elementary. Recent developments have forced that conversation to the forefront of evening conversation-

We recently had the girls screened for their new Pre-K program. At this private school, the kids are taken by classroom teachers away from the parents to be interviewed. I was told more than once not to sweat it, they weren’t grading my twosome- it’s only to assess their social and educational foundations.

I still chewed my nails nervously in the lobby during the entire half hour (oh wait, is THAT where Samantha is picking up that habit??).

When my children were finally returned to me, skipping and smiling, I got wonderful reports. We were approved for admission! The teacher asked me then, “What have you decided about classroom placement? Would you like them in the same class or in different ones?”

“Well, my husband is a teacher and I am very familiar with twin needs. We have decided that we will probably separate them soon. Maybe not this fall but soon after?”

Aren’t I just a know-it-all?? I cringe.

“Hm, can I suggest that you do separate them this fall?”

The lead teacher pressed the point a little bit. Enough to make my mind race and my palms sweat; why wasn’t I ready for this?? So I asked why she wanted them in separate classes.

“Well, every question I asked of Alexis was answered by Samantha. Every question for Samantha by Alexis. Even when we asked them directly not to answer for one another, they did.”

Yeah, Yeah, They Do That

Then, only in the last few weeks, we’ve started getting reports of the girls having some behavior issues in preschool. Nothing major, nothing really shocking. Except that EVERY TIME one got her card turned to yellow for something, the other sister would exhibit the exact same poor behavior within the hour. Those poor preschool teachers! Oh, don’t I know it? They DO mimic the good and, especially, the bad.

Those poor preschool teachers! Oh, don’t I know it? They DO mimic the good and, especially, the bad.

We MoMs know that part of the trials of two is that one rough evening usually involves both kiddos. Unfortunately for the school, it’s too late in the year to separate them now and we’re left containing the cabin fever and managing each incident.

I guess I thought we had this figured out. As I embarrassingly asserted at the Big Kids’ School, my husband teaches and I’m a twin research junky. I knew we’d cross this road and I thought I knew when it would be. Really, though, kids don’t develop according to timelines in text and we have been shown the right time to separate Alexis and Samantha (yesterday??).

Have you separated your kids? Was there any one (or few) things that brought you to that decision? Talk to me.

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