Quick Tip: Join a Mothers of Multiples (MOM) Club

One of the best perks of having twins is the immediate bond you develop with other parents of multiples. Parents of multiples are truly among the most energetic, funny, and loyal people I know!

I just returned from the 2009 National Organization of Mothers of Twins Clubs (NOMOTC) convention in Las Vegas, where I was an invited speaker. During the convention, I had the privilege of meeting and learning from so many fantastic parents of multiples.

The NOMOTC sponsors over 450 local clubs throughout the country. They have over 25,000 members, and they’re growing at a rapid rate given the tremendous rise in multiple births in recent years.

gives you an avenue for sharing your feelings through this unique parenting journey, and reminds you just how special and fortunate you are to have given birth to such amazing children.

World TTTS (Twin to Twin Transfusion Syndrome) Awareness Day

December 7 is World TTTS Awareness Day. As a pediatrician, member of the TTTS Foundation’s Medical Advisory Board, and mother of monochorionic twins (twins with a single placenta), I share the TTTS Foundation’s passion for combating TTTS through public awareness. Whether you are pregnant with twins or know someone pregnant with twins, please read this article for important information about TTTS.

What is Twin to Twin Transfusion Syndrome (TTTS)?

TTTS occurs in roughly 15% of twins who share a placenta (called monochorionic twins). It’s important for every family pregnant with twins to find out early in their pregnancy if their babies share a placenta. If your twins do not share a placenta, they are not at risk of TTTS.

In twins who share a placenta, it is not unusual for there to be blood vessel connections between them. Normally, these connections retain a reasonable balance of blood flow to and from each baby. However, in TTTS, the blood flow between the twins becomes unbalanced. The placenta sends too much blood to one baby and too little to the other. One twin becomes overloaded with blood while the other becomes anemic. Left undetected and untreated, TTTS can be life-threatening for one or both twins.

Why is TTTS awareness is so important?

TTTS is a life-threatening condition, but it does not have to be life-taking. Medical advancements have resulted in excellent outcomes for twins who are diagnosed and treated early. The earlier TTTS is detected, the better the outcome– hence why awareness of TTTS is so vital.

The most important thing parents can do is educate themselves on the signs and symptoms of TTTS. Research has shown excellent outcomes for twins with TTTS when parents and doctors are educated about TTTS and are actively monitoring for signs of TTTS.

What are the physical signs of TTTS?

  • Sudden increase in weight gain.
  • Sudden sensation of the abdomen being tight or uncomfortably stretched.
  • Decreased movement of one or both babies.
  • Hand or feet swelling early in pregnancy.
  • Contractions before your due date.

Though the signs above may be associated with other conditions, it’s important that pregnant mothers with these symptoms seek medical attention to rule out TTTS.

How is TTTS diagnosed?

If your twins share a placenta, it is vital from the beginning that a doctor who has expertise in managing twins with TTTS is involved in your care. Even though your twins may never develop the condition, it’s important to have a doctor involved who knows how to detect and treat TTTS should your twins develop it. Typically, perinatologists (OB/Gyns who specialize in high-risk pregnancies) are well-trained in the management of TTTS. If your doctor is not a perinatologist, you can continue to see your doctor while also seeing a perinatologist for consultation.

TTTS is diagnosed by ultrasound. Twins who share a placenta require frequent ultrasounds to monitor for TTTS. Ultrasound findings that may suggest TTTS in twins who share a placenta include:

  • Amniotic fluid measurement is less than 3 or greater than 8 centimeters.
  • Weight difference of more than 20-25% between the babies or slowed growth in one or both babies.
  • Marked difference in bladder size or the inability to see the bladder of one baby.
  • Signs of body swelling or heart thickening in a baby.

More information on TTTS

Every parent with twins who share a placenta (whether or not they have been diagnosed with TTTS), should contact the Twin to Twin Transfusion Syndrome Foundation right away. The TTTS Foundation has great information on their website. In addition, they will send written information about TTTS to families and their doctors. Because early detection is important in the treatment of TTTS, families should contact the TTTS Foundation as soon as they discover their twins share a placenta. Though the majority of twins will never face TTTS, knowing about TTTS will allow parents to actively monitor and detect it early should it occur.

Fortunately, advances in medical technology have resulted in increasingly better outcomes for babies affected by TTTS. Treatments for TTTS include amnioreduction and selective laser photocoagulation. You can find out more about each of these and other treatments at the TTTS Foundation website. If your twins are diagnosed with TTTS, it’s important to discuss each treatment option with your doctor. The TTTS Foundation can help facilitate discussion with your doctor by providing you with some important talking points. In addition, if your doctor is not an expert in managing TTTS, the TTTS Foundation can help you and your doctor find a TTTS expert who can provide consultation to you and your doctor.

About the TTTS Foundation

The TTTS Foundation was founded by Mary Slaman-Forsythe in 1989 with the mission to combat TTTS through early detection and treatment. Mary and her foundation have helped countless families affected by TTTS. December is TTTS Awareness Month, the same month Mary’s twins, Matthew and Stephen were born. I had the good fortune of connecting with Mary during my pregnancy and through the writing of Twins 101. Mary is an energetic, knowledgeable, and compassionate mother who is an international expert in TTTS. She is a wealth of information and gives great pep talks too. Please don’t hesitate to contact her should you have any questions about TTTS.

Facts about the Flu Vaccine

Flu season is here. For pediatricians like me, this brings to mind the image of clinic rooms and hospital wards packed with children suffering from the flu.

The flu hit children especially hard in 2009. During the 2009-2010 flu season, there were 276 flu-associated deaths in children. As a physician who works in a children’s hospital, I was happy to see less serious flu-related illnesses last year.

Because of the gravity and widespread nature of the 2009 flu season, the Centers for Disease Control and Prevention (CDC) now recommends flu vaccines for everyone 6 months and older. Children under 6 months of age are too young to be vaccinated, but can be protected by having those around them vaccinated.

For women who will be pregnant during flu season, vaccinating affords protection for mothers and their newborn babies who are too young to be vaccinated. Every year, I see far too many new mothers and newborn babies affected by the flu. Flu-related hospitalizations of newborns can be reduced by insuring pregnant mothers and visitors to a newborn’s home are vaccinated against the flu.

In 2009, the regular seasonal and H1N1 flu vaccines were separate. Now, they are given in combination. This means fewer shots for everyone.

For people who are ages 2 to 49 who are healthy, not pregnant, and do not suffer from any chronic conditions, the flu vaccine also comes in a nasal spray. This is a more expensive, but reasonable alternative to the injectable flu vaccine.

Dr. Le-Bucklin’s Appearance on AM Northwest

Recently, I shared some of my favorite picks for multiples on the AM Northwest morning show. As promised, here is a list of the items featured on the show and where you can buy them:

1. Graco Twin Bassinet– www.gracobaby.com.

2. Twin DNA Test Kit– www.affiliatedgenetics.com.

3. Butter 3 Free Nail Polish– www.butterlondon.com.

4. Hugster (Touch for Life) Deluxe Twin Nursing Pillow– www.twinzgear.com.

5. Kidco safety items– www.cvs.com.

6. Thing 1 and Thing 2 Dolls– www.trendsintwos.com.

7. Twins 101 book– www.amazon.com or www.doubleupbooks.com.

Best Stroller for Twin Preschoolers

I love this Baby Trend Sit N Stand Stroller LX and am grateful to my sister who told me about it. It’s lighter and more affordable than other double strollers.

Preschoolers often don’t need strollers anymore, but I do find this stroller very useful in busy, public places such as the airport or mall. When I need to keep track of my three kids in a public place, I have them all sit in the stroller.

I like how our twins can get it and out of it by themselves– perfect for trips to the zoo or an amusement park when you want your twins to be able to get in and out of the stroller often.

An added bonus is that it can actually carry three young children. While it’s considered a double stroller, we are able to have our twins sit while our older child stands in the back of the stroller.

Quick Tip: Assign Bottle/Cup Colors

The following tip comes from Shelby, mother of adorable boy-girl twins and owner of Double Up Books:

Pick a bottle color or sippy color that you designate to each twin that way you’ll always know whose drink that is, who doesn’t finish their drink, and who is drinking out of the wrong cup. For example, my son always has orange, blue or green cups and my daughter always has red, purple, and pink cups.

Do audiobooks contribute to infants’ language development?

Dr. Le-Bucklin’s Answer:

Congratulations to you and your wife! I’m sure you are very excited about your twin pregnancy. Having twins is such a blessing. You’re going to love parenting them!

Great question about audiobooks!

Audiobooks are great for older children and adults (as you have found). I love listening to them myself! However, for babies, I recommend parents invest their money in a simple tape or digital recorder and record their own voice instead.

The reason is that babies learn to recognize their parents’ voices by having heard them in the womb. Even before your babies are born, they are already attached to you! As newborns, your voice (and their mother’s voice) will attract their attention more than any other voice. Because of this attachment to you, a recording of your voice would have greater benefit than a commercially prepared audiobook. And while the time investment is greater, it’s probably cheaper in the long run!

You can be as creative as you want with the recordings. You can record yourself talking or even singing to your babies. If you don’t know what to say, you can simply read your favorite books to them. Hearing your voice is what matters.

These personal recordings are especially useful if you decide to leave your child in the care of a nanny or other childcare provider. They can play these recordings for your babies throughout the day. In the long run, these recordings will become cherished keepsakes for your children.

So I suppose the short answer to your question is that audio recordings of your voice are more likely to impact your babies’ development than commercially-prepared audiobooks.

If you do want to buy some commercially-prepared items, I would suggest buying some music recordings. Music (especially classical music) has been shown to have beneficial effects on a baby’s mood and development.

Hope that helps answer your question!

Best wishes! And feel free to contact me anytime! I’m always happy to chat with parents of multiples!

Note: I was recently interviewed by Lani, the mother of triplets and co-founder of the Multiples and More Blog Network. This question was from our interview.

What can parents do to help prevent autism?

Dr. Le-Bucklin’s Answer:

Currently, there is no proven way to prevent autism. However, early diagnosis is the key to improving the long-term outcome for children with autism. Intervention with behavioral, speech, and other therapies have been shown to have the most success when started at an early age. Parents can help with the early diagnosis of autism by attending regular well child visits with their pediatrician and keeping a close eye out for possible signs of autism.

According to Autism Speaks, parents should notify their pediatrician if they notice their child has any of the following possible signs of autism:

  • No big smiles or other warm, joyful expressions by 6 months of age.
  • No back-and-forth sharing of sounds, smiles, or other facial expressions by 9 months.
  • No response when the child’s name is called by 10 months.
  • No babbling by 12 months.
  • No words by 16 months.
  • No two word meaningful phrases (without imitation or repeating) by 24 months.
  • Any loss of speech, babbling, or social skills at any age.

For parents seeking more information about the diagnosis and treatment of autism, I highly recommend the Autism Speaks website. The site hosts an extensive collection of articles and videos which highlight key facts regarding autism. For parents of children with autism, the site offers vital information on treatment options and practical advice on how to meet their child’s unique needs.

Note: I was recently interviewed by Lani, the mother of triplets and co-founder of the Multiples and More Blog Network. This question was from our interview.

Do you believe there is a link between vaccines and developing autism?

Dr. Le-Bucklin’s Answer:

The Autism Speaks organization best summarizes the answer to this question below:

Though the debate over the role that vaccines play in causing autism grows more heated every day, researchers have still not found a definitive link between the two. According to organizations such as the Centers for Disease Control and Prevention, the American Academy of Pediatrics and the World Health Organization, there’s just not enough evidence to support the contention that vaccines – specifically thimerosal-containing vaccines – cause children to develop autism.

One study published in the medical journal Lancet faulting the measles-mumps-rubella (MMR) shot has since been questioned by its own authors, and many others have also failed to pass scientific muster. Still, the accusations continue, largely from parents of children on the spectrum, and it’s easy to understand why: There are still no answers to this day about what’s causing a disorder that appears to steadily be expanding its reach.

Note: I was recently interviewed by Lani, the mother of triplets and co-founder of the Multiples and More Blog Network. This question was from our interview.

Are multiples more likely to develop autism than singletons?

Dr. Le-Bucklin’s Answer:

Twins are no more likely to have autism than the general population. The exception is if a twin has a co-twin with autism. Because autism can run in families, twins are more likely to develop autism if their co-twin has it. However, being a twin, per se, does not necessarily increase one’s risk of autism if there are no affected family members.

Note: I was recently interviewed by Lani, the mother of triplets and co-founder of the Multiples and More Blog Network. This question was from our interview.