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Raising twins and triplets: Everything is a challenge

There’s lots of love and cuddles to go along with all the ‘craziness,’ say moms of multiples
Raquel Love with twins Connor, left, Logan, right, and son Lucas in back in West Vancouver.

Five years after Vancouver’s Tania Zulkoskey gave birth to twins, the world finally began to move as fast as everyone told her it would from the start.

“Everybody said the time would go by fast,”  says Zulkoskey. “It didn’t. Every day had 28 long, gruelling hours in it. Everything in the first year is triage.

“We went through six nannies in that first year.”

The first year of their twins  lives delivered a blizzard of challenges for Zulkoskey and her spouse, Diane Srivastava.

Only now that their fraternal twins have turned five and are in kindergarten have the couple s lives accelerated into a state closer to the bliss that people believed was always there.

“We’re living the dream five years into the game,” Zulkoskey says. “Now that they are in school we feel that time is moving fast.”

If moms of multiples could ask for one gift on Mother’s Day, it would probably be the gift of understanding and compassion from the rest of us.

Experts say parents of multiples tend to feel more guilty, more defeated, more exhausted than parents of singletons.

They get more bad advice than other parents and face more criticism.

Their children, often born early, are more frequently beset by developmental challenges.

The financial demands of raising multiples can be enormous, as are the strains placed on parents  relationships.

“Everything is a physical, mental, financial challenge,” says Grace Chan, a Vancouver-area mother of identical twin boys, aged 21 months.

“Your head is always spinning. You re always strategizing — how are we going to do this?”

Parents of single children may wonder how such a life could be anything other than an ordeal.


The answer moms of multiples often give is that their hard work is rewarded with more love than anyone can imagine.

 “It may be triple the work, but it’s an amazing amount of love and laughter and cuddles,” says Jessica Abou-Khazaal, a North Vancouver mother of triplet boys.

 “All of the craziness is worth it, and 10 times more, when you have three little people looking at you with unconditional love.”

There are more moms of multiples in B.C. than ever, thanks to fertility treatments and in-vitro fertilization, according to Perinatal Services B.C., an arm of the Provincial Health Services Authority.

The province's rate of multiple births rose to 3.3 per cent per cent of overall births in 2013-2014 from 2.9 per cent in 2004-2005, according to Perinatal Services.

Of the 1,483 multiples born in B.C. in 2014, 1,448 were twins. Thirty-five were higher-order multiples such as triplets and quadruplets  almost double the number nine years earlier.

 “The risk of having twins increases 20 times with fertility treatments, while the risk of having triplets or quadruplets increases 400 times,” according to Multiple Births Canada, an advocacy and support group for parents of multiples.

For parents of singletons, two of the most shocking aspects of moms of multiples' lives are likely the never-ending volume of care and the fact that most of them get used to it.

Chan, 33, counts herself lucky that Caleb and Luke, her twins, are easygoing, with similar likes and dislikes. But she says chronic fatigue comes with the territory.

“As for the first two months, my husband and I don t remember anything about them. It’s all a blur,”  Chan says of the never-ending crying, feeding and diaper changes.

An Australian study found that a parent of six-month-old triplets, and his or her helper, spend an average of 197 hours a week on caring for the children and household chores. In other words, care and chores take more hours than there are in one parent s week.

Abou-Khazaal, 32, says she and her husband haven’t had a solid night’s sleep since she was pregnant with her three sons, who are now two.

 “A lot of it has been and is overwhelming, and there is never not something to do,” she says. “But we don’t know any different. The chaos is normal.”

Each of four moms of multiples interviewed by the Sunday Province said efficiency is a key survival skill.

“Everything is structured and organized,” says Raquel Love, a North Shore mother of fraternal twin boys, aged six.

“You get into a rhythm and live and die by the calendar.”


Families of multiples also scramble to cope with the financial demands that may begin even before birth.

 “Women expecting multiples can be admitted to hospital as early as 24 weeks into their pregnancies,” Multiple Births Canada says.

 “If preschool children are at home, child-care arrangements must be made and if the family lives outside the community (where the hospital is located), travel and accommodation expenses will grow.”

Love and her husband, who also have a 10-year-old son, have learned to scrutinize every expense.

 “When it was just Lucas, it seemed like we could afford to take him places and send him to camp and do extracurricular activities,” says Love, 44.

“With the twins here, we always have to decide where our money is being spent.”

If Vancouver-area moms of multiples are surprised by the cost of diapers, formula and accessories such as strollers, some are staggered by the cost of daycare.

Chan says daycare runs from $1,200 to $1,980 per month. That's per child.

“There is no such thing as sibling discounts,” she says. “Everything is doubled.”

Zulkoskey, 43, and Srivastava, 45, have launched a challenge under the Canadian Charter of Rights and Freedoms arguing that both parents of twins should get paid parental leave from Employment Insurance.

 “If my partner got pregnant at the same time that I did, we would both have been granted paid leave, and no questions asked,”  Zulkoskey says.

 “Since I gave birth to twins, we have the same number of babies to care for  two  but are qualified for only one parental leave.

 “That doesn't make sense to us.”

The appeal is now with the Canadian Human Rights Commission. A change in EI rules wouldn t help Zulkoskey and Srivastava, but it could make a world of difference for other parents of multiples,  Zulkoskey says.


Kerry Jang, a University of B.C. psychiatry professor, points to advantages that are intertwined with the difficulties of parenting multiples.

While he agrees that the challenges posed by multiples are formidable, moms of multiples get to deal with tasks such as toilet training at a single point in time, Jang says. Families with singletons wade through these things again and again, he says.

“Generally, we have found that once you get used to the volume, you adjust on the fly,”  he says. “It becomes simpler. You only have to go through teething once. You only have to watch Barney once. You don t have to sing those songs for each kid.”

A big potential pitfall for parents of identical twins is expecting them to be alike all the time, he says.

“It’s about being open to what their personalities are,”  says Jang. “The twins research is clear that the best outcomes are from matching talents with appropriate environments.”

Abou-Khazaal says the personalities of her triplets are already evident. One is sensitive, one is more aggressive and active, while the other is a thinker  — “always tinkering and calculating his next move,” she says.

The fact that multiple mothers simply do not have enough time to go around can lead to guilt, says Zulkoskey, who works with parents of multiples in her counselling practice.

They re forced to make hard choices as certain children need more attention for reasons of health or because they're the squeaky wheel.

Abou-Khazaal says staying out of this guilt trap can be a challenge. “I don’t have the time to nurture them one on one as much as I could if it was one child or if I had them at different times,” she says. “That lack of time to be with them one on one as much as I d like is the toughest part for me.”

Love says multiples' moms may blame themselves for falling short of being supermoms.

“Raising good humans is hard work no matter how many children you have,” Love says. “Having multiples comes with its own set of challenges, but being a mom of singletons is just as tough and we need to be compassionate with ourselves.”


It doesn’t help matters that parents of multiples are critiqued more than are parents of singletons, Zulkoskey says. Everyone seems to have an opinion on whether you should or shouldn t dress them the same, keep them in the same class or separate them, and it s usually parents of singletons offering the most advice,  she says.

But many of the rules and practices appropriate for singles do not work for multiples, Chan says.

A few trooper  moms of twins may be able to nurse twins exclusively but many have to resort to pumps, bottles and formula. Even then, fatigue may overwhelm moms of multiples to the point they prop up bottles with a pillow or blanket in front of the closely monitored babies, Chan says.

Baby books suggest bonding during diaper changes by making eye contact, singing and smiling. But with twins you are changing one as fast as you can while keeping an eye on the other,  Chan says.

“When it comes to raising babies, sometimes we run on instinct,” Chan says. “Because there are more unpredictable incidents that may happen, you just act before you think about the tips and rules that you read in books.”

The upside of this double vision, she says, is that parents of twins get a second chance to catch a milestone such as a child's first steps if they miss it the first time.

Multiples are more likely than singles to experience delays with language development, and issues with behaviour, school and relationships, Multiple Births Canada says.

Little wonder that parents of multiples are more likely to experience depression and anxiety during and beyond the first year after the babies' births.

Linda Leonard, a multiple births specialist and retired UBC professor, says depression and anxiety may affect 20 to 45 per cent of expectant and new parents of multiples.

Social isolation is a big risk for moms of multiples, experts say, partly because their own experience differs from that of moms of singles, partly because it may be difficult for them to get out of the house.

Getting peer support, guidance and encouragement in groups such as North Shore Parents of Multiples can make a big difference, Abou-Khazaal, Love and Chan say. Abou-Khazaal is also in a Facebook group of moms of triplets born in 2013.

 “I’m on top of hundreds of women that have triplets and it’s been invaluable,” she says.

Some of the luckiest moms of multiples are those with a sense of humour resilient enough to help them laugh through their exhaustion. Abou-Khazaal falls into this group.

Much as she loves her triplets, Abou-Khazaal is putting her foot down on expanding her family down the road.

“They were natural and if we had three the first time, Lord knows what we d get the second.”


• The current rate of multiple births in Canada is one in 31, reflecting the influence of fertility treatments, Multiple Births Canada (MBC) says.

•  The chance of conceiving twins rises 20 times with fertility treatments. The chance of having triplets or quadruplets rises 400 times, MBC says.

• Multiple births account for slightly more than three per cent of all Canadian births but represent 28 per cent of the country's low-birth-weight population of infants, according to MBC.

• Twins are 10 times, triplets 30 times and quadruplets 110 times more likely to have cerebral palsy than a singleton, says MBC.

• Disabilities of most kinds are more common in multiples mainly, but not entirely, due to prematurity and low birth weight.

• In the first year of life, the bare-bones cost of raising twins is pegged at $7,000 more than it is for singletons, according to MBC. This excludes the cost of diapers, the need to renovate or move to a larger home, upgrading to a larger vehicle, the cost of help for the family, such as a nanny or child care, and the loss of a second family income. This cost difference rises to $14,000 for triplets, $20,000 for quadruplets and $28,000 for quintuplets.

•  May 28 is National Multiple Births Awareness Day in Canada. The date was chosen to mark the birthday of the Dionne quintuplets, born on that date in 1934 in northern Ontario.


 • On a typical day in B.C., four multiple-birth babies come into the world, according to data gathered by multiple births specialist Linda Leonard.

  • In 2011, 71 per cent of multiple births occurred to B.C. women aged 30 years and older, 38 per cent to those 35 and older and 8.5 per cent to those 40 and older.

  • That same year, 78 per cent of B.C. women aged 35 and older had their multiples via caesarean delivery.

  • Fifty per cent of B.C.'s mothers of multiples aged 35 and older delivered a low-birth-weight multiple of under five pounds, eight ounces.

  • Across Canada in 2011, the average length of twin pregnancy was 36 weeks; for triplets, it was 32-33 weeks.

  • About 45 per cent of multiples are born at term: 37 weeks of pregnancy. Fifty-five per cent are born before 37 weeks.

  • In 2011, the average Canadian twin baby weighed between five pounds, five ounces and five pounds, eight ounces.

  • The average triplet baby weighed between three pounds, 11 ounces and four pounds.