Strategies to Support Sustained Breastfeeding of Late Preterm Multiple Birth Infants

Strategies to support sustained breastfeeding in late preterm multiple birth infants include developing a family-centered feeding plan in collaboration with the medical team, assessing and supporting breastfeeding sessions, promoting lactogenesis with pumping or manual expression, and activating a support system for families.

Is sibling rivalry fatal?: siblings and mortality clustering

Evidence drawn from nineteenth-century Belgian population registers shows that the presence of similarly aged siblings competing for resources within a household increases the probability of death for children younger than five, even when controlling for the preceding birth interval and multiple births. Furthermore, in this period of Belgian history, such mortality tended to cluster in certain families. The findings suggest the importance of segmenting the mortality of siblings younger than five by age group, of considering the presence of siblings as a time-varying covariate, and of factoring mortality clustering into analyses.

Meeting the educational needs of multiple birth children

There has been a significant increase in the number of twins and higher multiples so that one child in 33 is now a multiple. It is therefore not unusual for schools to have several sets of twins, as well as triplets and even higher multiples. By being the same age and in the same school year if not class, twins and higher multiples are not like brothers and sisters born closely together. Teachers and parents need to be aware of particular issues that may affect the physical, intellectual, personal, social and emotional development of multiple birth children, and to ensure that school policy and practice include this special group of children and parents. These issues include: preterm birth catch-up and implications for starting school; the balance of competition and cooperation among multiples; separation in school and the evidence from recent longitudinal studies; legislative and other initiatives on the development of school policy; the particular needs of higher multiples.

Preparation for parenting multiple birth children

The experience of expecting and parenting multiples is decidedly different from that of a singleton pregnancy and parenthood. Multiple births are associated with substantial medical, health care, socio-emotional, developmental, educational and economic consequences for both families and society. This paper aims to advise health professionals on how best to help families prepare for and successfully respond to the demands of multiple pregnancy and the first 5 years of parenthood after the births of twins, triplets or more. Four inter-related principles of good practice are vital to the care of multiple birth families: the involvement of a range of disciplines, of the family and of the multiple birth community; the provision of specialised care; coordinated services; and the building of family competency including the capacity to make informed decisions. Preparation should include education on the special aspects of multiple pregnancy and parenting using multiples-focused resources, health promotion and risk modification strategies, infant care and feeding, child development and advice on securing help and support while ensuring family participation in all care decisions.