I'm back and with TWINS!!!

Did you miss me? Well, it is a new year (+ one or so months, ok now I am up to 6 before I finally finished and published this post) and I am ready to start back up again. So much has happened since I last wrote. I promise not to take 2+ years off again, but I had a good reason. I started a new job, got pregnant, found out I was having identical twin boys, made it through most of pregnancy until I developed Pre-eclampsia, gave birth, made it through a short hospital stay myself and a slightly longer NICU stay for the boys, our daughter started grade school, we bought a townhouse, moved, switched our daughter’s schools, and on top of all of that I switched positions at my place of work. All of that brings me to the here and now. Each of these amazing adventures pulled and pushed our family like Willie Wonka’s taffy-pulling machine and it had an impact on all our lives. I have so much that I can write about and share, but first TWINS!

So, yes it happened. There is nothing like finding out that you are growing more than one embryo inside your womb to wake you up. Let me set the scene. I was 9 weeks along, my husband was out of town at a conference and I was fine with missing the first appointment since we had been through this before; so away I went to my Doctor for the first ultrasound. Everything was going great. We found a good strong heartbeat, the embryo appeared normal in shape, and measured exactly as it should for 9 weeks along. Then the faithful words of my Doctor, “let us take a look around” to see how the placenta and the rest of my uterus looked. Everything looked great, the placenta was in the right place and appeared attached correctly; and then it happened... “wait, did you see that?” I had seen it - another heartbeat- but it was in a different location than before. Then the words that came next I will never forget, my Doctor exclaims, “There appears to be another one, looks like you are having twins”. How could this be, twins don’t run in my family and I was fortunate that we were able to conceive without medical assistance in my slightly more mature age.

TWIN FACTS:

Twin births are a relatively rare event even though statistics show that they are becoming more common with the twin birth rate rising 79% from 1980 to 2014 (18.9 to 33.9 per 1,000 births; National Vital Statistic Reports). This “trend” has been attributed to an increase in the use of fertility drugs (which we fortunately did not need), as well as, an increase in maternal age (that’s me). In 2011, it was estimated that 36% of twin births and 77% of triplet and higher-order births were attributed to medically assisted conceptions such as the taking of fertility medications, in-vitro fertilization procedures (IVF), etc. (Kulkarni, 2013). Additionally, multiple births occur more often as women approach perimenopause, due to more of the follicle stimulating hormone (FSH) being produced. Although this production is normally a sign of a decrease in fertility, FSH is the hormone needed for an egg to mature for ovulation and having extra hormone can lead to more than one egg maturing and releasing. So, while women of “advanced” maternal age are less likely to get pregnant, if they do, they are more likely to have twins. That explains a couple of the reasons for having fraternal twins (or dizygotic twins), however, this was not my case at all - lucky me. Ours were identical!

IDENTICAL TWINS:

Identical twins, also known in the scientific community as monozygotic twins, occur when one fertilized egg (zygote) splits into two, resulting in the development of two separate embryos. This type of twinning occurs in 3.5 per 1000 births (compared to 33.9 per 1,000 births for all types of twin) and more interesting is that this statistic is fairly consistent across all demographics (race, geography and maternal age) for natural conceptions. The risk of monozygotic twins with conceptions using IVF is 2.25 times higher than natural conceptions (https://academic.oup.com/humupd/article/15/1/45/860625/The-risk-of-monozygotic-twins-after-assisted). Additionally, monozygotic twinning can occur at different times after conception which can result in different numbers of amnions (inner sac) and placentas the embryos will have during their development. Most Identical twins result when the zygote splits 4-9 days post conception (65-70%), leading to the development of two amniotic sacs and one placenta. This is how our baby boys developed. A split occurring 1-4 days post conception (25-30%) results in two amniotic sacs and two placentas. The rarest twins result (1-5%) from a late split at 9-12 days post conception resulting in only one amniotic sacs and one placenta.

The crazy thing is that why a zygote splits and the actual cause of monozygotic twinning is still relatively unknown. What we do know comes from a 2007 discovery which showed that for twins to occur the cells of an very early developing embryo (when it is still just a ball of cells) collapses  leading to the ball splitting in half, resulting in two sets of genetic material that will then go on to develop into two separate fetuses. The lead researcher on the study, Dianna Payne, believes the split occurs because the cell junctions (where cells stick together) fail, possibly due to cell death or just weaken of the junctions themselves during the cell collapse. 

https://www.sciencedaily.com/releases/2007/07/070702145537.htm

Another researcher, Dr. Bruno Reversade, has been studying the genomes of families from areas of the world that have higher frequencies of twins hoping to find the “twinning” gene. He speculates that the “twinning” gene does not allow cells to “stick” together within the blastocyst leading to the split in the genetic material. http://www.reversade.com/

Dr. Judith Hall, a pediatrician and clinical researcher who specializes in genetic factors that affect children’s growth, suggests twinning depends on the timing of fertilization. Most mammals know their fertility cycle and therefore mate when eggs are freshly ovulated, but Humans mate at any time with the possibility of an older egg that may more likely split.

So twins...yeah, although they are becoming more common they are still rare and identical twins are still even more rare, I guess the mystery of why is still part of their magic. Cause magic is definitely what you need to make it through the first couple of years (possibly longer, only time will tell).

When do children understand what death means?

Last week we lost our dog, Rocky. She was a beautiful Siberian husky who in her younger years was full of energy and mischief. She was a typical husky - she destroyed things, she talked back, and she was a horrible listener, but I loved her very, very much.  She was my first born so to speak. She had been with me through so much:  a horrible breakup, starting graduate school, finding my husband, and the birth of our child. She was always the belle of the ball, everyone who met her loved her and we had many wonderful adventures together.

Unfortunately, Rocky was old and had some health issues so CJ never really got to know the Rocky that my husband, I and so many others loved. The morning after she passed as I was fighting back tears, my beautiful CJ said the sweetest thing:

Me: How did you sleep?

CJ: Fine, how did you sleep, Mommy?

Me: Not very well

CJ: Does your tummy hurt?

Me: No I am sad

CJ: ‘Cause you miss Rocky.

Me: Yes, I miss her very much.

CJ: Me too, Mommy

She hasn’t cried, and I consciously understand that as a 3 year old she doesn’t fully comprehend death. My husband and I explained to CJ that Rocky died and that she won’t be coming home again, but the concept appears to be above her cognitive ability. As you can imagine there are a lot of websites that address the issue of how to approach the subject of death with children. Personally the two that I found most useful are:

http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/When_A_Pet_Dies_78.aspx

http://kidshealth.org/parent/positive/talk/pet_death.htm

However, there is not a lot of scientific research about the level to which toddlers and young children understand the concept of death. Young children can experience separation anxiety when someone or something is missing; however researchers who examine the comprehension of death study the ability of children to understand four main subconcepts (Nagy, 1948; Speece and Brent, 1984; Speece, 1995; Hunter and Smith, 2008):

Irreversibility- once a living thing dies it cannot become alive again

Nonfunctionality- once something dies, its biological function ends

Universality- all living things must die

Inevitability- there is nothing to do to avoid death

The literature has indicated that a child’s age, cognitive ability, individual experiences with death, and communication about death may influence their understanding. 

The majority of the studies I have read were conducted from the 70’s - 90’s and suggest that a child’s understanding of the four subconcepts occur when they can demonstrate the logical thinking of object conservation—around 9 years of age.  A more recent study concluded that children were able to understand the four concepts of death around 6 years of age (Hunter and Smith, 2008). This study showed that a child’s cognitive ability to arrange objects in logical sequences was related to their ability to understand inevitability, universality, and irreversibility, while their ability to conserve was only linked to the understanding of inevitability. As expected, the experience of the death of a pet or relative helps a child understand the concept at a younger age; however, the researchers did not find a significant effect with open communication about death. This might be due to the lack of diversity in the study which was a result of the small sample size used.

One of the more poignant studies I found examined the role of communication in children’s understanding of death. The researchers concluded that children were more likely to be confused and need extra support at transitions in life if parents did not involve the child in the “death experience,” and that open communication between family members provided the emotional support needed for a healthy recovery (Weber and Fournier, 1985).

Our primary goal for CJ at this moment is for her to understand that Rocky won’t be coming home because her body stopped working, not because she was bad (as she has mentioned a few times). So we will continue the conversation about Rocky’s death with her. As part of that conversation we are planning a little memorial to remember Rocky–to say goodbye in a way that hopefully allows not just CJ, but my husband and I some closure on Rocky’s death.

The beginning!

So here we go. I have been thinking of starting a blog for sometime but something always came up.  I guess that is how it goes being a full time working scientist, wife, and a mom to an inquisitive, outgoing, fearless toddler.

A little bit about myself, I am a formally trained scientist. I am not a medical doctor, nor am I giving out medical advice. I have a PhD in Neuroscience, specializing in Development Biology. I am currently a Postdoctoral Fellow, researching the early genetic patterning events that lead to the development of the skeletal system. I am not speaking as an expert in the field of child development, but more as a mom who enjoys researching questions that I have about my developing toddler through peer-reviewed scientific literature. My goal with this blog is to summarize the scientific findings and what I have learned and distribute it to a wider audience. Any medical relevant topics that may be addressed should be used more as a starting point to discuss the topic with your doctor.

Additionally, I would love to have some of my other scientist Mommies and Daddies out there possibly contribute some blog posts, including my Neuroscientist Husband. Over two years ago, five of our graduate school friends became first time parents and in the next few months four more will be joining us in this amazing journey called parenthood. Here is too all the INS babies! 

I look forward to and encourage your input, the sharing of your own experiences, and your feedback. Hopefully you will enjoy reading the site as much as I enjoy writing it.