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Sanjay Gupta MD

A look at multiple children births

Aired November 20, 2004 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


TONY HARRIS, CNN ANCHOR: And now in the news, a Polish woman held hostage in Iraq by militant groups since October has been freed. That word coming from Poland's prime minister. And the woman who was held captive has been released. And she is said to be safe and sound.
In Michigan, an investigation is underway after a scene you might call basket brawl. Fists were flying fast and furious at the Piston's Indiana Pacers game last night. It started when Indiana's Ron Artest and Detroit's Ben Wallace got into it, mixed it up. Artest then stormed the stands, punching out a few fans after he was hit by a cup. The game was called with just over 45 seconds left on the clock.

And the world's oldest known living man has died. Fred Hale, Sr. of New York died in his sleep yesterday. He was 113 years old. His grandson says he retired 50 years ago as a railroad postal worker and beekeeper. In just over 10 days, Hale would have turned 114. The research center watching over Hale says he was the oldest living man. And the oldest living man now is a German who is 111-years old.

HOUSE CALL with Dr. Sanjay Gupta is up next. We'll see you back here at the top of the hour.

SANJAY GUPTA, HOST: Good morning, welcome to HOUSE CALL. Checking the medical headlines first. Top officials of the Centers for Disease Control and the FDA appeared before congressional panels this week. Lawmakers blamed the FDA for not acting sooner when it found problems with the plant making the flu vaccine. The FDA says it thought the problems were being fixed.

And some drug makers are placing radio transmitters on pill bottles starting this week. It's their way of trying to stop counterfeiters. The electronic tags are actually computer chips with antennas, but look like ordinary labels.

And the CDC announced that in 2002, the birth rate among U.S. girls, that's those age 10 to 14, is the lowest since 1946. The CDC points to abstinence programs and birth control as a major factor in the drop.

Now to our top story. Births of multiples have skyrocketed since the mid 1980s. And earlier this year, we found out that AMERICAN MORNING anchor Soledad O'Brien was one of those lucky moms. She was pregnant with twins.

She allowed us to peek inside what it was like to become a mom of multiples. So today, we'll be giving you a look at multiples pregnancy through college.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): For Soledad, it's only the beginning of her trek into the world of multiples. Most come the old fashioned way, like Soledad's babies. But about a third, according to the Society for Reproductive Medicine, come from invitro fertilization or IVF. With IVF, eggs are fertilized and implanted in the uterus. The hope that one of them will eventually become a healthy baby.

UNIDENTIFIED MALE: Can I eat it? I eat it.

GUPTA: Thirty-one-year-old Amy Dipasquale got two healthy babies, but only after years and years of fertility drugs and treatment.

AMY DIPASQUALE, MOTHER OF TWINS: It was very difficult and physically painful. The shots hurt. I'm still sore where I got a lot of the shots done.

GUPTA: Four years later and after several courses of IVF, she was pregnant with Mason and Matthew. The path for Amy and her husband was difficult, painful, and the cost, crippling. Each course of IVF is around $12,000. And there's no guarantee that it'll even work.

If it does work, there's a 30 to 40 percent chance of a multiple pregnancy, since usually more than one egg is implanted. Years ago, implanting three to four eggs was routine, resulting in a rash of multiple births. Now the movement is towards implanting just two eggs to avoid that scenario.

ZEB ROSENWAKS, DR., NY PRESBYTERIAN MEDICAL CTR.: The higher the number of multiple pregnancy, also the bigger the problem for the mother in terms of medical complications.

GUPTA: Complications like high blood pressure or gestational diabetes, and serious uterine stretching, which could cause early contractions or an in extreme cases, uterine rupture. And extra pounds make it difficult to move.

THOMAS PINCKERT, DR., MATERNAL FETAL MEDICINE: When mothers have triplets or quadruplets, we're looking at somewhere between a 40 to 80 pound weight gain.

GUPTA: And multiples often arrive early, which could cause...

ROSENWAKS: Prematurity of the lungs. You could have neurological issues, bowel issues, many, many problems for the baby.

GUPTA: In spite of all that, families like the Dipasquales keep trying, hoping for one baby, and being happy with even more.

DIPASQUALE: It's so worth it, the pain and the stress while you're going through it, because the end result is priceless.

(END VIDEOTAPE) GUPTA: Yes, definitely is priceless. And the birth of twins, triplets, quads, and more is on the rise with increasing popularity of fertility treatments. Talking with us this morning about it, Dr. Penny Glass. She's a developmental psychologist at the Children's National Medical Center in D.C.

First of all, welcome, doctor.

PENNY GLASS, DEVELOPMENTAL PSYCHOLOGIST: Thank you.

GUPTA: We get a lot of e-mails. And these are questions you probably hear all the time, questions coming from parents of twins and expectant parents as well. So let's jump right in. This is an e-mail from Davin in California, who writes, "My wife and I are about to have twins. What is the number one thing we should be preparing for, other than lack of sleep?"

So doctor, what can you tell Davin and his wife?

GLASS: Well, with any luck, I hope they would prepare for paternity leave, actually. I couldn't resist getting that in. I think what they should prepare for would be meals. And now's a good time to make meals and store them away. They talk about being prepared for lack of sleep, but I think being able to really devote your time to your children right now, it's going to be a big shock to parents who are accustomed to devoting their time just to each other. So that's a big adjustment to make.

GUPTA: And getting help, I mean, you sort of joked about the paternity leave...

GLASS: Right.

GUPTA: ...but getting that help is really important, right?

GLASS: It is. Making contact, friends and churches. And when they know that multiples are coming along, there are all sorts of people out there that are just wonderful about bringing in help. And it may even be that they bring in a meal for you, or just something like that. Any little thing will help.

GUPTA: All right, let's get to another question now from Carl in Mexico. "When my twins are together in the same crib, they quiet down. However, I'm worried that if I let them sleep together now, I will have trouble getting them to sleep alone when they're older. What would be your advice on that?" A lot of questions come in this sort of thing, comfort of one twin with the other.

GLASS: Right.

GUPTA: How about sharing your crib specifically?

GLASS: Well, I don't happen to be a proponent of that type of co-sleeping. I agree with him that I think he might have some problems later on. And I think it's easier to deal with it early. What I like to do is to make sure that the separate cribs are close to each other, sort of like head to head at right angles, rather than necessarily across the room. And you can provide each twin with a little something to hold onto that might have the smell, actually, of their sibling that reminds them that that other person is close by.

GUPTA: Talking about multiples with Dr. Penny Glass. So what does it take to run a home brimming with babies? We'll meet the Cusato quads. That's coming up.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Pretty much feed, bathe, nap, feed.

UNIDENTIFIED FEMALE: Tips from parents of multiples coming up.

And later...

UNIDENTIFIED MALE: It's pretty easy to tell us apart. So as soon as they learn that we're quads, they have told us...

UNIDENTIFIED FEMALE: Growing up as a quad and one of nine kids. We'll show you how they manage.

First, see if you can answer our daily dose quiz. How much does the birth of twins cost versus a single child?

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Checking the daily dose quiz, we asked, how much does the birth of twins cost versus a single child? The answer, healthcare costs for twins is four times higher compared to single children.

(END VIDEO CLIP)

GUPTA: And financial strain may be just one of the things you experience having multiples. There's also the stress on your relationship with your partner, less time with each individual child, and of course, lack of sleep. One family that knows all about this is the Cusatos. Their juggling act has been going on for more than eight months.

(BEGIN VIDEOTAPE)

KAREN PICCIHILLO-CUSATO, MOTHER OF QUADRUPLETS: At the beginning, I think, it was exciting. You know, and with the newspapers and the TV. Then there was reality. It was, you know, these babies require around the clock care.

GUPTA (voice-over): Most days, the clock starts at 6:00 a.m. when four separate cries are heard. First order of the day, dad makes between 10 and 20 bottles before going to work, leaving mom to conduct a three-ring circus, maybe a four-ring circus on other own. First up, feeding. As if that weren't enough, the two older children need feeding as well.

CUSATO: Are you hungry?

GUPTA: At 7:30, help starts to arrive, aunts, uncles, neighbors, friends. The Cusatos average five helping hands a day.

HEIDI MURKOFF, AUTHOR: Get as much help as you can get from as many people as you can get it from.

GUPTA: The biggest challenge, getting them on a schedule. Easier said than done. The Cusato quads aren't quite there yet.

CUSATO: One will be asleep, three will be up or two will be asleep, two will be up.

GUPTA: And then there's the keeping track. Who needs a nap? Which girl did I feed, Victoria or Gabriella?

CUSATO: We couldn't figure out why, you know, the one girl kept spitting up. Like why is she doing this? Oh, wait a minute, she ate twice in a row.

GUPTA: Feeding fiascoes like this prompted Karen to start writing everything down on a spreadsheet. The stats are staggering. The babies go through 20 bottles a day, 24 diapers, 20 outfit changes, which means Mom is doing at least three loads of laundry a day. By year's end, the Cusatos will have spent tens of thousands on formula, diapers, doctors' visits, and adding onto the crowded house to make more room.

CUSATO: It's pretty much feed, bathe, nap, feed, nap, feed.

GUPTA: Lots of work, but well worth it.

CUSATO: It's still unbelievable to hold each one and think -- I mean, we had these four beautiful, remarkable miracles.

(END VIDEOTAPE)

GUPTA: And those miracles, though, can sometimes cause mayhem when they grow older. In the popular ABC show "Desperate Housewives," one of those wives is also the desperate mom of rowdy twin boys.

(BEGIN VIDEO CLIP, "DESPERATE HOUSEWIVES")

UNIDENTIFIED FEMALE: Of course, given her continuing level of frustration, Annette also felt a little self-medication couldn't hurt.

(END VIDEO CLIP)

GUPTA: Hopefully all those parents of multiples out there aren't having to self-medicate, but still, it can be overwhelming. We've got a question now from a struggling parent.

John in Texas writes, "We are proud parents of a 7-year-old and of an - and of 8-month-old triplets. However, getting all four to sleep at night is becoming quite a struggle. None of the baby sleep advice books seem to cover this case."

Dr. Glass, what sort of advice it do you give to John?

GLASS: I would give two advices. It's difficult to get 8-month- old singletons to sleep. So just treat them like you're putting three individual babies to bed. For the 7-year-old, I would let him stay up after those children and not try to get him to bed at the same time. He needs that special time once those others are to bed.

GUPTA: That's a little bit time just between the 7-year-old and the parents.

GLASS: It's very important.

GUPTA: Another question now from Carl in Pennsylvania. "Our 7- year-old twin boys are the best of friends and want to do everything together. Unfortunately, they don't want to participate in activities involving other children since they're always occupied with only each other." Should they be concerned about that, doctor?

GLASS: I think it is appropriate to be thinking about that. And my suggestion would be to have a little family counsel for the parents to talk about that with the boys and see if they have suggestions of how they're going to sort of broaden their relationships.

GUPTA: All right, Dr. Penny Glass, good advice there. Think twins are a handful? Try nine. We'll meet the Swick family when HOUSE CALL continues.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: From clothes to eyeglasses and college tuition, multiple kids equals multiple bills.

UNIDENTIFIED MALE: I have an accounting degree. I mean, the numbers don't add up.

UNIDENTIFIED FEMALE: Plus, looking to drop your baby weight? Our bod squad has a plan you can follow. But first, more of this week's medical headlines in the "pulse".

(END VIDEO CLIP)

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): If you spend nine hours a day or more looking at a computer screen, you may be at risk of developing glaucoma, according to a new Japanese study. Researchers looked at more than 10,000 office workers and found that more than 5 percent had vision problems, including glaucoma linked to their computer use. 95 percent of that group were myopic or nearsighted.

And the abortion pill Mifepristone, also known as RU-486, must now carry a strong warning that it can cause serious infections, bleeding, and tubal pregnancies, says the FDA. The statement comes on the heels of reports of the third death in four years linked to the drug. Mifepristone was approved by the FDA in 2000 to terminate pregnancies up to 49 days after conception.

Christy Feig, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. We're talking about raising multiples. One of the struggles for all parents is helping their child come into their own. For multiples, individuality is an even bigger challenge.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Soledad's boys were born just minutes apart, twins who will forever be remembered for their similarities in these pictures.

Still the hope is one day, they will grow into individuals. And that's the goal that experts often give to parents of multiples. Of the nine children in the Swick family, there is a set of quadruplets, all freshman in high school, and a set of triplets, all college freshman. Seven teenagers at once.

TARA SWICK, QUADRUPLET: It's nice having brothers and sisters the same age. You kind of know how the guys think that are your age and how then they can talk about how the girls think.

GUPTA: Born in the late 1980s, the seven Swick's were part of an era of increased multiple births that has since tapered off. The Swick's used fertility drugs for all of the births. All of them are healthy and none of them are identical. But...

DREW SWICK, QUADRUPLET: It's pretty easy to tell us apart. So as soon as they learn that we're quads, they have troubles with our names.

GUPTA: As for sibling rivalry.

CARLY SWICK, QUADRUPLET: You just kind of decide for yourself that it won't bother you if they're better at something than you, because you have your own thing that you're better than them at. So it's all good.

KYLA SWICK, TRIPLET: One thing my parents said is they would try not to always call us, oh, triplets, come here. They try to say individual names so that we weren't always lumped into one group.

GUPTA: Parenting multiples may be a unique experience, but financially caring for all seven may seem impossible.

TOM SWICK, FATHER OF MULTIPLES: I have an accounting degree. I mean, the numbers don't add up. But the biggest thing you have to do is plan. GUPTA: Over the years, the Swick's have learned to haggle, getting group prices on everything from eyeglasses to soccer uniforms to college tuition. But the most important life lessons...

UNIDENTIFIED MALE: We already from a young age had to learn to be unselfish with each other.

MICHA SWICK, TRIPLET: You have to learn how to react to so many different personalities at the start of your life.

C. SWICK: Learning how to just do it on your own and not have to worry about your parents doing everything for you.

GUPTA: Learning how to manage such a large family may seem like an amazing feat, but to the Swick parents, it's remarkably simple.

UNIDENTIFIED FEMALE: If you're a good parent with one or two, you'd probably be a good parent with more.

(END VIDEOTAPE)

GUPTA: That's the Swick family, a really amazing family. And we're talking with Dr. Penny Glass. She's a developmental psychologist at the Children's National Medical Center in Washington, D.C.

Doctor, you saw that piece there. The Swick kids seem to have a good sense of their own identities. How do you help multiples come into their own?

GLASS: I think as parents interact with each child in their own, special, individual way, I think that helps them to come into their own identity. It's certainly easier with fraternal twins that are fraternals than it is with identicals.

GUPTA: Let's sort of keep on topic there now as well. Another question from Barbara in Michigan who writes, "I'm raising twin girls, both in the first grade. This year I insisted they remain in the same glass. I'm wondering, when is it a good time to separate the twins? Other moms of twins have told me not to separate the twins until junior high, but is that really healthy?"

And I should tell you, doctor, this question about separating kids in school was one of our most popular.

GLASS: Right.

GUPTA: Should multiples be in separate classes? And if so, when should that start, do you think?

GLASS: I think we have to think about the individual personalities of the children. You could have twins where one is more dominant than the other. And sometimes that younger - that sort of dominated child doesn't come to their fore until they're actually in a separate class from their twin. And in that circumstance, you would want to do it earlier, but gently. And I think it's important to just treat it as an individual case, knowing the special personalities of your children.

GUPTA: Lots of people paying attention to you this morning. Dr. Penny Glass, thank you so much for being with us this morning.

GLASS: You're welcome. It's my pleasure.

GUPTA: Coming up -- thank you. Coming up, we're going to check in with new mom and "AMERICAN MORNING" anchor, Soledad O'Brien.

UNIDENTIFIED FEMALE: The twins are about 12 weeks old. So what's the most surprising thing about being a mom of twins? We'll find out.

And losing weight, it's one of the hardest things to do after pregnancy. Some tips coming up.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

HOLLY FIRFIR, CNN CORRESPONDENT (voice-over): There's no greater joy than the birth of a healthy baby, but nine months in the making can take a toll on your body. Many doctors say if you gain more than the recommended 20 to 25 pounds during pregnancy, or if you don't lose the extra weight within six months of delivery, you're statistically likely to keep carrying those extra pounds. But don't let that scare you to start a crash diet or a rigorous exercise regime.

Instead, work on getting back to your pre-baby shape gradually. Doctors recommend waiting at least six weeks following delivery before resuming exercise.

UNIDENTIFIED FEMALE: Lift up your abs, all right?

FIRFIR: And remember to start slow and listen to your body. Get some fresh air and a good workout with a power stroll. Or try post- partum yoga classes. Want another way to zap calories and connect with your baby? Breast-feed. Besides being hailed the healthiest way to nourish your baby for the first year, breastfeeding expends about 500 calories a day.

Holly Firfir, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: Thank you, Holly. And losing weight and getting into a schedule after having a baby is difficult. Our "AMERICAN MORNING" anchor, Soledad O'Brien has been back to work for about a month now after having her twin boys. I talked with her earlier this week, and started by asking her how the boys were doing.

(BEGIN VIDEOTAPE) SOLEDAD O'BRIEN, NEW MOM OF TWINS: They're very healthy. We take them to the doctor at the end of the month. They're probably about 13 pounds, and they're doing really well. Sleeping about four hours every single night, not quite at the same time, which would be better.

GUPTA: Although she doesn't look like it, she is the mother of four children now, two older children as well. What's been different about raising twins this time versus your two older children?

O'BRIEN: Honestly, they're so little. So they don't do a heck of a lot yet. But they're just starting to reach out to touch each other. But just logistically, I don't know how people do triplets or quadruplets or quintuplets, because I can't carry two babies at the same time. That's really hard. And all the advice about nursing two, forget it. That just is not going to happen. I have to do one at a time.

It's just hard. It's logistically hard trying to keep one from crying, when the other one's, you know - one's happy, one's crying. Then they switch. So I'm kind of running around like a headless chicken all the time, embracing the chaos, I guess.

GUPTA: And you know, this series that we've been doing, crowded house, has been all about advice for parents of multiples. It's only been 12 weeks for you, but do you have a piece of advice raising multiples?

O'BRIEN: In some ways, I think it's the same advice you have with a single child, which is you just can't take it all too seriously. You're going to be tired, you're going to be exhausted, they're going to cry. And you have to kind of find some humor in that because otherwise you'll completely lose your mind.

I mean, you know, you just have to handle each day as it comes and not take it all too seriously. It's very, very hard. Oh, and get a lot of help. Ask everybody -- people walk in my house, I hand them a baby. Oh no, you can't stand around and do nothing. Take a baby and start rocking them.

GUPTA: I'm going to come visit. I want to take a baby for a little while.

O'BRIEN: All right, Uncle Sanjay, we'd love it.

GUPTA: Soledad O'Brien, mother of four and new twins as well. Thank you so much for your time.

O'BRIEN: Thanks, Sanjay.

GUPTA: All right.

(END VIDEOTAPE)

GUPTA: One of the best resources for parents of multiples is other parents. You've been hearing that all show. Try searching on the Internet or asking your doctor for information about your local club...

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com


Aired November 20, 2004 - 08:30   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
TONY HARRIS, CNN ANCHOR: And now in the news, a Polish woman held hostage in Iraq by militant groups since October has been freed. That word coming from Poland's prime minister. And the woman who was held captive has been released. And she is said to be safe and sound.
In Michigan, an investigation is underway after a scene you might call basket brawl. Fists were flying fast and furious at the Piston's Indiana Pacers game last night. It started when Indiana's Ron Artest and Detroit's Ben Wallace got into it, mixed it up. Artest then stormed the stands, punching out a few fans after he was hit by a cup. The game was called with just over 45 seconds left on the clock.

And the world's oldest known living man has died. Fred Hale, Sr. of New York died in his sleep yesterday. He was 113 years old. His grandson says he retired 50 years ago as a railroad postal worker and beekeeper. In just over 10 days, Hale would have turned 114. The research center watching over Hale says he was the oldest living man. And the oldest living man now is a German who is 111-years old.

HOUSE CALL with Dr. Sanjay Gupta is up next. We'll see you back here at the top of the hour.

SANJAY GUPTA, HOST: Good morning, welcome to HOUSE CALL. Checking the medical headlines first. Top officials of the Centers for Disease Control and the FDA appeared before congressional panels this week. Lawmakers blamed the FDA for not acting sooner when it found problems with the plant making the flu vaccine. The FDA says it thought the problems were being fixed.

And some drug makers are placing radio transmitters on pill bottles starting this week. It's their way of trying to stop counterfeiters. The electronic tags are actually computer chips with antennas, but look like ordinary labels.

And the CDC announced that in 2002, the birth rate among U.S. girls, that's those age 10 to 14, is the lowest since 1946. The CDC points to abstinence programs and birth control as a major factor in the drop.

Now to our top story. Births of multiples have skyrocketed since the mid 1980s. And earlier this year, we found out that AMERICAN MORNING anchor Soledad O'Brien was one of those lucky moms. She was pregnant with twins.

She allowed us to peek inside what it was like to become a mom of multiples. So today, we'll be giving you a look at multiples pregnancy through college.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): For Soledad, it's only the beginning of her trek into the world of multiples. Most come the old fashioned way, like Soledad's babies. But about a third, according to the Society for Reproductive Medicine, come from invitro fertilization or IVF. With IVF, eggs are fertilized and implanted in the uterus. The hope that one of them will eventually become a healthy baby.

UNIDENTIFIED MALE: Can I eat it? I eat it.

GUPTA: Thirty-one-year-old Amy Dipasquale got two healthy babies, but only after years and years of fertility drugs and treatment.

AMY DIPASQUALE, MOTHER OF TWINS: It was very difficult and physically painful. The shots hurt. I'm still sore where I got a lot of the shots done.

GUPTA: Four years later and after several courses of IVF, she was pregnant with Mason and Matthew. The path for Amy and her husband was difficult, painful, and the cost, crippling. Each course of IVF is around $12,000. And there's no guarantee that it'll even work.

If it does work, there's a 30 to 40 percent chance of a multiple pregnancy, since usually more than one egg is implanted. Years ago, implanting three to four eggs was routine, resulting in a rash of multiple births. Now the movement is towards implanting just two eggs to avoid that scenario.

ZEB ROSENWAKS, DR., NY PRESBYTERIAN MEDICAL CTR.: The higher the number of multiple pregnancy, also the bigger the problem for the mother in terms of medical complications.

GUPTA: Complications like high blood pressure or gestational diabetes, and serious uterine stretching, which could cause early contractions or an in extreme cases, uterine rupture. And extra pounds make it difficult to move.

THOMAS PINCKERT, DR., MATERNAL FETAL MEDICINE: When mothers have triplets or quadruplets, we're looking at somewhere between a 40 to 80 pound weight gain.

GUPTA: And multiples often arrive early, which could cause...

ROSENWAKS: Prematurity of the lungs. You could have neurological issues, bowel issues, many, many problems for the baby.

GUPTA: In spite of all that, families like the Dipasquales keep trying, hoping for one baby, and being happy with even more.

DIPASQUALE: It's so worth it, the pain and the stress while you're going through it, because the end result is priceless.

(END VIDEOTAPE) GUPTA: Yes, definitely is priceless. And the birth of twins, triplets, quads, and more is on the rise with increasing popularity of fertility treatments. Talking with us this morning about it, Dr. Penny Glass. She's a developmental psychologist at the Children's National Medical Center in D.C.

First of all, welcome, doctor.

PENNY GLASS, DEVELOPMENTAL PSYCHOLOGIST: Thank you.

GUPTA: We get a lot of e-mails. And these are questions you probably hear all the time, questions coming from parents of twins and expectant parents as well. So let's jump right in. This is an e-mail from Davin in California, who writes, "My wife and I are about to have twins. What is the number one thing we should be preparing for, other than lack of sleep?"

So doctor, what can you tell Davin and his wife?

GLASS: Well, with any luck, I hope they would prepare for paternity leave, actually. I couldn't resist getting that in. I think what they should prepare for would be meals. And now's a good time to make meals and store them away. They talk about being prepared for lack of sleep, but I think being able to really devote your time to your children right now, it's going to be a big shock to parents who are accustomed to devoting their time just to each other. So that's a big adjustment to make.

GUPTA: And getting help, I mean, you sort of joked about the paternity leave...

GLASS: Right.

GUPTA: ...but getting that help is really important, right?

GLASS: It is. Making contact, friends and churches. And when they know that multiples are coming along, there are all sorts of people out there that are just wonderful about bringing in help. And it may even be that they bring in a meal for you, or just something like that. Any little thing will help.

GUPTA: All right, let's get to another question now from Carl in Mexico. "When my twins are together in the same crib, they quiet down. However, I'm worried that if I let them sleep together now, I will have trouble getting them to sleep alone when they're older. What would be your advice on that?" A lot of questions come in this sort of thing, comfort of one twin with the other.

GLASS: Right.

GUPTA: How about sharing your crib specifically?

GLASS: Well, I don't happen to be a proponent of that type of co-sleeping. I agree with him that I think he might have some problems later on. And I think it's easier to deal with it early. What I like to do is to make sure that the separate cribs are close to each other, sort of like head to head at right angles, rather than necessarily across the room. And you can provide each twin with a little something to hold onto that might have the smell, actually, of their sibling that reminds them that that other person is close by.

GUPTA: Talking about multiples with Dr. Penny Glass. So what does it take to run a home brimming with babies? We'll meet the Cusato quads. That's coming up.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Pretty much feed, bathe, nap, feed.

UNIDENTIFIED FEMALE: Tips from parents of multiples coming up.

And later...

UNIDENTIFIED MALE: It's pretty easy to tell us apart. So as soon as they learn that we're quads, they have told us...

UNIDENTIFIED FEMALE: Growing up as a quad and one of nine kids. We'll show you how they manage.

First, see if you can answer our daily dose quiz. How much does the birth of twins cost versus a single child?

(END VIDEO CLIP)

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Checking the daily dose quiz, we asked, how much does the birth of twins cost versus a single child? The answer, healthcare costs for twins is four times higher compared to single children.

(END VIDEO CLIP)

GUPTA: And financial strain may be just one of the things you experience having multiples. There's also the stress on your relationship with your partner, less time with each individual child, and of course, lack of sleep. One family that knows all about this is the Cusatos. Their juggling act has been going on for more than eight months.

(BEGIN VIDEOTAPE)

KAREN PICCIHILLO-CUSATO, MOTHER OF QUADRUPLETS: At the beginning, I think, it was exciting. You know, and with the newspapers and the TV. Then there was reality. It was, you know, these babies require around the clock care.

GUPTA (voice-over): Most days, the clock starts at 6:00 a.m. when four separate cries are heard. First order of the day, dad makes between 10 and 20 bottles before going to work, leaving mom to conduct a three-ring circus, maybe a four-ring circus on other own. First up, feeding. As if that weren't enough, the two older children need feeding as well.

CUSATO: Are you hungry?

GUPTA: At 7:30, help starts to arrive, aunts, uncles, neighbors, friends. The Cusatos average five helping hands a day.

HEIDI MURKOFF, AUTHOR: Get as much help as you can get from as many people as you can get it from.

GUPTA: The biggest challenge, getting them on a schedule. Easier said than done. The Cusato quads aren't quite there yet.

CUSATO: One will be asleep, three will be up or two will be asleep, two will be up.

GUPTA: And then there's the keeping track. Who needs a nap? Which girl did I feed, Victoria or Gabriella?

CUSATO: We couldn't figure out why, you know, the one girl kept spitting up. Like why is she doing this? Oh, wait a minute, she ate twice in a row.

GUPTA: Feeding fiascoes like this prompted Karen to start writing everything down on a spreadsheet. The stats are staggering. The babies go through 20 bottles a day, 24 diapers, 20 outfit changes, which means Mom is doing at least three loads of laundry a day. By year's end, the Cusatos will have spent tens of thousands on formula, diapers, doctors' visits, and adding onto the crowded house to make more room.

CUSATO: It's pretty much feed, bathe, nap, feed, nap, feed.

GUPTA: Lots of work, but well worth it.

CUSATO: It's still unbelievable to hold each one and think -- I mean, we had these four beautiful, remarkable miracles.

(END VIDEOTAPE)

GUPTA: And those miracles, though, can sometimes cause mayhem when they grow older. In the popular ABC show "Desperate Housewives," one of those wives is also the desperate mom of rowdy twin boys.

(BEGIN VIDEO CLIP, "DESPERATE HOUSEWIVES")

UNIDENTIFIED FEMALE: Of course, given her continuing level of frustration, Annette also felt a little self-medication couldn't hurt.

(END VIDEO CLIP)

GUPTA: Hopefully all those parents of multiples out there aren't having to self-medicate, but still, it can be overwhelming. We've got a question now from a struggling parent.

John in Texas writes, "We are proud parents of a 7-year-old and of an - and of 8-month-old triplets. However, getting all four to sleep at night is becoming quite a struggle. None of the baby sleep advice books seem to cover this case."

Dr. Glass, what sort of advice it do you give to John?

GLASS: I would give two advices. It's difficult to get 8-month- old singletons to sleep. So just treat them like you're putting three individual babies to bed. For the 7-year-old, I would let him stay up after those children and not try to get him to bed at the same time. He needs that special time once those others are to bed.

GUPTA: That's a little bit time just between the 7-year-old and the parents.

GLASS: It's very important.

GUPTA: Another question now from Carl in Pennsylvania. "Our 7- year-old twin boys are the best of friends and want to do everything together. Unfortunately, they don't want to participate in activities involving other children since they're always occupied with only each other." Should they be concerned about that, doctor?

GLASS: I think it is appropriate to be thinking about that. And my suggestion would be to have a little family counsel for the parents to talk about that with the boys and see if they have suggestions of how they're going to sort of broaden their relationships.

GUPTA: All right, Dr. Penny Glass, good advice there. Think twins are a handful? Try nine. We'll meet the Swick family when HOUSE CALL continues.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: From clothes to eyeglasses and college tuition, multiple kids equals multiple bills.

UNIDENTIFIED MALE: I have an accounting degree. I mean, the numbers don't add up.

UNIDENTIFIED FEMALE: Plus, looking to drop your baby weight? Our bod squad has a plan you can follow. But first, more of this week's medical headlines in the "pulse".

(END VIDEO CLIP)

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): If you spend nine hours a day or more looking at a computer screen, you may be at risk of developing glaucoma, according to a new Japanese study. Researchers looked at more than 10,000 office workers and found that more than 5 percent had vision problems, including glaucoma linked to their computer use. 95 percent of that group were myopic or nearsighted.

And the abortion pill Mifepristone, also known as RU-486, must now carry a strong warning that it can cause serious infections, bleeding, and tubal pregnancies, says the FDA. The statement comes on the heels of reports of the third death in four years linked to the drug. Mifepristone was approved by the FDA in 2000 to terminate pregnancies up to 49 days after conception.

Christy Feig, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSE CALL. We're talking about raising multiples. One of the struggles for all parents is helping their child come into their own. For multiples, individuality is an even bigger challenge.

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Soledad's boys were born just minutes apart, twins who will forever be remembered for their similarities in these pictures.

Still the hope is one day, they will grow into individuals. And that's the goal that experts often give to parents of multiples. Of the nine children in the Swick family, there is a set of quadruplets, all freshman in high school, and a set of triplets, all college freshman. Seven teenagers at once.

TARA SWICK, QUADRUPLET: It's nice having brothers and sisters the same age. You kind of know how the guys think that are your age and how then they can talk about how the girls think.

GUPTA: Born in the late 1980s, the seven Swick's were part of an era of increased multiple births that has since tapered off. The Swick's used fertility drugs for all of the births. All of them are healthy and none of them are identical. But...

DREW SWICK, QUADRUPLET: It's pretty easy to tell us apart. So as soon as they learn that we're quads, they have troubles with our names.

GUPTA: As for sibling rivalry.

CARLY SWICK, QUADRUPLET: You just kind of decide for yourself that it won't bother you if they're better at something than you, because you have your own thing that you're better than them at. So it's all good.

KYLA SWICK, TRIPLET: One thing my parents said is they would try not to always call us, oh, triplets, come here. They try to say individual names so that we weren't always lumped into one group.

GUPTA: Parenting multiples may be a unique experience, but financially caring for all seven may seem impossible.

TOM SWICK, FATHER OF MULTIPLES: I have an accounting degree. I mean, the numbers don't add up. But the biggest thing you have to do is plan. GUPTA: Over the years, the Swick's have learned to haggle, getting group prices on everything from eyeglasses to soccer uniforms to college tuition. But the most important life lessons...

UNIDENTIFIED MALE: We already from a young age had to learn to be unselfish with each other.

MICHA SWICK, TRIPLET: You have to learn how to react to so many different personalities at the start of your life.

C. SWICK: Learning how to just do it on your own and not have to worry about your parents doing everything for you.

GUPTA: Learning how to manage such a large family may seem like an amazing feat, but to the Swick parents, it's remarkably simple.

UNIDENTIFIED FEMALE: If you're a good parent with one or two, you'd probably be a good parent with more.

(END VIDEOTAPE)

GUPTA: That's the Swick family, a really amazing family. And we're talking with Dr. Penny Glass. She's a developmental psychologist at the Children's National Medical Center in Washington, D.C.

Doctor, you saw that piece there. The Swick kids seem to have a good sense of their own identities. How do you help multiples come into their own?

GLASS: I think as parents interact with each child in their own, special, individual way, I think that helps them to come into their own identity. It's certainly easier with fraternal twins that are fraternals than it is with identicals.

GUPTA: Let's sort of keep on topic there now as well. Another question from Barbara in Michigan who writes, "I'm raising twin girls, both in the first grade. This year I insisted they remain in the same glass. I'm wondering, when is it a good time to separate the twins? Other moms of twins have told me not to separate the twins until junior high, but is that really healthy?"

And I should tell you, doctor, this question about separating kids in school was one of our most popular.

GLASS: Right.

GUPTA: Should multiples be in separate classes? And if so, when should that start, do you think?

GLASS: I think we have to think about the individual personalities of the children. You could have twins where one is more dominant than the other. And sometimes that younger - that sort of dominated child doesn't come to their fore until they're actually in a separate class from their twin. And in that circumstance, you would want to do it earlier, but gently. And I think it's important to just treat it as an individual case, knowing the special personalities of your children.

GUPTA: Lots of people paying attention to you this morning. Dr. Penny Glass, thank you so much for being with us this morning.

GLASS: You're welcome. It's my pleasure.

GUPTA: Coming up -- thank you. Coming up, we're going to check in with new mom and "AMERICAN MORNING" anchor, Soledad O'Brien.

UNIDENTIFIED FEMALE: The twins are about 12 weeks old. So what's the most surprising thing about being a mom of twins? We'll find out.

And losing weight, it's one of the hardest things to do after pregnancy. Some tips coming up.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

HOLLY FIRFIR, CNN CORRESPONDENT (voice-over): There's no greater joy than the birth of a healthy baby, but nine months in the making can take a toll on your body. Many doctors say if you gain more than the recommended 20 to 25 pounds during pregnancy, or if you don't lose the extra weight within six months of delivery, you're statistically likely to keep carrying those extra pounds. But don't let that scare you to start a crash diet or a rigorous exercise regime.

Instead, work on getting back to your pre-baby shape gradually. Doctors recommend waiting at least six weeks following delivery before resuming exercise.

UNIDENTIFIED FEMALE: Lift up your abs, all right?

FIRFIR: And remember to start slow and listen to your body. Get some fresh air and a good workout with a power stroll. Or try post- partum yoga classes. Want another way to zap calories and connect with your baby? Breast-feed. Besides being hailed the healthiest way to nourish your baby for the first year, breastfeeding expends about 500 calories a day.

Holly Firfir, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: Thank you, Holly. And losing weight and getting into a schedule after having a baby is difficult. Our "AMERICAN MORNING" anchor, Soledad O'Brien has been back to work for about a month now after having her twin boys. I talked with her earlier this week, and started by asking her how the boys were doing.

(BEGIN VIDEOTAPE) SOLEDAD O'BRIEN, NEW MOM OF TWINS: They're very healthy. We take them to the doctor at the end of the month. They're probably about 13 pounds, and they're doing really well. Sleeping about four hours every single night, not quite at the same time, which would be better.

GUPTA: Although she doesn't look like it, she is the mother of four children now, two older children as well. What's been different about raising twins this time versus your two older children?

O'BRIEN: Honestly, they're so little. So they don't do a heck of a lot yet. But they're just starting to reach out to touch each other. But just logistically, I don't know how people do triplets or quadruplets or quintuplets, because I can't carry two babies at the same time. That's really hard. And all the advice about nursing two, forget it. That just is not going to happen. I have to do one at a time.

It's just hard. It's logistically hard trying to keep one from crying, when the other one's, you know - one's happy, one's crying. Then they switch. So I'm kind of running around like a headless chicken all the time, embracing the chaos, I guess.

GUPTA: And you know, this series that we've been doing, crowded house, has been all about advice for parents of multiples. It's only been 12 weeks for you, but do you have a piece of advice raising multiples?

O'BRIEN: In some ways, I think it's the same advice you have with a single child, which is you just can't take it all too seriously. You're going to be tired, you're going to be exhausted, they're going to cry. And you have to kind of find some humor in that because otherwise you'll completely lose your mind.

I mean, you know, you just have to handle each day as it comes and not take it all too seriously. It's very, very hard. Oh, and get a lot of help. Ask everybody -- people walk in my house, I hand them a baby. Oh no, you can't stand around and do nothing. Take a baby and start rocking them.

GUPTA: I'm going to come visit. I want to take a baby for a little while.

O'BRIEN: All right, Uncle Sanjay, we'd love it.

GUPTA: Soledad O'Brien, mother of four and new twins as well. Thank you so much for your time.

O'BRIEN: Thanks, Sanjay.

GUPTA: All right.

(END VIDEOTAPE)

GUPTA: One of the best resources for parents of multiples is other parents. You've been hearing that all show. Try searching on the Internet or asking your doctor for information about your local club...

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