One identical twin with clubfoot but not the other

identical twins clubfoot in one twin

Author: Elysha Loiterton

It’s impossible to fully describe the existential shock of being told you’re pregnant with twins. This is doubly true (pun intended) when you’ve already spawned one child and you were only planning two.

One minute, I was anticipating a whitebread life with two kids, a dog, a cat and a modest car upgrade to a sedan. The next, I was fretting over three lots of childcare fees and rushing out to buy a second hand minivan.

One identical twin with clubfoot

Being pregnant with identical twins

But the surprises kept coming. The twins were identical boys, sharing a placenta with a dividing membrane between them (MCDA twins). The sonographer described this setup as sharing a kitchen but having two bedrooms.

I was enrolled in an exhausting regimen of fortnightly scans to monitor for the various unique calamities MCDA twins can suffer from. There was a size difference between our boys from the outset, and around the 16 week mark, the smaller twin had dangerously low fluid levels. It was at this time that we were informed he also had a talipes, also known as a clubfoot.

Frankly, the clubfoot diagnosis felt inconsequential to me at the time, as we were facing potentially fatal conditions. As clubfoot is treatable, I filed it in the “future Elysha’s problem” cabinet.

Fortunately, we sailed through the rest of the pregnancy. Those worrying fluid levels either recovered or were always OK, lurking just out of sight. However, the size difference between the boys persisted and Felix was born at 2.4kg while his brother Aemon was born at 2.9kg.

clubfoot in one twin

One identical twin with clubfoot

Immediately, it was apparent Felix did indeed have a talipes to his right foot. The filing cabinet I’d so blithely locked now needed to be accessed. Aemon also had a suspected medical difference, which was a complete surprise – a large birthmark up his left side, but that’s a different story.

As Felix was quite small and born at 36 weeks, we had to wait until he was 6 weeks old to see the clubfoot team at Queensland Children’s Hospital. The gold standard for clubfoot treatment is called the Ponseti method, and it involves a series of casts to correct the position of the foot. This is sometimes followed by a small procedure to release the Achilles tendon called a tenotomy. Once the foot is corrected, it must be held in position by a “boots and bar” contraption. This is worn for 23 hours a day for several months, and then eventually just overnight. The overnight requirement remains until age 4 or 5. So it’s certainly not a quick process, but it is highly effective. However, it’s important to note that some do have more complex journeys and may experience relapses.

medical differences in identical twins

Clothing for twins when one identical twin with clubfoot and one not

As soon as Felix had his first cast, we faced an important first world problem. How would we dress the boys identically now? After having my daughter, I swore off button onesies forever, but they really are the best option to wear around the casts and boots. If I dressed Aemon the same, this meant (gasp) two sets of buttons at every nappy change.

Fashion challenges aside, being so young, Felix doesn’t know life without his clubfoot treatment. He has tolerated each stage beautifully. There were several things I thought would be challenging because of the treatment, and they simply weren’t. For example, I was concerned about tandem breastfeeding (I just gave him his own dedicated boob) and finding suitable sleep sacks (normal ones fit fine). He’s currently half way through his 23 hour boots and bar period and loving life.

However, the future is less certain. How will daycare manage the boots? Will Felix hate that he has to wear boots to bed while his brother (with whom he shares a room) kicks freely all night long? Will he wonder why he was the one one identical twin with clubfoot, but not his identical twin?

Or perhaps most alarmingly, (for my bank account) will the kids all want their own cool boots, just like Felix? Only time will tell.


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