Two Babies, Two Bonds: Challenges in Attachment Relationships in Twins

The attachment relationship constitutes the first emotionally significant affective bond, usually between the infant and the mother, serving as a model for subsequent relationships. It is considered a vital component of social and emotional development in the early years and an important early indicator of infant mental health. In twins, the attachment process may exhibit unique characteristics, influenced by the dual parenting dynamic and the individual needs of each baby. With this article, we intend to explore the challenges of infant-caregiver relationships and the attachment process in twins through a brief, non-systematic literature review regarding a clinical case of a 21-month-old female born from a twin pregnancy complicated by selective fetal growth restriction (sFGR), prematurity, and very low birth weight. The patient was initially suspected of displaying an insecure ambivalent/resistant attachment style, differing from her twin sister. Studies have shown a high concordance in attachment style between twin pairs, although a higher prevalence of insecure ambivalent/resistant attachment style compared to the general population. This may reflect challenges commonly presented in twin pregnancies and the perinatal period, such as sFGR, prematurity, and feeding difficulties, which increase parental stress that may impair early attachment between parents and infants. Attachment is not a fixed bond. Early identification and intervention in infant-caregiver relationship difficulties within this vulnerable group can help mitigate the challenges of dual parenting, fostering secure bonds and promoting healthy infant development.