Pediatrician’s Patients Are All Multiples : Britain: As family size increases, so do problems for harried parents coping with worry and depression.

Twins or triplets may mean double or triple the blessings, but multiple births also can result in feelings of worry and depression.

“Parents often feel isolated, and health professionals don’t understand the psychological and social repercussions,” said Dr. Elizabeth Bryan, whose practice is restricted to twins, triplets, quadruplets and up.

The number of triplets and quadruplets has tripled in the last 30 years, particularly because of fertility drugs and in vitro fertilization. Twins occur in about one in 90 births, Bryan said.

Every three months, Bryan organizes luncheons for the children and parents of multiple births--whether or not they are her patients. She also gets calls from parents from various parts of the world who need advice or comfort.

“This is my eighth lunch,” Christine Hewinson, 32, mother of triplet toddlers Rebecca, Emma and David, said at a recent lunch. “It’s nice to know there’s one place I can go and not feel like a sideshow. Here, I’m one of the majority.”

Caring for one set of twins 18 years ago piqued Bryan’s curiosity and led to a study of 100 sets of twins, which in turn blossomed into a lifelong pursuit.

She launched a self-help group for parents, which now has more than 200 chapters around the world, including the United States, Japan and Ethiopia.

And Bryan presents monthly slide shows for prospective parents of multiple births, full of trivia, advice and biology.

She mentioned famous twins of literature from Tweedle-dee and Tweedle-dum to Shakespeare’s “Comedy of Errors.” She talked about an African tribe that believes twins have innate mystical powers and worships them, and another tribe that believes twins are possessed by the devil and kills them.

The audience chuckled appreciatively as the doctor poured scorn on a couple who named their identical daughters, Krysty and Kyrsty, and dress them identically every day.

The message was clear: Treat twins as individuals and don’t dress them alike.

She said it’s crucial to talk to toddlers individually and make eye contact to promote language development, frequently delayed in twins and triplets.

Children of multiple births are also prone to premature birth and low birth weight.

At a recent international meeting about in vitro fertilization in Paris, infertility experts said the trend is to put no more than two or three embryos into the womb to stem the rise in multiple births. The rest are frozen and saved for later use.

Bryan also started the first and only Multiple Births Foundation for professionals, which educates doctors and social workers.

Its headquarters are in a yellow mobile home parked permanently at Bryan’s hospital, London’s Queen Charlotte’s and Chelsea Hospital.

She says parents of twins, triplets and quadruplets suffer from stress and need special advice about raising more than one baby at a time.

A study of 12,712 mothers published in the British Medical Journal showed that mothers of twins are more likely to suffer from depression. Twins may not cause depression, but can push vulnerable women over the brink, she said.

“Dr. Bryan gives me such confidence,” said Christine Hewinson. “It’s so nice to know there’s someone so dedicated.