Moms Matter - Especially a Mom of Preemie Triplets
She was by their side every day in the NICU, through all the trials and each triumph.
Jennifer was a thirty-year-old healthy woman who endured IVF to conceive her babies. Her triplet pregnancy went well until 26 weeks gestation when Baby A’s membranes ruptured. She was admitted to the hospital, given antibiotics and antenatal steroids (to mature the babies’ lungs and brains). Jennifer and her husband, Jeff, were scared, as any new parents would be. They knew that extreme prematurity might be a dangerous journey for their girls.
Thirty-six hours after mom’s admission to the hospital, baby A began to have heart rate decelerations and her doctors recommended delivery. Jennifer’s babies were delivered by C-section under general anesthesia. Baby A weighed 930 grams (2 pounds), Baby B weighed 750 grams (1.6 pounds), and baby C arrived weighing a whopping 1,100 grams (2.4 pounds).
I was the lucky neonatologist who attended this delivery and cared for them during their NICU stay. Each infant was born quite responsive and each was intubated and placed on mechanical ventilation. Shortly after birth they were each given artificial surfactant directly into their lungs.
Baby A, whom they called Allison, responded well to the surfactant and was stablized on low ventilator settings. Baby B, whom they named Fern, struggled to breathe despite maximal respiratory support. After her dose of surfactant, Baby C, whom they called Caroline, was pink on minimal ventilator support and extubated to nasal CPAP, where she continued to breathe entirely on her own.
The girls received routine intravenous nutrition, and once mom had produced some expressed breastmilk, colostrum, they were all fed mom’s milk. Their breast milk feedings were advanced slowly and surely. Jennifer visited the NICU to see her daughters as soon as possible, and she continued to visit her girls daily while they were in the NICU. She was typically present for several hours each day. Most days Jennifer held two of her babies skin-to-skin, sometimes called “kangaroo care,” which encouraged their growth, minimized their apnea, and decreased their chances of infection. For several weeks, their mother’s breastmilk was fortified with protein, calories, electrolyes, vitamins, and minerals. Allison and Caroline gained weight well, and Allison was quickly weaned off the ventilator to nasal CPAP support, just like Caroline. All three girls had normal head ultrasounds, a screening test for any possible intracranial hemorrhage, a common complication of extreme prematurity.
Fern continued to struggle with severe respiratory distress and pulmonary hypertension. For several weeks she required maximal ventilatory support, while her sisters thrived.
Both Jennifer and Jeff visited their girls every day. Mom usually stood at their bedside talking, stroking, and singing to her daughters. Dad often sat nearby reading his Wall Street Journal. One day, unexpectedly, while her mother was visiting, Allison developed a severe heart arrhythmia. Her erratic heart rate caused her to go into shock, and for this she required cardioversion. Her mother stood twenty feet away calmly watching as our NICU team stabilized her daughter. Allison had a structurally normal heart and, subsequently, was treated with a medication that controlled her heart rhythm nicely.
Caroline grew and thrived without any complications. She had mild apnea of prematurity, which resolved. However, little Fern continued to struggle and required intravenous steroids in order to be weaned off the ventilator - at seven weeks of age! This treatment was not without risks for further complications, specifically an increase in cerebral palsy. Her brave parents chose to take the risks and treat Fern with life-saving steroids. The medication worked and Fern was extubated shortly thereafter. Jennifer held all three of her daughters together on a large fluffy pillow at eight weeks after their birth.
Fern’s CT scan of her brain at 38 weeks corrected age showed no evidence of periventricular leukomalcia (one harbinger of cerebral palsy). We were all - parents and NICU staff - relieved at this great news!
The triplets’ mother visited every day and during her daughter’s stay. In her spare time she assisted the NICU staff in creating a nursing mothers’ support group. Jennifer was lucky to have a great breastmilk supply, enough for all three girls. (Some moms are high milk volume producers.) Her presence in the weekly support group encouraged other mothers to join the NICU nurses and Lactation Consultant and support one another to establish and maintain an adequate breastmilk supply for their sick babies.
Allison and Caroline were ready for discharge by 39 weeks corrected age (very near their due date), long before their sister, Fern, was ready. Mom took this in stride and continued to visit Fern daily until she was ready to go home on a small amount of oxygen through a nasal cannula at 42 weeks corrected age.
Four years after her girls were sent home from the NICU, Jennifer helped to arrange a fundraising luncheon “baby shower” to raise money for Hand to Hold, a national nonprofit organization that provides NICU parents with peer support from seasoned NICU parents who have been trained to help out other NICU parents while their baby is in the hospital. Jennifer’s “baby shower” raised over $100,000 for this wonderful organization.
Jennifer said that she chaired the fundraiser “because of what I went through. I handled it poorly and I want other preemie moms to know that they don’t have to feel lost.” She went on the say that “Hand to Hold can help them feel hopeful, connected ,and give them the support I didn’t have.”
Oh my gosh, I am in tears from this story & on how this mama gave back for other NICU parents. As a mother who has MonoMono twins I spent a lot of time both on hospital bedrest and in the NICU and it is such a difficult time—and so many mamas going through that experience can use so much extra support. Bless you and all of your work for these babies (and mamas!) I can tell you they are by the far the best nurses and doctors I ever encountered ❤️
NICU parents go through so much, it can be hard to imagine for those who are unfamiliar. I never had to go through the NICU with my kids but as a psychologist I worked with families who had(I specialized in the Cleft-Craniofacial Care and supervised our psychology team in the NICU). Thank you for sharing the stories of these families.