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Challenge: NICU Parenting

NICU: Our Premature Twin Girls

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My entrance into motherhood was not what I expected. Pregnant with fraternal twin girls, I was told there was a risk of delivering my twins early, but never did I expect I would have them almost seven weeks before their due date.

During a routine doctors appointment, the strange tightening in my belly was not Braxton Hicks, but rather the beginning of labor. Straight from my doctor's office, I went right to the hospital. My doctor told me I was going to have the babies in three hours or three days, it was hard to know, and being admitted to the hospital was urgent.

Once admitted, the goal was to hold off labor progressing any further. I was given steroids to help the babies lungs develop and medication to slow down labor so the steroid could have at least 48 hours to advance the babies lung development. For the next three days, I was in tremendous discomfort as the medication had side effects making my body feel as if it was on fire from the inside. I was unbelievably uncomfortable, but I endured, knowing every minute, every hour, and each additional day, gave my daughters a stronger chance of developing their lungs which meant less time in the NICU.

On the third day, labor progressed, and one of the twins was in distress. I had no choice but to have an emergency C-Section for the safety of one of the girls.

My only thought, please let them be healthy and strong, please let them both survive.

Thankfully, both girls were delivered with low Apgar scores in the first minute which steadily improved. To hear them cry, albeit, tiny, muffled cries was the best confirmation they had made their arrival.

For babies born early, we were fortunate to have those three days for the steroid to take effect, as our girls were able to breathe without problems or much assistance. But there were other concerns we weren't prepared for, such as, the babies had a weak rooting reflex, the reflex developed in utero around the time they delivered, which helps babies to nurse and drink from a bottle. Our babies didn't have strong rooting reflex, and the feedings were challenging and took an extraordinary amount of time.

Both girls had heart monitors, breathing monitors, and spent two weeks in a covered isolette to regulate their temperature. In utero, around the 34th week of gestation, babies begin to put on the 'brown fat' which helps babies to stay warm and regulate their warmth and temperature. Our girls had barely any brown fat developed. And this was apparent looking at them, their skin was ruddy and somewhat translucent, and the fullness of a full term baby was visibly absent with our premature twins.

To us, though, they were perfect, and we were in awe.


The most challenging part of being a new mom with premature twins was I felt completely inadequate to care for my daughters. I imagine many parents feel this way, but, when your babies are NICU babies, it's not merely a 'feeling' you can't take care of your babies, it's a reality. Our babies, as all NICU babies, need specialized medical care and attention.

Recovering in my hospital room, felt lonely and out of order. Moms all around me and on the floor were rooming in with their infants. Hearing babies cry throughout the corridor was a heartbreaking reminder, my newborn girls, hooked up to monitors with round the clock care, were too fragile to thrive on their own. The NICU was the safest place for them to be. And while my head knew this, my heart felt heavy, that as a new mom, I couldn't take care of them. They needed a team of nurses, doctors, and specialists.

Those first days were challenging. Not being able to have the babies room in, needing to dress in scrubs and wash hands diligently with medical grade soap for minutes, holding and caring for the girls with wires and monitors all around, was difficult but necessary for their health and development.

For us, the most significant challenge came when I was released from the hospital, but my girls had to stay. Leaving the hospital without my babies was one of the hardest days. I kept repeating to myself: they are where they need to be, they will be coming home.

For the next week and a half, our new normal became visiting the babies daily, sometimes two times a day, to feel, hold, bathe and care for them. Each step of progress, being able to tolerate two ounces from a bottle then three to four ounces, being able to nurse, gaining weight, and regulating their temperature meant they were one step closer to coming home with us.

One question we almost always asked the doctors and nurses visiting the NICU: when will the babies come home? On the fourteenth day of our girls being in the NICU, the doctor said Sophia, the stronger of the twins, was likely going to come home in a few days. Grace, the more fragile, or as we said, delicate, would probably need another week. The next morning, we received a call, sharing that Sophia had made significant progress overnight and would be discharged later that afternoon, we could bring her home whenever we were ready. Panicked, overwhelmed, and not prepared because the doctor had said a few days, not less than twelve hours, we stalled and we didn't bring Sophia home until later that evening. Asking the same question about Grace, we were told a few days, only to get a similar call the next morning, she was ready to come home. We picked Grace up within an hour of the call.

The challenging part of being a mom of premature twins, was when they came home. How could babies that needed to be warmed, monitored for breathing and heart rate, and specially fed be ready to be home with us? Overwhelm, hormones and the stress of having NICU babies all created an insecurity. But, as each day progressed, I became more confident and able to care for the girls without overwhelming and worry.

When the girls were six weeks old and home in our care, Sophia, had a setback and difficulty breathing, her skin turning an ashen color and her lips a faint blue. Calling an ambulance and rushing her to the hospital, the paramedics, doctors, and nurses were able to stabilize her breathing, and she was discharged home later that evening. Worried, concerned and on constant watch with Sophia, a follow-up appointment with doctors revealed both girls had cardiac issues due to prematurity. The doctors reassured us, they would likely grow out the issues, and no intervention was needed, just monitoring.

Our premature twins required a lot of extra support the first six months of their life. But by the time they had their first birthday, they were thriving, meeting all developmental milestones and compared to their peers, and you'd never know they were premature.

As I look at my twin girls, now age fifteen, thriving, happy, healthy adolescents, one who is three inches taller than me, it's hard to imagine they came into the world so small and fragile needing so much support those first early weeks in the world.

Being a NICU mom is not a path I would have chosen, but, it was threshold I crossed over to begin motherhood, and for that, I am eternally grateful.

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