Guest Author - Kris Bigalk

Almost half of all twin pregnancies result in the birth of premature babies--those born before 37 weeks gestation. My own experience taught me that besides taking precautions to maintain the pregnancy as long as possible, parents should be familiar with the possible effects of premature birth, even if that birth is close to the 38 week mark. I had a very healthy, uneventful pregnancy until my 36th week, when my water broke unexpectedly and I gave birth to my twins a few hours later. One was low-birthweight and the other experienced apnea problems--and I was totally unprepared.

Apnea of Prematurity and Bradycardia (A's and B's)

This problem was one of the scariest for us. Our son Aren would "forget" to breathe (apnea) and then his heart rate would slow down (bradycardia). The nurses in the NICU discovered this when he turned blue and stopped breathing; they had to resuscitate him and then put him on a monitor that tracked his "spells". After a week in the NICU with no more spells, we brought him home, along with the monitor. While the monitor was comforting, we also experienced piercingly loud false alarms in the middle of the night. Luckily, the babies slept right through them, since they had gotten used to the monitor sounds in the NICU. We kept Aren on the monitor for a month, when the doctors told us his system had matured enough that we wouldn't have to worry about him forgetting to breathe anymore. He's been fine ever since.

"Silent" Reflux

About a week after bringing our babies home, we unhooked Aren from his monitor to feed him. Soon after beginning his bottle, he went limp and stopped breathing, then turned blue. I was successful in startling him into breathing again, but ended up taking him to the hospital again in an ambulance. After another few days in the hospital, we learned that he had "silent" reflux--and this was probably the cause of his apnea spells. In silent reflux, a baby experiences reflux of milk or formula, but doesn't actually spit up. Instead, their throat constricts to prevent the milk from going into the lungs--and, in effect, causes the baby to pass out. To prevent this, we got a sling for his crib and raised the angle of the mattress to 45 degrees, burped him frequently, and did our best to make him comfortable.

Hyperbilirubinemia

Newborn jaundice, or hyperbilirubinemia, is a common problem even with term babies. My sons were exposed to special lights, or phototherapy, to diminish the jaundice. This was probably the least distressing therapy in the NICU, since it looked like my little ones were enjoying a day tanning under sunlamps. Gabriel even got to sunbathe "au naturel", to heal a small diaper rash on his little behind. The boys also got special "sunglasses" to protect their delicate eyes.

When I went into labor during my 36th week, I thought that my babies would be fine--just small. I was wrong about that. When babies are born even a little early, there are developmental processes that might not be finished--and both babies are often not at the same place developmentally, regardless of their weight. For example, my son Aren was almost a pound heavier than his brother, but his brain was developing differently, causing the apnea problems. Both of my twins were on track by their original due date, and are doing fine. I just wish I had been more prepared to deal with some of the challenges that came our way when they made their entrance to the world a few weeks early.