That was Donna Loi’s first thought after her twins were born unexpectedly at 23 weeks and six days at Sunnybrook. She recalls her fear of having Davin and Dalaila so early, and of learning they were only 600 grams in weight.

“I questioned why this happened to us, to our babies. I was scared and confused about seeing all the medical equipment surrounding their little bodies in the incubators. They didn’t look like newborn babies that I was used to seeing,” says Donna.

The twins spent 132 days in Sunnybrook’s neonatal intensive care unit (NICU). The unit cares for the highest number of ‘micropreemies’, or babies born at less than 26 weeks. About a quarter of these babies are twins.

“We have focused our care on the smallest, most premature infants for many years now because this is the most fragile population of babies and they need us the most,” says Dr. Asaph Rolnitsky, Associate Chief, Newborn and Developmental Paediatrics of the DAN Women and Babies Program.

Sunnybrook’s outcomes are the best in the country for low complication rates associated with prematurity and also high survival. But having two babies in an intensive care unit is a tough emotional journey.

“Everyone describes the NICU experience as a roller coaster ride and they’re absolutely correct. But it isn’t a smooth coaster with one high peak and drop, it’s the kind of ride that forces your butt off the seat, gives you whiplash, and leaves your hair in a complete mess,” says Donna.

Dr. Rolnitsky agrees it is often a very rocky ride for families. He has reassuring words though. “The vast majority of preterm infants survive, and thrive, and reach normal development and quality of life. Even those who face challenges,” he says. “Parents’ involvement and role in the NICU is incredibly important as they are advocates for their babies. Their meaningful interactions with their babies – time cuddling, talking, singing and just being with them helps facilitate brain development. Parents are part of the medical team.”

Donna agrees that Sunnybrook’s family centered approach helps build parents’ confidence. When the twins were stable, Donna and Daniel changed their diapers, fed them, helped administer medication and vitamins and took them out of the incubators on their own. They were also encouraged to take part in decision making. Donna adds that the NICU team was there not just for Davin and Dalaila, but for her and Daniel too.

A highlight for the parents was when the twins were stable enough to come out of the incubators for kangaroo care, when babies are held skin-to-skin on a parent’s chest. “I was able to hold both at the same time, my heart dropped. This was a tiny glimpse of what I pictured having twins would be like,” says Donna.

Now the twins are two years old, going to daycare and thriving. “We are in a different place. We’re a silly, fun and happy family, and very thankful.”

The post The smallest, most fragile babies: One family’s story of their time in the NICU appeared first on Your Health Matters.

In December last year, she and her husband lost their son Josiah. He was stillborn. Then, in July 2020, the family welcomed twins, also at 27 weeks.

Elise was born weighing 908 grams and David was born weighing 1088 grams.

The twins are happy and healthy, home now with Danielle and her husband Akeem.

Danielle’s journey has been anything but ordinary. She went into preterm labour at 21 weeks of pregnancy, meaning she was in and out of Sunnybrook’s High Risk Obstetrics Unit until the twins were born.

The twins stayed in Sunnybrook’s Neonatal Intensive Care Unit (NICU) for 34 days before transferring to Michael Garron Hospital.

On top of that, she developed a brain condition that required her to have fluid drained from her spine.

Asked about her time at Sunnybrook, she breaks into a huge smile. “I remember every single staff person by name.”

She lists the names of nurses in High Risk Obstetrics who held her hand when she missed her husband due to visiting restrictions during the pandemic. It’s the same for the care team in the neonatal intensive care unit – she can name them all, from nurses to respiratory therapists to social workers.

One individual that left a mark was her maternal fetal medicine specialist, or high-risk obstetrician, Dr. Amir Aviram. “Dr. Aviram understood how difficult it was experiencing a pregnancy after loss and during a pandemic. It still brings me to tears remembering how we felt supported, so well informed and cared for.”

The twins stayed in Sunnybrook’s NICU for 34 days, then moved to Michael Garron Hospital for a few weeks. Danielle often thinks about her time at the hospital.

“When I was feeling down, staff always tried to brighten my day. They were professional but still warm and tried to gain insight into our lives. One nurse in particular asked the name of my first son. That meant a lot.”

Josiah, the name of Danielle and Akeem’s first son, means ‘God heals’. “We had faith we would have more children.”

The post Giving birth at 27 weeks: A family’s journey of heartbreak and joy appeared first on Your Health Matters.

“Watching them find their passions in life is incredible,” says mom Sandy Thompson. “There are no limitations. They want to try something new and they follow through.”

The twins had an early start to life. At 27 weeks of pregnancy, Sandy began experiencing a placenta complication. The girls were born, with Hailey weighing one pound, 13 ounces and Samantha weighing two pounds, eight ounces. Both were given a breathing tube right away and admitted to Sunnybrook’s neonatal intensive care unit. Samantha was able to progress from that in a couple of weeks to a continuous positive airway pressure (CPAP) machine after a few weeks.

Hailey developed an infection and was diagnosed with two serious heart defects. Her condition improved without the need for surgery. Samantha left the hospital 12 weeks after birth, and Hailey came home with Sandy and her husband Steven 20 weeks after she was born.

The family also learned the twins would be moved from the hospital’s Women’s College site to Sunnybrook’s Bayview campus, which Sandy describes as “seamless…the staff made the transition so smooth…and the new facilities were absolutely amazing.”

While thankful both girls are now healthy and thriving, Sandy admits their first couple of years of life were a blur. “It’s incredibly busy. You need to learn everything about caring for babies born prematurely, as well as trying to understand how to navigate the health care system and also transitioning from the hospital to community-based care,” explains Sandy, who adds that between both girls there were five to seven medical appointments a week during their first two years of life.

If she were to change anything about the girls’ stay in the NICU, Sandy says she would have taken advantage of the supportive resources at the hospital. “From social workers, to parent coordinators, there are so many supports. I would encourage families with a baby or babies in the unit to use all available services. I think they would have made my time easier as a parent.”

Looking at the family now, as they’re smiling, laughing and planning their next big hike, it’s difficult to imagine the challenging start Hailey and Samantha had in life. They’ve opted for remote learning during the pandemic, and the twins are excited to get back to a routine as grade five students.

Sandy urges parents of babies born prematurely to take each day as it comes. “If it’s a hard day, try to just get through it and hope tomorrow will be a better day. If tomorrow isn’t a better day, just hope that the next day will be better. Don’t be scared of the future. There is so much good ahead.”

The post Meet Samantha and Hailey: From the NICU to thriving 10-year-olds appeared first on Your Health Matters.

When pregnant with twins, trying to get a balanced diet with enough protein, carbohydrates, calcium and energy is important for your health and your babies’ health.

Protein

Protein helps with babies’ growth and also supports your needs when pregnant. A woman pregnant with twins needs an extra 50 grams of protein each day compared to someone pregnant with one baby. What does that look like? Those extra 50 grams would be equal to 220 grams (8 ounces) of meat or eight large eggs or about two and a half cups of cooked lentils. Keep in mind that this is on top of the usual amount needed for a pregnancy with one baby. A 60 kg (132 pound) woman would need about 66 grams per day if she’s carrying one baby or 116 grams per day for a twin pregnancy. 

Carbohydrates

Your carbohydrate needs are also higher with a twin pregnancy. You should aim for a minimum of 208 grams of carbohydrates daily to help with your babies’ development, your weight gain and to prevent ketones (a chemical you make when you don’t get enough carbohydrates). This is equal to six-and-a-half slices of whole wheat bread or four cups of rice or five cups of cooked pasta or seven-and-a-half chapatis.

Calcium

Getting enough calcium is important to help with growth, as well as maintenance of bones and teeth for you and your babies. It’s also important for helping to control blood pressure during pregnancy. All pregnant women should include three to four servings of calcium daily to meet your needs. Mix and match the calcium-rich foods you enjoy to ensure you receive enough. Each of the following is considered one serving of calcium:

• One cup of milk or fortified milk alternative (e.g. soy beverage, rice beverage, almond beverage)
• 1/3 cup of cubed pasteurized cheese
• One cup of yogurt

I’m feeling really nauseous – what are some tips for eating well?

It can be challenging to eat enough food if you are feeling nauseated or if your babies are not leaving you a lot of room in your stomach to eat. Here’s my advice to help you get enough to eat:

1. Have small, frequent meals and snacks with both carbohydrates and protein, for example:
   • Fruit and cheese
   • Greek yogurt and cereal
   • Hummus and pita
   • Sandwich with a cup of milk
   • Crackers with peanut butter
2. Include protein with every meal. Protein is found in:
   • Eggs
   • Fish – choose low mercury options like salmon, rainbow trout or sardines
   • Poultry (chicken, turkey)
   • Meat
   • Legumes/pulses (beans, lentils, chickpeas)
   • Greek yogurt
   • Cheese, cottage cheese
   • Tofu
   • Textured vegetable protein (e.g., veggie burgers, veggie dogs)
   • Nuts, nut butters (e.g. peanut butter)

We also recommend you take a prenatal vitamin each day. Discuss any other supplements with your health care provider.

What about my weight gain?

Recommended weight gain in twin pregnancies is based on your pre-pregnancy body mass index (BMI). You can calculate your pre-pregnancy BMI here.

If your pre-pregnancy BMI was between 18.5-24.9 it is recommended that you gain between 17-25 kg, or 37-54 pounds, throughout your pregnancy. If it was 25-29.9, the recommended weight gain is 14-23 kg, or 31-50 pounds. If your pre-pregnancy BMI was 30 or more weight gain of 11-19 kg, or 25-42 pounds, is recommended.

As most people with twins deliver before 40 weeks gestation, weight gain earlier in pregnancy is recommended. If you are finding it difficult to gain weight or get enough to eat, ask your care provider for a referral to a registered dietitian. 

The post Eating for three: what to eat when you’re pregnant with twins appeared first on Your Health Matters.

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Unlike many of the parents who unexpectedly find themselves in the NICU, I knew my twin girls would come early. Carrying mono mono twins means delivering by 32 weeks at the latest by C-section, but many, including mine, come earlier.

After discovering that I was having twins and they would be preemie, I thought I could handle it. I figured by 32 weeks, they would be little but pretty healthy; they would spend some time in the NICU growing chubby and then they would be home and the whole ordeal would be behind us. I have never been so wrong before in my life.

At 29 weeks, my two girls in distress, I was wheeled in for an emergency C-section. They were born, but did not cry, and were rushed into the next room, to the waiting staff who got them breathing and brought them to their new home in Sunnybrook’s NICU.

Before I became a preemie mum, I had no idea what being a preemie really meant. I knew there were health complications, but didn’t know that being born premature can affect feeding and even can have an effect when your baby goes to school years down the road.

I didn’t know then, what I do now, what so many preemie parents know; that having a baby in the NICU is one of the hardest things that you will ever go through. When my girls were still safely inside my tummy, we took a tour of Sunnybrook’s NICU. We knew we would spend time here, we just didn’t know how much. We peeked in the pods, met nurses and doctors; saw the tiny isolettes, the medical equipment. It was reassuring and terrifying at the same time. We knew we were lucky to be at Sunnybrook, where our son was also born not even two years before, we knew we were in the best hands, but that did not change the fact that we never wanted to find ourselves there. We didn’t want to walk by the parents sitting outside, waiting for ultrasounds, turning right into the unit, feeling scared of what we might find, but we did, every day for 80 days, I made that journey, and I am the better for it.

I am a better mother because of my preemie babies. Yes, I had, and still have, tremendous guilt about their difficult beginning in life. My heart aches for what they have been through, when they were so small that even preemie diapers were too big. Yet, every day when I held my girls, the greatest sense of peace and stillness would come over me. The sounds of the NICU would drift away, and it would just be the three of us. Now, ten months later, I remember that feeling. The feeling of being a mum to two beautiful fighters and their big brother, who loved to practice saying their names.

It is never easy being a preemie parent, it is a badge that many of us wear with honour for the rest of our lives, but we still confront our own fears, our reminders of the beginning. When it’s the hardest of days, when the doctors give us news that we can’t comprehend right away, when we question our abilities to parent, it is important to remember the calmness, the feeling of your baby, tucked safely on your chest, your hearts beating together as one. It is important to remember that peace can come from chaos.

The post Expecting Preemies appeared first on Your Health Matters.