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.

Each week, Dr. Grigoriadis, head of the Women’s Mood and Anxiety Clinic: Reproductive Transitions at Sunnybrook, sees patients who are pregnant and have depression. After reviewing general risks, like the increased likelihood of giving birth to a preterm baby at a lower birthweight, she talks with patients about treatment options.

Psychotherapy, or ‘talk therapy’, can be very helpful. “A lot of people prefer it over medication because there is no fetal drug exposure,” says Dr. Grigoriadis. “One of the problems is that therapy can take weeks to months to help with depression, so the patient and baby can be exposed to the negative impacts of depression during that time.”

Antidepressant medication can improve symptoms of depression very quickly and with very few side effects. However, medications do cross over to the baby to some extent and some patients may be hesitant to take them while pregnant.

This new approach, tDCS, uses a small electric current to locally stimulate a part of the brain that functions abnormally when an individual is depressed, requiring 30 minutes of daily treatment over three weeks. It can be done by patients at home after receiving training, while also continuing to see their regular health care team, including pregnancy care provider and psychiatrist.

“Our team has already done a small study with 20 pregnant patients with depression, which had promising results for safety and effectiveness. We’re looking for more patients for a larger study to see whether this should be offered widely during pregnancy,” adds Dr. Grigoriadis. The study is randomized, meaning patients will have a 50/50 chance of receiving tDCS or being placed in a control group which receives a similar looking device but does not deliver any electric current.

For more information and to enroll in the study, please visit https://sunnybrook.ca/content/?page=tdcs-pregnancy-depression-research-study.

The post Depression in pregnancy: Studying a new treatment 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.