This is a guest post from fellow father of twins, Tom Williams.
A common thought among first-time dads of twins is the Neonatal intensive-care unit (NICU). I had no experience with any of this before my twins came.
A Little Background
My twins were due 9/21/09. My wife’s water broke, for reasons still unknown, at 29 weeks and 2 days. I was at work (two hours away) and sped to the hospital, where she had been given her first dose of steroids (to help with lung development) while waiting for an ambulance transport to take her to a hospital with a Level 3 NICU.
We got to the Level 3 hospital, and she was given more doses of steroids and more medications to hold off labor while the steroids were given time to work. Twenty-four hours after they stopped the anti-labor medications, my wife went into labor. I was, once again, at work.
I got to the hospital, found out that she was in labor (she didn’t want to tell me because she didn’t want me doing 90 mph the two hour drive again). A few hours later, we were taken into an operating room so she could get an Emergency C section, as Landon was in the birth canal, but Carden was transverse across my wife’s uterus on the top.
At 10:01 PM on 7/13/09 we met our boys and our world changed. The boys were born and were whisked away by NICU staff to be checked out before my wife even got a chance to see them or hear their cries.
A few minutes later (it seemed like a lifetime) they were wheeled back in so we could touch them, see them, and meet our sons for the first time. We didn’t know it, but we were in for the worst six weeks of our lives.
What you might expect from a NICU
The boys were taken up one floor to the NICU. Around midnight, I was able to go up with my mother-in-law and see them. There were so many wires and tubes. It was one of the scariest sights of my life. I still get flashbacks when I see premature births or NICUs on TV. It’s one of those things you never forget.
The wires and monitors were the scariest. When the boys were first born, they were hooked up to oxygen as a precaution. The monitors watched oxygen level, breath rate and heart rate.
The biggest concerns are apnea (not breathing), desaturation (low blood oxygen level) and bradycardia (low heart rate). Monitors watched all of these things, and set off alarms when the levels went below a pre-set. That sound haunts your NICU visit, as does the monitor.
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Once I was able to hold them, after many weeks, I would find myself not looking at my sons, but at the monitor, scared, waiting for something to happen. Fortunately, one of the great NICU nurses reminded me what mattered: to focus on the little person in front of me, and how incredible he was. To focus on all the amazing things that he has done, instead of worrying.
That is what you need to do: Don’t focus on the bad things of your NICU stay. Focus on the good.
Focus on the fact that soon your twins will get to wear clothes. Focus on the fact that soon they will move out of the incubator. Focus on the fact that soon they will come off of the monitor. Focus on the fact that soon they will pass the car seat test. And before you know it, they will come home.
Our NICU Ending
Our boys came home, albeit a week apart. We found dual inguinal hernias on Landon the day before he was scheduled to come home, and he had an apnea after the surgery. Hospital policy was that he had to maintain five days without incident before he could go home. Major setback.
Because of this we encountered something you just might encounter: one twin will probably come home first. You will get used to having one baby home. Then a few days, maybe a week or two later, after you have gotten your schedule set with one baby, the game changes. And you have become a family.
For the first time, after many weeks, you finally feel like a family. You will realize that you have no idea what you are getting into, but you will learn really quickly.
You have no choice when you have twins. You are both worn thin. You will have parents of single babies coming up to you with comments like, “Oh, it must be so tough!!!”
After you have gotten used to things, you will look back and think to yourself that there may be tough moments, but you would never trade your life for theirs. Your twins are something special, and you are something special: a dad of twins.
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Picture by Cheryl
10 thoughts on “How to Survive Preemie Twins and the NICU”
To everyone reading this: Just remember, it gets better with time.
Thanks Tom for sharing your thoughts and experience with all of us.
Thanks to Joe for the terrific site and to Tom for this post. My wife is a type 1 diabetic and nearly 31 weeks pregnant w/ boy/girl twins. We fully expect some NICU time, but we’re praying they will hang on until at least 34 weeks so they will not be in for too terribly long.
This site has been a spectacular resource. Keep up the great work!
@Arthur – you’re welcome! Your situation is a complicated one but it sounds like you’ve got a grasp of the possibilities. I wish you and your wife all the best as you go through the remaining weeks of the pregnancy and welcome your twins into the world.
My wife was diabetic and got in labor at 35 week, but we were ready to go a month before that. We were very fortunate, and the twins stayed only a week long in the NICU. It is very hard to see such small babies *and* their mom very fragile at once. Thanks for sharing your story, Tom.
@Daniel – I’m glad you were ready for their arrival. I agree that it is hard to have everyone in a fragile state and not be able to do much about it.
Another thing to keep in mind is that the silver lining to a NICU stay is that you have a wealth of information at your disposal in the form of your NICU nurses. We learned far more about caring for our babies than we ever could have on our own with a “normal” delivery and hospital discharge after 48 hours. Take advantage of it! They will help you with anything, all you have to do is ask!
@Amy – wonderful point! They don’t charge for asking questions, so we should definitely take advantage of that.
Thank you for this post. I have been working on getting a write up done as well on this topic, I am not an author and have struggled to formulate all of my thoughts to get it done (a lot of re-writes and deletions) so I am just going to throw a lot of my experience out there in this reply. One of the things I ran into during our NICU stay (101 and 106 days for our twin girls born at 24 weeks gestation) was that there was not a lot of information out there on what dad’s go through or what to expect.
In our situation we had a little bit of experience on what being in the NICU was like as my sister had twins early (at 33 weeks I believe) so we had seen the wires and tubes and heard the alarms sounding, nothing though prepares you for the emotion you feel when it is your own child.
Our girls were born at 1lb 6 oz and were intubated and in their isolet. IV’s and wires and tubes and the billy rubin light… It is a lot to take in.
Your advice is spot on with what to focus on. There will be days that it feels like nothing is going right or there will be set backs. You have to focus on what I called the small wins each day and be cognizant of the set backs but don’t dwell on them. If one of the girls gained a ml or 10 that was a win and celebrate it. If they poop or pee celebrate it. If they go 10 minutes without an alarm going off celebrate it.
In the very early days of the NICU stay your main focus is getting through the first few days. You can think about long term but stay focused on winning the small battles at first. We again were very fortunate and for 24 weekers things moved along as well as they could.
A major issue I have heard and saw from time to time were that Dad’s taking a step back and letting Moms take the lead. While that is ok to a point it is important to remember that Mom is tired, scared and has all sorts of emotions that are increased by hormones. Be there for her as much as possible. In all likelihood she is going to need to be pumping. Your job should be to be supportive and help. Wash the supplies, set up the pump, (if you are fortunate enough to be able to stay at the hospital for a while, we had a ronald mcdonald set of suites we qualified to stay in at the hospital for the first 2 weeks) run the milk down to the NICU even in the middle of the night (its a good time to just get a quick status update and check on your twins too just by yourself). Most importantly be supportive and know pumping pretty much sucks and there is nothing you can actually do to take the complete suckiness of it away but being there helping will take some of it. Also don’t tell her she has to or it’s best for the babies… If it becomes too much of a burden for her, it’s ok to stop. The first couple of weeks are pretty critical but the hospital probably has donor milk to supplement and after 32-33 weeks they will probably be switched to formula to supplement for extra calories. Not pumping isn’t a bad thing and it will ease some of the stress Mom is going through (my wife had 2 skin infections and rashes caused by lanolin in the lotion which caused issues… so she had it pretty rough and even with that she pumped until 32 weeks, WAY longer than any of the nurses or I thought she would).
Another thing to take the lead on while your there and once you are able change diapers (AS MANY AS YOU CAN). This helps build confidence in touching your baby while they have the tubes and wires hooked up and gets you more comfortable in general.
You can let Mom take the lead on doing skin to skin. This is to a point though as you need your time so when you are able. Man up and take your shirt off and hold those babies close. No one will judge you and it is so vitally important.
A few of really big things that got us through our journey before bringing the girls home were just forming the relationship with our nursers, ALL OF THEM. Talking with them asking them questions. Sometimes about the progress but also just about them. You need normal conversation you need a human connection with adults. Otherwise you are going to hear nothing but beeps and alarms and drive yourself nuts. Also get out of the hospital, your not abandoning your children they are safe and in the best place possible. So go for walks, go to dinner, GO HOME. It is all ok. You will spend every chance you can with your twins but you need to get out of that room. Lastly you’re not alone but everyone’s journey is different so do not try and compare your stay to someone else’s. Do what you can to try not to compare your twins to each other either as they will each hit milestones at different times that’s what makes them individuals and so very special. Trying to make comparisons will make you question everything and put more pressure on you than you need.
While you are their document EVERYTHING, Keep a journal, write down questions that you may have when no one is there to answer them so you don’t forget. I did a weekly facebook post documenting the highlights of the week and its amazing how much happens in a week that you kind of gloss over at times as it happens. The day’s can seem long and it may feel like an eternity but before you know it they have one of your twins in a car seat and they say ok you can take that one with you now (it is VERY rare twins go home at the same time and can be somewhat stressful our NICU was phenomenal and we were able to bring the girl that got to go home first back each day and kept her bassinet in the room as well.) and you’re like “holy crap we aren’t ready yet how about a couple more days, are you sure we can take he/she home?” When did that happen.
I am not an expert, I am not a Dr but I am a NICU veteran now and I am happy to be a sounding board for any Dad that needs to ask questions, tell their story or just vent. It’s not always easy being the dad of twins but even more so being a dad of twins that has to spend time in the NICU.
@Matt – Thank you so much for taking time to share your NICU story! I’m sure it will help other twin parents as they read it.