Twins x 2

This post is has been a long time coming.  I should have written it a week ago but we've been moving to another apartment closer to the hospital so we've been a little distracted this week.

Niña

Last Monday in clinic a set of twins arrived for a check-up.  They were born 2 days prior at approximately 7 months gestation.  They didn't even have names yet, which is common here especially when born early and small and have a possibility of not surviving.  The little girl (Niña) weighed 3lb 4oz and the little boy (Niño) weighed 3lb 14oz.  They were brought in by their aunts who just wanted to make sure they were okay.  They said the mom was at home, very weak and not feeling well.  I requested that they bring the mom to the hospital and that we would hospitalize all 3 until everyone was doing well.  They agreed but had no transportation for the mom except the public bus and the mom was unable to walk through town to the bus stop.  Dave Fields, our IT guy, frequently fills in for needs such as this and drove to get the mom and bring her back.

Niño

We only had one incubator (that works currently) so the twins shared it.  They had frequent apnic spells (stopped breathing) with is common with prematurity but also can be sign of infection.  After some lab work that showed no infection the plan was to keep them in the incubator or next to mom's skin as much as possible to decrease the energy they spend on keeping warm and instead put it towards nursing and growing.  From their length, head circumference, and ear and foot features, I estimated them to be about 31-32 weeks gestation or 9 weeks premature.  This is about the time their suck reflex starts so although they were nursing they weren't very good at it.  Their mom was not producing enough milk and so we started having her pump after each feeding.

They were doing great, gaining weight, nursing better (not great yet), and their mom was starting to produce more milk with the help of the pump.  They kept asking about the bill and seemed very concerned about it.  Many times, myself, and employees from the hospital finance department told them not to worry about it and that it was much more important that these twins receive care and survive than for them to pay their bill.  Friday (4 days later) the father insisted on taking the twins home.  Several people stopped by to try to convince them otherwise but he said there has been many twins born in the family and they all have grown up just fine and he didn't see the need for the incubator, oxygen, breast pump or the hospitalization.
They left, supplementing them with newborn formula and all we can do is pray for them.  I scheduled a follow up clinic appointment for yesterday but they didn't show up.
The title "Twins x 2" is because we have another set of twins in the hospital that is long overdue a blog post too.  Part 2 is coming soon . . .