When babies arrive earlier than expected it can be a shock to both mom and baby. What was supposed to be a beautiful memory can quickly become a stressful and fearful experience. For one Iowa family, the birth of their twin daughters is a story that helps highlight the calm and team approach to care that is essential inside the neonatal intensive care unit.
From the moment they learned they were pregnant with twins, the Duncans figured a stay in the NICU was likely in their future, but the length of that stay is one they didn’t plan for.
“My water broke at 28 weeks and so they made it to 32. So we've been here for now 64 days,” said Alana Duncan.
Critical Care for Early Arrivals
Identical twins Saige and Sutton are the first children for Alana and Bryson. The pair arrived nearly two months ahead of schedule — meaning their fragile bodies need close observation while they continue to grow.
“When you come up here, it's a little scary at first, especially in the beginning when they're so little. Our Sutton was born at 3 pounds and 15 ounces and Saige was born at 2 pounds and 6 ounces. So a big difference between the two of them, but they needed lots of care,” said Alana.
“Every baby is a little different. We might have an idea of what the plan is, but every baby likes to kind of keep us on our toes and then we might have to pivot. We know big things that happen when babies are born early or even if they're born at their due date; Breathing seems to be the biggest factor. We kind of have the same pathway for that, but when babies are born early, we think about nutrition for them, making sure they're starting feedings, concern for infection, the whole spectrum. But the big topics are eating, breathing and growing,” said Rebecca Fish, MD, a neonatologist at Avera McKennan.
Focus on Family Centered Care
One of the hardest parts of a NICU stay is the physical separation between parents and babies, that’s why the care team looks for every opportunity to include mom and dad.
“I really like to have parents even start with just diaper changes because it almost seems intimidating when your kid is so little. And then I also really love helping parents with feeding. I think it's really special and it's an easy thing for them to do. You're going to be doing it at home. It's a really great way to be involved without it having to be too intimidating,” said Gwinn Reeves, RN, one of the NICU nurses on the twins’ care team.
“They're very good at educating us. We never felt like we were out of the loop, not once. We were always obviously one of their first contacts when they were deciding on whether to switch up a feed or whether to do a certain test,” said Bryson Duncan.
“We do family-centered rounds here in the NICU, so we come around as a multidisciplinary team to the room, to the bedside, and we want parents to be engaged. You want to hear what they're saying. They're the best advocate for their baby, and so they're probably the most important part of our team,” said Dr. Fish.
While the girls are genetically identical, Saige has always measured smaller. After delivery, Sutton was able hit her growth markers and was ready for life outside the NICU a little faster than her sister Saige.
“I mean, two steps forward, five steps back some days. It's been a big roller coaster from the very beginning,” said Alana.
“Saige is a pretty stubborn little girl. And I can say that, because at the end we were trying to figure out what she needed to do to eat. And so speech therapy worked with her. We tried every bottle nipple that we could think of and finally found the perfect match for her. And so it was really, really amazing to see. We were at a point where we were talking about, does Saige need a G-tube to be able to go home, to gain weight and grow? And then with just a lot of hard work and determination, we were able to find the perfect solution for what she needed. And she went home thriving, eating more than we ever anticipated,” said Dr. Fish.
Prepared for Life Outside the NICU
So after more than 3 months of calling the NICU home, the Duncans were finally ready to break free. Officially, they may be a family of 4 — but Alana and Bryson are taking more than these two girls back to Iowa.
“We're ready for sure to be home, but these nurses have been amazing. A lot of them have become like family. We have a nurse today that's been our nurse from the beginning, and she's just seen them grow and grow!” said Alana.
“It honestly means the world. It's so sweet that they remember our names and even just want to say thank you. Because it's such a joy to take care of their kids. So to hear thank you is just really nice,” said Reaves.
The Neonatal Intensive Care Unit at Avera McKennan cares for babies from all over the Avera regional footprint. Learn more about postpartum care at Avera.
