Two’s Company and Three’s a Crowd!
April is National Multiple Birth Awareness Month. In 2015, multiple births accounted for 3.6% of all live births. Almost half of all twins are born prematurely and/or have low birth weight; 90% of triplet, quadruplet, and quintuplet babies are born prematurely and/or have low birth weight.
As a nurse case manager at ProgenyHealth, I enjoy helping new parents of multiples work through their own challenges. I recently had the privilege of providing case management to a family with triplets. Alexander, Belle, and Christopher were born at 26 weeks and they each weighed about two pounds. Initially, they required ventilators and TPN (a method of feeding that bypasses the gastrointestinal tract). Their parents lived four hours away from the NICU so they stayed at the Ronald McDonald House near the hospital in order to spend as much time with the new babies as possible. While in the NICU, their parents obtained three cribs and three car seats. Their mother was pumping up to ten times a day to provide breast milk for the triplets. Our lactation consultant spoke with their mother to provide her with information and tips on breast feeding multiple babies and answered specific questions about taking medication while breast feeding. Through our case management program we also ensured that their parents were aware of and applied for SSI for the babies; who were eligible because of their low birth weight.
The babies stayed in the NICU for two and a half months. The boys were discharged home first. They went home with their mother, while their father stayed behind so he could stay with their sister in the NICU. Five days after the boys were discharged, their sister was discharged home.
Once home, there were medications to be given, feedings to be provided, and approximately 30 soiled diapers to be changed per day. By the time all three babies were fed and changed, it would almost be time to start all over again; it seemed to be a never ending cycle. The babies also had several doctor appointments with their pediatrician and specialists. Getting the three babies to appointments would take two people. The babies’ mother made a calendar to help keep track of appointments, medications, and feeding schedules.
Alexander, Belle, and Christopher are approaching their first birthday and are thriving. With help from healthcare providers, case management, and family members, their parents made sure they were happy and healthy. They continue to follow up with their pediatrician, ophthalmologist, and developmental specialist. The triplets also continue to receive physical therapy through early intervention.
The triplets will soon be discharged from our case management program, and I will miss speaking with their mother. Over the past several months, we spoke about how to keep organized while managing triplets, feedings, immunizations, Synagis injections, developmental milestones, and any other concerns their mother had at the time. Their mother mentioned that she sometimes enjoyed just having an adult conversation with someone. I admired how well these parents managed to care for their three babies and I hope that somehow I made their life just a little bit better during their first year of parenthood.
About Our Author:
Alice Beaver is a Certified Case Manager at ProgenyHealth. She is a registered nurse who has worked in managed care for several years and has both Utilization Management and Case Management experience. Alice enjoys spending time with her family and kayaking in various Pennsylvania state parks.