Managing Premature Twins

Management of Premature Twins babies

Twin babies at 32 weeks (8th month), were extracted after caesarian section (LSCS) for anterior placenta which makes normal delivery very challenging. The twin children were showing signs of distress and hence emergency LSCS was performed, however the twin babies were premature and required intensive care.

Premature birth or Preterm birth  is when the baby is born alive before 37 weeks of pregnancy, based on gestational age they have been categorized as:

  1. Extremely preterm (<28 weeks)
  2. Very preterm (<32 weeks)
  3. Moderate preterm (32 to <37 weeks)

Multiple babies being the commonest cause of pre term birth followed by conditions in mother – diabetes, hypertension, infections etc.

The commonest and visible symptom in pre-mature children is “breathing problems” as their lungs are not completely developed. Most often a temporary respiratory support is provided to help the baby breathe. The child’s oxygen levels are to be monitored and assessed for ventilator support.

Ovum’s pediatrician and neonatologist assessed post-partum health condition of the twins who showed signs of respiratory distress. The baby was provided the required respiratory support in Ovum’s neonatal intensive care unit for a day and the respiratory status of the twin children improved significantly.


“The children were moved to NICU due to low oxygen levels and were doing fine there.  The NICU team kept us updated on the status of children and their oxygen levels.”– Father of the twin children.


Other short-term complications should be evaluated in preterm birth as it can affect the brain, circulation, body temperature, jaundice, and gastrointestinal problems. Premature babies who can accept and start feeding on breast milk have a very low risk of developing serious gastrointestinal complication such as necrotizing enterocolitis (NEC).

Ovum’s pediatricians have steadily promoted breast feeding and this has helped faster recovery and normalization of the neonate’s health status. The target was to provide exclusive breast feeds to the twin babies as early as possible.

Breast feed in premature neonates comes with a wealth of health benefits such as protection from infection, improved development and shortened stress.


The mother’s milk for pre-term will be different and is most suited to:  

    • Provide maximum nutrition to a fairly under developed stomach and intestines,
    • Easy to digest and has a laxative effect helping the baby pass the first stools- meconium.   
    • Brain growth and development is highest in the final 3 months of gestation
    • Provides body warmth and prevents dip in baby’s body temperature

As in twin baby nursing, the shortage of breast milk did not keep the pre-term babies from getting their required nutrition, the insufficiency was compensated by procuring the breast milk from donors. Donor breast milk has helped transform the way pre-term infants’ nutrition is managed. Ovum hospital’s network with donor breast milk has immensely helped the twin babies with significant weight gain.

The babies were discharged at 4th week after establishing full feed of breast milk with a net gain of 0.6 kg per baby.

“The team in Ovum hospital managing the NICU including the neonatologists and the nurses are highly skilled and compassionate. Especially considering the care provided to my two children, I am very happy to have had such a dedicated team and my heartfelt gratitude to the staff at all levels of care”.- Parents of the twin children.