Born too soon

At birth, each baby weighed less than a regular carton of milk

Twins Josias and Elias Lee were born prematurely at 26 weeks. See how preterm babies like them are being cared for at KK Women's and Children's Hospital's Neonatal Intensive Care Unit.

Couple describes agonising experience after twin sons were born premature at 26 weeks

When auditor Damion Lee, 37, first gazed upon his newborn twins at KK Women's and Children's Hospital (KKH) on Aug 30, he was fraught with worry.

His sons weighed just 930g and 920g - slightly less than the weight of a regular carton of milk.

They were prematurely born at 26 weeks and had to be kept in an incubator in the hospital. "They were very red. It was overwhelming and I was worried for them," he said.

Newborn babies weighing less than 1,500g - considered very low birth weight - are often at higher risk of complications. A full pregnancy term is around 40 weeks.

The twins, Elias and Josias, were born via an emergency caesarean section. Mr Lee's wife, Ms Connie Lim, 35, an engineer, had gone to KKH on Aug 28 as she was bleeding.

Two days later, she was on the operating table.

The bleeding was due to placenta abruption, a serious pregnancy complication that occurs when the placenta separates from the uterus prematurely. This can be dangerous as the blood flow to the baby is interrupted, said Dr Nirmal Kavalloor Visruthan, a consultant at KKH's neonatology department.

Mr Damion Lee and his wife Connie Lim with their twin boys Josias (left) and Elias, who were born in August at just 26 weeks. The babies were in the neonatal intensive care unit in KK Women's and Children's Hospital for almost two months.
Mr Damion Lee and his wife Connie Lim with their twin boys Josias (left) and Elias, who were born in August at just 26 weeks. The babies were in the neonatal intensive care unit in KK Women's and Children's Hospital for almost two months. ST PHOTO: TIMOTHY DAVID

"The mother is also losing blood, therefore it can be dangerous for her too. In these cases, the babies are often delivered via emergency caesarean section," he added.

Ms Lim recalled: "At 8.30pm, the c-section team was activated and by 9pm, the twins were sent to Nicu (neonatal intensive care unit). Everything was bang and go."

Mr Lee and his wife, who also have a three-year-old son, are sad their babies had to suffer.

Mr Lee said: "You see your babies with tubes, with needles, with wires. There's no way to be prepared for it. It's how you face reality."

But reality was to hand them another shock.

  • Common causes of preterm births

  • Globally, prematurity is the leading cause of death in children under the age of five.

    Preterm birth occurs for a variety of reasons. Most happen spontaneously, but some are due to early induction of labour or caesarean birth, whether for medical or non-medical reasons.

    There are several factors that can put a pregnant woman at higher risk of a preterm birth. These include a previous preterm birth, multiple pregnancies such as twins or triplets, as well as chronic medical conditions such as high blood pressure, diabetes and infections.

    Pregnancy in adolescence is a major risk factor for preterm birth.

    There is no test that can accurately predict who might have a preterm birth.

    SOURCE: WORLD HEALTH ORGANISATION

HELPLESS AND GUILTY

Three weeks later, when Ms Lim made her daily visits to the Nicu, she was shocked to see Josias' mouth filled with fresh blood.

"He was very pale and the nurse told me the doctor was trying to save the baby. They told us to stroke the baby before they start to administer the medication," she said.

The doctor told the couple there was a 50 per cent chance that the boy would not make it.

Mr Lee said: "That was the day I wanted to jump off the building... My wife just cried. That was the worst day of our lives... We had to be prepared for the worst. We could not help him. It all depended on how he reacted to the medicine."

Fortunately, their son made it.

Still, the guilt and feelings of helplessness never went away.

"My wife blames herself for not being able to keep the babies longer in the womb," said Mr Lee.

The twins were moved to the special care nursery in October. Premature babies whose conditions are more stable are transferred to this nursery before they are ready to be sent home.

 

Josias was discharged on Nov 26, and Elias last Friday. At home, Mr Lee and Ms Lim will have to monitor their motor skills.

Now 42 weeks old, the boys have stage 2 retinopathy of prematurity. This is a potentially blinding eye disorder that primarily affects premature infants.

"It's still a long, long journey. I don't think one can ever be prepared for premature babies," said Mr Lee.

A version of this article appeared in the print edition of The Straits Times on December 19, 2017, with the headline 'At birth, each baby weighed less than a regular carton of milk'. Print Edition | Subscribe