June 25, 2008

We're Home, But One Baby Was Left Behind

This afternoon, my wife and our son Matthew were discharged from Lucille Packard Children's Hospital, four days after the arrival of our twins. And while we're excited to be home, in a comfortable environment, we have had the unenviable position of leaving Sarah, our second twin, behind. While she's expected to gain weight and strength to the point she can round out our home by the end of the week, the gap between what we had expected and what has happened is very real - leaving me feeling we're not going to be fully whole until everybody is home where they belong.

On Friday night, as I saw the pediatricians busily tending to our twins just moments after they were extracted via Caesarean section, they called out the weights of the babies. Matthew, born at 9:01, weighed in at 5 pounds even. It was less than I had hoped, but acceptable. When they called out Sarah's weight, at only four pounds, three ounces, my heart sank. She had come into the world more frail than we had hoped, and would need to work extra hard from day one.

Matthew Gray in the crib in his first night home.

I myself was a premature baby, more than 30 years ago, having been born two months ahead of schedule, and weighing in at four pounds, six ounces. A generation ago, such low birthweight was more life-threatening than it is in today's advanced medical world, and I struggled, to gain weight, to gain respiratory strength, and early on, it wasn't clear if I'd ever have full mental or physical capabilities. As my dad often jokes, "We were told you had a 50% chance of being disabled, and a 50% chance of being mentally challenged. We're still waiting to find out which one it is going to be."

When my wife and I found out we were going to have twins, we were ecstatic. Finding we were pregnant by the end of last year, and that we were having twins was amazing. We've been preparing for it as the months drew closer, as our home is fully prepped for pairs of everything - from outfits to swings, to booster chairs, and car seats. But while we knew twins would come before the full gestational period for a singleton, we certainly didn't think about having not just one, but two, lower birthweight, pre-term babies.

Google's calculator helps us know just how small Sarah is.

So far, while Matthew had met the threshold needed to stay with us since his debut, Sarah has not. While he was in the "Wellness Baby Clinic", Sarah lagged behind, in the "Special Care Nursery". Matthew stayed with us 24/7 each of the last few days, while we only could visit Sarah in 15 to 45-minute increments, to pass along milk, or to hold her and remind her she is as much a part of our family as her brother. She stayed behind, not just because of her low weight, but due to concerns she would be unable to keep her temperature regulated. And while she looks to be on the verge of being healthy enough to come home, it will be days yet. Now, we're here in Sunnyvale, and she, with the other children given a less than ideal start, is working hard at Stanford to get that chance.

It's well known that babies in their first week tend to lose as much as 10 percent of their original birthweight, before gaining it back and eventually, starting an upward trajectory, which for most Americans at least, never stops. But every night, we got an update on Sarah's weight. From 4 pounds, 3 ounces, it crept downward, to 4 pounds, 1 ounce, and eventually, to 3 pounds, 15 ounces, where it is today. Sarah has never, at her heaviest, been as big as I was when I was once considered dangerously small. And yet, we have had to put our trust in the doctors, who expect that she'll fight through the slow start and be with us soon.

Matthew only takes up half what the crib was meant to hold.

Nobody has expressed any great concerns about her humble beginnings, and the hospital is notoriously conservative. I also know that the 3 to 4 pound range isn't quite the drama it once was. But to be discharged today, and leave the hospital with just one baby instead of two makes me feel that in some way, we're already failing as parents. Our car ride home had one empty car seat. Our crib, divided for two, has only one occupant. And Sarah, who arguably needs the most help, is the only one we can't get to.

We're still very happy our twins are here, and despite their size, are healthy. I expect Sarah will be with us in just days, and that this part-time adjustment from zero kids to one to two in a week will seem like a small blip in short time, but while we've bonded with Matthew and know him well, we'll be starting almost from scratch with Sarah, and that just doesn't seem fair.