Twins Daphne and Josie overcame early heart and breathing challenges with the help of expert NICU care

Makenzie often hears, “Oh my gosh, I can’t imagine having two sets of twins. How do you do it?”

She usually smiles and says, “Well, we don’t know any different.”

While she and her husband, Chris, breezed through the newborn stage with their first twins, the early months with their second set were far from easy.

“Daphne spent 16 days in the NICU and Josie spent 36,” said Makenzie.

A baby shower turned birthday

At 33 weeks pregnant, Makenzie went in for a routine check with her perinatal specialist.

“I expected them to listen to the babies’ heartbeats and tell me everything looked good,” she said. “Instead, the nurse said, ‘The doctor would like to see you in her office.’”

Her heart raced as the doctor explained that both babies’ heartbeats looked a little “quiet and sleepy.” Makenzie was admitted for a 24-hour monitoring test.

When that test ended, everything seemed fine – but Makenzie was asked to come back on Sunday, the same day as her baby shower.

Still optimistic, she showed up to her appointment with hair and makeup done, expecting good news and planning to go to her shower right after. But during the visit, one baby’s heartbeat began rapidly rising and then dropping.

The specialist called Makenzie’s obstetrician (OB), then handed her the phone.

“My OB said, ‘I think we’re going to have some babies today,’” Makenzie recalled.

Just hours later, she delivered Daphne and Josephine (Josie) via C-section.

Specialized cardiology treatment

After delivery, the team immediately began to monitor Daphne’s heart. When her abnormal heart rhythm didn’t resolve, the doctors wanted to transfer Daphne to Children’s Health level IV Neonatal Intensive Care Unit (NICU), which has the expertise to help treat even the most complex conditions.

Chris accompanied Daphne to Children’s Health, while Makenzie – still recovering – stayed with Josie, who needed breathing support.

At Children’s Health, pediatric cardiologists performed an echocardiogram and prepared to treat Daphne with a procedure called cardioversion.

“It was terrifying to have our tiny newborn need to be shocked,” said Makenzie.

Thankfully, the team calmly explained cardioversion and how electricity would be delivered to the baby’s heart to stop the abnormal heart rhythm. Jordan Ezekian, M.D., Pediatric Electrophysiologist at Children’s Health℠ and Assistant Professor at UT Southwestern, even drew a diagram to show them what would happen.

“Usually, once we deliver the electrical shock to the heart, the heart rhythm corrects itself – and that’s exactly what happened for Daphne,” says Dr. Ezekian.

Feeling reassured by such expert care, Chris and Makenzie asked to transfer Josie to Children’s Health so both twins could be together.

Understanding their girls’ needs

With both babies in the same NICU, Daphne was given a beta blocker to help prevent more episodes of abnormal heart rhythm and Josie continued to receive oxygen for respiratory distress syndrome plus regular tube feedings.

“Babies born prematurely may need weeks of breathing support to keep their lungs open and get enough oxygen,” says Danielle Callaway, M.D., Neonatologist at Children's Health and Assistant Professor at UT Southwestern. “And often, because they’re so focused on trying to breathe, they aren’t able to simultaneously open their mouth to feed. And that means they require feeding tube support to get necessary nutrients, as Josie did.”

Makenzie remembers how all the beeping monitors, multiple tubes and tests, plus constant activity felt overwhelming at first.

“But the nurses always took time to explain what every tube, test or treatment was and why it was needed,” she says.

Making progress towards home

When Daphne and Josie “graduated” to a private NICU room, Makenzie and Chris settled into a routine of juggling work, caring for their toddlers and commuting 45 minutes to the hospital.

Makenzie leaned on the care team for support.

Makenzie also received postpartum care and lactation support as she transitioned from pumping to formula. Child Life specialists gave her crafts to take home for her older twins – another gesture that reminded her the team cared for the whole family.

“The care team wasn’t just concerned about our babies,” says Makenzie. “They cared about all of us.”

Dr. Callaway remembers the family well. “Makenzie and Chris care deeply about their kids and asked great questions, which helps make our jobs even more rewarding,” she says.

Meeting their twin siblings at home

Despite her heart issues, Daphne was the first to go home after 16 days. She still takes a beta blocker but will likely outgrow the need for it because she hasn’t had any abnormal heart rhythm episodes since she’s been at home. Her parents check her heartbeat morning and night with a stethoscope – and big sister Audrey loves helping, with her own stethoscope.

Josie needed a little more time to strengthen her lungs and coordinate eating and breathing. But after 36 days, she too was ready to go home.

The team taught Makenzie and Chris how to manage Josie’s feeding tube and connected them with follow-up care through the Children’s Health Remote Patient Monitoring (RPM) program.

In just a week at home, in a more relaxed environment, Josie no longer needed her feeding tube. And, after a month, she no longer needed extra oxygen.

“Even though Josie stayed longer in the NICU and came home with a feeding tube, she’s now the chunkier of the two,” says Makenzie with a smile.

Life at 7 months old and keeping perspective

Today, Josie still sees her pulmonologist and Daphne continues care with her cardiologist, but both are thriving 7-month-olds who love bananas and avocados – much to the surprise of their older siblings who insist, “But they don’t have teeth!”

Josie is starting to crawl, while Daphne prefers to be carried, which Makenzie credits to her more relaxed personality.

For other NICU families, Makenzie offers simple advice: lean on your care team.

As a busy mom of four, she’s also learned a lot about perspective.

“It feels huge and serious when your babies are in the NICU – and it is,” she says. “But later, it becomes just a tiny speck of time. As you watch your kids grow healthy, you’ll forget all about the scary parts and remember the incredible care your babies who needed it received.”

Learn more

The neonatologists at Children’s Health Level IV NICU are part of one of the nation’s top neonatology programs in the country. Many babies are referred to our NICU from North Texas and beyond because of our ability to prevent complications and use the latest, most innovative treatments.

Children's Medical Center Dallas is ranked among best children's hospitals and nationally recognized in all pediatric specialties, including neonatology and cardiology and heart surgery, by U.S. News & World Report.