Eight-month-old twins from Hayward Heath, West Sussex, recently met the surgeon who saved their lives even before they were born. The BBC reports how their mother, Katerina Ahouansou, at six months pregnant, during a routine scan, uncovered a serious issue with their development and blood supply.

Doctors diagnosed the twins with twin-to-twin transfusion syndrome or TTTS. It is a condition where one twin received more blood and nourishment than the other due to uneven blood vessel distribution in the placenta. In case there is no medical intervention, it could be fatal for both the twins.

A Specialist Steps In

This is when Ahouansou was referred to Professor Kypros Nicolaides at King’s College Hospital in London. Professor Nicolaides is a pioneer in fetal medicine and he specializes in a laser procedure that redistributes blood supply between twins in cases of TTTS.

When Ahouansou was scanned, Nicolaides observed that one of the twins were significantly smaller than the other. "There was a very high chance that if we did not intervene, both twins could die," he recalled.

An Operation No Less Than A Miracle

The life-saving laser surgery was performed and within a week the doctors saw an improvement with the twin who was smaller in size. When the twins were born, they weighed 1.5kg and 1.7kg. To recognize the efforts by the surgeon, Ahouansou named them Kai Kypros and Asher Nicolas after Professor Kypros Nicolaides.

Ahouansou also expressed deep gratitude for the professor's expertise and called him "proof that miracles can be performed by people who are devotees to their profession."

Professor Kypros Nicolaides has been at King’s College Hospital since 1980 and is widely regarded as a leader in fetal medicine. His groundbreaking research and development of screening and surgical techniques have saved countless lives.

Through his dedication, Professor Nicolaides has given many families hope, demonstrating how medical advancements continue to improve survival rates for complex fetal conditions like TTTS.

More about Twin-to-twin Transfusion Syndrome

As per the John Hopkins Medicine, TTTS is a rare pregnancy condition that affects identical twins or other multiples. It happens in pregnancies where twins share one placenta and a network of blood vessels that supply oxygen and nutrients essential for development in the womb. These pregnancies are known as monochorionic.

Sometimes, the blood vessels in the placenta are unevenly distributed, causing an imbalance in blood flow between the twins. The donor twin loses more blood than it receives, leading to malnutrition and potential organ failure. Meanwhile, the recipient twin gets an excess of blood, putting strain on the heart and increasing the risk of cardiac complications.

Impact on the Donor Twin

The donor twin loses blood volume (hypovolemia), reducing kidney function and urine production. This leads to low amniotic fluid levels (oligohydramnios) or, in severe cases, a complete absence (anhydramnios). Without proper blood circulation, the donor twin faces cardiovascular issues, increasing the risk of death.

Impact on the Recipient Twin

The recipient twin experiences excess blood volume (hypervolemia), causing increased urination and excessive amniotic fluid (polyhydramnios). The overworked heart struggles to handle the surplus blood, leading to cardiovascular dysfunction, heart failure, and, in extreme cases, death.

Delhi continues to choke, and again wakes up to toxic air on Friday, as the Air Quality Index (AQI) stayed in 'severe' category. As of 8am, the Anand Vihar monitoring station recorded an AQI of 418 as per the Central Pollution Control Board (CPCB). As of 7am, as per aqi.in, Delhi's average AQI was recorded at 455. As of mid-day, around 10am, the AQI was recorded at 303, which is equivalent to smoking 10.3 cigarettes noted aqi.in.

Parents too are now concerned about their children's health. A Delhi resident Akshat Verma, posted on his LinkedIn that his three-year-old son now needs to understand the term AQI. He writes: "One week he’s learning how to hold a pencil... next week he’s learning why he can’t go to school because the air is ‘too poisonous'."

Many parents echo the feeling, and many have raised questions too, including if at all an air purifier helps a child as the moment the child steps out, he will be breathing polluted air. Addressing all the questions, Dr Shreya Dubey, who is a leading pediatrician and newborn specialist uploaded a video on her Instagram @anantakidsofficial.

"If we have to stay in Delhi-NCR, then the child should have the habit to tolerate air pollution". "Doctor, if we use air purifier, won't the child's immunity become weak?" These are some of the questions the doctor is asked repeatedly by parents.

Her answer to all these questions is simple: "Air toxicity has nothing to do with immunity."

The doctor explains that if someone is smoking about 30 cigarettes a day, that does not make his immunity better than the one who smokes just 5 cigarettes in a day. The doctor says that exposure to toxic pollutants has no relation with tolerance or immunity building, in fact, longer exposure can cause more damage.

How Can You Protect Your Child Against Delhi's Toxic Air?

The doctor suggests to use air purifier for at least 8 to 10 hours at night so the child's lungs can recuperate. She also suggests that for those who cannot afford an air purifier, they can keep air purifying plants at home. In fact, NASA has compiled a list of indoor plants that can improve indoor air quality. The list includes:

• Spider Plant, that can remove formaldehyde, xylene, and toluene
• Snake Plant, that can remove formaldehyde, benzene, xylene, toluene, and nitrogen oxides
• Peace Lily, that can remove formaldehyde, benzene, trichloroethylene, xylene, and ammonia
• Aloe Vera, that can remove formaldehyde and benzene
• Boston Fern, that can remove formaldehyde and xylene

The doctor also suggests other alternative for an air purifier, which includes wearable purifier for indoor pollution, charcoal bags in child's room, and DIY fan filter boxes.

What Can Exposure To Pollution Do To You?

Chronic pollution exposure aggravates oxidative stress and systemic inflammation. This means, with every breath you take, you inhale a toxic swamp.

As per Pusan National University, long term air pollution exposure actually triggers allergic immune responses in the lungs. Furthermore, a 2022 study published in the International Journal of Environmental Research and Public Health also shows the negative impact on immune system with alarming and harmful air quality.

As per another 2000 study, published by the British Society for Immunology, people living in areas with higher pollution levels show measurably different immune responses than those in cleaner environment.

Air pollution contains toxins like particulate matter, ozone, carbon monoxide, nitrogen dioxide, and sulfur dioxide. It also includes hazardous air pollutants (HAPs), such as lead, mercury, asbestos, benzene, and other volatile organic compounds. When one breathes this toxic and poisonous air the respiratory system bears the initial brunt of it. The pollutants then damage the delicate tissues lining your airways, and disrupts the barrier that normally prevents harmful substances from entering your body. When this first line of defense is compromised, pathogens find it easier to established infections.

Winter may feel refreshing for adults, but for newborns, it is one of the most vulnerable seasons of the year. Infants have immature immunity and cannot regulate their body temperature efficiently, making them prone to cold stress, infections, and breathing difficulties. In a conversation with Health and Me, Dr. Manju Kumari shared essential guidance for parents navigating their baby’s first winter.

Keeping Your Baby Warm

Newborns lose heat rapidly, and even a slight drop in temperature can lead to distress. Dr. Kumari explains that “infants cannot regulate their body temperature effectively, which is why small measures go a long way.”

She advises dressing babies in soft, light layers rather than one thick piece of clothing, as layering traps warmth better and prevents overheating. The head and feet should always be covered with a cap and socks since “heat loss is maximum from these areas.”

Parents must ensure the room is comfortably warm, especially during sleep time. However, loose blankets should never be placed over a baby’s face or neck. “This increases the risk of SIDS,” she notes. Bathing should also be brief—no more than 2–3 minutes, with warm (not hot) water and away from fans or cold drafts.

Preventing Infections During Winter

With colder weather comes a spike in viral infections, making newborns particularly vulnerable. “Their immunity is still developing, so simple precautions matter,” Dr. Kumari says.

Parents should:

• Limit visitors during the first weeks
• Wash hands before touching the baby
• Avoid anyone who shows symptoms of a cold or flu
• Keep the room ventilated to reduce indoor pollution
• Maintain a clean environment for feeding and sleeping
• Stay updated with vaccinations and follow pediatric advice

According to her, infection control begins at home, and these small actions significantly reduce a baby’s exposure to harmful germs.

Caring for Skin and Breathing

Winter dryness and pollution can irritate a baby’s delicate skin and airways. Dr. Kumari recommends using gentle, fragrance-free moisturizers and avoiding strong soaps.

Blocked noses are common, and she advises saline nasal drops only under a paediatrician’s guidance. She emphasizes keeping infants away from incense sticks, scented sprays, smoke from cooking, and heater fumes. “Their lungs are extremely sensitive. Clean air around a newborn is non-negotiable,” she says.

A dust-free, odor-free sleeping area is crucial for easy breathing and quality rest.

Warning Signs Parents Should Never Ignore

Recognizing distress early can prevent complications. Dr. Kumari lists key red flags:

• Fast or labored breathing
• Feeding poorly or refusing feeds
• Fever or unusually low temperature
• Sudden lethargy
• Pale or bluish skin

“If any of these signs appear, seek immediate medical attention,” she stresses. Early intervention can make all the difference in a newborn’s outcome.

Small Steps, Big Difference

Winter care, Dr. Kumari assures, “is not as complicated as it seems.” Thoughtful adjustments, appropriate clothing, safe sleeping practices, good hygiene, and close monitoring, can protect babies from most seasonal risks.

“With a warm, clean, and safe environment, parents can ensure their newborns thrive even in the cold months,” she concludes. These simple habits not only safeguard health but also make the early months more joyful and stress-free for new families.

Every year on November 17, World Prematurity Day is observed, and this year, the global theme was 'Give preterm babies a strong start for a bright future'. The day is observed to raise awareness around premature birth, emphasize the importance of quality care, and advocate for better health outcomes for preterm infants and their families.

To understand how can one take better care of preterm babies, Health and Me spoke to Dr Sanjay Wazir, Medical Director, Neonatology and Pediatrics at Motherhood Hospitals, Gurugram.

Dr Wazir points out that at first the Neonatal Intensive Care Unit or the NICU may seem overwhelming, however, it must be seen as a sanctuary of healing. "In the NICU, premature or unwell newborns receive specialized medical attention, constant monitoring, and compassionate care from expert hands. Here, the mother and the baby are well taken care of. This will help the baby lead a healthy life. Hence, NICU care is important for all the premature or unwell babies," he says.

What The Parents Go Through?

Doctor rightly points out that for any parent seeing their babies in NICU could be frightening, especially seeing their child surrounded by wires, machines, or even incubator could trigger worry and confusion. However, he says that new parents should not fret or panic. He says that NICU is a place designed to give fragile newborns the best possible start in life. "Here, premature babies, those with low birth weight, or those needing medical support after delivery receive round-the-clock care from a dedicated team of neonatologists and nurses," he explains.

What Happens Inside The NICU?

The doctor explains that the NICU provides a controlled and nurturing environment where babies can grow stronger outside the womb. "It helps maintain their body temperature, supports breathing, and ensures proper nutrition through feeding tubes if necessary," he says.

Every machine in the NICU is for a specific purpose, right from oxygen support to heart rate monitoring, ensuring that each baby receives precisely what they need. Parents often find comfort knowing that the experts in the NICU are constantly watching over their child’s progress, explains the doctor.

The doctor points out that parents are essential part of the NICU journey. "Your touch, your voice, and your calm presence can help your baby feel safe and comforted," he tells to all the parents. However, what is extremely important is to maintain hygiene guidelines, staying involved in daily care, and communicating regularly with the doctors and nurses to "strengthen your bond and confidence as caregivers." The doctor says that during this time, the mother will also be taught about Kangaroo care, which is skin-to-skin contact that helps the mother bond with her baby.

Journey To Home

"Each beep and monitor in the NICU tells a story of progress. Some days may be tough, but the baby will be able to thrive after prompt attention," notes the doctor. While the experience can be emotional, parents must remember that the journey is also filled with hope. With expert care and a parent’s love, many premature and unwell babies go on to lead healthy, happy lives.