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.

The birth of a baby is often marked with celebration and joy. But when a baby arrives weeks before the expected date, it could take a psychological toll on the parents who, all of a sudden, are rushing in and out of the neonatal intensive care unit (NICU) instead of settling into routine with their newborn.

While premature babies need urgent medical attention, their parents also deal with a silent emotional burden that can continue long after the baby is discharged.

Anxiety about the baby's survival, concerns about development and the fear of managing them outside the hospital can turn the transition from NICU to nursery into another challenging phase.

On World Prematurity Day, the focus is not only on the medical needs of premature babies, but also on the psychological impact on the families.

Impact Of Premature Birth On Parents

Also read: AIIMS Delhi Performs India's First Open Fetal Surgery To Repair Spina Bifida

Premature birth can abruptly change the experience of becoming a parent. Birth plans may be disrupted, mothers may be separated from their newborns as even holding or feeding the baby can depend on the doctors.

For parents, watching a newborn receive respiratory support, feeding assistance and continuous monitoring can be nerve-wrecking. They may feel helpless or disconnected, especially when hospital protocols due to treatment limit their involvement.

Dr Chaitra N, Paediatrician at Milann Fertility and Birthing Hospital, Bengaluru, told HealthandMe, “Parents often enter pregnancy with a personal picture of how childbirth and the first few weeks with their baby will unfold. When a premature birth changes that experience, they may also experience a sense of loss for the moments they had imagined.”

She added, “It is important to make space for these feelings without treating them as a sign of weakness or inadequate parenting. Rather than comparing their journey with that of other families, parents should allow themselves to develop their own understanding of parenthood. Recognising small moments of connection, celebrating progress and letting go of unrealistic expectations can help them build a healthier emotional relationship with this new experience.”

Anxiety Due To Previous Pregnancy Losses

Also read: PM2.5 Levels 66x WHO Limit In Delhi: How Air Pollution Could Affect Children's Lung Development

The emotional impact of premature birth is harder on some parents as they may have undergone pregnancy losses in the past.

One case shared by Dr Shilpi Saraswat, Clinical Psychologist at Sakra World Hospital, Bengaluru, involved a 32-year-old woman who had experienced two miscarriages before her subsequent pregnancy.

Although she eventually delivered her baby prematurely at 33 weeks, the arrival of her child did not immediately ease her fears. She remained anxious about the baby's health, safety and developmental milestones. Even minor changes in the baby's behaviour could trigger worry,

Dr Saraswat said, “Her previous pregnancy losses also affected her confidence in handling everyday maternal responsibilities. She found it difficult to trust that her baby was developing normally and remained highly alert to even minor changes in the child's behaviour and health.”

The case highlights how previous trauma, fear of another loss and uncertainty about a premature baby's development can contribute to heightened vigilance and overprotective caregiving.

Returning Home From The NICU Can Be Challenging

Also read: Excessive Screen Time & Mental Health: Expert Urges Parents To Limit Children's Screen Time At Times Health Summit 2026

Discharge from the NICU is often celebrated as a major milestone. However, it can also bring a bunch of new worries. Parents who might have felt more secure due to proximity to medical professionals who were monitoring their baby may feel unprepared to take full responsibility for feeding, sleep and routine care.

Dr Shilpi Saraswat highlights the importance of practical and emotional support during this transition.

She said, “Returning home after a prolonged hospital stay can feel like stepping into a completely different phase of parenting. Families should be encouraged to divide caregiving responsibilities realistically rather than expecting one parent to manage everything. Partners can support each other by sharing night-time duties, attending follow-up consultations together and creating space for rest.”

She added, “Extended family members can also contribute by helping with household responsibilities instead of overwhelming parents with advice. Healthcare teams should provide clear discharge guidance and ensure that parents know whom to approach when concerns arise. These practical measures can make the transition less intimidating and help families gradually regain a sense of normalcy.”

According to Dr Saraswat, here are the key psychological concerns parents may face:

• Anticipatory anxiety and fear of uncertainty.
• Fear of losing the baby due to previous pregnancy losses.
• Emotional distress associated with past miscarriages.
• Heightened vigilance about the baby's health and development.
• Fear of developmental delays.
• Overprotective caregiving and difficulty adjusting to motherhood

Parents Need Support Along With Medical Care

A premature birth may change the beginning of parenthood, but it does not have to define the family's experience forever. From a baby's first feed to the first day at home, every milestone is important.

Supporting families through this journey means caring for parents as well as the babies who begin their lives in the NICU.

The emotional needs of parents should be considered alongside the medical treatment of premature babies. Hospitals can help by encouraging parents to participate in appropriate caregiving activities, providing access to counselling and connecting families with others who have experienced similar situations.

Partners and relatives also have an important role. Sharing responsibilities, offering help and avoiding comparisons with other babies can reduce some of the pressure parents experience.

Delhi's air quality remained in the 'very poor' category on Tuesday, with the Air Quality Index (AQI) at 304 around 7:15 am, according to Central Pollution Control Board (CPCB) data.

Following Diwali celebrations on November 8, PM2.5 concentrations in several parts of the capital exceeded 66 times the World Health Organization's (WHO) recommended 24-hour guideline, according to The Hindu.

Beyond immediate respiratory problems, repeated exposure to high PM2.5 levels could impair children's lung development and reduce their maximum lung capacity in adulthood, experts warn.

How Does PM2.5 Affect Children's Developing Lungs?

Also read: Delhi Pollution: Is Your Child's Cough Or Wheezing A Warning Sign? When Should Parents Worry?

Delhi's pollution is expected to persist, with cracker emissions, stubble burning and geographical factors contributing to recurring PM2.5 spikes. This raises concerns about the long-term effects of repeated exposure on children's developing lungs.

"Childhood is a critical period when airways expand, lung tissue develops and the tiny air sacs responsible for oxygen exchange mature," Dr Neetu Jain, Senior Consultant, Pulmonology, Critical Care and Sleep Medicine, PSRI Hospital, told HealthandMe.

Dr Manav Manchanda, Director of Respiratory and Sleep Medicine at Asian Hospital, said fine particles can penetrate deep into children's lungs, triggering inflammation, oxidative stress and irritation of the respiratory lining.

Repeated inflammation may affect lung growth, resulting in lower lung function than a child might otherwise have achieved.

"This does not mean every exposed child will develop permanent damage, but repeated exposure over several winters can potentially reduce their respiratory reserve," Dr Neetu said.

Which Children Are Most Vulnerable?

Also read: Delhi's 'Severe' AQI: Is Your Sore Throat More Than Pollution Irritation? When To See A Doctor

Lung development begins before birth and continues through infancy, childhood and adolescence.

Dr Neetu explained that exposure to air pollution during pregnancy can affect respiratory development. Infancy and early childhood are particularly important as the lungs undergo rapid structural growth, including the development of alveoli.

Lung development continues through adolescence, with lung function generally reaching its peak in early adulthood. Puberty is another important developmental window.

Dr Manav told HealthandMe that infants and preschoolers are especially vulnerable because their respiratory and immune defence systems are still developing. They also breathe more air relative to their body weight than adults, increasing their exposure to pollutants.

School-going children and adolescents are also at risk as their lungs continue to grow and outdoor activities add to their exposure.

Can Pollution Affect Children's Lungs Without Symptoms?

Read More: Air Pollution In Delhi: Experts Warn Of Red Eyes, Itching, Watering In Children

Pollution-related changes in lung function may not produce immediate symptoms. Red flags parents should watch for include:

• Reduced exercise tolerance.
• Getting tired more quickly while playing.
• Occasional or recurring coughing.
• Taking longer to recover after physical activity.
• Breathlessness or wheezing.

Can the Effects On Lung Development Be Reversed?

According to the experts, the recovery depends on the duration and intensity of exposure, the child's age and the nature of the lung-function changes.

Airway irritation and inflammation may improve when exposure is reduced. Children also retain some capacity for lung growth and adaptation.

However, recovery may not always be complete. Changes to lung development during critical growth periods may persist into adulthood.

People who enter adulthood with lower-than-expected peak lung function may have less respiratory reserve as lung function naturally declines with age.

How Can Parents And Schools Protect Children's Lungs?

Reducing children's exposure to polluted air is particularly important during severe pollution episodes. Children with asthma or other respiratory conditions should follow their prescribed treatment plans. Other measures include:

• Limit outdoor activities: Shift running, cycling and strenuous exercise indoors when pollution levels are severe.
• Modify school activities: Suspend outdoor assemblies, sports and physical education when air quality deteriorates.
• Improve indoor air quality: Properly sized HEPA air purifiers can help reduce indoor particulate matter when maintained correctly.
• Avoid indoor pollutants: Smoking, incense, mosquito coils and aerosol sprays can add to indoor pollution.
• Use protective masks: Appropriately fitted N95 masks can reduce inhalation of fine particles in children who can wear them safely.
• Watch for symptoms: Persistent coughing, wheezing, breathlessness, chest tightness or unusual fatigue should prompt medical evaluation.

Breast milk is the best source of nutrition for infants, providing essential nutrients and immune protection that support healthy growth and development. Breast milk ensures the required nutrition and immune protection for the child.

Certain maternal and birth-related factors, such as prolonged or complicated labour, caesarean delivery, postpartum complications, maternal illness, and delayed initiation of breastfeeding, may contribute to delayed onset of lactogenesis II (the onset of copious milk production).

Late onset of milk production may lead to the discontinuation of breastfeeding in the early stages and result in increased weight loss in the baby and the need for formula feeding.

Galactagogues, also called lactagogues, are substances that are believed to support milk production through various mechanisms. Some may influence hormones involved in lactation, including prolactin, although their exact mechanisms and effectiveness vary. They affect milk production in a physiological way. The most effective lactagogue is suckling. There are galactagogues, which increase milk production and can be taken through diet.

What Are Galactagogues

The word “galactagogue” is derived from the Greek words galacta, meaning milk, and agogos, meaning leading or promoting. They may be medicines or natural products such as food and herbs. Galactagogues work by influencing the hormones responsible for promoting milk production, which include prolactin (PRL).

Natural galactagogues have been used for a very long time to facilitate the production of breast milk. They are proven to be both safe and effective even though there is insufficient scientific evidence regarding their efficacy.

How Do Galactogogues works?

The exact mechanism of action of many natural galactagogues is not fully understood. Lactation is regulated by several factors and hormones. Prolactin plays an important role in milk synthesis, while oxytocin is responsible for the milk-ejection or let-down reflex. Some substances may influence hormonal pathways, including prolactin secretion; however, the mechanisms and clinical effectiveness of many herbal galactagogues remain uncertain.

Foods That Support Milk Production

Fenugreek Seeds

Fenugreek is one of the most commonly used herbal galactagogues. Some studies suggest that it may support milk production; however, evidence remains limited and inconsistent. It may also cause side effects such as gastrointestinal discomfort, diarrhoea, sweating, or a maple syrup-like odour of sweat and urine in some individuals.

Garlic

Garlic has been used as a natural lactation booster since ancient times. Garlic is one of the most effective functional foods that help enhance breast milk production. The aroma of garlic gets passed into breast milk and can help prolong the sucking time of babies and even affect their food choices later in life.

Fennel seeds

The consumption of fennel seeds works as a galactagogue by inducing the secretion of prolactin through the mechanism of a dopamine antagonist. These include anethole, a natural plant substance having estrogenic effects that assist in signaling the production of milk.

Barley

Barley contains beta-glucan, a type of soluble fibre. Some preliminary research suggests that beta-glucan may influence prolactin levels; however, more research is needed to determine whether barley consumption directly increases breast milk production. Barley contains gluten and should be avoided by individuals with coeliac disease or gluten-related disorders as advised by their healthcare professional.

Shatavari

It is rich in folic acid, vitamins A, C, and K, as well as phytoestrogens, which play a role in hormone regulation in relation to milk production, just like estrogen. Some of the factors regulating prolactin secretion are estrogens, which promote the growth of prolactin-secreting cells, enhance prolactin secretion, and reduce dopamine concentration. Tryptophan is another constituent that is known to be an essential amino acid that may increase prolactin secretion.

Drumstick leaves (Moringa)

Moringa (Moringa oleifera) leaves are traditionally used to support lactation and are also nutritionally rich. Some small studies suggest a possible benefit in supporting milk production, but further high-quality research is required to establish its effectiveness and optimal use.

Cumin seeds (Jeera)

Cumin seeds are commonly used as a culinary spice and have traditionally been included in postpartum diets. However, scientific evidence specifically supporting cumin as an effective galactagogue is currently limited. The plant has been found to contain estrogenic properties because of the increased development of mammary glands and hence milk production.

Ginger

Ginger is widely used as a culinary spice and has been traditionally included in postpartum diets. Limited research has explored its potential role in supporting lactation; however, there is currently insufficient evidence to confirm its effectiveness as a galactagogue.

Conclusion

Galactogogues have become a subject of increasing interest as an emerging field of study, as herbs and spices have been extensively used traditionally to increase milk production. While some plants have traditionally been used as galactogogues over many years, there is still little scientific information on their efficacy and safety, which varies depending on the specific herb.

Some research indicates possible effects, but additional high-quality research is required to prove their efficacy, safety, and mode of action. Therefore, galactagogues should be viewed as an auxiliary measure rather than a replacement for consistent and efficient breastfeeding and proper diet.