Miracle twins: The incredible story of monoamniotic twins who beat the odds

Kaleo and Mahtai Montegut are special twin boys. Their mother will tell you that, but she admits, she is biased. Although it's been a challenge, today they are six months old and thriving. That was not the case in the beginning.

At 10 weeks of pregnancy, Skye Dufrene and her husband Daniel were told by doctors that their twins were identical yet unique - formed from a single egg, sharing a single amniotic sac. “It was a shocker,” said Skye. Like most people confronted with a diagnosis they don’t immediately understand, she found herself scouring the internet for information. Doctors told her she had developed a condition referred to as a monoamniotic twin pregnancy. It occurs in only a small fraction of the population - occurring in less than one percent of all twin pregnancies in the US. “A lot of women choose not to go through with these pregnancies because of all the complications that can occur,” she explained. One of those complications: their umbilical cords were also tied together. Despite all of this, they didn’t terminate the pregnancy. According to Skye, “There were too many success stories.”

Skye saw a maternal fetal medicine doctor once a week as the pregnancy continued, monitoring the babies for any signs of trouble. The greatest concern was something called twin-to-twin transfusion syndrome where infants can unequally share the nutrients they receive from the placenta. Depending upon severity, the affected fetus may or may not survive. Mahtai was slower to develop. “This was a huge, huge concern the whole time,” said Skye. “The boys kept growing at different paces. One was a little smaller the entire pregnancy.”

This was complicated by the fact that at 19 weeks, Skye was diagnosed with an incompetent cervix. Doctors were worried the babies could be born too early. They had to sew her cervix closed in an attempt to reinforce it. Still, doctors had Skye admitted into the hospital at 22 weeks. She remained on bedrest and under close observation for the rest of the pregnancy.

The concern about Mahtai’s delayed growth didn’t diminish. It came to a point that doctors decided the best course of action was a C-section. The odds of survival for Mahtai became greater outside the womb, than in. The babies were born by C-section October 22, 2022 at 28 weeks and five days. “That was always our deal - if one of the babies doesn’t look good: Let’s go ahead and pull them both out. It was a scary decision,” Skye said.

Mahtai and Kaleo were born, each weighing just under three pounds. “When I heard their cries, I started crying, because of all the worry going in,” Skye remembers. The crying was a good sign from the boys. She smiles now while thinking of something the doctor had told her: “If Mahtai survives this pregnancy, he gets extra birthday cake today.” She made a mental note to always offer him an extra slice.

At this point, both boys were dealing with issues common for most premature babies. They just needed to grow.

Kaleo began to get sick. He had developed something called NEC, or necrotizing enterocolitis. It is a serious medical condition that primarily affects premature babies, causing inflammation and damage to tissues in the intestine. NEC can be life-threatening.

Kaleo was airlifted to Children’s Hospital New Orleans and admitted to the Level 4 Neonatal Intensive Care Unit (NICU), which handles the most complex cases and provides the highest level of care within the state of Louisiana. Skye remembers being so afraid for her baby. “One of the worst days of my life thus far,” she said. Treatment for NEC typically involves stopping oral feedings and providing nutritional support through an intravenous (IV) line, antibiotics to treat infection, and in some cases, surgery. Once at Children’s Hospital, under the care of Lisa Barbiero, MD, Kaleo was intubated, taken off of food and given lots of medication to fight against NEC. Doctors cautioned Skye and her husband that Kaleo may not survive and to be “prepared for anything.” Skye said, “As you can imagine, I was a mess.”

Meanwhile, Mahtai was still at the hospital where he was born. “One of the most heartbreaking moments ever was when I had to split my boys up. For weeks Daniel and I were driving back and forth to both hospitals everyday visiting and dropping breast milk off. Luckily, the Ronald McDonald House Charities supplied us with a room close by! It was so hard splitting our days in half, visits felt so quick,” Skye recalls.

After about a month, Mahtai began to have unusual stools and doctors became concerned about his liver. They decided to move him to Children’s Hospital for testing. “We agreed. Nervous about his liver, but excited for him to finally be reunited with his brother. We followed the ambulance to Children’s Hospital. Seeing my babies in the same room again was everything to us. My heart was finally at peace,” Skye remembers.

The stay at the NICU at Children’s Hospital came with a roller coaster of emotions. The babies had good days, bad days, then good again. “It was exhausting, but my husband and I celebrated the small victories, like when Kaleo was able to finally eat again,” Skye said. “Every day my husband and I were there singing lullabies to the boys and cheering them on. We even celebrated Christmas and New Years Eve with them in the NICU. One of the hardest things we faced was not being able to hold or touch our boys for most of their stay, giving all our love through a glass, but we made it work!”

After 90 days, Kaleo was cleared of NEC: no more feeding tube, no more stomach issues and everything else looked as it should. “I’ll never forget when his doctor told me ‘This baby is ready to go home!’ It was such a bitter-sweet moment because we knew that meant Mahtai still had some time left and we would have to split them up once again, but they assured us Mahtai would be released soon,” said Skye. It’s what she had been praying for, yet the reality of actually bringing a baby home was just then finally setting in. Skye remembers being so nervous. “Am I ready for this?” That question echoed in her mind, but the moment she saw Kaleo dressed and ready to go home those fears subsided.

Just six days later, after Mahtai’s liver issue was resolved, he was ready to go home too.

“It’s hard to put in words the amount of relief we felt,” Skye confided. “The NICU nurses were by our side through all of the ups and downs and were always there for us physically and emotionally.” Daniel waited in the car outside the hospital with Kaleo while Skye went inside to pick up Mahtai. Skye remembers fondly one final moment with her care team: “One of our awesome nurses helped me walk him down, because I was so nervous. We put him in the car and she gave me the biggest hug and told me we were going to be great parents, and I needed to hear that! Every day I look at my boys and I am so grateful for all the doctors and nurses that helped us along our long journey to get to this point. We couldn’t have done it without our Children’s Hospital NICU family!”

In total, the boys were in the Children’s Hospital NICU for a total of 96 days, finally getting home in January of this year.

The twins once again now share a space together: their nursery. “That was a big thing for us - that they sleep by each other every night.” Skye is so thankful for the care her family received at Children’s Hospital. She will remain forever grateful.

To learn more about what Children’s Hospital New Orleans has to offer your child, visit chnola.org. For more information on our Level 4 NICU, visit our website at:
Neonatal Intensive Care | Children's Hospital New Orleans (chnola.org)