The best decision: Triplet Jayden is thriving after CDH repair

Jayden is barely a year old, but he’s already been through more ups and downs than some adults. Born at just 27 weeks — along with his brothers Jacob and Jamari — he’s overcome tremendous odds, not just as a triplet and preemie, but because he was born with a serious condition called congenital diaphragmatic hernia (CDH).

“He’s doing great now,” says his mother, Eugenia. “I still can’t believe he’s here and he’s thriving.”

An unexpected complexity

Eugenia is familiar with prenatal care — she also has three older children. So when a standard ultrasound at 16 weeks took nearly three hours, she knew something wasn’t right. It was already a complicated, high-risk pregnancy: The boys are what is known as dichorionic triamniotic active triplets. That means that Jayden and Jacob are identical twins who shared a placenta in the womb (but had their own separate amniotic sacs), while Jamari had his own placenta and amniotic sac.

The ultrasound revealed another layer of complexity. “The doctors told me that Jayden had a CDH,” says Eugenia. “I hadn’t expected to be pregnant with triplets, let alone one with a serious health problem.”

In a CDH, the diaphragm — the layer of muscle between the chest and abdominal cavity — does not close completely, leaving a hole. As a result, the intestines and other abdominal organs can move into the chest, which prevents normal lung development. Eugenia’s doctors at Brigham and Women’s Hospital referred her to Boston Children’s Maternal Fetal Care Center, which is affiliated with Brigham and Women’s.

An emotional decision

There, she met Dr. Belinda Dickie, co-director of the Congenital Diaphragmatic Hernia Center, who explained more about the surgery Jayden would need once he was born.

“I was so emotional and worried that Jayden wouldn’t make it, based on what I had seen about CDH,” admits Eugenia. “But Dr. Dickie told me, ‘Our team will do whatever we can to save him.’ That meant a lot.”

But the pregnancy was still stressful. Although Jacob didn’t have a CDH, he was also at risk for complications because he shared a placenta with Jayden. Eugenia and her care team were concerned that neither twin would survive. At just 27 weeks, it was time to make a decision: Carry them to term and risk them being stillborn or deliver all three boys now via C-section.

“I was terrified, but I knew delivering them was my best option,” says Eugenia.

Ups, downs, and an alligator binkie

To her relief, all three babies were delivered safely. Less than an hour later, Jayden — who at just 1 lb., 4 oz., fit in the palm of his mother’s hand — was transferred to Boston Children’s NICU. Within just a few days, he underwent surgery with Dr. Dickie to repair his CDH.

The next six months of Jayden’s recovery were filled with ups and downs. While Jacob and Jamari have ultimately bounced back from being born prematurely, Jayden has experienced more challenges related to being born prematurely with a CDH.  He has been more sensitive to respiratory viruses needing extra support. Throughout it all, his care team — including Dr. Dickie, CDH Center co-director Dr. Jill Zalieckas, and nurse practitioners Hannah Fraser and Alicia Avola — have been by his side.

“That team is like nobody else,” says Eugenia. “They’re always right there, helping him. I made the best decision when I chose to deliver him early.”

Today, Jayden loves hanging out with his siblings, ‘reading’ squishy books, and watching kids’ TV. And he has a souvenir from his time as a Boston Children’s inpatient. “His favorite item is an alligator binkie that the NICU nurses gave him,” laughs Eugenia. “He just won’t give it up.”

Learn more about the Congenital Diaphragmatic Hernia Center.