When Amy and Michael Howard found out they were having triplets, they were astonished. Then when doctors told them their babies were 1 in 500 trillion they were completely blown away. There’s around a three in 100 chance of having triplets, but Hunter, Jackson and Kaden Howard are special for another reason. Their incredible story of hope and bravery has made them famous around the world.
Kaden had a triangle-shaped head and pointed forehead while Hunter and Jackson’s skulls were sticking out at the back. At first, the Howards assumed that it was because they had been squashed in the womb and hadn’t had enough room to properly let their skulls grow. They hoped the misshapen skulls would naturally grow into a normal shape, but doctors weren’t as hopeful. After running a series of tests on the newborn triplets, they were staggered to discover what had caused the strange head shapes. All the Howards could do was wait for the doctors to reveal their diagnosis and when they did, their world was turned upside down.
It was revealed that all three babies were suffering from a condition called Craniosynostosis. A rare condition, Craniosynostosis affects about 4 in 10,000 live births. To have a set of triplets with the condition, the doctors believed it was a 1 in 500 trillion chance. No-one had seen a case like it before and soon experts and doctors from around the world were interested in the triplets. There are several types of this condition that affect different areas of the skull, which explained why the triplets each had different problems. It’s caused by the premature fusion of different parts of the skull, which stops it growing in certain areas. To overcompensate this, the skull becomes overgrown in other parts to ensure there isn’t too much pressure on the brain. Worryingly for Amy and Michael, the dangerous condition could hold serious consequences for the future.
Craniosynostosis causes learning difficulties, sight problems and headaches. As the brain grew, there would be further risks for the triplets. Pressure on the brain would cause distress and challenges for their development. A definite cause of the condition has not been identified, but it’s believed to be down to a combination of genetics and other factors such as diet and medication. Women with or who are treated for thyroid disease while pregnant are believed to have an increased chance of having an infant with Craniosynostosis. After extensive assessment by medical staff, they decided the only strategy was groundbreaking treatment never seen before anywhere in the world.
The triplets were being treated at the Stony Brook Children’s Hospital, where they underwent several CT scans so the team there could gain more information about the case. After assessing the conditions, they decided the only option was to operate. Surgery to correct Craniosynostosis has to be carried out while they are six to 12-months. The malleability of the skull meant gaps close naturally. Any older and they may need to use bone filler. The triplets were only 11 weeks old at the time of the surgery and it would be the first of its kind in the world involving huge risks for the triplets.
Each operation would take around three hours and would be carried out by pediatric neurosurgeon Dr. Chesler and his team. The complex surgery involved the removal of a strip of bone from the skull. The skulls would reshape and fill the gap created. Dr. Chesler, who had been handling the triplets' case from the start, explained to the Howards how the surgeries would work and the risks involved. The hospital specifically put aside two complete days to dedicate to the procedure. While they appreciated all the effort given to help their sons, the Howards were understandably nervous at the thought of their children having such an extensive operation. The stressed parents endured two anxious days before discovering if the procedure had been a success.
They were relieved to finally be told that all three surgeries had gone perfectly and the boys were recovering well. Thankfully, no complications occurred and the delighted parents were able to take their boys home just two days later. As they got used to being a family of five, Michael and Amy had a few extra challenges to contend with. To ensure their skulls heal properly, the boys have to wear special helmets for 23 hours a day. The next step was a waiting game. While it was a relief to be home, they had to wait and see how they would respond to the operation and whether it would have the results they hoped for.
Michael admitted that at first, they were worried about how they would adjust to the headgear, but that thankfully they hadn’t been too much of a problem. The operation was carried out in January 2017, and speaking six months after, Michael said their recovery had been incredible and their heads were about normal size: "Aside from the helmets, you wouldn’t know there’s a problem. Overall, they’re happy, well-adjusted babies." Despite the hardships, the experience had only made them more positive and hopeful people. “We’ve been blessed throughout this whole thing,” Michael said. “It’s just been an amazing, amazing experience.” Craniosynostosis may be incredibly rare, but there are many dangers connected to multiple births.
Any multiple birth is more prone to complications than a singular pregnancy and those numbers increase depending on how many babies are expected. Preeclampsia, placental abruption, gestational diabetes and intrauterine growth restriction (IGR) are all conditions more common in pregnancies with multiple births. Even if they do not suffer from any of these, 90 percent of triplets are delivered preterm at around 32 weeks. This presents complications of its own as the babies are at an increased risk of developing mental retardation, cerebral palsy, vision loss, and hearing loss.