Index of Suspicion in the NurseryCase 1: Hypoglycemia and High Hematocrit in a Term TwinCase 2: Lethargy in Twins: Double TroubleCase 3: Skin Rash, Poor Feeding, and Diarrhea in a 22-day-old Male

Twins are born at 37-5/7 weeks gestation to a 41-year-old G4P2 woman who had unremarkable serology results. The delivery is via cesarean section because of a nonreassuring fetal heart rate. Twin B appears to be acrocyanotic and initially requires positive-pressure ventilation for 30 seconds before being able to maintain her oxygen saturation on her own. Apgar scores are 7 and 8 at 1 and 5 minutes, respectively. She also appears to be “jittery,” …