A 28-day-old male infant born at 36 weeks’ gestation is admitted to the hospital for the second time with rhythmic movements.

The infant is a monochorionic diamniotic twin born to a healthy primigravida with normal prenatal screens. The maternal medications were iron, folic acid, and a multivitamin. The prenatal course was significant for twin-to-twin transfusion syndrome resulting in intrauterine death of the second twin at 24 weeks’ gestation. This twin was the recipient twin. Follow-up fetal ultrasonography showed that this twin had moderate oligohydramnios, appropriate fetal growth, and normal Doppler studies without evidence of uteroplacental flow insufficiency. The infant was born at 36 weeks’ gestation because of unstoppable preterm labor. He emerged vigorous and had Apgar scores of 7 and 8 at 1 and 5 minutes of age, respectively. His birthweight was 2,600 g (39th percentile). He remained in the hospital for 2 days, and was discharged exclusively breastfeeding and...

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