Formerly conjoined twins thrive as toddlers

As their blonde pigtails bobbed around them, Sarabeth and Amelia Irwin chased each other at a local park, giggling while asking to be pushed on the swings and taking turns sliding into the grass.

It's a typical scene now but one that was hard for Phil and Alyson Irwin to picture over a year ago when their twin daughters were physically inseparable.

Born conjoined, Sarabeth and Amelia spent the first 13 months of their lives attached from their chests to belly buttons, only knowing a world facing each other from morning until night and sharing every moment – from sleeping to being held – together.

"Now watching them, it seems so natural," Phil said sitting on a bench near his daughters playing. "It makes you think back to all that happened and wonder 'was it all just a dream? Was that even real?"

In August 2020, the girls underwent a complex 11 hour separation surgery at University of Michigan Health C.S. Mott Children's Hospital that involved multiple specialists, nurses and care team members. 

The twins spent a month recovering at the hospital. But once they were home, it didn't take too long to get used to life in their own separate bodies and learning to crawl, walk and eventually run at "full speed."

"There are definitely a lot more steps in the day now chasing two toddlers," Phil said with a laugh. "But it's much more fun."  

"They run and play and fight and interact with their big sister and scream for Bubble Guppies and Peppa Pig. They're just being two-year olds. It's like it never happened."

Today, the sisters seek one-on-one time too, their parents say. Amelia often begs for tractor rides in their yard while Sarabeth enjoys town outings with her dad. They both love playing with their older sister, Kennedy, 5, who has assumed the "mother hen" role over her younger siblings.

"They like to play separately," Alyson said. "I think everyone expects them to want to be together all of the time, but no, they like their space."

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And behind those identical sets of blue eyes, each twin is developing a very different personality. Amelia "wears her heart on her sleeve" while Sarabeth is the "instigator." They take turns picking on each other. 

"They shared everything before – nap time, getting dressed, being held. If one needed something, you had to grab both at the same time. But they are definitely different people and as individual as can be," Phil said.

"It's been so rewarding to watch them explore the world. Now they have more freedom and choice to be who they are."

But even in separate bodies, Sarabeth and Amelia's tight bond remains.

Just one example: they have their "own language," their parents say, often sitting side by side in their highchairs, chattering away while trading cups or food in an apparent conversation that no one else understands.

And they always have the same answer when asked who their best friend is.

"They point at each other and give each other hugs," Phil said.

The girls still need regular physical and occupational therapy appointments as they continue building physical and cognitive skills, including eating and talking, milestones that were difficult to reach during their early childhood months spent conjoined.

And there have been some scares along the way, like a nine-day hospital stay each girl endured in summer of 2021 after getting infected with respiratory syncytial virus, or RSV.

But each day, they become stronger and learn something new, their parents say.

"It's been surreal watching everything happen," Phil said. "We're so fortunate to be so close to U-M and have the team we have and the support that we have."

Their U-M Health doctors, nurses and care teams are also excited about the twins' progress. On one of their follow-up visits, the Irwins reunited with the lead surgeons who performed the girls' separation surgery, including pediatric and fetal surgeon George Mychaliska, M.D., pediatric plastic surgeon Steven Kasten, M.D. and pediatric heart surgeon Richard Ohye, M.D.

"We are thrilled to see Sarabeth and Amelia's personalities blossom and to know that they're experiencing all the joys of childhood," Mychaliska said.

"During our last visit with them, the twins exceeded our expectations and were doing remarkably well – it was equal parts medical visit and social reunion. Our teams are honored to be a part of their extraordinary journey." 

Their parents will sometimes show the girls pictures from their time being conjoined, swinging in a shared swing, wearing customized outfits, sharing stroller rides and posing with their family.

They seem to have a vague recollection of those early days. 

"It's something they may not even remember, but it will always be a special part of their story," Alyson said.

"It wasn't that long ago but it already feels so far in the distance," she added. "It's so fun to watch them play and grow and learn. It makes all that stress from before worth it."  

"We're just enjoying each day and all of the moments."

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