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Oh man, I can't even imagine. I'm so sorry! It seems that the best thing that has been suggested is to bring meals to them. Don't bring flowers because, once those die, they can remind the parents of death of their LO. Also, a "just thinking of you" text every now and then can mean a lot. That way they feel your support but they don't have to respond if they don't feel up to talking.

ETA: Helping with laundry or cleaning the house would be a big help - basically taking the extra work off of them until they get adjusted.

@CsMama: I'm so, so sorry. I lost my son recently after a long hospitalization, but I can't imagine dealing with a loss at the same time dealing with hospitalization of another child. So hard.

If you and your family are local, I would suggest doing everything you can to be with the child that she isn't with at that time (when she is at the hospital, watch the 20 month old, when she needs time with her 20 month old, sit at the hospital). I couldn't bear to leave my son alone when he was in the hospital, like it meant we didn't care about him, so my mom ended up living with us for 4 months to make this happen. If it's possible give her time alone/time alone with her husband so that they can grieve and let go in a way that is difficult with others around. Try to keep her fridge stocked with easy stuff (we had a lot of frozen trader joe's food and a boss that sent over restaurant food). Listen to what she says she wants (a memorial, donations in his name, support/minister to talk to) and ask if its ok if you make it happen and, if it is, just do it. I wanted a memorial but I couldn't imagine planning it myself, so my dad did all the work and it ended up being perfect.
Mostly just know that listening and being present is all you can do right now, there is no perfect thing to do or say, but you will all get through this awful time. Hugs

@CsMama: I am so sorry for the loss of your sweet nephew and to hear your other nephew is still in critical condition. I was pregnant with triplets and my identical twin boys were delivered stillborn (their sister was born alive and amazingly healthy). The pain your sister is feeling right now is unfathomable. She is feeling a mix of emotions, from absolute sorrow to cautious joy for her surviving baby. Honestly, there is not much you can do right now to make her feel better other then to make sure she knows you are there for her. The guilt she feels is real, it will feel real to her for a long time and no amount of words will make it go away. We all know it is not her fault, and so does she on some level, but the guilt is all consuming and will likely be around dr a while. I, two years later, still question myself nearly daily. Now even though you can't make her feel better, you can help in other ways like helping to take care of her daughter, the household tasks, meals, etc. all of those things that will take her focus away from where it needs to be. You can also help by seeking out resources for your sister. I'm not sure where you are located, but check your local hospice chapter for a perinatal loss program. Our local chapter had an amazing program and I credit them fully for the fact that I am still standing today. Also look for any other pregnancy/infant loss resources in your area. Therapists, support groups, etc are amazing. She might not want the info now, but it will be wonderful for you to have it ready for her when she's ready to talk to someone. Also, be kind to yourself and the rest of your family. Yes, your sister has suffered a tremendous loss that no one understands, but you all lost a nephew, grandson, cousin, brother, etc. Your loss deserves mentioning also and you should all recognize that you will be going through the grieving process as well. Be kind to yourself and make sure you give yourself time to mourn the loss without focusing solely on your sister.

I'm sorry for the novel, this hit very close and I know I'm rambling just trying to get out anything I can think of. Please message me if you would like some specific resources or any additional information. Lots of love to you, your sister, and your entire family.

@CsMama: I also lost a son, although he was 5 weeks old at the time, so a different situation, but I totally get the pain. I am also in Houston, and can assure you that Texas Children's Hospital (which is I am sure where she is) is the best place to be.
As far as how to support her with her surviving little one, that is tough. I would say just listening and sharing in both her excitement and in her grief.
Maybe not right now, but soon you might get her something little to recognize both of her boys. The girls in my birth month group got me a necklace that had my son's name and birthstone, and I wear it almost everyday.
Other's suggestions about food are good. If she doesn't already know, tell her to check out the Ronald McDonald House. It is on the same floor as the NICU, and has space for her to eat and/or make food. We slept there every night after we could no longer sleep in our son's room, and are forever grateful for the time that allowed us to have with him. She won't be able to have her daughter there with her, but it might be a good option for her sometimes.

I am so sorry, my heart breaks for all of you.

I follow this preemie blog, she lost one of her early twins after a few weeks, so not quite the same, but maybe her story will be helpful or familiar at least to your sister. http://josephathome.blogspot.com/2014/11/five-years-since-saying-goodbye.html

many hugs to your sister, you and your family. it sounds like the funeral service was lovely and a touching way to remember jameson. glad to hear colt is doing better--i know he will provide much joy and comfort to your family.

So glad to hear he's doing well!

I did want to chime in with one thing. When we lost our daughter, my mom was just over the top about how upset she was, and it was really hard on us. We literally felt like she was more sad about it than we were, and it kinda pissed us off. I think maybe she thought talking about her grief might help me open up to talk about mine or something? Or that I needed to hear that other people were sad too, since there was no funeral or any opportunity for anyone mourn with us? I don't know. But it really made it harder on DH and me. So I don't have any additional advice about what to do, but I can say do not do that (and try to stop anyone else who does).