Thanks to Advances in Technology, More Tiny Babies Surviving
When Ocala resident Martha Perez-Espartero visited relatives in Homestead, she thought she had plenty of time to ready the nursery
and plan a baby shower. She was only 22 weeks pregnant. Instead, she went into labor. Alexander was born on Feb. 26 at Homestead Hospital weighing just lib., 2 oz.
(Image: In the NICU at South Miami Hospital. Martha Perez-Espartero holds son Alexander, who was born weighing just over a pound.)
He was rushed to the Level UJ Neonatal Intensive Care Unit at South Miami Hospital's Center for Women & Infants, which had opened earlier that month. After five and a half months of specialized care, several surgical procedures and daily ups and downs, he went home. Alexander continues to undergo therapy for developmental delays typical of a preemie, but is doing weU, his mother said.
Alexander is among an increasing number of very small premature infants who not only survive, but thrive. "He was the size of one of those little glass Coca-Cola bottles when he was born," said Ms. Perez-Espartero. "We weren't sure he was going to make it, but now he has a double chin and is actually getting chunky."
Premature babies like Alexander - the smallest and sickest babies - require the expertise that a level III neonatal intensive care unit offers. In addition to South Miami Hospital, the George Batchelor and Gloria Vasta Lewis Neonatal Intensive Care Unit at BapUst Children's Hospital has a Level III rating.
A full-term pregnancy is 37- 40 weeks. Medical journals report that jn 1960 virtually all babies born at 28 weeks or less died. By 1989, the percentage of survivors was 60 percent, and today approximately 90 percent of 28-weekers survive. Neonatologists say that preernie survival rates are improving thanks to advances in teclmology, an aggressive attitude toward treatment and the teamwork of physicians who specialize in neonatal cardiology, surgery and ocher specialties.
The use of specialized, gentler ventilators and nitric oxide, a gas that is delivered in a smaU dose through a baby's ventilator, are some of the factors that have made a "remarkable" difference, said neonatologist Jorge Perez, M.D., medical director of South Miami Hospital's Center for Women & Infants. "Those kids who would have died before from pulmonary insufficiency are given another chance now."
Phuket Tanlivit, M.D., a neonatologist at Baptist Children's Hospital, said advances in incubators and early tube feeding have also helped. "We start a high protein diet the first day rather than waiting," he said. "Years ago it was believed that calories were important. Today, we know that calories high in protein are important."
Dr. Tantivit was part of the team of doctors who took care of Amillia Taylor, believed to be the smallest baby to survive birth. At just 284 grams, abollt 10 ounces (nol much longer than a pen), Amillia was born at Baptist Children's Hospital after only 21 weeks and six days in the womb. She turned t1uee at the end of October.
"Amillia goes to pre-schooL She walks, she runs, she talks and she feeds hersel(," said her mother, Sonja. "Shes just a normal little girl. She loves the park and likes to swim." Amillia's favorite food is Popeye's Chicken and she watches the animated cartoon The Backyardigans on Nick Jr. Her little sister Eddie was also a preemie, born a year ago at 32 weeks and 3 pounds. She, too, is doing well.
Still, doctors warn that very low birtll-weight babies have a high mortality rate, and, if they do survive, they often have complications and permanent disabilities. "I don't really know how low we can go," Dr. Perez said. "We may be at the cusp at the 22-week mark. We've just started saving these kids so the jury's still out on whether or not they'll be healthy. But I believe we're on the right track and that the babies we save could be future presidents of the United States."