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Tiniest babies ever born who overcame the odds and survived
Source: Agencies |
December 13, 2011, Tuesday
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ONE is a healthy first-grader, the other an honors college student majoring in psychology. Once the tiniest babies ever born, both girls are thriving, despite long odds when they entered the world weighing less than a pound - 0.4 kilograms.
A medical report from the doctor who resuscitated the infants at a suburban Chicago hospital is both a success story and a cautionary tale.
These two are the exceptions, and their remarkable health years later should not raise false hope: Most babies this small do poorly and many do not survive even with advanced medical care.
"These are such extreme cases," said Dr Jonathan Muraskas of Loyola University Medical Center. They should not be considered "a benchmark" to mean that doctors should try to save all babies so small, he said.
The report involves Madeline Mann, born in 1989 weighing 9.9 ounces, then the world record; and 7-year-old Rumaisa Rahman, whose 9.2-ounce birth weight remains the world's tiniest. Rumaisa's birth weight was initially reported as several ounces less, but that figure was based on a different conversion scale.
Two other babies born since 1989 weighed less than Madeline, and a girl was born last year at her birth weight.
The report was released online yesterday in Pediatrics Journal.
It addresses a question that was hotly debated when Madeline was born 22 years ago, remains hot now - and still has no answer: "What is the real age of viability? No one knows," said Dr Stephen Welty, neonatology chief at Baylor College of Medicine and Texas Children's Hospital in Houston.
Muraskas and the report's co-authors say most newborn specialists consider babies born after 25 weeks of pregnancy to be viable - likely to survive - and so they should receive medical intervention if necessary to breathe.
Younger babies are generally in a "gray zone," where intervention isn't always so clear cut, the report suggests.
Some US doctors will attempt to save babies at 22 weeks, but that is not done routinely, said Dr Edward Bell, a University of Iowa pediatrics professor.
Bell estimates that 7,500 US babies are born each year weighing less than 1 pound, and that 10 percent survive.
Muraskas says his report highlights an overlooked fact: gestational age is more critical for survival than size.
Rumaisa and Madeline were both palm-sized, weighing less than a can of soda - the average size of an 18-week-old fetus but they were several weeks older than that. Their gestational ages - almost 26 weeks for Rumaisa and almost 27 weeks for Madeline - meant their lungs and other organs were mature enough to make survival possible.
Madeline had mild brain bleeding, but with no lasting effects. She and Rumaisa got treatment for an eye condition called retinopathy. Madeline has asthma and remains petite - 1.4 meters and about 29 kilograms at age 20. She is now 22 and at Augustana College, Rock Island, Illinois. Rumaisa is seven and attends first grade in suburban Chicago.
Jim Mann, Madeline's father, said that she has done so well is a source of pride, and wonder. "I don't know why, we were just extraordinarily lucky," Mann said.
A medical report from the doctor who resuscitated the infants at a suburban Chicago hospital is both a success story and a cautionary tale.
These two are the exceptions, and their remarkable health years later should not raise false hope: Most babies this small do poorly and many do not survive even with advanced medical care.
"These are such extreme cases," said Dr Jonathan Muraskas of Loyola University Medical Center. They should not be considered "a benchmark" to mean that doctors should try to save all babies so small, he said.
The report involves Madeline Mann, born in 1989 weighing 9.9 ounces, then the world record; and 7-year-old Rumaisa Rahman, whose 9.2-ounce birth weight remains the world's tiniest. Rumaisa's birth weight was initially reported as several ounces less, but that figure was based on a different conversion scale.
Two other babies born since 1989 weighed less than Madeline, and a girl was born last year at her birth weight.
The report was released online yesterday in Pediatrics Journal.
It addresses a question that was hotly debated when Madeline was born 22 years ago, remains hot now - and still has no answer: "What is the real age of viability? No one knows," said Dr Stephen Welty, neonatology chief at Baylor College of Medicine and Texas Children's Hospital in Houston.
Muraskas and the report's co-authors say most newborn specialists consider babies born after 25 weeks of pregnancy to be viable - likely to survive - and so they should receive medical intervention if necessary to breathe.
Younger babies are generally in a "gray zone," where intervention isn't always so clear cut, the report suggests.
Some US doctors will attempt to save babies at 22 weeks, but that is not done routinely, said Dr Edward Bell, a University of Iowa pediatrics professor.
Bell estimates that 7,500 US babies are born each year weighing less than 1 pound, and that 10 percent survive.
Muraskas says his report highlights an overlooked fact: gestational age is more critical for survival than size.
Rumaisa and Madeline were both palm-sized, weighing less than a can of soda - the average size of an 18-week-old fetus but they were several weeks older than that. Their gestational ages - almost 26 weeks for Rumaisa and almost 27 weeks for Madeline - meant their lungs and other organs were mature enough to make survival possible.
Madeline had mild brain bleeding, but with no lasting effects. She and Rumaisa got treatment for an eye condition called retinopathy. Madeline has asthma and remains petite - 1.4 meters and about 29 kilograms at age 20. She is now 22 and at Augustana College, Rock Island, Illinois. Rumaisa is seven and attends first grade in suburban Chicago.
Jim Mann, Madeline's father, said that she has done so well is a source of pride, and wonder. "I don't know why, we were just extraordinarily lucky," Mann said.
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