Palm-sized US baby growing

2011-12-15 21:16
This photo shows Melinda Guido shortly after her birth in late August with the hand of Dr Rangasamy Ramanathan as a comparison. (Los Angeles County-USC Medical Centre, AP)

This photo shows Melinda Guido shortly after her birth in late August with the hand of Dr Rangasamy Ramanathan as a comparison. (Los Angeles County-USC Medical Centre, AP)

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Los Angeles - At birth, Melinda Star Guido was so tiny she could fit into the palm of her doctor's hand. Weighing just 269g, she is among the smallest babies ever born in the world.

Most infants her size don't survive, but doctors are preparing to send her home by January 1.

Melinda was born premature at 24 weeks over the summer and spent the early months cocooned in an incubator in the neonatal intensive care unit in Southern California. Almost every day, her 22-year-old mother sits at her bedside and stays overnight whenever she can.

The day before her due date, Haydee Ibarra visited Los Angeles County-USC Medical Centre where her daughter has been since her birth in late August. Melinda is believed to be the second smallest baby to survive in the US and third in the world.

Ibarra caressed Melinda through the portholes of the incubator where nurses pinned up a homemade sign bearing her name. Now weighing 1.8kg, Melinda gripped Ibarra's pinky finger and yawned.

Dangerous

"Melinda, Melinda," she cooed at her daughter dressed in a polka dot outfit. "You're awake today."

During her pregnancy, Ibarra suffered from high blood pressure, which can be dangerous for both mother and foetus. She was transferred from a hospital near her San Fernando Valley home to the county's flagship hospital, which was better equipped to handle high-risk pregnancies.

There was a problem with the placenta, the organ that nourishes the developing foetus. The foetus, however, was not getting proper nutrition, blood and oxygen. Doctors knew Melinda would weigh less than 500g, but they were surprised at how small and fragile she was.

"The first few weeks, it was touch and go. None of us thought the baby was going to make it," said Dr Rangasamy Ramanathan, who oversees premature infants.

Even if she survived, doctors told Ibarra and her husband Yovani Guido, children born this extremely premature can have developmental delays and impairments such as blindness, deafness or cerebral palsy.

Ibarra, who previously had a stillborn, told doctors to do whatever necessary to help her baby.

"They said, 'We'll take the chance. Please try.' So we said. 'Okay we'll try,'" Ramanathan recalled.

Database

Melinda was delivered by caesarean section at 24 weeks and was immediately transferred to the NICU where a team of doctors and nurses kept watch around the clock. Infants born before 37 weeks are considered premature.

Melinda was kept insulated in an incubator and was hooked up to a machine to aid her breathing. She got nutrition through a feeding tube. Her mother said her skin felt like plastic because it was so thin.

"It takes a lot of good care and a lot of good luck. Most of them don't survive," said paediatrician Dr Edward Bell of the University of Iowa who keeps an online database of the world's smallest surviving babies who were less than 500g at birth.

The list currently contains 126 babies dating back to 1936. Since submission is voluntary, it does not represent all survivors.

Ten babies in that category were born in 2010 and survived. Melinda joins three other tiny survivors delivered this year in Berkeley; Seoul, South Korea; and Iowa City, Iowa. All are bigger than Melinda, who is not eligible to be listed until she is discharged.

Most tiny babies who survive tend to be female. That's because female foetuses mature faster than males of the same gestational age. Having more developed lungs and other vital organs increases odds of survival.

Bell published a study last year that found many survivors struggle with health and learning problems. For those for whom growth data is available, many are short and underweight for their age.

Discharge

There are some success stories.

The smallest surviving baby born weighing 261g is now a healthy 7-year-old and another who weighed 280g at birth is an honours college student studying psychology.

Their progress was detailed in a study published this week in the journal Paediatrics by doctors at Loyola University Medical Centre in Illinois where the girls were born.

In the past three years, Los Angeles County-USC Medical Centre treated two other babies with extremely low birth weight who survived, but Melinda holds the record at the hospital.

A month after she was born, she was treated for an eye disorder that's common in premature babies. She faced her biggest test in November when she underwent surgery to close an artery that usually seals after birth.

Ybarra held Melinda for the first time after the surgery. Before that, she could only touch her through the incubator. The next challenge is learning to bottle feed before discharge. Ramanathan predicted at least another two-week stay, dashing her parents' hopes of taking her home by December 25.

Ramanathan said it's too early to know how Melinda will fare when she grows up. Since she did not have major complications such as bleeding in the brain, he held out hope.

Melinda can breathe by herself, but still uses an oxygen tube as a precaution. On Wednesday, an ophthalmologist checked out her eyes and said everything looked good.

After the check-up, Ibarra lifted Melinda out of the incubator and sat in a rocking chair, cradling her.
Read more on:    health

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