World's tiniest preemies are growing up and doing fine
December 12, 2011
Weighed less than 10 oz. at birth
MAYWOOD, Il. -- In 1989, Madeline Mann became the world's smallest surviving baby after she was born at Loyola University Medical Center. She weighed 280 g. (9.9 oz.) -- about the size of an iPhone.
In 2004. Rumaisa Rahmam set a Guinness World Record after she was born at Loyola, weighing 260 g. (9.2 oz.).
Remarkably, Madeline and Rumaisa both have normal motor and language development, Loyola physicians wrote in a case report in Pediatrics, the official journal of the American Academy of Pediatrics. The article was published online Dec. 12.
Rumaisa remains the world's smallest surviving baby, and Madeline now is the world's fourth smallest surviving baby, according to a registry kept by the University of Iowa Children's Hospital. Rumaisa and Madeline are the smallest and second smallest surviving babies born in the United States. And Rumaisa and her twin sister, Hiba, are the world's smallest surviving twins. (Hiba weighed 1 pound, 5 oz. at birth).
Of the 85 smallest surviving babies in the United States, three were born at Loyola and five others were cared for by physicians trained at Loyola.
Lead author Jonathan Muraskas, MD, and colleagues caution that successful outcomes such as Madeline and Rumaisa are not necessarily typical. Many extremely low-birth-weight preemies either do not survive or grow up with severe, lifelong disabilities such as cerebral palsy, mental retardation and blindness.
Comparing other micropreemies with Madeline and Rumaisa could "propagate false expectations for families, caregivers and the medico-legal community alike," Muraskas and colleagues wrote.
Madeline and Rumaisa had several advantages. Female preemies tend to do better than males. They had relatively long gestational ages for their birthweights. And their mothers were given steroids before birth, which helped their lungs and brains mature more quickly.
During their pregnancies, Madeline's and Rumaisa's mothers experienced preeclampsia (pregnancy-induced high blood pressure). There was decreased blood flow through the placenta, which restricted the babies' growth. Madeline was born at 26 weeks, six days, and Rumaisa was born at 25 weeks, six days. Under normal conditions, it would take a fetus just 18 weeks to reach their birthweights.
Madeline spent 122 days in Loyola's neonatal intensive care unit, and Rumaisa spent 142 days. They each have met developmental milestones at appropriate ages. Rumaisa, 7, is a first grader and Madeline, 22, is an honor student at Augustana College in Rock Island, Il. But they both remain small for their ages.
Advances in neonatal care have allowed the resuscitation and survival of smaller and smaller newborns, Muraskas and colleagues wrote. They suggest that at the threshold of viability, three critical factors should be considered: gestational age, steroid treatment before birth and female gender.
"With Japan lowering its limit of viability to 22 weeks and public fascination with micropreemies, how small is too small? The medical, ethical and economic issues will continue to be vigorously debated."
Muraskas is co-medical director of Loyola's neonatal ICU, and a professor in the Departments of Pediatrics and Obstetrics & Gynecology, Divisions of Neonatology and Maternal/Fetal Medicine, of Loyola University Chicago Stritch School of Medicine.
Co-authors are Brian J. Rau, MD, Patricia Rae Castillo, MD, John Gianopoulos, MD, and Lauren Boyd, MD.
Loyola University Health System
Related Low Birth Weight Current Events and Low Birth Weight News ArticlesDeadly effects of certain kinds of household air pollution lead to call for biomarker studies
Almost four million people die each year from household air pollution (HAP) caused by exposure to the combustion of biomass fuels (wood, charcoal, crop residues, and dung), kerosene, or coal. Experts find link between low doses of vitamin D and adverse pregnancy outcomes
There is a link between vitamin D insufficiency and adverse health outcomes such as gestational diabetes and preeclampsia in mothers-to-be and low birth weight in newborns. Coffee and tea during pregnancy affect fetal growth
Drinking just two cups of coffee a day is associated with the risk of low birth weight. Researchers at Sahlgrenska Academy, University of Gothenburg, Sweden, have conducted a study on 59,000 women in collaboration with the Norwegian Institute of Public Health.African-ancestry babies get less prenatal care in Brazil
Low birth weights are more prevalent among Brazilians with African ancestry and may be attributed to less use of prenatal care facilities and where those ethnic groups live, according to a new study.Extremely high estrogen levels may underlie complications of single-birth IVF pregnancies
Massachusetts General Hospital (MGH) researchers have identified what may be a major factor behind the increased risk of two adverse outcomes in pregnancies conceived through in vitro fertilization (IVF).Prenatal DHA reduces early preterm birth, low birth weight
University of Kansas researchers have found that the infants of mothers who were given 600 milligrams of the omega-3 fatty acid DHA during pregnancy weighed more at birth and were less likely to be very low birth weight and born before 34 weeks gestation than infants of mothers who were given a placebo.Breast Milk Reduces Risk of Sepsis and Intensive Care Costs in Very-Low-Birth-Weight Infants
Feeding human breast milk to very-low-birth-weight infants greatly reduces risk for sepsis and significantly lowers associated neonatal intensive care unit (NICU) costs, according to a study by Rush University Medical Center researchers.US health disadvantage spans age and socioeconomic groups
On average, Americans die sooner and experience higher rates of disease and injury than people in other high-income countries, says a new report from the National Research Council and Institute of Medicine.Postpartum depression prevalent in under-developed countries, could impact baby health and mortality
Postpartum depression not only affects mothers but it could mean higher health risks for the baby - especially in low-income countries like Ghana where the condition isn't well-recognized, University of Michigan Health System research shows.Low vitamin D levels in pregnancy associated with lower birth weights, pitt research finds
Women deficient in vitamin D early in their pregnancies are more likely to deliver babies with lower birth weights, University of Pittsburgh Graduate School of Public Health research reveals.
More Low Birth Weight Current Events and Low Birth Weight News Articles
Low birth weight: Study of associated factors seen in institutional deliveries in a north eastern town of Bihar (India)|
by Setu Sinha (Author), Bijoy Mukherjee (Author)
Low birth weight has been a cause of concern since times immemorial. But the identification of factors associated with it came only after many careful observations by many learned men and women at different times and places. Despite its Universal presence, it acquires significant importance in the developing countries of the world where social, demographic and environmental factors, almost always act as villains competing with the poor standards of healthcare in these countries. LBW is closely associated with fetal and perinatal mortality and morbidity, inhibited growth and cognitive development, and chronic diseases later in life. At the population level, the proportion of babies with a LBW is an indicator of a multifaceted public-health problem that includes long-term maternal...
Helping Low Birth Weight, Premature Babies: The Infant Health and Development Program|
by Ruth Gross (Editor), Donna Spiker (Editor), Christine Haynes (Editor)
Each year in the United States, 250,000 infants are born too soon, weighing too little. For these low birth weight, premature infants, the future is uncertain, since they are at risk for a variety of serious medical and developmental problems—including behavioral and learning disorders that may have damaging effects for the rest of their lives. The extent to which a comprehensive early intervention program could improve or prevent these adverse outcomes was examined in the Infant Health and Development Program, a randomized controlled trial involving almost 1,000 infants in eight cities in the United States. This book describes in detail the program, its research methodology, the progress of the program, and the results of the clinical trial.
The program was administered by an...
Nutritional Strategies for the Very Low Birthweight Infant (Cambridge Medicine)|
by David H. Adamkin MD (Author)
The goal of nutritional management in VLBW and ELBW infants is the achievement of postnatal growth at a rate that approximates the intrauterine growth of a normal fetus at the same postconceptional age. In reality, however, growth lags considerably after birth; although non-nutritional factors are involved, nutrient deficiencies are critical in explaining delayed growth. This practical clinically-oriented pocketbook reviews and summarises all available clinical evidence. It enables the reader to implement parenteral or enteral feeding plans, with the goals of reducing postnatal weight loss, earlier return to birthweight, and improved catch-up growth. Both nutrient balance and growth and the impact on neurodevelopment and health outcomes are evaluated. With many tables and algorithms to...
Caring for Your Baby and Young Child, 5th Edition: Birth to Age 5 (Shelov, Caring for your Baby and Young Child, Birth to Age 5)|
by American Academy Of Pediatrics (Author)
The most up-to date, expert advice for mothers, fathers and care providers from the American Academcy of Pediatrics.
From the most respected organization on child health comes this essential resource for all parents who want to provide the very best care for their children. Here is the one guide pediatricians routinely recommend and parents can safely trust, covering everything from preparing for childbirth to toilet training to nurturing your child’s self-esteem. Whether it’s resolving common childhood health problems or detailed instructions for coping with emergency medical situations, Caring for Your Baby and Young Child has everything you need.
• Basic care from infancy through age five
• Guidelines and milestones for physical, emotional, social,...
What to Expect When You're Expecting, 4th Edition|
by Sandee Hathaway B.S.N (Author), Arlene Eisenberg (Author), Heidi Murkoff (Author), Sharon Mazel (Author)
Announcing a brand new, cover-to-cover revision of America's pregnancy bible. What to Expect When You're Expecting is a perennial New York Times bestseller and one of USA Today's 25 most influential books of the past 25 years. It's read by more than 90% of pregnant women who read a pregnancy book--the most iconic, must-have book for parents-to-be, with over 14.5 million copies in print. Now comes the Fourth Edition, a new book for a new generation of expectant moms--featuring a new look, a fresh perspective, and a friendlier-than-ever voice. It's filled with the most up-to-date information reflecting not only what's new in pregnancy, but what's relevant to pregnant women. Heidi Murkoff has rewritten every section of the book, answering dozens of new questions and including loads of new...
Spousal abuse during pregnancy and a risk of low birth weight baby?: A case control study from Karachi, Pakistan|
by Mufiza Farid Kapadia (Author)
This book explored the relationship of spousal abuse during pregnancy and a risk of delivering a low birth weight baby. The study was carried out in tertiary care hospitals of Karachi and consist of a sample of women from a socio-economically deprived background. Women were recruited within 24 hours of delivery and were inquired about spousal abuse using WHO domestic violence module. Other potential risk factors of low birth weight babies were also ascertained.
Catch-up growth for the extremely low birth weight infant.(Report): An article from: Pediatric Nursing|
by Alice S. Hill (Author), Hoang Nguyen (Author), Kimberly L. Dickerson (Author)
This digital document is an article from Pediatric Nursing, published by Jannetti Publications, Inc. on May 1, 2009. The length of the article is 6698 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available immediately after purchase. You can view it with any web browser.
From the author: Discussion: The ELBW infants showed gains relative to the full-term infant but lagged behind on each growth parameter at each assessment.
Title: Catch-up growth for the extremely low birth weight infant.(Report)
Author: Alice S. Hill
Publication: Pediatric Nursing (Magazine/Journal)
Date: May 1, 2009
Publisher: Jannetti Publications, Inc.
Volume: 35 Issue: 3 Page:...
It Starts with Food: Discover the Whole30 and Change Your Life in Unexpected Ways|
by Melissa Hartwig (Author), Dallas Hartwig (Author)
Now a New York Times bestseller!
Food can change your life in unexpected ways. It Starts With Food will show you how.
It Starts With Food outlines a clear, balanced, sustainable plan to change the way you eat forever--and transform your life in unexpected ways. Your success story begins with "The Whole30," Dallas and Melissa Hartwig's powerful 30-day nutritional reset.
Since 2009, their underground Whole30 program has quietly led tens of thousands of people to weight loss, improved quality of life and a healthier relationship with food - accompanied by stunning improvements in sleep, energy levels, mood and self-esteem. More significantly, many people have reported the "magical" elimination of a variety of symptoms, diseases and conditions - in just 30 days.
First Aid for the USMLE Step 1 2013 (First Aid USMLE)|
by Tao Le (Author), Vikas Bhushan (Author)
THE WORLD'S BESTSELLING MEDICAL REVIEW BOOK--WITH MORE THAN 1,200 FREQUENTLY TESTED FACTS AND MNEMONICS Conveniently organized by organ system and general principles 125+ color clinical photographs integrated throughout the text Hundreds of full-color illustrations clarify essential concepts and improve retention Rapid-review section for last-minute cramming Detailed test-taking strategies to help you maximize your study time Hundreds of student-recommended USMLE Step 1 review resources Advice from students who aced the 2012 exam 1200+ frequently tested facts and mnemonics Hundreds of high-yield color images and diagrams throughout Student ratings of more than 300 review products
The Paleo Answer: 7 Days to Lose Weight, Feel Great, Stay Young|
by Loren Cordain (Author)
How to take the Paleo Diet to the max for optimal weight loss and total health—from bestselling author and top Paleo expert Dr. Loren CordainDr. Loren Cordain's bestselling The Paleo Diet and The Paleo Diet Cookbook have helped hundreds of thousands of people eat for better health and weight loss by following the diet humans were genetically designed to eat: meats, fish, fresh fruits, vegetables, nuts and other foods that mimic the diet of our Paleolithic ancestors. In The Paleo Answer, he shows you how to supercharge the Paleo Diet for optimal lifelong health and weight loss. Featuring a new prescriptive 7-day plan and surprising revelations from the author's original research, this is the most powerful Paleo guide yet.Based on the author's groundbreaking research on Paleolithic diet...