The Age|1st July 2019
James defies odds after being born the size of 22-week-old baby
When James was born, he was so tiny he could fit into the palm of his father’s hand.
Weighing a little over 400 grams – the size of a 22-week-old fetus – he came into the world on April 4 this year, more than three months earlier than expected, at just 26 weeks.
“The odds he would survive for the first 24 hours were incredibly thin,” his mother, Libby Ward, 32, said. “It was devastating when we found out how tiny and vulnerable he would be.”
James is among the smallest babies born at the Royal Women’s Hospital in Melbourne, but research is showing the chances of survival for premature babies like him are steadily improving with the right care.Advertisement
Every year about 300,000 babies are born in Australia and of those just 0.4 per cent weigh less than one kilogram at birth. Half of babies born at 23 weeks will die very quickly. In the late 1970s, only one in four babies born under one kilogram survived, but this has risen to about 75 per cent.
During Libby’s routine 20-week scan, the obstetrician found that her placenta had stopped growing.
Libby and her husband Josh had to decide if they would allow doctors to resuscitate their son – who was likely to be born unable to breathe on his own.
“We were told the chances of James being born with severe disability or dying shortly after birth were significant and we were initially firm that we didn’t want to proceed with CPR or intensive care,” Josh said. “We decided that when James was born, we would wrap him in a blanket and hold him. For the brief moment he was alive he would know love.”
But the results of recent study at the hospital led the couple to have a change of heart.
The study of more than 750 extremely premature babies found that while babies born before 28 weeks are at much greater risk of death or long-term disability than those born at full term, most can survive if they are given intensive care.
It also found a premature baby’s likelihood of survival improved each day and most profoundly in the first week of their life. Their chances of growing up healthy were good: 83 per cent of premature babies that went home with their parents recorded no major long-term disability, compared to 97 per cent of children born full-term.
“The results of the study gave us hope in a really hopeless situation and we saw that James had a slim but fighting chance,” Libby said.
James was born flushed and red.
When doctors did an Apgar score on James, which is used to measure the health of a newborn, he scored one out of 10.
“It was terrifying because he didn’t look like a baby,” Josh said. “He looked more like a picture of a fetus. I thought there was no way that he could survive this.”
He would spend almost the next two months in an incubator. Despite immense odds, he thrived.
He now weighs almost two and half kilograms and it is hoped he will go home at the end of the week.
Due to the complexity of his case, James is a leading participant in eight cutting-edge clinical trials into babies like him, including a “cuddle study”, which examines whether health outcomes can improve for premature babies who are given skin to skin contact with their parents each day.
Parents are often left distressed following extremely premature births and this also potentially affects the child’s development, neonatologist Jeanie Cheong said.
“It’s sound simple, but it’s pretty profound in terms of the experience for both the babies and their parents during such a vulnerable time,” Associate Professor Cheong said.
James is also part of an international trial being led by the hospital that aims to decrease premature babies’ risks of developing chronic lung disease.
One in two babies born before 28 weeks will die or develop bronchopulmonary dysplasia, a chronic lung condition, associated with brain development problems and breathing difficulties later in life.
Early research has shown a dramatic decrease if babies are given steroid treatment into their lungs through a breathing tube, coupled with the quick delivery of surfactant, a chemical that prevents the tightly-packed air sacs in a premature baby’s lungs from sticking together.
James is showing no signs so far of long-term disability and his parents believe he will continue to surprise people.
“He will be underestimated,” Libby said. “He has shown how strong he is. He will be playing with babies of the same age and people will look at him and he will be so small but I think he will be able to keep up.”