Just Over 1 Pound

In 1999, Katelin Elizabeth Moran, who at 1 pound, 2.4 ounces, was the tiniest infant ever to be born and survive at St Peter's Hospital, in Albany, NY.
Katelin, called "St Peter's Hospital's Littlest Angel" by a hospital neonatologist, was born on May 11, 1999 to Kelly and Shawn Moran of Watervliet, NY Already tiny, Katelin lost almost 20 percent of her weight after her birth and at one point, when she was three days old, she weighed a mere 15 ounces.

With her mom just 23 weeks pregnant, Katelin was only 11 ? inches long at birth -- just a little longer than the length from the tip of the thumb to the tip of the pinky finger on her Dad's outstretched hand. Her tiny head measured only 20 centimeters (8 inches) around, far less than the average 35 centimeters (13 ? inches) circumference of a full-term newborn. Katelin's legs were so small that her parents could fit their wedding rings over her feet and slide them up to her thigh, and the diapers used for "normal" preemies had to be cut in half to fit her.

"Even with the advent of new life-saving techniques for such tiny infants, the odds for survival are still only about 15 percent or about one in seven for babies of this gestational age and size," says Dr Robert Jansen, chief of neonatology at St Peter's. Katelin left St Peter's weighing 4 pounds, 5 ounces and in good health 100 days following her birth. In fact, Katelin's trip home is fairly close to the actual time she was supposed to have been born on September 4 -- as is often the case with infants born prematurely.

"It's very rewarding for the staff as a whole -- the doctors and nurses -- to see a baby survive despite such huge odds against her and to go home in such good condition, and with parents who are so totally committed to her," says Dr Jansen.

Bed rest for mom; Chicken Pox for dad
On May 3, 1999, Kelly was admitted to St Peter's with a placental abruption -- a condition where the placenta is separating from the wall of the uterus. Placental abruption is often associated with bleeding and premature birth. To delay the onset of premature labor and dilation of the cervix, Kelly was placed on complete bed rest. This time she was tilted with her feet elevated higher than her head to take gravitational pressure off her cervix.

As if the couple hadn't been through enough, when Kelly was hospitalized she also had to go without Shawn. He had come down with chicken pox and was not allowed to visit the hospital until just three days before the birth.

On May 11, Katelin's arrival could not be delayed any longer. When Kelly went into labor at 5:15 am, the doctors broke her water at 6:45 am and little Katelin was born at 6:54 am.

Life-saving surfactant and constant sare
Immediately after Katelin was born, Dr Alan W. Geis administered synthetic surfactant. Surfactant, a substance that normally coats the alveoli in the lungs of adults and healthy infants, is usually missing in the lungs of severely premature infants. The lack of surfactant is a major cause of death from hyaline membrane disease or premature lung.

The development of synthetic surfactant in the last several years has revolutionized neonatal care and has made the survival of many preemies possible.

Katelin was also immediately placed on a ventilator and transferred to the Neonatal Intensive Care Unit (NICU) where her father, grandparents, the family's pastor and a team of physicians and nurse specialists were waiting. Once in St Peter's NICU, Katelin was monitored 24-hours-a-day. In addition to the constant care provided by the unit's physicians and nurses, her parents also kept almost constant vigil.

A series of surgeries
Katelin's daily struggle to survive was punctuated by three surgeries over a period of three months.

The first surgery was a heart procedure to repair a blood vessel that was not closing properly, allowing blood to flow unrestricted. The second procedure was eye surgery. The three-hour procedure was the most stressful for the Morans because Katelin was on a ventilator continuously for three days following the procedure. However, it was a procedure necessary to prevent the little girl's retinas from detaching from her eyes.

Her third surgery, a hernia procedure, was performed a few weeks later and a fourth operation removed a cataract that had formed on her left eye. Too little for a lens implant, she was fitted for a contact lens that is removed and cleaned weekly as well as a patch for her right eye.

The patch forces her left eye to work a little harder, thus improving its vision. PregnancyAndBaby.com

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