Against the Odds, 11-Ounce Maggie Thrives
An ultrasound at 24 weeks brought bad news – Amanda's twins were not growing as they should. Her perinatologist predicted she could deliver within 48 hours and sent Amanda and her husband, Troy, to Memorial Regional Hospital for observation.
At the hospital, Amanda was given steroid shots to help strengthen the babies' lungs while doctors used biophysical profile ultrasounds to monitor the twins. The goal was to extend Amanda's pregnancy as long as possible.
After five days, tests indicated the baby boy had developed reverse diastolic flow, meaning between heartbeats, his blood was flowing back to his mother. Doctors said the baby boy, named Noah, would likely die. They were concerned that his sister, Maggie, also might die.
"They said, 'We have to do a cesarean section, now,'" Amanda says.
Noah was born weighing just 8 ounces. He died about an hour later in his father's arms.
Maggie, however, entered the world kicking and screaming and was rushed to the Wasie Neonatal Intensive Care Unit (NICU) at Joe DiMaggio Children's Hospital. She weighed only 11 ounces. But despite her small size, and because Maggie had reached a gestational age of 24 weeks, there were medical reasons to believe she could survive.
Maggie's NICU Journey
At birth, Maggie's entire blood volume was about five teaspoons. Her heart was the size of a fingernail. In fact, she was so tiny the medical equipment had to be adjusted to fit her.
Neonatologist Bruce Schulman, MD, Medical Director of the Wasie NICU, worked with a team of doctors and nurses to keep little Maggie alive.
"I told her mom that what we try to do is mimic the womb," says Dr. Schulman.
Maggie was placed on a ventilator to support breathing, given intravenous nutrition, and her incubator was flooded with humidity to help create a womblike environment. The rest was left to Maggie.
While her body was fragile, Maggie's will to live was strong.
"From the very beginning with Maggie, we – the staff and parents – realized we were in relatively uncharted territory taking care of a baby who weighed just 11 ounces at birth," says neonatologist Lester McIntyre, MD, who is Chief of Neonatology Services for Memorial Healthcare System. "For example, what should the normal blood pressure be for a baby this small?''
For the first month, Amanda stayed at the Conine Clubhouse, across the street from Joe DiMaggio Children's Hospital, while Troy returned home to work. Based on availability, families of patients at the children's hospital can stay free at the clubhouse, which is named after Florida Marlins player Jeff Conine.
"It was a blessing to stay there," Amanda says. Troy visited Maggie as often as possible and the couple attended weekly meetings of the support group for NICU parents.
Eventually, Amanda went home. But every day she made the 60-mile round-trip commute to see Maggie. "I put 7,000 miles on my car," she says.
Six weeks went by before Amanda held her baby for the first time. By then, Maggie weighed 1 pound, 11 ounces.
The days and weeks ahead were filled with tense moments as Maggie struggled to survive. She underwent 35 blood transfusions and three surgeries – patent ductus arteriosus (PDA) ligation (for a congenital heart defect), retinopathy of prematurity (ROP) eye surgery and bilateral inguinal hernia surgery.
"Through all of this, Maggie continued to 'chug along' with her family always at her side," Dr. McIntyre says. "Maggie's hospital course exemplified our family-centered approach with continued close collaboration and consultation with very proactive and informed parents and the healthcare team."
Heading Home, Meeting Milestones
After five months, Maggie was released from the hospital, weighing 6 pounds, 8 ounces and measuring 18 inches long. She continues to meet milestones and amaze her parents. She has not been readmitted to the hospital since she went home – thanks in part to the excellent care her parents have provided, doctors say.
To celebrate her first birthday, Maggie returned to Joe DiMaggio Children's Hospital for a special party with some of the people who helped save her life.
"The whole NICU put a lot of effort into treating her," Dr. Schulman says. "She is the tiniest baby who ever left our unit."
For that, Maggie's parents are grateful.
"Memorial and Joe DiMaggio Children's Hospital gave us our child," Amanda says. "The doctors and nurses embraced Maggie like she was their own baby. They fought for Maggie as hard as Maggie fought for herself."