Doctors at Sutter Medical Center prepared Baby Leni’s mom for the worst when he arrived on May 9, four months early at her Sacramento home and weighing just 1 pound and 4.5 ounces.
As paramedics scrambled from a nearby firehouse, Leni’s great-aunt tied a shoe lace around his umbilical cord and his mom Chastity said she looked at the tiny, featureless infant in the palm of her hand and thought, “Oh, my God, please live. Don’t die on me.”
On Monday, doctors, nurses, paramedics, journalists and Leni’s family spent 90 minutes inside Sutter’s Anderson Lucchetti Women’s and Children’s Center talking about the boy who lived. Now weighing 6 pounds and 3.5 ounces, Leni is expected to go home later this week, his mother said. She asked the media not to use their last names to allow her and her son to maintain their privacy.
Dr. Gustavo Sosa, a neonatologist practicing at Sutter, said babies born under the best of circumstances under 22 weeks gestation and with a neonatal team in attendance have only about a 10-15 percent chance of survival. Infants born under the circumstances that Leni was born, he said, probably have less than a 5 percent chance of survival.
“In the first few weeks, we would talk about whether he was going to survive the day, and then hoping that he would survive the week, and that turned into weeks and months,” Sosa said of discussions he had with Chastity, “and now our conversations are: ‘Can the baby come home tomorrow?’ ... It’s getting very close. He’s within a few days, a handful of days of going home.”
The 20-year-old mom said doctors believe she went into labor early because a bladder infection irritated her placenta before she could receive treatment. She referred several times to Leni as her miracle baby.
“He’s a champ. He’s feisty,” she said. “That’s the main thing that kept him alive, even being on so many machines and everything, he literally was still trying to rip off all his wires.”
Not knowing whether her son would live, Chastity said, she celebrated “every little thing” he accomplished – from when he first fed from a bottle to the first time he took at pacifier to when he could first wear clothes.
“He was naked for the majority of the time,” she said. “This is his first trip with me actually holding him, where he’s not in an incubator.”
And, on his first trip out of the neonatal intensive care, Leni met one of the paramedics who rescued him: Sacramento Fire Department’s David Robinson. Chastity thanked him and presented him with a framed side-by-side picture of Leni, with one image of the preemie within weeks of his birth and a second image of him now.
Robinson, a paramedic for 10 years, said it was a stressful situation, but he and his partner used a tiny bag and mask reserved for preemies to ensure Leni would get oxygen. They also wrapped him in the aluminum-covered Mylar heat sheets often worn by marathoners after a race to prevent hypothermia. They do so by reflecting body heat back onto the wearer.
Hypothermia was one of many challenges for Leni, Sosa said.
“His lungs were very, very underdeveloped, very premature,” Sosa said. “The ventilator that Leni was on for several weeks is called a high-frequency jet ventilator and was breathing for him at 420 times a minute. That’s what he needed for us to breathe adequately for him.
“Leni needed medication for blood pressure support, needed IV nutrition for many weeks until we were able to very slowly establish oral feedings. For months, he required to be fed via tube that went from his mouth or his nose down to his stomach. Gradually he leaned to nipple feed.”
The greatest challenge for a preemie is just surviving delivery, said Dr. Paul Walsh, the medical director of the pediatric emergency unit at Anderson Luchetti. He was on duty the day that Leni arrived and described the challenges the Sutter medical team faced in this preemie’s early days and those that lie ahead for him.
“The thing is to maintain oxygen at a level that the baby’s brain will survive and grow,” he said. “However, even though oxygen is your friend, it’s also your enemy. If you give too much, you can cause lung damage. There’s a constant battle between maintaining the right amount of oxygen.”
Even nutrition requires a balancing act, Walsh said.
“When you’re in the uterus, you’re fed through a placenta. That’s the perfect way to do it when you’re 22, 23 weeks. Once you start feeding a child these calories, their intestines sometimes can’t handle it. They can run into problems with the intestine dying in response to excessive calories, but if you don’t give enough calories, the child won’t grow, so this is a constant dilemma.”
As Leni grows up, Walsh and Sosa said, he will require long-term follow-up because of potential problems with vision, kidneys and lungs. Plus, he’ll be coming of age, Walsh said, just as fall and winter viruses start to hit, so he will need lots of support from his family as he moves out and into the world.
If Leni had arrived on time, he would have made an appearance last Thursday, Chastity said. Instead, he came five days before Mother’s Day. This year, that annual holiday fell on May 14, his mom’s birthday. Chastity said Leni was the best gift she could have gotten for either.
Recounting what she called a crazy, emotional journey brought Chastity to tears several times on Monday, but she also joked about her son’s appetite and his penchant for keeping tabs on her with one eye until he falls asleep.
“I can’t wait to take him home,” she said. “I just love him.”