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Incredible Survival of 400 gram baby- Smallest to survive in India and South Asia

Udaipur: In a State where the skewed sex ratio is a reflection on the way the birth of girls is received by many, the very premature birth of “ Baby of Seeta ” weighing just 400 grams and subsequent struggle of the doctors and the family to keep her alive and healthy has come as a whiff of fresh air. Baby Seeta is the smallest baby ever to survive not in India but also in South Asia. Doctors calls her “our miracle baby”, saying: “She’s just fought and fought and fought against all the odds. But she’s made it.”

Born to a couple married for 35 years, when her blood pressure was uncontrollable halfway through her pregnancy and the ultrasonography revealed fetoplacental insufficiency [ absent blood flow to fetus]. So she was taken up for emergency caesarean section on June 15,2017.  Baby Seeta weighed just 400 grams and measured just 8.6 inches when she was born, her minuscule feet only slightly bigger than a fingernail. She was not breathing when she was born. But the couple decided to fight to keep her alive.

“When the baby was born, we were uncertain of what could happen,” Dr Sunil Janged, Chief Neonatologist said.
The baby required artificial breathing support to regularize her breathing and then she was quickly transferred to Jivanta neonatal ICU. The baby was managed & looked after at Jivanta Neonatal ICU under precise care of Neonatologist Dr. Sunil Janged, Dr. Nikhilesh Nain & trained nursing staff. To salvage a baby of this size was challenging. There is no reported survival of a baby weighing this small in India and South Asia . Last reported smallest survival was a baby Rajni weighing 450 grams at Mohali , Chandigarh in 2012.

“Babies born this small have extremely poor function of all body organs which include lungs, heart, brain, kidneys, intestine, skin, adrenals etc. and all of them need support for survival of the baby. Problems related to any one system can singularly kill the baby and is the commonest outcome in these cases. The babies that small have less than 0.5 % chance of survival without brain damage.” said Dr Pradeep Suryawanshi, Senior Professor Neonatology Bharti University Pune.. She was struggling to breathe, so was immediately put on advanced respiratory support [ ventilator] to expand her tiny , immature lungs. She cannot be fed adequately due to immaturity of gut. We had to start the baby on total parenteral nutrition, which basically means giving all the essential nutrients such as amino acids, lipids, carbohydrates, minerals, multivitamins and trace elements directly into blood circulation. Such baby quickly looses all body water through their fragile parchment like skin by evaporation or they may drain all body water through their immature kidneys. Initial days were difficult as her birth weight dropped down . Gradually she started digesting few drops of milk. She was able to digest milk by 7 weeks of her life and able to drink from spoon after 4 ½ month . This small baby required respiratory support on and off as she used to hold breath during sleep. The biggest challenge for our team was to prevent any infection to the baby and our team managed it very well.. She required multiple blood transfusions during her NICU stay.

There were many difficult days and many tears, but she clearly wanted to survive. Special thanks to our amazing NICU nursing staff who took care of this little angel during her stay here, and her parents who were dedicated partners in her care.

In all, she was in the NICU for almost 210 days and today she is being discharged when discharged, her weight was close to 2400 grams. By far the progress and clinical course in the NICU was very satisfactory. Her brain is structurally normal and eyes are also developing normal. Now she is a beautiful angel and according to Jivanta Nursing staff she is Miss World for them . They named her ‘ Manushi” ​“We are greatful to Seeta and her family and we appreciate them for setting a new example to the community. Rajasthan where the girls still considered a burden, are thrown in the trash immediately after birth or are left in the orphanage, Seeta couple treated girl baby who had negligible chance of survival .” added Dr Ajay Gambhir, Past National President NNF India.

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It is the latest technology, high end equipments and expertise of NICU team, which has given this phenomenal result and that Jivanta is now routinely having a more than 95% survival of extremely low birth babies.” said Dr S K Tak, Head – Dept of paediatrics, Ananta Medical College.

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