Danielle McLeod was looking forward to an easy second pregnancy and ultimately caring for her infant son as a confident and assured second-time mom.
But that expectation changed when little Ryan was born three months early this past winter after just 27 weeks gestation and weighing only 2 pounds and 1 ounce.
“His head wasn’t much bigger than a pacifier,” Danielle recalls. “He was the littlest baby I had ever seen. He was so skinny, and was all arms and legs. I was amazed at how active he was for such a little person. Like many preemies, he was a fighter from the start.”
And fight Ryan did inside CHOC Children’s Small Baby Unit (SBU), a portion of CHOC’s neonatal intensive care unit (NICU) dedicated to the care of babies born with extremely low birth weights. These patients are born at less than 28 weeks gestation and weighing less than 1,000 grams, or about 2 pounds and 3 ounces.
In the SBU, “micro-preemies” like Ryan receive coordinated care in a developmentally appropriate environment. A trailblazer in neonatal care nationwide, the unit is saving babies who just decades ago wouldn’t have likely survived.
“With its coordinated care in an environmentally appropriate location, the Small Baby Unit is designed to care specifically for babies like Ryan,” says Dr. Kushal Bhakta, Ryan’s neonatologist and medical director of the SBU. “When he came to the unit, he required significant ventilator support due to an ongoing infection, and he had a long road ahead of him.”
Danielle’s breezy pregnancy took a sudden turn early in her second trimester when her doctor found in her womb a subchronic hematoma, an indicator that she might deliver her baby early.
Danielle was put on bed rest, but a few weeks later, bleeding and signs of labor showed. At the hospital, doctors were able to stop the labor and admitted Danielle to keep it from beginning again too early. But about six weeks later, Danielle’s water broke and she underwent an emergency cesarean section.
On Valentine’s Day, after two weeks of ups and downs, Ryan was transferred to the SBU at CHOC and the McLeod family began their four-month journey.
“I don’t think people understand the pain that comes with having a child and not being able to hold him immediately or not being able to take him home shortly after delivery and share him with the world,” Danielle says.
She continues, “It was difficult knowing that there were many obstacles for Ryan to overcome before he could even think about coming home. Simple things like eating by mouth, a task that should come naturally, are challenging for babies born premature.”
During that time, while also focusing on growing, Ryan also battled chronic lung disease and a brain bleed, and learned to eat and breathe on his own. Meanwhile, Danielle and husband, Jared, learned how to care for a baby born more than three months early.
“I’ll never forget our first day at CHOC,” she says. “I was so overwhelmed, scared, and nervous. Once Ryan was settled in the SBU, his nurse came in to do his very first set of cares. I sat and watched, afraid to touch him. He was so fragile.”
She continues, “His nurse said, ‘Get in there, mama. You can do it.’ She had me put my hand on him, my hand covering his whole little torso. She talked me though what to do when caring for an extra small baby. From then on, I felt confident to be close to my little fighter.”
After 17 weeks in the SBU, Ryan finally went home to join his parents and brother. He still receives oxygen treatment and undergoes physical therapy twice a week, but is doing well.
It takes a village of physicians, nurses, therapists, social workers and other clinicians to help bring babies like Ryan home — and every one on the care team partners with patients’ families.
“During his stay in the unit, Ryan overcame great obstacles, thanks to the partnership between his care team and his parents,” Dr. Bhakta says. “Our goal in the unit is to get our patients home with the best possible outcomes. Today, Ryan is doing well and has a bright future ahead.”
Small but mighty, Ryan is rolling over and pushing himself up well, and is working toward sitting up by himself.
“He also loves smiling and laughing, especially at his big brother,” Danielle says.
“We’re moving in the right direction,” she says. “We are so grateful to all the wonderful nurses and doctors who cared for Ryan. I know he is doing so well because of the amazing care he received while in the SBU. We love our little fighter. He’s such a good baby. He is truly a miracle and we are blessed to be able to witness this little guy’s journey.”