One family, two NICU stays

Each year, one in 10 babies in the U.S. are born prematurely. For the Cushing family, that statistic is two in two. Eleanor and Spencer’s eldest son, James, was born at just 24 weeks gestation. Their newest addition, Walter, was born at 31 weeks.

Today, both boys are doing well, thanks to respective stays in the CHOC Children’s small baby unit (SBU), a special unit within the neonatal intensive care unit (NICU) that focuses on caring for the unique needs of the smallest and sickest babies.

Big brother James

James Theodore was born at a local hospital weighing just 1 pound 6 ounces. He was transferred to CHOC when he was 1 day old and spent four and a half months in CHOC’s SBU.

james-birth-small-baby-unit
James, shortly after his birth.

James’ SBU stay – July to November – was filled with myriad health challenges, in addition to his goals of gaining weight and learning to breathe on his own. During his hospitalization, James fought off a bloodstream infection, was intubated multiple times to help him breathe, underwent a minor cardiac procedure and eye surgery, and worked through feeding challenges. By the time he graduated from the SBU, his weight was up to 6 pounds. He was discharged with supplemental oxygen and a pulse oximeter to monitor the oxygen levels in his blood and had multiple follow-up appointments to track his progress.

Throughout a lengthy hospitalization, CHOC staff made sure the Cushings still had the opportunity to celebrate traditional milestones with their new baby – including his first Halloween. He was dressed up as Winnie the Pooh – in a Build-A-Bear costume, since typical Halloween costumes were still too big for him. His parents and nurses donned coordinating outfits to round out the Hundred Acre Wood characters.

James is now 3 years old. He’s smaller than other kids his age and has a slight speech delay, along with a new prescription for glasses. But despite his early start in life, James is doing well.

Each year on James’ birthday, the Cushings return to CHOC’s SBU to visit the doctors and nurses who cared for him during his early days.

James visit_Dr. Bhakta
Each year on his birthday, James visits the CHOC staff who cared for him as an infant. He’s pictured here with his dad Spencer (left) and Dr. Kushal Bhakta, medical director of CHOC’s SBU.

“Despite James’ life-threatening obstacles, the SBU team was able to care for our son and save his life,” Eleanor says.

Little brother Walter

Due to her existing medical issues, Eleanor knew she would likely deliver early with any additional pregnancies. When she and Spencer were ready to add another child to their family, they switched medical plans so that she could eventually deliver at St. Joseph Hospital in Orange, right next door to CHOC’s expert neonatologists and other pediatric specialists.

Walter Rudolph was born at 31 weeks gestation and admitted to CHOC’s SBU, just like his older brother. At birth, he weighed just 3 pounds, 7 ounces. Walter’s goals in the SBU focused on growing and gaining weight. Six weeks after birth – and two weeks before his original due date – he was discharged from the hospital. In that time, he had grown to 5 pounds, 11 ounces.

walter_small baby unit
Eleanor holds her newborn son Walter, alongside smiling big brother James.

During Walter’s SBU stay, he was cared for by many of the same doctors, nurses, and developmental and respiratory therapists who cared for his older brother.

“When James was born, it was so nice to see so many familiar faces from our first SBU stay,” Eleanor says.

These familiar faces included Dr. Kushal Bhakta, medical director of CHOC’s SBU, and Dr. Michel Mikhael, a CHOC neonatologist.

“Our medical team was not only super smart, but they were also warm and compassionate,” Eleanor says. “There was always a theme with staff; they were always asking, ‘Do you have any questions? Can I get you anything?’”

Eleanor and Spencer are both nurses by trade, but at CHOC they got to focus on just being parents.

“Because of our medical backgrounds, we knew what the machines and monitors were doing, but we didn’t have to worry about any of that. We got to focus on just being parents,” Eleanor says.

walter-nicu-graduation
Walter, on his graduation day from CHOC’s NICU. His graduation cap was knit by CHOC volunteers, and his graduation certificate showcases his impressive growth in the NICU.

With two NICU stays behind her family, Eleanor’s message to CHOC staff is a simple one.

“Thank you to everyone who walked us through this journey,” she says. “We are a stronger family because of it.”

Learn more about CHOC's small baby unit

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Meet CHOC NICU Graduates

For decades, the board-certified neonatologists in CHOC’s three neonatal intensive care units have cared for thousands of babies needing specialized care. Say hello to a few graduates of the CHOC NICU.

Dylan & Payton Law

Dylan, age 9, and his younger sister Payton, age 7, were both born 6 weeks premature and cared for by the doctors and nurses of the neonatal intensive care units at both CHOC Children’s and CHOC Children’s at Mission Hospital. Their mom McKenzie shares a thank you to their care teams.

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My family will forever be grateful for the blessings CHOC has given us― our children. Not only did Dr. Hanten save Dylan’s life, but all the nurses, doctors, and staff at CHOC took incredible care of Dylan, giving him strength and providing unforgettable emotional support for our family during a terribly scary time. Two years later those same doctors and nurses took care of his little sister Payton, who also spent a month in the NICU. They treated us like family, not just patients. They calmed our fears, held our hands, and loved our babies. CHOC has a special team of angels here to carry our little ones for us when we needed them the most.

When Dylan was born, doctors and nurses swarmed the delivery room. The doctors administered several doses of epinephrine to Dylan, but he didn’t breathe on his own for 22 minutes. They finally heard a faint heartbeat, but told us the likelihood of Dylan making it through the night was uncertain. At 2 days old he was transported via ambulance to CHOC in Orange, where we found out that he had brain damage. It was devastating to hear that our son may not walk, talk or eat on his own. Today, Dylan is a happy, kind, and compassionate little 9-year-old. He has ataxic cerebral palsy and struggles daily with his hands shaking, but that doesn’t stop him from enjoying school, Jujitsu, playing with his little sister, going to church, doing art projects, and playing outside. -Mackenzie Law

Noah Wenrick


Nine hours after Noah was born, a nurse noticed something was off during a routine check-up, and soon the family was sent to the NICU. Noah was diagnosed with a lung infection and stayed in the NICU for almost two weeks. His mom Ashlie pens a thank you note to his care team.

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A huge thank you from the Wenrick family to the whole CHOC NICU team for all that you do every day! You made us feel like family while Noah was in the NICU. Being new parents it was scary for us, but you helped us understand every step up to the day Noah got to go home! Now he’s a healthy and active 3-year-old. -Ashlie Wenrck

Ryan McLeod


You first met Ryan, a graduate of CHOC’s small baby unit, in November during #PrematurityAwareness Month. Look at him now! Ryan is a happy-go-lucky boy who recently celebrated his first birthday with a trip to Disneyland. At his Mickey Mouse-themed birthday party for family and friends, his parents set up a CHOC Walk station and encouraged their loved ones to join Ryan’s Sidekicks, their first-ever CHOC Walk team. Ryan’s dad says, “The way my wife and I look at things after going through this experience is that we want as many people and possible to gain awareness and support the CHOC NICU and their exceptional Small Baby Unit.”

Austin, Michaela & Caden Shay


Triplets Austin, Michaela and Caden were born a day shy of 31 weeks and spent 80 days in the neonatal intensive care unit at CHOC Children’s at Mission Hospital. Their mom Jennifer, a clinical nurse at CHOC at Mission, shares a thank you for her co-workers who cared for her children.

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On behalf of my entire family, I would like to thank the doctors and nurses that took care of our triplets at CHOC at Mission in the fall and winter of 2009. Austin, Michaela and Caden thrived with the tender loving care provided by the staff. Born a day shy of 31 weeks, Austin weighed 3 lbs. 9 oz., Michaela weighed 3 lbs. 3 oz., and Caden weighed a whopping 2 lbs. 0.5 oz. Despite my nursing knowledge, I was treated first and foremost as a mom. The nurses, doctors, and staff were always very professional in addition to being extremely considerate and attentive to our needs.

We cannot thank you enough for what you have given our family. We truly believe that our children― Caden in particular― would not be here today without the care they received in the NICU. It is because of the dedication of the CHOC at Mission NICU staff that we have three relatively healthy 7-year-olds at home today. What a happy and crazy home it is! Though we can never repay you for all that you have done for our family, we wish to thank you from the bottom of our hearts. You are all honorary aunts and uncles! Without the dedication of this team, I would not be the mommy of four that I am today. You have blessed our family beyond measure.     -Eternally grateful, Jennifer Shay

Willow Dee


After a healthy pregnancy, Willow was born just after 36 weeks via an emergency c-section. She was immediately transported to CHOC for body and brain cooling, to prevent seizure, stroke or damage to the brain. Her mother Cara shares a thank you note to the team that cared for now thriving almost-two-year-old.

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To our CHOC caregivers,

We want to thank you with our entire hearts for truly transforming a nightmare into a beautiful dream. After an extremely healthy pregnancy without any red flags, Willow was born at 36 weeks and 2 days. Twelve hours after my water broke, there was extreme blood loss prompting the nurse to call a code. The on-call OB-GYN at the hospital where I delivered was in my room within seconds. Willow’s heart rate was around 60 beats per minute, only half of what it should be. An emergency cesarean immediately followed. Doctors discovered that I had a very rare condition called velamentous cord insertion where the umbilical cord inserts into the fetal membranes, then travels to the placenta. This means exposed blood vessels are vulnerable to rupture. Willow had lost a substantial amount of blood that required two blood transfusions and she was intubated.

The life-saving, phenomenal level of care that we received from our team at Hoag Hospital quickly continued at CHOC. After a perfectly healthy pregnancy, I never could have foreseen my daughter would be taken via ambulance to a different hospital just five minutes after I saw her for the first time. EVERY single day, I think about our nurses and doctors at CHOC. They were calm, abundantly informative and so gentle. The doctors answered as many questions as we had and we were never rushed. They are truly masters of their craft. Before this experience, I never thought a NICU could be comforting.

The NICU doctor said that Willow had experienced “insult” to her brain; the lack of blood flow had caused hypoxic-ischemic encephalopathy. Fortunately, CHOC has a body and brain-cooling process that is used in situations like this to prevent stroke, seizure and damage to the brain. Our daughter is lucky; her 72-hour cooling process resulted in zero stroke, seizure, or worse.

Today, Willow is 20 months old and thriving! She is a miracle because of all the hands that worked on her. We feel grateful to have spoken on behalf of CHOC over the last 20 months to help raise much needed funds for the new all-private-room NICU that opens this summer. We believe in paying it forward to the future families that now can stay with their baby as they heal. We love our caregivers at CHOC more than they may know.                                               –Love, Cara Dee

Faith Amouroux

Diagnosed at 18 weeks gestation with a congenital diaphragmatic hernia, Faith was born at 40 weeks gestation and spent four months in the neonatal intensive care unit. Today, she is a happy and active six-year-old girl. Her family shares a note of thanks for the team that cared for her.

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Our family thanks God everyday and we are forever grateful for the caring and dedicated NICU team at CHOC. Our daughter, Faith was diagnosed at 18 weeks gestation with a birth defect called CDH (Congenital Diaphragmatic Hernia). We learned that 80 percent of her diaphragm was missing and were told that the statistic were not good. Her chances for survival were slim and if she did survive, she would have many health issues. Faith was born at 40 weeks gestation and after ECMO, CDH repair surgery & four months in NICU she pulled through. Faith is now 6 years old and has had a few minor hurdles but continues to defy the odds. She is doing great. Faith loves to sing, dance, play dress up, jump rope and read. Thank you CHOC; you have an awesome NICU team. -Amouroux Family

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Inside the Small Baby Unit: Ryan’s Story

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.

small baby unit
Patient Ryan shortly after his birth and before he was transferred from another hospital to the Small Baby Unit at CHOC Children’s.

“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.

small baby unit
Ryan was born at 27 weeks gestation and spent 17 weeks in CHOC’s small baby unit before going home.

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.”

small baby unit
Members of Ryan’s care team included Dr. Kushal Bhakta, medical director, and Ryan’s mom Danielle.

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 baby unit
At CHOC, parents are valued members of the care team. Here. Ryan’s dad holds him for the first time in the small baby unit.

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.

small baby unit
After graduating from CHOC’s small baby unit, Ryan has been enjoying being home with his family and playing with his older brother.

“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.”

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Meet Dr. Kushal Bhakta

In recognition of prematurity awareness month, we’re highlighting Dr. Kushal Bhakta, medical director of CHOC Children’s Small Baby Unit (SBU).

Dr. Kushal Bhakta
Meet Dr. Kushal Bhakta, medical director of the small baby unit at CHOC Children’s

The Small Baby Unit – the first of its kind – opened in 2010. The special 12-bed unit within our neonatal intensive care unit (NICU) is designed for babies born at less than 28 weeks gestation or who weigh less than 1,000 grams. The space is designed to aid in babies’ development with dim lighting and low noise levels, mimicking the womb’s environment as closely as possible. The unit is also nurturing for patients’ families. Since they are going through many of the same experiences, families are able to bond and support one another.

“It’s an amazing blessing to be part of these families’ lives. So many parents write to us and send pictures long after they’ve left the hospital. There is a mutual respect, and they become part of our extended family,” Dr. Bhakta says.

Board certified in pediatrics and neonatal-perinatal medicine, Dr. Bhakta is part of a specialized, highly trained team at CHOC. He owes the success of the unit to his team, he says.

“It’s inspiring to see the team’s passion for the lives of these babies,” Dr. Bhakta says. “From nurses to respiratory therapists, and all other disciplines, everyone on the team takes care of our patients like they were their own children.”

The highly committed team is improving quality and outcomes in extremely low birth weight infants. Impressive outcomes from the two years before and four years after the SBU’s opening in March 2010 include:

  • Significant reduction in chronic lung disease of prematurity.
  • Significant reduction in the rate of hospital-acquired infections.
  • Significant reduction in infants being discharged with growth restriction . These factors are linked to cognitive and physical disabilities.
  • Reduction in the average number of laboratory tests and X-rays per patient.

Dr. Bhakta’s vision for the SBU is to be recognized nationally and beyond as the premier destination for the care of extremely preterm infants. Dr. Bhakta and his team have hosted many hospitals interested in modeling their units after CHOC’s SBU. As leaders in their field, the team hopes to continue to improve patient outcomes.

“We’ve come so far in how we treat this patient population, he says. “We don’t want to only adapt knowledge, but create the knowledge and help set standards of care for these patients.”

Dr. Bhakta received his medical degree from Baylor College of Medicine and completed his pediatric residency and neonatal-perinatal fellowship training at Baylor College of Medicine and Texas Children’s Hospital, in Houston, Texas. He later joined the faculty at Baylor College of Medicine/Texas Children’s Hospital as assistant professor of pediatrics, where he also obtained an advanced certificate in teaching through the Educational Scholars Fellowship Program.

Dr. Bhakta has received several awards throughout his career, including “Super Doctors Southern California Rising Stars” in 2014 and 2015.

In his spare time, this dedicated physician enjoys spending time with his wife and two daughters.

Learn more about CHOC Children’s Small Baby Unit.

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Small Baby Unit Before and After

In observance of Prematurity Awareness Month, meet a few graduates of the Small Baby Unit (SBU) at CHOC Children’s. The only of its kind in Orange County, the SBU focuses on caring for the unique needs of the smallest and sickest babies. This special unit is designed for babies born at less than 28 weeks gestation or who weigh less than 1,000 grams.

moanalani

Moanalani Solomon
Current age: 1
Birthday: July 14, 2015
Gestational age at birth: 28 weeks
Birth weight: 2 pounds, 13 ounces
Personality now: “Moanalani is an extremely happy baby who loves to chat with anyone who will listen.  She can roll over and wants to show that trick off as soon as she’s on the floor. She is feisty and absolutely full of life,” says Noelani, Moanalani’s mother.
Reflections on the journey: “We got to know every family in the unit. We really became such a support group for each other. We exchanged phone numbers and birth dates of all the other babies, and asked ‘How did you get here?’ and ‘What’s your story?’ You become family. You’re here for the same purpose. That’s what we really clung to,” Noelani says.

small baby unit

Lucas Zaragoza
Current age: 1
Birthday: June 16, 2015
Gestational age at birth: 24 weeks
Birth weight: 1 pound, 8 ounce
Personality now: “Lucas is always happy, loveable, mischievous, very alert, and curious,” says Heather, Lucas’ mother.
Reflections on the journey: “The nurses told us we’d be very hands on, take his temperature, change his diaper, hold him. They said, ‘It’s OK, we’ll walk you through it.’ They’re part of our family now. We don’t know we would be without CHOC and the nurses and doctors and everyone who had a hand in Lucas’ care,” Heather says.

small baby unit
Jeremiah Zazueta
Current age: 6
Birthday: March 22, 2010
Gestational age at birth: 25 weeks
Birth weight: 2 pounds, 4 ounces
Personality now: “Jeremiah, known as J.J., is a kindergartner full of life and personality. He is very outgoing and friendly. He enjoys playing T-ball, singing, reading, and playing with Hot Wheels. In other words, he’s a typical active boy,” says Maria, Jeremiah’s mother.
Reflections on the journey: “At that moment, you just want them breathing. The doctor said if he cries when he’s born, that’s a good thing. I heard a whimper like a kitten and that gave me peace. The doctor said he’s a feisty one – he was moving his arms. This one’s a feisty one,” Maria says.

small baby unit

Parker Evans
Current age
: 4
Birthday: Sept. 29, 2012
Gestational age at birth: 23 weeks
Birth weight: 1 pound, 1 ounce
Personality now: “Parker’s battle to survive despite the odds seems to have established a bold defiance of the day-to-day challenges that life presents. Every task, no matter how simple or complex, is something that she routinely and emphatically proclaims, ‘I want to do it all by myself!’ The smallest of her peers and behind in her physical development, Parker seems to be the only one not to notice. She has a zest for life and is intent on taking full advantage of the chance she has been given,” says Kristina, Parker’s mother.
Reflections on the journey: “We ended up falling in love with the Small Baby Unit, the nurses and the consistency. Everyone in that unit made a huge difference,” Kristina says.

small baby unit

Faith and Brayden Kohrs
Current age
: 3
Birthday: Nov. 26, 2012
Gestational age at birth: 24 weeks
Birth weight: Both 1 pound, 10 ounces
Personality now:  “We love their amazing hearts, helpful spirits and beautiful souls. They are truly our two little blessings. The kiddos love to travel. They do really well on road trips. Going out with Grandpa Kohrs on his boat in Lake Havasu is always a blast. Faith loves to dance. Brayden loves blocks and Legos. They both love Mickey Mouse Club House, music and books,” says Marydith, the twins’ mother.
Reflections on the journey: “We love the wonderful, wonderful Small Baby Unit staff. They are the reasons we have our babies today. They are just amazing,” Marydith says.