what's the earliest a baby can be born and survive? - Mothering Forums

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#1 of 24 Old 08-10-2006, 06:14 PM - Thread Starter
 
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I feel like when I get to this milestone, I can wipe a little sweat off my brow. I'm actually not that worried with this pregancy, but I like to be able to say to myself, "Ok, if the baby were born today it would probably survive, even though it would take a lot of medical intervention." Then later I can reassure myself that the baby surely live, but just have a long stay in the NICU. So...is it 25 weeks? I know I've read that almost all babies born after 28 weeks survive.

I don't have any risk factors or history of premature births, I just play these mind games with myself.
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#2 of 24 Old 08-10-2006, 06:19 PM
 
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the *smallest* baby ever to survive is Rumaisa Rahma and she was 8" long and 25 weeks at birth. It was last year I think so you may remember her and her twin being on the news. According to - now I can't remember the name of the paper - 50 babies a year survive at 23 weeks.

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#3 of 24 Old 08-10-2006, 06:24 PM
 
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The old "age of viability" was 27 weeks. It was set to that for a LONG time. Now (as of what, 3, 4 years ago) it went to 24 then 23 weeks. So the medical community generally considers this # of weeks to be "viable" given the most up to date medical care.

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#4 of 24 Old 08-10-2006, 06:29 PM
 
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I work in antepartum, and I see premies and losses all the time.

The earliest I've seen personally survive was a 23 4/7 weeker. He's still in NICU, and probably will be for a looooong time if he makes it. His sister (twin) prolapsed a cord and didn't make it.

But then again, we have 32 and 33 (even 35) weekers who just don't make it. Not because there's something specifically wrong with them, they're just not mature and vigorous enough. (brain bleeds and necrotizing entero-colitis--where the intestinal tissue becomes infected and rots--are also a big problem for the early ones, so they might survive for a few days-weeks, but...not in the long run)

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#5 of 24 Old 08-10-2006, 06:35 PM
 
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Quote:
Originally Posted by riversong
I feel like when I get to this milestone, I can wipe a little sweat off my brow. I'm actually not that worried with this pregancy, but I like to be able to say to myself, "Ok, if the baby were born today it would probably survive, even though it would take a lot of medical intervention." Then later I can reassure myself that the baby surely live, but just have a long stay in the NICU. So...is it 25 weeks? I know I've read that almost all babies born after 28 weeks survive.

I don't have any risk factors or history of premature births, I just play these mind games with myself.
Hi Mama, How funny. I've been playing this game myself. Thinking ok, if the baby was born there's a chance, or getting to be a pretty good chance. I figured I was the only one!! :

I also don't have any risk factors or history of premature birth, but I've played this game with I think all my pregnancies!! SO just wanted to let you know you're not the only one!

Sara

Homeschooling Mama to 6. Waiting for baby #7 to arrive mid September.
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#6 of 24 Old 08-10-2006, 06:40 PM
 
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I have been thinking about this milestone a lot too. you aren't the only one!

ND

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#7 of 24 Old 08-10-2006, 06:41 PM
 
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When I was in the hospital delivering my 21w, 0d second son a helpful but lacking common sense NICU nurse told me, "if only you'd waited a week before going into pre-term labor, we don't even attend the birth until 22 weeks, since there's no chance of survival until then." I guess it never occurred to her that her words were more hurtful than helpful.

And, yes, I understand the OP's emotions and thoughts here. I have 5 days until this pg gets to that 22 week mark.

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#8 of 24 Old 08-10-2006, 06:58 PM
 
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Not from you DDC, but I saw this and had to respond. I saw a preemie and his mom here getting pics for his passport. I asked how old and she said FOUR MONTHS. This baby was tiny!!!! I was shocked. She then told me he was born at not quite 23 weeks.

Here's his story. http://english.samsunghospital.com/h...ptCode=EngHome

Long term prognosis is that he is normal and healthy and should have no extraordinary delays as a result of his early birth.
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#9 of 24 Old 08-10-2006, 07:07 PM
 
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I play the same mind games with myself! Have with each pg. I've always at least told myself that somewhere in the 30s would be viable- I am so amazed to hear that 20-something weekers can survive!

However, then my question is: at what cost? What does "survive" mean? We had a friend of the family who had a very early preemie, 25 weeks I believe, and her little boy is very challenged with a plethora of ailments. She had her little guy when I was newly pg with my DC#1, so the possibility was forefront in my mind my entire pg (as if I don't worry enough... *sigh*). So I think that's where my self-imposed 30-something weeks comes in, to have a baby survive and be healthy.
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#10 of 24 Old 08-11-2006, 12:16 AM
 
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I always heard 26 weeks gave a hair of a chance and the odds increased from there.
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#11 of 24 Old 08-11-2006, 12:28 AM
 
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I mentioned the 23 week milestone to DH when we hit it, and he thought I was off my rocker. You aren't alone, mama!
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#12 of 24 Old 08-11-2006, 01:29 AM - Thread Starter
 
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Well, it's good to know that I'm not the only one!

mary3mama- I can't imagine why a nurse would say something like that to you. As if you chose to have pre-term labor?! As if it's no big deal that the baby was too young to survive?!

sierratahoe- I agree. Just survival is not really what I find reassuring. I think it's knowing that there's the possibility that the baby would live and be physically and mentally healthy that I try to comfort myself with.
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#13 of 24 Old 08-11-2006, 01:48 AM
 
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I'm sure CMM could tell you, survival/lack of complications are very individual. MIL's friend gave birth at 24w, son is perfectly fine, no delays. My friend gave birth at 28w, no problems. However, some people give birth much later and the child has many more problems if they survive. It just depends on the complications that arise for each individual.
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#14 of 24 Old 08-11-2006, 10:00 AM
 
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Oh Mary3Mama, how awful for you to have someone say something like that as you are going through such a painful thing

ND

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#15 of 24 Old 08-11-2006, 11:02 AM
 
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This is always a milestone that I like to reach, too. I have always been told 24 weeks, but I know they are now even considering 23 weeks in the medical community. The use of surfactant for the lungs has made a big difference in how much earlier they can save the little ones. I have known several babies over the 4+ years I have been on baby boards to be born at 24-25 weeks with no lasting problems. It really is amazing!

Carrie, mom to Johnathan (7-02), Brodie (2-04), Kate (12-06), Jordan (9-08), (4-09) & Maggie (3-10)
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#16 of 24 Old 08-11-2006, 11:04 AM
 
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Since I had a 29 weeker last time (he's perfectly fine with no delays, and is actually BIG for his actual age now!), I play the "baby is viable now" game too! Technically, 23 weeks is about the earliest a baby is viable, but there's still very small chance of survival at that point. I think the chance of survival is 50% at 24 weeks? There's a list of percentages somewhere on the net, and basically, each week baby stays in, it's better off, and a week can make a huge difference! There were several 25 weekers born this year on MDC, and they're doing pretty well.

My DS was born at 29w4d, but he was the size of a 31-32 weeker and did really really well - just 4 weeks in the NICU, and came home with no problems except some mild reflux that he outgrew by 6 months. But every baby is individual, and the complications they have while in the NICU can affect things. The only thing DS had going on was some mild apnea, which is normal in preemies until their nervous systems mature. And he had to learn to take oral feedings, and hold his own temp. He was breathing 100% on his own the day after birth (thank you steroids and surfectant), and within a few days, he was getting tube feedings instead of IV. So the only tubes/wires he had on him during most of his stay was the feeding tube going down his mouth/throat into his stomach, and the monitor wires that attach to chest and feet (not sticking in baby). As I said though, he did *very* well, and not all babies his age (or even older) do that well in the NICU.

Size can affect things too, including long term issues. I believe 3.5 lbs is the cutoff for the big risk of ROP (Retinopathy of Prematurity - an eye problem)? The smaller the baby, the more complications they're at risk for. So if your baby is big for gestational age, that *can* be helpful (although it doesn't always help everything).

As far as long term issues go... I've read that after 28 weeks, the chances of having a normal life with no long term developmental issues is pretty good. And IRL, I actually know several 28 weekers who have no problems whatsoever (most are high school/college age - they all came out of the woodwork when I was hospitalized for PPROM!). And the technology is better now than it was back then.

My big goals this pregnancy have been... 22 weeks without PPROM (lungs develop 18-22 weeks, and need amniotic fluid for that), 24 weeks (what I consider viability), 29 weeks (when I PPROM'd last time), 36 weeks (when my midwife can legally attend my birth out-of-hospital - what I *wanted* to do last time).

I'm 25 weeks now, and if my baby came today, I think he would probably survive, especially since he is measuring big like his brother did. But I'd feel ALOT more comfortable if he waited until the 30s, preferably at least mid-30s, so the NICU stay can be shorter (or possibly even avoid one and have a take-home baby!). But hopefully, I'll avoid the hospital altogether. Maybe I'll be posting here at 43 weeks, saying "Ok, you can come now!".

Mama to Tornado Boy (6/04), The Brute (11/06), and Mischief (05/09)... expecting in February '15
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#17 of 24 Old 08-11-2006, 05:52 PM
 
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Yes, my actual goal is 36/37 weeks, when I'm clear for a homebirth!!
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#18 of 24 Old 08-11-2006, 06:38 PM
 
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I like to read the blog of a neonatalogist, and he says that a 24 weeker has a 55-60% chance of survival and a 25% chance of severe delays. So the long term prognosis for a 24 weeker (caveat! one born at a hospital with a Level 3 NICU capable of providing effective treatment for a 24 weeker) is amazingly good.

http://neonataldoc.blogspot.com/2006/08/change.html

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#19 of 24 Old 08-11-2006, 06:41 PM
 
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Supposedly 23 weeks is THE earliest, but chances are not good.

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#20 of 24 Old 08-11-2006, 09:56 PM
 
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I popped over from January DDC. I asked this question at my last appointment. The Dr. said my magic date for "viability" is September 17, which marks the beginning of my 24th week.
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#21 of 24 Old 08-13-2006, 10:10 PM
 
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I worked in pediatrics as a physical therapist before DS was born. I saw quite a few 24 and 25 weekers that did remarkably well.

In some cases, they were only mildly delayed or were later discharged without any significant delays (after therapy for a few months). Some of the children born that early had sigificant health problems and delays. Quite a few fell somewhere in between, having something like mild cerebral palsy that probably wasn't noticeable to someone without specific medical training.

I was often amazed at how many 24 and 25 weekers did quite well long term, although it is certainly an uphill battle.
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#22 of 24 Old 08-14-2006, 03:36 AM
 
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Here is a quote from the March of Dimes website:

Quote:
However, most babies born after about 26 weeks gestation do survive to one year (about 80 percent at 26 weeks and about 87 percent at 27 weeks), although they may face an extended stay in the NICU. Unfortunately, about 20 to 40 percent of the very lowest birthweight babies develop serious lasting disabilities.
One of the general rules I've always heard (however mostly from when I was pg with twins 5 years ago, which is a long time in terms of advances with neonatal care, survival rates, long term disability rates, etc) is that if a baby has an 80% chance of survival (like the 26 weeker), there is an 80% chance that he/she will suffer no long term ill effects from prematurity.

If the baby has a 50/50 chance, the chance of long term disability for survivors would be 50/50 as well. However, I noticed in one of the earlier posts that mentioned a neonatologist's blog, the numbers for 24 weeker survival AND survival without long term complications was actually much better than what it was presented to us 5 years ago.

Realistically, I'd say 26 weeks would be when I'd breathe a bigger sigh of relief. Sure, 23-24 holds SOME hope where there simply is NONE at 22 weeks, but it's not great by any means.

What amazes me is that by 29-30 weeks, the survival rates are so high at that point, they really don't improve all that much by carrying to term. Amazing what an excellent NICU can do these days.
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#23 of 24 Old 08-14-2006, 10:59 AM
 
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I do this too. I guess so if I did go into labor at say 23 weeks...I would be able to have some kind of hope that the baby could make. Verses if it was 20 weeks and I knew the baby would not. I will be 23 weeks on Sunday and I see that as a milestone.
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#24 of 24 Old 08-14-2006, 05:38 PM
 
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Quote:
Originally Posted by wifeandmom
What amazes me is that by 29-30 weeks, the survival rates are so high at that point, they really don't improve all that much by carrying to term. Amazing what an excellent NICU can do these days.
Wow. I'm not sure I'd go so far as to say that....

Kelly, mama (12yoDS), doula, RN, and writer.
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