India’s smallest and youngest pre term baby: Nirvaan, born after 22 weeks, survives life threatening events

Four-month-old baby dies after doctors give him painkiller, parents allege medical negligence.

New Delhi, September 23: Battle for life, fought for 132 days in Neonatal Intensive Care Unit (NICU) at a city hospital, Mumbai boy is called as miracle baby.

India’s smallest and youngest pre term baby, named Nirvaan, was born after just 22 weeks. He has a normal functioning brain, vision, hearing and has potential for long term neurological development.

Born on 12 May 2017, Nirvaan was treated by a team of 14 doctors and 50 nursing staffs. The baby had a birth weight of 610 gms, with 22 cm head size and a length of 32 cm.

Director of Surya Child Care Bhupendra Avasthi said, “Nirvaan had immature lungs at birth requiring ventilator support right from the labour room. He required respiratory support for 12 weeks which included six weeks of ventilator support. Multiple doses of surfactant injections were instilled into the breathing tube to expand his lungs.”

According to Avasthi, Nirvaan survived life threatening events such as pneumothorax (air accumulation around the lungs) and brain bleeds to emerge as a victor.

Avasthi asserted, “A month-long steroid treatment was needed to help him breathe on his own. The steroid treatment also increased his risk of having infection and high blood sugars which required antibiotic and insulin therapy. Multiple blood transfusions, LASER treatment of eyes and hernia surgery were also required during this period. Oral feeds could be given only after three months of age.”

Medical science says that infants born between 22 and 24 weeks of pregnancy are considered periviable infants or infants born at the limits of viability, as a foetus may not exist independent of the mother prior to 22 weeks.

Medically, when it comes to 22-week gestation premature infants, 40-50 per cent of them are born dead (still born) worldwide. Among those born alive, less than five per cent continue to survive. The surviving infants are at high risk of having serious neuro developmental disability such as cerebral palsy, mental retardation, hearing loss, visual impairment and epilepsy.

Stating that there was no report of a surviving 22-week newborn before Nirvaan in India, the doctors said that there was also limited experience with other hospitals in managing such babies.

Doctors said that after six weeks, Nirvaan was taken off the ventilatory support and weighed 1kg while on complete milk feeds. He was, however, continued on non-invasive respiratory support for the next six weeks.

“Multidisciplinary management in the form of heart and brain scans, bone integrity checks, hearing assessments, skin care, physiotherapy, lactation support was required. The family was also provided emotional support through rigorous counselling by the medical team,” said Avasthi.

Earlier, the Surya Hospital had also received a case of the country’s first surviving 24-week newborn baby.