Baby who was born weighing 335 grams leaves the hospital – 04/18/2023 – Health

Everything thought out to the smallest detail. It was like this during the 147 days that Emanuelly Yasmin spent in the Hospital Municipal Vila Santa Catarina, in São Paulo. After all, care had to be adapted to care for the smallest baby ever registered in the public health system in the country.

Emanuelly arrived at 2:46 pm on November 18, 2022, weighing 335 grams and 25 centimeters. She was so small that her feet measured 3.5 centimeters, the size of her mother Camila Soares’ thumb, 27 years old.

Camila says that Manu’s pregnancy was a surprise. In May 2021, she became pregnant with a boy, Miguel Henrique. The baby was expected to be born in February 2022, but at five months she discovered that her little heart was no longer beating. At the time, she was referred to Vila Santa Catarina for curettage and was diagnosed with hypertension.

Shortly afterwards, the second pregnancy came and again the pregnancy did not evolve as expected. She and her husband, sushi chef Fernando de Sousa Silva, 28, thought they would not be able to have a child. That’s when the news about Emanuelly came out.

Like Miguel, the little one was scheduled for February, but began to suffer from her mother’s pressure variation. This time, however, Camila was aware of the problem and, when an ultrasound indicated that the child was not growing properly, she went to the hospital.

“I thought, ‘Her heart is still beating. Whatever God wants,'” her mother recalls. Camila went to the emergency room and was admitted the same day. There, she began to receive corticoids and magnesium sulfate, which respectively help to stimulate the maturation of the lungs and have a neuroprotective effect.

After four days, the team decided on an emergency C-section. “The mother and the baby were not well. The discussion was whether it would be possible to save her, if we could help her to breathe, but Camila’s pressure was very difficult to control and Manu was suffering”, recalls Luísa Zagne, medical coordinator at hospital pediatrics and neonatology.

Manu was intubated with the smallest cannula on the market. Afterwards, she was taken to an incubator that humidifies and warms the air and makes it possible to carry out some tests without the need for removal. It was necessary to avoid manipulation as much as possible and simulate the uterus as best as possible, says Zagne.

Vila Santa Catarina is managed by Sociedade Beneficente Israelita Brasileira Albert Einstein, and Einstein lent some of the equipment used during hospitalization, including a respirator that follows the baby’s flow, providing more natural movements, and a device that works in synchrony with the the diaphragm and contributes to extubation.

“With Manu we had to adapt. It was a unique challenge”, says Zagne.

The tables that estimate the survival rate of premature infants, for example, start with babies weighing 400 grams, above Emanuelly’s weight. It was necessary to wait a few more days for the extubation because there was no device that would fit the little girl’s face and even the premature cap was left over her head.

“She was so tiny. Seeing her in the incubator was heartbreaking,” recalls Camila. The baby’s fragility was such that the mother had to ask the psychologist for help when they authorized her to touch her daughter, a week after giving birth. She was afraid of contaminating it with some bacteria.

“The first touch was very good. It was such a nice feeling! There I was sure that she was going to leave the ICU”, he reports.

The following months were filled with small victories and a few scares, such as when the baby’s saturation suddenly dropped just at the time when the team had authorized Fernando to place her in skin-to-skin contact.

“It was desperate. Everything whistles, the doctors run”, says Camila. “Knowing that I can now pick it up and that no wires are going to come unplugged is so good, it’s reassuring.”

Since the last 13th, Camila has been with Emanuelly at her mother’s house, in the São Judas neighborhood, which has the best structure for the care that the baby needs. Manu still uses oxygen and receives a health team once a week.

Like other premature infants, she will also be referred for follow-up with a pediatrician, neurologist, ophthalmologist and speech therapist to stimulate and monitor her development.

For now, Manu is an isolated case, but the health team hopes to share the learning in publications and congresses and help to replicate the care in other places. “We hope our experience helps,” says Zagne.