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‘Miracle’ as Melbourne hospital saves its smallest ever premmie

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‘Miracle’ as Melbourne hospital saves its smallest ever premmie

At just 365g, Tarneit bub Oskar was born weighing less than a can of Coke — so tiny that doctors struggled to find equipment small enough for his body. But this was a baby, born of miracles, who wouldn’t say die.

When Oskar entered the world more than 14 weeks premature, many did not think he would survive. He was just 365g – lighter than a standard soft drink can – and staff struggled to find equipment small enough for his tiny body. In the days after his birth, he measured just 19.5cm. But proud mum Kate Phillips, 38, said little Oskar — who had already beaten the odds to be here in the first place — refused to go anywhere. "I don’t know what I did to deserve so many miracles, but we got lots of them" she said. And so, after spending the first 141 days of life in hospital, it was finally time for Oskar to head home this week. The smallest ever surviving baby from Western Health’s Joan Kirner hospital has a big, new world to discover.

Kate said she and her husband Sean Schmirgal "never thought the day would come" where — after weeks of going home alone — they could finally bring Oskar with them. "It was surreal," she said. "It was like we’ve left a part of our life, we’d left that world behind." She said the pregnancy was "a miracle" to begin with, and she was told she could never have children when she was just 12-years-old. "I did IVF for eight-and-a-half years and nothing took," she said. "I never thought at my age, he would come along." But a routine 20 week scan last December found Oskar was not growing properly — the placenta cord had not formed properly — there was virtually no amniotic fluid.

Kate was admitted to Joan Kirner Women’s and Children’s Hospital, but the best medicine in the world cannot save a baby born at 20 weeks. Staff did not expect her pregnancy would last and for a month, Kate underwent daily scans to check if her baby was still alive. Time that should have been spent planning the baby’s nursery was instead spent discussing his funeral. So it was a surprise to everyone when Kate made it to the new year and on January 2, she was rushed into an emergency caesarean. She said it all happened so fast – doctors told her she could lose her life if they waited any longer – that she barely had time to process that Oskar was about to be born after a little more than 25 weeks gestation. "I believe not many babies at all have ever survived as long in utero as he did with those conditions," she said. "It was like every step was a brick wall until he was born and he started surprising everyone." She said the consultant in the delivery room had to repurpose equipment. "We were told they just don’t make instruments and equipment small enough to handle a baby his size," she said. "They had to come up with new methods to help him, and so they did." When he was born, Oskar’s eyes were still fused shut – not opening until seven days later – and he was so fragile his parents could not touch him for more than a week. Kate said it took six midwives to carefully remove him from his special crib and create a "little nest" for him in her arms when she held him for the first time after more than three weeks. "We just couldn’t fathom how teeny tiny he was," she said.

Western Health neonatologist Damien Gilby said the hospital, which opened in 2019, had never had a baby so small survive until now. "And he’s the smallest baby that I’ve cared for in a long career," he said. "Being extremely premature but also with this case being extremely growth restricted, they impart challenges for every organ in the body from the brain to the heart to the lungs to the gut." Kate said the doctors encouraged them to celebrate the small wins, and so that was what she did. "There was some moments early on where we could have lost him, but he just kept going," she said. "Every step of the way, he just thought ‘no, I want to prove you wrong’. "I just thought ‘okay, one small task at a time." Eventually these small steps became less about responding to life-threatening critical care situations, and were more focused on getting Oskar ready to go home involving everyone from occupational therapists to physios. Speech therapists were called in to help him feed and the infant mental health team was there to ensure he didn’t associate hospitals and medical staff with pain. Kate said his personality began to "shine through" – and he was known for his side eye and game with his grandmother. Whenever she visits and he hears her talking, he suddenly shuts his eyes and pretends to be asleep, before breaking into a smile.

"He’s a very feisty little boy," she said. Dr Gilby said it was "amazing" for them to see Oskar meet milestones. "It’s really rewarding for our whole team, because there’s a huge team of people that goes into the 24/7 care that’s required," he said. "We’ve all been around for weeks while he’s been up and down, and struggling through one challenge after another, but he’s fought through them all."

Kate cannot speak higher of the staff who popped in for visits if he moved to a different ward and gathered at reception to farewell the boy they cared for like their own. From the doctor who made Oskar a graduation cap to the midwives who would sit and chat with Kate on the bad days, filling her in on news from the outside world, she said they were "just magic". "The NICU midwives in particular … they’re sort of part of our family now," she said. "Without them we wouldn’t have gotten out of this situation with our sanity. "It’s not thanks to one, or two or three people. "It literally is that whole department. They just go above and beyond and there’s no words to express how grateful we are." Western Health neonatology head Dr Clare Collins said babies who weigh less than 500g at birth were "at the boundaries of viability". "The majority unfortunately do not survive. "I don’t often say this, but baby Oskar really is a miracle baby."

Now settling into life at Tarneit thanks to the hospital in the home program, Kate was most excited for the simple things in life. "Last night, it was really nice to get into bed and be a family of three and have him there with us,’ she said. "He is so surrounded by love. "I just can’t wait for him to go out and experience the world."

(top right)The couple have finally been able to bring Oskar home. Picture: David Caird
(middle left) Ms Phillips and baby Oskar, with neonatologist Damien Gilby holding the smallest jumpsuit for a baby that Oskar has finally outgrown. Picture: David Caird


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