Hospital's tiniest surviving preemie heads home for the holidays

December 21, 2016 by Karen Ann Cullotta, Chicago Tribune

When Kacie Mormance was born in May, she weighed just 14 ounces - slightly more than three sticks of butter - but the smallest surviving preemie to be born at Northwest Community Hospital already has found a way to give her parents a present for the holidays.

"It's the best Christmas gift ever," said Chris Mormance, Kacie's father, thanking , many of whom wiped away tears, as he and his wife, Randa Mormance, bundled up Kacie and her twin sister, Naomi, to head home.

Dozens of nurses and doctors gathered Thursday afternoon to wish the family well as they left, for the first time as a quartet, through the Arlington Heights hospital's doors. Naomi and Kacie Mormance were born at 25 weeks gestation - roughly 15 weeks early, with Kacie being what hospital officials described as the smallest preemie born at the hospital to ever survive.

"We have had other preemies born at a similar gestational age, but they were not that small," said Dr. Joel Fisher, a neonatologist at the hospital who oversaw the twins' care during their stays.

Kacie weighed less than a pound and measured 11 inches long when she was born, but on Thursday, she left the hospital weighing 10 pounds, said Don Houchins, the executive director of the suburban Chicago hospital's Women and Children's Services.

"When Kacie was born, she could easily fit into your hand, which is really on the low end of weight for preemies that survive," Houchins said. "Her twin, Naomi, was only 800 grams at birth, but she was twice as big."

After spending nearly three months in the Neonatal Intensive Care Unit, known as the NICU, Kacie's sister Naomi was released from the hospital, and has been home with her parents since August, where she is thriving, said Fisher.

"It's been a real roller-coaster ride, but the nurses and doctors here have made it a great journey," Randa Mormance said.

The ride began in May, when Randa Mormance gave birth to the two girls nearly four months shy of full term. Randa Mormance, who had a high-risk pregnancy, was being treated by a maternal fetal medicine specialist when it was discovered that one of the twins was growing more than the other, Houchins said.

"If they wanted to save both babies, the doctors decided they had to do a C-section early," Houchins said, adding that doctors gave her steroids to help mature the babies' lungs as much as possible prior to the girls' birth. He said the hospital has treated preemies born at 24 weeks' gestation.

Once the babies arrived, doctors had a slew of risks to manage.

"When they're so small, there are so many things that can go wrong," Houchins said. "Obviously, the first thing we have to do after they're born is stabilize them. But after that, we have to constantly monitor them to ensure they're getting enough oxygen, that they are properly hydrated, and we try to protect them from intra-ventricular hemorrhages in the brain."

Houchins said among the medical issues facing is their lungs are not as developed as they would be if the pregnancy had gone to full term, typically around 40 weeks.

"They can't be too cold or too hot," Houchins said, "and (they) have to have just the right glucose, sodium and potassium levels."

A common cold could end up developing into pneumonia in a premature infant, Houchins said. Vision problems also are common among premature babies, he said, and many are at risk for cognitive developmental delays.

The family said they were thankful for the team of physicians, nurses and hospital employees who took care of the girls during their stays.

"If it wasn't for you guys, I don't know what would have happened," Chris Mormance told the hospital staff members.

After Naomi's release from the hospital in August, Kacie required four more months in the hospital's NICU, as well as a five-week stay at Lurie Children's Hospital in Chicago, where she was treated by a pediatric retinal specialist for possible eye conditions that can require surgery, Fisher said.

"We're very happy with Kacie's growth, and to have gone from 400 grams to 4,800 grams in seven months is remarkable," he said. "But with her being born 15 weeks early, we still have to account for the prematurity when we assess her future development, like her speech, and adjust the milestones for her age."

As two of the 257 babies who received care and "graduated" from the hospital's NICU in 2016, Kacie and Naomi will be scheduled for follow-up appointments at the 's Neonatal Development Follow-up Clinic every six months until they turn 2 years old, Fisher said.

Kacie went home Thursday equipped with oxygen, a feeding tube and a special heart and breathing monitor that will alert her parents with a warning alarm if her respiration or heart rates drop, Fisher said.

The feeding tube, which is laced through Kacie's nose and goes down into her esophagus, ends with a tip in her stomach, providing extra nutrition, Fisher said.

The Mormances were also trained on how to adjust the equipment - Fisher said he anticipates that Kacie will tug at the tubes at some point - and were also taught how to perform CPR.

"We're just thrilled that Kacie's going home, and that she's so healthy," Fisher said. "When she was first born, she was very sick, and she still has some residual lung disease. But we're just thrilled to get her to this point."

The Mormances said they're already enjoying Kacie's personality.

"She's a flirt and a bundle of joy," Randa Mormance said.

She said after the family's seven-month-long ordeal, they are now looking forward to enjoying Christmas with their twin daughters at home, where the babies' presents are already wrapped and waiting under the tree.

"The kids need to be away from other people as much as possible so they don't catch anything, but we can't wait to have them both at home," Mormance said. "We got our strength first from God, then from the NICU nurses and Dr. Fisher, who are all amazing. It's probably going to be a pretty hectic Christmas for us, with lots of happy screaming from the twins."

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