Jillese Slaughter went shopping a month ago for ornaments to adorn a tree she put in her daughter's hospital room at Cardinal Glennon Children's Medical Center. The new mom came across a silver heart hanging on a red ribbon. It read, "Our First Christmas Together 2009."
She bought it as a sign of hope.
"One day at a time is how they (doctors) take it," said Slaughter, 18, of McGee, Mo. "Things could change any minute."
Her daughter, Laylee Gail Bryant, is one of the smallest premature babies born in the St. Louis area that has survived, say doctors at the three high-level neonatal intensive care units — Cardinal Glennon, St. Louis Children's Hospital and St. John's Mercy Children's Hospital. Laylee was born Nov. 10, weighing 381 grams, or about 13 ounces, just a little more than a can of soda. Doctors see viable babies born that small only every few years.
Slaughter has rarely left her daughter's room the past six weeks, making the three-hour trip home only a few times. The baby's father, Patrick Bryant, 20, works more than 60 hours a week as a welder, she said, but comes when he can.
Slaughter sleeps on a couch against the wall that pulls out to a twin bed and uses a shower provided for parents. She can't sleep at home, she said. "Laylee deserves me to be there, even though I can't hold her or do anything. I can't leave her there by herself. I hate it."
Slaughter suffered preeclampsia during her pregnancy. Her blood pressure climbed dangerously high and the placenta, which provides nutrients for the baby, wasn't functioning, she said. She spent two weeks at St. Mary's Hospital as doctors tried to control her blood pressure. But she remained sick, and her baby wasn't growing. When the baby's heart rate dropped dangerously low, doctors had to deliver her by an emergency Caesarean section.
Laylee was 25 weeks and 5 days, a gestational age commonly seen in the NICU. But because of her growth problems, she weighed more like a baby 21 to 23 weeks gestation. "The fact that she's 25 weeks gives her a better chance of survival, but because she's below 400 grams, flips everything," said Cardinal Glennon neonatologist Dr. Mohamad Al-Hosni.
In general, the closer to the 40-week due date that a baby is born, the better his or her chances are for being born healthy.
Research shows even a few days or weeks can make a huge difference: A baby born at 23 weeks has a 10 percent to 35 percent chance of surviving and greater than 50 percent chance of a long-term disability. At 25 weeks, survival improves to between 50 percent and 80 percent, and the chances of a long-term disability drop to between 15 percent and 25 percent.
A machine breathes for Laylee, and she gets nutrition through a tube in her chest. Because of her underdeveloped lungs, she will have trouble breathing for at least the first two years of her life; but so far, she hasn't shown any other major problems. She's had two surgeries on her heart and bowel that are typical for extremely preterm babies.
Laylee's long-term prognosis will be more apparent in three months, when she might even be ready to go home, said Dr. Tom Havranek, who helps care for Laylee. Parents want definite answers, but all the babies are different. "It's a tricky business," Havranek said. "I don't have a crystal ball."
When Slaughter arrived Tuesday after a short visit home for a family Christmas celebration, she watched through the glass incubator as the nurse inserted a feeding tube through Laylee's mouth. For the first time, she was able to tolerate some of Slaughter's pumped breast milk through the tube. Her scale tipped two pounds, more than double her birth weight.
Laylee opened her eyes and kicked her feet. Slaughter reached in through a door in the incubator to stroke her black hair and let her tiny hand grasp her finger. "There's no feeling like that," Slaughter said.
Slaughter expects Laylee's father to join them for Christmas. They plan to spend the day much like the others, keeping watch and telling her they love her. A friend made Laylee a headband with a red and green bow, which she'll wear for pictures.
Slaughter hung a tiny red stocking above the white Christmas tree, but doesn't plan to fill it with anything. When she bought it, Laylee could fit in it, she joked. "But probably not anymore." That is the only Christmas gift she needs.