The baby arrived suddenly and much too early. Tiny Nalleli Perez Lopez was so fragile the doctor in her remote Mexican town said she would never survive.
Her father thought otherwise. Heartbroken but determined, he brought his daughter home from the doctor’s office. He carefully made a bed for her in a shoebox. Warmed her with water bottles and chicken lights.
She was unable to nurse or take a bottle, so he used a syringe to trickle breast milk and rice water into her mouth.
Nalleli’s mother prayed. She told Jesus it was not time to take her daughter.
“You give her to me―you have to be here for us,” she said.
That was a big accomplishment. We were known as the preemie family.
Twenty-eight years later, she said that same prayer. This time, for her grandson.
Nalleli, the 2-pound infant who survived and thrived, now was the mother of a baby boy—Izak Guadalupe Saldana Perez.
Like his mother, Izak arrived months early, weighing 2 pounds, 1 ounce. But unlike his mother, he had the full resources of a highly specialized neonatal intensive care unit at Spectrum Health Helen DeVos Children’s Hospital.
Preventing preterm births
Having one premature infant increases the risk a mother will deliver prematurely in a future pregnancy.
But there are steps women can take to reduce that risk, says Vivian Romero, MD, a maternal fetal medicine specialist with Spectrum Health Medical Group. She advises parents to consult with an obstetrician and maternal fetal medicine specialist to improve the chance that their next child will be a healthy, full-term baby.
If a woman has delivered a premature baby before, she should seek advice before becoming pregnant―and plan enough time between pregnancies. Typically, doctors advise women to wait 18 to 24 months.
Research shows that becoming pregnant within 18 months of giving birth increases risk of a preterm birth or having a small baby.
Also, if a woman is at risk of delivering early, doctors will screen the length of her cervix, because a short cervix is a strong predictor of preterm delivery. If a woman is at risk of delivering a premature baby, she may be prescribed progesterone.
“That is shown to be beneficial to people with history of preterm birth,” she says.
Dr. Romero often sees patients who wonder if they are at risk of early delivery because their mother had a premature baby. However, research has not found any genetic link that is passed down from mother to daughter.
“Twenty years from now, we may know more about the whole process of preterm birth,” she says. “To date, we don’t have a gene that tells you, if you have a mutation, you are more likely to deliver premature.”
Because so many variables are involved in preterm birth, Dr. Romero says it’s crucial to get good prenatal―and preconception―medical care.
“We don’t really know what causes preterm birth,” she adds. “The pathway that causes preterm birth in one person may be different in another person.”
Nalleli’s father, marveling at the help available, reassured his daughter that her son would pull through.
“It’s two miracle babies in the family,” he said.
For all the differences between Izak’s and Nalleli’s care as preemies, important similarities existed in their first days of life: Love and nurturing.
“Some of the technology has changed leaps and bounds,” said Krista Haines, MD, a neonatologist who cared for Izak in the NICU. “But some of the core concepts of how we care for preterm babies―such as skin-to-skin kangaroo care―have not changed.”
From despair to joy
The birth of their grandson Izak brought back memories that Gracie and Pedro Perez had long kept quiet.
Twenty-eight years ago, they lived in the mountains of Western Mexico with their 2-year-old son.
One day, Pedro, a bull rider and veterinarian, came home from a rodeo exhausted. Gracie, 28 weeks pregnant, told him she felt a strange feeling in her belly.
She lay down on the bed. And without pain or warning, Nalleli began to arrive. At Gracie’s call, Pedro rushed into the room. He unwrapped the cord from the baby’s neck as she slid into the world.
They didn’t have the money to go to a “really real hospital,” Gracie explained. Instead, Pedro took the baby to a local doctor’s office, which had one or two rooms that served as a small hospital for the town.
A short time later, he returned home, the infant still cradled in his arms. Gracie started to cry. She knew what that meant. The doctor said her baby would die.
“No,” Pedro said. “That’s not going to happen.”
He had cared for many newborn animals. He would put that knowledge to use for his daughter.
In addition to food and warmth, he made sure Nalleli had frequent skin-to-skin time with her mother. He laid the baby on her mother’s chest and covered them both with a blanket. He had seen how newborn calves and foals benefited from close contact with their mothers.
“When the mother is more close to the babies, it’s much better and warmer,” he said. “They don’t have too much stress. The baby feels protected, and it makes them feel better.”
Gracie prayed and kept a steady conversation with her newborn daughter.
“Every moment, I say I need you in my life. I need you here,” she said.
Nalleli ate well and grew steadily. Her parents rejoiced. And everyone in their small town took notice.
“This was a big accomplishment,” Nalleli said. “We were known as the preemie family.”
When she heard the story of Nalleli’s birth, Dr. Haines marveled at the way her father cared for her.
“It’s impressive that he applied certain aspects of his knowledge of veterinary medicine to caring for his premature baby,” she said.
Izak arrives early
When Nalleli was 8 months old, the family moved to Chicago. Later, they moved to Fennville in West Michigan, where they performed with a Mexican dance troupe, Los Gallos de Oro.
You have angels there, watching over the babies.
Nalleli grew up and had a daughter, Xiomara, who is now 7.
Last summer, Nalleli and her husband, Antonio Saldana, learned they were expecting a baby boy.
Izak arrived 15 weeks early, on Oct. 18, 2015.
He spent his first days in the Small Baby Unit, an area of the NICU at Helen DeVos Children’s Hospital that provides specialized care for infants born before 27 weeks gestation.
As he battled to survive, coping with lung disease and infections, Izak needed all the advantages technology could provide, Dr. Haines said. A ventilator provided oxygen at first. As his lungs developed, he moved to a continuous positive airway pressure treatment, or CPAP. Eventually, he only needed oxygen delivered through a nasal cannula.
He also progressed in his feedings―making the switch from feeding tube to a bottle. Like his mother, Izak benefited from plenty of skin-to-skin time with his parents.
Visiting her grandson in the hospital, Gracie said she found the technology “amazing.” But she was just as impressed by the expertise of doctors and nurses and other medical staff, who provided support she and her husband could not imagine when they cared for Nalleli in her first days.
“You have angels there, watching over the babies,” she said.
On a chilly January day, two weeks before his due date, Izak was ready to go home. He would get to spend his first night in his own crib, in his home with mother and father and big sister.
We finally get to go home, knowing we have a healthy baby.
He was 3 months old then, a 6-pound, 8-ounce boy with dark hair and deep hazel eyes.
As they waited for the final paperwork, Nalleli sang to him in Spanish. Izak slept in his dad’s arms.
“I feel good,” Antonio said. “We finally get to go home, knowing we have a healthy baby.”
“He is a miracle baby,” Nalleli said.
She hopes one day to provide support and education for other parents whose children are born premature, particularly Hispanic moms and dads. After all she has learned through her son’s medical challenges, she wants to help others navigate those first, difficult days.
“God gives us challenges and (the resources) to help other people,” she said.
Jennifer LaFlure, RN, stopped by Izak’s crib to say goodbye.
“I love it when they get to go home before their due date,” she said. “That’s a big deal for our little ones.”
For Dr. Haines, watching Izak’s progress was deeply rewarding.
“It is wonderful to see Izak growing and developing well,” she said. “These outcomes and stories give us motivation and inspiration to do what we do each day, caring for the tiny, extremely premature babies in our Small Baby Unit.”
It’s a warm spring day in Fennville, four months later. Antonio and Nalleli step outside their home with their son. Sunglasses protect Izak’s eyes from the bright sunshine―and make him look even cuter, if that’s possible. He gazes wide-eyed at new leaves budding on the trees and grass rippling in the breeze.
Antonio holds him up to the slats in a barn door for a close look at two miniature horses.
“He’s a really easygoing kid,” Antonio says.
At 7 months, Izak can stand on two feet―grasping Mom or Dad’s fingers. He loves to eat mashed potatoes and carrots. He has a smile that melts hearts.
Although he still needs oxygen at night, he has grown into a healthy 16-pound, chubby-cheeked baby. His progress has his parents looking with optimism to the future―when he can dance, play basketball or ride horses.
And for now, they celebrate how far he has come.
“We are already talking about his first birthday party,” Nalleli says.