2nd smallest preemie in U.S. could go home soon

Melinda Star Guido, Haydee Ibarra

Haydee Ibarra, left, holds her 14-week-old daughter, Melinda Star Guido. (Photo: AP/Jae C. Hong)

LOS ANGELES (The Blaze/AP) — Today is Haydee Ibarra due date. But she isn’t visiting the Los Angeles County-USC Medical Center to give birth. She has actually been visiting the hospital nearly every day to visit her daughter Melinda Star Guido who was born 22 weeks pre-mature and is believed to be the second smallest baby to survive in the U.S. and third in the world.

At birth, Melinda was so tiny she could fit into the palm of her doctor’s hand. When she was born in August, she weighed just 9 1/2 ounces — less than a can of soda.  While most infants her size don’t survive, there are some growing up into healthy children and adults to this day, maintaining the debate among doctors of what age and weight is viable for an infant to survive.

Here‘s Melinda’s story:

Melinda spent the early months cocooned in an incubator in the neonatal intensive care unit in Southern California, with her 22-year-old mother sits at her bedside almost every day and stays overnight whenever she can. Doctors hope to send Melinda home with her mother by New Years Day.

Ibarra caressed Melinda through the portholes of the incubator where nurses pinned up a homemade sign bearing her name. Now weighing four pounds, Melinda gripped Ibarra’s pinky finger and yawned.

Melinda Star Guido

14-week-old Melinda Star Guido holds her mother's little finger. (Photo: AP/Jae C. Hong)

“Melinda, Melinda,” she cooed at her daughter dressed in a polka dot onesie. “You’re awake today.”

During her pregnancy, Ibarra suffered from high blood pressure, which can be dangerous for both mother and fetus. She was transferred from a hospital near her San Fernando Valley home to the county’s flagship hospital, which was better equipped to handle high-risk pregnancies.

There was a problem with the placenta, the organ that nourishes the developing fetus. The fetus, however, was not getting proper nutrition, blood and oxygen. Doctors knew Melinda would weigh less than a pound, but they were surprised at how small and fragile she was.

“The first few weeks, it was touch and go. None of us thought the baby was going to make it,” said Dr. Rangasamy Ramanathan, who oversees premature infants.

Even if she survived, doctors told Ibarra and her husband Yovani Guido, children born this extremely premature can have developmental delays and impairments such as blindness, deafness or cerebral palsy.

Ibarra, who previously had a stillborn, told doctors to do whatever necessary to help her baby.

“They said, `We’ll take the chance. Please try.’ So we said. `OK we’ll try,’” Ramanathan recalled.

Melinda Star_Haydee Ibarra AP

Melinda Star in an incubator and her mother's three fingers. (Photo: AP/Haydee Ibarra)

Melinda was delivered by cesarean section at 24 weeks and was immediately transferred to the NICU where a team of doctors and nurses kept watch around the clock. Infants born before 37 weeks are considered premature.

Melinda was kept insulated in an incubator and was hooked up to a machine to aid her breathing. She got nutrition through a feeding tube. Her mother said her skin felt like plastic because it was so thin.

“It takes a lot of good care and a lot of good luck. Most of them don’t survive,” said pediatrician Dr. Edward Bell of the University of Iowa who keeps an online database of the world’s smallest surviving babies who were less than a pound at birth.

The list currently contains 126 babies dating back to 1936. Since submission is voluntary, it does not represent all survivors.

Ten babies weighing less than a pound were born last year and survived. Melinda joins three other tiny survivors delivered this year in Berkeley; Seoul, South Korea; and Iowa City, Iowa. All are bigger than Melinda, who is not eligible to be listed until she gets discharged.

Most tiny babies who survive tend to be female. That’s because female fetuses mature faster than males of the same gestational age. Having more developed lungs and other vital organs increases odds of survival.

Bell published a study last year that found many survivors struggle with health and learning problems. For those for whom growth data are available, many are short and underweight for their age.

There are some success stories.

The smallest surviving baby born weighing 9.2 ounces is now a healthy 7-year-old and another who weighed 9.9 ounces at birth is an honors college student studying psychology. Their progress was detailed in a study published this week in the journal Pediatrics by doctors at Loyola University Medical Center in Illinois where the girls were born.

In the past three years, Los Angeles County-USC Medical Center treated two other babies with extremely low birth weight who survived, but Melinda holds the record at the hospital.

A month after she was born, she was treated for an eye disorder that’s common in premature babies. She faced her biggest test last month when she underwent surgery to close an artery that usually seals after birth.

Ybarra held Melinda for the first time after the surgery. Before that, she could only touch her through the incubator. The next challenge is learning to bottle feed before discharge. Ramanathan predicted at least another two-week stay, dashing her parents’ hopes of taking her home by Christmas.

Ramanathan said it’s too early to know how Melinda will fare when she grows up. Since she did not have major complications such as bleeding in the brain, he held out hope.

Melinda can breathe by herself, but still uses an oxygen tube as a precaution. On Wednesday, an ophthalmologist checked out her eyes and said everything looked good.

After the checkup, Ibarra lifted Melinda out of the incubator and sat in a rocking chair, cradling her.

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Full ban on driver calls could be tough to enforce

WEST PALM BEACH, Fla. (AP) — A driver in the next lane is moving his lips. Is he on a hands-free cellphone? Talking to someone in the car? To himself? Singing along to the radio?

If lawmakers follow the advice of a federal board, police officers will have to start figuring that out — somehow.

The National Transportation Safety Board said this week that drivers should not only be barred from using hand-held cellphones, as they are in several states, but also from using hands-free devices. No more "Sorry, I'm stuck in traffic" calls, or virtually any other cellphone chatter behind the wheel.

Though no state has yet implemented such restrictive rules, the NTSB's recommendations carry weight that could place such language into future laws, or motivate the federal government to cut funding to states that don't follow suit.

Many of the men and women patrolling the nation's streets and highways wonder how they would sort the criminally chatty from the legally chatty.

"It would be almost impossible to determine if someone was talking on a phone or exercising their vocal cords," said Capt. Donald Melanson of the West Hartford, Conn., police department, which took part in a national pilot program aimed at cracking down on drivers' cellphone use. "That would be much more difficult to enforce, almost to the point where it would be impossible."

Officer Tom Nichols of the Port St. Lucie, Fla., police said a law written like the NTSB suggests would be difficult to enforce because so many variables would be at play.

"If you identify someone who has a hands-free set hooked up to their ear that doesn't mean they are talking on the phone," he said. "They could be talking to a passenger. They could be talking to a child in the back. They could be singing."

Police could end up turning to technology for help. They might even end up with the cellphone equivalent of a radar speed gun.

Fred Mannering, a Purdue University civil engineering professor who is associate director of the Center for Road Safety, said that since all cellphones emit signals, a simple Bluetooth detection device could spot them.

Computers are already common in patrol cars, and Mannering said a relatively cheap add-on could fit them to track cellphone signals.

"It would be really easy for police to have a computer on board and pick up those signals," Mannering said, "but it is sort of Big Brother."

The NTSB's proposal, announced Tuesday as a unanimous recommendation of its five-member board, urges all states to impose total bans except for emergencies. It cited deadly crashes caused by distracted drivers across the country, and noted that many studies have shown that hands-free cellphones are often as unsafe as hand-held devices.

The recommendation poses an astounding number of questions. What about chauffeurs and traveling salesmen who spend their entire day on the road? And roadside Amber Alert and Silver Alert notifications that implore drivers to call in if they spot a specific vehicle? What comes of phone lines dedicated to those "How's My Driving?" signs on trucks? How will you let someone know you're stuck in traffic?

Joe Schwieterman, a DePaul University professor who studies people's use of technology while traveling, said he can't envision a law so restrictive ever hitting the books because phone use has become commonplace for drivers. He called such an approach "draconian" and said that if such a law were passed, the public would despise it as "imperial overreach," then ignore it.

"It's a little like speeding laws where it will become just culturally acceptable to violate," he said. He said a no-call law would be followed only if violations carried stiff penalties like those for drunken driving.

Lewis Katz, a law professor at Case Western Reserve University, said a nationwide ban on using cellphones while driving would be wildly unpopular, and likely the target of legal challenges. But he believed such a law, and the methods police might use to enforce it, ultimately would be deemed as constitutional as seatbelt enforcement.

"I'm sure that it would be challenged on all sorts of constitutional grounds, including free speech," he said in a phone call from his car. "But it seems to me that it doesn't in any way infringe on any constitutional rights. It's a simple safety issue."

Whether the NTSB's recommendations will motivate decision-makers remains to be seen, but they have certainly caught their attention.

Transportation Secretary Ray LaHood, who has made combating distracted driving the signature issue of his tenure, stopped short of an endorsement. His department is separate from the NTSB.

"My focus is going to be on preaching to people: Take personal responsibility. Put your cellphone and your texting device in the glove compartment when you get behind the wheel of a car," LaHood told reporters at a news conference in Chicago. "You can't drive safely when you have your hand on a cellphone and are trying to drive a 4,000- 5,000 pound vehicle."

Florida House Speaker Dean Cannon, a Republican, said he was wary. His state is among those that have resisted passing laws restricting drivers' cellphone use.

Cannon said future technological advances may prove more effective than legislation at addressing driver distraction issues. As an example, he cited his new iPhone, which can make phone calls and send text messages via voice command.

"In these attempts to try and prevent every bad thing from happening," he said, "it's all too easy to overly restrict personal freedoms and individual rights and responsibilities."

Sheriff Ric Bradshaw, the top law enforcement official in Palm Beach County, Fla., said that if lawmakers take the NTSB's suggestions to heart, they should address all manner of distracted driving.

"I see women putting makeup on. I see a guy with an electric shaver. I see one woman with a newspaper. I see a guy with a dog in his hands. All of those are worse than texting," he said.

Monique Bond, a spokeswoman for the Illinois State Police, said training would be key to enforcing any ban. Officers are already looking for unbuckled seat belts and swerving drivers; they'd have to add to their mental checklists.

"It's something that is not insurmountable," Bond said. "How you're going to spot it, or how you're going to look for it — you have to acclimate the troops and acclimate the operations as to how to do this."

Chief Walter McNeil of Quincy, Fla., president of the International Association of Chiefs of Police, said enforcement of a total ban would be difficult, but that distracted driving needs to be addressed.

"We certainly need to deal with the overall problem with distracted drivers, and getting some level of uniformity in how we enforce that would be helpful," he said.

___

Associated Press writer Dave Collins in Hartford, Conn., contributed to this report.

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