At 3 1/2 Pounds, a Tiny Miracle Is Going Home

He’s lighter than a small sack of sugar and can stretch out in a shoe box. But 3-month-old Ethan Sechrest is finally going home today, one of the smallest babies to ever survive a premature delivery.

Ethan was born 14 weeks early at Saddleback Memorial Hospital in Laguna Hills, weighing 14.3 ounces--a little more than a can of soda. He has since quadrupled his weight into a comparably hefty 3 pounds, 8 ounces, and leaves the hospital with a remarkably clean bill of health, which neonatologists at several California hospitals say is rare.

Most babies born at 26 weeks weigh nearly twice what Ethan did, experts said.

“It’s the first time I’ve ever taken a baby from the operating room to the warmer by cupping it in the palm of one hand,” said neonatologist David L. Vogel, who helped deliver Ethan by caesarean section March 14. “His whole foot was like the size of my fingertip. You just step back and look at him and you can’t believe it. And I was supposedly prepared for what his size would be.”

Ethan’s mother, Deann Sechrest, was 24 weeks pregnant when she was admitted to Saddleback two weeks before his birth. Babies born at 24 weeks usually have a 50-50 chance of survival. The usual pregnancy lasts about 40 weeks.

Worried perinatologists tried to stave off delivery as long as possible. Ethan was exceptionally small and underdeveloped and they wanted to give his tiny organs more time to mature. Doctors determined that Ethan was so little because his mother’s placenta wasn’t functioning properly and the baby wasn’t getting enough nourishment. The result, perinatologist James T. Kurtzman said, was a complete loss of amniotic fluid.

“It was like he was wrapped up in Saran wrap,” Kurtzman said. “There was no room for him in there, and he certainly couldn’t get the food and support he needed.”

All too familiar with the challenges facing a baby that size, doctors twice told Deann and Alan Sechrest that they should be prepared to discontinue life support after Ethan was born.

The Sechrests refused to consider the odds, focusing instead on their faith and the doctors to whom they had entrusted their son.

“We just wanted them to do whatever they needed to do to get him born,” said financial analyst Alan Sechrest, 36. “Everyone kept going back and forth, ‘Will he be better in there or out here?’ And we didn’t want to second-guess ourselves about anything. It was awful. We prayed and prayed.”

Kurtzman suggested an unusual procedure called amnio instillation, which involves injecting fluid into the placenta, which in Deann’s case was only about the size of a silver dollar. It required guiding a needle through her stomach and into the womb, without hitting the baby, but once Kurtzman found the mark and plunged the fluid in, “it was like [Ethan] started dancing,” said his father, who watched the procedure on a monitor.

“I’ve never seen anything so incredible,” he said. “He started kicking and moving his arms all around. . . . It was like he had a whole new lease on life.”

Ethan was born 10 days later, red and squirming and with his eyes wide open, which encouraged his team of doctors, even as they wondered how his fragile body could possibly sustain him in the days to come.

“I called him the pocket baby, because he could fit in the front pocket of my scrubs,” said obstetrician Daniel R. Sternfeld, who helped deliver Ethan and the Sechrest’s two older children, now 4 and 2. “His chances were so dismal. As a doctor, you know this. As a father, you hope for a miracle.”

Little Ethan surprised even the most veteran doctors with his resilience. He didn’t wait for the ventilator tube to be removed from his throat; he turned his head one day and disconnected it, just like that.

His tiny heart--barely the size of his father’s thumb--was strong and steady, and he had no problems with his kidneys or liver, a blessing his doctors attribute to those precious 10 days after the fluid injection. In early May, he underwent laser eye surgery, which doctors hope will correct an eye disease common to underdeveloped infants that otherwise would have left him blind.

“We’ve never seen a baby this size,” said Dr. Ronald Naglie, who oversees the intensive care unit at Saddleback. “Then to watch him get stronger every day and hang in there like he did. . . . It was truly amazing. He defied all odds. And just look at him--he’s huge now.”

Ethan is not the smallest baby ever to survive. Long Beach Memorial Hospital delivered a 14-ounce boy at about the same gestational age who is now is 3 years old. However, it is highly unusual for such an undersized and underdeveloped fetus to survive, neonatologists said.

“This is an unusual baby,” said Dr. Sally Sehring, professor of pediatrics at the UC San Francisco Medical Center, which has one of the oldest neonatal intensive care programs in the nation. “We have about 1,000 admissions a year, and we probably have one birth at less than 500 grams a year. And of those, not many have survived.” Ethan weighed 405 grams.

Officials at Mattel Children’s Hospital at Los Angeles and Cedars-Sinai Medical Center agreed, adding that they have never seen a baby as small as Ethan survive at 26 weeks’ gestation.

Naglie and his team of doctors gathered Friday to say goodbye to Ethan and his parents, who were learning how to work the breathing monitor they will be taking home with their son today--a full week before his original June 16 due date.

“He’s been through so much, you just can’t imagine,” said Deann Sechrest, who chose the name Ethan because it means “strong.”

“He may be tiny, but there’s nothing small about his spirit,” she said.