Defying the Odds: Baby Oliver's 130 Days in the NICU

Maddie and her husband, Craig, were elated to learn they were pregnant with their first child. At around five weeks, Maddie went to WakeMed Obstetrics & Gynecology - Brier Creek for prenatal care. The first two visits were exciting for the young couple. 

Maddie recalls, "Our son had a strong heartbeat in his first ultrasound. We got to see it, and everything was measuring really great."

During the 18-week anatomy scan at Maternal Fetal Medicine - Raleigh Medical Park, they learned their son's femur was measuring below average. 

"It was below the first percentile, so it gave him an estimated fetal weight below the third percentile."

Emily Willner, MD, FACOG, their maternal fetal medicine doctor, informed them that since measurements are so tiny early on, small differences in the measurements can have a big impact on overall size. To check again, she had them return at 21 weeks. 

Maddie shares, "It was really scary to think something could be wrong."

At 21 weeks and four days, they learned he was measuring small all over at 294 grams when he should have been around 450 grams; he was growth restricted. He also had abnormal blood flow in the umbilical cord, which meant the placenta wasn’t functioning normally. Placental insufficiency was limiting his growth and making his body work harder to retrieve nutrients from the placenta.

"He wasn't viable yet," shares Maddie "which was a terrible word to hear."

Because the baby was only 21 weeks and so small, medical staff needed a bit more time to intervene. Dr. Willner urged the couple to return at 24 weeks, so they could do another assessment of his growth. 

At 24 weeks, he was still measuring small, but he was viable because he needed to be 400 grams, and he was measuring at 403 grams.

A Wait and See Admission at WakeMed Raleigh Campus

At that point, Dr. Willner admitted Maddie to WakeMed Raleigh Campus where they performed 20-minute nonstress tests on their baby's heart — three times per day. This helped the team determine if he was thriving in utero. They soon learned he had reversal of blood flow in the umbilical cord between heart beats, which meant he had to work even harder to get oxygen and nutrients from the placenta, and it was causing him fetal distress. 

Placental insufficiency also caused Maddie to have high blood pressure, putting her health at risk as her body worked overtime to support her baby. Neonatologist James Perciaccante, MD, discussed these findings with the couple and helped them understand Oliver's upcoming NICU stay.

Dr. Perciaccante explains, "We talked about how the placental insufficiency was affecting his ability to get nutrients and oxygen, and he was, therefore, struggling to grow. At 24 weeks and 400 grams (~14 ounces) the odds of surviving were almost insurmountable, but if he somehow managed to hold on for a couple more weeks before the placental insufficiency began to affect his heart rate, he would have a real shot at survival."

The team determined they needed to deliver him at 26-weeks gestation.

Maddie remembers, " It was a very stressful and difficult 18 days — though the hospital staff was wonderful."

Reflections on a Life-Saving Heart Monitor Extension

On the day he was delivered, August 11, 2023, Maddie had been kept on the monitor longer than usual. Nurses monitored at 9:00 am, 3:00 pm, and 9:00 pm. That particular morning, they kept Maddie on the monitor an additional two minutes because the nurse was busy with another patient. That two minutes saved her son's life. 

Maddie smiles, "The nurse was reaching to take me off the monitor, when he had a very small deceleration, so the nurse said, 'I'm so sorry. You've got to stay on for another hour.' At around 10 am, he had a very big deceleration where his baseline heart rate went from about 150 to 60, and it stayed for about four minutes."

Dr. Willner reviewed the monitor and determined he would need to be delivered in that moment by emergency caesarean section. She performed Maddie's surgery. 

Maddie shares, "Dr. Willner came in and said, 'You're about to be really popular.' I said, 'Okay.' Suddenly, all these doctors and nurses came in and prepped me."

Baby Oliver: A Born Fighter

Baby Oliver was 10 inches long and weighed 15.5 ounces (440 grams) at birth, which is less than a pound. He was taken to the neonatal intensive care unit (NICU) immediately after birth on August 11 and remained there until his discharge on December 19.

Oliver was diagnosed with issues with adrenal gland functioning. A nasogastric tube was used to deliver maternal milk feedings, while his system was underdeveloped. Oliver eventually had a surgical gastrostomy tube placed prior to his discharge to ensure he would receive adequate nutrition at home, while he continued to work on his oral feedings. 

He also had chronic lung disease and anemia of prematurity. Steroids helped support his lung development. He was also intubated for about seven weeks because he had to be extubated and reintubated twice. 

Since the couple would spend so much time at the NICU, nurse Sam gave the couple a NICU tour, served as a member of Oliver's care team and assured them that Oliver was in the best of hands.

"We really appreciated the tour and the care she gave our son."

Sam adds, "Their story is a piece of why I love my job. After touring them through the NICU, to introduce them to their "home" for the few months, it has been such a joy to get to know Maddie and Craig and to watch Oliver grow." 

Before Oliver was able to come off of the jet ventilator, WakeMed neonatologist Tara Bastek, MD, made sure the couple held their son when he was two weeks old. A few days later, when he was switched from the jet ventilator to a traditional ventilator, nurse practitioner Mary Elizabeth, supported them in that first experience of kangaroo care (skin-to-skin care between a baby and loved one). Respiratory therapists Christina, Janna and Blair ensured Oliver was breathing during the transition from his isolette to Maddie's arms.

"They made sure I got to hold him that first time. It was amazing to see his little face up close."

Oliver had a pulmonary hemorrhage when he was just two days old, and the care team, led by nurse practitioner Holly Wells, saved his life. Despite concerns for the worst outcome, Oliver pulled through. 

Maddie says, "He's the toughest kid I know. He has spent his entire life defying odds."

WakeMed Team Honoring Individualized Care Over Data

With his many medical conditions, the chances for survival were low, but WakeMed's care team was determined to provide him the highest level of care.

Maddie recalls, "Dr. Bastek shared, 'I don't care about statistics. I don't care whether his chances are 50 percent or 5 percent. I care about this baby right in front of me.'"

This outlook helped shaped the couple's approach to their son's tumultuous survival experiences, where one day he was fine and another, he was fighting a life-threatening situation. 

Yet, the couple confronted their fears. Craig was hopeful and optimistic though he did tear up the day he witnessed his son's hemorrhage. Maddie battled anxiety and asked lots of questions, experiencing an especially tough day about a month into his NICU stay. 

"A NICU nurse saw me crying and brought me a box of tissues. That was my first experience of their empathetic care. They were just incredible."

Maddie also reflects on the wonderful impact of husband Craig's support. 

"I'm just 34, so a lot of my friends are pregnant. They are having baby showers, pregnancy photoshoots and other celebratory experiences. I missed all of that. Craig was very much a positive presence, helping me navigate that grief."

Though Maddie missed some pregnancy milestones with friends, her WakeMed care team made an effort to celebrate each of Oliver's accomplishments and experiences, including his first kangaroo care, his first poop, his removal from the ventilator and more. With each new skill, they informed and encouraged the couple, giving them hope.

Jen Peterson, MD, medical director for the WakeMed NICU, personally cared for their son in the NICU on a weekend that Maddie and Craig decided to go away for a much-needed reset.

"We were so grateful for this, and for all the time we spent there. The care team, including neonatologist Laura Edwards, MD, took time sitting with us, talking to us, laughing with us and crying with us. Somehow, they did the same for all the other babies and families too."

On the day of Oliver's discharge, nurse Megan gave the couple a doll the size of Oliver when he was born as a memento of his progress and resilience in the face of nearly impossible odds.

"To this day, we take a picture of him next to it each week to show how much he has grown."

Neonatologist Stephen DeMeo, DO, discharged Oliver. He'd been a familiar face throughout their stay.

"He admitted Oliver to the NICU and discharged Oliver on his last day. He also came in after my caesarean-section and told us they were able to intubate Oliver. We'd been worried he'd be too small and that the breathing tubes would be too big. Dr. DeMeo will forever be special to us because he got our boy breathing."

A First Birthday That Gave Love Back

The couple was elated to celebrate Oliver's first birthday. They didn't want a traditional cake smash, especially since Oliver would not be able to indulge. Instead, they made an Amazon wish list of treats, which they circulated to friends and family. They separated those treats into 50 little gift bags, consisting of a book, a journal, a gift card, snacks and toiletries and took them to the NICU to give to families.

"One of the things I remember wanting during our stay was a toothbrush, toothpaste and a comb. Since we couldn't always hold Oliver, we also relished reading books to him."

They also put together gifts for the care team, filling plastic drawer units with snacks, lip moisturizer and other small items. This helped Maddie associate their stay with the positive outcomes they'd achieved.

Reflections on the Best Care Team

Maddie glows, "Oliver was a very popular boy at the NICU. He had a few primary nurses, including Courtney, Katie, Olivia and Caroline. Probably 200 took care of him, and they made every single parent and patient feel like the most important one there."

Katie adds, "As one of Oliver's primary nurses, it was such a privilege to get to know him and his parents. They were there every single day, providing hours of kangaroo care, which really helped Oliver do so well."

Maddie has since become good friends with their nurse practitioner, Holly Wells, who saved Oliver's life after his hemorrhage.

"She just refused to give up on him," explains Maddie. "Now that the trouble is behind us, I asked her to be blunt about what she expected from his time in the NICU. She shared that data showed he had only a 15 percent chance of viability, but she ignored the odds."

Wells' continues, "This is the most incredible family who I am now honored to call friends! They so graciously thank me every day for taking care of Oliver, but what they don’t know is that being part of Oliver’s life fills my bucket in ways I didn’t even know I needed!"

Oliver's Life Today

Oliver is a bubbly, cooing baby. He adores and recognizes his family.  

Oliver is seen by WakeMed Children’s – pediatric cardiologist, Jennifer Whitham, MD, for a heart defect. 

"She's wonderful," Maddie notes. 

He also sees WakeMed Children’s – pediatric pulmonology team. Oliver was removed from oxygen in April 2024 and is now breathing on his own.

"Oliver is crushing it," says Maddie.

Oliver also has regular visits with WakeMed Children's – Pediatric Primary Care, WakeMed Physical Therapy (for feeding intervention), WakeMed Children's – Pediatric Surgery (for care of his gastrostomy tube and nutrition evaluation), speech therapist Juliet for bottle feeding therapy, several lactation consultants for nursing and more. 

He also sees neonatal/pediatric dietitian Karen, who is thankful to be part of Oliver's journey: 

"I feel lucky that I have had the opportunity to take care of Oliver — both in the inpatient and outpatient settings. I met Oliver and his parents early in his NICU stay, and now I follow him to monitor his growth and adjust his gastrostomy tube feedings at home. It's been rewarding to watch him grow and thrive over the past year."

"She has helped him grow," Maddie shares with a smile. "We see the light at the end of the tunnel, so now we get to encourage other parents starting this journey."

Dr. Willner asserts, "Maddie and Craig brought Oliver by the MFM office recently, and it warms my heart to see how Oliver is thriving. He was so small when he was born and had a lot of hurdles to overcome. The NICU team has done an amazing job of helping Oliver and his family. Seeing his success reinforces the work we do on a daily basis, helping families navigate complicated pregnancies."

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About WakeMed Level IV NICU

WakeMed’s highly specialized Level IV Regional NICU offers:

• 48 patient beds, including 27 single private rooms and eight rooms that accommodate multiples (twins and triplets)
• Full-time neonatologists – Specialists in the care of critically ill babies
• Full-time perinatologists – Specialists in treating high-risk pregnancies
• A team of neonatal, pediatric and family practice nurse practitioners
• Highly skilled neonatology staff, including pediatric psychologists, child development specialists, speech-language pathologists, registered nurses and PhD-level physical therapists
• Lactation consultants
• WakeMed Mother’s Milk Bank – Direct access to one of the few human milk donation programs in the country and the only one in the southeast
• Special Infant Care Program for outpatient follow-up 
• Special neonatal delivery team 
• Dedicated neonatal respiratory therapists

About WakeMed Maternal Fetal Medicine

Our multidisciplinary team of maternal fetal physicians, genetic counselors, sonographers and nurses provides a wide range of specialized services for women who have a high-risk pregnancy. You can rely on the expertise and experience of our team — which includes 9 board-certified Fetal Echocardiography sonographers — to provide you the best quality care. This includes women who are at increased risk for genetic disorders due to advanced maternal age or family history, women who are experiencing or have a history of pregnancy complications and women with preexisting medical conditions that might adversely affect a pregnancy outcome.

About WakeMed Obstetrics & Gynecology

At WakeMed Obstetrics & Gynecology, we provide a full range of services for women of all ages in Raleigh, Cary, Clayton, Holly Springs, North Raleigh, Brier Creek and Morrisville, North Carolina.

Our specialties include:

• Prenatal Counseling
• Low- and High-Risk Pregnancies
• Infertility
• General Gynecological Health
• Gynecological Surgeries, including Laparoscopic Surgery
• Maternal-Fetal Medicine
• Urogynecology
• Pre-Menstrual Syndrome and Other Menstrual Problems
• Endometriosis
• Menopause
• Urinary Incontinence