Tiny baby gets help in overcoming health odds

PHOENIX (AP) High-tech medical technique and cooperation between hospitals came together to save the life of tiny Madeline Mosqueda, who was born at 28 weeks, weighing 1 pound 5 ounces.

Her hand was so tiny, it would slip through her mother's wedding band.

She struggled with a host of problems: a hole in her heart, breathing and digestive difficulties, and a bleeding in her brain before she was born. "She had a lot of odds against her," said Dr. Stephen Pophal, chief of pediatric cardiology at the Scott and Laura Eller Congenital Heart Center at St. Joseph's Hospital and Medical Center in Phoenix.

The world of modern medicine melded with old-fashioned cooperation to save the infant's life.

Madeline is one of 0.5 percent of babies born in the U.S. weighing between 1.1 and 2.2 pounds, according to the National Center for Health Statistics.

Pophal went to Chandler Regional Hospital to visit Madeline where she was born and where she stayed for 31/2 months. He also kept track of her through telemedicine, which allowed him to read her tests long distance. She had electrocardiograms, ultrasounds, chest X-rays and echocardiograms, especially important for patients with a hole in the heart.

"It's a matter of being able to read (the test) within a minute of when it's done," Pophal said. "It's essentially almost a live broadcast of the information, as opposed to having the doctor come in and log in, which could mean hours of delays."

The drama began when Rebecca Mosqueda of Chandler was 28 weeks' pregnant and suddenly developed HELLP syndrome, a life-threatening complication.

Madeline's due date had been Feb. 1, but she was born by emergency Caesarean section on Nov. 15. She was 12 inches long.

"She was teeny, tiny thing," her mother recalled.

A decade ago, an infant in Madeline's condition likely would not have survived, Pophal said.

"We're calling her a miracle baby; maybe she would have been a miracle baby a decade ago, but 20 or 30 years ago, no way."

Madeline was too small to tolerate open-heart surgery, so she stayed in Chandler while she gained weight.

The infant was small for her gestational age. She was on oxygen, was fed with a tube and was given nearly a dozen medicines.

Since she lived in an incubator, her parents couldn't cuddle her.

Finally she was transferred to St. Joseph's where she underwent surgery March 4, when she weighed 6 pounds 9 ounces.

She went home March 25 but stayed on oxygen another month.

She now weighs 11 pounds, and there's a possibility she will need another heart operation, but for now "she's doing a million times better," Rebecca said.

Rebecca is a music therapist who works with children with special needs, and her husband, Brian, is an eighth-grade social-studies teacher at Santan Junior High School.

Madeline is the first grandchild on both sides of the family.

"She's a happy girl," Rebecca said. "She looks around, and now she's able to go out of the house for a little bit."

Rebecca said the baby received a lot of love and support from family and church.

And the infant is being looked in on by staff from the Arizona Early Intervention Program at the state Department of Economic Security.

The program is a system of supports and services for families of children from birth to 3 years old with developmental delays or disabilities.

Dr. James Zozobrado, chairman of Chandler Regional's department of pediatrics, said Madeline's prognosis is good.

"All our tests right now ... look very, very hopeful," he said.

Cathy Best, a registered nurse who cared for Madeline, said the baby was alert.

"As she got older, she still needed oxygen, but it didn't stop her from interacting and growing. . . . She'd respond to voices, and if you'd talk to her, she'd pay attention. . . . She still has that cute smile."

The infant was able to stay close to family in Chandler because in August, the medical center was designated a Level II-EQ nursery by the nonprofit Arizona Perinatal Trust, which means the hospital can care for babies born as young as 28 weeks' gestation.

The designation is a result of having the trained personnel and the ability to provide such services as mechanical ventilation and pressurized oxygen, said Deb Christian, the trust's executive director.

Doctors say Madeline benefited from a good working relationship between medical professionals at the two hospitals, which are part of Catholic Healthcare West.