‘I was mentally prepared to lose him’: Baby born at 23 weeks and less than a pound marks first birthday

Kane Nash arrived a year ago in Spokane. He was what specialists call a “micro preemie” – the tiniest of premature newborns.

Born at 23 weeks, Kane weighed 15 ounces and measured 10.5 inches long.

Before the July 9, 2023, cesarean section delivery at Providence Sacred Heart Children’s Hospital, parents Chris and Amber Nash heard the baby’s survival odds: a 21% to 26% chance.

Amber Nash had pre-eclampsia, a dangerous high-blood pressure pregnancy condition, threatening her and the baby. She asked Spokane neonatologist Dr. Lisa McGill-Vargas for just the facts: A preemie like Kane faced multiple medical issues and possible neurodevelopmental ones, because his organs hadn’t yet developed.

“Dr. McGill-Vargas said, ‘I’m going to be honest, although he’s 23 weeks, he’s measuring 21 weeks.’ That is how depleted my placenta was and not giving him what he needed,” said Amber Nash, 37. “She said, ‘I don’t know if we have a breathing tube small enough to fit.’

“I was mentally prepared to lose him.”

Specialists did get that tiny tube into Kane, who spent about two months on breathing ventilators. His first diaper had to be specially folded down because he was so small. During a six-month stay in Sacred Heart’s Level 4 neonatal intensive care unit, Kane also fought pneumonia, an intestinal disease, a brain bleed and other issues.

“His lowest weight was 410 grams, because he lost some weight at first,” Amber Nash said. “We couldn’t even touch him early because his skin was so fragile.”

But he’s continued to defy all the odds in the past year, upping the reasons for his 1-year-old birthday Tuesday. About 65 guests, both family and some of his Sacred Heart nurses and specialists, are expected to be at his party planned for the weekend. His parents were able to bring him home to their Blanchard, Idaho, residence just before Christmas.

These days, Kane is thriving. He’s vocal, rolling over and sitting up on his own. He still has a gastrostomy tube for feeding and does physical-speech therapy, but he’s otherwise healthy and is doing well developmentally.

“From 15 ounces to 15 pounds is basically what he did in a year,” said Amber Nash, who works for Northwest Specialty Hospital in human resources. His nickname is “tiny little chicken nugget.”

“He’s got a clean bill of health; He’s got signed off by the cardiologist, by the pulmonologist, by neurology, by the eye doctor. Literally, it’s just a G-tube. That’s it. That’s unheard of.”

Kane also was a surprise a year ago in another way; that’s because Amber Nash had ovarian cancer with a 10-pound tumor at age 19 and was told having a child was unlikely.

In March 2023, while at a doctor’s office for stomach problems, she learned she was pregnant.

During Kane’s stay in the NICU, Amber stayed at his bedside and took some respite to sleep at the nearby Ronald McDonald House. Chris Nash came up often for long weekends, around work and care for his other son, Aiden, who is now 14. The couple, married since 2014, have raised Aiden together.

When Kane was born, Chris Nash recalls watching people surround their baby to get a tube in for breathing.

“When he came out, they put him on a cart to get his tube in, and he was already trying to move his hands and trying to bat at them,” Chris Nash said. “It felt like a long time, but it was probably minutes. I was laser-focused on them. So as they gave me the thumbs-up, that’s where I broke down.”

From the start, Kane was active and feisty, said McGill-Vargas, Sacred Heart’s NICU medical director and neonatologist with Pediatrix Neonatology of Eastern Washington since 2016. Pediatrix provides neonatologists to NICUs across the United States.

She wasn’t on duty for Kane’s delivery but did provide care throughout his stay.

“He came into the world tiny but mighty,” McGill-Vargas said. “I think his story is so special because we have a mom who didn’t think she’d ever have an opportunity to get pregnant. Then she shows up unfortunately part way through her pregnancy with some real complications, and now this miracle pregnancy is really threatened.

“Across the country, the odds are against him. Over 50% of babies that tiny don’t make it to hospital discharge and don’t make it home breathing on their own – smiling, laughing, interacting and just truly doing really well.”

When McGill-Vargas finished her fellowship in 2014, the cutoff to offer the earliest premature care was at 24 weeks, when breathing support could be effective. With advances in medical equipment and premature care, “we now offer resuscitation down to 22 weeks,” she said.

“In Spokane, we do see 22 and 23 weekers,” McGill-Vargas added. Although Kane was 23 weeks and six days gestationally at birth, that’s still considered a “periviable period” where even in Level 4 NICU care, “still a lot of those babies don’t survive. They’re just too premature.

“I can’t speak enough to the involvement of his parents. His mom was in that NICU every single day (except) the only day she missed was the day when she had gallbladder surgery herself. They’re just amazing parents who fought for their baby.”

At delivery, early preemies will have significant breathing issues and need an endotracheal tube for a ventilator, McGill-Vargas said. In early preemies, the lung is still developing alveoli, the very small air sacs where the exchange of oxygen and carbon dioxide takes place.

“Another one of the discoveries that has really helped with survival is a medicine called surfactant that goes in the breathing tube and goes to the lung, so Kane got it right away and was placed on a ventilator,” she said.

Kane was at high risk for electrolyte abnormalities and low sugar levels, so he had a tight schedule to get fluids, and “total parenteral nutrition,” for a balance of protein, carbohydrates and fats as a model for steady growth.

“We know that when a baby is in the womb, they gain weight at about 20 grams a day on average,” McGill-Vargas said. A small amount of breast milk also goes into that preemie nutrition and is slowly increased. Because Amber Nash had an early double mastectomy because of her cancer risk, she said donor breast milk was used.

Chris Nash said the Sacred Heart staff kept them calm. “You show up with a bunch of questions. They had answers or rebuttals for everything, just for peace of mind and for me to understand that they really know what they’re doing.”

His wife also credits being surrounded by help.

“We’re just so grateful for the support at the hospital, from the staff, from Ronald Mcdonald house, from my work, from our friends. Without all that, we probably wouldn’t have had the best outcome.”

Today, Kane still has issues with taking food by spoon, which is why he’s working with a speech therapist, Amber Nash said. He’s slowly eating some solid foods, though. And there will be birthday cake to demolish.