World's Smallest and Youngest Preemies

Cases of Survival of Extreme Premature Infants

Haydee Ibarra, 22, covers her daughter Melinda Star Guido with her blanket as they leave the Los Angeles County-USC Medical Center January 20, 2012 in Los Angeles, California. Melinda Star Guido, the third smallest surviving baby known in the world, was born on August 30, 2011 weighing only 9.5 ounces.
Christina House-Pool/Getty Images

To someone who has never seen an extremely premature baby, it's hard to describe just how small these tiny miracles can be. The average baby born at 22 to 24 weeks gestation, the very earliest age of survival for preemies, weighs just over a pound at birth. The smallest surviving premature babies ever born weigh only about half that — around 8 1/2 ounces.

Approximately 15 million babies are born preterm, according to a 2012 report in Lancet. But the survival gap is getting wider between high versus low-income countries. In the United States, incredible advances in neonatal intensive care have allowed for the survival of smaller and younger babies.

The age of viability is usually considered to be 24 weeks of gestation, and that is the cutoff used when trying to save the life of a preterm infant. At that gestational age, studies have found a 26 to 44% chance of survival for babies born between 24 to 25 weeks.

For these babies to survive, they require access to many medical resources. They face high odds of having some level of learning disability or developmental impairments. They are also at increased risk of cerebral palsy, visual impairments, and hearing impairments.

The World's Smallest Preemies

These babies were some of the smallest to survive. The details of their births and survival give lessons on the risks and care needed for these babies.

Rumasia Rahman

Born September 4, 2004, Rumasia Rahman and her fraternal twin sister Hiba were born at 25.6 weeks gestation, just over 15 weeks before their due date. At birth, Rumasia weighed just 260 grams, or 8.6 ounces — about the size of a small cell phone. She was 9.8 inches long. Rumasia's twin sister Hiba was more than twice her size, at 1 pound 4 ounces and 12 inches long.

Rumasia and her twin were delivered early because their mom suffered from severe preeclampsia, which can cause babies to be smaller than average for their gestational age. Although she was very tiny at birth, Rumasia grew to be a normal school-age child. She had laser eye surgery for retinopathy of prematurity (ROP) and wears glasses, is smaller than other kids her age, and has mild motor delays, but shows no other long-term effects from her premature birth.

Melinda Star Guido

At the time of her birth in August 2011, Melinda Star Guido became the second smallest baby in the U.S. and the world's third smallest baby to survive long enough to leave the hospital. Melinda was born at 24 weeks because her mom had dangerously high blood pressure. She weighed just 9.5 ounces at birth.

She used supplemental oxygen at home to treat bronchopulmonary dysplasia (BPD) and had to have surgery to repair a patent ductus arteriosis (PDA) and laser eye surgery for ROP. Her brain is free from any bleeding from intraventricular hemorrhage (IVH), an excellent sign for her future. She went home after 16 weeks in the hospital, weighing 4.5 pounds.

"Tom Thumb"

Perhaps the world's smallest surviving baby boy is a German baby nicknamed "Tom Thumb" because his parents prefer to keep his identity secret. "Tom" was delivered in June 2009 at 25 weeks gestation. He weighed 275 grams, just over 9.7 ounces.

Madeline Mann

Born in 1989, Madeline Mann was the world's sixth smallest surviving preemie, born at 26.6 weeks gestation. Although she weighed just 280 grams at birth (9.9 ounces), Madeline is a healthy young woman who attended college. Although Madeline is only 4 feet 7 inches tall, wears glasses, and has asthma, she has no other long-term effects of her premature birth.

Kenna Moore

Kenna was smaller than a soda can when she was born on Jan. 9, 2012, at 9.6 ounces . She was born at 24 weeks in Charlotte, North Carolina after her mother suffered from high blood pressure. She came off her feeding and oxygen tube at the age of 3 and is a healthy, thriving little girl who wears glasses.

World's Youngest Preemies

The babies listed above have all had remarkable outcomes, and show no major developmental delays. It is important to note that these babies, although all very small, were all born at 24 weeks gestation or later. At such a young age, every day spent inside mom is very valuable and helped these babies to mature beyond their small size.

Medical science is improving all of the time, but babies born at 24 weeks or earlier are at risk for a number of long-term effects of prematurity.

The outcomes for micropreemies are not always as good as for those born later, even if they are smaller. There are always miracles, though, as proven by the world's youngest surviving preemies. A few 21-week gestation preemies have survived, including these two cases:

James Elgin Gill

James Elgin Gill, a Canadian man born at just 21 weeks 5 days in 1988, set a record when he was born for world's most premature baby. James was born so early that he was expected to die at birth or — if he survived — to have multiple and severe handicaps. James beat all of the odds, growing to be a healthy adult.

Amilia Taylor

American baby Amilia Taylor was born at 21 weeks 6 days in October 2006. Because Amilia was conceived by in vitro fertilization, her gestational age can be pinpointed exactly, an impossibility for most infants. Although she needed oxygen at hospital discharge, was anemic, and has mild osteopenia, she is otherwise healthy.

A Word From Verywell

The stories of these preemies may give you hope or solace if you have a pre-term infant or lost a child. Each case will be different, and medical care advances each year.

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  3. Chicago Tribune, "Tiniest baby thrives on her 1st birthday." Sep. 20, 2005

  4. Time, "Incredibly, World’s Tiniest Preterm Babies Are Doing Just Fine." Dec. 12, 2011

  5. ABC News, "Melinda Star Guido: California's Tiniest 'Miracle Baby' Goes Home." Jan. 21, 2012

  6. Los Angeles Times, "California's tiniest baby goes home from hospital." Jan. 20, 2012

  7. The Telegraph, "Premature baby 'Tom Thumb' born at 25 weeks weighing half a pound survives." March 5, 2010.

  8. The Associated Press, "Tiniest babies' stories called exceptions to the rule." Dec. 12, 2011

  9. ABC News,"One of World's Smallest Surviving Infants Goes Home." July 10, 2012

  10. WYFF, "World's 4th smallest baby is now 3-years-old and thriving." March 24, 2015

  11. Guinness Book of World Records 2010, Available at:

  12. The Guardian, "Against all odds." Feb. 21, 2007

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