World's Smallest and Youngest Preemies

Cases of Survival of Extremely 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

If you've never seen an extremely premature baby, it's hard to describe just how small these tiny miracles can be. Between 22 and 24 weeks gestation is considered the very earliest age of survival for preemies. These preemies weigh an average of just over a pound at birth. Incredibly, though, the smallest surviving premature babies weigh only about half of that, around 7.5 ounces.

Approximately 15 million babies are born preterm, according to a 2012 analysis published in Lancet. Of those that are born before 28 weeks, many do not survive. Those that do face high rates of disability and other medical complications. The survival gap between high versus low-income countries is getting wider. 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. More often than not, this is the cutoff used when trying to save the life of a preterm infant. Research published in the Journal of Medical Ethics observed a 26% to 44% chance of survival for babies born between 24 to 25 weeks. However, depending on the circumstances, some babies born before 24 weeks also may survive, although the chances are even lower.

For these babies to survive, they require access to many medical resources. They face high odds of having some level of disability or developmental impairment, such as cerebral palsy, visual impairment, hearing impairment, or cognitive delays.

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.

Kwek Yu Xuan

In June 2020, at 24 weeks pregnant, Wong Mei Ling of Singapore had to have an emergency Caesarean section due to preeclampsia, a life-threatening form of high blood pressure that can happen during pregnancy. Doctors expected the baby to weigh around 1.5 pounds. Instead, the baby girl, Kwek Yu Xuan, weighed only 7.5 ounces.

After 13 months of intensive neonatal care, this baby went home weighing about 14 pounds. The medical professionals who cared for the baby at the hospital had to improvise when taking care of Yu Xuan as many of their normal tools and techniques were too big for the baby's small body. Yu Xuan continues to have problems with her lungs that require being on a ventilator but is otherwise doing well.

Baby Saybie

Born at just 23 weeks and 3 days, in December 2018, Baby Saybie beat the odds. She weighed just 8.6 ounces and was 9 inches long, making her one of the tiniest babies known to have survived. To put her tiny size in perspective, she weighed about as much as a large apple.

Baby Saybie (who also had to be delivered early due to preeclampsia in her mother) is unusual in that she experienced very few of the medical complications many micro-preemies tend to have, such as issues with their lungs, heart, and brain. Her NICU team called her progress miraculous.

Today, despite being small for her age, Baby Saybie continues to thrive with few known medical issues. She is now living at home with her family in California.

Rumaisa Rahman

Born September 19, 2004, Rumaisa Rahman and her fraternal twin sister Hiba were born at 25 weeks and 6 days gestation, about 15 weeks before their due date. At birth, Rumaisa weighed just 8.6 ounces (244 grams)—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.

Rumaisa 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 (as can being a twin). Rumaisa had laser eye surgery for retinopathy of prematurity (ROP) and wears glasses. Though she is smaller than other kids her age, she shows no other long-term effects from her premature birth.

Melinda Star Guido

At the time of her birth on August 30, 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 developed high blood pressure during her pregnancy. She weighed 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. In the months after her birth, her brain ws free from any bleeding from intraventricular hemorrhage (IVH), an excellent sign for her future. After more than 16 weeks in the hospital, Melinda went home weighing 4.5 pounds.

"Tom Thumb"

One of the world's smallest surviving baby boys at the time of his birth is a German baby nicknamed "Tom Thumb," because his parents prefer to keep his identity private. "Tom" was delivered in June 2009 at 25 weeks gestation. He weighed 275 grams, just over 9.7 ounces. "Tom" is notable because most of the other very small babies who have survived are girls.

Madeline Mann

Born in 1989, Madeline Mann was born at 26 weeks. Today, she is still one of the world's smallest surviving preemies. Although she weighed just 9.9 ounces (280 grams) at birth, which was a world record at the time, Madeline became a healthy young woman who attended college. Madeline is short in stature, wears glasses, and has asthma, but has no other long-term effects of her premature birth.

Kenna Moore

Kenna Moore was smaller than a soda can when she was born on January 9, 2012, at 9.6 ounces. She was born at 24 weeks in Charlotte, North Carolina. after her mother suffered from high blood pressure and preeclampsia. After 183 days in the hospital, Kenna went home with feeding and oxygen tubes and is now a healthy little girl.

World's Youngest Preemies

The babies above have all had remarkable outcomes, and many show few major developmental delays. It is important to note that these babies, although they were all very small, were born at 23 weeks gestation or later. At such a young age, every extra day spent inside the womb is very valuable and helped these babies to mature beyond their small size.

James Elgin Gill

James Elgin Gill was born in Ottawa, Ontario, on May 20, 1987, around 128 days early or 21 weeks gestation. He set a record when he was born for the 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.

Amillia Taylor

Miami-born Amillia Taylor was born at just under 22 weeks gestation in October 2006. Because Amillia was conceived by in vitro fertilization (IVF), her gestational age can actually be pinpointed exactly. Although she needed oxygen at hospital discharge, she is otherwise healthy today.

A Word From Verywell

The stories of these preemies may give you hope or solace if you have a pre-term infant or are a risk for pre-term labor and delivery. While, sadly, all preemies will not have the positive outcomes of those listed above, some will. Each case will be different, and fortunately, medical care advances each year, giving greater hope for the survival of more premature babies.

22 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Smith PB, Ambalavanan N, Li L, et al. Approach to infants born at 22 to 24 weeks' gestation: Relationship to outcomes of more-mature infants. Pediatrics. 2012;129(6):e1508-16. doi:10.1542/peds.2011-2216

  2. Rysavy MA, Li L, Bell EF, et al. Between-hospital variation in treatment and outcomes in extremely preterm infants. N Engl J Med. 2015;372(19):1801-11. doi:10.1056/NEJMoa1410689

  3. Taylor A. Tiny baby in Singapore, just 7.5 ounces, does home after 13 months in hospital. Washington Post.

  4. Blencowe H, Cousens S, Oestergaard MZ, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162-72. doi:10.1016/S0140-6736(12)60820-4

  5. Kinney MV, Lawn JE, Howson CP, Belizan J. 15 Million preterm births annually: what has changed this year?. Reprod Health. 2012;9:28. doi:10.1186/1742-4755-9-28

  6. Brazier M, Archard D. Letting babies die. J Med Ethics. 2007;33(3):125-6. doi:10.1136/jme.2006.020099

  7. Glass HC, Costarino AT, Stayer SA, Brett CM, Cladis F, Davis PJ. Outcomes for extremely premature infants. Anesth Analg. 2015;120(6):1337-51. doi:10.1213/ANE.0000000000000705

  8. Chiu A. 'She's a miracle:' Born weighing about as much as 'a large apple,'Saybie is the world's smallest surviving baby. Washington Post.

  9. Biemer J. Tiniest baby thrives on her 1st birthday. Chicago Tribune.

  10. Malone T. Years later, tiniest U.S. babies mature into typical kids. Chicago Tribune.

  11. Muraskas JK, Rau BJ, Castillo PR, Gianopoulos J, Boyd LAC. Long-term follow-up of 2 newborns with a combined birth weight of 540 grams. Pediatrics. 2012;129(1):e174-e178. doi:10.1542/peds.2010-0039

  12. Marra A. Melinda Star Guido: California's tiniest 'Miracle Baby' goes home. ABC News.

  13. Tumposky E. Tiny Melinda, one of world's smallest newborns, beating odds, might go home soon. ABC News.

  14. California's tiniest baby goes home from hospital. Los Angeles Times.

  15. Hall A. Premature baby 'Tom Thumb' born at 25 weeks weighing half a pound survives. The Telegraph.

  16. Rochman B. Incredibly, world’s tiniest preterm babies are doing just fine. TIME.

  17. Tiniest babies' stories called exceptions to the rule. Herald Tribune.

  18. Carollo K. One of world's smallest surviving infants goes home. ABC News.

  19. Kenna Moore, baby born smaller than a soda can, goes home from hospital. HuffPost.

  20. Guinness World Records 2010. Bantam Books.

  21. Moorhead J. Against all odds. The Guardian.

  22. Lawn JE, Davidge R, Paul VK, et al. Born too soon: Care for the preterm baby. Reprod Health. 2013;10(Suppl 1):S5. doi:10.1186/1742-4755-10-S1-S5

By Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia.