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, considered the very earliest age of survival for preemies, weighs just over a pound at birth. The smallest surviving premature baby ever born weighed only about half of that, at just 8.6 ounces.

Approximately 15 million babies are born preterm, according to a 2012 analysis published 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 more often than not, is the cutoff used when trying to save the life of a preterm infant. In 2007, research published in the Journal of Medical Ethics observed 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 impairment. They are also at increased risk of cerebral palsy, visual impairments, and hearing impairments.

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.

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. 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. Her brain is free from any bleeding from intraventricular hemorrhage (IVH), an excellent sign for her future. After more than 16 weeks in the hospital, Melinda finally went home 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 born at 26 weeks. Today she is the world's fourth smallest surviving preemie. 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, N.C., after her mother suffered from high blood pressure and pre-eclampsia. After 183 days in the hospital, Kenna went home with a feeding and oxygen tube, and is now a healthy little girl.

World's Youngest Preemies

The babies above have all had remarkable outcomes, and show no major developmental delays. It is important to note that these babies, although they were all very small, were born at 24 weeks gestation or later. At such a young age, every day spent inside the womb 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 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 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. Each case will be different, and fortunately, medical care advances each year.

Was this page helpful?
Article 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. Allyn B. Saybie, Born at 8.6 Ounces, Is Now Believed to Be the World's Tiniest Surviving Baby. National Public Radio, May 29, 2019.

  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. Biemer J. Tiniest baby thrives on her 1st birthday. Chicago Tribune. September 20, 2005.

  9. Malone T. Chicago Tribune. Years later, tiniest U.S. babies mature into typical kids. December 12, 2011.

  10. Teoh S, Chin L, Menon V, et al. World records in obstetrics and gynaecology.

     J Obstet Gynaecol. 2006;26:(7):607-611. doi:10.1080/01443610600889769

  11. Marra A. Melinda Star Guido: California's Tiniest 'Miracle Baby' Goes Home. ABC News. January 21, 2012.

  12. Tumposky E. Tiny Melinda, One of World's Smallest Newborns, Beating Odds, Might Go Home Soon. ABC News. December 15, 2011.

  13. California's tiniest baby goes home from hospital. Los Angeles Times. January 20, 2012.

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

  15. Rochman B. Incredibly, World’s Tiniest Preterm Babies Are Doing Just Fine. TIME. December 12, 2011.

  16. Tiniest babies' stories called exceptions to the rule. Herald Tribune. December 12, 2011.

  17. Carollo K. One of World's Smallest Surviving Infants Goes Home. ABC News. July 4, 2012.

  18. Kenna Moore, Baby Born Smaller Than A Soda Can, Goes Home From Hospital. HuffPost. Updated July 16, 2012.

  19. Guinness World Records 2010. New York: Bantam Books.

  20. Moorhead J. Against all odds. The Guardian. February 21, 2007.

  21. 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

Additional Reading