Fragile beginnings: Inside a premature baby's fight for survival
In a remarkable instance of medical precision, innovation, and care, Jaslok Hospital and Research Centre in Mumbai has successfully treated a 30-week-premature infant born with low birth weight and a life-threatening congenital condition called Tracheo-oesophageal Fistula (TEF). With a survival rate of less than 50% in such high-risk cases, this milestone achievement is a testament to coordinated paediatric care, cutting-edge neonatal surgery, and multidisciplinary teamwork.advertisementA RARE AND COMPLEX START TO LIFEThe baby, born prematurely in Vapi, Gujarat, weighed only 1.3 kg at birth and was diagnosed with Type C Tracheo-oesophageal Fistula—a condition where the food pipe (oesophagus) and windpipe (trachea) are abnormally connected. This causes choking, excessive salivation, and lung infections. The condition required urgent medical intervention.The parents contacted Dr Fazal Nabi, Director of Paediatrics at Jaslok Hospital, who personally travelled to Vapi to oversee the safe transfer of the baby to Mumbai, ensuring continuous artificial ventilation and expert monitoring during transport.IMMEDIATE CARE IN THE PAEDIATRIC ICU
Upon arrival at Jaslok Hospital's Paediatric Intensive Care Unit (PICU), the infant was placed on ventilator support. Stabilisation included haemodynamic management, inotropes to support the heart and blood pressure, and aggressive infection control measures.Dr Fazal Nabi led the intensive care, preparing the fragile infant for critical surgery. "Every hour mattered. The risks were high, but early intervention was the only chance," he recalled.advertisementBy Day 3, the baby was stable enough for surgery. Dr. Nargish Barsivala, Consultant Paediatric Surgeon, performed a one-stage corrective procedure involving the ligation of the fistula and end-to-end oesophageal anastomosis.'Surgery on such a tiny patient is extremely high risk—the tissues are delicate, and precision is everything,' said Dr Barsivala. The operation was successful, but challenges continued post-surgery.TACKLING POST-SURGICAL DIGESTIVE CHALLENGESDespite successful correction of the TEF, the infant's digestive tract, underdeveloped due to prematurity, posed further complications. The intestines weren't moving as expected, and the baby couldn't swallow adequately. Feeding was managed via a nasogastric (NG) tube alongside partial Total Parenteral Nutrition (TPN).After a month, when swallowing issues persisted, the team decided to perform a Feeding Gastrostomy—a surgical insertion of a feeding tube into the stomach, allowing more effective and comfortable nutrition delivery.A DELICATE OESOPHAGEAL DILATATION PROCEDUREThe turning point came with an extremely delicate oesophageal dilatation to resolve narrowing in the oesophagus. Dr Pankaj Dhawan, Consultant Gastroenterologist, performed the high-risk procedure using the smallest dilator available.The operation required seamless coordination between the surgical team, anaesthesia support, and the PICU. Gradually, the baby began swallowing independently, allowing for the removal of feeding tubes.Mrs. Trupti, the infant's mother, shared, 'My baby was born after 8 years of marriage through IVF. To see him survive such odds feels like a miracle. I am forever grateful to the doctors at Jaslok for treating him like their own.'TEAMWORK, TECHNOLOGY, AND TENACITYadvertisementDr Milind Khadke, Chief Medical Officer at Jaslok Hospital, highlighted the broader significance of the case: 'This is more than just a successful surgery—it's an example of what's possible when medical expertise meets compassionate care and advanced technology. It marks a rare achievement in neonatal surgery in India.'EMPOWERING THE FAMILY FOR HOME CAREAs the baby, now weighing 1.8 kg and breastfeeding independently, prepares to go home, the Jaslok team is guiding the family on post-discharge care. This includes safe feeding techniques, medication protocols, and early warning signs to monitor for possible complications.This extraordinary case underscores the vital role of specialised neonatal surgery, early intervention, and coordinated hospital care in improving survival outcomes for premature infants with rare conditions. Thanks to the expertise at Jaslok Hospital, one more child is headed home healthy, and one family is whole again.Must Watch
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