23-Week Pre-Term Baby Survives 104-Day NICU Battle at Pune Hospital
A male baby, born at just 23 weeks of pregnancy on October 1, 2025, at Surya Mother and Child Super Speciality Hospital, Pune, weighing only 670 grams, about the size of a papaya, has completed an intense and closely monitored 104-day journey in the Neonatal Intensive Care Unit (NICU) of the hospital.
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With organs that were still developing, the newborn needed immediate ventilator support, surfactant therapy to help the lungs function, and continuous care from the neonatal team from the very first hours of life. According to doctors, this was an extremely high-risk start to life.
“At 23 weeks, a baby is still in the early part of the sixth month of pregnancy, and the lungs are only beginning to produce surfactants, the substance that helps keep the lungs open. That is why breathing support becomes one of the first and most urgent needs in babies born this early,” said D. Sachin Shah, director of Neonatal and Paediatric Intensive Care services at Surya Mother and Child Super Speciality Hospital, Pune.
“In this case, the baby was intubated at birth, shifted to the NICU, and managed with ventilator support and two doses of surfactant.”
India has the highest number of preterm births in the world, with an estimated 3.5 million cases each year, and babies born this early make up only a very small fraction of that burden.
One challenge after another
For this baby, the challenge was not only being born too soon but staying stable through one complication after another.
According to Dr Shah, during his NICU stay, he developed a fungal bloodstream infection caused by Candida albicans, chronic lung disease, neonatal jaundice, anemia of prematurity, early-stage necrotising enterocolitis (a critical intestinal disease in premature infants), neonatal CMV infection (transmitted from mother to fetus and a leading cause of nonhereditary hearing loss and neurodisabilities), and retinopathy of prematurity(caused by abnormal blood vessel growth in the retina).
“Because his skin was still very immature, even basic handling had to be modified. In the first week, the baby developed peeling skin over the chest. The team used specialised wound care, silicone tape instead of regular adhesive tape, and protective dressings over pressure points such as the knees, buttocks, and elbows. He was also cared for in a humidified incubator designed to recreate a womb-like environment as closely as possible,” Dr Shah explained.
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The baby received prolonged respiratory support, antifungal medication, phototherapy for jaundice, blood transfusions and supportive medicines for anaemia, insulin for high blood sugar, IV fluids, antibiotics, and carefully paced nutrition through tube feeds before oral feeding could begin.
Infection control was a major part of care throughout. The baby was managed with a 1:1 nursing ratio, minimal handling, scheduled line and syringe changes, low-light, low-noise care, and careful head positioning. For the first seven days, even sponging was avoided to protect the skin barrier. The incubator was changed every 14 days, and essential lines and syringes were changed every 24 hours.
‘Smiling, recognising mother’
“The baby is now on oral feeds, including breastfeeding, and when he came for review in the last week of February, he had achieved normal weight gain. He is smiling, sucking and swallowing well, showing neck movements, and recognising his mother. For a baby born at 23 weeks, these are deeply reassuring milestones,” he added.
Dr Amita Kaul, HOD and senior consultant Paediatrics at Surya Mother and Child Super Speciality Hospital, Pune said, “At this gestation, survival depends on hundreds of small decisions made correctly, every single day. It is not one intervention, but the discipline of intensive neonatal care that makes the difference. This case reflects the kind of steady, high-alert care that extreme prematurity demands.”
