Wearing a pink knit hat and wrapped in a pink princess blanket, Melinda Star Guido was greeted by a mob of television cameras and news photographers outside the Los Angeles County-USC Medical Center.
"I'm just happy that she's doing well," said her 22-year-old mother Haydee Ibarra. "I'm happy that I'm finally going to take her home ... I'm just grateful."
Melinda was born on August 30 weighing just 9.5 ounces (269 grams), less than a can of soda. She was so tiny that she fit into her doctor's hand. Melinda is believed to be the world's third-smallest surviving baby and second smallest in the U.S.
Now weighing 4.5 pounds (2.04 kilograms) and breathing through an oxygen tube as a precaution, doctors said Melinda has made enough progress to go home. Her brain scan was normal and her eyes were developing well. She also passed a hearing test and a car seat test that's required of premature babies before discharge.
It's too early to know how she will do developmentally and physically, but doctors planned to monitor her for the next six years.
"I am cautiously optimistic that the baby will do well, but again there is no guarantee," said Dr. Rangasamy Ramanathan, who oversees premature babies at the hospital.
Most babies as small don't survive even with advanced medical care. About 7,500 babies are born each year in the U.S. weighing less than 1 pound (0.45 kilogram), and about 10 per cent survive.
Melinda has come a long way since being delivered by cesarean section at 24 weeks after her mother developed high blood pressure during pregnancy, which can be dangerous for mother and fetus.
She was whisked to the neonatal intensive care unit where she breathed with the help of a machine and received nutrition through a feeding tube. Infants born before 37 weeks are considered premature.
Even after discharge, such extremely premature babies require constant care at home. Their lungs are not fully developed and they may need oxygen at home. Parents also need to watch out for risk of infections that could send infants back to the hospital. Even basic activities like feeding can be challenging.
"They may need extra help and patience while they learn to eat," Dr. Edward Bell, a pediatrician of the University of Iowa who runs an online database of the world's smallest surviving babies born weighing less than a pound.
The list features 130 babies dating back to 1936 and does not represent all survivors since submission is voluntary. Melinda was not eligible to be included until she was discharged.
Two years ago, Bell published a study in the journal Pediatrics that found many survivors have ongoing health and learning concerns. Most also remain short and underweight for their age.
There are some rare success stories. The smallest surviving baby born weighing 9.2 ounces (260 grams) is now a healthy 7-year-old and another who weighed 9.9 ounces (280 grams) at birth is an honours college student studying psychology, according to doctors at Loyola University Medical Center in Illinois where the girls were born.
Soon after birth, Melinda was treated for an eye disorder that's common in premature babies and underwent surgery to close an artery. Ibarra held Melinda for the first time after the operation in November. Her parents said the toughest part was battling traffic after work every day to see their daughter.
Registry: http://www.healthcare.uiowa.edu/tiniestbabiesSuggest a correction