Little Emma finally will be going home

Perhaps the footprints say it all.

Smaller than her mother's thumb, the ink-stained impression of baby Emma's feet hangs inside her room at Evergreen Hospital Medical Center in Kirkland.

It's a touching but stark reminder for David and Elena Lamb, who still get chills remembering that day in April when their daughter was born at 25 weeks and just 15.4 ounces, a weight low enough to rank her barely above the world's tiniest babies.

How long they've waited to take her home. Four hospitals in five months; too many specialists to count. But finally, the end is in sight. Thursday, nurses laid Emma in a car seat for an hour to make sure her vitals would be stable enough for the ride home to Woodinville. After passing the test, doctors said Emma will be ready to leave by next week. She's now 8 pounds, 4 ounces.

"We've been on some journey, haven't we?" Elena whispered to Emma, holding her close in the neonatal intensive-care unit (NICU).

With medical and technological advances, doctors can deliver babies at 25 weeks, and in some cases, even sooner, said Susan Hasty, nurse manager for Evergreen's NICU.

But a baby weighing in at less than a pound is remarkable.

"It's really rare," she said. "You always remember that baby."

Babies are considered premature when they are delivered before 37 weeks. Nearly a half-million babies in the United States were born prematurely in 2003 — a 33 percent increase since 1981, according to the March of Dimes. Advanced maternal age, infections and high blood pressure are some risk factors, but in 40 percent of all cases, the cause is unknown.

The University of Iowa keeps a registry of the world's smallest babies known to have survived since 1936. There are 90 listed, with birth weights ranging from nine to 14 ounces.

Emma Lamb was born April 13 by C-section. She was so tiny, and her pale skin so translucent, "you could see right through her," said Pam Gunderson, a family friend.

For a while there, it was touch-and-go. Emma developed a tear in her bowel, and her weight dropped to 12 ounces. Cataracts clouded her eyes, and a vein in her heart was open.

The Lambs and their friends prayed she would survive. Holy Family students in Kirkland recited the rosary for Emma over the intercom.

"There is a purpose for little Emma," said family friend Gisele Matthews. "There is a reason why she is here."

The Lambs never thought they would have children. Doctors had told Elena she wasn't able to conceive, given her history of polycystic ovarian disease, a condition in which cysts grow on the ovaries and reduce a woman's chances of conceiving.

The couple eschewed fertility treatments and considered adoption. Then in November, just after their ninth wedding anniversary, Elena discovered she was pregnant at age 36.

Everything was going great. She was eating, walking, working. But in mid-March, during her second trimester, doctors noticed a spike in her blood pressure. An ultrasound revealed that the placenta and Emma were dangerously undersized.

As the days passed, Elena's blood pressure rose while Emma's heart rate dropped, so doctors at the University of Washington Medical Center decided to deliver the baby.

David watched as the delivery team hunched over Emma, compressing her chest. She'd stopped breathing.

"The doctor was just turning to me, gaining composure to say they'd tried everything they could, when she started breathing again," said David, 35.

Emma lay for days under the protective cover of an Isolette, and Elena didn't get to hold her until 16 days after she was born. The new mother worried about bonding, that her baby wouldn't know her.

Those fears are gone now. It will take time to see what long-term effects Emma's early delivery will have on her development. Doctors predict it will take Emma about four to five years to catch up to other kids her age, growth-wise.

But on Thursday, the family nestled together in the hospital room, and Elena turned to looked at those tiny footprints on the wall.

Soon this memento will be packed up, as the Lambs embark on the journey they've been waiting for — parenting.

Sonia Krishnan: 206-515-5546 or skrishnan@seattletimes.com