At just 19 months old, little Curtis Means has already secured a place in the record books. Though he wasn't due to be born until the fall of 2020, the infant arrived that July — a staggering 132 days early — and beat the odds to become the world's most premature baby to survive — a distinction certified by Guinness World Records.
As Curtis's mom, Michelle Butler, tells Yahoo Life in the video above, she was just 21 weeks and one day into her pregnancy with him and his twin sister, C'Asya, when she went into premature labor on July 5, 2020. Though she'd so far had an uneventful pregnancy — and had carried her two older children to full term, or 40 weeks — Butler was considered high-risk due to having twins. As such, Butler's doctor was quick to act when the expectant mother started feeling like something was wrong with the pregnancy. The issue turned out to be a bulging amniotic sac, necessitating an emergency cerclage procedure, or stitch, that reinforces the cervix. But after being discharged, Butler would soon find herself being once again admitted to the University of Alabama at Birmingham Hospital (UAB) as she started having contractions on the drive home.
"It's too early. I ain't ready," she remembers thinking at the time. Though she understood that it was unlikely she'd go full-term with twins — less than half of twin pregnancies reach 37 weeks — she says she "was never expecting to go straight into labor at five months."
The premature labor also presented Butler's medical team with a huge challenge. Dr. Brian Sims, a professor of pediatrics in the UAB Division of Neonatology and the neonatologist on call at the time, tells Yahoo Life that "survival increases with gestational age." He notes that 22 weeks was the earliest age the hospital's Regional Neonatal Intensive Care Unit (RNICU) had previously seen up to that point. This prompted a difficult conversation with Butler, whose twins had less than a 1 percent chance of survival.
"The main conversation that we have with Mom at this age is: Just based on the numbers, those babies do not survive," Sims says. "So Mom and I had to have that conversation that based on ... the evidence in hand ... there were no babies [at that gestational age] that had survived. And that was a true statement, but, you know, it's a tough thing to have to talk to a mom about, that the baby has little to no chance of surviving."
Despite the grim prognosis, Butler was determined to "keep on having faith." Though the RNICU offers compassionate care — in which parents spend time holding their babies rather than having doctors try more aggressive resuscitation efforts — Sims says she told him she wanted to at least give her babies a chance.
Curtis was the first to be born, measuring in at just 15 ounces and 11 inches long; sister C'Asya weighed 14 ounces and measured 10 inches long. While C'Asya "responded minimally" to treatment and, as Sims notes, "acted more like a baby at 21 weeks that was pre-viable" — as in, too premature to survive — her brother showed more promise.
"We gave him a little bit of oxygen to see what his lungs were going to do, and Curtis literally was trying to breathe immediately," Sims recalls. "He was taking some breaths on his own ... and his oxygen numbers were improving the more he tried to breathe. That shows that the lungs are functioning. And with that information, we gave him a little more support and he again demonstrated that he was responding positively. ... Basically, he escalated things to the point that we gave him a chance, because he showed us that he was trying as well."
He adds that "just with a few breaths, we could tell that Curtis was different." Sims stresses that babies can respond in hugely different ways, citing how Curtis's own twin, C'Asya, unfortunately did not pull through. The tiny girl died overnight.
Butler says she prayed as her daughter's condition worsened. She recalls a vision from God, who "came to me in the room and told me 'if you give me C'Asya I'll let you keep Curtis.' So it was a hard pill to swallow, and I swallowed it and I gave him C'Asya at about 3:41 in the morning and he let me keep Curtis."
Curtis's own fight was far from over, however. He continued to receive care for months through UAB's Golden Week Program treating premature infants, all as a pandemic raged on. Butler says her face mask was her "next best friend" as she took precautions when visiting her son, finally getting to hold him when he was 4 weeks old. Golden Week's treatment places priority on skin-to-skin contact, something Sims notes is "critical for development" for babies this age.
At 3 months old, Curtis's breathing tube was removed, a milestone Sims sees as a turning point in his recovery. For the preemie to be able to breath on his own showed a remarkable lung capacity, he says, adding that, "within a short amount of time, he was able to show us that he was bigger and stronger than we expected."
While there were also "bad days" when his mom wondered if he'd make it, Curtis was ultimately able to finish his 275-day stay and "graduate" from the RNICU on April 6, 2021 — one day after he turned 9 months old. Though he still has health challenges and delays — including taking medication for hypertension, being on oxygen, using a gastrostomy, or G-, tube for feeding and requiring on-demand feeds every three hours to build up his calorie intake as an underweight child — Butler sees him now as a regular kid who loves FaceTiming and is learning to master pulling up.
"Curtis's personality is one of a kind," she says as her "happy baby" merrily babbles next to her. "From the day he was born, he told his life story and his goals that he's trying to accomplish. He's doing it. He's doing it on his time, but we're getting there."
—Video produced by Stacy Jackman.
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