neonatal growth

Drive-by shooting robbed baby of more than just its mother

The person who fatally shot a pregnant Toronto woman on the weekend robbed her prematurely delivered baby of more than just a mother — also gone are the child’s best chances for a healthy life.

Candice Rochelle Bobb, 35, was killed Sunday in a drive-by shooting while riding in the back seat of a car. Her baby boy was delivered by emergency caesarian section, then transported to the trauma centre at Sunnybrook Hospital, where he remained in stable condition Tuesday.

Doctors have the immediate challenge of keeping the baby alive.

The infant’s exact gestation period was unconfirmed but estimated at five months. Babies born between 22 and 26 weeks are classified as “extremely pre-term” or micro-preemie. Babies born at under 22 weeks are the most fragile of all, and have an extremely low rate of survival, according to the Canadian Neonatal Network.

If they do survive, micro-preemies face a much higher risk of chronic lung disease, intracranial (inside the skull) bleeding and an eye condition called retinopathy of prematurity, which can cause blindness, says Dr. Michael Narvey, section head of neonatology at the Children’s Hospital Research Institute of Manitoba.

The infant will usually spend the first five or six months of its life in hospital, likely needing help to breathe and eat.

In any event, it takes more than just feeding tubes and ventilation machines to sustain a baby’s development: what micro-preemies need most is a parent, according to experts.

They need contact, and especially skin-to-skin contact with their mother — so-called kangaroo care (KC), which has been shown to improve the baby’s breathing and sleep, helps stabilize the baby’s heart rate and seems to reduce pain. The Canadian Paediatric Society strongly encourages such skin-to-skin care.

“The effects of KC are dramatic and effective,” Narvey says on his blog, All Things Neonatal.

It “improves infant growth, breastfeeding and mother-and-infant attachment, which won’t happen here,” Narvey says.

It’s unclear whether the father of Bobb’s baby, or another family member, is available to step in.

But nothing can replace all the benefits — like increased immunity and resistance to infection — that come from a mother’s own milk, something that’s even more crucial for babies born prematurely than those born full-term.

Higher risk, but also hope

Down the road, extreme pre-term babies are at higher risk of cognitive, behavioural or physical impairment. One study published earlier this year in the journal Pediatrics found that more than half of infants born at under 28 weeks gestation went on to have “moderate or severe” cognitive deficits.

However, research conducted at Ottawa Hospital and the Children’s Hospital of Eastern Ontario suggests Bobb’s baby could still have a good outcome.

Of babies born at under 26 weeks gestation, the majority survive “free of disabilities or with what we would view as minor disabilities,” says Dr. Brigitte Lemyre, a neonatal ICU doctor at both hospitals who was involved in the study.

“Contrary to popular view, it’s not the majority of children born extremely premature that are severely disabled; it’s the minority,” she told CBC News. “The majority actually do well and thrive and have a very good quality of life, according to their parents and themselves when they grow up.”

It’s impossible to predict the long-term outcome of such an inauspicious birth.

“There are examples of babies who have done phenomenally well, who have no problem whatsoever, who were born at the extremes of gestation,” Narvey says. 

Officials at Sunnybrook Hospital declined on Tuesday to provide any updates on Bobb’s baby.