“Nash is pure joy in a tiny package”: Most premature baby born 19 weeks early turns one – Guinness World Records

Case Report: Neonatal Survival and Progress in the Context of Sustainable Development Goals

Case Summary: Patient Nash Keen

This report details the case of Nash Keen, a patient who holds the record for being the most premature baby to survive. The case highlights significant advancements in neonatal intensive care and underscores the importance of integrated health systems in achieving positive health outcomes.

• Patient: Nash Keen
• Initial Status: Extreme prematurity
• Duration of Intensive Care: Approximately six months in a Neonatal Intensive Care Unit (NICU).
• Discharge Date: Early January 2025
• Current Status: Discharged and demonstrating consistent developmental progress with ongoing medical support.

Advancements in SDG 3: Good Health and Well-being

The survival and subsequent development of patient Nash Keen serve as a significant case study for progress towards United Nations Sustainable Development Goal 3, particularly Target 3.2, which aims to end preventable deaths of newborns and children under 5 years of age.

1. Reduction of Neonatal Mortality: The successful outcome for a patient born under such extreme circumstances demonstrates the capacity of modern medical interventions to drastically reduce neonatal mortality rates. Dr. Amy Stanford noted that this case is “paving the way for the care of other babies born as early as he was,” indicating a direct contribution to improved healthcare protocols.
2. Access to Quality Essential Health-Care Services: The patient’s continued progress is contingent upon a comprehensive support system that aligns with SDG Target 3.8. This includes:
   • Supplemental oxygen
   • Enteral feeding via a feeding tube
   • Auditory support with hearing aids
   • Enrollment in a specialized medical daycare for therapy and monitoring
   • Regular follow-up appointments with a multidisciplinary care team

The Role of Strong Institutions and Reduced Inequalities (SDG 16 & SDG 10)

The case underscores the critical role of strong, effective, and inclusive institutions (SDG 16) in providing the high level of care necessary for such outcomes. The University of Iowa Health Care NICU exemplifies an institution capable of delivering complex medical services, thereby contributing to the reduction of health inequalities (SDG 10).

• Institutional Capacity: The NICU provided a comprehensive care environment that, as described by the patient’s mother, Mollie Keen, involved treating the patient “like one of your own” and including the family “every step of the way.” This indicates a holistic, patient-and-family-centered approach that is a hallmark of a strong healthcare institution.
• Advocacy and Resilience: The medical team’s dedication, as articulated by Dr. Stanford, to “keep advocating for our patients and their families, even in the most challenging circumstances,” reflects an institutional commitment to equitable health outcomes and resilience. The family’s determination is cited as a source of inspiration for the medical staff.

Multi-stakeholder Partnerships for Sustainable Development (SDG 17)

The success of this case is a testament to the power of partnerships, a core principle of SDG 17. A collaborative network involving the medical team, the family, and the community was essential for the patient’s journey.

1. Medical-Family Partnership: The family reported that the medical staff became “our people, our family.” This deep collaboration between healthcare providers and recipients is a model for effective, patient-centered care that is fundamental to achieving health-related goals.
2. Community and Societal Support: The family received extensive support from friends, the local community, and the wider public. This broad base of support highlights a societal partnership in fostering well-being and providing encouragement to families navigating difficult medical challenges.
3. Dissemination of Knowledge and Hope: By sharing their story, the Keen family aims to “give hope to other families” and “show what’s possible.” This act of public communication contributes to a wider societal understanding and supports a culture of hope and resilience, aligning with the collaborative spirit of the SDGs.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The entire article is centered on the health and survival of Nash Keen, the world’s most premature baby. It details his journey from the Neonatal Intensive Care Unit (NICU) to his ongoing medical needs and development. The narrative highlights the critical role of advanced medical care, specialized therapies, and a dedicated healthcare team in ensuring the survival and well-being of a highly vulnerable infant. This directly aligns with the core objective of SDG 3, which is to ensure healthy lives and promote well-being for all at all ages.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.

   The article is a case study in achieving this target. Nash’s survival as the “most premature baby” is a testament to medical advancements that prevent neonatal death even in the most extreme circumstances. The story of his survival and subsequent progress, as Dr. Stanford notes, is “paving the way for the care of other babies born as early as he was,” directly contributing to the knowledge and practices that reduce neonatal mortality.

2. Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

   The article extensively describes the high-quality, essential healthcare services Nash received. This includes months of care in a specialized NICU, ongoing support such as oxygen, a feeding tube, and hearing aids, and access to a “specialized medical daycare” where he receives therapies. The regular check-ups with his care team at University of Iowa Health Care further exemplify access to quality and continuous healthcare, which is a cornerstone of this target.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. Indicator 3.2.2: Neonatal mortality rate.

   While the article doesn’t provide statistical rates, Nash’s survival is a direct, qualitative data point for this indicator. His story as a record-breaking survivor demonstrates a successful outcome in preventing neonatal death, which is what this indicator measures. The fact that his case is “history in the making” implies it sets a new benchmark for survival, impacting future mortality rates for extremely premature infants.

2. Indicator 3.8.1: Coverage of essential health services.

   The article provides a detailed, qualitative list of the essential health services provided, which can be used to measure the coverage and quality aspect of this indicator. Specific services mentioned include:

   • Specialized care in a Neonatal Intensive Care Unit (NICU).
   • Post-discharge medical support (oxygen, feeding tube, hearing aids).
   • Access to specialized medical daycare.
   • Provision of multiple therapies.
   • Regular follow-up appointments with a specialized care team, including neonatologists.

   These services represent a comprehensive package of care for a high-need patient, illustrating a high level of service coverage.

SDG Analysis Table

Source: guinnessworldrecords.com