A Micro-preemie Grows Up and Gives Back

Seventeen-year-old Irika Katiyar is a fierce squash player, Bollywood dancer and singer. She plans to become a doctor after going to college. Looking back at the circumstances of her birth, her mother, Barkha Madan, calls this nothing short of “miraculous.”

Irika and her twin brother, Irith, were born at just 27 weeks’ gestation, weighing less than 2 pounds each. Barkha had a high-risk pregnancy, and so she was carefully followed at Lucile Packard Children’s Hospital Stanford. “I got attention immediately when something went wrong,” she says. Barkha’s doctors were able to stop her early contractions long enough to delay the babies’ birth for a crucial few weeks.

When a baby is born early, every week—every day—that the pregnancy can be extended means the baby has a better chance of avoiding significant medical issues. Barkha’s twins were micro-preemies, a term for babies weighing less than 1,000 grams or born before 28 weeks’ gestation. It’s common for babies this small to have challenges, ranging from the immediately life-threatening (needing help with breathing) to inconveniences (having to go slowly with increasing feedings), and Irika and Irith needed intensive care during their three-and-a-half-month-long stay in the Neonatal Intensive Care Unit (NICU).

“The concerns for Irika were the same as for any other tiny preterm baby: maintaining body temperature, establishing nutrition, supporting breathing, attending to any medical concerns, and looking out for complications of prematurity,” says Dr. William Benitz, her neonatologist. “At Packard Children’s, we do that well, and constantly work to do it even better. So she was the beneficiary of our many years of experience taking care of and finding ways to improve the care of babies like her.”

The twins managed to avoid major complications, despite needing heart surgery during their NICU stay, battling infections, and suffering setbacks. Barkha credits the NICU staff, which provides not only medical care but also developmental care to address complications of prematurity. “If it weren’t for Stanford’s NICU, we wouldn’t have kids today,” she says. The NICU team at Stanford Medicine Children’s Health includes doctors, nurses, respiratory specialists, physical therapists, a developmental specialist, a nutritionist, and family-to-family support.

During the extended hospitalization, Barkha and her husband didn’t know that things would turn out so well. They struggled with the knowledge that their babies were at high risk for a host of long-term problems, ranging from severe brain injury to developmental, vision, and hearing deficits. “The NICU stay was hard for us, with so many ups and downs,” says Barkha.

That’s why a surprise note of encouragement from a stranger meant so much. A 15-year-old girl, who had been born a micro-preemie herself, dropped off baby blankets and notes of encouragement to families, including theirs, in the NICU. The note about her current good health and happiness gave them great hope. “My mother always talks about this as one of the most uplifting moments of our stay at the hospital,” says Irika.

Sixteen years later, Irika was inspired to make a similar gesture when she came across the note, which her mother had saved. “I thought it was sweet how that girl took the time to give back like that and tell parents that a child with issues like mine could have a normal life,” she says. She met with Dr. Benitz to ask if she could make a similar gesture, and she landed on the idea of gifting a little book to the NICU families.

“I wrote and illustrated a rhyming baby book about premature babies in order to inspire families in situations like mine,” she says. She gave out copies to NICU families and to other grateful “graduates” at the 2019 NICU reunion party, which brings together NICU patients and their families, doctors, and nurses each year.

“Not long ago, most babies as small and immature as Irika did not survive,” says Dr. Benitz. “Our ability to support and rescue such tiny babies, and to have them come out as intact as she has, is a major achievement that has developed in the time since I started taking care of these babies 40 years ago.” This fact isn’t lost on Barkha for a minute. “I think all of these kids who come out of the NICU are born fighters,” she says. “I always tell my kids that it means they have big things to do in life. They are miracles, and they have miracles to create themselves.”

Visit our Facebook page to hear Irika tell her story.