Tiny fighter, extraordinary journey

After 125 days in Hoag’s neonatal intensive care unit (NICU), baby Annie was going home. For her parents, Marlee and Austin Ayers, the moment felt overwhelmingly joyous and surreal, and one that 17 weeks earlier, felt almost impossible. At just 24 weeks pregnant, Marlee went into labor. “In the car on the way to the hospital, we were trying to make sense of what was happening,” she says. “My baby shower was still weeks away. We hadn’t finished her nursery or settled on a name for her. There was still so much left to do.” They arrived at Hoag Hospital Newport Beach, where the care team determined Marlee was 4 centimeters dilated. She was admitted to Hoag’s antepartum unit, where patients with pregnancy complications receive specialized care leading up to delivery. Marlee was placed on bedrest and various medications to help prevent further labor and protect her baby’s brain and lung development. “Our only goal at that point was to stay pregnant as long as possible,” Marlee says. “Every hour mattered.” The medications postponed Marlee’s labor for one week, “but Annie was going to come when she was going to come,” she says. “One morning, I knew something wasn’t right. The nurse took one look and within seven minutes, I was in the operating room.” Marlee awoke from anesthesia to discover Annie had been moved to Hoag’s NICU. Born three months premature, she weighed just under two pounds. A ventilator enabled her breathing. “Given how early she had arrived, her survival wasn’t guaranteed, and that first week was so disorienting,” she recalls. “The neonatologists and respiratory therapists were honest when they shared that there would be many peaks and valleys in getting Annie to where she needed to be. But each provider would sit with us, answer every question, and continue to give us hope.” Through a multidisciplinary team of neonatologists and nurses, respiratory and occupational therapists, lactation consultants, social workers, and pharmacists— combined with ultramodern technology—Hoag’s Level III NICU provides advanced, around-the-clock care for infants born prematurely or with medical complications. Due to the fragility of their blood vessels, premature babies are at high risk for brain bleeds, which are one of the initial risks to development neonatologists look for. After careful evaluation, neonatologists determined Annie wasn’t suffering from any brain bleeds, an early milestone her mom attributes to the swift care, early interventions, and medications she received during labor. After a week of recovering from her cesarean and staying by their daughter’s side in the NICU, Marlee returned home with her husband while Annie remained at Hoag. “You have this movie playing in your mind of what bringing your new baby home is going to be like,” she says. “No one really talks about how strange it is to leave the hospital with an empty car seat.” To help her navigate the first few months of postpartum life while Annie was in the hospital, Marlee sought support from Nicole Young, a licensed clinical social worker with Hoag’s Maternal Mental Health program. “Nicole had so much experience with new moms who had been through this,” Marlee says. “She really understood the NICU and could comprehend the day-to-day nitty gritty we were going through, which was incredibly helpful.” And while many days and nights were spent next to the incubator that held their baby girl, the day Marlee and Austin longed for finally arrived. “Getting to hold Annie for the first time was such a win,” she says. “She was showing us what strength truly looked like.” Though it would take months, Annie continued to achieve milestones, like finishing a bottle of formula, and developing enough strength in her lungs to require less supplemental oxygen. “While most babies in the NICU only need one ventilator, Annie needed multiple ventilators before being able to breathe on her own, and Hoag had every single type available for her,” Marlee says. Since her discharge, Annie has been receiving follow-up care from neonatal experts through Hoag’s specialized development clinic to ensure she always hits her developmental milestones. Having recently celebrated her first birthday, the little girl is happy and thriving. In attendance were the nurses, as well as neonatologist Dr. Angela Noltemeyer, who cared for her during her NICU stay. “Annie is the strongest, most resilient little girl I know,” Marlee says. “We can’t wait to see what she does next.”

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