What is the youngest baby born and survived?

Babies born extremely prematurely face significant health challenges and uncertainty about their survival and long-term outcomes. Medical advancements have enabled progressively younger preterm infants to survive over time. The current record holder for the youngest premature baby to survive is a girl born in 2020 at just 21 weeks and 1 day gestational age. She weighed 245 grams (8.6 oz) at birth, breaking the previous record of 21 weeks and 2 days set in 1987. While her survival is extraordinary, most babies born so early do not make it. This article will explore the science behind viability at the edge of life, profile the youngest surviving babies, and examine their outcomes.

What is the earliest a baby can be born and survive?

The current limit of viability – the gestational age at which a premature baby has a 50% chance of survival with intensive medical care – is approximately 24 weeks. However, there have been rare exceptions of babies surviving at younger gestational ages of 21-22 weeks. The factors that enabled their survival will be discussed later in this article. At less than 23 weeks gestation, a baby has extremely underdeveloped lungs and other organ systems that are not equipped to support life after birth. But with intensive treatment in a neonatal intensive care unit (NICU), some are able to defy the odds.

Who is the youngest premature baby to ever survive?

The current Guinness World Record holder for the world’s most premature baby to survive is a girl born in 2020 at Children’s Sharp Hospital in San Diego, California. She was born at just 21 weeks and 1 day gestational age. Her estimated due date was December 8, 2020, but she was delivered via emergency C-section on June 1, 2020 after her mother experienced medical complications. At birth, the baby girl weighed only 8.6 oz – lighter than a large apple.

Profile of World’s Youngest Surviving Premature Baby

Here are more details on the world’s most premature surviving baby:

  • Date of Birth: June 1, 2020
  • Gestational Age at Birth: 21 weeks, 1 day
  • Birth Weight: 245 grams (8.6 oz)
  • Length at Birth: 25 cm (9.8 inches)
  • Gender: Female
  • Location: San Diego, California, USA
  • Days in NICU: 165
  • Discharged from Hospital: October 6, 2020

At her birth in June, doctors gave her less than a 1% chance of survival. But after nearly five months in the NICU, she was able to go home when her original due date would have been. Doctors and nurses cared for her for 165 days in the NICU, providing oxygen support, nutrition through an IV, and monitoring her around the clock.

Previous Record Holders for Youngest Premature Babies

Before the 21-week baby was born in 2020, the youngest premature baby to survive was born in 1987 in Florida. That baby girl was born at 21 weeks and 2 days gestational age. Until the 2020 baby broke the record, this girl held the record for 33 years. Here are the details on the previous record holder:

  • Date of Birth: May 20, 1987
  • Gestational Age at Birth: 21 weeks, 2 days
  • Birth Weight: 25.9 oz (710 grams)
  • Gender: Female
  • Location: Florida, USA

In 2014, a baby boy in Alabama survived after being born at 21 weeks and 4 days. He weighed 14.9 oz at birth. These three cases represent the earliest viable births ever recorded.

Current Limit of Viability

While babies have survived at 21-22 weeks gestational age, these cases are extremely rare exceptions. The current medical consensus is that the limit of viability – the gestational age at which premature babies have a reasonable chance of survival with intensive care – is approximately 24 weeks. According to the American College of Obstetricians and Gynecologists, below 23 weeks gestation, survival rates drop off steeply compared to each additional week beyond 23 weeks.

Here are some statistics on survival rates at various gestational ages:

Gestational Age Percentage of Survival
23 weeks 15-27%
24 weeks 40-70%
25 weeks 50-80%
26 weeks 80-90%
27 weeks Over 90%

As can be seen, at 23 weeks gestation only around 1 in 4 babies survive. But by 24 weeks, survival jumps to 40-70% with proper medical care.

Challenges Caring for Extremely Preterm Babies

Babies born at less than 23 weeks face enormous challenges and risks to survival:

  • Underdeveloped lungs – The lungs are one of the last organs to develop in utero and remain immature at extreme prematurity. Babies born so early often struggle to breathe and survive without intensive breathing support.
  • Higher risk of infant respiratory distress syndrome – Related to undeveloped lungs, premature babies have higher rates of respiratory illness.
  • Greater risk of serious infections – The underdeveloped immune system cannot fend off infections, which can rapidly become life-threatening.
  • Difficulty regulating body temperature – Lack of fat and skin immaturity make temperature regulation extremely difficult.
  • Higher likelihood of heart problems – The circulatory system is immature, and heart problems like patent ductus arteriosus are more common.
  • Greater chance of neurological complications – The brains of extremely preterm babies are highly vulnerable to bleeding and damage.
  • Higher rates of necrotizing enterocolitis – This serious intestinal condition is a major cause of mortality in premature infants.
  • Difficulty feeding and gaining weight – Weak sucking reflexes and coordination to swallow and breathe make feeding a challenge.

With intensive round-the-clock monitoring and interventions, some extremely preterm babies can overcome these hurdles, but many do not survive.

Medical Advances Enabling Young Premature Babies to Survive

The survival of premature infants at 22 weeks and younger represents major medical achievements. Some key interventions and technologies that have enabled more viability at extreme prematurity include:

  • Improved ventilation techniques – Gentler ventilators with sensors reduce risk of lung injury.
  • Less invasive surfactant administration – Surfactant lines the lungs and improves breathing but used to require intubation.
  • Prenatal steroids – Steroids given before birth speed up fetal lung maturation.
  • Better lung protective strategies – Techniques like continuous positive airway pressure (CPAP) are less invasive.
  • Enhanced nutrition and feeding methods – Providing vital nutrients intravenously and better feeding tubes.
  • Advanced neonatal intensive care units – Whole teams specializing in premies provide coordinated, data-driven care.
  • New medications and therapies – Inhaled nitric oxide improved outcomes as have antifungals and other drugs.
  • Better understanding of complications – Enables preventative and proactive interventions.

These major medical advances developed over recent decades have enabled more micro preemies born at the edge of viability to survive. However, outcomes remain very precarious at these early gestational ages.

Outcomes for Extremely Premature Babies Who Survive

Premature babies who survive being born at less than 23 week gestation face ongoing risks and potential long-term effects:

  • Higher risks even after going home – Vulnerability to infections, rehospitalizations, and SIDS remain elevated.
  • Increased chance of chronic lung disease – Many will require oxygen support for months or years.
  • Greater likelihood of long-term breathing problems – Such as asthma, sleep apnea, and respiratory infections.
  • Higher rates of neurological complications – Such as developmental delays, cerebral palsy, and learning disabilities.
  • Vision and hearing problems – Retinopathy of prematurity can cause blindness while ear immaturity may require tubes.
  • Behavioral, social, emotional issues – Attention deficits, autism spectrum, and mental health issues are more likely.
  • Growth and nutrition concerns – Failure to thrive, short stature, and metabolic issues may persist.

However, outcomes are highly variable for micro preemies. With early intervention services and supportive care, many can go on to lead relatively normal lives without severe long-term health issues. But ongoing vigilance is necessary.


The current record holder for the world’s youngest premature baby to survive was born at an extremely early 21 weeks and 1 day gestation. Prior to recent medical advancement, viability this early in pregnancy was unheard of. While this baby beat the odds, most infants born at less than 23 weeks do not survive. At the edge of life, essential organ systems are too immature. But with intensive NICU support, especially targeted lung maturation and stable respiration, a small percentage are able to overcome the challenges. More research into how we can continue pushing the limits of viability while optimizing long-term outcomes remains urgently needed. Extremely premature babies who beat the odds face ongoing risks developmentally, medically, and neurologically. However, some go on to live fairly typical lives. The extraordinary cases of 21-week preemies surviving gives hope for incremental improvements in care for these tiny fighters.

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