SURVIVAL OF THE LITTLEST July 30, 2020 Six years later, smallest patient ever at Horizon’s Rexton Health Centre is a success story. “It takes a village to raise a child.” This African proverb may sound cliché, yet it was exactly what was needed to keep little Logan Robichaud fit and strong when he was born three months premature, and in the years that followed. Now, at six years of age, he is just like any other boy in Kent County, active and witty. He giggles and laughs out loud when he describes their family’s pets, including chickens that lay blue eggs.These sounds of joy are music to his family’s ears, as Logan had a lot to overcome since birth. In fact, he is the smallest patient ever to be seen at the Horizon’s Rexton Health Centre. His mom credits his strength and growth to raising him in a community setting built on collaboration and resilience. “Everything we need is right here,” Amanda said, about the joys of rural living, the proximity to rivers and beaches, and the camaraderie of health care providers who live and work in the area. Her experiences in the neonatal intensive care units have inspired her to pursue her studies. She is now a licenced practical nurse and had previously been a phlebotomist. She works at both the Rexton Health Centre and the Stella-Maris-de-Kent Hospital, and is also a volunteer firefighter. 5 PER CENT SURVIVAL RATE Inner strength comes in all shapes and sizes. After his emergency birth that started at Horizon’s The Moncton Hospital and ended at the IWK Health Centre (IWK) in Halifax, this premature baby endured longs stays in Neonatal Intensive Care Units (NNICU) in both cities. Much to the surprise of his mother, his arrival was far from his older siblings’ normal births. Most women will go into labour between 38 and 42 weeks of pregnancy; Logan was born at 23 weeks and 6 days, weighing only 590 grams (less than a baseball) and measuring 11 inches. According to the New Brunswick Perinatal Health Program, Logan is one of the smallest premature babies born since 2010 and the fact he has no underlying medical conditions is exceptional. Logan is now in perfect health, has never needed glasses and has had no major surgeries. “He was critical but stable for a long time, but he was so strong… he did better than what I thought he could do,” explained Amanda, who is still astonished by her son’s innate strength to this day. What is also remarkable is that Amanda went through the labour process on her own. Logan’s father, a fisherman, was away at sea and missed his birth. Amanda recalls making the first few critical decisions alone, with the support of her health care team. There were certainly risks associated with a premature delivery, and Amanda is very grateful for every piece of advice she received from the nursing staff by her bedside. When recalling these adrenalin-pumping times, Amanda also fondly remembers quiet moments in the NNICU in Halifax. Both parents spent much of their time taking turns performing kangaroo care, a recommended method of keeping a baby chest-to-chest and skin-to-skin to maintain the heart rate and breathing as steady as possible while also improving brain development. “We did a lot of kangaroo care with our son,” said Amanda. “It got to the point that the nursing staff said they would put us all on catheters!” Amanda’s sense of humour was matched by the nursing’s staff comic relief and this helped lighten the situation. A positive atmosphere was very important, especially since her newborn son, while being housed in NNICUs in Halifax and then Moncton, underwent regular X-rays and received specialized attention from a team of experts including pharmacists and dietitians. MUCH MORE THAN TEAMWORK When Logan finally came home to Richibucto Village months later, a tight-knit community of health care professionals at Horizon’s Rexton Health Centre, were at hand to keep him on the right track. Amanda made many connections throughout her and Logan’s journey. She credits the many health care professionals along the way who collaborated, shared medical files, and helped Logan and other premature babies beat the odds while reassuring worried parents she met during her hospital stay. Being away from the hospital setting meant he needed another very sterile environment. Amanda describes it as living in the bubble and all family members had to have up-to-date vaccinations, and everyone had to wash their hands all the way up to their elbows. The house also had to keep cozy at 21 C. Despite everything, Logan was able to thrive and live through a few illnesses, and his health was constantly monitored even when he was transferred to TMH. He departed the IWK in style, outfitted in a tuxedo made for a small, stuffed bear. Other than the health care teams in Moncton and Halifax, Amanda had another team working to support her family back home. On her way to give birth in Halifax, her friends and mother moved into the house in Richibucto Village. “I had a friend with teenaged daughters and they basically moved into the house to help, and then my mom also moving in with them,” she said. “It was a struggle to get everything organized but they were so good to and stayed with the kids.” A CARING COMMUNITY Even as an infant, Logan had appointments at the Horizon’s Rexton Health Centre every other day to weigh him and ensure he was growing at a good pace. Nurse Joanne Richard recalls the complexities of taking Logan’s measurements. “He had to be handled with care and I would ask his mother Amanda to place him on our scale,” Joanne said. Amanda appreciated having these services so close to home and did not mind driving to Sainte-Anne-de-Kent for speech and language appointments and to Horizon’s The Moncton Hospital for occupational therapy sessions for her son up until the time he started school last September. This summer, Logan can truly enjoy his vacation before returning to school. There are no more follow-up appointments, and he can just focus on being a regular child, but his inner strength and his connection to his community will always set him apart from his classmates.