RICHLAND, Wash. — Sitting in a chair at Kadlec Regional Medical Center, Monica Perez of Pasco cradled her daughter -- still just 3 pounds, 14 ounces at 3 months old -- and watched the infant wave pink arms while swaddled in a blanket.
When little Cataleya babbled a few squeaking sounds, Perez gave her a pacifier to suckle, and the baby lapsed into a contented sleep while mother and child waited for a nurse to tell Perez she could take her daughter home for the first time since her birth Sept. 1.
If all had gone according to plan, Cataleya wouldn't have been born for another few weeks. Perez's due date wasn't until Dec. 17, but a case of high blood pressure during Perez's pregnancy led to the baby being born at just 26 weeks of gestation.
Cataleya weighed less than 1 pound at birth, making her the smallest baby ever to be admitted to Kadlec's Neonatal Intensive Care Unit.
The odds were stacked against the baby since she stopped growing in her mother's womb at 22 weeks.
Perez, 31, told the Herald that she went to see a specialist because of her pregnancy-related high blood pressure, which wasn't being helped by medication, and the doctor told her to prepare for the worst.
"He told me she probably was not going to make it," Perez said. "He told me to prepare myself for a stillbirth."
She left the doctor's office in a daze, carrying the awful possibility that her unborn child might die within days.
Perez, and her fianc Carlos Vargas, counted the days until her next appointment at 26 weeks, knowing each day could be the one they lost their daughter.
At 26 weeks, Perez went for another ultrasound. Her blood pressure was so high that she was admitted to Kadlec, where she was told that she likely would stay until her due date in December.
"I had just gotten a job offer," she said. "I had to turn it down."
The next day, doctors told Perez that her baby would have a better chance of survival if they performed a cesarean section than if she were left in the womb to gestate.
Dr. Anthony Hadeed, a neonatologist and medical director of Kadlec's NICU, told the Herald that severe high blood pressure can result in dangerous complications, including placental abruption -- when the placental lining separates from the mother's uterus.
The placenta develops during pregnancy to nourish the growing fetus, and placental abruption can result in the baby being deprived of oxygen and nutrition. It also can cause heavy bleeding in the mother -- putting mother and child in jeopardy.
When Cataleya was born, she was slightly less than 11 inches long and weighed 15 1/2 ounces. Her head circumference was only about 8 inches. Hadeed said a normal, full-term baby usually is about 20 inches long with about a 14-inch head circumference.
Being born so early and so small, Cataleya's lungs, brain and digestive system were still maturing, and she was at risk for brain hemorrhage and infection, or for not tolerating feedings.
Perez said the first time she saw Cataleya the night after she was born, she was gripped by fear.
"I kept thinking, 'She's not going to make it. She's not going to make it.' " Perez said.
But Perez and her fiancé agreed not to give up hope.
"We said we were going to live every day like she's going to be OK," Perez said.
But Cataleya -- whom Perez said was named for a film character who was a warrior -- lived up to her namesake and fought.
"We picked it just because it was different and we liked it," she said. "As time progressed and the more and more she fought; (the name) was perfect."
She didn't experience the range of possible complications, and after initially dropping down to just about 12 ounces in weight from heat loss, she rallied and grew.
Doctors, nurses and her parents watched her and kept her warm, hydrated and loved.
And she became one of the 15 percent to 25 percent of the children born so tiny and fragile who live.
Faced with finally being able to take Cataleya home, Perez said she was excited, but that it would be strange to be away from the hospital after so many months.
"It's scary to not have these monitors we've been staring at every day, not having nurses to call in," she said. "It's sad leaving the NICU, sad leaving the nurses."
But she also was ready for Cataleya to come home and be part of the family alongside four siblings -- and for life to continue.
The baby still is too small to fit into a car seat, so a special car bed designed for infants under 5 pounds needs to be used for the ride home.
But after three months of watching Cataleya grow and fight, Perez no longer thinks of her as tiny.
"To us, she's huge."
-- Michelle Dupler: 509-582-1543; email@example.com