When caregivers ushered her into the sunshine with bubbles, cheers and applause, it was a joyful milestone for the youngest preemie ever to graduate the neonatal intensive care unit at Novant Health Betty C. Cameron Women and Children’s Hospital in Wilmington.

At 142 days of age, Mylee Maureen Accatino was headed home at last, with her mom, Kimmy Kreuzer, 35, and dad, Danny Accatino, 36, of Leland.

Mylee close up
Mylee Maureen Accatino was about the size of a papaya when she was born and the odds of her leaving the hospital were slim. But with the NICU team at Novant Health Betty C. Cameron Women and Children’s Hospital constantly at her side, she was able to leave the hospital at 6 pounds, the size of many full-term babies.

The send-off from the NICU professionals who had shepherded the family to this milestone — “Team Mylee” — was a dramatic step on an odds-defying journey. It began in Kreuzer’s 21st week of pregnancy when signs of premature labor sent the couple to the emergency room.

Her cervix was dilating, they were told, but if Kreuzer could make it to 22 weeks and five days, she could receive steroids that would strengthen her baby’s underdeveloped lungs and give her the best chance for survival.

But Mylee wouldn’t wait.

She entered the world feet first, on April 26 — seven hours and 21 minutes ahead of the benchmark. Her eyes fused shut, her skin shiny and translucent, she was 11 inches long and weighed 1.04 lbs., roughly the size of a papaya.

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Specialists rushed her to the NICU, with the new dad in tow. By the time Kreuzer was able to join them, Mylee was on life support, had multiple tubes — and was establishing herself as a force to be reckoned with.

“I remember a nurse saying, ‘We have Miss Mylee here, and she is very feisty, so she’s obviously resilient,’” Kreuzer said. “That made me smile.”

Still, the odds were not in Mylee’s favor.

Her chances of survival? 20%

But she and Accatino knew it would take the combined efforts of neonatologists, nurse practitioners, RNs, respiratory specialists, nutritionists, lactation consultants and other experts, as well as their own, to surmount the hurdles facing their daughter.

“There’s a range, depending on the baby's birth weight, singleton versus multiple, steroid use and gestation,” said neonatologist, Dr. Sheri Carroll. “With Mylee’s specifics, her chance of survival at birth was, on average, 20%.”

Mylee Nicu Parents
For little Mylee, the skin-to-skin contact she had with her parents played an important role in her care. They spent 274 hours having “kangaroo” time with Mylee as pictured here.

Nicknamed “nano-preemies,” those very early babies who do survive are at high risk for severe and life-altering complications, from lung issues to brain bleed, cerebral palsy and blindness, according to the March of Dimes. Many who leave the hospital need breathing aids and feeding tubes.

“They pretty much warn you that it’s going to be an emotional roller coaster — one step forward, three steps back essentially,” Kreuzer said. “But you can't ever really prepare for when it happens.”

Parents were ‘part of the team’

Ask Mylee’s parents and her care team what accounts for her success, and each points to the other.

“What made the difference for her was her parents,” Carroll said. “They were at her bedside every day for rounds, very aware of what the treatment plans were and how they could help.”

A cause of premature labor

In about 1% of pregnancies, the mother's cervix begins to open long before the baby is ready to be born. It's why Kimmy Kreuzer gave birth 18 weeks shy of full-term.

“I want women to know it's a real thing,” she said.

In fact, losses in second trimester or later are often a result of the condition, which is known as an insufficient, or incompetent, cervix, according to the American Pregnancy Association.

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They provided Mylee with the two things that benefit preemies most, Carroll said — breast milk and skin-to-skin contact. Also known as “kangaroo care,” skin-to-skin contact helps regulate a newborn’s heartbeat and temperature, boost oxygen levels and ease the pain of frequent injections and blood draws. It also helps the family bond.

”They were the poster-children parents for that,” Carroll recalled.

In all, the couple logged 274 hours of kangaroo time.

Often, Accatino, a retired Marine, tackled his college studies on a laptop while Mylee slept curled inside his shirt. He appreciated having a tangible way to help.

“A lot of the times the father kind of gets forgotten but for me, just having her on my chest, whatever problems I had in the day just melted away,” said Accatino, who tracked every milestone along the way on a paper calendar. From surgeries and sickness to Mylee opening her eyes for the first time — on Mother's Day, he wrote it down.

“We felt like a true part of the team,” said Kreuzer, a physical therapist.

Care teams bond with families

Spending hours a day in the NICU let the couple see the team’s expertise and dedication up-close. Kreuzer said the NICU nurses got to know Mylee so well that they were the first to spot signs of a life-threatening infection because she just “wasn't acting right.”

She said nurses Katherine Cope, Lynda Smith, Karen Clemens, Victoria Lamonte, Tonya Todd and Jen Mann became trusted allies.

Over the weeks, they were at Mylee's isolette as she grappled with apnea and pneumonia, recuperated from two surgeries — one on her retinas, to prevent blindness, and another to repair a hernia — among other challenges. They also saw her bounce back after her heart stopped briefly, necessitating chest compressions and epinephrine to get it going again.

“She was just very strong-willed and was a fighter more than you normally see,” Cope said.

Mylee went home on Sept. 14. She didn’t even need breathing or feeding tubes. She tipped the scale at just over 6 pounds, the size of many full-term newborns. “You form a bond with these families. It's very bittersweet to see her go home,” Cope said. “And then you get to see her grow — and that's pretty awesome.”

An army of specialists

Mylee Parent close up
Mylee’s mother Kimmy Kreuzer said that the nurses and doctors that helped care for Mylee became the family’s trusted allies. Every nurse in the NICU got to know Mylee. Once it was time for her to go home, they were overjoyed but also a bit sad. “You form a bond with these families. It's very bittersweet to see her go home,” said nurse Katherine Cope.

How she'll grow and develop is unknown. An array of specialists — ophthalmologists, dermatologists, pulmonologists, gastroenterologists, cardiologists, and more —will continue to monitor Mylee’s progress.

It won't be clear how well she's doing until she's old enough for key developmental milestones like crawling, walking and talking.

But Mom and Dad are confident. Mylee eats well, is sleeping more and is alert to voices and movement on TV and video screens. She scowls and smiles and recently began to laugh.

“Everyone asks ‘How have you dealt with this?’” Kreuzer said. “And you know, I just try to look at it not as like ‘why has this happened to me and why did she have to go through this?’ We got to witness this miracle and she's so healthy. We just feel so blessed with that.”