In what doctors are calling a remarkable triumph of modern medicine, a baby born at just 21 weeks of gestation in Iowa City, Iowa, US, has defied the odds and recently celebrated his first birthday, earning a Guinness World Record as the most premature baby to survive.
Nash Keen, born on July 5, 2024, arrived 133 days before his expected due date. Weighing only 10 ounces (283 grams), roughly the size of a bar of soap, he spent nearly six months in the Neonatal Intensive Care Unit (NICU) at the University of Iowa Health Care Stead Family Children's Hospital. In January 2025, Nash was finally strong enough to go home to Ankeny, Iowa, with his parents Mollie and Randall Keen.
Now a thriving one-year-old, Nash has been officially recognised by Guinness World Records as the most premature baby to survive, beating the previous record set by a baby born in Alabama in 2020 by a single day.
Mollie Keen’s journey to motherhood had already been marked by heartbreak. A previous miscarriage led to the discovery of a medical condition that made it difficult to carry a pregnancy to term. So, when a 20-week prenatal checkup revealed she was already 2 cm dilated, alarm bells went off.
Typically, babies born before 22 weeks of gestation are not expected to survive, and hospitals often don’t attempt lifesaving interventions at that stage. But the Keens learned that the neonatal team at the Stead Family Children's Hospital was pushing boundaries, offering care to babies born at 21 weeks.
Mollie went into labor just days before the 21-week mark, but with expert medical support, doctors were able to delay the birth just long enough for Nash to meet the minimum threshold. Dr. Malinda Schaefer, the high-risk obstetrician who delivered Nash, described the moment as a turning point in maternal-fetal medicine.
“Nash’s birth is pushing the limits of what we thought was medically possible,” Dr. Schaefer said, adding that she had honest conversations with the family about the very real risks and possible complications. “But ultimately, it’s the parents who must live with the outcomes, and they deserve complete transparency.”
The weeks that followed Nash’s birth were full of uncertainty. Doctors and nurses worked round the clock to keep him stable, battling a range of life-threatening challenges. Despite being born on the edge of viability, Nash’s parents found strength in the calm professionalism of the NICU staff.
“One thing I noticed was how calm the medical team was,” Mollie said. “We learned to watch them. If the doctors weren’t panicking, we tried not to panic either.”
Nash’s journey wasn’t without complications. He remains on oxygen support and is fed via a feeding tube, although he is slowly transitioning to pureed food. He also has a minor heart defect that doctors believe may resolve as he grows. While he hasn't started crawling yet, he can roll over and is working hard to stand with support.
“He’s learning to stand on his two feet, literally,” Mollie added. “He’s got a lot of strength in those legs.”
Nash’s survival is not just a family victory, it’s a milestone for the medical community. As advances in neonatal care continue, more extremely premature babies are being given a fighting chance. Doctors say Nash’s case may influence global discussions about gestational viability and neonatal intervention standards.
While the road ahead may still include challenges, Nash’s first birthday marks an incredible achievement. To his family, he’s more than a record-holder, he’s a symbol of resilience and hope.
“He’s a very determined, curious little boy,” Mollie said. “He’s all smiles, all the time.”
And now, he’s officially a world record holder too.
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