Wide-eyed and adorned with a pink bow, nine-month-old Margo Buller felt the Louisiana humidity for the first time on Tuesday as doctors, nurses and staff of Children’s Hospital New Orleans tearfully sent her off.
The last time Margo went through the doors of Children’s Hospital, she weighed one pound, five ounces.
“You know the standard bottle of water, just like the bottle of water that you get in a pack?” said Savanna Buller, Margo's mom. “That's the size that Margo was from head to toe.”
Margo Buller was born at 25 weeks.
Margo Buller snoozed through her first car ride on Tuesday, a journey home from New Orleans to Lake Charles that her parents, Savanna and Daniel Buller, thought might never come.
At 25 weeks, despite bedrest and medication, Savanna’s baby needed to be delivered.
Though she was tiny, Margo’s parents thought she was strong that first day. She pulled out her own breathing tube after being intubated. Then, they noticed their daughter's abdomen was swelling.
Margo developed necrotizing enterocolitis, an intestinal condition that can be fatal. Then came sepsis, a life-threatening response to infection that causes inflammation throughout the body and causes organs to shut down. Margo needed a life flight to another hospital with more specialists.
The doctor told Savanna to hold her before the flight, even as she was intubated. It might be the last time she would get to embrace her daughter alive, she remembers the doctor saying.
Savanna, a labor and delivery nurse, had no complications with her first three children, ages 10, 6 and 4. But about halfway through her fourth pregnancy, her blood pressure spiked. She had preeclampsia, a severe condition in which pregnant women have dangerously high blood pressure. It’s one of the leading causes of maternal death and disability.
Louisiana has the highest number of hypertensive disorders during pregnancy, about 9% compared to about 3% nationally. But Savanna, 29, didn’t have the typical risk factors. Doctors don’t know why the condition, which develops suddenly, happens to some people.
Mom and dad Savanna and Daniel Buller stand with baby Margo in the NICU Tuesday, June 4, 2024, at Children's Hospital in New Orleans, La.
Louisiana also has the second-highest rate of premature births at 13.3%, according to data from the March of Dimes. In the U.S., about one in 10 babies are born prematurely, defined as less than 37 weeks gestation, each year.
“It’s the nationwide crisis of perinatal and maternal health,” said Dr. Jessica Zagory, who performed Margo’s abdominal surgeries.
Louisiana has attempted to address abysmal maternal and infant health outcomes in recent years, driving down rates of hemorrhage through risk assessments, trainings, new procedures for measuring blood loss and supply carts. Even still, the pandemic and opioid crisis have added new challenges, keeping Louisiana’s outcomes at the bottom.
Margo beat the odds, even with challenges. Data show infants like Margo with necrotizing enterocolitis have about a 50-50 chance of making it out of the hospital, said Zagory.
“She really is a miracle,” said Zagory.
Each month, Margo improved with the help of surgeries and occupational and physical therapy. She babbles now, says “Dada” and can drink from a bottle, though she will need a gastrostomy tube for "a while.” On Tuesday, hospital staff tried to get a smile as her parents posed for a photo before carrying Margo down the hall.
“You want to get a smile?” asked nurse Christine Ranatza, known to the Bullers as Auntie Chrissy.
Two peek-a-boos later, Margo grinned.