Nash Keen, a baby born at just 21 weeks of gestation and weighing only 10 ounces, has celebrated his first birthday — defying medical odds and earning a place in the Guinness World Records as the world’s most premature baby to survive.
Born on July 5, 2024, a staggering 133 days before his due date, Nash arrived so early that his chance of survival was, by all existing medical standards, considered zero.
But thanks to the swift and innovative work of the neonatal team at University of Iowa Health Care’s Stead Family Children’s Hospital, Nash not only survived but is now thriving.
A Pregnancy Marked by Heartbreak and Hope
The Keen family’s story began with heartbreak: Mollie and Randall Keen had suffered a miscarriage just six months before learning they were expecting again in early 2024. At a routine 20-week scan, Mollie had concerns about how she was feeling and asked for a closer examination.
“When we went to our doctor’s office for the 20-week scan, I had some concerns about how I was feeling so I asked them to look at me closer—which they normally don’t do at that appointment—and they found I was already two centimeters dilated,” Mollie told Iowa Health Care via the University of Iowa Health Care Stead Family Childrens Hospital.
It was the start of a terrifying waiting game. Admitted to the hospital, Mollie and Randall were told by doctors that if their baby could make it just a little longer — until midnight on July 5 — there might be a chance.
The neonatal intensive care unit had recently begun offering lifesaving interventions for babies born at 21 weeks gestation.
A Record-Breaking Birth Against All Odds
Thankfully, Mollie’s contractions subsided for two days.
Just hours after passing the 21-week mark, Nash was born, becoming the earliest surviving baby in recorded history — beating the previous record by a single day.
His birth, described by high-risk obstetrician Dr. Malinda Schaefer as part of a “new frontier in maternal fetal medicine,” was made possible by a combination of quick medical intervention, an optimal birth position, and a skilled NICU team ready for the unprecedented.
“We want what is best for patients, so we really try to convey that we do not know what the outcomes will be for these extremely premature births. And it is important for parents to understand most survival rates are low, and if babies do survive, they have a very high risk of long-term complications, even at 22 weeks,” Dr. Schaefer said.
A Tiny Fighter in the NICU
When Nash was born, he weighed just 285 grams — less than a can of soda.
His size posed a huge challenge, but miraculously, he was big enough for a breathing tube and other essential medical equipment.
“We never want the parents to lose hope, but we have to be very honest with them,” said Dr. Patrick McNamara, division director of neonatology. “I would have told his parents, ‘The chance is zero, but I hope I’m wrong and we will do everything we can to help him.’”
Dr. McNamara and his colleague Stanford described Nash as incredibly resilient. “He let us do what we needed to do to help him,” Stanford added.
Months of Intensive Care — and One Very Special Homecoming
At about one month old, Nash began to show stronger signs of survival. “Around the one-month mark, we all began to breathe a little easier,” said Stanford. “While we knew Nash still had a long journey ahead, that was the point when we started to feel more confident that he had a real chance of going home.”
During his six-month stay in the NICU — longer than his time in the womb — Nash endured countless echocardiograms, medications, and careful monitoring. His parents remained by his side throughout, celebrating every milestone, no matter how small.
By January 2025, after 189 days in the hospital, Nash was cleared to go home. The medical team had recently resolved his chronic pulmonary hypertension, and although he still has a minor heart defect, doctors believe it will resolve itself over time.
“All Smiles”: Nash’s Bright Future
Today, Nash is hitting developmental milestones and bringing endless joy to his parents in Ankeny, Iowa. Despite requiring oxygen and a feeding tube, he’s learning how to stand, full of curiosity and personality.
“I never lost hope for Nash,” Mollie said. “I want him to see his story as a source of strength.”
As Stanford put it, the goal is that by the time Nash enters kindergarten at age five, “no one will know that he was born so early.”
On July 5, 2025, Nash celebrated his first birthday — a milestone that seemed “nearly impossible” just a year ago.
But for the baby who beat the odds and made history, impossible is just another challenge to overcome.
A huge happy birthday to Nash. A huge congratulations to parents Mollie and Randall. And a special thank you to the amazing staff at the University of Iowa Health Care Stead Family Children's Hospital.