'She takes anything you throw at her': early arrival Paige thrives despite the odds

Paige has endured a series of health setbacks since her birth at just 24 weeks. But thanks to expert medical care, she has made great strides

Karen O'Keeffe with her one-year-old daughter Paige and her four-year-old son Alex at their home in Ballyvolane, Cork.

When Karen O’Keeffe asked her partner, Stephen, to drive her to Cork University Maternity Hospital in the small hours of a November morning, she was expecting to be treated for a urinary tract infection.

Only hours earlier, the Ballyvolane-based mum had come home early from a night shift at the Cork-based pharmaceutical company where she worked. She’d felt tired, hadn’t been herself and thought an early night would sort her out.

Now – six months pregnant and with their then three-year-old son, Alex, in the car alongside them – the couple arrived at CUMH at 4am. “Things escalated quickly,” recalls Karen. “I was carrying my baby quite low in the pelvis and I had a bit of pressure so I thought it was a UTI. Instead I was told I was 6cm dilated and they were bringing me straight to the delivery room. I asked if there was a tablet they could give to stop this and they said no, I was gone too far.

“I was just numb. It was so fast I couldn’t put two and two together. I had nothing got baby-wise, not even maternity or breast pads for myself. I’d come in wearing the clothes I’d worn to work the previous evening.”

Paige was born at 24 weeks, just over a year ago, within an hour of Karen arriving at the maternity unit. “She was born in the amniotic sac. Everybody was telling me this was good luck, that fishermen would pay thousands for the sac because it’s supposed to bring good luck.”

While Karen had never met anybody who’d had a premature baby – “I knew nothing of the world I was about to go into” – she knew being born at 24 weeks and weighing just 640g wasn’t the luckiest start in life. “Obviously she would be mechanically functioned. Those first days we were just praying from hour-to-hour, from day-to-day,” says Karen, who was expressing milk for her infant and very aware of “getting good nutrients into her”.

Difficult start in life 

With her baby in an incubator in neonatal ICU, Karen began a diary, recording daily Paige’s progress. “She spent so long in the incubator. When they’re that small, [premature] babies don’t want to be touched so we’d only get to change her nappy once a day. It was six weeks before I held her. I couldn’t dress her.”

When Paige weighed 1.7kg she was transferred to an open cot. “We felt she was progressing. We could hold her. She had clothes put on her for the first time. I put her in a Minnie Mouse baby grow and a hand-knitted pink cardigan and hat.”

Paige has an array of issues due to being so premature: chronic lung disease, pulmonary hypertension, she’s on oxygen 24/7 and her PDA (Patent ductus arteriosus) has not closed – a common occurrence in premature infants. “She went off oxygen at the end of January but had to go back on it three days later. She’s been on it since,” says Karen.

And while Paige is fed by nasogastric (NG) tube, she was at one stage bottle-fed. “She got her first bottle in January. She started off on one bottle a day and got up to 70ml, but she got pulmonary hypertension. She was bringing up the feed and aspirating it into her lungs. That was the hardest part for me – the one thing that broke me, giving up feeding my child when I was on a ward full of mothers who were all feeding their babies, whether breast- or bottle-feeding.”

Paige came home for the first time at the end of July. “It was the scariest day,” says Karen. “All the weeks you spend wishing and hoping for her to get home. And then to get full responsibility for your child, after being surrounded by a full medical team from when she was born, it was nerve-wracking. A child with all these needs and complications – I was terrified.”

Since then it has been a case of “in and out” to the Ladybird Ward of CUH, with repeated infections requiring Paige to be hospitalised. And yet, says Karen, Paige is a very happy baby. “She takes anything you throw at her – any new piece of equipment, any procedure. She’s after getting a hearing aid, an inhaler. She’s just an easy baby, so placid and pleasant. I want to thank all the staff in the neo-natal ICU. We are so grateful to them."

Consistency of care 

Sarah Murphy, paediatric nurse on the Ladybird Ward, says Paige is an amazingly resilient baby. “You go into her room and say ‘hello Paige’ and she’ll smile – she has the biggest blue eyes – and she kicks her legs and nearly tries to speak to you.”

Working on Ladybird for two and a half years, Sarah says the ward typically has 15-18 inpatients, all under 18 months. “The care is family-oriented. Consistency of care is very important. If I’m on for three days, I’ll have the same patients for those three days, so I know exactly what’s going on, and the parents build up a bond with you – it’s important they feel they can trust you with their precious little babies.”

A big part of Sarah’s job is training parents in caring for their infant – parents might be learning about management of oxygen therapy or how to insert an NG feeding tube. For these challenged babies – all born during the pandemic – the past 18 months haven’t made life easier. “Babies respond so well to facial expression. They look to connect with your face and your smile but they’re not getting that with the mask. We still speak to them and they respond very well to that – but all they’re seeing is your eyes and a white mask,” says Sarah.

For Karen and Stephen – who are so grateful to CUH staff – raising Paige is about taking each day as it comes. “It’s a long road ahead, but Paige is coming along and we will try to get her to where she needs to be.”