A baby born at just 21 weeks gestation in Iowa has defied all odds to celebrate his first birthday — and has now been recognized by
Guinness World Records
as the most premature baby to survive.
Nash Keen was born on July 5, 2024, in Iowa City — 133 days before his due date. Weighing just 10 ounces (283 grams), about the size of a bar of soap, Nash spent more than six months in the neonatal intensive care unit (NICU) at the University of Iowa Stead Family Children’s Hospital. He finally went home in January with his parents, Mollie and Randall Keen, to Ankeny, Iowa.
“Nash is so full of personality. He’s a happy baby,” Mollie said on Wednesday. “Given everything he’s been through, you’d expect him to be more fragile — but he’s not. He’s determined, curious, and always smiling.”
Nash’s survival is part of a growing trend of micro-preemies being successfully treated in top-level NICUs. Upon turning one, Guinness World Records officially named him the world’s most premature baby to survive — surpassing the previous record-holder, a baby born in Alabama in 2020, by one day.
For Mollie and Randall, Nash’s arrival marked a miracle after heartbreak. Mollie had previously suffered a miscarriage and was later diagnosed with a condition that made carrying a pregnancy to term risky. During her 20-week prenatal checkup, doctors found she was already 2 centimeters dilated — a serious warning sign.
Typically, doctors do not attempt life-saving measures for babies born before 22 weeks, but Mollie learned the neonatal team at Stead Family was equipped and willing to intervene for babies born at 21 weeks. With medical support, she was able to delay labor just long enough to hit that critical threshold.
The days and weeks that
followed
were filled with intense uncertainty as medical staff worked around the clock to stabilize and support Nash’s fragile body.
“One of the things that stood out to me about the NICU team was how calm they always were,” Mollie said. “If they weren’t panicking, we knew we didn’t need to panic.”
Dr. Malinda Schaefer, the high-risk obstetrician who delivered Nash just after he reached the 21-week mark, called his birth a milestone in maternal-fetal medicine. Still, she was candid with the Keens about the risks.
“It’s not me who lives with the outcomes,” Schaefer explained. “So I believe in open, honest conversations so families can make the right decision for themselves.”
Now over a year old, Nash is still overcoming challenges common for babies born so prematurely. He remains on supplemental oxygen and is fed through a feeding tube, though he’s preparing to try pureed foods. He also has a minor heart condition that doctors expect will improve with time.
He’s not crawling yet, but he’s rolling over and working on standing.
“He’s learning to stand on his feet — which is amazing,” Mollie said. “He’s got a lot of strength in those little legs.”
Despite everything, Nash is thriving — and proving every day just how far medicine, and one determined little boy, can go.
