My how you”ve grown! World”s smallest babies saved by same doctor 15 years apart both leading happy, healthy livesMadeline Mann, 22, weighed 9.9oz at birth, while Rumaisa Rahman weighed 9.2oz

Madeline Mann is a 22-year-old honors college student studying psychology in Rock Island while Rumaisa Rahman is seven years old and goes to school in Chicago.

But this pair have one very special thing in common – at the time of their births they were both the tiniest babies to have survived.

Not only that but their lives were saved following their early births by the same doctor.

 Madeline Mann

Madeline Mann is 4ft8″ but suffers no long-term health complications despite weighing just 9.9oz at birth

Dr Jonathan Muraskas of Loyola University Medical Center, who resuscitated both children has now released a report based on his experiences to help answer the question – when do premature babies reach a point when they are likely to survive

His report looked at Madeline, born in 1989 weighing 9.9 ounces, which was then the world record; and Rumaisa, whose 9.2-ounce weight at birth in 2004 remains the world”s tiniest.

Both of them could fit into the palm of an adult hand at birth and required intensive medical intervention.

They were delivered by cesarean section more than a month early because their mothers had developed severe pre-eclampsia, dangerously high blood pressure linked with pregnancy.

Both babies were hooked up immediately to breathing machines with tubes as slender as a spaghetti strand slipped down their tiny airways.

Before the births, both mothers were given steroid drugs to speed up growth of the babies” immature lungs. Even so, Rumaisa and Madeline were on breathing machines for about two months, and hospitalised for about four months.

Madeline had mild brain bleeding, commonin tiny babies but with no lasting effects apart from asthma.

Her father Jim said that at just 4ft8″ tall, his daughter”s main problem was finding clothes to fit her.

Rumaisa is also expected to develop normally.

Rumaisa Rahman in December 2004 Rahman aged one

My how you”ve grown: Rumaisa Rahman weighed a record-breaking 9.2oz at birth, but was pictured happy and healthy a year later. She is expected to develop normally

However Dr Muraskas was keen to point out that these were extreme cases and should not be considered as a “bench mark”.

“These are such extreme cases,” he said in the report published in Pediatrics.

He added that although they were both the equivalent size of an 18-week-old foetus, Rumaisa was nearly at 26 weeks gestation, while Madeline was at almost 27 weeks. This meant their lungs and other organs were mature enough to make survival possible.

Therefore the report highlights a sometimes overlooked fact: gestational age is even more critical for survival than size.

Dr Muraskas and his co-authors saidmost newborn specialists consider babies born after 25 weeks of pregnancy to be viable – likely to survive – and so they should receive medical intervention if necessary to breathe.

Younger babies are generally in a “gray zone,” where intervention isn”t always so clear cut.

In Japan, doctors have lowered that threshold – the gestational age – to 22 weeks. Normal pregnancies last about 40 weeks.

Dr Edward Bell, from the University of Iowa estimates that about 7,500 U.S. babies are born each year weighing less than 1 pound, and that about 10 per cent survive.

“What is the real age of viability No one knows,” said Dr Stephen Welty, neonatology chief at Baylor College of Medicine and Texas Children”s Hospital in Houston.

Madeline”s father is also stumped as to why his daughter survived.

“I don”t know why, we were just extraordinarily lucky,” Mr Mann said.