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“It takes a lot of good care and a lot of good luck. Most of them don’t survive,” said pediatrician Dr. Edward Bell of the University of Iowa who keeps an online database of the world’s smallest surviving babies who were less than a pound at birth.

The list currently contains 126 babies dating back to 1936. Since submission is voluntary, it does not represent all survivors.

Ten babies weighing less than a pound were born last year and survived. Melinda joins three other tiny survivors delivered this year in Berkeley; Seoul, South Korea; and Iowa City, Iowa. All are bigger than Melinda, who is not eligible to be listed until she gets discharged.

Most tiny babies who survive tend to be female. That’s because female fetuses mature faster than males of the same gestational age. Having more developed lungs and other vital organs increases odds of survival.

Bell published a study last year that found many survivors struggle with health and learning problems. For those for whom growth data are available, many are short and underweight for their age.

There are some success stories.

The smallest surviving baby born weighing 9.2 ounces is now a healthy 7-year-old and another who weighed 9.9 ounces at birth is an honors college student studying psychology. Their progress was detailed in a study published this week in the journal Pediatrics by doctors at Loyola University Medical Center in Illinois where the girls were born.

In the past three years, Los Angeles County-USC Medical Center cared for two other babies with extremely low birth weight who survived, but Melinda holds the record at the hospital.

Prematurity comes with high costs. Ramanathan estimates it costs $3,000 to $5,000 a day to care for a premature infant.

A month after birth, Melinda was treated for an eye disorder that’s common in premature babies. She faced her biggest test last month when she underwent surgery to close an artery that usually seals after birth.

Ybarra held her daughter for the first time after the surgery. Before that, she could only touch her through the incubator.

The next challenge is learning to bottle feed before discharge. Ramanathan predicted at least another two-week stay, dashing her parents’ hopes of taking her home by Christmas.

Ramanathan said doctors don’t know how Melinda will fare when she’s older. Since she did not have major complications such as bleeding in the brain, he held out hope.

Melinda can breathe by herself, but still uses an oxygen tube as a precaution. On Wednesday, an ophthalmologist checked out her eyes and said everything looked good.

After the checkup, Ibarra lifted Melinda out of the incubator and sat in a rocking chair, cradling her.

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