A year ago, Nash Geens was born weighing less than a can of soda, smaller than a grapefruit. On July 5th this year, just a few weeks after celebrating his first birthday, Guinness World Records officially recognized him as the world’s smallest premature baby at birth.
Nash’s mother, Mollie Keen, shared in a Guinness World Records interview about the heart-wrenching first year with her son, saying, “It feels like a dream. A year ago, we couldn’t have imagined what the future would hold, and now we’re celebrating his first birthday.”
The Geens family gathered with friends and relatives at their home in Ankeny, Iowa to celebrate Nash’s first year of life, receiving dozens of outfits and a stack of diapers as gifts. At one year old, Nash is now lively and healthy, but for the first six months of his life, everything was foreign as he spent that time in a hospital a hundred miles away.
Nash was born at 21 weeks, a staggering 133 days ahead of schedule. He weighed less than 10 ounces (about 283 grams) when he was born at the Stead Family Children’s Hospital at the University of Iowa Hospitals & Clinics. During his first month, his life hung in the balance.
After Nash’s birth, he was immediately rushed to the hospital’s Level IV Neonatal Intensive Care Unit, where he was connected to the hospital’s smallest life-saving equipment. The equipment seemed too large for his extremely tiny veins and mouth.
Dr. Amy Stanford, the neonatologist overseeing Nash’s care at UIHC, pointed out the unique challenges of caring for such an extremely premature infant compared to typical preterm cases.
Dr. Stanford stated in a press release from UIHC, “Babies born at 21 weeks are so small that even our smallest tubes for breathing and IVs are too big. But once the breathing tube was in, his heart rate stabilized, and his oxygen levels normalized.”
The parents were informed by the doctors about the slim chances of Nash’s survival and were told from a technical standpoint that Nash had almost no hope of surviving. Mollie revealed to Guinness World Records that being surrounded by medical equipment and monitors with healthcare professionals all around was “emotionally overwhelming,” but “Nash had a faint yet steadfast vitality that ignited hope in us.”
Nash’s father, Randall Keens, expressed gratitude to the medical staff for tirelessly giving his son a chance to fight – responding to every alert from the heart monitor. Mollie emphasized that Nash’s resilience was unstoppable. “About a month later, our whole family could finally breathe a little easier,” she told IHC.
The most significant milestone for Mollie was the first time she held her son. Wires and monitors connected to Nash, his body so fragile that she could hardly feel his chest. She was nervous at first, but as she held him close, all the tension melted away. She described it as a pure mixture of relief and love.
Despite Nash growing bigger, becoming more stable in health, and increasingly robust, doctors continue to require ongoing blood draws and echocardiograms for monitoring – stating that he might need to manage his heart condition for life. Meanwhile, the Geens family showers Nash with endless love. Six months later, in January 2025, Nash was finally allowed to go home.
However, he is not entirely out of the woods yet.
Currently, Nash’s mother mentions that he rarely cries, still needing nasal cannula oxygen support and relying on a feeding tube. With the help of hearing aids, he can laugh heartily at animal sounds from toys. Hearing loss and heart issues were his complications at birth. He now receives daily care, regular check-ups, and rehabilitation therapy at a specialized day care center.
“He has been through so much, but Nash is naturally a very calm child,” Mollie revealed to Guinness World Records. “He loves watching other kids play and run around in front of him. Yes, he is a happy child.”
Nash’s life has brought a ray of light to the family: he is a “rainbow baby.” Less than a year before Nash was born, the Geens couple tragically lost their baby girl, McKinley, at just 18 weeks of pregnancy. Mollie was diagnosed with cervical insufficiency, leading to a thin uterine wall and premature dilation of the cervix during pregnancy. She also suffered from polycystic ovary syndrome, making conception difficult.
After conceiving Nash, doctors informed her that her cervical issues caused premature dilation of the cervix, leaving the Geens couple terrified. “At two o’clock on Tuesday morning, I began having intense contractions,” Mollie recalled to IHC, “and we quickly rushed to Iowa Hospital for admission.”
On July 5th, just hours after reaching 21 weeks, Mollie felt that “something was wrong,” and the medical team rushed into the room. Nash’s birth made him the world’s earliest recorded premature baby. The attending physician and high-risk obstetric specialist, Dr. Malinda Schaefer, stated that his survival was partly due to a cutting-edge technology in the field of maternal-fetal medicine today.
Dr. Schaefer expressed relief that Nash’s “delivery process went smoothly” and he was in the “head-down” position, thus negating the need for a cesarean section. “We tried to deliver Nash as much as possible on the birthing bed, which was another advantage for him,” she said. Post-delivery, the healthcare team immediately focused on controlling postpartum bleeding.
Dr. Edward Bell, neonatologist at the University of Iowa Hospitals & Clinics, emphasized, “Our NICU at this hospital has been an international leader in treating 22-week premature infants. Therefore, even though most hospitals believe that 21-week premature infants like Nash are not yet suitable for intensive care, we will initiate treatment for 21-week preterm infants as long as the parents agree.”
One treatment method utilized by the hospital is hemodynamic monitoring, utilizing ultrasound to assess blood flow and cardiac function to optimize treatment plans. Studies indicate that this technique can reduce the risk of death or severe brain bleeding by half.
Over a year and one month after his birth, Guinness World Records certification officers visited Nash. He surpassed the previous record holder for the smallest premature baby at birth, Curtis Zy-Keith Means, who was born on July 5, 2020, at 21 weeks and 1 day. Nash also broke the premature birth record held by the Bryant Family quadruplets – Lainey, Kali, Lennon, and Koen – born on May 31, 2024, at 23 weeks and 4 days, a record held for nearly thirty years.