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March of Dimes 2001 National Ambassador Justin Lamar Washington
WHITE PLAINS, N.Y. -- Justin Washington is a warm, outgoing, and friendly six-year-old. He loves to swim, play with his friends, and ride his bike near his Miami home. Those who meet Justin realize right away that he is special -- but they don't know the full story. In his short lifetime, Justin has already beaten odds stacked higher than a six-year-old can reach.
After a number of miscarriages, Justin's parents, Kraig and Dorenda Washington, were happy to discover in 1994 that they were again expecting. Their baby was due in March of the following year. Dorenda followed her physician's instructions, having weekly check-ups, taking prenatal vitamins and restricting physical activity.
Early in her fourth month of pregnancy, Dorenda Washington began having contractions while visiting her parents in Tennessee and was rushed to Centennial Medical Center in Nashville. Doctors there confirmed she was in premature labor and worked to prolong her pregnancy to save the baby's life.
The effort was only temporarily successful. Justin was born on November 13, 1994 -- four months premature -- weighing 1 pound, 8-1/2 ounces. After his birth he was taken to Centennial's neonatal intensive care unit (NICU), where he stayed for over a month. He was later transferred to Vanderbilt University Medical Center's NICU for surgery, then returned to Centennial, but following complications he again went to Vanderbilt for surgery and remained threre until he was released.
Because his lungs were severely underdeveloped, Justin was placed on a ventilator to help him breathe and given surfactant therapy. Surfactant is a substance the body produces to help re-inflate the lungs after each breath, but which premature babies are often not yet able to produce in sufficient quantity. Treatment by giving surfactant through the windpipe was developed in part by research funded by the March of Dimes.
Justin underwent intestinal, hernia and laser eye surgery, the last to correct a detached retina resulting from the constant administration of oxygen. He was treated for hyperbilirubinemia, which results from a temporary liver malfunction due to prematurity. He also suffered from asthma during his first year.
Justin was finally released from the hospital in March 1995 and was flown by American Airlines, with a Vanderbilt NICU nurse, home to Miami and a nursery with enough equipment to resemble a NICU. He grew stronger and healthier with each passing day until the equipment was no longer needed. Today, Justin is a healthy little boy who seems to have no residual effects from his ordeal.
Medical Overview
Justin survived through a number of measures either supported directly by the March of Dimes or in areas of care that it has supported:
- Surfactant for respiratory distress syndrome (RDS).
- Justin had a diagnostic TORCH (toxoplasmosis, other, rubella, cytomegalovirus, and herpes simplex) work-up to check for various congenital infections: The March of Dimes has supported research on all of these.
- He had hyperbilirubinemia, in this instance, due to failure of a premature baby's immature liver to dispose of waste-products from routine breakdown of red blood cells, and potentially leading to brain damage. The March of Dimes has supported hyperbilirubinemia therapies, including funding development of a therapy using tin-heme complexes, to reverse the condition, whether due to preterm birth or genetic disorders of bilirubin disposal.
- Justin suffered anemia of prematurity, and the March of Dimes has supported a research project on the use of EPO (erythropoietin) to correct it.
- He also had intravenous feeding (parenteral hyperalimentation) for 48 days, apparently due to necrotizing enterocolitis (NEC). The March of Dimes supported two research projects on IV nutrition for premature newborns, one of which was investigation of whether a particular amino acid (taurine) must be included in IV formulations for premature babies, as they are not able to manufacture it on their own, although term babies can.
There are also areas where ongoing March of Dimes research and programs are addressing the problems that endangered Justin:
- Bronchopulmonary dysplasia (BPD) - Justin had it as a consequence of RDS and/or the necessary treatments; the March of Dimes has funded recent research into it causes and how it might be prevented.
- Necrotizing enterocolitis (NEC): the March of Dimes has recently funded research on this often life-threatening intestinal disease associated with preterm birth.
- March of Dimes PERI (Perinatal Epidemiology Research Initiative) is looking broadly at biological and environmental factors that are plausible contributors to preterm birth, as a basis for prevention.
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