DES MOINES, Iowa — An Iowa boy who was born at just 21 weeks is now the Guinness World Records title holder for the most premature baby.

Nash Keen, of Ankeny, turned one year old on July 5th as family members celebrated the giggly baby’s milestone, which seemed almost impossible to reach. The path to his birth was a difficult one for parents Randall and Mollie, who lost a previous pregnancy at 18 weeks and feared the same outcome after Mollie began experiencing issues 20 weeks into her pregnancy with Nash.

“We were devastated. We thought we were going through the exact same thing, and we thought we were going to lose this baby,” Mollie said. “At that point, I didn’t know what I could do to turn things around.”

That’s when Mollie learned from a friend about the University of Iowa Health Care Stead Family Children’s Hospital’s neonatal intensive care unit, which had begun to perform lifesaving measures on babies born at 21 weeks.

Mollie began contracting heavily in the early morning hours of July 2nd, 2024 and rushed to Iowa City to be admitted. Her water broke shortly after arriving but her care team was able to delay labor, and it was two days later when Mollie felt something wasn’t quite right.

“I just remember feeling a bit off,” Mollie said. “So, I had them check to see how dilated I was and maybe a second later I had a bunch of people in my room.”

Nash was delivered by high-risk obstetrician, Malinda Schaefer, MD, PhD, just under 10 hours after he surpassed 21 weeks of gestation.

Nash weighed 10 ounces at birth and medical staff wondered if he was too small for some of the medical equipment which would need to be utilized.

“Sometimes babies born at 21 weeks are just too small for even our tiniest breathing tubes and intravenous lines,” said Amy Stanford, MD. “Our NICU team assessed Nash, and I was able to place a breathing tube. Once we had the breathing tube in, his heart rate stabilized, and his oxygen levels were good.”

The first few weeks in the NICU, Nash faced multiple health issues.

“Around the one-month mark, we all began to breathe a little easier,” Stanford said. “While we knew Nash still had a long journey ahead, that was the point when we started to feel more confident that he had a real chance of going home.”

Randall and Mollie were able to take Nash home in January of 2025, after 189 days in the hospital.

Nash continues to get care at Stead Family Children’s Hospital and from local specialists. He has a minor heart defect that is being monitored, but doctors said it should resolve itself as he ages.

“My ultimate goal for Nash is by the time he’s five years old when he goes to kindergarten, no one will know that he was born so early,” Stanford said.

Doctors are hopeful that Nash’s cognitive function wasn’t affected by his premature birth because he didn’t experience any brain bleeds while in the NICU. It’s a common complication in extremely premature infants.

His mother, Mollie, just wants her son to know how loved he is. “I want him to grow up and be healthy, happy, and confident in who he is. I want him to see his story as a source of strength.”

University of Iowa Health Care provided the interviews and images used in this story.