THE PARENT: Alyssa Spruill, 30, of Atlantic City

THE KIDS: Hakeem, 11; Jaheem, 10; KaMaya, 9; Emmanuel, 7; MaKenna, born March 12, 2018

THE HARDEST MOMENTS WHEN MAKENNA WAS IN THE NICU: "At home, looking at all the stuff I had for this baby, but there was no baby to show for it."

By the time Alyssa was pregnant with her fifth child, she knew a few things about survival.

She'd endured one pregnancy while still in high school — so petrified of her mother's response that she wished there were a back door to the bathroom where she got the positive test result — then welcomed three more children in the next four years while switchbacking between El Paso, where her husband was stationed in the Army, and her mother's home in Pleasantville.

Alyssa had experienced four C-sections, the dissolution of her marriage, a surprise pregnancy (she thought she had food poisoning), and an abrupt change of heart by the man who was the father of that baby. He bailed out when she was less than five months along.

But Alyssa had never seen anything like MaKenna, delivered 16 weeks early, a 13.7-ounce, translucent-skinned infant who fit in the palm of an adult's hand.

"She was so tiny and so fragile," remembers Alyssa, who first glimpsed her daughter in a photo on a nurse's cellphone; her own condition, severe preeclampsia that prompted the emergency delivery, resulted in a stay of several days in the AtlantiCare ICU.

"She looked like a little alien. I couldn't see her head or her eyes; this little hat covered her face. Even the smallest Pampers didn't fit her. She was still under the lights. She had tubes coming out of her stomach.

"I was happy she was here, but so sad. The doctor had told me — she was really honest — there's a good chance she's not going to make it."

Alyssa's family likes to joke about the fertility of its women; Alyssa is the oldest of five and remembers caring for her youngest sister, born when Alyssa was 11. She babysat for nieces and nephews and fantasized, along with her boyfriend, about having at least four kids.

Still, she was stunned to find herself, during her senior year in high school, hunkered in a bathroom with a pregnancy test in hand. "I kept getting sick," she remembers, "but I thought, 'No, I can't be pregnant.' I was scared, but then I was excited. I wanted a boy."

That boy — Hakeem, named for his father, was born via emergency C-section because of insufficient amniotic fluid. "He came out so pale. The first thing I said was, 'He's so white. Is he OK?' They said, 'Yeah, he's fine.' "

Alyssa was pregnant with her second child when her boyfriend proposed. By the time they wed — a courthouse ceremony with Hakeem blowing soap bubbles he'd borrowed from another wedding couple — Jaheem was 6 months old.

With her third pregnancy, Alyssa thought to herself: "This better not be a boy." She was more nauseated this time around, unable to keep down any food for the first trimester. When she was four months pregnant, her husband was sent to Kuwait; Alyssa and the boys returned to her mother's house. Her husband was overseas again, in Dubai this time, just after Emmanuel came along.

"Emmanuel was a total surprise," Alyssa says. "My sister laughed so hard: You said you wanted four!" The other jolt was the end of her marriage; the couple divorced shortly after Emmanuel's birth.

Seven years later, Alyssa thought she'd come down with a violent case of stomach flu. When a coworker asked, "Are you pregnant?" the words felt like a flashback. "MaKenna's dad was excited, like I was. But somewhere in the middle of the pregnancy, he changed his mind. I decided I was just going to go through with it."

At 24 weeks, Alyssa was diagnosed with preeclampsia. She couldn't even look at the blood-pressure readings — at one point, the upper number topped 200 — because they just amped up her stress.

Her doctors hoped to hold off delivery until at least 30 weeks, but Alyssa's blood pressure couldn't be stabilized, and they feared she might have seizures or a stroke. They delivered MaKenna March 12.

AtlantiCare nurse Bernadette Paolino cared for MaKenna during the 113 days she spent in the NICU.
AtlantiCare
AtlantiCare nurse Bernadette Paolino cared for MaKenna during the 113 days she spent in the NICU.

Every day, Alyssa sat in the NICU, talking to her daughter through a porthole in the incubator. "I would open it up and wave to her, sing to her. I just started singing 'Ain't No Mountain High Enough.' My kids love that song."

She prayed, too: Give me the strength. Give her the strength. Give the doctors the strength. She's going to get through this. She's going to get through.

Alyssa had named MaKenna after watching a Discovery Channel program about a girl who'd survived a shark attack off Makena Beach, on Maui. In the NICU, nurses started calling the infant "Mighty MaKenna." They added beads to a bracelet for every milestone: when she came off the ventilator, when she was able to swallow the breast milk Alyssa diligently pumped.

Her skin became less fragile, her fingers less skeletal. "You could see the muscles forming in her arms and her calves," Alyssa says. "And I always noticed when her head got bigger." She held MaKenna for the first time when the baby was two months old; by then, she stretched from the tip of Alyssa's middle finger to the base of her wrist. Alyssa sat in a NICU rocker, holding MaKenna skin-to-skin, and cried.

"When I first came into the NICU, I didn't understand half the things they were saying," she recalls. "By the end, I knew how the monitors worked, how the incubator worked. It became second nature."

The AtlantiCare team — doctors, nurses, and techs — who gathered to say goodbye to “Mighty MaKenna,” Alyssa, and her brother Hakeem the day she was discharged. The bouquet holds 113 carnations, one for each day MaKenna spent in the NICU.
AtlantiCare
The AtlantiCare team — doctors, nurses, and techs — who gathered to say goodbye to “Mighty MaKenna,” Alyssa, and her brother Hakeem the day she was discharged. The bouquet holds 113 carnations, one for each day MaKenna spent in the NICU.

She cried again, along with members of MaKenna's care team, when they finally left the hospital July 3. Hakeem beamed as he pushed the stroller. The staff had made a bouquet of 113 pink and white carnations, one for each day MaKenna spent in the NICU, a journey chronicled in an Aug. 19 story in the Inquirer. Everyone hugged everyone. Alyssa pocketed the milestone-bead bracelet, a series of minuscule footprints.

Then she took MaKenna home, unwound her oxygen tubes, and did the thing she'd been longing to do for nearly four months: She lay down on the bed and cuddled her daughter close.