'Miracle' baby, once one of the country's smallest, now a teen who 'always gives it her all'

The envelope sent to the hospital for "Baby Zoe" had no return address.

There was no note inside, nothing stuffed in the envelope but a precious gift for the premature infant, whose footprint was smaller than her father's thumb.

"It was a pair of peach, little, teenie, tiny booties," said Zoe's mom, Tammy Koz. "And I still have them on my rearview mirror in my car, and I don't know where they came from."

Koz kept everything strangers gave her family. All the letters, drawings, newspaper clippings, photos, stacks of blankets and baby outfits are packed in storage bins in a closet in their home near Joliet.

Every year, around the day Zoe came into the world at Edward Hospital in Naperville, weighing a mere 10.8 ounces, so tiny she could fit in the palm of a hand, mother and daughter take out the bins and sort through the keepsakes.

For most of her life, Zoe was too young to fully understand what those things meant to her parents, why someone would care enough to knit her a pair of booties.

It wasn't until the last time going through her baby stuff that Zoe, a soft-spoken, levelheaded 17-year-old who doesn't like to make a big fuss, cried.

"It makes me realize how much of a miracle I really am," she said.

Zoe, once the nation's third-smallest baby to ever survive, is growing up. She just started her senior year at Plainfield Central High School. She has a job. She knows what she wants to do with her life.

"Very proud," said her mom, pausing to compose herself. "I don't know if I can get any more words out."

Shorter than Barbie

Zoe's parents met, as the "very corny story" goes, working at a McDonald's in 1995, Tammy Koz said. She went to Naperville North High School, and Eric Koz went to Bolingbrook. They got married in 2001.

"Growing up, all I ever wanted was to be a mom," Koz said. "I never had a dream for a career or anything like that. I wanted to be a mom so bad."

Her first pregnancy ended in a miscarriage. During the second trimester of her pregnancy with Zoe, an ultrasound showed she was barely growing.

Koz has lupus, an autoimmune disease that causes inflammation of joints, skin and organs. Doctors believed the disorder had prevented her placenta from developing properly, leaving Zoe without enough supply of nutrient-rich blood through the umbilical cord to grow to normal size.

Doctors left Tammy and Eric Koz with a heartbreaking decision. Deliver Zoe at 24 weeks knowing she very likely wouldn't make it, or wait in hopes that more time in her mother's womb would give Zoe better odds.

"I started going in every other day to the high-risk doctor just to do ultrasounds to make sure she was still alive," Koz said.

At 27 weeks into the pregnancy, doctors decided they couldn't wait any longer. Zoe was born by Caesarean section on Jan. 6, 2004, three months before her due date.

A baby who's that far along might weigh on average 2 pounds, maybe a little bit more, said Dr. Bob Covert, medical director of Edward Hospital's neonatal intensive care unit and a partner in DuPage Neonatology Associates.

Zoe weighed 305 grams, or two-thirds of a pound, making her at that time the third-smallest surviving baby ever delivered in the United States, according to the University of Iowa "Tiniest Babies" registry. Just 9.5 inches long, she was shorter than a Barbie doll.

"It's very, very rare in the United States or the world to survive even under 500 grams, let alone under 400 grams," said Covert, who oversaw Zoe's care.

"We were faced with a lot of technical challenges in terms of the ventilators, in terms of the IVs, in terms of the breathing tubes, but also in terms of not fully knowing what to expect. We want to be optimistic, but we have to be realistic."

'Fighting spirit'

Zoe's delicate skin put her at higher risk for infection. She had to be fed intravenously. But she had more maturity in her lungs and other systems than those of babies born at a younger gestational age, Covert said.

And by the time she was introduced to reporters as "Baby Zoe" that February, Covert could tell she had a "spunky" side.

"I do think there are certain babies, especially when they're very small, that kind of are programmed to overcome what they've been dealt," Covert said. "Maybe that's genetic. Maybe it's some fighting spirit, but she clearly had it."

Zoe's parents celebrated every hard-won gram of weight she gained in the NICU, every little milestone. Her mom, then 25, couldn't hold her firstborn child until three weeks after she was born. Her dad got to change Zoe's diaper and help her nurse take her vitals and dress her for the first time on Feb. 14, 2004, Tammy Koz wrote in an online journal.

"She was in there for 153 days," Koz said. "It feels like a lifetime ago in some ways, but then emotionally, it feels like yesterday. I can relive every minute of it. I just remember everything about it."

While Zoe spent five months in the NICU, she avoided many of the setbacks common to other preemies.

"There was just so many things in that NICU that we saw, and it's like you almost feel guilty because Zoe didn't have any of them," Koz said.

'Bright future'

Zoe's parents finally brought Zoe home from the hospital in June 2004. What were their expectations for their daughter?

"Zoe is capable of doing anything like anybody else," Koz said. "And that's just how we've always raised her and always believed it, and she's living that today."

That's not to say there weren't nervous mom moments.

"I remember her first day of kindergarten. I followed that bus to school. I did," Koz said. "I got in my car and I followed that bus to school to make sure she got to school."

When Zoe was almost 5, her younger sister came along. "She was my second miracle," their mom said. That pregnancy was relatively smooth. Now, 12-year-old Faith has passed Zoe's height by about 4 inches.

"That's a very common outcome of babies who have this growth restriction," Covert said. "She'll probably never reach her full height potential, but she was also faced with a lot of developmental uncertainties."

Zoe, at 4 feet, 10 inches tall, uses an inhaler to increase her lung capacity. She still wears hearing aids. But on the whole, she's a thriving teen.

"She had a lot of obstacles to overcome both in the NICU and since being home," Covert said. "And I just think she has a really bright future ahead of her."

Covert and other Edward Hospital doctors and nurses reunite with NICU families every two years. They've seen Zoe grow into a young woman who loves animals. Her three-legged rescue cat Macaroni is quite possibly her "favorite thing in the world," her mom said.

For her 18th birthday in January, Zoe might get a tattoo of paw prints or a cross.

"It makes me really happy to see me helping out animals and making them feel better," said Zoe, who works as a kennel attendant at a veterinary clinic. "I'm just mentally built that way to deal with sick animals."

She's also working toward a vet technician certification through the Wilco Area Career Center in Romeoville while she finishes her senior year. Zoe will probably have a low-key graduation celebration with just her closest friends and family. And then she plans on heading to Joliet Junior College.

"I just hope I can get through graduation without looking like a fool," her mom said, laughing.

Koz wants everyone who sent her family gifts, filling up those bins in her daughter's closet, to know that Zoe's story, 17 years later, is still a happy one.

"Zoe is driving. She has a job. She's a straight A and B student. She's in a vet tech program at school. She's a normal kid."