Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Children's Hospital Logo
Connect With Us:

Monroe Carell Jr.
Children's Hospital
at Vanderbilt
2200 Children's Way
Nashville, TN 37232

(615) 936-1000

Children's Hospital Logo
Printer friendly version of this page  E-mail someone a link to this pageBookmark and Share  Open RSS Feed
Meet Josie

More Patient Stories:  

Catherine Josie Smith's coos and love for spending time in the arms of her big sister, Addy, are a far cry from the rough first three months of her young life.

The only signs that the now almost 6-month-old fought for her life are a hoarse voice and some scar tissue on her lungs, which are expected to heal. But her recovery took a lot of healing and care.

While still in her mother's womb, doctors had diagnosed Josie, as she is known to her family, with hydrops fetalis, an abnormal fluid buildup in a fetus or newborn that can be fatal.

Catherine Smith, her mother, was supposed to have a routine 32-week prenatal checkup in April, but a day later had an emergency caesarean section to deliver Josie in Huntsville, Ala.

At a week old, Josie seemed to be getting better. She was taken off a ventilator, and her fluid was drained from her lungs. It built up again. Her parents couldn't touch her for fear that stimulation would make the fluid accumulation worse.

"The doctors became doubtful that Josie would live," Smith remembers. "It was so difficult and painful to watch her and not be able to help her or show love to her by touching her."

Josie's condition wasn't fully diagnosed until she arrived at Monroe Carell Jr. Children's Hospital at Vanderbilt in May, a day after Mothers' Day. Doctors at Children's  Hospital were better able to care for Josie after they diagnosed her with congenital chylothorax, a condition in which her lymphatic system leaked fluid into her lungs. It was the likely cause of the hydrops fetalis.


Josie was the only infant in the neonatal intensive care unit who got cheers for losing weight. At one point, she weighed about 7 pounds, and more than half of that was fluid. The weight loss was actually saving her life because it meant the liquid was draining.

The fluid leaked more when she drank breast milk or regular infant formula. Doctors put her on a special, low-fat infant formula that would allow her system to heal, but also give her nourishment.

In July, Josie went home with her mother, father, Stan Smith, and siblings Addy, 7, Harley, 3, and Will, 1.

Josie is thriving and weighs 10 pounds, 8 ounces. She already knows what she likes, and will turn down a bottle if it's not the type she was started on at the hospital.

"Each smile, coo, laugh, batting of her eyes, and day we have with her is a gift from God, and we are so grateful for the opportunity to raise her," said Smith. "Josie's team of doctors was very compassionate during our dark days and tireless in answering all of our questions and even calling from home to check on her."

For Smith, who went to school and trained at Vanderbilt to be a nurse practitioner, the experience was surreal. "Our experience at Vanderbilt was more than excellent," she said. "I never expected to be on the receiving end of it, but it was beyond my expectations."

Search Patient Stories:
Valued Participant of Vanderbilt Health Affiliated Network