Defying the Odds: At Less than Five Pounds, Caperton Hobbs Undergoes Three Life-Saving Surgeries

Springdale Coaches Brett and Meagan Hobbs are used to working around the unexpected.

Plans can change in sports; injuries happen, and coaches have to bring in new talent.

So, when it came to the unexpected early birth of their son, Caperton "Cape" Hobbs, they immediately recruited star players: Arkansas Children's surgeons and neonatal specialists. These experts saved their son's life.

Cape was born on Oct. 17, 2024, after his mother suffered from pre-eclampsia, which progressed to HELLP syndrome. At just 1 pound, 6 ounces, he was airlifted via the Arkansas Children’s Angel One Transport Team from Washington Regional Medical Center in Fayetteville to Arkansas Children’s Hospital (ACH) in Little Rock, the state’s only Level IV Neonatal Intensive Care Unit (NICU).

During the next 179 days in the NICU, Cape would undergo three rare-for-his-size surgeries that would save his life, highlighting the pediatric expertise of the ACH general surgery and NICU teams: a gastrostomy tube, or G-Tube, placement at 1 pound, 6 ounces; a ligation of his tracheoesophageal fistula at 1 pounds, 8 ounces; and repair of his esophageal atresia with permanent ligation of his tracheoesophageal fistula and repair of his duodenal atresia at 4 pounds.

"Arkansas Children's is the best at what they do," Brett said, with Meagan adding, "In our eyes, that's where he was meant to go. I don't think there's any way he would have survived if anything happened in a different order or under different circumstances. Everything does happen for a reason."

‘He was going to be the one’

At almost 11 months old in September and 17 pounds, 4 ounces, Cape is happy, thriving and off oxygen, his mother said. The Hobbs' first child, Cape, was a miracle baby after struggling with fertility issues and turning to in vitro fertilization (IVF).

"We were worried because we had a few chemical pregnancies with prior embryo transfers, and he was our fifth and final attempt. I was nervous about the pregnancy," Meagan said. "It was emotional and scary, but we were excited that this was just meant to be, and he was going to be the one."

Brett, a teacher and head football coach at Springdale High School and Meagan, a teacher and girls’ volleyball coach at J.O. Kelly Middle School, said their son was surrounded by love through prayer and the compassionate care of the ACH experts.

"I'd sing to him almost every day in the NICU. I sang 'Vacation' by Widespread Panic. That's my favorite band. The lyrics, 'With you by my side, I might get back alive from my next vacation,' I know those lyrics don't fit exactly, but I always thought with us by his side, he's going to make it," Brett said. "From the people at the front desk to the nurses and doctors, we built great relationships with all those people. You build that bond and relationship when you see they genuinely care about your child and offer comfort and understanding for what you're going through. It really made a big difference."

Surgery 1: G-Tube Placement

When Cape Hobbs arrived at ACH following his premature birth, the primary issue over the next almost six months was his lung function. Meagan explained that since Cape was premature his lungs were not fully developed and would be damaged by the connection to his esophagus. Air was trapped in his stomach and required immediate surgery on Oct. 18, to place a G-tube into the stomach for nutrients, fluids and medication and, in Cape’s case, to vent the trapped air. Brett was there, but Meagan was still recovering in Northwest Arkansas, arriving two days later on Oct. 20.

“We put in about 100 gastrostomy tubes a year, but you don’t put a gastrostomy tube in a less than 800-gram baby every year. That’s very rare. This one was necessary to ensure we could keep the stomach from perforating,” meaning tearing, said M. Sidney Dassinger III., M.D., a pediatric surgeon, chief of pediatric general surgery, medical director of surgical quality at Arkansas Children’s and professor of pediatric surgery at the University of Arkansas for Medical Sciences (UAMS). “I put the tube in his stomach in the NICU because he was too fragile to move to the operating room. Other surgeons were there to offer advice or scrub in, if needed. He’s definitely among the smallest babies we’ve put a gastrostomy in. You can’t get much smaller.”

Surgery 2: Ligating the Tracheoesophageal Fistula

Cape suffered from a tracheoesophageal fistula, an abnormal connection of the trachea to the esophagus, which allowed fluid from the stomach into his lungs. As a fetus develops, the trachea (connecting the voice box to the lungs) and the esophagus (connecting the stomach to the mouth) form as one tube but should separate. This congenital condition happens when the tube fails to separate. His esophagus was also abnormal, called esophageal atresia, and did not reach his stomach. This condition impacts about one in 3,500 births. While many with this condition are born prematurely, they are usually larger than Cape, said Jeffrey Burford, M.D., a pediatric surgeon and the National Surgical Quality Improvement Program pediatric surgeon champion at ACH and an associate professor of surgery at UAMS.

Cape also had a hole in his heart, patent ductus arteriosus (PDA), causing increased blood to flow into his lungs. The PDA resolved with medication, but stomach fluid spilling into his lungs due to the tracheoesophageal fistula. The fluid was significantly damaging his lungs. Even though doctors wanted to wait until he was at least 2 pounds to perform surgery, the growing damage moved up the procedure to when he was just 1 pound, 8 ounces. It was the first day Meagan got to hold their son.

"They were trying to save his lungs," Meagan said, adding that the news was "devastating," considering his small size. "We knew it needed to be done. There's nothing scarier than knowing there's a good chance he won't come out of this."

Dr. Burford ligated the fistula, also known as closing off the connection between the trachea and esophagus, on Oct. 25. It was done in the NICU instead of an operating room because Cape was too fragile to be moved safely.

"He is the smallest child that I have operated on to ligate a tracheoesophageal fistula," Dr. Burford said. "Surgery took about an hour and 20 minutes, and involved a team of two surgeons, a surgical fellow, an anesthesiologist and certified registered nurse anesthetist, the circulating nurse and surgical technologist, and, since we performed the surgery at the bedside in the NICU, the neonatology team was directly available to assist. Operating on an infant Cape's size is technically challenging. To care for these children, we work with our partner pediatric surgeons and pediatric surgical fellows (general surgeons training to become pediatric surgeons). Caring for these children isn't just a one-person job."

Surgery 3: Repairing of Esophageal Atresia with Permanent Ligation of the Tracheoesophageal Fistula and Repairing a Duodenal Atresia

Through compassionate and expert care, Cape grew to 4 pounds. His esophagus had grown enough to connect to his stomach, and he could handle having a bigger operation. On Dec. 10, Dr. Dassinger performed this extensive reconstructive surgery, which included:

• Repair of esophageal atresia with permanent ligation of the tracheoesophageal fistula, permanently disconnecting the trachea from the esophagus and connecting the two ends of the esophagus (the tube leading to the stomach).
• Repairing the duodenal atresia, meaning the first portion of the small intestine (the duodenum) is blocked, preventing food and fluids from passing through.
• A Ladd’s procedure, that rearranged the orientation of the intestines.

Cape was among the smallest patients to have this surgery at ACH.

"We have anesthesiologists who are comfortable managing the airway on somebody this small. We had a surgical team used to taking care of children this small and surgeons who are used to managing this particular disease process and doing operations on children of this size," Dr. Dassinger said.

The surgery took about three to four hours.

"Performing these operations at a Level IV NICU, that is also a verified, Level 1 Surgery Center from the American College of Surgeons provides the best care for babies. It represents what's great about the Arkansas Children's system because we can have the sickest, smallest, most vulnerable babies with these complex congenital anomalies that get great care in our NICU before, during and after the reconstructive surgery," Dr. Dassinger said. "We provide a whole system of care. In Cape's case, we now provide follow-up care close to home at Arkansas Children's Northwest."

The successful surgery laid the groundwork for Cape to leave the NICU on April 13, 2025.

"It was the biggest relief because the worst was behind him. All he had to do then was focus on recovering and growing," Meagan said. "I remember walking back there, and he was a little swollen and had his little chest tube again, but he did it and survived and was so strong. It was relief. I could breathe."

Arkansas Children’s: ‘They get it’

Looking back on their time at ACH, the Hobbs said there were many moments when team members went above and beyond for their son. They gave him a book stamp customized to say "Property of Caperton Hobbs," decorated his sleep pod and gave him the star treatment with photoshoots.

"I get emotional thinking about it because of how much they cared for him," Brett said through tears. "I don't think they realize how much it helped us, too."

Meagan praised the NICU nurses and several team members, including neonatologist Elizabeth Kim, M.D., who followed the family throughout their almost six-month stay.

"Dr. Kim was a huge advocate for him, and she really pushed for the surgery. She did not want him to have further damage to his lungs. Before his surgery, she led us in a very emotional prayer, which was amazing. She knew what was at risk but did an amazing job of prepping us. She had a hard conversation with us that he might not make it. She wanted to be the one to tell us," Meagan said.

Dr. Kim, a neonatologist at Arkansas Children’s and associate professor and assistant director of breastfeeding medicine in the department of pediatrics in the division of neonatology at UAMS, said the family was “an absolute joy to walk with” during Cape’s complex journey.

"In the NICU, I feel my role extends far beyond clinical care. These families are walking through some of the hardest moments of their lives, and it's a sacred responsibility to support them emotionally and spiritually - not just medically," Dr. Kim said. "I see it as my duty to help them feel seen, heard and held, whether leading a prayer before surgery, sitting with them in silence or explaining every detail with honesty and compassion. Families deserve to know that they're not alone, that their baby matters deeply to us and that we're walking this road with them."

Today, Cape sees specialists at ACNW in Springdale for cardiology, orthopedics, pulmonology, urology, ophthalmology, general surgery and primary care.

"It's a really hard journey overall. Unless you've lived it, you don't really get it," Meagan said of being in the NICU. "But those Arkansas Children's doctors and nurses, they get it because they see it every day. It's nice to know they genuinely care."

This article was written by the Arkansas Children’s content team and medically reviewed by Jeffrey Burford, M.D., M. Sidney Dassinger III., M.D., and Elizabeth Kim, M.D.