ABSTRACT
An estimated ratio (i.e., 1 in 10) babies are born too early every year. Roughly 1 million children die each year due to impediments raised pertaining to preterm birth. One such extreme preterm male baby was presented in the neonatal care unit with respiratory distress and grunting. Baby was confirmed to have ventricular septal defect along with patent ductus arteriosus and craniosynostosis which was treated with medications and surgical managements. He was also engaged with various prophylactic and empirical antibiotic therapies to cover the microbial growth. The most disturbing stage here was the appearance of liver mass sizing 5.8 cm × 1.3 cm accompanied with area of necrosis, diagnosed with hepatoblastoma which was evident with the aid of ultrasound. Hence, chemotherapy was commenced which was in accordance with Societe Internationale d Oncologie Pediatrique Epithelial Liver Tumor Study Group-3. Although the existing comorbidities haunted the baby for a long time, he finally made it successfully to get into track by fighting all the hurdles bravely, which was a sheer miracle. Along with the clinicians/surgeons, we Clinical Pharmacists worked hand in hand to ensure the baby to be receiving optimized drug regimen keeping in mind the risk-benefit ratio.