At one pound, 11 ounces, Ramona Wednesday, also known as baby D, is the big one. Her older brother by two minutes, Tyler Jackson, or baby C, is the tiniest, barely registering a pound on the scale.

There s also Kayla Lizabeth, Justin Michael and Anna Belle Americus.

The three girls and two boys were born Thursday afternoon by Caesarean section to Bridget Maskell in Women & Children s Hospital.

It was believed to be the first delivery of quintuplets ever in Western New York, and by the time doctors and nurses finished, Maskell, 34, and her husband John Mistalski, 36, more than doubled the size of their family.

Maskell also has 8-year-old twins, son Brandon and daughter Aimee Jo.

"It s incredibly rare," Dr. Stephanie Mann, the hospital s director of perinatal medicine, said of the quintuplet birth.

Indeed, of the more than 4.3 million births in the U. S. in 2006, just 67 were quintuplets or higher order births, according to the latest data from the National Center for Health Statistics.

The newborns, who were due in January and arrived more than three months premature, were being monitored closely in the hospital s Neonatal Intensive Care Unit.

Mann said infants delivered at 25 weeks of gestation have about a 30 percent chance of survival. They also are at greater risk of significant neuro- logical and respiratory development problems.

"You really don t know how they re going to do for another couple of weeks," said Mann.

Maskell had hoped to carry her babies much longer. Their chances of survival would have increased dramatically had they stayed in the womb beyond 30 weeks. But last Monday, Maskell went to the hospital because she was bleeding, and by Thursday, her contractions were down to two minutes apart. One of the babies had separated from the placenta, causing the preterm labor.

The hospital organized teams of four to five doctors and nurses for each baby. One after the other, they entered a new world, beginning at 1:54 p. m. with Kayla Lizabeth and concluding at 2 p. m. with Anna Belle Americus.

"It was a huge undertaking. But we re really set up to do this," said Mann.

If they survive, the newborns probably will need to stay in intensive care for at least four months, she said.

Maskell and Mistalski, who both work for Walmart, were upbeat about the future prospects of their new brood.

Maskell said she was looking forward to the day each child could come home.

"They can grow up to be perfectly healthy," she said. "It depends on each child, how they fight for it. We re hoping for a good recovery for all of them."

The Lockport couple had been trying for two years to conceive a child before they contacted a fertility specialist.

"That was our plan — to have one more," she said.

Maskell eventually received an injection of Ovidrel, which contains a hormone that causes a woman s eggs to mature and be released, allowing for conception during ovulation.

She was not implanted with embryos, as in the controversial case of Nadya Suleman, the California mother who gave birth to octuplets after having six embryos implanted in her.

Maskell and Mistalski were told there was less than a 5 percent chance they could end with triplets or more.

Maskell s fertility doctor, Dr. Ralph C. Sperrazza, would not discuss Maskell s case, citing patient confidentiality.

But Sperrazza said using Ovidrel always comes with the risk of multiple eggs being fertilized. Patients are counseled about that risk and encouraged to consider a procedure known as "reduction" in the case of three or more fetuses.

As the name implies, reduction involves killing some fetuses so that one or two might survive and be born with less risk of serious health problems.

"The overwhelming majority of our patients ahead of time, say, Yeah, I m going to reduce, " said Sperrazza. "It minimizes the risk."

But Maskell said she couldn t bring herself to do that.

"They wanted me to reduce down to two. I understand completely how some parents have to make that decision, but it wasn t the right decision for me to make," she said. "I couldn t fathom how I was going to pick which ones are going to survive and which ones aren t. I couldn t do it."

They ve yet to be able to hold their new little ones, who lay inside isolettes, special incubators that carefully control oxygen levels, temperature and humidity for premature babies.

The five of them together took up a whole room in the intensive care unit.

"It s good to see that they re moving around and stretching out," said Mistalski. "They ll probably be here until at least January. Each day, they re making progress."