Little 20-month-old David Stewart wore to the party a baby blue and white jumper with a slogan across the front: "Nobody Knows the Trouble I've Been."

That's a statement of fact for David, whose parents are overjoyed to have him alive and well after two surgeries within four months after his birth.

"David was born three months early. He weighed 2 pounds and 4 ounces. His whole arm was about as long as your finger," said Susan Stewart, David's mother.

David was just one of more than 60 babies and toddlers who last week attended the second annual birthday party at Fairfax Hospital for "graduates" of the hospital's intensive care nursery.

The celebration -- complete with birthday cake, ice cream, potato chips and balloons -- reunited the children and their parents with the hospital's neonatal staff.

Dr. Lloyd Kramer, who invented the "infant simulator" that simulates a mother's womb with a rocking water bed and piped in maternal voice and heartbeat, was surrounded by mothers, fathers, babies and neonatal staff members as parents took turns to show Kramer his former patients. Kramer, who is director of nurseries, took each child into his arms, kissed it and commented on how big and healthy the child had become.

"These kids represent some of the sickest and smallest babies born in the hospital," said Kramer. "We have this party because we lose touch with babies. So we bring them back to see the results of our work.

"The smallest baby we've had in our intensive care nursery was under a pound and a half. It was a little girl and she's around here somewhere at this party."

Parents in the crowd of approximately 150 people renewed old acquaintances made when their children were intensive care patients.

"You form friendships here," said Michele Arkin-Hodges, whose 17-month-old twin girls, Tara and Margot, were born three months premature. "I see people that I saw everyday (when the twins were in the intensive care nursery), and you were very happy when their babies made any progress as well as your own," she said.

"We'll come back next year for sure," the Washington resident said.

Arkin-Hodges was in the hospital for 15 days before the twins were born, she said. Tara was 2 pounds, 5 1/2 ounces at birth and Margot weighed one pound, 10 ounces. "I went through a depression period after the twins were born. I had never seen anything so little in my life. It was a shock," she recalled.

Across the room from the Hodges family stood 3 1/2-year-old Audrey and her mother Andrea Peterbark from Arlington. Hand-in-hand and wearing look-alike beige print dresses, they looked at photos of some of Audrey's former roommates in the intensive care nursery. Audrey pointed at pictures and her mother tried to remember each one.

Audrey, who was 2 1/2 pounds at birth, has been the source of her mother's closer relationship to God, Peterbark said.

"My gynecologist was worried that she would not make it. She gave her 24 hours (to live). So I prayed about it and my husband prayed about it. He was more worried than I was that she wouldn't make it," Peterbark said.

Two weeks after David Stewart's birth, he had heart surgery to close a valve that connects two main heart vessels together. The defect, called ductus arteriosus, is more common in premature than full-term infants.Normally, when a baby is born, the valve will automatically close. But with premature babies, the valve does not always close, allowing blood to flow into the baby's lungs.

David was finally allowed to go home after three months in the nursery. But he had to come back a month later for hernia surgery. "They knew that he was going to have surgery before he left," explained Richard Stewart, David's father. "He just had to gain more weight before the hernia operation."

"We came to see him everyday," said David's mother, "and right away they wanted us to touch him, feed him and change him. They (neonatal staff) didn't make us feel as if we were in the way at all."

"The people here are wonderful," Richard Stewart said. "I can't thank them enough."

The infant mortality rate at Fairfax Hospital has been lower than anywhere else in the country in the last five years, Kramer said. "We have beaten places like Sweden, which is the model group for hospitals everywhere, and beaten them by a large percentage," he said. "Last year, the (U.S.) national morality rate was 12 for every 1,000, Sweden was eight for every 1,000, and Fairfax was four for every 1,000 births."

Although the neonatal staff is happy with the high survival rate of its patients, Kramer has some doubts about the future: "This is something I'm not sure we can continue; because as the hospital gets more prominent, more people are bringing in babies -- sicker babies."

On the fourth floor of Fairfax Hospital in the intensive care nursery away from the bouncing, playing, running, screaming children, are 35 more babies -- sleeping, eating or crying -- but most of all fighting to stay alive so that they may one day join the other alumni of the nursery and celebrate life and living.

"It's very reassuring to the nurses to see the babies out strong and healthy after taking care of them in the intensive care nursery," said Betty Ann Craze, director of Pediatric and Neonatal Nursing.

"I think most nurses here (in the intensive care nursery) are optimistic and try to be supportive of parents. We got all out for the babies," she said.