WHAT IS A NEONATOLOGIST?

A pediatrician or your pediatrician is able to solve most of the health problems related to newborns, however, a Neonatologist is trained to handle the most complex and high-risk situations.

If your newborn is premature, has a serious illness or birth defect, a neonatologist may assist at the time of delivery and in the after care of your newborn. If there is an issue that has been identified before your baby was born, a neonatologist may become involved to consult with your obstetrician in your baby's care during your pregnancy.

WHAT TYPES OF TREATMENTS DO NEONATOLOGISTS PROVIDE?

Neonatologists generally provide the following care:

• Diagnose and treat newborns with conditions such as breathing disorders, infections and birth defects.
• Coordinate care and medically manage newborns born premature, critically ill, or in need of surgery.
• Ensure that critically ill newborns receive the proper nutrition for healing and growth.
• Provide care to the newborn at a cesarean or other delivery that involves medical problems in the mother or baby that may compromise the infant's health and require medical intervention in the delivery room.
• Stabilize and treat newborns with any life-threatening medical problems.
• Consult with obstetricians, pediatricians, and family physicians about conditions affecting newborn infants.

Neonatologists work mainly in the special care nurseries or newborn intensive care units of hospitals. In ome cases, after a newborn has been discharged from the unit, a neonatologist may provide short-term follow-up care on an outpatient basis. Your neonatologist will coordinate care with your baby's pediatrician.

TESTS AND PROCEDURES

Many of the tests, procedures, and monitoring that occur in the NICU can be very intimidating. Yet every piece of equipment and every procedure performed is there to help your newborn get better. These tests and procedures are performed with equipment made especially for newborns, and every effort is made to easy any anxiety and discomfort your baby may experience. Please ask your baby's doctor or nurse if you have any questions or concerns regarding any test or procedure. You may observe the following:

• Temperature Control - Many newborns need help in maintaining their body temperature. Your baby may be put in an open bed with a radiant warmer or in an incubator/isolette. A small probe on your baby's skin, monitors and regulates temperature in both cases.
• IVs - or (intravenous lines) administer fluids and/or medications to your baby, and are sometimes used for monitoring their condition. Babies most commonly have an IV placed in hand, foot, or scalp (your baby's nurse or technician will make this as painless as possible). At times a specialized larger IV may be inserted in order to provide larger quantities of fluids or medications.
• Arterial line - Similar to an IV, an arterial line is inserted into an artery in order to monitor blood pressure and blood oxygen levels.
• Monitors - Your baby will be connected to a variety of monitors, which are equipments that measures various vital signs, such as heart rate, oxygen levels, and blood pressure. They are usually connected to the heart rate monitor through several painless "leads", these are small patches that stick to the skin with a wire coming from it to the monitor, attached to the chest, abdomen and leg. Your baby may also be connected to a machine that monitors blood oxygen levels. This monitor is attached to your baby like a small bandage on the fingers or toes or in very tiny babies, a foot or hand. Blood pressure is measured using a small cuff placed around the baby's upper arm or leg.
• Tests - Your baby's attending physician may order a number of different tests or procedures to diagnose, to monitor and to treat an illness or injury. Tests are usually laboratory tests or imaging tests, and may include:
  • Blood tests
  • Cardiac catheterizations
  • CT scans
  • Eye exams
  • Hearing tests
  • HIV testing
  • MRIs
  • Lumbar puncture (spinal tap)
  • Ultrasound
  • Urine tests
  • Weighing
  • X-rays

Advanced technologies:

• Vaccines/Immunizations - Since it is important that premature babies get their shots on schedule, it's possible that your baby will receive his/her first sets of shots while still in the NICU.
• Rescue therapies for acute breathing difficultiesPhototherapy Lights - These lights are used to prevent jaundice by breaking down the bilirubin in your baby's blood. When they are used, your baby's eyes will be covered with protective patches.
  • Ventilators - Newborns who need help breathing may be attached to a ventilator. This machine is connected to the baby usually through an endotracheal tube (a tube that is placed into the windpipe through the mouth or nose). Depending on your baby's condition, he or she may be put on a conventional, mechanical ventilator or a specialized ventilator (such as high frequency oscillator or high frequency positive pressure ventilation).
  • Other therapies include:
    • Administration of surfactant
    • Inhaled nitric oxide
    • Extracorporeal Membrance Oxygenation (ECMO)
• Catheter of the bladder - Some baby's may be too ill to pass urine on their own or all excreted fluids may need to be measured. In those cases, a Foley catheter is inserted into the bladder to drain urine from the body.
• Feeding tube - Newborns may need a tube inserted from the nose or mouth into the stomach to provide nutrition.
• Umbilical catheter - This is a small plastic tube inserted into one of the two arteries or the vein in the baby's umbilicus. Medications, fluids, as well as blood can be given. Blood and fluid can taken without extra needle pricks using an umbilical catheter.

Newborn babies with medical problems can cause a special challenge, since sometimes babies are born before their bodies are ready to leave the womb. Important organs such as the heart, lungs, stomach and skin may not be mature enough to function without special help.

Neonatologists have the special training required to evaluate and treat newborns' medical problems. In addition, neonatologists use equipment that is designed specifically for the tiniest patients.

If your pediatrician suggests that your baby needs to be evaluated by a neonatologist, you can be assured that your child will receive the best possible medical care.