28 September 2015

The Evolution of Neonatal Care

In the last few decades, neonatology has evolved dramatically in its ability to care for premature infants. Whereas before doctors provided active care to babies at 30 weeks, neonatologists are now equipped to provide care for newborns at just 22 or 23 weeks. Years ago, babies under 1000 grams were not resuscitated; today, infants at under half that weight are provided care. In fact, a report published in JAMA this month found that among extremely preterm infants born at US academic centers over the last 20 years, reductions in several morbidities were observed. Survival increased most significantly for infants born at 23 and 24 weeks gestation.

Research has produced technological and innovative new treatments which have broadened the scope of patients that NICUs can care for. There have been marked changes in the philosophy and approach to NICU care. Treatments now trend towards being gentler and less intrusive. This is especially true regarding the manner in which infants receive breathing support. Nasal prongs delivering enriched air may be all that a premature infant needs. In the past, most babies born at two pounds and less always received mechanical ventilation necessitating breathing tubes in their windpipes. Skin-to-skin contact between mother and child is also prioritized when feasible, since research has proven its numerous health benefits.

Earlier this summer, Dr. Richard Auerbach, Senior Vice President of Children’s Services for Sheridan, was quoted in a Huffington Post article about the evolution of neonatal care. Check it out here to learn how preemie care has evolved over the decades, from Dr. Martin Couney’s experimental incubator treatment (which was paid for with Coney Island sideshow fares) all the way to its modern incarnation.