Guidelines developed for extremely premature infants at NCH proven to be life-changing

October 31, 2012
One of the challenges that Dr. Shepherd's team is facing is changing the way people view the chance of survival for small babies. Their approach is to make people understand that each and every infant has enormous potential for a normal outcome and satisfying life.

For the last decade, prematurity has been the leading cause of infant mortality in the United States. As a result of prematurity many infants enter this world too early with a small chance of survival. In order to help treat these extremely premature infants, physicians at Nationwide Children's Hospital developed a set of guidelines tailored to meet the needs of these tiny infants, some born up to four months early. Now, a new study shows that these guidelines are not only improving survival rates for extremely premature infants, but also improving their quality of life.

This study, appearing in the Journal of Neonatal-Perinatal Medicine, included more than 200 'small babies' – infants born less than 27 weeks gestation – who stayed in the Small Baby Pod inside the Unit (NICU) at Nationwide Children's. These small babies received care following the Small Baby Guidelines and were monitored from birth to at least 2 years corrected age.

Results from this study showed that by following these guidelines, the survival rate of these small babies increased over time. "Our approach was to standardize the level of care, ensuring that every baby received the same care," said Edward Shepherd, MD chief of the Section of at Nationwide Children's Hospital and co-author of the study. "The idea being that if we do everything the same, for each of these infants, that our results should be better."

Before these guidelines were instituted, there were very few survivors of babies born less than 27 weeks gestation. In fact, many families and professionals viewed these small babies as having a predestined conclusion of not making it through the first few days of life. However, the findings from this study show that patients who receive care following these Small Baby Guidelines, do very well compared to normal children of the same age.

"The challenge is to convince families and our peers that these are children who, while they have had many challenges, can ultimately lead a normal life," said Dr. Shepherd, also an assistant professor of Clinical Pediatrics at The Ohio State University College of Medicine. "If you treat patients as if they do not have a chance for survival, these patients don't do as well as they could. Our approach was that each and every one of these infants has enormous potential for a normal outcome and for a satisfying life."

In addition to improving , this study showed that treating babies with this unique approach leads to shorter hospital stays. While often go on to develop infections, necrotizing enterocolitis (NEC) and/or bronchopulmonary dysplasia (BPD), by following these guidelines, babies are recovering from these diagnoses and improving their developmental outcomes leading to an earlier discharge. "This is a real win-win; a shorter stay means parents get to take their child home sooner and it saves an enormous amount of resources," said Dr. Shepherd.

Part of the success of the Small Baby is due to the multidisciplinary approach to treating these infants. The specialized care team includes everyone from physicians and nurses to cardiologists and nutritionists. The goal of this multidisciplinary approach is that every member of the team should understand the goals, the expectations and the gold standard of care so this can be achieved in each patient.

While there is still a need for new approaches to prevent the many illnesses premature infants face when entering the world too soon, physicians and researchers at Nationwide Children's continue to study ways to prevent illnesses seen in and the cause of .

Explore further: Neonatal and infant feeding disorders program saves infants from lifetime of feeding tubes

More information: www.nationwidechildrens.org/small-baby-guidelines

Related Stories

Neonatal and infant feeding disorders program saves infants from lifetime of feeding tubes

September 6, 2011
An innovative approach to treating neonatal feeding problems at Nationwide Children's Hospital has allowed infants who were struggling to feed orally to be discharged earlier and without feeding tubes, subsequently saving ...

Guidelines for ventilator use help premature infants breathe easier

June 13, 2011
Guidelines that reduce the use of mechanical ventilation with premature infants in favor of a gentler form of respiratory support can profoundly affect those children's outcomes while reducing the cost of care, according ...

Survival rates for premature babies in high-level NICUs are better than previously reported

July 23, 2012
Premature babies are more likely to survive when they are born in high-level neonatal intensive care units (NICUs) than in hospitals without such facilities, and this benefit is considerably larger than previously reported.

Preemies still receive inhaled nitric oxide despite lack of supporting evidence and standards

March 12, 2012
Many premature infants throughout the United States continue to receive inhaled nitric oxide (iNO) during their NICU stay, despite the lack of evidence to support its use. Whether or not a preemie will receive iNO treatment, ...

Surviving premature babies in Malawi continue to have poor growth rates and development delay

November 8, 2011
A detailed study from Malawi, published in this week's PLoS Medicine, shows that during the first 2 years of life, infants who were born prematurely (before 37 weeks gestation) continue to have a higher risk of death than ...

Recommended for you

Breastfed babies are less likely to have eczema as teenagers, study shows

November 13, 2017
Babies whose mothers had received support to breastfeed exclusively for a sustained period from birth have a 54% lower risk of eczema at the age of 16, a new study led by researchers from King's College London, Harvard University, ...

Obesity during pregnancy may lead directly to fetal overgrowth, study suggests

November 13, 2017
Obesity during pregnancy—independent of its health consequences such as diabetes—may account for the higher risk of giving birth to an atypically large infant, according to researchers at the National Institutes of Health. ...

Working to reduce brain injury in newborns

November 10, 2017
Research-clinicians at Children's National Health System led the first study to identify a promising treatment to reduce or prevent brain injury in newborns who have suffered hypoxia-ischemia, a serious complication in which ...

Why do some kids die under dental anesthesia?

November 9, 2017
Anesthesiologists call for more research into child deaths caused by dental anesthesia in an article published online by the journal Pediatrics.

Probability calculations—even babies can master it

November 3, 2017
One important feature of the brain is its ability to make generalisations based on sparse data. By learning regularities in our environment it can manage to guide our actions. As adults, we have therefore a vague understanding ...

Early childhood adversities linked to health problems in tweens, teens

October 30, 2017
Adverse experiences in childhood—such as the death of a parent, growing up in poverty, physical or sexual abuse, or having a parent with a psychiatric illness—have been associated with physical and mental health problems ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.