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

Small drop in measles vaccinations would have outsized effect, study estimates

July 24, 2017
Small reductions in childhood measles vaccinations in the United States would produce disproportionately large increases in the number of measles cases and in related public health costs, according to a new study by researchers ...

At the cellular level, a child's loss of a father is associated with increased stress

July 18, 2017
The absence of a father—due to incarceration, death, separation or divorce—has adverse physical and behavioral consequences for a growing child. But little is known about the biological processes that underlie this link ...

New comparison chart sheds light on babies' tears

July 10, 2017
A chart that enables parents and clinicians to calculate if a baby is crying more than it should in the first three months of its life has been created by a Kingston University London researcher, following a study of colic ...

Blood of SIDS infants contains high levels of serotonin

July 3, 2017
Blood samples from infants who died of Sudden Infant Death Syndrome (SIDS) had high levels of serotonin, a chemical that carries signals along and between nerves, according to a study funded in part by the National Institutes ...

Is your child's 'penicillin allergy' real?

July 3, 2017
(HealthDay)—Many children suspected of being allergic to the inexpensive, first-line antibiotic penicillin actually aren't, new research indicates.

Probiotic supplements failed to prevent babies' infections

July 3, 2017
(HealthDay)—Probiotic supplements may not protect babies from catching colds or stomach bugs in day care, a new clinical trial suggests.

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.