Celebrating its 30-year anniversary in 2006, the Neonatal Follow-Up Program at Women & Infants remains dedicated to providing supplemental care to infants who spent time in the Special Care Nursery.
While the goal of supporting optimal growth and development for all babies remains the same, Dr. Betty Vohr, medical director of the Program, answers some questions about its purpose, evolution and future.
Here are the photos and stories of the 13 NICU graduates featured in Women & Infants' 2007 calendar.
What is the Neonatal Follow-Up Program?
The mission of the Follow-up Program is to continue to provide care for graduates of the Neonatal Intensive Care Unit (NICU). The follow-up team consists of a medical director, neonatologists, fellows, psychologists, a nutritionist, a clinical coordinator, an occupational therapist, data entry personnel, and a data analyst.
We routinely see infants who: were born prematurely, weighing less than 1250 grams (2 pounds 12 ounces) at birth; NICU infants with a variety of complications including IVH, BPD, asphyxia, meningitis, and congenital malformations; and infants discharged on cardiorespiratory monitors.
What types of care/services are offered through the program?
The follow-up clinic provides medical and neurodevelopmental management for graduates of the NICU, and maintains a database of outcomes. Referrals come from the NICU discharge planner, private practitioners, Early Intervention, the Visiting Nurse Association, and parents.
How long are babies followed in the program?
Visits may be scheduled from birth to adolescence as indicated. Standard follow-up is for five years.
How are families involved in the program?
Families bring their children in for comprehensive multidisciplinary assessments and receive detailed feedback and recommendations.
Is there a measure of success? If so, what is it?
Our success is making certain that families are linked to all of the support services they need after the baby is discharged from the hospital. Secondly, the research studies we have participated in during the past 30 years have identified interventions - such as surfactant, antenatal steroids, breast milk - that have contributed to improved outcomes of special NICU babies.
How many babies have gone through the program since its inception 30 years ago?
We have seen approximately 6,600 infants. The number of patients enrolled has steadily risen from more than 100 in 1974 to more than 270 in 2005. The number of patient visits recorded each year is currently just under 1,000.
What types of babies were coming into the program in its first year?
In 1974, we had one baby weighing less than 1000 grams (2 pounds 3 ounces) enrolled. In 2005, there were 67 infants weighing less than 1000 grams. The initial eligibility criteria for infants to be admitted to the program was very low birth weight of less than1500 grams (3 pounds 4 ounces). This was dropped to 1250 grams (2 pounds 12 ounces) in 1990.
How has that changed over the years?
In 1974, our smallest survivors were born at 27 to 28 weeks of pregnancy. Today, we have many very tiny survivors born at 23 to 24 weeks pregnancy. The numbers of twins and triplets has also increased dramatically so that about 25% of babies born weighing less than 2 pounds 3 ounces are now multiples.
Is this program unique?
Currently it is recommended that all tertiary care centers with Neonatal Intensive Care Units have follow-up programs to assess outcomes of their graduates. Women and Infants Hospital has one of the oldest continuously running follow-up programs in the country.
What is the future for neonatal follow-up?
We will continue to provide state-of-the-art, coordinated, family-centered care and support and to monitor the neurodevelopmental outcomes of our NICU graduates.
In order to provide answers to your most pressing health care questions, the clinicans at Women & Infants participate in an ongoing series of web-exclusive interviews.