An Exceptional Level Of Care For Newborns

Infants who are born premature or critically ill are treated by specially trained neonatologists

You did everything right during your pregnancy—you went to all of your prenatal care appointments, didn’t smoke or drink, protected yourself from infections, and even reduced your stress. But you still went into preterm labor and gave birth to your baby early.  Don’t feel guilty—it can happen to any woman.

“You may do everything that you think you know to do, and do it correctly, and still have a premature infant,” says Monuj Bashambu, MD.

As a neonatologist, Dr. Bashambu is specifically trained to treat infants who are born premature or who have a serious illness or injury. Board Certified in Pediatrics and Neonatal-Perinatal Medicine, Dr. Bashambu is the Medical Director for the Level II Neonatal Intensive Care Unit in the Mary Telfair Women’s Hospital at St. Joseph’s/Candler.

“If we’re called to the delivery, we have a team that is solely focused on the health of the infant, including myself, a neonatal nurse, and a neonatal respiratory therapist,” Bashambu explains. “We have the tools to make sure an infant is receiving an adequate amount of oxygen. We also monitor the baby’s temperature, blood pressure, blood glucose level and other vital signs.”

A baby is considered premature if he or she is born before 37 weeks of pregnancy.  According to the March of Dimes, about 1 in 10 babies are born prematurely in the United States each year. These infants are at risk for health problems because their bodies have not matured enough for life outside the womb. They are often small and may have problems breathing or maintaining their body temperature. They also face a higher risk of infections or jaundice.

Physicians and nurses in the Level II Neonatal Intensive Care Unit (NICU) assess and treat any health problems for these infants after delivery.  Babies may need to stay in the NICU for an extended period to benefit from these caregivers’ expertise and their equipment, which is specifically designed for these tiny patients.

“We do our best to send babies home as soon as we can,” Bashambu says. “There are so many different scenarios that can cause an infant to be in the NICU for a longer period of time, and unfortunately we can’t predict those.”

While the infant is in the NICU, Dr. Bashambu and the neonatal nurses look for acute problems that may predispose the baby to a chronic problem.  For example, a baby’s immature lungs may cause him or her to suffer from respiratory distress syndrome (RDS). This occurs when the lungs can’t make enough of a liquid protein called surfactant, which coats the lungs and helps keep them open. A lack of surfactant makes it harder for the infant to breathe.

Some infants can be treated for RDS and recover with no long-term breathing problems. Others may deal with chronic conditions later in life such as asthma or another breathing disorder known as bronchopulmonary dysplasia, or BPD.

When speaking with worried parents, Dr. Bashambu takes care to note that an infant’s resilience can often be remarkable when compared to adults.

“An adult body is already set, but babies are just developing,” he says. “They have an amazing ability to recover. I tell parents that an occurrence of a health issue in the NICU does not definitively mean that there will be a problem down the road.”

In Dr. Bashambu’s experience, parents of premature infants are appreciative of this kind of encouragement as they prepare to finally take their baby home.

“Families want to stay positive,” Bashambu says. “And I remind them that when they go home with their baby, they should be able to do the same things with their child that they would have if he or she had been born full-term. Reading to them, breastfeeding if possible, giving them all kinds of love and attention. They will get that chance and it’s just what their newborn needs.”

Almost Home

Physicians and nurses in the Level II Neo-natal Intensive Care Unit want the same thing as the parents of infants there—to get the newborns healthy enough to go home as soon as they can. In general, babies are ready to go home when they can:

• Breathe on their own, without recent apnea or low heart rate
• Breastfeed or bottle-feed
• Stay warm without the help of an incubator
• Gain weight

Parents may also need to provide medication for their infant, or the baby may need to remain in the NICU for a longer time if it allows neonatologists to send the child home without needing further medication.

“Our goal as neonatologist is to send babies home requiring as little of neonatal-specific interventions as possible,” says Monuj Bashambu, MD. “We want to lower the stress as much as we can for the parents.”