Mount Sinai collaborates nationally to enhance care for most vulnerable babies

Mount Sinai Hospital’s neonatal team is joining a national network to assess and track the Hospital’s most fragile patients’ first three years of life.

Statistics show that babies born prematurely or at a low birth weight are at an increased risk of having developmental problems such as visual impairment, hearing loss, autism and cerebral palsy. The best and only way to improve the long-term health and development of this group is to provide the necessary therapy as early as possible. Neonatologists hope that with early intervention, long-term risks to the babies’ health can be prevented.

That’s why the Canadian Institute for Health Research has provided funding to expand the existing Canadian Neonatal Network to include a national standardized database that tracks the development and general health of infants born at less than 29 weeks’ gestation and/or at a birth weight of less than 1,250 grams. Dr. Shoo Lee, Mount Sinai’s newly appointed Paediatrician-in Chief and Canadian Neonatal Network lead, is spearheading this latest initiative.

Mount Sinai is home to Ontario’s busiest level 3 neonatal intensive care unit. The hospital’s neonatology team understood that participating in the national network and creating an onsite neonatal follow-up clinic was an important part of its commitment to neonatal care and research.

“The new clinic will complete the circle of care for many of our infants,” says Dr. Ed Kelly, Mount Sinai Hospital neonatologist and Director of the neonatal follow-up clinic. “Joining this network will allow easier collaboration with other tertiary centres across Canada, enhancing neonatal care and research at Mount Sinai.”

Dr. Kelly estimates that 250 infants in Mount Sinai’s level 2 and 3 neonatal nurseries will be eligible for this new clinic each year. “The follow-up will allow our team to alert parents to developmental issues earlier and provide the best referrals. Equally important, the clinic and the shared database will provide a broader control group to draw findings about why some preemies do well and apply those best practices to the types of cases that haven’t been as successful in the past,” he explains.

Parents and their babies will visit the Mount Sinai clinic at designated points of the child’s development. During these appointments, the care team, which includes a neonatologist, occupational therapist, physiotherapist, nurse practitioner, psychometrist and psychologist, will have the baby do a number of activities – such as hand movements, sitting, walking – to assess if his or her range of abilities is similar to the skill level of other children his or her own age.

“In a typical session, the health-care professional will get down on the floor with the baby to go through the various activities,” says Dr. Kelly. “The range of assessments will tell us if the baby needs certain therapies. We know that this population (of premature babies) is more vulnerable to developmental problems. The best option right now is early therapy, however, our hope is the national network will help us better understand these issues so we can one day provide preventative treatment.”

Mount Sinai’s neonatal follow-up clinic will open in summer 2009 in the women’s and infants’ ambulatory area. “It’s wonderful that the Canadian Neonatal Network now has the funding and capacity to extend their network to neonatal follow-up clinics,” says Dr. Kelly. “This opens up greater opportunities for discoveries in the development of pre-term babies.”