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Special care to protect newborns’ fragile brains

When babies are born with serious health problems, physicians’ main goal is to keep them alive. Thanks to decades of advances, such as support for preemies’ underdeveloped lungs and surgical procedures to correct complex birth defects, doctors can now save many babies who would once have died.

But some of these tiny survivors of high-risk birth still suffer permanent developmental problems. It’s only recently that physicians have begun to understand how to protect fragile infants’ developing brains.

As I describe in today’s issue of Inside Stanford Medicine, Lucile Packard Children’s Hospital recently became one of the first hospitals in the country to devote a section of its neonatal intensive care unit to specialized neurologic care for newborns. The new “Neuro NICU” will treat babies at risk for neurologic injury, including preemies, full-term infants deprived of oxygen during birth, and babies with congenital heart defects, who may receive too little oxygen in utero.

But knowing how to treat newborns’ brains is tricky because they change so fast, the story explains:

“The challenge and exciting thing about treating these tiny babies is that the brain is developing on a literally day-by-day basis,” said Courtney Wusthoff, MD, Packard Children’s neonatal neurologist.

Fortunately, new research findings and brain-monitoring technologies are helping doctors better understand infants’ immature nervous systems. For instance, they now have the tools to detect seizures that would once have gone undetected:

“In the past, it’s been assumed that you could just tell by looking if a newborn was having a seizure,” Wusthoff said. But it turns out that 80 to 90 percent of seizures in this age group cause no outward changes. “Newborns’ brains are not developed enough to show on the outside what’s happening on the inside.”

Wusthoff and her colleagues anticipate that the next several years will give doctors even better ways to understand and care for babies’ brains.

Previously: Increasing breast milk feeding rates for preemies at California hospitals , A look at the world’s smallest preterm babies and Advancing heart surgery for the most fragile babies
Photo of Jackson Thomas and Packard Children’s NICU nurse Diana Powell courtesy of the Thomas family

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