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The History of Neonatal Intensive Care Units
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Invention of Incubator
This was the begining of Neonatal Intensive Care, and could save babies that were born a few weeks early. -
Neonatal Care Truly Begins with Midwives and Obstetricians
Before the 1900's, most premature babies could not be saved. However with the invention of the incubator, most doctors and midwives delivering babies were able to care for these special needs infants. It was not pediatricians that initially care for these infants. -
First Techniques of Collecting Infant Blood Discovered
Until this time, there was no practical way to collect blood from infants. DR. Kenneth Blackfan was the first to figure out a sucessful way for this to be done. It did not involve a needle, but required for the nurse to open the blood vessles and drain out the blood. -
First Transportable Incubator Created
The creation of transportable incubators allowed for babies to be moved easily around hospitals, which facilitated the treatments that they needed. A baby that needed surgery could be moved to the OR easily, and they could move the incubators around the unit when the babies moved from their intensive care to intermediate care. -
Beginning of March of Dimes
Although originally created for the prevention of polio, the March of Dimes has been instrumental in raising awareness about prematurity. -
Martin Couney's Incubator Baby Exhibitat the New York World's Fair
From 1939 to 1940, Martin County's Fair had an exhibit in thier freak show that showed tiny babies in incubators. This did not have much sucess at the fair, because no one was interested in seeing the babies. However, all of these babies, as far as we know, survived and grew up healthy, These incubator babies were not the first to be put on display, only the most well known. -
Angiocardiography for infants with congenital heart disease
Infants with congenital heart disease did not have a way of being tested until this time. When doctors were able to figure out what kind of heart conditions an infant had, they were better able to treat the infant. -
Creation and use of DPT vaccine
Most childhood diseases that killed infants could not be prevented before vaccines were created. The DPT vaccines protects against diptheria, pertussis and tetnus. It was a successful development. Children that were vaccincated did not suffer and die because of these preventable diseases, which was a hugh development in pediactric medicine. -
Virginia Apgar develops the APGAR scoring for infants.
The first test that every person takes after they are born is called the APGAR test. This test evaluates 5 important features of infants right after they are born and then 10 minutes after they are born. Color, heart rate, respiration, reflex and muscle tone are all evaluated on a 10 point scale, Generally, a baby with a 7 or lower has some kind of complication and needs assiastance in the delivery room immediatly. -
First neonatal surgical unit, Alder Hey Children's Hospital, Liverpool
Before this children's hospital opened up a surgical unit just for infants, surgery on very small infants was almost never done. In fact, most surgery that was needed for infants was urgent, and this surgical unit saved many infant lives. Today, children's hospital are specially equiped for infant surgery, and even some hospitals that are not for children have the right equipment to perform some types of surgery, especially infant heart surgery. -
The first discription on light therapy in jaundice infants
Published in the Lancet, doctors were starting to be able to treat neonatal jaundice. Jaudice happens when the liver of the baby is not working correctly and the infant cannot break down bilirubin that builds up in thier blood. This can cause brain damage if left untreated. Therefor this devleopment also saved many lives. -
Discovery of the cause of RDS
Doctors noticed that babies lacked a substance called pulmonary surfactant on their lungs, making it difficult to breathe. This started new research on neonatal ventilation. -
March of Dimes Changes Mission
The March of Dimes Founder announces that their new mission will be to raise awareness on birth defects prevention, and from there they begin to ensure the prevention of premature birth as well. Since then, the March of Dimes has funded some of the most important research that has been done to prevent and treat birth defects and prematurity. -
The first time neonatology is recognized as a profession for a doctor
This was the first time that the doctors who took care of babies had their own title, as before it was pediatricians who did this work. Neonatology is a branch of pediactric medicine. -
Hospital Birth Rates Increase
Before the 1960's, there were few hospital births. Most babies were born at home. In the 60's, doctors insisted that hospitals were much safer for deliveries. The rate of hospital births went up from 5% and 60%. -
Discovery of bone marrow transplants to prevent birth defects
Robert Good discovered the use of bone marrow to treat birth defects that created compromised immune systems. He also discovered the thymus gland and its importance in the the immune system. -
First PKU kits are assembled and mass produced
PKU is a genetic disorder that prevents someone from synthesizing the amino acid phenylalanine. If they do not detect PKU early, the person can develop mental retardation. The severe effects of PKU can be avoided by testing for it and adjusting the diet of the infant. The March of Dimes was the organization that funded the distribution of these test kits. Test kits are still used in every Maryland hospital today. -
Prevention of maternal Rh sensitization by anti-Rh antibody
When a mother who is Rh negative has a baby that is Rh postive, the second pregnancy will almost always result in miscarriage because the body of the mother has created antibodies against the postive Rh factor of the baby. Until 1966, there was no way to prevent this. However in 1966 there was a vaccine developed that allowed for women to prevent the anti-postive antibodies from aborting the developing embryo. -
Development of Total Parenteral Nutrition
This type of nutrition is not food, but a substance with the exact amount of each nutrient that an infant will need. This development was important because before this time, almost all nutrition was given intravenously, which was not very helpful for infants, as it doesn't give them a chance to digest the milk they are given. This artificial nutrition given to the baby through an umbilical catheter or a feeding tube. -
The First March of Dimes March for Babies
Since 1970, the March of Dimes has spondered the March for Babies, which is an all day walk for people who want to support the March of Dimes. Families and friends of a baby can walk for in honor of that baby, or people can walk on their own. This year the March for Babies is on May 7th and 7 million people are expected to participate. Local chapters of the March of Dimes run thier own walks in different parts of the country. This event raises money for premature infants research. -
Start of using CPAP in infants
Use of CPAP led to higher survival rates in preterm infants -
The 1973 Rehabilitation Act
This act prevented medical professionals from discriminting on providing medical treatment to those with previous medical conditions. Adults with AIDS or some form of mental disability cannot be discriminated against when they are brought to a hospital in an emergency. This act was used in the Baby Doe case, as medical professionals had no right to deny care to an infant that was born premature or with little chance of a normal life. In fact, this was the act that influenced the Baby Doe Laws -
First infant heart transplant
Infant heart surgery is very tricky. Infants cannot have thier chest cavities cut open to reach the heart, the doctors go in through the side to reach the heart. This makes heart transplants, which is already very difficult, even more difficult. However, today it can be done with success. -
The Baby Doe Case Begins
This was the beginning of the laws surrounding neontal intensive care, starting with the birth of baby doe. -
Baby Jane Doe is born
In the middle of the Baby Doe laws debate, baby Jane Doe is born with multiple abnormalities and was another source of great conflict for medical ethicists. -
First use of pulmonary surfactant for RDS
T. Allen Merritt developed a pulmonary surfactant used to treat respiratory distress syndrome in newborns -
Baby K is born
Baby K was a baby born with anencephaly, which is when all but the brain stem is missing. Although the doctors wanted to withhold treatment, the mother refused. -
Death of Baby K
Although this ended the Baby K case. it lead an exception to the Emergency Medical Treatment and Active Labor Act (EMTALA) -
Chukwu Octuplets
Born at 30 weeks, all 8 babies survived, although required extensive care in an NICU. The babies all weighed around 2 pounds at birth. Today they have no long term medical problems. -
New regulations for Postnatal Steriods
In 2002, doctors started to recommend that postnatal (after birth) steroids are not used on infants. They were previously used to help the lung development in infants at risk for respiratory distress syndrome (RDS). However, mothers are still given prenatal (before birth) steroids because those steroids help the baby without the damage that postnatal steroids can cause. -
The Born Alive Infant Protection Act
Although not related completly to the unit, it protects any child that it born alive inside the United States, and ensures that the baby can receive any health care that it needs from a health care professional. -
1 in every 8 babies is premature
The number one reason that newborns die is because of being born premature.
