Critically ill newborns often spend the first several months of their lives in the Neonatal Intensive Care Unit (NICU) at BWH. After hospital discharge, these vulnerable patients remain at risk for ongoing complications, yet providers have no formal mechanism for continuing care or tracking the progress of patients and families during this formative period. A new center opening at the Brigham is poised to change all of that.
Located at 221 Longwood Ave. and scheduled to open in the coming weeks, the new Center for Child Development will provide a comprehensive, team-based approach to outpatient care of infants and children at risk for developmental delay and/or ongoing medical problems following NICU discharge.
The center encompasses three discrete, but intertwined, areas of focus: the Research Suite, led by Lianne Woodward, PhD, director of Research in the Department of Pediatric Newborn Medicine; the NICU Follow-up Program, run by Jennifer Benjamin, MD, attending neonatologist and infant follow-up specialist; and the Feeding Program, directed by Pamela Dodrill, PhD, NICU feeding therapist.
The new center at BWH will advance the department’s vision to provide long-term support for NICU patients and families by addressing clinical needs and filling gaps in research. The latter will allow Pediatric Newborn Medicine to track and analyze the short- and long-term outcomes of the care provided in the NICU and identify ways to improve care delivery in the future.
“Our responsibility as care providers for this fragile patient population is not only to provide the highest quality of medical and developmental care during their NICU hospitalization, but also to ensure that ongoing issues at the time of discharge are addressed for the long term,” Benjamin said. “We need to learn from our own patients, which will allow us to optimize the care we provide to future NICU babies and families.”
Holistic, Patient-Centered Care and Research
BWH neonatologists will identify which infants in the NICU will be best served at the center, with appointments in the Follow-up Program typically occurring every four to six months during the child’s first three years of life.
“We not only focus on the assessment and management of a child’s developmental progress at regularly scheduled intervals, but we also evaluate other areas of concern, including overall growth and nutrition, behavior management and social and family issues, such as parental well-being,” Benjamin said.
According to Dodrill, depending on an infant’s needs, there may be a clinical assessment to identify feeding issues, monitor related therapies, measure infant growth and recommend interventions to improve feeding and nutrition.
In addition to the care of infants and toddlers, the longer-term goal of the center is to create opportunities for wider family support, such as providing in-center access to a mental health specialist and/or social worker who can help families directly with any difficulties they may be experiencing.
On the research side, Woodward said investigators will now be able to track the outcomes of NICU babies from discharge through early childhood. The initial areas of focus include the influence of early nutrition, maternal mental health factors and brain injury during the neonatal period on a child’s brain and behavioral development.
Specifically, Woodward said the suite offers opportunities for state-of-the-art evaluations of a child’s cognitive, language, behavior and motor development, in addition to family assessments.
In combination with the new neuroimaging research platform in the Brigham’s Building for Transformative Medicine, the opportunities to study the effects of pregnancy complications and early neonatal risk on children’s long-term brain and behavioral development is immense, Woodward said. “This will open up collaboration and partnership opportunities not only within the center but across the hospital and country, all of which will be key to our success.”
Woodward said she’s excited about what the new space will offer to patients, families and staff.
“A major focus in our design was to make this a very child- and family-friendly space,” Woodward said. “From the beginning, we had a vision to create a center that was developmentally supportive. Every decision was made with our patients and families in mind. We can’t wait until we can officially open our doors and begin offering these services.”