Neonatology

In honor of the New Year, we’re taking a look back at some of our most popular and memorable blog posts from 2014. Below is a list of our top 10 posts. Here’s to another great year of health news to come. Happy New Year!

Lung Liquid Similar to One Used in Movie “The Abyss” Saves Infant’s Life, Doctors Encourage FDA Approval of Clinical Trials

Two doctors at Seattle Children’s went the extra mile to save Tatiana, one of the sickest babies they’ve ever seen. They got ‪FDA‬ approval to use a long-forgotten drug and are now inspired to help make this drug available to save more lives.

Visit with Macklemore Helps 6-Year-Old Heart Patient Recover

AJ Hwangbo was a happy-go-lucky 6-year-old without a worry in the world until mid-November when he developed a life-threatening heart condition. While specialists at Seattle Children’s Hospital helped AJ heal physically, the young boy struggled to bounce back emotionally. But, AJ’s joyful spirit returned after hospital staff arranged for him to meet his hero – local artist Macklemore. Read full post »

Elise Pele had been in labor for hours awaiting the arrival of her baby girl, Tatiana, on the evening of Aug. 29. Elise remembers wanting desperately to hear her baby cry – a sign that everything was ok. But that cry never came. She saw Tatiana for only a few seconds before nurses rushed her to the neonatal intensive care unit (NICU) at a local hospital.

“I instantly knew something wasn’t right and I was terrified,” Elise said. “The doctors told me my baby wasn’t breathing right and had to be transferred to Seattle Children’s.”

Tatiana experienced meconium aspiration syndrome where she inhaled a mixture of meconium (stool) and amniotic fluid during labor due to stress, which obstructed and irritated her airways, leading her down a path where doctors thought she would likely die. Read full post »

Photo courtesy of Paul Joseph Brown/GAPPS

When you see pictures of tiny preterm babies, you likely marvel at how they fit in the palm of a hand, or how a wedding ring can slide up their arm and reach their elbow. What you may not consider is the lifelong toll premature birth can have on a person – if they survive it at all.

New research shows that for the first time ever, preterm birth is now the leading cause of death for all children under age 5 around the world.

More than 15 million babies are born too soon every year, and nearly one million of them don’t survive infancy. Those who do survive are often faced with lasting health issues such as cerebral palsy, developmental delays, or respiratory, vision and hearing problems. The burden is magnified in many developing countries, where world-class neonatal intensive care units, let alone a basic level of healthcare, are not available.

Dr. Craig Rubens, executive director of the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children’s, says a larger, coordinated research effort is critical to lowering the number of babies born preterm. Read full post »

Rohit Nariya, research associate at GAPPS, adds preservative to hundreds of vials before they’re added to the collection kits.

What does a pregnant woman in Yakima have to teach a researcher at St. Louis University? How can a Seattle woman’s healthy, full-term pregnancy impact future pregnancies in Europe or Africa? The answers are closer than you might think.

Over the past seven years, the team at the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) – an initiative of Seattle Children’s – has worked to increase awareness, collaborations and research in support of their mission to improve the health of moms and babies worldwide.

One big gap (pun intended) the GAPPS team noticed early on was that a collection of widely-accessible, high-quality, pregnancy-related specimens (like cheek swabs, amniotic fluid and cord blood) for researchers didn’t exist. At the time, researchers who needed these types of specimens had to develop their own methods to collect and store them – a time-consuming and costly process.

Enter the GAPPS Repository: a biobank of pregnancy-related specimens that eligible researchers worldwide can access for their research projects. Read full post »

The following is part 2 of our two-part series on ECPR, a combination of CPR and ECMO offered at Seattle Children’s Hospital to save the most fragile patients’ lives. Part 1 covered Hannah Mae Campbell’s incredible story where ECPR and a heart transplant saved her life and allowed her to be the thriving toddler she is today. Here, we discuss how Seattle Children’s has spearheaded a first-of-its-kind ECPR simulation program to improve the process that allows the hospital to save patients in a time of crisis.

In an ECPR simulation in Seattle Children’s neonatal intensive care unit, the surgeon works to get the mannequin on the ECMO pump.

ECPR takes place when a patient goes into cardiac arrest, does not respond to CPR and is then put on Extracorporeal Membrane Oxygenation (ECMO), a machine that functions for the heart and lungs when the organs fail or need to rest. Hannah Mae Campbell’s experience demonstrates the importance of technology like ECMO and why it’s important to continually improve complex, life-saving processes like ECPR.

Since January of this year, Seattle Children’s has executed the largest-scale ECPR simulations in the nation, with medical staff coming together bimonthly to practice as though they were in a real ECPR situation. Even though Seattle Children’s ECPR outcomes are higher than the national average, the hospital initiated the simulations with the goal of standardizing each step of the process to further improve outcomes for patients. Read full post »

Shortly after Julie Wyatt delivered baby Nolan Wyatt on December 15, 2013 in Olympia, she received some startling news. Nolan was diagnosed with a congenital diaphragmatic hernia (CDH) – a hole in his diaphragm – a potentially life-threatening condition. It was something they didn’t see coming. Typically, CDH can be diagnosed before birth using an ultrasound, but Nolan was a rare exception. Read full post »

The following is part 1 of a two-part series on ECPR, a combination of CPR and ECMO offered at Seattle Children’s Hospital to save the most fragile patients’ lives. Here, we tell Hannah Mae Campbell’s story and how ECPR saved her life. In part 2, we’ll discuss how Seattle Children’s has spearheaded a first-of-its-kind ECPR simulation program this year to improve the process that allows the hospital to save patients in a time of crisis.

Today, Sept. 24, marks a remarkable milestone for the Campbell family – the end of a long, tumultuous journey that began the day their daughter, Hannah Mae Campbell, was born. It’s the anniversary of the day Hannah received a new heart, and a chance at life two years ago.

Hannah’s journey begins

When Jennifer Campbell of Everett, Wash., was pregnant with Hannah she prepared as much as she could and followed all the prenatal guidelines to a tee. This was her first baby and she, as all parents do, wanted her little girl to be perfect.

Once Hannah was born on May 18, 2012, Jennifer and her husband Jon remember how the joy of seeing their little girl for the first time quickly turned into terror. Hannah was lethargic, her hands and feet were blue and her heart was rapidly pumping at 253 beats per minute. The room at the local birthing center quickly filled with doctors and then Hannah was taken to the neonatal intensive care unit (NICU). Twelve hours later, Hannah was transferred by ambulance to Seattle Children’s Hospital.

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Complications that can arise around the time of birth may reduce oxygen and blood flow to a baby’s brain, causing hypoxic-ischemic encephalopathy (HIE), a leading cause of death or neurological impairment among infants. In the past eight years, cooling therapy (hypothermia) has become the standard form of care for HIE, as it’s been found to be effective in reducing brain injury, but doctors say it’s not enough – about half of affected infants still have a poor outcome.

For this reason, researchers have launched a nationwide study, called the Neonatal Erythropoietin and Therapeutic Hypothermia Outcomes in Newborn Brain Injury (NEAT-O), to see if using the hormone erythropoietin (Epo) in conjunction with cooling therapy may further reduce the risk of neurologic deficits in full-term infants (at least 36 weeks gestation) with HIE.

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Update: In January 2020, the New England Journal of Medicine published results from the completed PENUT (Preterm Epo Neuroprotection) Trial. The study found that erythropoietin (Epo) treatment administered to extremely preterm infants did not result in a lower risk of neurodevelopmental disabilities when tested at 2 years of age. Babies receiving Epo as part of the study required less transfusions in volume and number, resulting in a lower exposure to blood donors. Other research underway continues to study the use of Epo to treat term babies whose brains did not get enough oxygen at birth (asphyxia).

No soon-to-be parent ever wants to think they may meet their baby too soon, but this is unfortunately the reality for the parents of about 50,000 infants who are born premature in the U.S. each year. Premature babies often face a host of medical problems and also are at a higher risk for long-term neurodevelopmental disabilities. In fact, prematurity accounts for about 45 percent of kids with cerebral palsy, 35 percent of kids with vision impairment, and 25 percent of kids with mental or hearing impairment.

Seattle Children’s neonatologist Sandra Juul, MD, PhD, suspects a hormone called erythropoietin (Epo) holds the key to reducing the negative effects that premature birth can have on the brain, and she has launched a national, multi-center trial to test this theory.

In the randomized, placebo-controlled study, called the PENUT (Preterm Epo Neuroprotection) Trial, 940 extremely preterm infants (born between 24-28 weeks gestation) will be enrolled at 18 research centers and 29 hospitals across the nation. The University of Washington is the primary enrolling site in Washington, but eligible patients who are then transferred to Seattle Children’s Hospital will also be involved. The study is funded by the National Institute of Neurological Disorders and Stroke (NINDS).

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In honor of World Down Syndrome Day, Melanie Harrington shares excerpts from her blog, Our Journey Through Life – a rich chronicle of a baby’s fighting spirit and a mother’s courage to walk “the road less traveled” and arrive a better person.

May 2012: Our world changes forever
We get the call we’ve been dreading:  the baby boy I’ve been carrying for 15 weeks has Down syndrome. What?! How can this be? I’ve done everything right. I don’t drink, smoke, take medicine or eat foods I’m not supposed to eat. Why me? Why us? I am mad, sad, anxious and confused. Will we be able to love this baby? What does his future hold? Bullying, dependence, frustration? And, what does my 2-year-old son Cody’s future hold? Constant defending? Jealousy?

I’m feeling very un-mommy-like thoughts that I never thought I could feel about my unborn baby. Can I handle this? Can my husband, Chuck? Will our marriage survive? Right now, I don’t know the answer to these questions.

My doctor refers us to a genetic counselor for more testing. I don’t really gel with the first counselor, so she refers me to Seattle Children’s Genetic Counseling Clinic. This counselor immediately puts me at ease and I like her honesty. I also see Dr. Margaret Adam, who is wonderful and gives me lots of helpful information. Dr. Adam reassures me that Down syndrome can affect any family – one out of every 800 babies born in the U.S. has the condition.

June 2012: Grief…then acceptance
I still feel out of control – so desperate to understand what is really happening. I go to sleep and wake up not remembering if the diagnosis is a dream or real, then I remember. We cry a lot and worry all the time. We grieve for the child we thought we were having and we don’t know if we can ever come to terms with the child we are having.

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