In 1960, more than 18 of every 1000 newborns in the United States died within the first 28 days of life. By 2016, the neonatal mortality rate had dropped to just four in 1000. The improvement was the result of numerous, interrelated forces, including prenatal care, nutrition, medical strides, and public health policies.
One particular advance—the emergence of Neonatal-Perinatal Medicine as a distinct clinical pediatric sub-specialty—merits special attention. The American Board of Pediatrics offered the first certification examination in 1975. Faculty members of this Department of Pediatrics, however, were helping form the subspecialty’s foundation and bettering patient outcomes decades earlier.
Eight areas in which the department’s clinical services have enhanced Neonatology nationally are:
Regional connections. In 1939, less than a decade after the Department of Pediatrics was formed, physicians on staff at The Children’s Hospital began traveling to Wyoming to share new knowledge on preterm infant care.
Care of the preterm infant. In 1947, the University opened the Premature Infant Teaching Unit with Lula Lubchenco as medical director. Over the years, this has developed into NICU care for inborn and outborn neonates at the University of Colorado Hospital and the Children’s Hospital Colorado, with surgical care for conditions diagnosed prior to birth provided through the Colorado Fetal Care Center.
High-altitude impact on neonates. In 1957, John Lichty and colleagues published “Studies of babies born at high altitudes: Relation of altitude to birth weight.” This led to fundamental discoveries of the importance of the relationship between birthweight and gestational age, and of the effect of fetal and maternal oxygenation and nutrition on fetal growth and development.
Fetal growth and nutrition. The arrival of Frederick Battaglia in 1965 marke the beginning of ongoing decades of groundbreaking basic research into the physiology and pathophysiology of growth and nutrition in the mammalian fetus.
Family involvement. In the late 1960s, Colorado native and pioneer thinker Edith Jackson consulted with Department of Pediatrics faculty on the psychosocial aspects of optimal newborn care.
Infant transport. In the mid-1960s, newborn transport to Children’s Newborn Center still involved new fathers, accompanied by a hospital nurse, taking a portable incubator to the birth site and returning with the infant. One of the nation’s first neonatal transport teams was launched when Joe Butterfield, Newborn Center director, flew in a DC-3 “Gooney Bird” to a remote southern Colorado airstrip to receive the newborn from the local doctor.
Early intervention. Early newborn screening for cystic fibrosis, phenylketonuria, and other congenital conditions were developed or enhanced by Department of Pediatrics faculty with life-saving results.
Care innovations. Department of Pediatric faculty members have pioneered such critical developments in neonatal care as inhaled nitric oxide therapy for neonatal pulmonary hypertension and early intravenous nutrition for extremely low birth-weight infants.