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Advances in neonatal care

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Dr Manoj Kumar Sharma, Consultant Neonatologist, Shalby Multispecialty Hospitals, Jaipur talks about neonatal care and recent advancements

The neonatal period (the first 28 days of life) is the most crucial period for a child’s survival, as this period carries the highest risk of death than any other period during childhood. As per National Health Portal, every year 2.6 million babies die in the first month of life worldwide, and nearly 0.75 million die in India each year.  Most of these deaths occur in the first week.

Since the first month of life lays the foundation for lifelong health and development, proper neonatal care is extremely important and can save millions of little lives each year. With the rapid advent of technology, there have been several advances in neonatal care that are helping prevent death in new-borns. The main causes of new-born death in India are prematurity, birth complications and severe infections; all of which are preventable to some extent by quality health care.

When a baby is born, there are often unseen life-threatening conditions that can create serious complications and it is important to spot them in order to avoid severe problems for the infant. The latest science offers various imaging technologies to help in the same.  One such technology, which is actively shaping up neonatal care in the modern world is LUS. For pre-mature babies, respiratory conditions like NRDS (new-born respiratory distress syndrome) are very common and can cause breathing difficulties, which can prove fatal. LUS (Lung Ultrasound) can be used for early detection and management of respiratory complications of infants. As a powerful diagnostic technique, LUS is a non-invasive research tool to describe several neonatal respiratory disorders in a qualitative manner along with help in USG guided surfactant therapy. A new technique like surfactant therapy by LIS catheter make the surfactant delivery very smooth and easier than intubation by ET. What makes it extremely significant in the field of neonatal care is the specific pathology inherent in lung immaturity, prediction of BPD in later stage as well as in the sensitivity of neo-nates to repeated radiation exposure. A highly insightful technology, its assistance in determining the prognosis of preterm infants has been successfully applied to the diagnosis of infant lung diseases such as pneumonia, transient tachypnoea, BPD monitoring and prediction.  etc.

When it comes to infant care, it is extremely important for medical professionals to thoroughly examine every aspect of the new-born’s health to rule out any complications. Sonography is, today, a preferred procedure for radiologists and gynaecologists to understand the health of various organs in the body and detect any abnormalities or new developments. It is also used commonly by doctors to study the developing foetus. But ultrasonography (USG) is swiftly transforming the neonatal care domain. Its diagnostic imaging techniques and therapeutic applications can help gauge the health of infants and examine their condition and is an especially effective tool when safeguarding the life of a premature baby.  USG is playing a huge role in ruling out neurological complications in premature infants who require intensive care, such as bleeding in the head or injury to the white matter of the brain surrounding the ventricles, which can cause periventricular leukomalacia.  Cranial sonography is also swiftly gaining ground in neonatal care and is a technique for scanning the brain using high-frequency sound waves. It is one of the most useful procedures for detection and follow-up of intracranial haemorrhage and hydrocephalus.  It allows rapid evaluation of infants in the intensive care units without the need for sedation and without any risk of harm for the infant.

Technology is also rapidly changing the management and treatment timing in the field of medicine. This also includes telemedicine, which is today transforming the medical world and providing instant guidance, assistance, and solutions to a wide range of medical problems. Owing to the felicitation of remote healthcare provided by the telemedicine infrastructure, doctors can evaluate and treat patients without being physically present at the location. This is a tremendous boon for neonatal care.

Today, a huge percentage of neonatal deaths in the country are caused by sepsis, birth asphyxia or low birth weight. Adding to the same, it has been observed in countless cases that lack of in-person assistance has proved fatal, failing to provide infants timely assistance, which has led to many infant deaths.  The widespread availability of telemedicine features is swiftly tackling the problem of lack of neonatal amenities, which has hindered quality care among new-born children. Receiving prompt assistance and attention through telemedicine practitioners, who can identify signs of deterioration in a child’s condition early, is helping to save the life of new-borns across the globe. It can also help reduce the number of unnecessary neonatal transfers and offer immediate expertise to a critical child, streamlining coordination between onsite health workers and remote neonatologists. The discipline is also evolving and can have positive implications for even long-term infant health, with telehealth programs for new parents swiftly gaining popularity. Especially in the post-pandemic times, this newly evolved discipline can additionally also reduce the risk of catching the COVID-19 infection among new-borns.

Today’s healthcare system is well equipped to combat the many challenges of ensuring optimal health in infants everywhere, owing to the many rapid developments in the field of neonatal care. With technology and medical practitioners working passionately towards the common objective of saving countless millions of young lives, the world is sure to witness a stronger and healthier generation of children in the coming years.

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