Neonatal Care
Overview
Babies born with congenital abnormalities that impact the brain or nervous system, those who experience a brain injury before or after birth, or babies who develop a brain infection need the specialized expertise of a pediatric neurologist. The pediatric neurologist works closely with neonatologists, experts in the care of very young infants.
The pediatric neurologists at UK HealthCare provide care not only to infants in the neonatal intensive care unit (NICU), but also to babies in utero if the mother’s obstetrician suspects an abnormality in the baby’s brain. Pediatric neurologists also provide guidance and treatment to infants, toddlers and children after discharge.
Types
- Congenital brain malformations
- Congenital infections
- Conditions acquired by infants and newborns, including newborn seizures, newborn stroke, Erb’s palsy, meningitis or encephalitis
Symptoms
Reasons an infant may need neonatal a pediatric neurologist or neonatal care include:
- Abnormal eye movements or vision problems
- Dystonia, uncontrolled contraction of one or more muscles or muscle groups
- Microcephaly or macrocephaly (a head that is too small or too large)
- Seizures
- Spasticity, an inability to control stiff or tight muscles
- Torticollis, pain or stiffness that makes it difficult to move the neck
Prevention
- A mother’s healthy lifestyle and proper prenatal care reduce the need for neonatal care, but many conditions that require this type of care cannot be prevented.
Risk Factors
- A family history of genetic abnormalities
- Mother developing or experiencing a recurring infection during pregnancy
- Mother participating in risky behaviors, such as drug or alcohol use, during pregnancy
- Premature birth
Diagnosis
- Medical history and symptom review. In some cases, the mother’s medical history and ultrasound images taken during pregnancy may indicate a problem that will require immediate medical attention for a child at birth.
- Physical examination. Upon birth, physical symptoms may indicate the need for neonatal neurological care.
- Imaging tests. After birth, any serious health condition may require imaging tests to determine the presence and extent of disease.
Treatment
Because babies’ brains develop quickly before and after birth, it’s imperative that babies receive prompt diagnosis and treatment to prevent additional long-term damage.
Treatment varies for these conditions, but may include:
- Observation may be necessary for mild issues to monitor the progress of the condition. This could include regular visits with a pediatric neurologist, imaging studies and other tests.
- Medications may be used to treat seizures, muscle rigidity or infections.
- Surgical procedures can be used for many congenital brain malformations. For example, surgeons may place shunts to drain excess fluid in the brain or perform a procedure to improve the function of the brain or spine.
Follow-up Care
- Following release from neonatal care, many infants will require frequent checkups that might include imaging studies and additional tests. It’s critical to keep all follow-up appointments with the physician team.
- Caregivers should monitor the child for any indications of changes to the condition, whether that is increased symptoms or worsening of the symptoms.
- Depending on the severity of a child’s health issue, caregivers will need to learn to provide at-home care. A pediatric neurologist or neonatal care provider will offer guidance about resources that can teach the skills a child needs.
- Physical therapy may be necessary to help the child age-appropriate skills.