Penn State Children’s Hospital: Saving Lives In the NICU, One Ounce at a Time

By Cari Wade Gervin
Tuesday, November 3, 2020
Specialty: 

Safety, innovation and collaboration positions Penn State Children’s Hospital as a leader in providing neonatal care — even during a worldwide health crisis.

Infants at risk of premature birth experience a significant difference in their prognosis with every week they stay in utero, allowing them to gain weight and develop the necessary functions to live. Providers with Penn State Children’s Hospital recognize the fragility of this time in a family’s life and strive to provide transparent, expert care that results in positive outcomes.

“This is a very intimate time in a family’s life,” says Jeffrey R. Kaiser, MD, MA, Chief of the Division of Neonatal-Perinatal Medicine at Penn State Children’s Hospital. “We work very hard in a multidisciplinary way and include the parents in that care.”

For women in central Pennsylvania with high-risk pregnancies or unplanned preterm labor, Penn State offers the best chance for survival of their baby.

“We’re the only Level IV NICU (the highest level) in all of central Pennsylvania,” Dr. Kaiser says, who is also the Kenneth V. and Eleanor M. Hatt Professor of Neonatal Medicine and a Professor of Pediatrics and Obstetrics and Gynecology at Penn State College of Medicine. “Our comprehensive perinatal program allows mothers to get acquainted with the facilities and staff — high-risk obstetricians, neonatologists and pediatric subspecialists, among others — who will be caring for neonates. There are neonatologists in the hospital 24/7. If a pediatric surgeon’s services are needed, I can get them there in minutes, because they’re also in-house.”

Care During COVID-19

That collaborative spirit served specialists at Penn State Children’s Hospital well while they worked to develop rigorous protocols to protect their patient population from COVID-19. Dr. Kaiser leads the hospital’s approach to treating neonates born to mothers with confirmed or suspected COVID-19.

Shaili Amatya, MD, a neonatologist at Penn State Children’s Hospital and Assistant Professor of Pediatrics at Penn State College of Medicine, led a team of doctors and nurses, including Dr. Kaiser, in writing a multidisciplinary journal article about the care of babies exposed to mothers with COVID-19. The article, which appeared in the Journal of Perinatology, includes information about how providers should isolate mothers who test positive for COVID-19, information about testing newborns for the disease, guidelines for proper respiratory support for newborns and guidance about breastfeeding, visitation and more.

“We spoke almost daily with providers from Obstetrics and Gynecology, General Pediatrics, Critical Care Pediatrics, Pediatric Hospital Medicine, Pediatric Infectious Diseases and NICU Nursing leadership to develop these guidelines,” Dr. Kaiser explains. “It has been a good foundation for us as we build up more data on COVID-19 and take care of our patients.”

A dedicated COVID-19 team of seven neonatologists are now on a shared call schedule at all times and specific plans are in place across the hospital.

“The nurses know what to do, we know what to do, and we know where we’re going to admit the babies born to mothers with COVID-19,” Dr. Kaiser says. “If they are premature, they’re going to the NICU. If they are full-term without problems, they are going to go to the Children’s Hospital.”

As of July 2020, the hospital had delivered the babies of four mothers who tested positive for COVID-19. Not one of those babies contracted the disease.

Still, Dr. Amatya says physicians at Penn State Children’s Hospital are focused on the follow-up care of those babies, since so little is still known about the disease.

“We have strong discharge guidelines,” Dr. Amatya says. “Telehealth is a good way to make sure that the families are being followed, as well as things like making sure that the baby’s weight is being monitored.”

The pandemic has also made it hard for families to visit their infants in the NICU and receive discharge instructions, so the nursing staff has used iPads to keep families connected.

“Over the iPad, they teach the family how to take care of the baby,” Dr. Amatya says. “Physicians go beyond to make sure that the patients and their families are treated well.”

Collaborative Value

When providing such a high level of care for babies and mothers in crisis, it’s important that physicians, nurses and the rest of the staff are all on the same page.

“When I joined Penn State, it was the team spirit that blew me away,” Dr. Amatya says, who joined the staff in 2019. “Everybody works so well with each other.”

The level of teamwork is also what attracted Dr. Kaiser to the hospital in 2017.

“The reason why I came to Penn State was because of the camaraderie and the opportunity to design the most technologically advanced new NICU in the country.”

The collegiality extends to physicians outside of the hospital, too. Dr. Kaiser says he recently sent out a letter to all providers in the central Pennsylvania area telling them that if they need guidance with a difficult delivery, they can call 24 hours a day, 7 days a week.

“I also gave them my cell phone number, so if they’re having problems in the middle of the night, they can just give me a call,” Dr. Kaiser says.

Prioritizing Safety and Technology

The NICU at Penn State Children’s Hospital averages around 600 admissions a year, and approximately one-third of the patients are admitted from outside hospitals. That high volume is due in part to the fact that the hospital offers innovative treatments and technology not found elsewhere in the region:

  • A new, 56-bed NICU is on track to open later this year with a hybrid room model, a mixture of private and multibed rooms, the latter of which is intended to help prevent neurodevelopmental delays for premature infants by offering increased exposure to human voice.
  • The hospital has the only ECMO program in the region for babies who are in extreme respiratory failure.
  • It’s one of the only facilities in central Pennsylvania to offer total body cooling for babies who have a lack of oxygen at birth and proper neurodevelopmental follow-up. “For babies who have a lack of oxygen at birth and need total body cooling, some are so sick that they can’t breathe on their own, so we have to put them on ventilators,” says Jeffrey R. Kaiser, MD, MA, Chief of the Division of Neonatal-Perinatal Medicine at Penn State Children’s Hospital. “We also have 24/7 pediatric neurology coverage. So, if I need a pediatric neurologist to help me at 3 a.m. for one of these newborns who develop seizures, they are available to help.”

The hospital also has pediatric cardiologists, endocrinologists, pulmonologists, surgeons, anesthesiologists, nephrologists, hematologists and infectious disease doctors, in addition to its high-risk neonatologists.

“We have the whole gamut of pediatric specialists,” Dr. Kaiser says. “So if we are not sure what a baby has, we’re going to call our specialists who can help us figure things out. This just does not exist anywhere else in the rest of central Pennsylvania.”


Learn how to partner with the Penn State Children’s Hospital Neonatal-Perinatal Medicine program at childrens.pennstatehealth.org/neonatology.