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In Memoriam

Robert B. Cotton, MD

Dr. Robert B. Cotton, Jr. passed away on Friday, January 2nd, 2015 at the age of 74.  Bob had been ill for some time and died in the company of his family.

Dr. Cotton joined the Vanderbilt faculty in 1975 and served with distinction until his retirement. He conducted groundbreaking research that focused on infants with patent ductus arteriosus, a cardiac consequence of prematurity, which resulted in a novel therapeutic approach utilizing the drug indomethacin to close the ductus in lieu of surgery, while simultaneously describing the benefits of a surgical approach for some. Few physician scientists have achieved true bench to bedside translation of their research during their career.  Bob’s achievements have benefited countless numbers of premature infants and are accepted as standard therapy in Neonatology. In collaboration with Dr. John Oates, these studies also set the standard for pharmacologic studies in premature infants, paving the way for expanding bedside investigation and pharmacotherapeutics to this extremely vulnerable and challenging population. Later studies on newborn lung disease involved the development and use of novel approaches for infant ventilation that resulted in multicenter clinical trials. He was continuously funded throughout his long career and was participating in research and mentoring young investigators up until his death.  Taken together, Bob’s research contributions placed Vanderbilt Pediatrics at the forefront of clinical investigation in premature infants and further established Vanderbilt Neonatology as a premier program worldwide.

More information »

Trainees and Early Career Neonatologists

The Section on Perinatal Pediatrics Trainees and Early Career Neonatologists (TECaN) group is dedicated to the interests of trainees and neonatologists who are within 7 years of their fellowship completion.  The group was established and is supported by the Section of Perinatal Pediatrics of the AAP.  TECaN strives to engage, educate and support young neonatologists as they advance through their training, seek employment, evaluate professional positions, and progress along their career trajectories.  The group also promotes communication and networking among members. The TECaN Council comprises district fellow representatives from each of the ten districts and other elected and nominated positions.

Meet the new TECaN Council »

Visit the TECaN website »

Become a TECaN member »

1975 Apgar Awardee:
Clement "Clem" Andrew Smith

The Virginia Apgar Award is the most prestigious honor conferred by the Section on Perinatal Pediatrics.  Since 1975, this award has been bestowed upon an individual whose cumulative career contributions continue to influence the well-being of newborn infants in a powerful way. This third in a series of vignettes on Apgar Awardees highlights the accomplishments of Clement "Clem" Smith. 

Clement (“Clem”) Andrew Smith was born in 1901 in Ann Arbor, Michigan. Growing up as the son of a Professor of English and Vice-President of the University of Michigan sheds light on why he completed a Master’s program in English before obtaining his M.D. degree at the University of Michigan in 1928.  His literary interests and talents would later serve to galvanize the impact of his scientific writings among the generations of neonatal physicians to follow him. He had a particular love of poetry and had a lifelong friendship with the American poet Robert Frost, whom he met during Frost’s tenure as a teaching fellow at the University of Michigan.

More on Dr. Smith »

New Website Feature!
Current Articles of Interest

A new and energetic Perinatal Section Publications Working Group has been formed over the past several months, This group is tasked with reviewing current literature for Articles of Interest and presenting them on the Section Website. Each month they will select approximately 25 articles as high relevance to the ongoing practice of Neonatal-Perinatal Medicine. From this list, the group will highlight a handful of articles with short written summaries. All selected articles, including those highlighted and the master list from which they're chosen, will be posted on a new Articles of Interest webpage with links provided to PubMed for each selected paper. All monthly postings will be archived and stored with an eventual goal of creating a searchable, browseable database of noteworthy publications. This page will offer information of great interest to every neonatologist.

Website Working Group :

Jonathan Mintzer, Page Editor - Stony Brook Children's Hospital
Rachel Chapman - Children's Hospital Los Angeles
Craig Nankervis - Nationwide Children's Hospital
Christopher Rouse - United States Naval Hospital Okinawa
Jeffrey Shenberger - Baystate Medical Center

Articles of Interest »

Should you have any feedback, suggestions, questions, or concerns, please feel free to contact Dr. Mintzer directly.

Regional Networks Advance Quality Improvement

Neonatal quality improvement networks are emerging around the country and are moving forward the agenda for better perinatal health.  In this first of a series on such networks, we describe the work of the Florida Perinatal Quality Collaborative (FPQC).

The FPQC was established in 2010 at the University of South Florida (USF) with seed funding from the March of Dimes.  The FPQC, a partnership among state organizations, perinatal professionals, hospitals and payers, aims to improve maternal and infant health outcomes in Florida through evidence-based quality improvement (QI) projects. 

Learn more about the FPQC »

AAP-ACOG Issues Joint Statement: Oppose Water Immersion During the 2nd Stage of Labor

A joint statement by the American Academy of Pediatrics and the American College of Obstetrics and Gynecology acknowledges growing public interest in immersion in water during labor and delivery. Their evidence-based review revealed no evidence supporting improved maternal or fetal outcomes associated with immersion during labor and delivery and rare but serious complications of underwater delivery of the infant. AAP and ACOG experts concluded that, ‘the practice of immersion in the second stage of labor (underwater delivery) should be considered an experimental procedure that only should be performed within the context of an appropriately designed clinical trial with informed consent.’ AAP and ACOG experts further noted that, ‘facilities that plan to offer immersion in the first stage of labor need to establish rigorous protocols for candidate selection, maintenance and cleaning of tubs and immersion pools, infection control procedures, monitoring of mothers and fetuses at appropriate intervals while immersed, and immediately and safely moving women out of the tubs if maternal or fetal concerns develop.’

Read the full statement »

1986 Apgar Awardee: Graham "Mont" Liggins

The Virginia Apgar Award is the most prestigious honor conferred by the Section on Perinatal Pediatrics.

Since 1975, this award has been bestowed upon an individual whose cumulative career contributions continue to influence the well-being of newborn infants in a powerful way. This second in a series of vignettes on Apgar Awardees highlights the accomplishments of Graham "Mont" Liggins (b. 1926, d. 2010). Dr. Liggins was a native of New Zealand (a country where, important to his later career, sheep outnumber people by a factor of 13 to 1). He received his basic medical training and contributed as a general practitioner on the South Island before moving to Newcastle upon Tyne in the UK to pursue training in obstetrics. When he returned to Auckland in 1959, a fellow obstetrician, Dr. Bill Liley, whetted his interest in researching the causes of preterm labor. In the course of experimenting with the effects of steroid and ACTH infusions in pregnant ewes and fetal sheep on preterm labor, he serendipitously observed 10 lambs born spontaneously between 117-123 days gestation that had partial lung aeration on histology.

More on Dr. Liggins »

AAP-Vermont Oxford Fellow Scholar’s QI Presentation

Anastasia Ketko, Fellow in Neonatal-Perinatal Medicine at the University of Michigan, CS Mott Children’s Hospital, presents her work at the 2013 Vermont Oxford Annual Meeting and Quality Congress. Dr. Ketko’s project focused on oxygen saturation alarm fatigue and strategies for reducing this phenomenon.

View the presentation »

New AHRQ Toolkit Designed to Improve
Safety of Fragile Newborns

A new toolkit is available to help improve the safety of infants born preterm or with complex congenital conditions as they transition from the neonatal intensive care unit to their home. Funded by the Agency for Healthcare Research and Quality, the toolkit features information on how to create a Health Coach Program, where the “Health Coach” serves as a teacher and facilitator who encourages open communication with the parents/caregivers to identify their needs and concerns and facilitates follow-up care for the infant by primary care providers. As an online product, the Health Coach Program can customize a broad range of information for each family based on their needs and concerns. Included are approximately 30 fact sheets, directed to either the clinician or the infant’s family, on topics that range from medications to breastfeeding to insurance coverage tips.

See more here »

An Update on Research Issues in the Assessment
of Birth Settings - Workshop Summary

More than 30 years ago, the IOM and the National Research Council released the report Research Issues in the Assessment of Birth Settings which determined methodologies and research needed to evaluate childbirth settings in the United States. Since the release of the report in 1982, the issues surrounding birth settings have evolved and new research has emerged. In March 2013 the IOM held a workshop to review updates to the 1982 report. Presentations and discussions highlighted research findings that advance understanding of the effects of maternal care services in different birth settings on labor, clinical and other birth procedures, and birth outcomes. The workshop also identified datasets and relevant research literature that may inform a future study.

More details »

Tonse N.K. Raju, MD, FAAP

We are very pleased to announce that Tonse N.K. Raju, MD, has been selected as Chief of the Pregnancy and Perinatology Branch (PPB), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

In this role, he will oversee the national and international research and educational activities supported by PPB, provide feedback about the activities of his Branch to the professional colleagues at large, and offer input to the NICHD leadership about the future research needs in the field of perinatal and neonatal care.

Formerly a Professor of Pediatrics and Obstetrics and Gynecology at the University of Illinois, Dr. Raju has been serving as Medical Officer at NICHD since 2002. Dr. Raju is a true friend to the Section on Perinatal Pediatrics.

Section on Perinatal Pediatrics
at the NCE 2013!

The Section on Perinatal Pediatrics has organized another outstanding meeting at the AAP NCE in Orlando FL October 25-25, 2013.  Highlights include the Merenstein Keynote address delivered by Dr. Linda Van Marter, a Friday evening Poster Session and Reception, a session on Neonatal Transfusion Medicine and recent controversies as well as a Sunday morning session on Current Controversies in Neonatal Medicine.  The meeting will end with a workshop on CPAP and a Mock Malpractice Trial. 

Registration is now open »

Perinatal Program »

2014 ABP Neonatal-Perinatal Medicine Certifying Exam
10/31 Application Deadline Approaching

The American Board of Pediatrics (ABP) will administer the 2014 Neonatal-Perinatal Medicine Certifying Examination on April 10, 2014 at Prometric computer testing centers. All applicants must complete applications online at during the open registration periods. An applicant must complete subspecialty training before April 1, 2014, in order to apply for the certifying examination. The final deadline for application submission is October 31, 2013, at 3 pm EDT. No exceptions will be allowed for applicants who miss the application deadline. Following application, a copy of a valid, unrestricted license that includes the candidate’s name, license number, and expiration date must be received by the ABP by February 25, 2014.

Eligibility requirements and requirements for online applications are found on the ABP Web site.

ABP website »

2013 National Infant Mortality Awareness Month

September is National Infant Mortality Awareness Month (NIMAM) and text4baby is partnering with organizations including the National Healthy Start Association and U.S. Department of Health & Human Services’ Office of Minority Health to spread the word about this critical health crisis in the U.S. and the importance of connecting more mothers to health information through programs like text4baby.

More details »

Neonatologists Must Sign Up for Medicaid Payment Increase

The Affordable Care Act includes a historic investment to expand access to health care for children, and we want to make sure you know about it. The ACA requires states to increase Medicaid payment for certain “primary care” Evaluation and Management codes (CPT 99201-99499) and vaccine codes to Medicare rates for services rendered in CYs 2013 and 2014. An American Academy of Pediatrics (AAP) analysis of billing data estimates that pediatric neonatologists stand to receive an average 42.5 percent increase in Medicaid revenue as a result of the increase. More information

Learn how to sign up »

50th Anniversary of
Patrick Bouvier Kennedy's Birth

August 7th marks 50 years since the birth of Patrick Bouvier Kennedy, the last of children born to President John and Jacqueline Kennedy. The infant was born in 1963 at 34 weeks gestation, nearly 6 weeks premature and weighed 4 pounds, 10 ounces. He suffered from a respiratory condition called Hyaline Membrane Disease, now referred to as surfactant deficiency, cause by inadequate production of a lipid and protein substance that helps lung alveoli open. Despite heroic attempts to save his life, including the use of a hyperbaric chamber, the baby died on August 9th at 39 hours of age. This baby’s tragic death was an impetus to the development of the subspecialty of Neonatology in the field of Pediatrics.

Today, more than one thousand neonatal intensive care units exist in the United States and advancements, such as neonatal ventilators, animal derived surfactant, and improved nutrition make the chances of survival of an infant born at Patrick’s weight and gestational age greater than 98%.

New York Times article »

Update on ACA and Health Care Financing and Politics

Mark Del Monte, JD presented up-to-the-minute information about what is going on in Washington with respect to implementation of the ACA, and the positive effects that this legislation can have on the families and children we serve.

Mr. Del Monte’s Presentation »

Neonatal-Perinatal Medicine Oral History Project

These newly-updated archives comprise the oral histories obtained through personal interviews of key personnel in the field of Neonatal Perinatal Medicine. Drs. Larry and Carol Gartner have commenced this project and, to date, 15 oral history interviews have been conducted and transcribed. All future recordings will be digital. Once North American interviews have been completed, the Gartners, Dr. Avroy Fanaroff, and others on the Section History Committee will begin to interview neonatologists in the United Kingdom and Europe.

Oral History Transcripts »

2013 Workshop on Perinatal Practice Strategies Post Script

Global Perinatal Health

Among a host of superb workshop offerings, there were a number of particularly noteworthy presentations, including: the Butterfield Lecture: Helping Babies Breathe: Wally Carlo, MD gave this year’s lecture in honor of Dr. Joe Butterfield. He presented striking data that demonstrated that a low cost approach ($2 per disability adjusted life year) to educating underdeveloped global communities about essential newborn resuscitation and care principles resulted in a 15-20% decrease in perinatal mortality. This work by Dr. Carlo and collaborators has been published in part in the New England Journal of Medicine (2010;362:614-23) and in Pediatrics (2010;126:e1064-71). Global Perinatal Health

Dr. Carlo’s Presentation »

Pediatric Academic Societies: May 3rd to 7th
Stevenson and Inder Headline AAP-Sponsored Events

Dr. Stevenson Dr. Inder
David Stevenson, MD Terrie Inder, MD

The Pediatrics Academic Societies meetings in Washington, DC May 4-7 promise to offer a great deal of interest to academic and practicing neonatologists.  Along with a myriad of sessions previewing the latest developments in clinical and laboratory science, the the AAP Section on Perinatal Pediatrics has organized several events including the William Silverman Lecture and the Infant Follow-up Club.

The 2013 Silverman Lecture will be delivered by David Stevenson, MD, whose presentation is entitled, ‘Unexpected Death, Kernicterus" and Bill Silverman:"Semper plangere".

The Infant Follow-up Club will host Terrie Inder, MD who will address ‘Neuroimaging of the Premature Brain at Term and Beyond: Research or Clinical Care?"

Learn more about the Silverman lecture and Infant Follow-up Club »

There is a great deal more that the PAS offers neonatologists and scientists interested in fetal and neonatal research.

Neonatologists Track at PAS »

Trainees will benefit from the a number of career development tracks offered on Friday, May 3rd.

Learn more about early career educational opportunities »

Newly Published Perinatal Care Guidelines

One of the most valuable benefits of the AAP Section membership, The AAP Guidelines for Perinatal Care, was just released in its 7th edition. Jointly developed by the AAP and ACOG, Guidelines provide a single resource for the most recent recommendations on quality care of pregnant women, their fetuses, and their neonates. This unique resource addresses the full spectrum of perinatal medicine from both the obstetric and pediatric viewpoints, adding important new information, including:

  • Proven policies, procedures, and best practices for community programs, community and regional hospitals, and medical centers
  • Evidence-based recommendations for safe, effective diagnostic and therapeutic interventions in both maternal-fetal medicine, and neonatology
  • Recent developments in quality optimization, newborn care, inter-hospital coordination, antepartum care, postpartum care, obstetric complications, and neonatal complications.

Members, access your complimentary eBook »

For a 15% discount on a print copy, enter promo code GPC »

Multidisciplinary Guidelines for the Care of
Late Preterm Infants

The National Perinatal Association is pleased to announce the launch of the Multidisciplinary Guidelines for the Care of Late Preterm Infants, a new tool for healthcare providers, parents, case managers and others involved in the care of babies born between 34-36 6/7 weeks gestation. The guidelines provide evidence-based recommendations that focus on the management of late guidelines can be used as a roadmap that provides guidance for the healthcare team and for families and are categorized in the areas of: In-Hospital Assessment and Care, Transition to Outpatient Care, Short-Term Follow-Up Care and Long-Term Follow-Up Care.

Free guidelines »

2012 Apgar and Education Awards Announced

Av Fanoroff and Richard MartinAt the recent AAP National Conference and Exhibition, Dr Waldemar ("Wally") Carlo, a household name in Neonatal-Perinatal Medicine throughout the globe, was awarded the 2012 Virginia Apgar Award, the American Academy of Pediatrics Section on Perinatal Pediatrics highest honor.

Learn more »
Apgar Award »

Dwayne Pursley and Wally CarloDr Richard J Martin is the 2012 recipient of the Neonatal Education Award from the Perinatal Section of the American Academy of Pediatrics. Dr. Martin is a Professor of Pediatrics, Reproductive Biology, and Physiology & Biophysics at Case Western Reserve University.

Learn more »
Neonatal Education Award brochure »

In Memoriam: Dr. Antony F. McDonagh, 2012 Landmark Awardee

We are sad to report that Dr. Antony (Tony) McDonagh, the recipient of the Perinatal Section’s Neonatal Landmark Award for 2012, died suddenly on October 22nd. An organic chemist, he devoted his professional life to the understanding of porphyrin metabolism, neonatal hyperbilirubinemia and phototherapy. Without Tony McDonagh, we would still be treating newborns with phototherapy but would not understand what we were doing.

Phototherapy was introduced to the world in 1958 but did not reach the United States until 1968. By then it was quite clear that placing infants under a bank of fluorescent lights would lower the serum bilirubin level, but the mechanism for this effect remained a mystery for some time. In a series of seminal papers, he explained that light energy changes the shape and structure of bilirubin by means of photochemical reactions that generate yellow stereoisomers of bilirubin and other colorless oxidation products.

He had a unique ability to reduce complex subjects to terms that could be understood by the practicing pediatrician and his contributions to our understanding of bilirubin metabolism and, in particular, our understanding of phototherapy, represent true landmarks in the practice of neonatology. In addition to his scientific contributions he was a kind and gentle person, much loved by all who knew him and he will be sorely missed.

Landmark Award Brochure - Antony F. McDonagh, PhD, FRSC »

Multidisciplinary Guidelines for the Care of
Late Preterm Infants

The National Perinatal Association is pleased to announce the launch of the Multidisciplinary Guidelines for the Care of Late Preterm Infants, a new tool for healthcare providers, parents, case managers and others involved in the care of babies born between 34-36 6/7 weeks gestation. The guidelines provide evidence-based recommendations that focus on the management of late guidelines can be used as a roadmap that provides guidance for the healthcare team and for families and are categorized in the areas of: In-Hospital Assessment and Care, Transition to Outpatient Care, Short-Term Follow-Up Care and Long-Term Follow-Up Care.

Free guidelines »

Help reVITALize Obstetric Data Definitions

Over the past year, the American College of Obstetricians and Gynecologists (ACOG) has been spearheading a campaign known as reVITALize. The goal of the reVITALize campaign is to refine obstetric data definitions in order to reduce discrepancies across the country and ultimately improve data quality, collection, and overall usability. The Public Comment period for the refined reVITALize Obstetric Data Definitions is open! until January 15, 2013. We ask interested stakeholders to review the refined data element definitions and submit comments. Thee data elements in Public Comment are grouped into five separate forms according to category. Those commenting are permitted to provide feedback on any number of categories and do not have to complete all of the category forms at one time

Visit the reVITALize page on the ACOG website »

Newborn Male Circumcision

The American Academy of Pediatrics  published an updated policy statement and technical report on newborn male circumcision. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure's benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV.

Read the Policy Statement »
/ Technical Report »

GAPPS Repository Pregnancy Specimens and Data
Available to Researchers

If you read Jay Shendure's recent paper, Noninvasive Whole-Genome Sequencing of a Human Fetus, you have seen what can be accomplished using biospecimens from the Global Allilance to Prevent Prematurity and Stillbirth (GAPPS) Repository, which comprises pregnancy specimens and linked phenotypic data. You can pursue research studies without the burden of creating a unique cohort of pregnant women. These samples are a valuable resource for researchers in many fields including genetics, epidemiology, pathophysiology, translational science, fetal origins of adult diseases, and healthcare delivery.

Learn more and submit requests for samples »

The Capital

Affordable Care Act (ACA)

Are you wondering what the ACA and the recent Supreme Court ruling means for pediatricians, neonatologists and you? The AAP website has lots of information and easy to understand explanations of this complex and controversial law. It is important for us to understand this in view of the current controversies and upcoming elections. Read it now!

Read more information »


Neonatology - 50 Years of History (video)

Dr. Alvin Miller, MD, FAAP, has been caring for newborns since 1962 and has been a first-hand witness to the advances, progress, and misadventures in the care of newborn term and premature infants.  Compared with what was seen 50 years ago, the outcomes of preterm and other critically ill newborns has significantly improved.  In this video, Dr. Miller offers a summary of the most important historical moments in the evolution of neonatal-perinatal medicine:  including  images and recollections of advances and failures in treatment and the people who made it all happen.  Dr. Miller's eloquent presentation will help the viewer understand and appreciate the specialty of Neonatology for what it is today.

Neonatology History Video »
Neonatology History Handout »

David Stevenson

Stevenson Leads Process to Revise Subspecialty Training & Certification

In 2010, the American Board of Pediatrics (ABP) convened a large group of pediatric subspecialists in an invitational conference to discuss the possibility of modifying clinical training and certification in the pediatric subspecialties. This initiative, launched in July 2011, was motivated by the ABP’s desire to evaluate clinical subspecialty training with a special emphasis on competence. The process will be coordinated by a task force on subspecialty clinical training and certification led by Dr. David Stevenson. The task force will evaluate the current model of pediatric subspecialty fellowship training, emphasizing the importance of competency-based education, and recommend changes to the current model of training and certification, if needed.

Learn more about the ABP initiative »

March of Dimes

Toward Improving the Outcome of
Pregnancy (TIOP) III

Chapter Three

TIOP III: Enhancing Perinatal Health Through Quality, Safety and Performance Initiatives is the third in a series of collaborative efforts developed by the March of Dimes, American Academy of Pediatrics and American College of Obstetricians and Gynecologists.

Chapter 3 is great overview of perinatal epidemiology by the definitions and the numbers. This section outlines the definitions of fetal, neonatal, infant, and maternal mortality, which closely complements the most recent statement by the Committee of Fetus and Newborn (July 2011 COFN Statement on “Standard Terminology for Fetal, Infant and Perinatal Death”). The chapter and the bibliography serve as a great reference for grants, papers, and presentations when discussing perinatal epidemiology, both current and trends over the years. The most updated information includes preliminary data from the 2008 Vital Statistics report.

Ch 3: Epidemiologic Trends in Perinatal Data »

Obtain the full TIOP III report »


Scottsdale Workshop 2012

GPS for the Neonatologist:
Finding Leadership Everywhere

On March 30th-April 1st, beautiful Scottsdale will once again welcome participants in the AAP Perinatal Section Workshop on Perinatal Practice Strategies. Highlights include:

Butterfield lecturer, Dr. Alan Jobe, who will offer his unique insights on Why Research Matters or Conundrums in Neonatal Neonatology and Imprinting the Blueprint: The Role of Epigenetics in Neonatology

Dr. Elena Fuentes-Afflick's lecture and workshop on "Hispanic Disparities in Perintal Care and the Latino Health Experience"

An educational track for trainees and early career neonatologists that includes a 4-hour leadership workshop, and workshops on the basics of managing budgets and NICU finance, career planning and career advance in early practice, and NIH/NICHD Resources and Support

Spring Workshop website »

Results of a Survey on Older Neonatologists

View the results of this survey by Dr Alice Gong »

If you couldn't make it...
NeoPREP 2012 Presentation Slides Synched
with Audio for only $999*

Never Before Offered!
10% discount for Section Members

Information from over 40 experts in neonatology.

Access to ALL presentations, which includes 12 concurrent sessions.

Over 66 hours of review relating to neonatal-perinatal medicine emphasizing evidence-based decision-making focusing on the scientific basis for the clinical practice of neonatology.

A thorough review of the American Board of Pediatrics content specifications at your fingertips.

For more information about purchasing these review materials »

AAP/CDC Collaboration: Question and Answer (Q & A)
"Prevention and Control of Influenza:
Considerations for Newborns and Very Young Infants

The American Academy of Pediatrics (AAP) in collaboration with the Centers for Disease Control and Prevention (CDC) has developed a Q & A to address 5 common questions regarding prevention and control of influenza in newborns and very young infants.

View the Q&A »

COFN Technical Report on Phototherapy to Prevent Severe Neonatal Hyperbilirubinemia 35 or More Weeks of Gestation

This report standardizes the use of phototherapy consistent with the American Academy of Pediatrics clinical practice guideline for the management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation.

Full Technical Report »

Perinatal Section Chair Testifies on Neonatal Drug Shortages

DeWayne Pursley, MD, MPH, SoPPe Chair, testified before the U.S. Food and Drug Administration Center for Drug Evaluation and Research (September 26, 2011) the on the urgent issuesconcerning drug shortages affecting children and newborns.

Read Dr Pursley's testimony »

Mary Ellen Avery

In Memoriam: Mary Ellen Avery, MD

It is with great sadness that we report that Mary Ellen Avery, MD, Children's Hospital Boston former physician-in-chief and past-president of the American Association for the Advancement of Science, passed away on December 4th at the age of 84. Known as Mel to her friends and colleagues, Dr. Avery lived a life defined by a groundbreaking discovery of pulmonary surfactant that has saved the lives of hundreds of thousands of infants. Her passing is a great loss to both the Children's family and the global pediatric community. Dr. Avery’s legacy lives on through every baby saved by surfactant treatment.

Dr Avery's full memoriam »

Neonatal Resuscitation Program:
2011 Changes Reflect ILCOR and AAP/AHA Guidelines

The Textbook of Neonatal Resuscitation, 6th edition, released in April 2011, incorporates a number of changes including the transition to online testing, an educational approach that places increased emphasis on simulation-based learning, and a number of modifications of the NRP algorithm. The new NRP algorithm eliminates evaluation of amniotic fluid in the initial rapid assessment, incorporates pulse oximetry in neonatal resuscitation, recommends more conservative use of supplemental oxygen during resuscitation, and advocates expeditious intubation when chest compressions are needed.

See a brief summary of changes in the NRP algorithm »

Textbook of Neonatal Resuscitation, 6th edition »

Perinatal Section Newsletter - August 2011

The latest edition highlights TIOP III, Section Awardees, Getting to Know Howard Kilbride, The View from our Chair (DeWayne Pursley), Committee Reports, NCE and Spring Workshop highlights, a salute to Jayant Shenai, a history feature on ROP, District News, Russian Neonatology, and Dr Forrest Bird.

Download the August 2011 edition »

March of Dimes

Toward Improving the Outcome of Pregnancy (TIOP) III:
The Quality Improvement Movement

TIOP III: Enhancing Perinatal Health Through Quality, Safety and Performance Initiatives is the third in a series of collaborative efforts developed by the March of Dimes, American Academy of Pediatrics and American College of Obstetricians and Gynecologists. Published at the end of 2010, this effort focuses on quality improvement in perinatal care. The prior initiatives were TIOP I: Recommendations for the Regional Development of Maternal and Perinatal Heath Services, published in 1976 which focused on regionalization of perinatal care and TIOP II: The 90s and Beyond, published in 1993 which focused on care during pregnancy.

In coming months, we will feature chapters from TIOP III. This month, we focus on Chapter 1: History of the Quality Improvement Movement. This chapter provides a brief historical perspective on the quality improvement movement in the United States, starting from Florence Nightingale to the formation of the Joint Commission and the new emphasis on quality improvement by the Institute of Medicine.

Ch 1: History of the Quality Improvement Movement »

Obtain the full TIOP III report »

Peter Pronovost

Safe Patients; Smart Hospitals

Peter J Pronovost, MD, PhD, Professor at John Hopkins University School of Medicine, discusses CUSP, the comprehensive unit-based safety program that recognizes the importance of unit culture and teamwork in improving care. Dr. Pronovost, who was awarded a MacArthur Fellowship for his work in improving patient safety, is internationally known for introducing checklists and showing how they can be used to imrpove the quality and safety of care.

Safe Patients; Smart Hospitals presentation »

NRP Textbook

Neonatal Resuscitation Program: 2011 Changes Reflect ILCOR and AAP/AHA Guidelines

The Textbook of Neonatal Resuscitation, 6th edition, released in April 2011, incorporates a number of changes that resulted from a 5-year collaborative process between three organizations: the International Liaison Committee on Resuscitation (ILCOR), the American Academy of Pediatrics (AAP) and the American Heart Association (AHA), the groups that developed Guidelines for Emergency Cardiovascular Care. Changes introduced in the 6th iteration of the NRP include the transition to online testing, an educational approach that places increased emphasis on simulation-based learning, and a number of modifications of the NRP algorithm. The new NRP algorithm eliminates evaluation of amniotic fluid in the initial rapid assessment, incorporates pulse oximetry in neonatal resuscitation, recommends more conservative use of supplemental oxygen during resuscitation, and advocates expeditious intubation when chest compressions are needed.

See a brief summary of changes in the NRP algorithm »

Textbook of Neonatal Resuscitation, 6th edition »

NIH Research Priorities:  
Neonatal Resuscitation and Neonatal Patient Safety

Studies in Neonatal Resuscitation

Patient Safety Research During Neonatal Care

Application Receipt Dates for all of the above: September 19, 2011;
September 19, 2012; September 19, 2013

Safe and Effective Instruments and Devices for
Use in the Neonatal Intensive Care Units

Application Receipt Date for both: September 19, 2010

Sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Heart, Lung, and Blood Institute.

For more information, contact Tonse Raju. 

Bevacizumab: Effective Therapy for Zone 1, Stage 3+ Retinopathy of Prematurity (ROP)

In a landmark study of 150 infants with stage 3+ ROP published in the February 17th New England Journal of Medicine, intravitreal treatment with bevacizumab (Avastin) was shown to be superior to laser treatment among infants with zone 1, but not zone 2, disease. An additional benefit of this therapy is, unlike laser treatment, it was associated with preservation of growth of retinal vessels after treatment.

Learn more »

MOMS Study Results Published

Recently, the results of the MOMS study on prenatal intervention for meningomyelocele were published in the New England Journal of Medicine. The randomized clinical trial was stopped early, yet enrolled 183 of the planned n=200 sample. The study found that fetal intervention was associated with reduced need for ventricular shunting and better motor development at 30 months but was associated with fetal and maternal risks.

A Randomized Trial of Prenatal vs Postnatal Repair of Myelomeningocele »

Call to Action to Support Breastfeeding

On January 20, 2011, Surgeon General Regina M. Benjamin released The Surgeon General's Call to Action to Support Breastfeeding, during a live webcast, in the Jack Morton Auditorium at The George Washington University. This new call to action from the Surgeon General outlines 20 actions to remove some of the obstacles faced by women who want to breastfeed their babies.

Live WebCast »

Helping Babies BreatheHelping Babies Breathe, A New Global Initiative

Helping Babies Breathe educates birth attendants in developing countries about the essential skills needed to assist babies through the first 'Golden Minute' of life. This culturally-sensitive program is targeted to 63 countries and offers the promise of substantially reducing infant mortality worldwide.

Helping Babies Breathe Web site »

"The Action Plan" poster highlighting "The Golden Minute" »

Roger SollNeonatology: A Team Sport

Butterfield Lecture by Roger F. Soll, MD, FAAP

Dr. Roger Soll, the 2010 Butterfield lecturer, is an internationally-recognized authority on neonatal clinical trials and evidence-based medicine. Currently, Dr. Soll is Professor of Pediatrics at the University of Vermont College of Medicine and Director of the Newborn Intensive Care Unit and the Neonatal-Perinatal Medicine training program. He is the President and Director of Clinical Trials and Follow Up for the Vermont Oxford Network. Under Dr. Soll's leadership, the Vermont Oxford Network has completed many clinical trials, including evaluations of surfactant therapy, early corticosterioid treatment, skin care, and a newly-completed trial of delivery room respiratory stabilization of extremely preterm infants.

Dr. Soll's Butterfield lecture entitled, Neonatology: A Team Sport, highlights the importance of team-building and a collaborative model of care in achieving the highest standards of neonatal care.

Neonatology: A Team Sport »


Vermont Oxford Network
Shares Quality Improvement

The Vermont Oxford Network (VON) is a not-for-profit organization established with the goals of improving the quality and safety of medical care for newborn infants and their families through a coordinated program of research, education, and quality improvement.

Now comprised of over 850 neonatal units around the world and enrolling over 50,000 very low birth weight infants each year in its database, VON provides members with confidential, risk adjusted reports that allow NICU teams to assess their performance and identify opportunities for improvement. The Network also offers members a variety of programs to support local and regional quality improvement efforts, including:

  • Intensive NICQ improvement collaboratives,
  • The iNICQ internet improvement collaboratives
  • The Network Annual Meeting & Quality Congress

The Perinatal Section is grateful that VON has made their slide and audio presentations from these programs available to members of the Section on Perinatal Pediatrics.

Section members' link to the QI Presentation »
Learn more about the Vermont Oxford Network »

MOD toolkit Elimination of Non-medically Indicated Deliveries
Before 39 Weeks Gestational Age

A new quality improvement toolkit, aimed at supporting hospitals in eliminating non-medically indicated deliveries before 39 weeks, is now available to all interested professionals on the March of Dimes website.

March of Dimes toolkit »

NCE 2009 Presentations

If you were unable to make it to the NCE in Washington, DC, or would just like to refresh your memory, check out the presentations from the Section on Perinatal Pediatrics special programming at the 2009 NCE. Please check back as more will be added. Thank you to all those who worked so hard to make this programming a huge success and to those who took time out of their busy schedule to support the section.

NCE 2009 Presentations »
NCE 2009 Abstracts »

ABP Explains Maintenance of Certification

In the past, medical specialists and subspecialists focused on Board certification. The new standard, however, is Maintenance of Certification (MOC), of which Board certification is just one of four parts. The American Board of Pediatrics (ABP) has created a new presentation to demystify MOC and to detail how MOC will change in 2010.

View the ABP MOC presentation »

March of Dimes' Symposium on Quality Improvement
to Prevent Prematurity

In October 2009, this Symposium brought together a multidisciplinary group to discuss quality improvement as an essential component in the strategy to prevent prematurity, promote health, and save costs. The Symposium explored that state of quality initiatives to births that are not inevitable or medically necessary.

Symposium provided by the Clinical Directors Network »

Global Perinatal Health Takes Center Stage

In launching one of the Section’s major strategic goals -- a commitment to work to improve global perinatal health -- the Section on Perinatal Pediatrics has joined with the Section on International Child Health and the AAP Office of International Health.

Read the Strategic Plan to preview Section plans re: global health »

Learn about International-CATCH projects »

Learn more about our liaison partner, the Section on International Child Health »

Slideshow Honoring Jerry Merenstein Debuts

View the photos that capture the essence of our much-missed friend and colleague, Jerry Merenstein, MD. (2.22.10)

View the Jerry Merenstein Slidshow »

Call For Continuing Medical Education (CME) Process Reform

A commentary published in the Oct. 28 issue of the Journal of the American Medical Association (JAMA) critiques the current physician continuing medical education (CME) process and calls for reform. The authors propose a CME model that focuses on maintaining and improving quality and efficiency of care as an alternative to the current model, tied to state licensure requirements and hindered by excessive commercialization, unstandardized curricula and a lack of effect on patient care. They suggest “mandatory participation in well-conceived maintenance-of-certification processes” and reference ABMS Maintenance of Certification ® (ABMS MOC ® ). The authors go so far as to suggest that MOC be strongly considered as a mandatory requirement for maintenance of licensure (MOL). Such a concept may someday become a future reality.

View full text of the commentary »

New AAP Immunization Web Site

The AAP is pleased to announce the creation of a new, comprehensive online resource for pediatricians and families that addresses the topic of immunizations. This new site replaces the Childhood Immunization Support Program Web site and contains information about vaccine-preventable diseases, vaccine safety information, and tools and resources to help pediatricians effectively and efficiently administer immunizations in their offices.

Access through the AAP Web site »

IOM Recommends Greater Resident Work Hours Restrictions:
ONTPD Response

Duty hour recommendations from IOM came out with stringent duty hour requirements. In response, the Association of Medical School Pediatric Department Chairs has published a paper in the May issue of Pediatrics.

Resident Duty Hour Restictions: Is Less Really More? »
View the IOM report on work hours »
"Dhu'ZZs and PayTients - hOur Duty" article »

Best Practice for Infant Surgery - New Position Statement

Infants who have surgical problems are among the most vulnerable hospitalized newborns. Optimal care of these infants requires collaboration among members of skilled multidisciplinary teams. The American Pediatric Surgical Association has issued a position statement, endorsed by the American Academy of Pediatrics, which outlines best practice standards for infants with surgical conditions.

View the APSA statement »

Pregnant Women Strongly Urged to Get Flu Shot

(09/21/09) A national coalition of health care and information providers for pregnant women and children have an urgent message for pregnant women concerning influenza. The normal changes of pregnancy place pregnant women at increased risk of the harmful effects of flu infection, and as such, they should take increased precautions.

The joint statement for pregnant women regarding influenza and immunization »

AHA Issues Statement on Comparative Effectiveness Research

Choosing the best among various effective therapies can prove to be a vexing clinical challenge. Comparative effectiveness research can assist clinicians in their efforts to weighh the risks and benefits of therapeutic options. The American Heart Association recently issued a vision statement of principles for the conduct of comparative effectiveness research that will be useful to researchers conducting these studies as well as to clinicians assessing the merits of such research.

Read the full text of the AHA statement »

Perinatal Strategic Plan 2008

In early 2007, a new Section strategic planning process was initiated. Guided by Section members’ input, the Strategic Planning Committee identified four new areas for the Section’s strategic focus in the next 5 years: education, leadership, quality and global health.

Learn more about the Section Strategic Plan»

Whooping Cough is Making a Comeback, Risking Serious illness or Death Among Newborns

Whooping cough, also known by the medical term pertussis, is a vaccine-preventable disease that is caused by a bacterium (germ). It is highly contagious and newborns are at highest risk of being seriously ill with the infection. A baby begins to develop immunity to whooping cough (also called pertussis) after his or her first set of immunizations but is not fully immune to whooping cough until the immunization series is complete (at 6 months of age or more). This low immunity that is normal in early infancy, in addition to a baby's very small lung and airways, make babies with the infection very vulnerable to its most serious effects. Whooping cough lasts for many weeks, causing spasms of severe coughing, often with a whooping sound at the end of the cough. In newborns, the breathing problems caused by whooping cough can be very severe and can even interfere with breathing in air and cause blue spells, pauses in breathing, vomiting, fainting (passing out), or even death. It can be spread from child to child or from an adult who typically is only mildly sick and seems only to have a cold or bronchitis. The number of cases of whooping cough in the United States has been steadily increasing since the 1980s, making more babies each year vulnerable to this life-threatening infection.

Learn more about whooping cough (pertussis) »

Learn more about whooping cough prevention »

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