There are two kinds of specialists who will look after your premature baby: neonatologists and paediatric surgeons. After medical school, they spend about six to eight years in specialty training, depending on their area of focus. Each role involves varying degrees of training and research. Your baby will also be cared for by a clinical nurse specialist/neonatal nurse practitioner as well as doctors in training.
Neonatologist
What is a neonatologist?
A neonatologist is a doctor specializing in the care of newborn babies. These doctors care for babies with problems like prematurity, breathing problems, infection, jaundice, feeding problems, and birth defects.
When might your baby be referred to a neonatologist?
Your baby would be referred to a neonatologist through an obstetrician, paediatrician, or family doctor. In emergency situations, your baby would be referred to a neonatologist through the delivery room obstetrician, paediatrician, or family doctor. Symptoms that tend to lead to a referral to a neonatologist include prematurity, breathing problems, infection, jaundice, feeding problems, and birth defects.
How does the neonatologist make a diagnosis?
To evaluate a premature baby, the neonatologist takes the medical history of the pregnancy, labour and delivery, and the baby’s progress since birth, and does a physical examination. To explore a concern further, they may order blood tests and an X-ray. Often a problem can be identified at this stage. This is called a diagnosis. For problems that require surgical treatment, the neonatologist will refer the premature baby to a paediatric surgeon, who will assess the baby’s condition and operate on the baby if necessary.
Paediatric surgeon
What is a paediatric surgeon?
A paediatric surgeon is a medical doctor who does operations on newborns, babies, and children. The surgeon is responsible for planning and supervising the baby’s operation. This person has expertise in surgery and paediatric surgery, and plays an active role during a child's recovery in the intensive care unit.
When might your baby be referred to a paediatric surgeon?
A paediatric surgeon will see a premature baby after being referred by a neonatologist once it's clear that the baby’s problem might require surgery. they will review the child's medical records and any test results to evaluate the condition.
The paediatric surgeon will then meet with the baby’s parents to discuss what treatment options are available. The paediatric surgeon and a team of other doctors and nurses will prepare the premature baby for surgery, do the surgery, and look after the baby following the procedure. Later, the baby will be seen again by the surgeon to see that they are recovering well.
Doctors in training
If your premature baby is being treated at a teaching hospital, you and your baby will encounter doctors in training. Doctors go through a number of different stages of education and training.
A medical student is someone in a four- or six-year program to learn to be a doctor. Many medical students have a university degree already. After graduating from medical school, doctors must have further training, like an apprenticeship. A one-year internship is required in many places before a doctor can get a license. If a doctor has a name tag that identifies them as a rotating intern, it means they rotate through a number of different specialties during the year.
To be a specialist or a family doctor, a doctor must do a residency. These residents rotate through different areas within their specialty. Different specialties have different lengths of training. Paediatric residency requires at least three years training in paediatrics. The Family Medicine residency requires at least two years training in family medicine. A resident's name tag may tell you their speciality and what year of training they are in.
You may hear interns and residents referred to as house staff or house officers. This refers to the interns and residents who are on call and in the hospital overnight.
Fellows spend between one and three years learning a subspecialty within a specialty. They have already been residents and provide quite a bit of care without direct supervision. However, there is always a staff doctor responsible for your baby’s care. This person has finished all of their training and has taken special exams.
This may seem like a lot of doctors involved in your baby’s care. But having trainees in a hospital keeps the quality of care high.
Clinical nurse specialist/neonatal nurse practitioner
A clinical nurse specialist/neonatal nurse practitioner (CNS/NNP) has specialized knowledge of the newborn population that enable them to provide medical and holistic care to newborn babies in the hospital. These nurses generally provide assessments along with education and guidance in the following ways:
- around a specific diagnosis
- helping a child adjust to hospitalization or a surgical procedure
- managing a child's special needs at home
- making informed decisions
- helping the family adapt to caring for a child with a chronic illness
In the acute care setting, these nurses stabilize the baby, minimize complications, and provide physical and psychological support. They are also involved in diagnosing, prescribing medications, ordering and interpreting diagnostic tests, and performing advanced procedures.