Dr. Lajos Kovacs, the Jewish General Hospital’s Chief of Pediatrics and Neonatology, credits the success of the department to teamwork and the support of the JGH Foundation

Public knowledge of neonatology – the care of infants born prematurely or with health problems – often centres on how premature and small babies can be. Less discussed is the research, equipment and dedicated work required to support vulnerable infants, or details of the different and serious issues that can arise in caring for them. It takes ever-evolving best practices in treatment to maximize their chances of not just surviving but thriving.

There has been tremendous progress in almost all aspects of neonatology in recent years, said Dr. Lajos Kovacs, Chief of Pediatrics and Neonatology at the Jewish General Hospital (JGH). The 34-bed Neonatal Intensive Care Unit (NICU) has excelled in the field for decades, but the team doesn’t rest on its laurels.

“Even though we are doing very well, we want to find ways we can still improve,” Dr. Kovacs said.

JGH Foundation donors fund ‘kangaroo care’ chairs and other equipment

The use of recent advances to benefit the JGH’s smallest patients and their parents has been made directly possible thanks to donors.

“We rely on donors to help with many things in the NICU, like purchasing equipment, funding staff training, and more,” Dr. Kovacs said. “Our relationship with the JGH Foundation is stronger than ever.”

For example, the JGH Foundation recently funded the purchase of special “kangaroo care” reclining chairs for the whole NICU. These chairs provide a dedicated, comfortable space for parents of each baby to have “skin-to-skin” time with their newborns, including allowing mothers to breastfeed.

“We encourage skin-to-skin contact between parents and their babies as recent research has shown it is extremely beneficial to premature babies, resulting in them needing less care support and oxygen,” said Dr. Kovacs. “The babies can spend hours lying on their parents’ chests, so the new chairs allow everyone to be comfortable.”

This important role for parents also helps alleviate their anxieties. “Research shows that high parental stress is correlated with higher levels of behavioural and developmental problems for the children, said Dr. Kovacs. “This experience allows parents to feel empowered to help their baby, be present and take part in their care.”

One issue in skin-to-skin care is that the babies need to continue to be monitored, so the wires involved can be a nuisance. Dr. Kovacs said the JGH aims to become a testing site for new wireless technology for this monitoring so holding their babies can be “less scary” for new parents.

Other new technology is greatly helping care in the NICU. Some premature babies have trouble swallowing properly, which can affect how much they feed or risk milk being aspirated into the lungs. When this issue occurs, a specialist inserts a tiny endoscopic camera into the throat to see what is causing the problem so appropriate adjustments can be made, sometimes as simple as changing a baby’s position while feeding.

This equipment was purchased using funds from donors to the JGH Foundation. Originally only the specialist could see the image through a special eyepiece, but further donor funding has now permitted the purchase of equipment that displays the image on a large screen, allowing viewing by other health professionals and even the parents.

“It’s so wonderful to work with our multidisciplinary team. We all know each other’s roles and see the bigger picture in a patient’s care. It’s why we succeed.” – Dr. Lajos Kovacs

JGH Foundation donors also support the neonatology team in other ways, including helping it pay a significant new membership fee from the Canadian Neonatal Network so the JGH team can stay connected with experts elsewhere. Funding has also been provided that allows NICU nurses to attend specialized training courses away from the hospital to keep their skills up to date with new advances.

Dr. Kovacs noted that the advances his team has made mean only very exceptional NICU patients at the JGH now need to be transferred to a children’s hospital for specialized care. For example, he said, in some premature infants, a vessel in the heart needed only in utero can fail to close soon after birth, as is normal. It would previously be treated by special surgery at a children’s hospital, requiring a very disruptive transfer. “This never happens anymore,” Dr. Kovacs said, “because we found if you wait, it will close on its own. We are always learning.”

Pediatric services coordinated throughout the region

Along with heading Neonatology, Dr. Kovacs also leads the Pediatrics teams at the JGH and throughout its healthcare network, the CIUSSS West-Central Montreal.

“We try to ensure service availability is coordinated throughout the healthcare network to better match up children needing services with the available resources, such as to treat autism or developmental delays.”

Dr. Kovacs cites his group’s teamwork as a vital ingredient: “It’s so wonderful to work with our multidisciplinary team. We all know each other’s roles and see the bigger picture in a patient’s care. It’s why we succeed.”

To make a donation to the Jewish General Hospital Foundation, please go to www.jghfoundation.org