RotaryGrams for April 13, 2022 (Apr 13, 2022)

Program Review

April 6, 2022

“Impacting Small Lives in a Big Way!”

Dr. Snehal Doshi

Neonatologist

Baptist Hospital of Southeast Texas

by Shelly Vitanza

Dr. Doshi is a neonatologist at Baptist Hospital of Southeast Texas. He works in the NICU with a team of doctors and nurses to care for the little patients born in the area.

A NICU is a neonatal intensive care unit that cares for neonates – any baby less than four weeks old from full term birth. A full-term birth is 40 weeks so a neonate is any child born 36 weeks or earlier. One in six of all babies born at Baptist come to the NICU. Not all of them are born early. Some babies are full term but there are other complications. Some babies stay many days in the NICU; some have even celebrated their first birthdays in the NICU. Babies can be born at 23 to 22 weeks and be viable.

Everyone in the hospital touches the NICU in some way from marketing, housekeeping, dietary, respiratory. Every worker in the hospital works to get the babies and families ready to go home and be healthy.

There are significant differences between a preemie baby and a full-term baby. Babies born early, or preemies, may have respiratory distress and other breathing complications. At week 35, a baby’s brain still needs to grow 50%. The baby doesn’t have enough fat to regulate temperature until 34-plus weeks.

Full-term babies have fully developed lungs at 40 weeks. Their brains have more definition, so the baby’s brain is higher functioning. The 40-week baby has enough fat and energy to regulate body temperature and other vital functions. The full-term baby has the ability to suck/swallow which leads to health, rapid weight gain so the baby can grow.

Doshi compares preemies to brownies. A preemie is like cooking brownies. If you take them out too early, the brownies look good on the outside but on the inside they are still raw. Babies are still developing on the inside. Baptist took care of a baby born at 27 weeks. Her name was Avianna. For comparison, she was the size of an Elf on the Shelf. She weighed about a pound and a half. It took 2-1/2 months to grow her to 4-1/2 pound and get her home. She spent most of that time on oxygen to support her breathing. The mom was discharged after delivery within 2-to-3 days.

Baptist Neonatal Intensive Care Unit can take care of any size baby, which means babies and their families can stay in Beaumont. The hospital has transfer capabilities if needed. They also have lacation consultants and donor breast milk.

A typical baby weighs 6 to 8 pounds. A blueberry is the size of a baby at 7 weeks. A peach is the size of a 14-week baby. A corn cob is the size of a 24-week baby. A cantaloupe is the size of a 34-week baby. A watermelon is 40-weeks.

Doshi provided some milestones in neonatology including:

- 1870: 230 infants out of 1000 births passed away.

- 1915: The number of infant deaths had decreased to 99 out of 1000.

- August 7, 1963: Patrick Kennedy, the President’s son, died at 34 weeks. He was 4 pounds and 10 ounces.

- 1965: First NICU opened in Connecticut.

- 1975: Neonatology became a field of study.

- A 2-pound baby born in 1960 had a 95% chance of dying. That same baby in 2000, had a 95% chance of survival.

There is a huge economic burden to families who have preemies.

- Average out of pocket expenses is $336-$800 a month

- All nonmedical expenses – childcare for other children, gas for trips to hospital, more time off work, non-covered medical expenses.

- The cost of care for an ex-preemie in the first year is over $70,000.

The NICU has been supported by Baptist Hospital of Southeast Texas Foundation. The Foundation has provided specialized beds, - Giraffe Beds that are basically a womb for the baby to continue to grow; phototherapy lights for jaundice; transport isolettes and cameras so parents can watch their babies from home.

This equipment allowed Doshi and the nurses at Baptist to evacuate a 100 babies to Houston during Hurricane Harvey and stay with the babies until they could return to Beaumont.

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