AUDIOLOGIST

Most newborns should have their hearing tested before the hospital discharge. There are several types of hearing tests that can be done on babies. The clinical care team will determine the best type of test and the best time for your baby to be tested. An audiologist is trained to test and follow-up with babies with abnormal hearing. The testing that the audiologist performs may be done in the Newborn Intensive Care Unit (NICU) or after discharge.

CARDIOLOGIST

A cardiologist is a physician that has special training in the diagnosis and treatment of diseases and conditions of the heart and blood vessels. They might be asked (consulted) to see your baby by the neonatologist to help diagnose a heart condition.

These heart conditions may include:

• Abnormal structure of the heart (are all the parts of the heart arranged normally?)
• Function of the heart (is the heart pumping blood normally?)
• Rate and rhythm of the heart beat (is the heart beating at a normal rate? in a normal rhythm?)

Aside from examination of the babies, these physicians might perform or interpret tests like x-rays, electrocardiograms (EKG), echocardiograms (ECHO), or cardiac catheterization. If the structure of the heart is not normal due to a birth defect, they might work with the cardiovascular surgeon to perform surgery on the heart. Cardiologists might see babies for some time in follow-up after leaving the hospital.

CARDIOVASCULAR SURGEON

A cardiovascular (heart) surgeon is a physician who has training as a surgeon, along with specialized training to do surgery to correct or treat defects of the heart. This might include a heart that developed incorrectly prior to birth or abnormalities that occurred after birth.

Sometimes, surgery can correct the problem, while at other times total correction is not possible. In these cases, surgery is performed to make the heart work better, even though it still does not have a normal structure. The surgeon will work closely with the cardiologist to care for the baby before and after surgery.

DERMATOLOGIST

A dermatologist is a physician who has special training in the diagnosis and treatment of diseases and conditions of the skin, hair, and nails. They might be consulted in the Newborn Intensive Care Unit (NICU) to assist in the diagnosis of a skin lesion or rash. They might also help the NICU team to care for skin lesions or rashes that require special treatment.

Aside from examining a baby, these physicians might obtain a biopsy of a skin lesion. The dermatologist might also work with the pathologist to interpret biopsy results.

DEVELOPMENTAL PEDIATRICIAN

A developmental pediatrician is a pediatrician who has special training in the evaluation and care of infants having difficulty doing what other children their age are able to do. They are trained to evaluate the level of functioning for each infant through a series of developmental tests. They will also help to locate resources within each community to provide therapies to help infants and children in meeting milestones. There might be overlap in what they do with neurologists.

Developmental pediatricians work closely with nurse practitioners, occupational therapists, and physical therapists to decide on the best therapies for each child.

DIETICIAN

A dietician has special training in nutritional support (feeding). They might also specialize in pediatric (children’s) nutritional care. They help evaluate the nutritional status and intake of an infant. They also make recommendations for the many choices of nutrition that can be given via the bloodstream (IV – Intravascular catheter) or through different types of feedings.

ENDOCRINOLOGIST

An endocrinologist is a physician with special training in the diagnosis and treatment of infants with problems in their endocrine or hormone systems. Endocrinologists might be asked to see patients for problems with salts (i.e., calcium or sodium), high or low blood sugars, or abnormal development of the glandular systems of the body or sexual organs. To help diagnose these conditions, tests, such as electrolytes, thyroid functions, or abdominal ultrasounds might be ordered.

GASTROENTEROLOGIST

A gastroenterologist is a physician with special training in the evaluation and treatment of infants with problems of the digestive system (stomach and intestines) and liver. They might be asked to see patients when they have problems digesting food properly or for liver problems, such as hepatitis or cholestasis. To help in the diagnosis and care of these babies, tests, such as x-rays, liver function tests, or abdominal ultrasounds might be ordered.

GENETICIST

A geneticist is a physician with special training in the evaluation and treatment of infants with congenital (inherited) problems, including chromosomal problems or syndromes. To help in the diagnosis and care of these conditions, they might order or use tests, such as chromosomes, metabolic studies, and sonograms.

HEMATOLOGIST-ONCOLOGIST

A hematologist-oncologist is a physician with special training in the diagnosis and treatment of blood disorders (hematologic system) and types of cancer. They might be asked to see a patient for bleeding problems due to low platelets or other clotting factors.

To help in the diagnosis and care of these babies, tests, such as a CBC or clotting studies, might be ordered.

INFECTIOUS DISEASE SPECIALIST

An infectious disease specialist is a physician with special training in the evaluation and treatment of infections. They might be asked to see a patient when they develop unusual or serious infections.

Infections in babies can include blood infections or infections of the brain and spinal cord (meningitis). Tests, such as a CBC, blood cultures, CRP, and spinal taps, might be ordered to help evaluate an infection.

MATERNAL-FETAL MEDICINE SPECIALIST

A maternal-fetal medicine physician or perinatologist is an obstetrician with special training in the care of pregnant women having problems (high risk). They can care for mothers with problems, such as premature labor, multiple pregnancy, hypertension in pregnancy, or diabetes.

NEONATAL NURSE PRACTITIONER (NNP)

Neonatal Nurse Practitioners are expert neonatal nurses who have obtained a graduate degree (or certificate), with emphasis in caring for the needs of critically ill newborns and their families. The NNP works in collaboration with a neonatologist to diagnose and treat the conditions of babies. The NNP also performs procedures to aid in the diagnosis (e.g., spinal taps) and management (e.g., chest tube placement) of medical conditions. They are highly skilled professionals with great experience in the care of newborn infants.

NEPHROLOGIST

A nephrologist is a physician with special training in evaluating and treating problems with the kidneys and urinary system. They might be consulted for problems due to abnormal development of the kidneys such as hydronephrosis (excess fluid within the kidney and collecting tubules), or to help care for a baby when their kidneys are not functioning correctly.

Nephrologists might order tests, such as an electrolytes or abdominal ultrasounds, to evaluate these problems. If a baby has abnormal development in the structure of the kidneys which requires surgery, the nephrologist will work with a surgeon or urologist.

NEUROLOGIST

A neurologist is a physician with special training in the evaluation and treatment of disorders of the brain, nerves, and muscles. They might be asked to see infants that have problems, such as seizures or bleeding in the brain.

The neurologist might order a head ultrasound, electroencephalogram (EEG), CT Scan, or MRI scan to help identify the cause of the problem. If the infant has an abnormality in the brain or spinal cord that requires surgery, they might work with a neurosurgeon.

NEUROSURGEON

A neurosurgeon is a physician trained as a surgeon with highly specialized experience to operate on abnormalities in the brain and spinal cord. These abnormalities might be due to abnormal development prior to birth, such as spina bifida or from complications that happen after birth, such as a skull fracture or hydrocephalus. In addition to the neonatologist, the neurosurgeon might work closely with the neurologist for the management of certain conditions.

OBSTETRICIAN

An obstetrician is a physician with special training in the prenatal care and delivery of women who are pregnant. They may also assist women who are trying to get pregnant. As well as caring for the normal pregnancy, the obstetrician might follow women with such problems as diabetes or decreased fetal growth. They might consult with the perinatologist or the neonatologist.

OPHTHALMOLOGIST

An ophthalmologist is a physician with special training in evaluating and treating eye problems. They might be asked to see a baby in the Newborn Intensive Care Unit (NICU) for birth defects of the eye.

They evaluate premature infants for retinopathy of prematurity (ROP). They perform examinations of the inside of the eye, called retinal exams. These exams are very similar to what older children and adults get in an ophthalmologist's office when being evaluated for glasses. For certain conditions of severe ROP, they might perform laser surgery or other corrective surgery on the eyes.

ORTHOPEDIC SURGEON

An orthopedic surgeon is a physician with special training in the evaluation and treatment of conditions involving bones. They might be asked to see babies who have birth defects of the arms or legs, hip dislocation (dysplasia), or fractures of the bones. To evaluate the bones, orthopedic surgeons might order ultrasounds or x-rays. If needed, they can perform surgery or place casts.

OSTOMY NURSE

An ostomy nurse is a nurse with special training in the care of skin wounds and ostomies. An ostomy is an opening in the abdomen through which the end of the intestine or the collecting system of the kidney protrudes. Ostomies are the result of surgery needed to treat many intestinal problems, such as necrotizing enterocolitis. In some cases, ostomy nurses are consulted to help with the care of complicated wounds.

OTOLARYNGOLOGIST / EAR NOSE THROAT (ENT) SPECIALIST

An otolaryngologist or Ear, Nose, and Throat (ENT) specialist is a physician with special training in the evaluation and treatment of problems with the ear, nose, throat, and airways. They might be asked to help manage infants who have problems with breathing, such as those with a trachea that is “floppy” (tracheomalacia) or obstructed, or a blockage of the nose as in choanal atresia.

OCCUPATIONAL / PHYSICAL THERAPISTS (OT/PT)

Occupational/Physical Therapists (OT/PT) are professionals with advanced training in working with infants with developmental needs. This work includes neurobehavioral assessments (postural tone, reflexes, movement patterns, and responses to handling). In addition, the OT/PT professionals will help determine a baby's nipple-feeding readiness and oral-motor skills. They also provide family education and support.

PATHOLOGIST

A pathologist is a physician with special training in laboratory testing and examination of body tissues. They supervise the laboratory where tests, such as electrolytes and CBCs (Complete Blood Counts), are performed. They also examine tissues under the microscope that are obtained during a surgery or an autopsy.

PEDIATRICIAN

A pediatrician is a physician with special training in the care of infants and children. They might do limited care of babies in the Newborn Intensive Care Unit (NICU), but they are usually the primary care providers for healthy newborns. In addition, they provide primary care for most babies after they leave the NICU.

PHLEBOTOMIST

A phlebotomist is a hospital staff professional who is trained to obtain blood samples for performing tests as ordered by the physician. In babies, the phlebotomist generally gets the blood sample from a heel stick (actually, the soft pads on either side of the heel) or from a vein.

PULMONOLOGIST

A pulmonologist is a physician with special training in dealing with infants and children with problems of the respiratory (breathing) system. Even though the neonatologist cares for many infants with respiratory problems, the pulmonologist might be consulted for unusual conditions of the lung. They also help to manage breathing conditions that require significant care after discharge from the Newborn Intensive Care Unit (NICU).

RADIOLOGIST

A radiologist is a physician with special training in obtaining and reading x-rays and other tests. The neonatologist will usually read most of the x-rays, while the radiologist commonly reads specialized x-rays using radio-opaque solutions, such as barium enemas or ultrasound tests, such as neurosonograms (ultrasound test of the brain).

RESPIRATORY THERAPIST (RT)

Respiratory Therapists (RTs) have training to deliver multiple treatments to the cardiopulmonary system (heart and lungs). RTs may administer chest physiotherapy, assist in the management of ventilators, and deliver medications to the lungs. They are actively involved with babies having breathing problems, such as respiratory distress syndrome (RDS) or bronchopulmonary dysplasia (BPD).

RTs might also be members of the Newborn Intensive Care Unit (NICU) Transport Team or become an Extra-Corporeal Membrane Oxygenation (ECMO) specialists after specialized training.

SOCIAL WORKERS

Social workers are professionals with special education and training to determine the psycho-social, emotional, and financial needs of families. They help families find and coordinate resources in the hospital and community that will help to meet their needs. Social workers also help in the discharge planning.

UROLOGIST

A urologist is a physician with special training in evaluating and treating conditions involving the urinary system that might require surgery. They are consulted on infants with conditions that result from birth defects, such as hydronephrosis or hypospadius. With some conditions, they will work closely with a nephrologist.

X-RAY TECHNICIAN

An x-ray technician is a professional trained in obtaining x-rays. X-rays can be of the chest or involve the use of solutions to make body parts easier to identify, as with barium enemas. X-rays of bones are also commonly performed in babies for a variety of reasons.