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Fortunately most pregnancies end in healthy full-term babies; however, sometimes babies need special care because they are premature, too small, or have an illness or abnormality. When that happens at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School, these babies are cared for in the special care nursery (also called Level 2 nursery), which provides highly specialized care and support.

Lucienne Sanchez, M.D., a newborn specialist at Mount Auburn Hospital, says, “The great majority of babies born at Mount Auburn Hospital are healthy and do not need specialized care, but, those who do need the intensive care of the Level 2 nursery also generally do very well and are able to go home with their parents as healthy infants.”

Newborn infants may have problems for a variety of reasons. Some problems result from high-risk pregnancies when a baby with special needs is anticipated. Other times, the baby’s problems develop during the birth process and the baby’s special needs are only evident at birth. “This is why,” Dr. Sanchez emphasizes, “we strongly recommend that all mothers deliver their babies in a hospital, because in many instances, we don’t know until after the baby is born whether he or she will need extra care.”

Babies in the special care nursery at Mount Auburn Hospital may have a range of needs that must be addressed for them to survive and thrive. Premature babies may need breathing support to help their underdeveloped respiratory systems. These babies are carefully monitored in the nursery and supported with oxygen and mechanical ventilation, as needed. Sometimes premature babies may have slow or irregular heartbeats and/or breathing rates so they are also carefully monitored until their heart rates and breathing stabilize.

Infection and pneumonia are other common problems in sick newborns who may need to be treated with antibiotics (to fight their infections). Sometimes premature babies have problems metabolizing sugar in their bodies—an issue that’s essential to address since sugar is the primary nutrient for a baby’s developing brain. Premature babies may also be unable to control their temperature and may need to be placed in special isolettes for temperature management. In addition, some premature babies have trouble coordinating their sucking and swallowing capabilities and, as a result, need nutritional support.

Dr. Sanchez, says, “At Mount Auburn, we can handle any acute, shot-term need a baby may have. We can provide CPR, intubation, or mechanical ventilation, although babies who need long-term ventilation are eventually transferred to a hospital specializing in long-term care.”

Babies are also frequently transferred to Mount Auburn from other hospitals because of their specialized needs. The special care nursery nurses are very experienced experts in their field and know how to handle the complex and serious problems sick newborns may have. Dr. Sanchez emphasizes that parents, who can visit their infants 24 hours a day, appreciate the individualized and one-on-one care their babies receive at Mount Auburn Hospital.

Dr. Sanchez also points out that impressive research is ongoing in the area of treating premature and sick newborns. It used to be that a baby born at 34 weeks of gestation had very little chance of surviving. Today almost all babies born at this point survive and most babies who are born at greater than 24 weeks of gestation do very well. For instance, science and technology have progressed to such a degree in newborn medicine that a medication called “surfactant,” a substance that many premature babies are missing, can be instilled directly into a newborn baby’s lungs. This therapy alone has greatly improved the survival rate of premature babies in the United States.

“Seeing newborn babies, who sometimes have many medical problems, improve so dramatically in our special care nursery is very gratifying,” says Dr. Sanchez.

To sign up for the Mount Auburn Hospital prepared childbirth series of classes, please call us at 617-499-5094.