Care of newborn babies has vastly improved in India over last two decades. The department of Neonatology takes pride in undergoing this transformation. This unit came into existence in 70's.This was one of the first few level III units in northern India. With improving technological and medical expertise this unit has established as one of the best, not only in Delhi but also in India.
About the unit
We being one of the largest units have about 1200-1500 admissions per annum. This unit has 4 separate areas – consisting of two ICU’s (Intensive Care Unit) area and two step down Intermediate care units (High dependency units).Our NICU is 35 bedded level III unit, equipped with 16 ventilated beds each with wall mounted new generation multi-parameter monitors with inbuilt pulmonary graphics. Each ventilator bed is connected to a central monitoring system which allows continuous monitoring of babies. Step down areas can accommodate 19 babies; all beds are attached to multi-parameter monitor. All babies are nursed in thermo-neutral environment under radiant warmer/incubator.
Strength of the unit comes from the "State of the Art" Obstetrical and perinatal services rendered in the hospital, which attracts large number of high-risk deliveries. NICU services are covered by 7 consultant neonatologists, along with 10 post doctoral resident doctors including DNB neonatology fellows. We have a nurse: baby ratio of 1:2 for intensive care area and 1:3 nurse: baby ratio for babies not requiring intensive care. Apart from newborn care area, unit also offers a special lactation room where mothers are provided lactation counseling and can also express their milk with help of breast pumps.
Allied Pediatric Sciences
Neonatal Transport Services
Transporting sick newborn babies in our country is a challenge. Our unit has two transport incubators with inbuilt breathing machines with the help of which even very sick babies can be transported. We offer transport services round the clock. In last 10 years we have transported more than 500 babies by road including 18 air transports.. We have airlifted babies from all parts of India and few even from neighboring countries. We have 24x7 helpline no-01142251167 to deal with all transport related queries. We recently transported a 26 weeks/610 gms baby from Kathmandu. Baby required surfactant and was on mechanical ventilator for 14 days. After a stormy neonatal course baby was discharged after 64 days. Baby is now doing well.
The unit is first in country to be accredited with DNB neonatology program-Post MD Neonatology training equivalent to DM Neonatology. Our pass percentage in last 7 years of DNB program is more than 90% and we always attract the first two candidates selected in the common entrance test conducted by DNB. Our students have won the best DNB fellow award twice. We have also started NNF fellowship program from last year successfully. We plan to do collaboration with other institutions in the country conducting DNB and DM programs and do exchange program for better learning skill of our postgraduates.
Quality care initiatives
It is very important to have inbuilt quality care initiatives in the management of patients and we are doing number of initiatives like Hospital care associated infections audit, hand washing procedure audit, Insertion and maintenance bundles for the central lines, Surveillance information sheet, ventilator associated infection audit and human milk audit for preterm babies. The plan for the future years is to compare the various audits of our department with other departments in the country and outside. We recently sent our antibiotics usage data for international audit as part of ARPEC data base.
Research, publications and Awards
The department has been involved in a number of national (PHFI ) and international researches (NIH) and a number of publications have been there in the indexed journals. Departmental consultants have been involved as editors of the “Ganga Ram Journal” and involved in its regular publishing. Departmental research paper won NNF gold paper award in 2011. Understanding the need for strong methodological evidence based clinical practice today, our unit pushes forward research activities by our neonatal fellows and at one given time, 8 – 10 research projects are ongoing. We look forward to keep research and publications one of our top agenda and put Sir Ganga Ram Hospital on the international neonatal research map.
Neonatalology department is very active with academics holding National and International conferences and CMEs. The recent past saw two big international conferences “International Conference of Neonatal Nursing (2008)” and “Federation of Asia Oceania Perinatal Societies annual congress 2010” being held by the faculty of the department. Most of the faculty members have been holding important active positions in National professional bodies. We plan to hold more such conferences in future as well as plan to do neonatal skill based training CMES for tier II and II centers in the country to improve the skill of neonatal care.
The department has been collecting perinatal audit and the audit of the extramural neonates and the same is published in the hospital audit. We were part of the National Neonatal Perinatal Database also in year 2000.We plan to be the part of national and international collaborations and start sharing data with each other so as to improve neonatal care in our hospital further.
Survival as per birth weight Survivals
The survivals of premature babies have improved in the last decade with advances in neonatology. Almost 80% of babies
Parent’s Information Guide
We encourage parents to get involved in the care of their babies as we feel that there can be nothing better than the “Human Touch” for the stimulation and recovery of sick babies. So parents form a very important cogwheel in the management of babies admitted in the NICU.The department has come out with a “Parent Information Booklet” which is given to all parents on admission of their baby to the Nursery. This booklet introduces the parents to the Neonatal intensive care and serves as a reference during the baby stay in the nursery – it contains simple information about various gadgets and monitoring devices in the nursery and also touches upon common neonatal diseases and their management. The highlight of this booklet is the liberal use of excellent photographs for better demonstration of the text.
Frequently Asked Questions
I have delivered today I don't have milk's?
The milk produced in the first 2-3 days (colostrums) is less in quantity but it is sufficient and very essential for the baby. The more the baby suckles the more milk will be produced. After first 2-3 days, enough milk is usually produced.
When should the baby be first put to the breast?
New born must be put to the breast within half to one hour of the delivery. Starting to breast-feed immediately after birth stimulates the production of hormones that help milk production. Early skin to skin contact even if the baby does not suckle stimulates milk production. It also helps in improving the mother child bonding.
Elders in the family want to give honey to the baby before I start breast-feeding Is it alright?
Prelacteal (any fluids given in the initial 2-3 days after birth) feeds should not be given as they replace the essential colostrums and the baby’s earliest feeds. Babies given prelacteal feeds are more likely to develop infections and allergies. Prelacteal feeds also interfere with sucking.
How often should I breast feed?
Babies should be fed on demand. (as and when they want to feed)
Advantages of demand feeding:
Feed at least 10 times in 24 Hours more if he/she is willing. You should let him suckle whenever he seems interested. The baby should also be breastfed during the night.
What should be the duration of one feed. Should I feed from both breast at one feed?
The baby should be allowed to feed from one breast till he/she is satisfied. Foremilk is the milk that is produced early in a feed. Hind milk is the milk that is produced later in a feed, this milk contains more fat with provides energy and satiety so it is important not to take the baby off the first breast till he had enough hind milk-otherwise he will not be satisfied after the feed. Let the baby suckle from only one breast at each feed. But if he wants more milk shift to the other part.
Should I give water to my baby, as it is very hot?Babies do not need other drink (of water) before they are 6 months old, even in hot climate. Babies get a large amount of water from foremilk, this is all that the baby needs.
I have had a caesarian section so I am in pain. How do I breast feed?
You can breast fed in whatever position you and the baby are comfortable
Till when should exclusively breast feed?
Breastfeed exclusively for 6 months, Break milk is adequate for the baby till the age of 6 months if the baby is growing well.
I have flat / inverted nipples can I breast feed successfully?
Tell the mother after delivery before you start breastfeeding you should try to make the nipples stand out by using finger thumb/ pump / syringe. If the nipples cannot be made to stand out even after manipulation and the baby is unable to suckle give the baby expressed milk.
Is it necessary for me to breast fed at night? What difference will one bottle feed (at night) make?
Breastfeeding at night gives the baby extra time for suckling. More Prolactin (which is a hormone that helps in milk production) is secreted at night than during the day. So it is always better if you breast feed the baby during the day and night. This helps to keep up the milk supply. Moreover even one bottle feed at night may cause infection. The easiest way to do so is to let the baby sleep with you so that he can breast feed without disturbing you.
How do I know that my baby is getting enough milk?
An exclusively breast fed baby who is getting enough milk usually passes dilute urine 6-8 times in 24 hours. Also for the first 6 months babies will again 125 grams (500 grams / month) if adequately breast-fed. If the baby is gaining enough weight and passing urine 6-8 times a day he / she adequately breast-fed.My baby is passing watery stools is it because I am breast feeding him?
Breast milk is safe. Some exclusively breast fed babies pass frequent watery stools at times green or with mucus but they are normal, active and pass urine frequently. This is physiological and breast feeding should be continued. Similarly some normally thriving breastfed babies pass a motion once every 3-5 days this too is normal.
Healthy tips for Newborn care