Intestinal Rehabilitation (Reed Dimmitt, MD)
There are many congenital and acquired diseases of the newborn that result in intestinal failure and the need for intestinal rehabilitation. These infants often need long term home intravenous nutrition, multiple operations, and medical management to improve intestinal function. The Georgeson Center for Advanced Intestinal Rehabilitation was established 3 years ago and has expanded to provide gastroenterology/nutrition, pediatric surgery, and occupational support. We are a site for an FDA trial of a new type of intravenous lipid composed of omega-3 fatty acids that helps prevent intravenous nutrition associated liver disease. The establishment of this program has resulted in improved continuity of care and better outcomes.
Newborn Follow-up Clinic (Myriam Peralta-Carcelen, MD)
The Newborn Follow-up Clinic is a regional multi-disciplinary developmental clinic in Birmingham, Alabama. Children qualify for this clinic if they were classified as extremely low birth weight (under 1000 grams or 2lbs 3oz), were born less than 29 weeks, had a severe congenital heart defect, had the procedure of ECMO, and other groups of child with high risk conditions. They are referred to the clinic from various regional NICUs, including UAB Hospital and Children’s of Alabama and pediatricians from around the state.
The Newborn Follow-up Clinic has been following groups of high-risk children since its inception in 1977. The program assesses the progress of these children who have an increased likelihood for developmental problems that may appear gradually over the first few years of life. Follow-up evaluations are done to identify problems in either physical growth or development.
In a typical clinic visit, the child will potentially see a developmental pediatrician, nurse practitioner, physical therapist, occupational therapist, audiologist, psychologist, optometrist and social worker. The evaluations done at this clinic will involve “playing” with your child. Evaluations will be done at each visit and will vary depending on the age of your child. These evaluations may include tests of physical abilities, intelligence, vision, hearing or nutrition.
The clinic staff can be reached or a referral to the clinic can be made by calling the office number at 205-638-6966. For more information, please visit the UAB Newborn Follow-up Clinic.
Of the approximate four million births that occur in the United States each year, 2 percent of these infants will be born <32 weeks gestation age and 12.5 percent at <37 weeks gestational age. Advances in healthcare technology have enabled many premature and term infants to survive, resulting in an increase in the number of NICU graduates (Hoyert, DL, Mathews, TJ, Menacker, F, et al. Annual summary of vital statistics:2004. Pediatrics 2006:117:168). Although most NICU graduates are discharged when their adjusted gestational age is near or at term, they differ in their medical needs compared to normal term infants. NICU graduates often have long-term respiratory issues the most common of which is bronchopulmonary dysplasia (BPD). BPD is a chronic pulmonary disease of infancy that follows prolonged mechanical ventilation and oxygen therapy. The clinical severity of BPD cases varies from thriving infants requiring low levels of supplemental oxygen to chronically ill infants who remain ventilator dependent throughout childhood. Additional clinical problems in infants with BPD may include growth failure and developmental delay. Infants with BPD have abnormal lung function during the first years of life and require close monitoring and supportive care. In order to meet the needs of this special population the UAB Pulmonary Division developed a BPD clinic to provide comprehensive care through an interdisciplinary approach. Clinical management of this population is focused on monitoring the cardiorespiratory status of the patient, ensuring growth, minimizing respiratory exacerbations and monitoring development. This clinic currently serves children throughout the state of Alabama and portions of Mississippi. Children are typically followed in this clinic until they have been weaned off diuretics and supplemental oxygen.