Neonatal-Perinatal Medicine – Environment

The only free-standing children's hospital in the state, Connecticut Children's Medical Center offers a full range of inpatient and outpatient services in every area of pediatric specialization. Connecticut Children's is the home of the Department of Pediatrics for the UConn School of Medicine, and serves the community as the principal pediatric care and teaching institution for northern and central Connecticut and western Massachusetts. Connecticut Children's is located in downtown Hartford immediately adjacent to Hartford Hospital, a 900-bed teaching hospital in the downtown area serving greater Hartford.

Fellows in our program rotate through the Connecticut Children's Medical Center level IV neonatal ICU in Hartford, and the level III NICU at UConn Health in Farmington. Pediatric residents, neonatal nurse practitioners and physician assistants provide primary clinical care in both units. Both units are supervised by full-time faculty from the Division of Neonatology at UConn School of Medicine's Department of Pediatrics, and both units contribute data to the Vermont-Oxford Network. Full-time perinatologists oversee the high-risk delivery service at both sites.

Connecticut Children's 32-bed neonatal ICU, a level IV regional referral facility supported by well-established programs in high-risk perinatology, genetics, prenatal diagnosis, pediatric surgery, and cardiothoracic surgery, admits 550-600 infants annually. The Connecticut Children's NICU is an active ECMO, cardiac and pediatric surgical referral facility. It is also home to the Connecticut Children’s Neonatal Transport service, a program that provides transport to 300 critically ill infants across the region on an annual basis.

The NICU at UConn Health in Farmington is located about 20 minutes by car from downtown Hartford. This unit is comprised of 30 level III beds. It receives inborn high risk infants from the Maternal-Fetal Medicine Program and infants transferred from the region with medical problems. The UConn Health NICU has active programs in infant feeding, apnea, gastroesophageal reflux and retinopathy of prematurity.

Patient characteristics at the two program sites

NICU-East

  1. Births per year at Hartford Hospital: 3,679
  2. Neonatal ICU admissions per year: 653
    • Birth weight < 1500 grams: 93
    • Birth weight < 1000 grams: 55
    • Inborn: 502
    • Outborn/transports in: 151
  3. Average NICU daily census: 31
  4. Average NICU length of stay: 18 days
  5. Number of patients per year requiring mechanical ventilation: 151
  6. Number of neonatal surgical cases
    • Cardiac: 42
    • General: 78 (includes PDA ligations)

NICU-West

  1. Births per year at UConn Health: 886
  2. Neonatal ICU admissions per year: 272
    • < 1000 grams: 37
    • < 1500 grams: 56
    • Inborn: 208
    • Outborn/transports in: 64
  3. Average NICU daily census: 20
  4. The average length of stay: 26 days
  5. Number of patients per year requiring mechanical ventilation: 53
  6. Number of neonatal surgical cases
    • Cardiac: 15
    • General: 53 (includes PDA ligations)

The Neonatal Transitional and Follow-Up Clinic is staffed by a nurse coordinator, occupational and physical therapists, a dietitian and neonatologists. Dedicated and experienced occupational and physical therapists perform developmental examinations on infants, including the Bayley III. Shabnam Lainwala, M.B.B.S., Ph.D., the director of the neonatal follow-up program, is a board certified neonatologist with research interests in neurodevelopmental outcomes of premature infants and growth and nutrition. Marilyn Sanders, M.D., is a board-certified neonatologist with 20 years of experience in neurodevelopmental follow-up and has an interest in neurodevelopmental outcomes of premature infants. Drs. Carla Jacobson-Kiel and Arpana Mohnani have extensive neurodevelopmental follow-up experience and also see NICU graduates in the Neonatal Transitional and Follow-up Clinic. Drs. Sanders, Lainwala, Jacobson-Kiel and Mohnani provide medical and neurologic assessment to the Follow-up Clinic patients and determine plans. Neonatal fellows work under the direct supervision of the neonatologists in the provision of follow-up care to high-risk infants. They develop an understanding of the neurodevelopmental outcomes of at-risk infants including low birth weight/preterm infants, infants with intracranial abnormalities, asphyxiated infants and growth restricted infants. They also become competent in neurodevelopmental assessment of infants and toddlers from four months to two years.

Fellows enjoy access to extensive reference, computer, and multimedia resources within the Division of Neonatology and through Hartford Hospital, Connecticut Children's Medical Center, UConn Health, at the UConn School of Medicine's Lyman Maynard Stowe Library, and through other resources of the UConn School of Medicine and the University of Connecticut.

Fellows may choose to meet their scholarly activity requirement by pursuing clinical or basic science research experiences in the Division of Neonatology, the Department of Pediatrics or in many of the research laboratories across UConn Health. Interested fellows may pursue a Master of Science degree through the Graduate School's Master of Science in Clinical and Translational Research Program, or a Masters of Public Health through the UConn School of Medicine, at their own expense.

Fellows in neonatal-perinatal medicine may combine their fellowship with training in other pediatric subspecialty fellowships at the UConn School of Medicine/Connecticut Children's Medical Center. Fellows successfully completing these training programs are eligible for certifying examination in both subspecialties.