Small Baby

Prematurity

Our Level IV Neonatal Intensive Care Unit at UCLA Mattel Children's Hospital is experienced in caring for the smallest and most premature babies, who require specialized care. Babies born less than 29 weeks require delicate and protective care, which is why we have protocols to care for these delicate babies and their unique medical and developmental needs.

Neuroprotection

Premature babies' brains are still in a crucial stage of development and require special care to minimize potential negative impacts on the brain from premature birth and foster neurodevelopment. Our small baby protective strategies include:

• Keeping babies warm with a set bed humidity and radiant warmer.
• Minimize touch and stimulation by medical team with set "touch times", typically every 6 hours.
• Minimize noise levels.
• Developmentally appropriate light exposure.
• Careful positioning of babies to minimize risk of intraventricular hemorrhage, a type of bleeding in the brain unique to extremely preterm infants.
• Minimize invasive procedures as much as possible.
• Kangaroo care (parental skin-to-skin contact with baby). This has been proven to increase parental-infant bonding and improve premature babies' health.

Lung support

Small premature babies face an increased risk for lung disease given their immature lungs. We use lung protective strategies when providing respiratory support to our smallest babies. This includes lung protective ventilator modes and the use of non-invasive respiratory support.

Nutrition and growth

We have specialized nutrition and feeding protocols for our small babies, designed to optimize nutrition, promote tolerability and prevent feeding complications. We start our small babies on intravenous (IV) nutrition, while gradually increasing milk feeds. We work closely with our pharmacists and dietitians when managing IV and milk nutrition.

• Breast milk: We encourage maternal breast milk production for our babies. In addition, we offer donor breast milk. Extra nutrients are added to your baby's milk to provide the extra nutrients babies normally would receive during the third trimester of pregnancy.
• Infant driven feeding: A specialized protocol is instituted when your baby is mature enough to show signs that they are ready to start trying to feed by mouth. We first offer non-nutritive breast feeding so they can "practice" feeding and bond with mother. And when your baby is ready, we will have them attempt to breast feed with each feeding.

Follow up care:

When your baby is ready to go home, they will need special follow depending on their birth weight, how early they were born, and other risk factors they may have incurred during their time in the NICU. We have a specialized "High Risk Infant Follow Up" Clinic, in which we follow babies' development and growth closely over the first 2-3 years of life. We have clinic locations at both the Ronald Reagan andSanta Monica campuses. Our clinic is staffed with highly trained providers composed of the following:

• Occupational therapist
• Physical therapist
• Dietician
• Psychologist
• Social work
• Developmental pediatrician
• Neonatologist

Our team will help coordinate referrals to community services and early-intervention programs.