What is a neonatologist?

A neonatologist is a doctor who specialises in the care and treatment of newborn babies. They care for both sick and healthy babies up to 4 weeks old. The neonatologist’s first task is to assess the newborn’s health at the moment of birth. Neonatologists also treat small patients whose condition was diagnosed during foetal development or who were born prematurely.

These doctors train by completing a residency in paediatrics and then obtaining a doctorate in neonatology, the field of medicine specialising in the care of newborns.

The newborn

The neonatal period lasts 28 days. A newborn is a quite distinct medical individual, far from a miniature adult. It is characterised by a complex set of adaptations to life outside the womb and by powerful plasticity, which it shows in its development and in recovering from various injuries. Yet it is extremely fragile in terms of its limited resources and, under stress or illness (hypoxia, hypothermia, acidosis, infection, congenital malformations, prematurity, separation from the mother and so on), may suffer long-term harm or fail to survive if it does not receive adequate care in time.

Neonatology is a young specialty that emerged as a sub-specialty of paediatrics in the second half of the 20th century, in response to the need for specialists in individual newborn care, to improve survival at low gestational ages and to reduce infant morbidity and mortality. It appeared in the United States around 1960, almost at the same time as the first neonatal intensive care unit.

With mother and baby in the delivery room

A neonatologist, accompanied by a nurse, is always present at the birth together with the obstetrician. The neonatologist is the first doctor to assess the newborn’s condition and manages the process of adapting to all the changes that follow the transition from life in the womb to life outside it.

Births in Switzerland always take place in the presence of highly qualified neonatologists, who guarantee the highest level of safety and the sense of security newborns need.

Immediately after birth, the neonatologist provides routine newborn care:

  • placing the baby under a radiant warmer or on the mother’s chest
  • wiping the skin
  • suctioning secretions if they are abundant
  • treating the umbilical cord

After the baby is born, the neonatologist also assesses its condition using the Apgar score. Skin colour, heart rate, response to external stimuli, muscle tone and breathing are taken into account. The baby is then weighed and measured. The neonatologist also checks the head, spine, internal organs, arterial blood flow, knees, hip joints, feet, genitals, palate and tongue.

Neonatologists play an extremely important role in the lives of both the young mother and the newborn. Alongside the medical procedures that safeguard the baby’s health, the neonatologist is the doctor who guides the newborn’s first contact with its mother.

The neonatologist must determine the newborn’s state of health as quickly as possible and identify any deviations from the norm. This is the starting point for any further diagnostics and treatment. Severe malformations are often detected only after birth. The neonatologist may then keep the baby in the neonatal pathology unit.

If the neonatologist identifies deviations from the norm, diagnostics and treatment in Switzerland are available. The paediatrics department in Switzerland treats children from the first days of life.

Which conditions does a neonatologist diagnose?

The conditions diagnosed by a neonatologist include:

  • brain disorders;
  • non-traumatic intracranial haemorrhage;
  • genetic diseases;
  • intrauterine growth restriction;
  • birth asphyxia;
  • perinatal intestinal perforation;
  • congenital malformations;
  • bronchopulmonary dysplasia;
  • jaundice;
  • complications of prematurity.

Specialists the neonatologist works with

The list of neonatal conditions a neonatologist deals with is therefore very long. Importantly, specialists from other fields of medicine are often involved in diagnosing and treating these conditions, such as:

  • paediatric surgery,
  • cardiology,
  • neurology,
  • endocrinology,
  • urology,
  • rehabilitation,
  • orthopaedics,
  • ophthalmology.

The most complex cases of neonatal pathology, in particular premature babies with a very low birth weight (down to about 500 g), are usually admitted to the neonatal unit immediately after birth, where they are cared for by qualified specialists: neonatologists, midwives and neonatal nurses.