Neonatology

Treatments and Services

Seattle Children’s Neonatal Intensive Care Unit (NICU) provides a range of innovative therapies. Some are offered nowhere else in the Northwest. Our Neonatology team takes a precision medicine approach, tailoring care to your baby's needs and condition.

When a known or suspected problem is found during pregnancy, care begins before birth at our Fetal Care and Treatment Center. We also make sure your child gets the follow-up care they need at either Seattle Children’s or the Infant Development Follow-Up Clinic at UW Medical Center.

Precise Diagnosis of Genetic Disorders

Many babies in the NICU have medical conditions caused by changes in . Identifying a specific genetic cause helps us diagnose babies more precisely and start treatment personalized to your child’s condition.

We offer as a first genetic test for all our NICU patients unless their clinical findings are fully explained by physical trauma during birth, complications of prematurity, infection or a pre-existing precise genetic diagnosis. Offering rGS to nearly all babies in the NICU means more babies receive a precise diagnosis sooner. Early rGS enables your healthcare team to start treatment for the genetic disorder before it causes many complications.

Complex Neonatal Surgery

We perform complex neonatal surgery to fix birth defects in the baby's:

Often these surgeries require multiple teams of pediatric surgeons, including general surgery, , , and .

Life Support and ECMO

Extracorporeal membrane oxygenation (ECMO) is a way to provide life support using a heart-lung pump when a person’s heart or lungs aren’'t working well or need time to heal. With ECMO, oxygen-poor blood is drawn into a machine that removes excess carbon dioxide. It adds oxygen and returns the oxygen-rich blood to the body.

Seattle Children’'s is the only hospital that provides neonatal ECMO in our region (Washington, Alaska, Montana and Idaho). The Extracorporeal Life Support Organization (ELSO) has named Seattle Children's a Center of Excellence in ECMO – Gold Level.

While on ECMO, your baby will be for comfort and closely monitored by a nurse and an ECMO specialist.

State-of-the-Art Breathing Support

The type of breathing support that your child needs and length of time they are on oxygen depend on their condition. They may have different kinds of support while they are in the NICU.

  • When using conventional breathing machines (ventilators), we choose an approach that works with your baby’s own breathing to best support their lungs.
  • High-frequency ventilation is a gentler type of breathing machine that sends small, quick puffs of air into your child’'s lungs.
  • For babies who do not need ventilator support, we provide a steady flow of air to their lungs from a machine via a mask or prongs into their nose. This is called “noninvasive ventilation” because the mask or prongs can be removed easily.
  • We deliver inhaled nitric oxide (iNO) through a breathing tube into the windpipe to treat and high blood pressure in the lungs. It helps the blood vessels in the lung open so they can carry oxygen-rich blood into the body.

Our Bronchopulmonary Dysplasia Program is a team of experts focused on caring for babies with long-term lung problems called bronchopulmonary dysplasia (BPD). We provide seamless care from your baby’s first assessment through treatment and long-term follow-up. Research shows that when hospitals have dedicated teams, babies with severe BPD have shorter hospital stays and better outcomes.

Neuro NICU

The expert team in Seattle Children’s Neuro NICU provides , specialized care to help protect and heal the brains of babies born with or at risk for a condition that affects their nervous system. Ours is the only neonatal neurocritical care program in Washington, Wyoming, Alaska, Montana and Idaho.

Our advanced neurodiagnostic and neuroimaging technology helps us see and understand what is happening in and around your baby’s brain:

  • Near-infrared spectroscopy () to measure blood oxygen in the brain
  • Video electroencephalography () to help monitor brain activity and detect seizures
  • Non-invasive to take pictures of your baby’s brain without radiation

Just as important as the tools, our experts have the knowledge and experience to read these advanced tests and scans when used with newborns.

Whole-Body Cooling (Therapeutic Hypothermia)

After birth, some babies show signs that they have had severe lack of oxygen for a period of time. (This is called asphyxia or hypoxic-ischemic encephalopathy/HIE.) Cooling the baby to about 91° F (33.5° C) for 3 days may reduce brain injury. Learn more about this body-cooling process, called therapeutic hypothermia (PDF).

Before and during this treatment, we can continuously record and measure brain wave activity. The brain monitor provides real-time information about an infant's brain function. It helps identify activity. A baby must be at least 35 weeks gestation (no more than 4 weeks early) for this treatment.

We can start cooling therapy during transport to our hospital to assure your baby receives the best care as soon as possible. Seattle Children’s Hospital is a high-volume cooling center, which means we have a lot of experience treating babies affected by HIE.

Continuous Renal (Kidney) Replacement Therapy (CRRT) (Hemodialysis and Peritoneal Dialysis)

CRRT is a 24-hour, non-stop temporary dialysis therapy. Dialysis removes waste and extra fluid from the blood when the kidneys do not work well. Hemodialysis uses a dialysis machine to filter the blood. Peritoneal dialysis uses the lining of the belly (peritoneum) as a filter. CRRT works like the kidneys and allows us to gently filter your baby’s blood. This gives babies with kidney failure (renal failure) a chance for their kidneys to rest and get better. Learn more about dialysis.

Follow-Up Programs for Complex Conditions

Many babies born too early or with complex conditions will need follow-up care throughout childhood. We make sure your child gets the follow-up care they need at either Seattle Children’s or the Infant Development Follow-Up Clinic at UW Medical Center.

To support your child’s long-term health and quality of life, Seattle Children’s offers specialized programs such as:

For Healthcare Professionals