American Board of Pediatrics (Neonatal-Perinatal Medicine)
Professional History
My professional activities span the realm of clinical service, administration, research and teaching, all devoted to discovering, implementing and teaching evidence-based clinical care of seriously ill newborns.
As the NICU director, I am responsible for patient care, research endeavors, and educational needs. I have developed numerous important guidelines for our NICU and have collaborated on a wide range of medical improvements. We were the first NICU in New England to provide a specialized hypothermia program for babies with difficult births and now use sophisticated neurologic imaging to assess brain function. I collaborate with engineering laboratories to develop improved medical devices. I am the course director of a program to teach difficult conversations with families.
I also work on projects for resources limited settings. I helped develop a nonelectric infant warmer and collaborated with Rwandan doctors and ministry of health to develop and teach their National Neonatal Protocols.
I have authored original research papers and manuals including The Manual of Neonatal Care, The Manual of Neonatal Surgical Intensive Care, and The Manual of Neonatal Mock Codes.
Approach to Care
In the Boston Children’s Hospital (BCH) Neonatal Intensive Care Unit (NICU) our philosophy is to ensure that every patient receives the best care for the best possible outcomes. This requires a team based approach with all members being essential:
Families: We practice family-integrated care; we encourage families to be at the center of all we do, understanding and participating in the care of their baby.
Doctors: At BCH we have an enormous breadth and depth of world-class medical and surgical subspecialists who cover all aspects of pediatric medicine and who are continuously innovating new diagnostics and novel therapies to treat newborn diseases. The treatment of each patient is coordinated by our attending neonatologists.
Nurses: We have highly experienced neonatal nurses and nurse practitioners who devote themselves to the bedside care of babies and their families, working in a primary team model to promote consistency. We are the only NICU in the country to have received the Gold Level Beacon award, a testimony to the extraordinary performance of our nurses.
Ancillary staff: this includes respiratory therapists, nutritionists, lactation consultants, pharmacists, physical and occupational therapists, social workers and interpreters who all work with us to meet our patients’ needs.
Publications
An Implementation Science Study of a Heat-Producing Wrap to Complement KMC in Rwanda. View Abstract
Recognizing neonatal refeeding syndrome and thiamin supplementation: A case report. View Abstract
The 21st Century Cures Act: Perspectives of Clinicians in a Level-IV Neonatal Intensive Care Unit. View Abstract
A mixed methods study of perceptions of bias among neonatal intensive care unit staff. View Abstract
A Multimodal Approach to Training Coronavirus Disease (COVID-19) Processes Across Four Intensive Care Units. View Abstract
Parent and staff perspectives on the benefits and barriers to communication with infants in the neonatal intensive care unit. View Abstract
Reducing Benzodiazepine Exposure by Instituting a Guideline for Dexmedetomidine Usage in the NICU. View Abstract
Mortality in the neonatal intensive care unit: improving the accuracy of death reporting. View Abstract
Need for more evidence in the prevention and management of perinatal asphyxia and neonatal encephalopathy in low and middle-income countries: A call for action. View Abstract
Protease inhibitor plasma concentrations associate with COVID-19 infection. View Abstract
Safety and effectiveness of a non-electric infant warmer for hypothermia in Rwanda: A cluster-randomized stepped-wedge trial View Abstract
Inverse Opal Films for Medical Sensing: Application in Diagnosis of Neonatal Jaundice. View Abstract
Neurophysiological Assessment of Prolonged Recovery From Neuromuscular Blockade in the Neonatal Intensive Care Unit. View Abstract
Neurologic Injury and Brain Growth in the Setting of Long-Gap Esophageal Atresia Perioperative Critical Care: A Pilot Study. View Abstract
Performance of a Nonelectric Infant Warmer in Rwandan Health Centers. View Abstract
Nutritive sucking abnormalities and brain microstructural abnormalities in infants with established brain injury: a pilot study. View Abstract
Improving Access to Lactation Consultation and Early Breast Milk Use in an Outborn NICU. View Abstract
Early Management of Infants With Robin Sequence: An International Survey and Algorithm. View Abstract
Reducing time to initiation and advancement of enteral feeding in an all-referral neonatal intensive care unit. View Abstract
Implementation of a Guideline to Decrease Use of Acid-Suppressing Medications in the NICU. View Abstract
Progressive IgA Nephropathy Is Associated With Low Circulating Mannan-Binding Lectin-Associated Serine Protease-3 (MASP-3) and Increased Glomerular Factor H-Related Protein-5 (FHR5) Deposition. View Abstract
A Regional Evaluation of Survival of Infants with End-Stage Renal Disease. View Abstract
The
Development and Implementation of a Newborn Medicine Program in a Resource Limited Setting
View Abstract
A bioinspired omniphobic surface coating on medical devices prevents thrombosis and biofouling. View Abstract
Falls and comorbidity: the pathway to fractures. View Abstract
Developing a quality and safety curriculum for fellows: lessons learned from a neonatology fellowship program. View Abstract
Whole genome sequencing identifies SCN2A mutation in monozygotic twins with Ohtahara syndrome and unique neuropathologic findings. View Abstract
Placental pathology in asphyxiated newborns meeting the criteria for therapeutic hypothermia. View Abstract
Can induced hypothermia be assured during brain MRI in neonates with hypoxic-ischemic encephalopathy? View Abstract
Donation after cardiac death: the potential contribution of an infant organ donor population. View Abstract
An interdisciplinary, family-focused approach to relational learning in neonatal intensive care. View Abstract
Early versus late MRI in asphyxiated newborns treated with hypothermia. View Abstract
Correlation of 2-methoxyestradiol levels in cord blood and complications of prematurity. View Abstract
Premature infant swallowing: patterns of tongue-soft palate coordination based upon videofluoroscopy. View Abstract
Maternal preeclampsia predicts the development of bronchopulmonary dysplasia. View Abstract
MAp44, a human protein associated with pattern recognition molecules of the complement system and regulating the lectin pathway of complement activation. View Abstract
Polymorphisms in mannan-binding lectin (MBL)-associated serine protease 2 affect stability, binding to MBL, and enzymatic activity. View Abstract
Neonatal arterial thrombosis at birth: case report and literature review. View Abstract
Inhaled epinephrine for the treatment of transient tachypnea of the newborn. View Abstract
No certain predictors for mutation status in a Danish cohort with familial hypercholesterolemia: a descriptive study. View Abstract
Potential substitution of cord blood for infant blood in the neonatal sepsis evaluation. View Abstract
Antenatal neurosurgical counseling: approach to the unborn patient. View Abstract
Once-daily gentamicin dosing for the preterm and term newborn: proposal for a simple regimen that achieves target levels. View Abstract
Very low birthweight Infant's placenta and its relation to pregnancy and fetal characteristics. View Abstract
Very low birthweight placenta: clustering of morphologic characteristics. View Abstract
Plasminogen activator inhibitor-1: defining characteristics in the cerebrospinal fluid of newborns. View Abstract
Sonographically detected subarachnoid hemorrhage: an independent predictor of neonatal posthemorrhagic hydrocephalus? View Abstract
Thymic transplantation across an MHC class I barrier in swine. View Abstract
Labor and delivery characteristics and risks of cranial ultrasonographic abnormalities among very-low-birth-weight infants. The Developmental Epidemiology Network Investigators. View Abstract
Medical management of neonatal posthemorrhagic hydrocephalus. View Abstract
CNS fibrinolysis: a review of the literature with a pediatric emphasis. View Abstract
Intraventricular urokinase for the treatment of posthemorrhagic hydrocephalus. View Abstract
Predictors of ventriculoperitoneal shunt among babies with intraventricular hemorrhage. View Abstract
Cerebrospinal fluid plasminogen activator inhibitor-1: a prognostic factor in posthaemorrhagic hydrocephalus. View Abstract
Central apnea in a child with congenital autonomic dysfunction and universal pain loss. View Abstract