Neonatal Follow Up

Neonatal Developmental Follow-up Clinic: What is it and who is it for?

 

Why is there a clinic?

Babies born early or are sick after birth often spend their early days, weeks or months in hospital. While in the NICU their illness may put them at risk for having trouble with normal development. Those born earlier and those with illness in the NICU are at higher risk of these challenges. 

The follow-up clinic does not replace your child’s primary care provider. You still need to take your baby to the doctor or pediatrician who provides the routine care such as vaccinations, management of fevers and routine colds , and advice about routine nutrition.

Having you and your baby come to clinic also helps us gather information about how babies with higher-risk are developing, which can help us evaluate the care your baby received, and help us improve care for other babies.

Which babies are seen at the clinic?

Clinics can be in a hospital or a community setting. They have different criteria for who they see, often based on number of weeks of gestation at birth, birth weight, or the presence of illness.

Why attend?

The staff at the clinic have skills and experience in spotting the challenges that children who have been in the NICU may be having. They will help to create a plan to help you help your child achieve his/her fullest potential. If you do not attend the clinic, you will miss out on a chance to use them to help you and your child.

Who are the staff?

The clinic staff may include doctors, nurses, physiotherapists, occupational therapists, speech and language pathologists, psychologists and psychometrists. A clinic coordinator (secretary) will book the day and time of the appointments. 

What does it entail? 

Clinic visits happen about 5 times over the first 3 years. The first visit is usually at 3-4 months after the due date (corrected age). Visits are often at 4, 8, 12 18 and 36 months. Some clinics have a visit at 6 weeks and some do see the children into early school age. 

What happens at the visit?

Up to 12 months, the visits are mostly play-based. The clinician will play with the child to assess his/her development in a number of areas. These include:

• neurological (brain) development,  

• gross motor skills (big muscles – how we move, crawl, stand up and walk), 

• fine motor skills, (hand muscles – how we reach, grasp, manipulate, write with our hands), 

• communication skills (how we look at somebody, smile, laugh, cooing, babbling and talking), 

• social skills (interact with those around them). 

Based on this assessment, they will give you feedback. This, may include some home-based suggestions, or referrals for extra supports.

During the toddler and preschool years, many clinics complete assessments that focus on a child’s developing problem solving/cognitive skills, as well as their developing language.  While children may be seated for these assessments at a small table, they still involve playful activities.  The most widely used test at this age and up to 3 years is the Bayley Scales of Infant and Child Development - 4 (BSID-IV), though it is not necessarily offered at every clinic.

 

Thank you to Dr. Edmond Kelly, Director of the Neonatal Developmental Follow-up Clinic at Mount Sinai Hospital, for sharing information about neonatal follow up with us.

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