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Families first: U neonatology team focuses on finding better ways to care for sick babies while easing the strain on families

When Misty and Matt Motzko’s son, Logan, was born unexpectedly at 24 weeks, weighing only a pound and a half, the whole family needed expert care. Nothing could have prepared the Motzkos for their baby’s harrowing entry into the world—but under the circumstances, Misty says, they couldn’t have landed in a better place. Misty, Logan, and Matt Motzko are now healthy and happy at home. (Photo: Jen Taylor Photography)

That place was University of Minnesota Amplatz Children’s Hospital’s Level III Neonatal Intensive Care Unit (NICU).

Logan spent the first 119 days of his life in that NICU, and for the first 10 days, his parents couldn’t even hold him because he was so fragile.

When the Motzkos were finally able to bring Logan home, just before Christmas 2008, Misty and Matt felt a bit of “separation anxiety” from the NICU team, she says.

“I can’t do justice to how great they were,”Misty says of the team that cared for Logan and his frantic parents. “We’re very fortunate we were there.”

Leaders in lifesaving care and research

About 700 infants are admitted to University of Minnesota Amplatz Children’s Hospital’s NICU each year, and the staff takes a family-centered approach to caring for those premature and critically ill babies. Some of them—and their mothers—have already spent weeks or months in the care of the University of Minnesota Medical Center, Fairview’s Maternal-Fetal Medicine Center, whose physicians work in tandem with the NICU team to provide a seamless transition for at-risk babies and moms.

The NICU team at University of Minnesota Amplatz Children’s Hospital is recognized nationally for its research aimed at maximizing outcomes like Logan’s and expanding critical knowledge in the relatively new discipline of newborn intensive care.

Michael Georgieff, M.D., director of the Division of Neonatology in the University of Minnesota Medical School’s Department of Pediatrics, cites a research effort by his colleague Kari Roberts, M.D., as an example of work that has strong potential to improve treatment of premature babies and lower care costs for families. Michael Georgieff, M.D. Roberts is developing a better way to administer surfactant—a fluid, often deficient in preemies, used to help the lungs’ tiny air sacs remain open for normal breathing.

“Usually you’ll put a tube in the baby’s throat; it’s quite invasive,” Georgieff says. “Kari’s been working on something called a laryngeal mask airway that allows her to spray the surfactant so you don’t have to put that tube in. It’s pretty exciting stuff.”

Georgieff, himself, along with colleague Raghavendra Rao, M.D., is examining the effects of iron and glucose on the developing brain.

“The part of the brain we use for recognition memory—recognizing voices, faces, objects—is very rapidly developing in the late fetal and early newborn [phase],” Georgieff says. His research shows that children who are irondeficient at birth experience diminished brain development. And given that iron deficiency is the most common nutritional deficiency worldwide, the findings have big implications.

Rao’s research shows how dependent this area of the brain is on having a ready source of sugar for energy. Misty Motzko holds 10-day-old Logan for the first time. Their colleagues are doing equally momentous work in other areas of newborn health. Catherine Bendel, M.D., is the site leader of a multicenter study aimed at fighting the fungal infection Candida albicans in premature infants, while Cheryl Gale, M.D., strives to understand the basic biology that makes Candida cause such devastating disease in babies. Dana Johnson, M.D., Ph.D., founder of the University’s Adoption Medicine Program and Clinic, continues his research on the effects of neglect and deprivation on brain development and child health.

Collaborating to improve care

The NICU team also participates in the collaborative Vermont Oxford Network to improve care outcomes for newborns and their families. Through the network, some 800 NICUs around the globe are sharing information, developing recommendations, and conducting audits and peer reviews in areas such as infection reduction and resuscitation and stabilization in the delivery room.

NICU medical director Thomas George, M.D., believes that one of the team’s most exciting cooperative arrangements is a new collaboration with North Memorial Medical Center in Robbinsdale. Thanks to a partnership between North Memorial and University of Minnesota Physicians, the Robbinsdale hospital now has access to the University’s neonatology expertise.

“This collaboration emphasizes keeping sick newborns in their communities,” George says. Thomas George, M.D. It’s the fourth community-based NICU where University neonatologists are working (the others are at Fairview-affiliated sites in Burnsville, Edina, and Maple Grove)—in addition to University of Minnesota Amplatz Children’s Hospital in Minneapolis.

Meeting families where they live is just part of the team’s commitment to a family-centered approach to newborn care.

“These infants can be in the hospital for months,” George says. “When we’re able to keep kids closer to home, it makes it easier for families….This way they can have their support system nearby; they can be at the baby’s bedside more often.”

In addition, University physicians are providing more related specialty services—pediatric cardiology, gastroenterology, and surgery—on site at North Memorial to offer comprehensive care.

Serving whole families

Logan Motzko’s parents experienced firsthand the University team’s dedication to serving whole families, and it helped sustain them through an incredibly tough and frightening time.

The Motzkos periodically send photos of Logan, who is now 18 months old, to some of the NICU nurses at University of Minnesota Amplatz Children’s Hospital. And George reconnects with the family at checkups—one of the most rewarding aspects of his job, he says.

“To see [Logan] now—he’s this darling, curly-haired little boy,” George says. “I really can’t imagine him doing much better!”

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