Neonatologist

What is a neonatologist?

A neonatologist is a healthcare provider who specializes in premature babies or newborns with high-risk or complex health conditions. If your baby is born premature or with an illness or congenital disability, a neonatologist will be the provider managing your baby’s care. Neonatologists are often involved in a pregnant person’s prenatal care if the health condition is diagnosed before birth. In some cases, they’re in the delivery room to treat newborn babies immediately after they’re born.

Most neonatologists work in hospitals in neonatal intensive care units (NICUs). NICUs are a special type of newborn nursery that provides 24-hour care to sick or premature babies. A neonatologist may provide follow-up care after your baby is discharged from the NICU and work with your baby’s pediatrician.

What does a neonatologist do?

A neonatologist provides specialized care and attention to babies born with severe illnesses, injuries or birth disorders. They can become involved in your pregnancy when a congenital disorder is diagnosed before birth. Neonatologists work with obstetricians to ensure that sick babies have all the medical care they need at birth. Sometimes they aren’t involved until after a baby is born because the condition was unexpected.

A neonatologist:

• Diagnoses and treats disorders, infections or illnesses in newborns.
• Coordinates and manages care, surgery and treatment.
• Orders blood tests or imaging tests like X-rays, echocardiograms (EKGs) or ultrasounds to monitor conditions or organ function.
• Makes sure sick or ill babies receive the proper nutrients.
• Assists in the delivery room and provides immediate care to an infant with medical conditions at birth.
• Consults with obstetricians, maternal-fetal medicine and pediatricians on the infant’s care.
• Provides support to families during their baby’s NICU stay.

Why would I need to see a neonatologist?

You may first see a neonatologist during pregnancy if the fetus is diagnosed with a congenital disability. These could include structural issues to one of the fetus’s organs or an inherited genetic condition like cystic fibrosis. Neonatologists work with OBGYNs and maternal-fetal specialists to help manage the baby’s care before, during and immediately after delivery. A neonatologist may be needed when an unexpected health condition or injury is discovered at birth.

Some reasons you may see a neonatologist are:

• Your pregnancy is high-risk.
• There’s a high chance that your baby will be born prematurely.
• The fetus has been diagnosed with a congenital disorder.
• Your baby is born prematurely.
• Your baby is injured during delivery.
• Your baby is born with an infection or illness.
• There’s some other unforeseen complication during or after birth.

What conditions or diseases does a neonatologist treat?

Neonatologists treat sick and injured newborns or babies that need special care after birth. Some of the most common conditions or diseases neonatologists treat are:

• Prematurity or underdeveloped organs.
• Low birth weight or fetal growth restriction.
• Congenital malformations or birth disorders.
• Respiratory or breathing problems.
• Heart conditions like heart failure, septal defects or bradycardia.
• Brain conditions like seizures or bleeding in the brain.
• Low blood sugar or hypoglycemia.
• Managing nutrition and growth or inserting feeding tubes.
• Jaundice or other liver or kidney problems.
• Birth injuries.

What’s the difference between a neonatologist and a pediatrician?

Neonatologists are pediatricians for newborn babies with injuries or diseases that require special care. Neonatologists start as pediatricians but then receive specialized training in neonatology. Neonatologists focus solely on newborns whose lives are at risk due to a disease or congenital disability. A pediatrician provides routine wellness checkups and treats illnesses in infants and children until they’re 18 years old. Neonatologists and pediatricians sometimes work together to treat or manage a baby’s care.

How does someone become a neonatologist?

Neonatology is a subspecialty of pediatrics. Neonatologists receive training as a pediatrician before specializing in neonatology.

First, a neonatologist attends college and obtains a bachelor’s degree. Next, they complete the Medical College Admissions Test (MCAT) and attend medical school. After medical school, neonatologists complete a residency program in pediatrics. The residency lasts approximately three years. A neonatologist will get hands-on experience working with children in clinical settings during their residency program.

After residency, a neonatologist needs to complete their fellowship in newborn intensive care or neonatology. A fellowship program lasts another three years. The final step is to become certified by the American Board of Pediatrics and by the sub-board of Neonatal-Perinatal Medicine.

It takes at least 11 years to become a board-certified neonatologist but may take up to 14 years.

What treatments does a neonatologist perform?

Neonatologists use a wide range of treatments to manage your baby’s health condition. The NICU is full of special equipment to help care for your baby. A neonatologist will work with your baby’s surgeon if surgery is required. Common procedures and treatments used by neonatologists are:

• Continuous positive airway pressure (CPAP), extracorporeal membrane oxygenation (ECMO), ventilator or other breathing treatment.
• Warming treatments for premature babies who aren’t maintaining their body temperature.
• Cooling therapy for babies with brain injury.
• Light therapy to treat jaundice.
• Intravenous (IV) treatments of fluid, antibiotics and medication or blood transfusions.

What can I expect from my appointment with a neonatologist?

If you see a neonatologist during pregnancy, they’ll start by educating you on the disease or condition the fetus is suspected of having. They may go over a treatment plan; however, this may not be entirely known until after your baby is born. Neonatologists will monitor your pregnancy up until delivery. Depending on the condition, the neonatologist may help deliver your baby and transfer them to the NICU for immediate care.

If your baby is born with an unexpected health condition, a neonatologist will educate you on the condition and tell you how they plan to treat your baby. They’ll go over the risks and benefits of treatment and what you can expect. Don’t be afraid to ask them any questions you have about your baby’s condition or care.

Do neonatologists deliver babies?

Neonatologists assist in delivering babies in certain circumstances. For example, if your baby has a medical condition that requires immediate treatment, a neonatologist will assist your obstetrician in the delivery room.

Is a neonatologist a doctor or a nurse?

A neonatologist is a doctor and has completed medical school.

A note from Cleveland Clinic

Neonatologists are healthcare providers with the unique ability to treat newborns with medical conditions or congenital disorders. You may see a neonatologist during pregnancy, or your baby may need to see one immediately after birth. Neonatologists are there to provide the best care to your newborn and make sure that despite their scary start, they grow up healthy.