The first intensive care nursery at WakeMed opened in July 1973, two years before the American Board of Pediatrics created the first subspecialty board exam for Neonatal-Perinatal Medicine. The two-room unit, which had space for just 14 isolettes, was made possible by funds from hospital volunteers alongside a negative pressure respirator donated by the March of Dimes. It was staffed by a small team of nurses, one physician — Dr. Archie Johnson — and pediatric residents from UNC.

WakeMed Neonatology Today

Today, the WakeMed Neonatology team includes eight neonatologists and 38 advanced practice providers who care for babies within the 48-bed Level IV Regional NICU at Raleigh Campus, the eight-bed NICU at Cary Hospital and the six-bed Special Care Nursery at North Hospital. Rounding out the care team are the incredibly committed pediatric specialists and subspecialists, nurses, nurse aides, respiratory therapists, lab techs, and other clinical and support staff.

The field of Neonatology has undergone tremendous change, innovation and growth in the past 50 years, and these advancements have made all the difference for millions of babies. According to the journal Nature, a 1-kg infant born in 1960 had a mortality risk of 95%; by 2000, a baby of that size had a 95% probability of survival.

Program Milestones

Our WakeMed program has also achieved numerous milestones that have helped advance the practice of neonatology and improve outcomes for our tiniest patients and their families:

• Becoming the fourth NICU in the world to earn Newborn Individualized Developmental Care and Assessment Program (NIDCAP) certification, as well as being home to the Carolina NIDCAP Training Center — a designation first earned in 1989.
• Creating NEOFAX (originally Neodex) neonatal drug manual, by WakeMed neonatologist Tom Young, MD, and Barry Mangum, PharmD, which quickly became the leading manual of its kind and has been translated into several languages.
• Becoming the first hospital in Wake County to incorporate single-patient rooms in a NICU setting, which offers more privacy and quiet time for babies and families.
• Establishing North Carolina’s first HMBANA accredited human milk bank, which today is based at Cary Hospital and provides safe, pasteurized donor milk to babies in NICUs along the East Coast.

“Developmentally supportive care has always been the focus at WakeMed,” explains James Perciaccante, MD, director of Neonatology. “We do our best to individualize care to promote healthy brain development by allowing the baby to rest when asleep and clustering care during the times they are awake. It is important not to disrupt the neuronal connections that are happening.”

If follow-up care is needed after a NICU stay, babies are transitioned into the Special Infant Care Program, where comprehensive care continues for up to three years.

Support for Families

Family support is equally important, and WakeMed offers several resources, including the Ronald McDonald Family Room and Ronald McDonald House rooms (both at Raleigh Campus), family respite rooms and real-time, 24/7 secure video access to NICU patients through the NicView™ streaming system. For the last several years WakeMed has also had a dedicated family navigator, who helps advocate and support families throughout their NICU journey. Many of these services and other enhancements to NICU care have been supported by the WakeMed Foundation.

The Future of Neonatology

Looking to the future, Dr. Perciaccante explains that despite the many technological advancements of the past several years, neonatology is currently shifting toward less invasive care. While the technology is important to have when needed for life-saving care, he says, there is more emphasis today on using natural interventions and encouraging babies to spend time with their parents, which is truly the best thing to support healthy development.

This blog is adapted from an article in our Families First Magazine. Interested in getting future issues of Families First delivered to your home? Subscribe here.