DPNBM Annual Report 2021

The best for every baby 2021 Annual Report Department of Pediatric Newborn Medicine

Brigham and Women’s Hospital Leads the world in expert family-centered newborn medicine Dear Colleagues and Friends, Here at the Brigham we are proud to share another year of providing “the best care for every baby.” Within this report we present the growth of our newborn care within and beyond the walls of the Brigham. We love what we do and we love pushing the boundaries of what’s possible to deliver better care for our babies and families. It is my distinct privilege to lead this passionate, skilled, and driven team who work so hard and focus tirelessly on meeting the needs of every family. We have all been through so much over the last two years caring for families in the most stressful times of the COVID-19 pandemic. It has been challenging for all healthcare providers. Here at the Brigham, we have pulled together to stand strong for our babies and families. Today, we are grateful. Thank you so much for your interest in our department and programs. We are proud to share our mission and our commitment to the babies and our families. With kindest wish, Terrie Inder, MBChB, MD Mary Ellen Avery Professor of Pediatrics in the Field of Newborn Medicine, Harvard Medical School Chair, Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital 2

The best for every baby Our mission is to provide the highest quality care to all infants and their families that is compassionate, comprehensive, and skilled; alongside educating for future generations of health professionals, advancing knowledge of newborn science and care, and advocating for optimal health of newborns. Our vision is to be the regional and national leader in discovery and application of skilled and compassionate newborn and family care. Parents want the best for their baby, both before and after birth. Our goal is for every baby to receive the best possible newborn care and every family to be fully informed, engaged, and involved in their baby’s care right from the very beginning. 3

We lead the field in… Clinical care Our department leads the field in newborn medicine, with particular expertise in achieving better outcomes for premature and seriously ill babies. Teaching As the teaching hospital of Harvard Medical School and a residency and fellowship site for Mass General Hospital and Boston Children’s Hospital, we train the next generation of neonatal practitioners. Research Our nationally and internationally recognized clinicians are leaders in neonatal research; their clinical and lab-based studies expand what is possible for the babies we serve and infants across the globe. In 2021 we facilitated Hosted 6,690 births 350+ Maintained an average daily physicians in training census of Developed 52.5 babies 80 active research studies 4

Department makeup Awards & Honors 7 Faculty Awards new Jo Ellen Altschaefl, MD physicians BWH Outstanding Clinician and 2021 Brigham Health Distinguished Clinician Award 6 Mandy Belfort, MD, MPH leadership Pillar Award Honored Nomination for Research promotions Katherine Bell, MD Pillar Award Honored Nomination for Education 45% are 31 researchers Elizabeth Flanigan, MD, MPH neonatology 2021 Brigham Health Distinguished Clinician Award 52% hold leadership faculty Tanzeema Hossain, MD titles Pillar Award Honored Nomination for Education 20 10% are Anne (CC) Lee, MD, MPH researchers Pillar Award for Community Service pediatrics 35% hold Simon Manning, MD faculty leadership BWPO Professionalism Award titles Carmen Monthé-Drèze, MD Harvard Medical School Diversity Inclusion and Community Partnership Faculty Fellowship and for being named a formal mentor as part of the Boston Combined Residency program’s Mentor MED Mentorship Program Silvia Patrizi, MD Pillar Award for Diversity & Inclusion Fotios Spyropoulos, MD American College of Cardiology Young Investigator Award Staff Awards Yamiley Cayemnitte, RN, Essence of Nursing Award Carrie Dodge, RRT, 2021 PHIL Award Pamela Dodrill, PhD,CCC-SLP,BCS-S, Diana Bracco Outstanding BCS-S Applicant Award Marissa Hayes, RN, DAISY award 5

Expert care for high risk infants With 66 beds, the Brigham and Women’s Hospital Newton Wellesley Hospital’s Special Care Neonatal Intensive Care Unit (NICU) is the largest in Nursery (SCN) Massachusetts. We are well prepared to provide the The Level II SCN at Newton-Wellesley Hospital best and most advanced care possible to newborns provides 24-hour newborn specialist care to babies with critical and unique health challenges. Our Level born prematurely, or with certain medical conditions III facility cares for over 3,000 babies annually. beyond what can be provided at a mother’s bedside. The SCN is made up of 12 baby care areas that are Our NICU team is highly collaborative and private and spacious, taking into consideration the multidisciplinary. In addition to your medical team, comfort and bonding needs of babies and families. your baby is supported by a team of allied health Many of our faculty at BWH also staff the Newton professionals to ensure the highest quality of care. Wellesley Hospital SCN. Specialty care teams are designed to meet a baby’s individual needs and regularly consult with families. A leader in the community DE&I Task Force improve the recruitment, retention and promotion of Underrepresented in Medicine, to create and Directors: Silvia Patrizi, MD, Tanzeema Hossain, MD, celebrate a diverse and inclusive environment for and Carmen Monthe-Dreze, MD patients and all members of the department, and work to restore trust among underrepresented The Department of Pediatric Newborn Medicine is minorities through acknowledgement and repair. committed to opposing discrimination in all forms. Currently, the Diversity, Equity & Inclusion (DE&I) Task Transition to Home Force is focused on antiracism, yet strives to promote inclusiveness and expression of each individual’s Director: Mollie Warren, MD beliefs and dialogues. This new program is based on a remote monitoring Our task force works to implement strategies telecommunications platform through MyChart to dismantle racial inequalities in the health that aims to discharge babies home about 5-8 outcomes of newborns and their families, to days sooner (on average) and follow them virtually 6

at home. Our physicians and allied health Bridges to Moms staff monitor each child’s growth and feeding development and give parents more autonomy Director: Roseanna Means, MD and agency in their child’s care. The Transition to Home program will utilize an iPad loaner system The Bridges to Moms initiative uses intensive to ensure that all families have equitable access case management support to connect women to the technology needed to participate in the affected by housing insecurity to community-based program. Additionally, families can reach out for resources in order to establish a safe network of quick access during business hours via MyChart transportation, baby supplies, food, etc. The group messaging or pager. meets with moms during the prenatal, peripartum, and postpartum period to evaluate both their health needs and barriers that may affect a mother’s nurturing relationship with her child. A leader in innovation Parent Mental Health Music Therapy in the GDU Director: Cindy Liu, PhD Director: Carmina Erdei, MD With approximately 40% of NICU parents This initiative is a partnership between BWH and screening for depression, mental health is an Roman Music Therapy Services which introduces important component to measure the success clinical music therapy services to infants and of the department. The goal of this program is to their families in the Growth & Development Unit serve NICU parents and provide them with health (GDU). The program supports families and staff screening assessments and psychotherapy for the by providing education related to music exposure duration of their child’s stay. Our team consists of and music therapy interventions within the family- a social worker, psychiatrist, and a psychologist centered developmental care model. This program with services being delivered by the psychiatric aims to enhance age- and developmental stage- social worker. Ultimately, the hope is to be able to appropriate stimulation, support the progression of coordinate referrals to community resources upon a developmental skills, provide pacification support, child’s discharge from the NICU. and strengthen the parent-infant relationship within a family-centered care framework. 7

A leader in quality NeoQIC Family Engagement Photo therapy machine, commonly used to treat jaundice NIRS Machine (Near-infrared Spectroscopy) Director: Maggie Everett, MD This initiative is focused on improving adherence to evidence-based family engagement practices and reducing disparities by race/ethnicity and language status that occur at Level II Special care Nurseries and Level III Neonatal Intensive Care Units statewide. Our group is working to identify root causes of dissatisfaction among families and identify areas for improvement. We are working to target initial family meetings and daily rounds in collaboration with local network hospitals. Neuroprotection of Premature Infants Director: Mohamed El-Dib, MD, FAAP Extremely low gestational age (ELGA) infants born prematurely at <28 weeks GA are at a higher risk of developing intraventricular hemorrhage (IVH). IVH decreases the survival rates of premature infants, while those who do survive are at risk for significant developmental complications. Due to above average rates of IVH in the BWH NICU, this project is focused on identifying factors contributing to the development of IVH. Our multidisciplinary group aims to reduce and standardize the amount of sodium given to our ELGA babies through medication flushes, as a secondary contributor to IVH, by participating in the Clinical Process Improvement Leadership Program (CPIP). Social Media: The education team develops the department’s social media strategy. The goal is to highlight major research publications, staff/faculty awards, and relevant current events to grow our professional and community-based following. Currently, the group is focused on using both Instagram and Twitter platforms. Director: Tanzeema Hossain, MD | @brighamNICU 8

A pioneer in technological advancement The BWH NICU is home to Aspect’s Embrace The MRI suite does not require a special safety zone Neonatal Magnetic Resonance Imaging (MRI) or RF-Shielded Room, allowing parents to remain system. This system facilitates safer scanning of close to their child during the procedure. Additionally, vulnerable newborns and is housed in the NICU. The the MRI scanner features a temperature-controlled scanner cuts down on unnecessary time and risk environment and a full-color video display which spent transporting infants to and from a scanner allows for the baby’s care team to view and monitor that is outside the NICU. The Embrace system allows the child throughout the procedure. BWH clinicians to routinely scan babies almost immediately after birth which helps to increase the quality of life, improve care for newborns, and enable at-risk newborns to grow into healthy children. The ultimate goal of the scanner is to assess our babies quickly and safely while aiding our physicians to make accurate diagnostic decisions. A leader in pediatric education Our educational programming targets many facets 196 consulting residents & fellows of the department and includes trainee education 141 rotating interns & residents programs, faculty development and education, 25 rotating fellows wellness and resiliency programming, teaching awards, 18 summer students & interns presentations, and publications, and also includes program feedback and social media strategy. The overarching goal is to provide continuing education to staff and trainees (including medical students). We train the best Primary training site for: • Boston Combined Residency Program in Pediatrics • Mass General Hospital Pediatric Residency Program • Harvard Fellowship Program in Neonatal-Perinatal Medicine 9

Far from home The story of Miles Habibi Harris “I’m sure it’s nothing, likely a false alarm. Should I get checked out immediately here in Boston or get back home [to California] to see my doctor tomorrow?” These were the thoughts flooding Azita Habibi’s mind on July 8th, 2021 as she began to experience odd symptoms at 32 weeks pregnant while visiting Cape Cod. Azita and her husband were preparing to return home to California later that evening. Finally, at the recommendation of a dear OBGYN Miles, 2 weeks friend, Azita decided to head to Brigham and Women’s Hospital that evening, rather than taking the cross-country flight back to San Francisco. After being admitted to BWH, the providers in Labor Miles, 3 weeks & Delivery discovered that Azita had some bleeding in her uterus, causing the atypical symptoms she had felt earlier. Azita understood that in the best-case scenario she would be on bedrest for two weeks and deliver at 34 weeks gestational age. This was the first of many shockwaves to hit her system. “Two weeks in a hospital in Boston thousands of miles away from home? I’m going to deliver my baby at 34 weeks? Isn’t that TOO early?” she worried. As Azita tried to settle into sleep in her hospital room, around 3 AM that night she felt a huge rush of water between her legs and began to feel contractions, increasing in intensity, and realized that her baby was not waiting until 34 weeks… The next thing Azita knew she was in Labor & Delivery again, except this time, she was being administered an epidural and several doctors were explaining what would happen to her over the next 24 hours - what to expect in the NICU and beyond at BWH. It was a blur, but she remembers feeling like she was in several very capable hands, all of whom were compassionate for the shock and trauma she was experiencing. About 5 hours later, Azita delivered her first child Miles, 1 month weighing 3 lb 14 oz and measuring 17 in. After seconds of skin-on-skin contact, her fragile baby boy was whisked away to the NICU as she was treated in post-partum. “From the moment I walked into Neighborhood 1, there was no lack of information, transparency, and empathy from the entire staff at Brigham... It was all so new and unfamiliar and yet the staff were patient, generous with their time, and genuine in their care.” –Azita Habibi 10

“I have boundless gratitude for those nurses. Knowledgeable, fearless, and nurturing, these nurses continue to inspire me. We could not have made it through those two months without the tireless, extraordinary NICU nurses at the Brigham.” Miles and mom Azita, 3 months other extraordinary nurses who cared for him. “I have boundless gratitude for those nurses. As soon as she could, Azita went up to the NICU Knowledgeable, fearless, and nurturing, these nurses where her baby was in an isolette, wires and tubes continue to inspire me. We could not have made hooked up and several doctors and nurses waiting it through those two months without the tireless, for her arrival. From the moment she walked into extraordinary NICU nurses at the Brigham.” Neighborhood 1, there was no lack of information, transparency, and empathy from the entire staff at They were fortunate that Miles developed and Brigham. They were welcoming and encouraging gained weight in line with his gestational age and of Azita and her husband asking any question, were discharged just days before his due date participating in morning rounds, and taking part in of September 2nd, 2021. After discharge, Azita their baby’s care. It was all so new and unfamiliar and her husband remained in Boston for another and yet the staff were patient, generous with their three weeks to complete Miles’s two-month time, and genuine in their care. immunizations and ensure he was adjusting well to life outside of the NICU. After returning home Azita learned that while 32 weeks had seemed to Oakland, CA, where they were finally able to incredibly early to her, it was considered moderate settle into a new, more permanent rhythm, Miles prematurity with extremely high odds of survival flourished. “He’s delighting us with his smiles and and “normal” developmental outcomes in the NICU. animated babbles. He’s a master of tummy time, The first ten days were very difficult, watching her which I attribute to his head start in the NICU with fragile baby begin his life wrapped in wires, under the Physical Therapist, Jess. We know that Miles phototherapy lights, and connected to a c-pap device is thriving now because of his impeccable care at necessary to breathe properly. “Babies are resilient,” Brigham for the first 8 weeks of his life. While this said everyone around her. unexpected preterm birth was nothing short of an ordeal for my husband and I, the silver lining of During their first 48 hours Azita and her husband this entire experience was that it happened at the needed to declare a name for their baby. After much Brigham NICU. I have no doubt in my mind that he deliberation they agreed on the name of Miles, given received the absolute BEST care in the world at that he was born miles and miles away from home. Brigham, and for that, I am forever indebted.” The chair of the NICU, Dr. Terrie Inder, stopped by after hearing Azita’s crazy story and “was as Miles with mom and dad, 8 months 11 impressively brilliant as she was empathetic and warm, and helped to put [their] anxious minds at ease. She generously gave [the Habibis] a book titled “The Early bird,” a touching story about a premature pukeko bird, warming [their] tender hearts.” Over the next 7 weeks, Azita and her husband watched Miles develop and grow outside of the womb and quickly picked up on the NICU norms. Despite being fish out of water, they developed a rhythm in the Brigham NICU, facilitated by “the amazing NICU nurses.” Miles (and Mom) quickly developed bonds with his primary nurses, aka his angels - Alli, Ciara, Linda, and the many

The best at every stage Well Baby Nursery Our faculty and staff are passionate about supporting parents and their loved ones during those magical and sometimes stressful first days of parenting. We are committed to providing the best care for babies, taking into account that the needs and preferences of each family are unique and important. To provide the best care, it requires a team of clinicians that are dedicated to understanding your baby and family’s needs. In addition to routine care, the BWH Faculty Newborn Service is also able to provide a number of supplemental services including lactation consultation and expertise in newborn behavior and development. As an academic medical center, we are proud of our record in excellence and collaboration in clinical care, teaching, and research. As such, our pediatricians help develop and implement the clinical practice guidelines that ensure evidence- based, consistent, medical practice at BWH. Additionally, our pediatricians are teachers, as well as clinicians, and are joined by students and trainees from Harvard Medical School and the Boston Combined Residency Program in Pediatrics to care for well newborns and their families. Finally, as a premier research institution, BWH offers interested families the option to participate in a variety of research studies. The newborn hospitalists: Performed 15,452 Performed 1,315 Trained newborn visits in procedures: 18 interns and Fiscal Year 21 54 Harvard Medical • 1,276 circumcisions School students • 101 frenotomies 12

Center for Child Development 190% The Center for Child Development (CCD) is a increase in converted state-of-the-art facility housing the department’s referrals from outpatient programs. This 1,889 square foot space FY20-FY21 houses several outpatient and research initiatives. Since opening its doors in November of 2017, the 83.7% CCD has performed 5,279 clinical and research encounters. The CCD provides support for patients net promoter and families through a number of programs score* including: the NICU Follow-up Program, feeding and nutrition program, lactation consulting, and the 100% Transition to Home Program. referral In the coming months, the CCD will also launch conversion rate a schoolaged program to follow patients who continue to require services after they graduate from the NICU Follow-up Program at age three. NICU Follow-up Program: We typically see infants two to four weeks post-hospital discharge until the transition to pre-school around age three. Through a multidisciplinary approach, the program supports infants with a range of medical and developmental conditions. *Measures patient satisfaction through assessing loyalty, satisfaction, and enthusiasm with a company/service by classifying people as either promoters or detractors 13

From NICU… Noah, 1 day Noah, 1 month The story of Noah Magnus Jana and Keith Magnus were beyond excited when they found out they were finally pregnant in March of 2018 after several rounds of unsuccessful fertility treatments. Their baby boy was to be born in mid- November. The first few months of Jana’s pregnancy were uneventful, but by the end of July, Jana felt like she was very swollen. “I knew that pregnant women had swelling so I just assumed that this was normal swelling and weight gain.” At the urging of her co-workers, Jana scheduled an appointment with her doctor. The doctor informed her that she had extremely high blood pressure and protein in her urine - signs of preeclampsia. Jana was 25 weeks pregnant and was transferred immediately to Brigham and Women’s Hospital to be monitored. She was diagnosed with preeclampsia and severe hypertension. Noah Magnus was born 3 months early on August 9th, 2018, weighing just shy of 1.5 lbs. Noah would spend 120 days in the Brigham and Women’s Hospital NICU. Jana and Keith were fortunate that during Noah’s 4-month stay, which they refer to as his residency, he had very few complications and an overall smooth journey. However, having a micro-preemie was not something they knew anything about - they didn’t even know the term existed. From the day they were admitted, Jana and Keith met with the NICU team, who prepared them to deliver a baby that early. During his 4 months-stay, Noah was cared for by an amazing team of doctors, respiratory, physical and occupational therapists, and perhaps most importantly to them, were his nurses. This included his 4 primary nurses (Marianne, Julie, Chris and Patty), who showed them how to care for Noah from Day 1. They learned how to take his temperature, change his diaper, swaddle, bathe, kangaroo care, feed, and so much more. They made sure Jana and Keith were involved from the very beginning with education and participation. Noah, dad Keith and mom Jana, 4 months 14

From Left: Jennifer Benjamin, MD, Director of NICU Noah, 3 years Follow-Up Program, Noah, Mom Jana, Dad Keith, and Kenia Gomez, Ph.D, Center for Child Development Clinical “The NICU Follow-up Program has Psychologist. been extremely helpful and informative in understanding Noah’s …to follow-up growth and behavior due to being a micro-preemie.” On December 7, 2018, Noah was discharged home, but that was not the end of his NICU story. Kenia Gomez, PhD, and Noah, 3 years After his discharge, Noah participated in the NICU Follow-up Program, led by Dr. Jennifer Benjamin, a neonatologist who also cared for Noah when he was in the NICU. As a part of the NICU follow up program, Noah was seen by several other specialists: a speech and language therapist to help with feeding skills; a dietitian to monitor Noah’s growth and provide nutrition advice; and a psychologist who performed neurodevelopmental testing and provided feedback and recommendations based on results. This was in addition to all the other appointments Noah had outside of the follow up program such as pulmonology, cardiology, early intervention, and pediatrician appointments. “It seems like a lot on top of the other appointments Noah has always had”, Jana says, “But the NICU Follow-up Program has been extremely helpful and informative in understanding Noah’s growth and behavior due to being a micro-preemie. They flagged some speech delays and then we were able to add speech to Noah’s early intervention plan, which helped him so much. Now he doesn’t stop talking!” Noah graduated from the NICU Follow-up Program on October 26, 2021. “Each day brings new words, new actions, and above all, about a million new smiles. He’s simply so happy to be alive.” 15

Advancing multidisciplinary care Kristin Khang, RRT the feeding mechanism during swallowing. This procedure is considered the “gold standard” for Speech and Language Pathology detecting laryngeal penetration and aspiration during swallowing. The SLP team works collaboratively with medical and nursing providers to support the care of infants Respiratory Therapy during their stay at BWH. Some examples of feeding and swallowing developmental support include Our NICU RTs are highly trained in Neonatal diagnosing sucking and swallowing disorders to Respiratory Care and are an integral part of our determine abnormal anatomy and/or physiology babies’ care teams. The NICU RTs provide and associated with these disorders, performing manage support for our babies’ respiratory needs instrumental swallowing assessments to evaluate starting in the delivery room and throughout our swallowing function and determine aspiration risk, babies’ stay in the NICU. They respond to all high- and helping to establish early feeding patterns that risk deliveries including those of infants born before support optimal feeding, nutrition, and interaction 32 weeks gestation, infants with serious congenital patterns throughout childhood. defects, or infants who need respiratory assistance upon delivery. All of our NICU therapists are The speech and language pathology team at registered respiratory therapists (RRT) and some are the BWH NICU is an accomplished group of also credentialed as neonatal-pediatric specialists individuals who routinely work to provide the best (NPS). care to infants. Some of the NICU feeding team’s Different types of respiratory support that our accomplishments this year are: babies may utilize include oxygen delivery devices, • The team participated in a review of NICU CPAP, mechanical ventilation, high frequency ventilation, and nitric oxide. The NICU RT staff are feeding Clinical Practice Guidelines which also responsible for maintaining and running the informs feeding practices throughout the NICU Blood Gas Lab in the Neonatal ICU which facilitates and can affect patient safety, contribute to delays optimal and timely management of infants requiring in achieving early feeding milestones, prolong respiratory support. length of stay, and potentially contribute to long- term feeding difficulties. David Beadles, RRT • Pamela Dodrill, PhD, CCC-SLP, BCS-S participated in an international expert committee to develop consensus definition for Pediatric Feeding Disorder (PFD) which was published. • The team is about to commence performing video-fluoroscopic swallow studies (VFSS) with BWH Radiology. VFSS is a radiographic procedure which provides a dynamic view of 16

NICU developmental team Occupational Therapy along their journey. “The infants and families can really integrate all of the knowledge they’ve Our Occupational Therapy clinical specialist (OT) learned in the NICU environment, take it home with Jessica Pacheco, MOT, OTR/L, CNT, provides them to carry on with their infant’s developmental services both in the NICU and the Center for progression, and then come to the Follow-Up Clinic Child Development. She’s specially trained to help for additional guidance,” she explains. “We meet the premature and medically complex babies participate infants and caregivers where they’re at, and then in their “occupations.” Historically, NICUs have take next steps to create goals to set them up for focused on the medical aspects of fragile infant success once they leave the walls of the NICU and care. More recently, the Brigham NICU team has head into the community.” evolved to make sure these vulnerable patients and their families are set up for long-term success Physical Therapy with high-quality, expert neurodevelopmental care, including the occupational therapy that Jessica Developmental therapists in the NICU consist of provides. physical and occupational therapists. They work with families to help infants develop age-appropriate See what our OT has to say about her work: skills and provide infants and families with the For families involved, it is often a traumatic, life- best resources to achieve motor milestones. altering event, and we do our best as a team to help Developmental therapists support families and help support an infant’s neurodevelopmental progression them understand how to bond, care for, and interact with their infants. Developmental therapists can help families: • Recognize “ready to interact”/engagement and stress/disengagement cues • Understand movement and development • Perform age-appropriate activities with infants • Help learn what infants can hear, taste, smell, see, and feel • Explain ways to comfort infants • Promote bonding between families and infants • Describe and show families how to touch, hold, handle, and care for infants in safe and supportive ways • Recommend therapy resources post-discharge Tricia Flynn, PT, CNT, NTMTC 17

Social Work From top left: Maria Conley, NICU Family Support Specialist, Andrew Piercey, LICSW and Alicia Katz, LICSW, The Care Continuum Team in the NICU consists Care Coordination Manager. of social workers, case managers, and family From bottom left: Kara Belinsky, LICSW, support specialists. The clinical team practices in Marysabel Gomez, LICSW and Susan Berliner, LICSW collaboration with the health care team promoting health and equity along with safe discharges into the community. Social workers are the leaders in making sure our families get the help they need including food, resources, and baby essentials along with providing emotional support during a NICU admission. Our social work team consists of skilled clinicians who all specialize in caring for infants to ensure we can meet families’ needs. The social work team provides a number of services to families including: • Supporting families of multiples • Facilitating support and communication with Boston Children’s Hospital for children with abnormalities • Empowering and promoting positive outcomes through advocacy and support Social work also: Supported Provided over Offered over Made over 29 $10,000 100 3,000 car seats and in gas cards meals for strollers for breastfeeding footprint families mothers necklaces Nutrition Services NOURISH study protocol, assisting with consent and study protocol calculations and upkeep. The The Neonatal Nutrition Team, comprised of Neonatal Nutrition Team continues to be involved in Registered Dietitian-Nutritionists (RDNs), continues policy and clinical practice guideline development. to participate in daily rounds to assist the medical In addition, quality improvement data collection team in the management of enteral and parenteral is ongoing by the RDNs, with plans to regularly nutrition support, as well as growth monitoring review and share key Nutrition and Growth-related and assessment of Brigham and Women’s tiniest benchmarks with our entire NICU staff. From patients. Our team expanded in 2020 to include birth, through discharge and beyond, the Neonatal more time in the Center for Child Development Nutrition team strives to provide up-to-date, clinic, and the Transition to Home Program, evidence-based best practice for our patients, while in order to provide for more continuity of care also contributing to the overall body of knowledge of through discharge home and beyond. The RDNs Neonatal Nutrition science. also participate in the education of the trainees in an ongoing basis and play an active role in the 18

From left: Lynn Thomas, RN, Sarah Wood, RN, Jenna Bausch, RN, and Katie McMahan, RN Nursing Primary care nursing model “Nursing is not only a science, but an art, and we are proud every day to be The Brigham and Women’s NICU nursing team an impactful part of the lives of our uses a primary care model as a foundation to patients and their families.” provide consistent, excellent care on a daily basis. Primary care nursing is a standard in which nurses Impacts of the COVID-19 Pandemic form teams to provide consistency for our babies in the NICU and families during their stay in the NICU. Being a primary care team member ensures continuity of During 2020-2021 the entire department of Pediatric care, uniformity between caregivers, and stability for Newborn Medicine had to navigate unchartered the entire family. Primary nursing allows for nurses territory with the novel COVID-19 pandemic. to learn the nuances of each baby and recognize Extensive efforts were made to collaborate with any subtle changes in clinical status due to their our obstetrics and well newborn colleagues to repeated time spent at the bedside of their primary design protocols that would ensure our babies, patients. Along with ensuring opportunities for families, and staff remained as safe as possible. As clinical awareness, primary nursing also creates more information became available regarding the solid bonds and relationships between the nurses COVID-19 virus, we learned that keeping well babies and families. Many families have expressed the with their parents was permissible if masks were comfort they feel when they know a primary nurse worn and excellent hand hygiene was performed. cares for their baby; it gives them a true sense of For our NICU patients, we continue to maintain an security and well-being. Primary nursing allows our environment with only essential personnel to limit families and staff the opportunity to navigate an often any possible exposures to our tiny patients, who unexpected NICU stay with a sense of steadiness cannot be protected by a mask. We continue to and familiarity which allows for the development of navigate this worldwide pandemic together and long-lasting relationships that extend beyond the are proud of the entire staff on their resiliency and families’ NICU stay at BWH. Nurses in the NICU at attention to detail on how to keep our patients, BWH take pride in the clinical care that they provide families, and staff as safe as possible. In 2021, we to their patients every day. They are also experts in did not have one positive patient within our Neonatal celebrating milestones of our patients, however small Intensive Care Unit, despite delivering over one or large they may be. They thoughtfully try to brighten hundred COVID-positive moms during the patient rooms with pictures, name signs, and the pandemic. achievements. They understand that each small step is significantly impactful to the families of the babies 19 we are lucky enough to care for.

Nursing Discharge to Home with supportive guidance is one that NICU nurses excel at. The NG tube program has been an enormous NG Tube Teaching success for our infants and their families, allowing for an opportunity for infants to grow at home with Over the last year, a team of NICU nurses worked their parents who feel confident and empowered to to define and improve a process that educates feed their baby safely via an NG tube. This program and empowers families of infants who require NG is now expanding under the guidance of Dr. Mollie (nasogastric) tubes beyond their time in the NICU. Warren, who has created the Transition to Home Nursing worked side by side with medicine and Program, and provides even more opportunities for our speech and language pathologists to create support, education, and close monitoring. educational documents and processes to help support our families in placing the NG tubes themselves. The skill and finesse required to provide education and From left: Carmina Erdei, MD, Keisha Charlot, RN, Donna DeLuca, RN Kendra Woo, BS, RRT, Stephanie Shine, RN, Victoria Mansfield, BS, RRT Izzy Dorsey, RN, Nicole Cherubino, RN, Rachel Goodick, RN, Jennifer Whalen, RN, Kerri Duggan, RN, Kthleen Zanelli, RN, and Debby Schlehuber, BSN, RNC-NIC 20

Expanding access to basic care: Global Health Dr. Anne (CC) Lee, Director of The Brigham Global ENAT Study Nurse measures a participating mother’s Newborn Health Lab, conducts research focused mid-upper arm circumference (MUAC) to screen on clinical interventions to improve the health for malnutrition of mothers and babies in underresourced global settings. Dr. Lee and the AIM Lab initiated the ENAT (Enhancing Nutrition and Antenatal Infection Treatment) study in the West Gojjam and South Gondar Zones of Amhara regional state, Ethiopia. This project is a pragmatic randomized clinical effectiveness study that aims to test the impact of antenatal interventions to optimize maternal nutritional status and infection management in pregnancy, on maternal and infant health outcomes. This study, funded by the Bill and Melinda Gates Foundation, will enroll over 2000 pregnant women and infants. Despite challenges including COVID-19, civil unrest and severe flooding, the team has enrolled 2000 women in the first year of the study. With continued support from the Gates foundation, the Global AIM team and partners at Addis Continental Institute of Public Health have also established a biobank of specimens for future studies of metabolomics, proteomics, microbiome and other discovery analysis. Another landmark in 2021 was the establishment of an infant follow up program. In a collaboration of global experts in neurodevelopment and neuroimaging, ENAT will be receiving one of the first low-field, portable magnetic resonance imaging devices. A Hyperfine MRI machine was due to arrive in the ENAT field site in the Fall of 2021, providing both research and clinical services. This machine will not only provide a unique opportunity to implement an MRI system in a rural field research setting but will be used to explore early infant MRI outcomes associated with prenatal interventions. Michele Stojanov (BIDMC) training ENAT Study Nurses in conducting fetal ultrasound for gestational age dating at a participating health center in Amhara Region, Ethiopia 21

A leader in neonatal research The Department of Pediatric Newborn Medicine Areas of focus: has a robust research program that focuses on both clinical and translational research as well as • Neonatal cardiovascular, pulmonary, basic science investigation. Research initiatives are and integrated biology led by the Research Executive Committee (REC), a multidisciplinary group of leaders responsible for • Pediatric, newborn, and fetal the productivity, allocation of research resources, developmental neuroscience and quality of research done within the department. • Global advancement of infants and The department also has a Clinical Studies mothers (AIM) Coordination Team, led by the director of research, and consists of research nurses, coordinators, and • Newborn genomic medicine assistants. Currently we support 22 investigators • Nutrition for mothers and infants overseeing 80 active studies. This includes 16 active clinical studies with several more planned to Supporters: commence in 2022. • National Institutes of Health (NICHD, The majority of clinical studies are based in our NHLBI, NIGMS, NINR, NIMH) neonatal intensive care unit, but also include well baby studies as well as our global newborn health • Bill & Melinda Gates Foundation program. Thus far in 2021, researchers within the • Gerber Foundation department have submitted 53 new proposals • American Academy of Pediatrics (AAP) valued at 69 million dollars. • CRICO/Research Management In 2021 16 Foundation we received: • US Health Resources & Services new active Administration funded studies • Industry Partners $2.9M We innovate, investigate, and collaborate to in new support* provide the best care for every baby. *impacted by COVID-19 pandemic 5:1 return on sponsor investment 22

Highlighted active research protocols Baby AMOR Study Dr. Lise Johnson developed a randomized controlled trial (RCT) of a Newborn Behavior Observation (NBO)-based intervention to improve the health and well-being of moderately and late preterm infants and their mothers. Bose Study Drs. Carmina Erdei and Terrie Inder aim to evaluate the feasibility of a music- based program in the NICU, and to assess any neurophysiological and behavioral effects in preterm infants receiving the intervention. Lifestyle Intervention in Preparation for Pregnancy (LIPP) Study Dr. Rimi Sen developed a randomized, controlled trial of a lifestyle intervention (moderate calorie restriction with a shift to a Mediterranean diet and regular exercise) in post-partum women with overweight or obesity who are planning a subsequent pregnancy in the next 12-24 months. Nourish Study Dr. Mandy Belfort developed a randomized, controlled clinical trial of individually targeted fortification for human milk-fed preterm infants during NICU hospitalization. Screened But Not-Cooled Study Drs. Terrie Inder and Mohamed El-Dib seek to investigate the short-term outcomes among a cohort of infants that were screened for Therapeutic Hypothermia (TH) but ultimately did not receive treatment. Transcutaneous Carbon Dioxide Monitoring in Neonates Receiving Therapeutic Hypothermia for Neonatal Encephalopathy (TCOM in HIE) Study Drs. Mohamed El-Dib, Terrie Inder, Helen Christou, Maria Franceschini, Eniko Szakmar and Jill Robinson, RRT aim to understand how low pCO2 has been associated with worse neurodevelopmental outcomes in those receiving therapeutic hypothermia for neonatal encephalopathy. 23

Highlighted COVID-19 research study The Perinatal Experience and COVID-19 Effects (PEACE) Dr. Cindy Liu leads this nationwide longitudinal study which began in May 2020. The purpose of this work is to understand the psychosocial effects of COVID-19 on women during the perinatal period (pregnancy and postpartum). Through our online surveys, we have learned about the experiences of stress, well-being, and resiliency among mothers and their infants during this unprecedented time. To date, we have enrolled over 2000 women and are now in Wave 2 of our data collection. Our work has uncovered how grief related to the pandemic is linked to maternal mental health and bonding, and how the health worries about COVID-19 exacerbates the mental health concerns particularly among NICU parents. By conducting and analyzing behaviors from recorded Zoom-based interactive sessions, we are now working to understand how the responses to the pandemic in the first year might have an impact on the mother-infant relationship and infant response to stress. With additional funding, we plan to implement a Wave 3 data collection to follow children in toddlerhood. To date, we have published 8 papers from this project, with this work featured in major news outlets including US News and CBS Boston. More information about our work can be found at https://www.peacestudy2020.com/ Related Publications: COVID-19-related health worries compound the psychiatric distress experienced by families of high-risk infants. Liu CH, Mittal L, Erdei C. J Perinatol. 2021 05; 41(5):1191-1195. PMID: 33658613. Risk Factors for depression, anxiety, and PTSD symptoms in perinatal women during the COVID-19 pandemic. Liu C, Erdei C, Mittal L. Psychiatry Research. 2020 Nov 4:113552. doi: 10.1016/j. psychres.2020.113552. Epub ahead of print. PMID: 33229122. Psychological risks to mother-infant bonding during the COVID-19 pandemic. Liu CH, Hyun S, Mittal L, Erdei C. Pediatr Res. 2021 Oct 14. PMID: 34645943. 24

COVID-19 Updates From the NICU “This year has posed unprecedented challenges for the NICU and our Under the leadership of Terrie Inder, MBChB, MD, families. Not only do parents have our NICU is specifically prepared to provide families the same concerns that the rest with safe, expert care during the pandemic. Central of society is facing regarding the to these efforts is our physical environment, which pandemic, but they also face the offers families private, isolated rooms to care for reality that having their newborn their newborns. Furthermore, the unit functions in the NICU can be a scary, stressful independently from the rest of the hospital, such that experience. advanced neonatal assessment—like MRI scans— can be undertaken within the safety of our walls. During a pandemic, it can feel nearly Thanks to these features, combined with the safe care practices of our medical team, in 2021 no babies impossible. Our dedicated team has tested positive for COVID-19 while in our care. risen to the occasion admirably, 0 continuing to work around the clock babies in the NICU tested to care for our families while also positive for COVID-19 in keeping them safe. I’m both proud of 2021 and humbled by their unwavering focus and resiliency during these difficult times.” -Dr. Terrie Inder 27.6% 14 From the Center for Child Development increase in new patient Patient Gateway virtual visits are As with all areas of healthcare, the care model in enrollment from available within The Center for Child Development has changed 2020 through 14 days of the rapidly due to the COVID-19 Pandemic. Providers 2021 among order being have shown incredible adaptability, pivoting from CCD patients placed fully in-person sessions to a fully virtual model, and most recently, adjusting to a hybrid model of care. While these changes didn’t occur without some challenges, as a clinic we have learned much from our post-pandemic experiences. 25

What makes us the best Our people Brigham and Women’s Hospital Department of Pediatric Newborn Medicine Faculty Leadership Team Terrie Inder, MBChB, MD Helen Christou, DM Elizabeth Flanigan, MD, MPH Department Chair Executive Vice Chair for Chief of Clinical Operations Research, Education & Faculty Academic Affairs Elisa Adbulhayoglu, MD, Katharine Herrick, MD, Simon Manning, MD Sujatha Ramadurai, MD MS, FAAP IBCLC NICU Medical Director Medical Director of Well NICU Associate Medical Director of Special Care Newborn Care Director, Director of Fetal Care Nursery, Newton-Wellesley Hospital Mandy Belfort Brown, Jennifer Benjamin, MD Sule Cataltepe, MD Margaret Everett, MD, MS MD, MPH Director of NICU Medical Director of Director of Quality and Director of Clinical Research Follow-Up Program Newborn Respiratory Care Safety 26

Katherine Bell, MD Megan Connelly, MD Mohamed El-Dib, MD, FAAP Carmina Erdei, MD Associate Director of Associate Medical Director Director of Neonatal Director of the Growth & Education of Well Newborn Care Neurocritical Care Development Unit Tanzeema Hossain, MD Lise Johnson, MD Anne (CC) Lee, MD, MPH Cindy H. Liu, Ph.D Director of Education Co-Director of the Director of Global Health Director of Developmental Brazelton Institute Risk & Cultural Disparities Program Carmen Monthe-Dreze, MD Richard Parad, MD, MPH Silvia Patrizi, MD Rimi Sen, MD Director of Physician Director of Newborn Director of Diversity, Director of Faculty Well-Being Medicine Genomic Equity & Inclusion Development Program & Physician Credentialing Mollie Warren, MD Director of Transition to Home Program 27

Neonatologists Laura Bernardini, MD Donna Brezinski, MD Saila Ghanta, MD Terri Gorman, MD Elisabeth Kaza, MD, DSc Stella Kourembanas, MD Amy Levingston, MD Nisreen Maari, MD Chief of Newborn Services, Boston Children’s Hospital Alyssa Marshall, DO Krysten North, MD, MPH E. Annette Scheid, MD Francheyska Silfa Mazara, MD Fotios Spyropoulos, MD Melissa Woythaler, DO, MS 28

Pediatricians Susan Beebe, MD Anna Cooley, MD Amanda Gallant, MD Kathryn MacMillan, MD, MPH Timothy Porter, MD Carolyn Rundquist, MD Erica Swartz, MD Brigham and Women’s Hospital 29

Advanced Practice Providers Corey Boyd, RNC, MSN, Stephanie Garley, PA, Deb Giambanco, NNP Adrianne Louloudes, PNP NNP-BC NICU NICU Well-Baby Nursery NICU Deb Marks, PNP Rachael McClure, PA Katrina Miller, PNP Kathleen Murphy, DNP NICU NICU NICU NICU Advanced Practice Providers not pictured: • Nicolette Dickerhoff, NNP, MS • Susan Quinn, MS, ARNP, NNP-BC Research Faculty Sara Cherkerzian, SM, ScD Pamela Dodrill, PhD, Joseph Volpe, MD CCC-SLP, BCS-S Research Faculty not pictured: • Mark Perrella, MD 30

NICU Staff Respiratory Therapy Allied Health Jesslyn Lenox, MHA, RRT-NPS, AE-C, Director of Pulmonary Services Speech and Language Pathology Jill Robinson, BS, RRT-NPS, Manager of Newborn Respiratory Emily Adams, MS, CCC-SLP, CNT, CLC David Beadles, RRT, Day Clinical Coordinator Pamela Dodrill, PhD, CCC-SLP, BCS-S Jessica Zellmann, BS, RRT-NPS, Katherine Gibson, MS, CCC-SLP, BCS-S Night Clinical Coordinator Elizabeth (Lizzy) Kling , MS, CCC-SLP Savannah Beale, RRT Danielle Ben-David, MPH, RRT-NPS Occupational Therapy Melissa Catino, BS, RRT Breda Devlin, BS, RRT-NPS Jessica Pacheco, MOT, OTR/L, CNT Carrie Dodge, BS, RRT Saranna Ellis, BS, RRT-NPS Physical Therapy Kristin Khang, RRT Kristianna Kinsley, RRT Jessica Ahonen, PT, DPT, PCS, CNT, NTMTC Jess Lucas, RRT Patricia Flynn, PT, CNT, NTMTC Victoria Mansfield, BS, RRT Sara Tenenholtz, PT, DPT, PCS, NTMTC Jordan Murphy, BS, RRT Emily Ouelette, RRT Social Work Andrea Oulton, RRT Christine Piro, BA, RRT-NPS Kara Belinsky, LICSW Tracy Pisani, RRT Susan Berliner, LICSW Amy Serino, RRT Maria Conley, Family Support Specialist Kendra Woo, BS, RRT Marysabel Gomez, LICSW Alicia Katz, LICSW, Care Coordination Manager 31 Andrew Piercey, LICSW Mara Sceery, RN Case Manager Abby Takesian, LICSW, Parent Mental Health Program Nutrition Alyssa Brodsky, MS, RDN, LDN Dierdre Ellard, MS, RDN, LDN Hunter Pepin, MS, RDN, LDN

NICU Staff Catherine Higgins Julie Papek Susan Holland Sharon Perry Nursing Maureen Hughes Caryn Picard Karen Johnson Yelena Platsman Julie Cadogan, MSN, RNC-NIC, CNL Myrene Johnson Laura Podoloff Interim Nurse Director Laura Keating Kathleen Powers Christine Kerble Corinne Pryor Deborah Schlehuber, BSN, RNC-NIC Jennifer Kirby-Cencarik Tanya Rapoza Assistant Nurse Director Lorraine Kolesar Karen Riedel Linda Kornilowicz Lindsay Robillard Elizabeth Brennick, MSN, RRT, RNC-NIC Maureen Kunz Kristen Robishaw Newborn Clinical Educator Felicia Kuplast Miguel Rodriguez Krista Kyle Kelli Roof Casey Hinkley, RN Elizabeth Lambert Michelle Roy Newborn Clinical Educator Courtney Lamoureux Danielle Ruzicka Courtney Landers Karissa Sabatino Karen Agostini Amy Czarnecki Janine Lawlor Camille Sanabria-Cooper Amanda Ahlquist Mark Danahy Kaitlyn Lepine Melanie Santino Felicia Alberto Mallory Decas Jeanine Levantian Mary Sawyer Jenny Alcantara Donna DeLuca Lauren Lewis Emily Schiarizzi Shuli Aronson Ashley Denham Jenna Lyons Kara Shallow Jodi Ayub Jennifer DeVincent Amanda MacPherson Stephanie Shine Beatrice Banda Meredith Dewey Katrina Mansfield Jordan Sidebottom Cara Barouch Sara Dickinson Allison Manzelli Susan Smith Jennifer Bausch Alexandria DiGiuseppe Jessica Marchetti Karen Smith Kathleen Binell Irene Diodati Lynda Marchi Patricia Socrat Tricia Blaine Suzanne Dolan Jennifer Martin Irina Solodar Sandra Borgerson Julianne Donnelly Maria Martinez Cara Souza Emily Boudreau Ismenia Dorsey Sarah Katherine Mascoli Ashley Spencer Meghan Bradford Zachary Drolette Emily Grace Mastropaolo Leah Spinazzola Nancy Brazeau Denise Dubuisson Emily Matte Jennifer St Gelais Rachel Breslin Kerri Duggan Krista McCarthy Amanda Stanley Winnie Briggs Jennifer Eaton Annmarie Mcdermott Heather Starr Kylie Brink Doreen Fay-Salamone Sarah McDonald Julianne Stratham Anna Bukvic Lynne Fitzgerald Julie Mcgillicuddy Sheila Stringfellow Morgan Burns Danielle Flaherty Katie McMahan Jill Sugrue Constance Burns Jennifer Fluckiger Joan McMenemy Ashley Taylor Cynthia Cahill Deanna Flynn Christina Meehan Heidi Taylor Laura Calderone Sara Francis Melinda Melzar Charlotte Thibodeau Kirsten Calicchio Kerry Franey Julie Miezejeski Rebecca Tierney Philip Capistran Janet Frink Kathleen Moran Caroline Todd Jessica Capobianco Cheryl Gardner Judith Moschella Mary Tomaino Jaquelin Carattini Danielle Gerardo Gina Mungovan Lynn Tomasz Alecia Carmody Alyssa Ghazalie Lindsey Murphy Marianne Toppen Keisha Charlot Linda Gill Maryellen Muszynski Sarah Tyler Kristin Chatelain Marelvis Gonzalez Morales Laura Niboh Rachel Villagran Nicole Cherubino Erica Gordon Katie Nicoloro Kara Voss Shannon Clark Maria Grant Elizabeth Norris Naiomi Walker Catherine Coleman Maureen Grasso Cassidy Norton Jennifer Whalen Kacie Conlon Mariah Griffin Sheila O’Connor Meghan Whitman Jennifer Conrado Unnur Gudmundsdottir Lillian O’Leary Danielle Wight Tava Coter Kristen Gula Christine Ordway Kathleen Zanelli Taylor Cotti Noreen Halloran Michaela Osgood Ciarra Crisostomo Nina Hanley Tiffany Page Kate Cunningham Marissa Hayes Judith Panzeri-Hill Christine Curley Danniel Haynes 32

A tale of twins… overnight were always something to look forward to.” For Laura, being on the patient side was a new The story of Will and Jack Mullins experience she looks forward to carrying into her own nursing practice. Getting to the NICU was an adventure for Laura “Looking back, it is humbling to know how many people and Ryan Mullins. When Laura was unexpectedly at the Brigham supported us through the journey,” admitted to the Brigham at 25 weeks, their twins’ said Laura. Exactly 100 days from Laura’s admission, arrival appeared imminent. Meeting Dr. El-Dib shortly Will and Jack came home no worse for the wear, after admission was a tremendously reassuring first capping off a memorable summer at the Brigham! introduction to the NICU amidst all the unknowns. Will and Jack, 2 weeks Despite the day-to-day outlook, Laura’s determination to remain pregnant with the help of the 8th floor Will, Jack, mom Laura and dad Ryan, 1 month Antepartum unit led to an unexpected, but very fortunate, nine-week inpatient stay. Through Will and Jack, 3 months participating in discussions on the twins’ case at daily huddles, Laura was assured that the NICU was prepared for all scenarios and eased the family’s concerns. Laura speaks fondly of her boys’ stay in the NICU saying, “As the weeks ticked by, the NICU’s quick responses to all of our questions gave us confidence that the twins would be getting the best possible care.” When Laura delivered Will and Jack at 34 weeks, the long-anticipated transition to the NICU was flawless for the boys thanks to standout efforts by NICU nurses Felicia, Julie, Judith, and Irina as well as Drs. Inder, Van Marter, Manning, Brezinski, and Kaza who had helped along the way. Starting the night of the boys’ arrival in the NICU, the team was encouraging and involved the family in every aspect of their care. At morning rounds, the team actively engaged Laura, knowing she is a pediatric nurse who had worked with BWH NICU alums herself. While Laura may have had a leg up initially, the team made sure Ryan was quickly proficient in feeding and changing diapers. In the first few days after the boys’ arrival, nurses Charlotte (the family’s neighbor!) and Felicia decorated the room. This is something Laura has done for many of her patients, which made the room feel more like a nursery instead of a hospital. As soon as the boys were settled, the nurses, NPs and doctors turned to check on Laura and her recovery. “While the process can feel daunting at times, the NICU’s focus on the whole family made everything easier, “ said Laura. Will and Jack’s primary nurse, Cheryl, helped them settle into a new routine very quickly. Laura remarks, “And, while it was never easy to leave at the end of the day, the calls to check-in with the nurses 33

Highlighted publications Aging at the beginning of life: a longitudinal study of telomere Graded Approach to Intravenous Dextrose for Neonatal length in hospitalized very preterm infants. Belfort MB, Qureshi Hypoglycemia Decreases Blood Glucose Variability, Time F, Litt J, Bosquet Enlow M, De Vivo I, Gregory K, Tiemeier H. in the Neonatal Intensive Care Unit, and Cost of Stay. Sen PLoS One. 2021 Jan; 16(1): e0243468. S, Cherkerzian S, Turner D, Monthé-Drèze C, Abdulhayoglu E, Zupancic JAF. AJ Pediatr. 2021 04; 231:74-80. PMID: 33338495. Fatty Acid-binding Protein 4 Expression in Tumor Cells as a Potential Marker for Anaplastic Meningiomas. Lee V, Optimizing initial neonatal resuscitation to reduce neonatal Smith TW, Arikan MÇ, Zhang L, Çataltepe O, Çataltepe S. Appl encephalopathy around the world. Patterson J, North K, Immunohistochem Mol Morphol. 2021 Feb 1;29(2):e10-e16. doi: Dempsey E, Ishoso D, Trevisanuto D, Lee AC, Kamath-Rayne 10.1097/PAI.0000000000000848. BD. Semin Fetal Neonatal Med. 2021 Jun 22; 101262. PMID: 34193380. Clinical Characteristics and Breastfeeding Outcomes in Term Dyads Following In-Hospital Supplementation with Pasteurized The roles of life stress and preventive health behaviors on Donor Human Milk or Formula. Riley J, Cherkerzian S, Benjamin parent mental health during the COVID-19 pandemic. Liu CH, C, Belfort MB, Sen S, Drouin K, Gregory K. Breastfeed Med. 2021 Smiley PA, Vicman JM, Wong GTF, Doan SN. J Health Psychol. 09; 16(9):717-724. PMID: 33872065. 2021 Jun 29; 13591053211026742. PMID: 34187219. Targeting human milk fortification to improve very preterm Effect of Omega-3 Supplementation in Pregnant Women with infant growth and brain development: study protocol for Obesity on Newborn Body Composition, Growth and Length of Nourish, a single-center randomized, controlled clinical Gestation: A Randomized Controlled Pilot Study. Monthé-Drèze trial. Belfort MB, Woodward LJ, Cherkerzian S, Pepin H, Ellard C, Sen S, Hauguel-de Mouzon S, Catalano PM. Nutrients. 2021; D, Steele T, Fusch C, Grant PE, Inder TE. BMC Pediatr. 2021 13(2):578. Apr 9;21(1):167. doi: 10.1186/s12887-021-02635-x. PMID: 33836708; PMCID: PMC8033746. Differences in clinical and laboratory biomarkers for short and long-term respiratory outcomes in preterm neonates. Parad RB, Carbonic anhydrase inhibition improves pulmonary artery Breeze JL, Terrin N, Rogers LK, Salafia CM, Greenough A, Davis reactivity and nitric oxide-mediated relaxation in sugen- JM. Pediatr Pulmonol. 2021 Aug 26. PMID: 34437765. hypoxia model of pulmonary hypertension. Christou H, Michael Z, Spyropoulos F, Chen Y, Rong D, Khalil RA. Am J Physiol Regul Acetazolamide Improves Right Ventricular Function and Integr Comp Physiol. 2021 06 01; 320(6):R835-R850. PMID: Metabolic Gene Dysregulation in Experimental Pulmonary 33826428. Arterial Hypertension. Spyropoulos F, Michael Z, Finander B, Vitali S, Kosmas K, Zymaris P, Kalish BT, Kourembanas S, Reading Aloud with Infants in the Neonatal Intensive Care Unit: Christou H. Front Cardiovasc Med. 2021; 8:662870. PMID: A Unit-Based Program to Enhance Language Enrichment and 34222363. Support Early Foundational Relationships. Erdei C, Klass P, Inder TE. Am J Perinatol. 2021 Jun 07. PMID: 34100273. Primary neuronal dysmaturation in preterm brain: Important and likely modifiable. Volpe JJ. J Neonatal-Perinatal Med 14:1- Challenges in respiratory management during therapeutic 6, 2021. hypothermia for neonatal encephalopathy. El-Dib M, Szakmar E, Chakkarapani E, Aly H. Semin Fetal Neonatal Med. 2021 Jun 19; Mesenchymal stromal cell-derived syndecan-2 regulates the 101263. PMID: 34244080. immune response during sepsis to foster bacterial clearance and resolution of inflammation. Han J, Shi Y, Willis G, Imani Induction of Sepsis Via Fibrin Clot Implantation. Ghanta S, J, Kwon MY, Li G, Ayaub E, Ghanta S, Ng J, Hwang N, Tsoyi K, Kwon MY, Perrella MA. Methods Mol Biol. 2021; 2321:17-25. El-Chemaly S, Kourembanas S, Mitsialis SA, Rosas IO, Liu X, PMID: 34048004. Perrella MA.FEBS J. 2021 Aug 06. PMID: 34355516. Patient characteristics associated with SARS-CoV-2 infection in parturients admitted for labor and delivery in Massachusetts during the Spring 2020 surge: A prospective cohort study. Reale SC, Lumbreras-Marquez MI, King CH, Burns SL, Fields KG, Diouf K, Godlfarb IT, Ciaranello AL, Robinson JN, Gregory KE, Grad YH, Huybrechts KF, Bateman BT. Paediatric and Perinatal Epidemiology, DOI: 10.1111/ppe.12743 Neuroimaging of the Preterm Brain: Review and Recommendations. Inder TE, de Vries LS, Ferriero DM, Grant PE, Ment LR, Miller SP, Volpe JJ. J Pediatr. 2021 10; 237:276-287.e4. PMID: 34146549. A randomized controlled trial investigating the impact of maternal dietary supplementation with pomegranate juice on brain injury in infants with IUGR. Ross MM, Cherkerzian S, Mikulis ND, Turner D, Robinson J, Inder TE, Matthews LG. Sci Rep. 2021 02 11; 11(1):3569. PMID: 33574371. 34

Paying it forward Philanthropy fuels our department’s work to provide care, discover breakthrough treatments, and train future leaders in newborn medicine. We’re grateful to the main individuals, foundations, and corporations that have advanced our vital work. Their generosity has helped us: Expand patient care initiatives, including emotional support for NICU parents during their extended hospital stays. Bolster field-leading research that seeks to improve care and outcomes for NICU babies, and identify optimum nutrition for breast-feeding mothers. Improve our hospitals’ patient areas to meet the evolving needs of our families and create optimum environments for growth. Educate parents about the importance of establishing a literacy and language-rich environment for the developing brains of both preterm and term babies through reading and music. Your gift makes a difference… If you would like to help give every baby a strong start at life, please consider supporting the work of the Department of Pediatric Newborn Medicine. Gifts can be directed to our department as a whole, or to a specific fund or research initiative. To make a gift visit: http://bwhgiving.org/newbornmedicine Or call Susan Ramsey, Assistant Vice President, Development Office at 617.424.4223 35

We innovate, investigate, and collaborate to provide the best care for every baby. Department of Pediatric Newborn Medicine 75 Francis Street | Boston, MA 02115 www.brighamandwomens.org/pediatric-newborn-medicine