Mechanical ventilation: Sick/preterm infants may have lung immaturity/dysfunction. These neonates may require ventilator support. The NICU takes pride in declaring that it was the first unit in private set up to start ventilation and today we handle the most difficult and tricky ventilatory strategies with great success.

High Frequency Ventilators: Babies who have severe lung disease may fail on conventional ventilators. Our Unit has one of the best high frequency ventilators for supporting such babies and were one of the first units to start using this technology.

Surfactant delivery: Premature lungs are deficient in a substance known as surfactant, leading to a stiff lung and breathing difficulty. In this situation, commercially available natural surfactant is instilled into baby’s lung through a special tube. Giving surfactant to these babies improves their lung function, helps them to come off the  ventilator faster and ultimately help in improving survival and reducing lung injury. We have now started administering surfactant through non invasive techniques like a laryngeal or supraglottic airway (SALSA) and this proves less traumatic on these small babies. We are presently conducting a randomised trial on the use of this non – invasive technique. We are also one of the few centres to practice and utilise the technology of bedside lung ultrasound to assess and decide therapy for babies with HMD ( Hyaline Membrane Disease).

Inhaled nitric oxide: Babies who have severe respiratory failure with high pulmonary artery pressure may require inhaled nitric oxide (a gas delivered into the lungs) to maintain adequate oxygen levels in blood. We are amongst the few units in India which has the experience of using nitric oxide and facilities for monitoring of such critically sick babies. With the advent of this gas the outlook and outcome of babies with hypoxic respiratory failure has vastly improved.

Parental nutrition: Because of poor swallowing capability and immature gastrointestinal functions, the small preterm and sick baby are not able to tolerate oral feeds well and requires intravenous nutrition in form of glucose, fats and proteins for better survivals. This parenteral nutrition is prepared by aseptic precautions under a laminar flow and is delivered via an intravenous route, till the time the baby is able to tolerate oral feeds. Not many units in India use laminar flow for aseptic preparation of Parenteral nutrition and drugs.This parenteral nutrition usually is given through central lines.

Intra – vascular lines: The advent of technological advancement and expertise in Neonatal care has lead to the survival of the tiniest, most premature and sickest of babies. This has only been possible with skilled and expert central line insertions techniques. We routinely perform both central venous access (umbilical, PICC and femoral) ) and central arterial access ( umbilical and peripheral) in all these babies. These intravascular lines has gone a long way in helping the survival of such babies as it helps in better nutrition, drug delivery, use of inotropes, blood pressure monitoring, ease of sampling. Today we can also boast of advanced USG guided central line insertion of Internal Jugular vein.

Phototherapy and Exchange Transfusion: Babies who develop significant jaundice require special lights called phototherapy for their managment. We have more than 10 such units including latest technology LED ( Light Emitting Diode) phototherapy and bili-blankets. Some Babies who don’t respond to intensive phototherapy may require exchange transfusion. We do around 10-15 such successful exchange transfusion per year. Most of these babies are extramural babies.

Bedside Echocardiography (POCUS) : Point of care ultrasonography and echocardiography is a very important tool in the diagnosis and management of hemodynamic instability. heart problems in premature as well as term babies. We are very fortunate to have such services available round the clock and this has made a big and significant difference in improving outcomes in such babies. All neonatal echo are done bedside by Neonatal cardiologists.

Neuroimaging: Premature babies are prone to have intraventricular hemorrhage (brain hemorrhage) especially in first week of life. Very preterm infants are periodically evaluated with bed side ultrasound by sonologists, who are available round the clock.Facilities of advanced imaging like MRI, Diffusion weighted MRI, MR Angiography are also available at our centre.

In case of bedside ultrasound showing enlarged ventricles ( sacs in the brain containing fluid) called hydrocephalus ,we usually perform bedside ventricular taps to ascertain infections in the brain and ventricles. We are also proud to say that we perform state of art neonatal brain surgeries including insertion of shunts both ventricular subgaleal  and   ventricular peritoneal.

Cerebral Function Monitoring : Sick babies are usually sluggish and neurologically depressed and need careful monitoring of their neurological status. We boast of one of the best bed side CFM ( cerebral function monitors) with video assistance technology which helps in diagnosis and prognosis of these sick babies. It also helps us in detecting sub clinical seizures and thereby helps in their management.

We now offer body cooling ( Therapeutic hypothermia) in the first few hours of birth in a select group of babies who are born depressed and hypoxic at birth. This intervention has shown to have improved outcomes in these babies .

Eye Examination: Retinopathy of prematurity (ROP) is a disease of very preterm babies, which can lead to blindness if not treated in time. To prevent ROP, a team of very experienced neonatal ophthalmologists, periodically examine retina of these preterm infants as per international guideline. Babies with advanced stage of ROP are offered advanced ophthalmic interventions like bedside laser therapy and anti- VGEF drug instillation to halt progression of disease and improve visual outcomes.

Universal Hearing screening: All babies born in hospital are subjected to OAE (otoacoustic emission) test which is done to pick up babies with hearing loss. It is a simple bedside test done in the hospital . Some babies may require advanced tests like Brain stem evoked response audiometry (BERA) , which is also available in our hospital.

Genetic counselling services: All babies born or admitted to our hospital are universally screened for certain metabolic/ genetic diseases like hypothyroidism, G6PD deficiency and congenital adrenal hyperplasia. For this a few drops of blood are collected on a filter paper. Sick neonates with congenital anomalies or suspected inborn errors of metabolism are evaluated extensively with help of geneticists. We are fortunate to have one of the country’s best and state of art genetic department with advanced testing centre and comprehensive counselling.

Lactational Support: We are proud to be able to have a dedicated lactation counselor who takes sessions on breast-feeding and helps mother with expression of breast milk. She is also actively involved in stimulating mothers to express their milk timely and explains the different techniques of expression and advantages of human milk. She also spends valuable time helping relieving & counselling parents of sick neonates in NICU.

Developmental supportive Care: A team of Developmental Pediatrician and an Occupational therapist and support staff visits the nursery regularly and remains involved in the developmental support of the sick preterm babies. We try to give physical, visual and auditory stimuli once sick babies are stable, for their faster recovery and rehabilitation. We are very sensitive with the noise and light levels in the nursery and this is continuously monitored with devices within the unit. We make our best effort to do “bundle of care” services to minimise pain and discomfort to our babies. Mothers are also involved in the care of the baby; they are encouraged to hold the baby next to their skin (Kangaroo Mother Care), which helps in better growth and development of infants apart from helping in establishing lactation.

Fetal medicine:Antenatal monitoring of the fetus for diagnosis and management is an essential area of Perinatology. We have the Department of Fetal medicine where various antenatal procedures like amniocentesis, chorionic villous biopsy and intrauterine transfusion etc are done and appropriate counselling offered.