Neonatology: Divyen Shah and Michael Harrison explain what is involved in this subspecialty of paediatrics. (Cancers).

You do not often come across medical students and junior doctors who have a burning desire to become neonatologists, the exception being those tutored by an inspirational teacher. For many senior house officers, the experience of working in a neonatal unit (as part of a paediatric attachment) provides lasting memories of endless rounds of blood gases, cannulations, baby checks, all-powerful midwives, and attending deliveries of newborn babies because of meconium stained liquor.

If, however, you can see past this stage, you will discover that neonatology is an exciting and advancing specialty that is rapidly progressing in training, research, and technology.

Neonatology is a subspecialty of paediatrics, and as such all paediatric trainees will be exposed to neonatology at a tertiary level regardless of the subspecialty they go on to pursue. It is a relatively new subspecialty. Babies were first ventilated with endotracheal tubes in the late 1960s, and ultrasound examination of the head became established only in the 1970s.

The work

The day to day work of a neonatologist entails looking after babies needing varying degrees of intensive care. Neonatologists are also responsible for the well babies on the postnatal wards. In a tertiary level unit, a notable number of babies will be very premature, under 30 weeks' gestation. Many babies need intubation and ventilatory support …