Canadian Medical opened its center for newborns at risk. Could you let us know what type of children the center is aimed at? The center places primary focus on children who suffered perinatal stress. These are usually newborns whose arrival to this world was accompanied by a varied range of complications. Some of the children can be born to pregnant mothers at risk or their delivery was considered non-standard. In addition, the center treats children who have experienced problems within the first month after birth. 

Can you let us know of some concrete examples? These are generally children who were born prematurely as well as those who had a low body weight at birth. Further, it includes newborns who experienced breathing difficulties immediately after being delivered as well children who had to be resuscitated. Additionally, it can also include children who suffered delivery trauma or have undergone an infection during the neonatal period.  A specific group at risk involves children born from multiple pregnancies. Finally, it can also include children born through a C-Section or those showing certain undesired symptoms. There are many cases that this applies to. The most important factor is that the pediatrician - or gynecologist - accurately identifies the risks in question and recommends specialized care when needed. Here at Canadian Medical, cooperation between pediatricians and gynecologists is strong and our doctors are well trained to indentify newborns at risk. Unfortunately however, there are many documented cases external to CM where these risks were underestimated and those children received specialized care unnecessarily late. Sometimes, this means that the damage caused is serious and may not always be reversible. This particular group of children at risk is more likely to experience health complication and neurodevelopment defects. This is why it is important to introduce timely and regular comprehensive care, ideally at a center in coordination with other specializations as well as your family to further help support you. Primarily, it is a form of preventive care.

What problems can occur with babies at risk? These generally include undesired changes in psychomotor development. At the onset, these complications manifest themselves through changes in the muscle tonus, incorrect motion patterns, inappropriate reactivity, irritability and apathy as well as slow development or its stopping altogether. The problems are often complex in nature as individual systems in the body are interconnected and show similar symptoms. We can for example identify that the child is not in a good shape, has problems with the intake of food, worsened movement coordination as well as a slower rate of development. Such deviations must be caught early and accompanied by the appropriate treatment. As a result, it then becomes possible to prevent long-term or permanent complications in the future. 

How are children with developmental problems treated? The concrete intervention method is recommended by a neonatologist based on the medical history of the baby as well as based on the overall state of development, making the approach highly individualized in its nature. With these children, we often encounter eating disorders and general lack of well-being. Such a baby requires a specialized nutritional approach and regimes - such as orofacial stimulation - as well as involving a nutritional therapist. Children who were born prematurely and have spent considerable time separated from their mothers require a relationship to be established through so-called attachment. This is why we have a psychologist in our team. As part of early therapeutic interventions, we employ various forms of rehabilitation. We like to use the Vojta Method (reflex locomotion therapy) as well as many other methods including the Bobath Concept, positioning, handling or soft methods involving balls, overballs... as well as hippotherapy (horse-riding therapy) all of which proving effective. We select the right method in close coordination with the physiotherapist. With older children, we also seek the help of a speech therapist or an ergotherapist who focuses on supporting fine motor skills. Based on the situation at hand we cooperate with many other specialists at CM. These most commonly involve a developmental neurologist, a pulmonologist, allergologist, gastroenterologist, surgeon or an eye doctor. The Center of Special Care for Children focuses on the concept of multidisciplinary care which takes into account the various developmental and therapeutic aspects. 

Do such centers exist elsewhere in Prague? Yes, they do. However, their capacity is stretched too far and too thin. Currently, approximately 20% of all babies are considered at risk and only a small amount of these children are provided comprehensive and long-term attention at specialized practices. These children generally end up being cared for by a regular pediatrician who may not be able to detect and diagnose all of the problems found in the child's early development phases. 

How is the center's approach different to other facilities? Our approach differs in the sense that we help the families which face unfortunate circumstances by providing medical care with the highest comfort possible. Consultations are allocated the necessary time and the team of specialists is at the patient's disposable immediately. Our effort is team-based and we discuss and share the patient's medical records. We strive to ensure great communication between our specialists and the families which come to us. The care that we provide is carried out in a sophisticated and pleasant environment. 

You have a profession that is difficult in many aspects. What makes you happy at work? I am very happy when I encounter premature babies that are developing well despite the odds. They have a low body weight, spend much of their time in an incubator and start off their development slow along with many accompanying problems. However after teaching the mother, strengthening the bond, working with the family and with the help of many other interventions, just 2 years later the baby is capable of catching up with babies who were born without such problems. They are born 4 months earlier and despite this fact, they can catch up. Those are the moments when my work makes clear sense to me. 

MUDr. Patricia Zemanová Konopová is a specialist with an attestation in the field of pediatrics and neonatology. Aside from Canadian Medical itself, she has spent many years at one of Prague's best neonatology facilities in the Czech Republic - the The Institute for the Care of Mother and Child (ÚPMD) in the Podolí district of Prague. She studied in Barcelona and London. She also served as an intern at the Department of Pediatrics of the Oslo University Hospital as well as at its Institute of Pediatric Research.