Perspectives magazine is an annual glossy supporting the Mount Sinai Hospital Auxiliary, Mount Sinai Hospital and the Samuel Lunenfeld Research Institute.
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10 Clinical Care corrected age for preterm infants. The ophthalmologist on call provides follow-up eye exams for retinopathy of prematurity. PNAC is covered by the same neonatologist who is on call in the Mother & Baby Unit. Attendance at the clinic has increased from 302 in the latter half of 2011 to 660 in 2013. Neonatal Developmental Follow-Up Clinic In 2010, the Mount Sinai Hospital Neonatal Developmental Follow-Up Clinic was established under the guidance of Dr. Shoo Lee with Dr. Edmond Kelly as the Clinical Director. Prior to this, a combined clinic was available at SickKids but as the respective NICU populations of the two hospitals are quite different, it was Dr. Lee's vision to provide developmental follow-up services to children at the hospital they were born in by neonatologists familiar with the types of patients admitted. We have been very successful in promoting the importance of developmental follow-up of high-risk infants with more than 80% of infants returning for their follow-up visit (see Table 1). The clinic staff includes a physiotherapist, occupational therapist, speech and language pathologist, nurse practitioner, psychometrist, and psychologist. The team provides standardised assessments at 4, 8, 12, 18, and 36 months of age for high-risk foetal and neonatal populations. The visit findings are discussed with the infant's family and suggestions and information provided to enhance the infant's development. The infant's family physician is also notified. Referrals to the appropriate diagnostic and therapeutic service or services are made when necessary. The outcomes of the infants over each calendar year are also available to all department physicians so that they are aware of the outcomes of these high-risk infants. This is especially important as new treatments both to the neonate and the foetus become available. Research is an essential component of the follow-up clinic and we have been involved in evaluating the developmental outcomes of infants enrolled in a number of studies. Under the direction of Dr. Lee, we are part of, and one of the largest contributors to, a national neonatal outcome database—the Canadian Neonatal Follow-Up Network (CNFUN). We have also been involved in studies of the long-term effects of: • Administration of multiple antenatal corticosteroids; • Exposure to prenatal anti-Ro antibodies; • Congenital complete atrio-ventricular heart block; • High-dose steroid therapy; • Insertion of chest shunts in-utero and just after birth; • Circulatory arrest in infants under 3 months of age; • Breast milk and infant nutrition in the DOMINO study; and • Involving parents in the care of the infant in the NICU through the Family Integrated Care program. The clinic provides learning opportunities for interested medical and allied health personnel including nurses, physiotherapists, and occupational therapists. Fellows from the Neonatal-Perinatal Training Program are allocated time in the clinic to learn about developmental medicine through observation and hands-on experience. The Rogers Hixon Ontario Human Milk Bank Using mother's own milk in the NICU has been proven to lead to improved short-term and long-term outcomes for sick, fragile neonates. Mothers of very low birth weight infants are highly motivated to provide their own milk for their infant; however, only 30% have enough milk to exclusively feed their infant. Previously, this would have been supplemented with a cow's milk-based formula as there was only one human milk bank in the whole of Canada. With the opening of the state-of-the-art Rogers Hixon Ontario Human Milk Bank at Mount Sinai in January, 2013, we are now able to provide breast milk to all our most vulnerable patients throughout Ontario. The Medical Director of the milk bank is Dr. Sharon Unger and the milk bank is a partnership between Mount Sinai, SickKids, and Sunnybrook Health Sciences Centre. Its opening has been met with huge enthusiasm from families, health- care providers, and donor mothers alike. Currently we receive approximately 15 to 20 enquiries every week from potential donor mothers and have screened and approved more than 300 donor mothers in the first year of operation. Since beginning to dispense milk in April 2013, all Level 3 NICUs in Ontario with the exception of Kingston General Hospital, are now receiving donor milk from the milk bank and dispensing it to their very low birth weight infants (Kingston is awaiting the delivery of new freezers and then will begin dispensing donor milk as well). Additionally, 8 Level 2 NICUs in Toronto are now receiving donor milk from the milk bank with plans for the remaining hospitals to begin donor milk programs in 2014. Initial plans were to dispense 10,000