Center for Healthy Infant Lung Development Overview

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Who we are

The Center for Healthy Infant Lung Development (CHILD) at Boston Children's Hospital is dedicated to providing comprehensive treatment to newborns, infants and children with various forms of lung disease. We are one of the largest centers in the world that cares for premature infants and full-term infants who have breathing difficulties, such as bronchopulmonary dysplasia,  apnea, and wheezing in the first years of life.

We offer a multidisciplinary approach to maximize the growth and development of the lungs, which helps children reach their maximum potential in all aspects of their normal activities, including exercise, feeding and learning.

Our staff

CHILD is staffed by an experienced team of Boston Children's clinicians, all of whom have specialized training in the care of infants and toddlers with lung disease. Our multidisciplinary staff includes experts from:

When appropriate, we also work closely with pediatric specialists in Otolaryngology, Gastroenterology and Cardiology at Boston Children's to ensure that every child receives the most comprehensive and coordinated care.

Our staff is available 24 hours per day, 7 days per week, and we pride ourselves in how available we are to our families.

Our expertise

We provide comprehensive evaluation and follow-up care to children from infancy to young adulthood with lung and breathing abnormalities.

Our clinical staff members are involved in your child’s treatment from day one. In addition to caring for premature infants who have been discharged home from the neonatal Intensive Care Unit (NICU), we also treat newborns and infants with neonatal surgical issues, like congenital diaphragmatic hernia and VATER (vertebrae, anus, trachea, esophagus and radial and/or renal) syndrome.

Our clinic has demonstrated the ability to keep our patients from getting rehospitalized much less frequently than national averages, and our patients also show impressive growth!

As our patients grow older, we assist children who are dependent on medical technology for breathing. This includes providing care to children who live at home with medical equipment and helping children in their transition back to home and school. We also provide long-term follow-up care to prevent acute respiratory illness.

In addition, we help families whose infants have failed car seat testing, and must make the transition from car beds to car seats, and determining safe timing of airline travel for infants with lung disease. Read more about our Car Seat Rechallenge Clinic.

Lower re-hospitalization rates for premature infants with BPD: a CHILD success story

A few years ago, Boston Children’s double-boarded neonatologist/pulmonologist Lawrence Rhein, MD, and colleagues established a specialized follow-up program for premature infants with bronchopulmonary dysplasia (BPD), the Center for Healthy Infant Lung Development (CHILD).  Since then, outcomes for this population have been dramatically improved.

In a recent study, Rhein found that rates of re-hospitalization at both one year and two years of life were considerably lower than those in other published reports. Boston Children’s rates of re-hospitalization in these infants who were less than 32 weeks gestation were 11 percent and 16 percent at 1 year and 2 years, respectively. These compare to rates of 38 to 56 percent in other studies.

Although comparison studies use slightly different methodologies, one non-Boston Children’s study described 24- to 28-week gestational age infants at 18 months of age, and found that 56 percent of the infants with BPD and 43 percent of the infants without BPD were re-admitted. Another reported a re-hospitalization rate of 49 percent in the first year of life for a cohort of patients with BPD.*

As shown below, for several consecutive quarters in 2010 and 2011 Boston Children’s had BPD-related re-hospitalization rates in the 1-6 percent range—dramatically lower than other published rates.

 
Click to display larger chart

blue line= Boston Children’s patients 2 weeks to 3 years of age with at least one BPD-related hospitalization

n= total number of BPD patients 2 weeks to 3 years of age seen within last 2 years in Boston Children’s CHILD Clinic

* references available

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The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
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