Current Environment: Production

Medical Services

Specialties

Programs & Services

Languages

  • English

Education

Undergraduate School

Haverford College

1985, Haverford, PA

Medical School

Harvard Medical School

1990, Boston, MA

Internship

Boston Children's Hospital

1991, Boston, MA

Residency

Boston Children's Hospital

1993, Boston, MA

Graduate School

MPH

Harvard University School of Public Health

1995, Boston, MA

Fellowship

Joint Program in Neonatology

Boston Children's Hospital

1996, Boston, MA

Certifications

  • American Board of Pediatrics (Neonatal-Perinatal Medicine)

Professional History

My professional activities span the realm of clinical service, administration, research and teaching, all devoted to discovering, implementing and teaching evidence-based clinical care of seriously ill newborns.

As the NICU director, I am responsible for patient care, research endeavors, and educational needs. I have developed numerous important guidelines for our NICU and have collaborated on a wide range of medical improvements. We were the first NICU in New England to provide a specialized hypothermia program for babies with difficult births and now use sophisticated neurologic imaging to assess brain function. I collaborate with engineering laboratories to develop improved medical devices. I am the course director of a program to teach difficult conversations with families.

I also work on projects for resources limited settings. I helped develop a nonelectric infant warmer and collaborated with Rwandan doctors and ministry of health to develop and teach their National Neonatal Protocols.

I have authored original research papers and manuals including The Manual of Neonatal Care, The Manual of Neonatal Surgical Intensive Care, and The Manual of Neonatal Mock Codes.

Publications

  1. An Implementation Science Study of a Heat-Producing Wrap to Complement KMC in Rwanda. Ann Glob Health. 2024; 90(1):49. View Abstract

  2. Recognizing neonatal refeeding syndrome and thiamin supplementation: A case report. JPEN J Parenter Enteral Nutr. 2023 03; 47(3):437-441. View Abstract

  3. The 21st Century Cures Act: Perspectives of Clinicians in a Level-IV Neonatal Intensive Care Unit. Am J Perinatol. 2024 03; 41(4):511-514. View Abstract

  4. A mixed methods study of perceptions of bias among neonatal intensive care unit staff. Pediatr Res. 2023 05; 93(6):1672-1678. View Abstract

  5. A Multimodal Approach to Training Coronavirus Disease (COVID-19) Processes Across Four Intensive Care Units. Clin Simul Nurs. 2023 Mar; 76:39-46. View Abstract

  6. Parent and staff perspectives on the benefits and barriers to communication with infants in the neonatal intensive care unit. J Child Health Care. 2023 09; 27(3):410-423. View Abstract

  7. Reducing Benzodiazepine Exposure by Instituting a Guideline for Dexmedetomidine Usage in the NICU. Pediatrics. 2021 11; 148(5). View Abstract

  8. Mortality in the neonatal intensive care unit: improving the accuracy of death reporting. J Perinatol. 2022 05; 42(5):671-676. View Abstract

  9. Need for more evidence in the prevention and management of perinatal asphyxia and neonatal encephalopathy in low and middle-income countries: A call for action. Semin Fetal Neonatal Med. 2021 10; 26(5):101271. View Abstract

  10. Protease inhibitor plasma concentrations associate with COVID-19 infection. Oxf Open Immunol. 2021; 2(1):iqab014. View Abstract

  11. Safety and effectiveness of a non-electric infant warmer for hypothermia in Rwanda: A cluster-randomized stepped-wedge trial. EClinicalMedicine, The Lancet. 2021; 34:100842. PMID: 33997734. View Abstract

  12. Inverse Opal Films for Medical Sensing: Application in Diagnosis of Neonatal Jaundice. Adv Healthc Mater. 2021 02; 10(4):e2001326. View Abstract

  13. Neurophysiological Assessment of Prolonged Recovery From Neuromuscular Blockade in the Neonatal Intensive Care Unit. Front Pediatr. 2020; 8:580. View Abstract

  14. Neurologic Injury and Brain Growth in the Setting of Long-Gap Esophageal Atresia Perioperative Critical Care: A Pilot Study. Brain Sci. 2019 Dec 17; 9(12). View Abstract

  15. Performance of a Nonelectric Infant Warmer in Rwandan Health Centers. Glob Pediatr Health. 2019; 6:2333794X19884820. View Abstract

  16. Nutritive sucking abnormalities and brain microstructural abnormalities in infants with established brain injury: a pilot study. J Perinatol. 2019 11; 39(11):1498-1508. View Abstract

  17. Improving Access to Lactation Consultation and Early Breast Milk Use in an Outborn NICU. Pediatr Qual Saf. 2019 Jan-Feb; 4(1):e130. View Abstract

  18. Early Management of Infants With Robin Sequence: An International Survey and Algorithm. J Oral Maxillofac Surg. 2019 Jan; 77(1):136-156. View Abstract

  19. Reducing time to initiation and advancement of enteral feeding in an all-referral neonatal intensive care unit. J Perinatol. 2018 07; 38(7):936-943. View Abstract

  20. Implementation of a Guideline to Decrease Use of Acid-Suppressing Medications in the NICU. Pediatrics. 2017 Dec; 140(6). View Abstract

  21. Progressive IgA Nephropathy Is Associated With Low Circulating Mannan-Binding Lectin-Associated Serine Protease-3 (MASP-3) and Increased Glomerular Factor H-Related Protein-5 (FHR5) Deposition. Kidney Int Rep. 2018 Mar; 3(2):426-438. View Abstract

  22. A Regional Evaluation of Survival of Infants with End-Stage Renal Disease. Neonatology. 2017; 112(1):73-79. View Abstract

  23. The Development and Implementation of a Newborn Medicine Program in a Resource Limited Setting . Public Health Action. 2015.

  24. A bioinspired omniphobic surface coating on medical devices prevents thrombosis and biofouling. Nat Biotechnol. 2014 Nov; 32(11):1134-40. View Abstract

  25. Falls and comorbidity: the pathway to fractures. Scand J Public Health. 2014 May; 42(3):287-94. View Abstract

  26. Developing a quality and safety curriculum for fellows: lessons learned from a neonatology fellowship program. Acad Pediatr. 2014 Jan-Feb; 14(1):47-53. View Abstract

  27. Whole genome sequencing identifies SCN2A mutation in monozygotic twins with Ohtahara syndrome and unique neuropathologic findings. Epilepsia. 2013 May; 54(5):e81-5. View Abstract

  28. Placental pathology in asphyxiated newborns meeting the criteria for therapeutic hypothermia. Am J Obstet Gynecol. 2010 Dec; 203(6):579.e1-9. View Abstract

  29. Can induced hypothermia be assured during brain MRI in neonates with hypoxic-ischemic encephalopathy? Pediatr Radiol. 2010 Dec; 40(12):1950-4. View Abstract

  30. Donation after cardiac death: the potential contribution of an infant organ donor population. J Pediatr. 2011 Jan; 158(1):31-6. View Abstract

  31. An interdisciplinary, family-focused approach to relational learning in neonatal intensive care. J Perinatol. 2011 Mar; 31(3):212-9. View Abstract

  32. Early versus late MRI in asphyxiated newborns treated with hypothermia. Arch Dis Child Fetal Neonatal Ed. 2011 Jan; 96(1):F36-44. View Abstract

  33. Correlation of 2-methoxyestradiol levels in cord blood and complications of prematurity. Pediatr Res. 2010 May; 67(5):545-50. View Abstract

  34. Premature infant swallowing: patterns of tongue-soft palate coordination based upon videofluoroscopy. Infant Behav Dev. 2010 Apr; 33(2):209-18. View Abstract

  35. Maternal preeclampsia predicts the development of bronchopulmonary dysplasia. J Pediatr. 2010 Apr; 156(4):532-6. View Abstract

  36. MAp44, a human protein associated with pattern recognition molecules of the complement system and regulating the lectin pathway of complement activation. J Immunol. 2009 Dec 01; 183(11):7371-8. View Abstract

  37. Polymorphisms in mannan-binding lectin (MBL)-associated serine protease 2 affect stability, binding to MBL, and enzymatic activity. J Immunol. 2009 Mar 01; 182(5):2939-47. View Abstract

  38. Neonatal arterial thrombosis at birth: case report and literature review. Am J Perinatol. 2008 Jun; 25(6):347-52. View Abstract

  39. Inhaled epinephrine for the treatment of transient tachypnea of the newborn. J Perinatol. 2008 Mar; 28(3):205-10. View Abstract

  40. No certain predictors for mutation status in a Danish cohort with familial hypercholesterolemia: a descriptive study. Clin Biochem. 2007 Dec; 40(18):1347-52. View Abstract

  41. Potential substitution of cord blood for infant blood in the neonatal sepsis evaluation. Biol Neonate. 2005; 88(1):12-8. View Abstract

  42. Antenatal neurosurgical counseling: approach to the unborn patient. Pediatr Clin North Am. 2004 Apr; 51(2):491-505. View Abstract

  43. Once-daily gentamicin dosing for the preterm and term newborn: proposal for a simple regimen that achieves target levels. J Perinatol. 2003 Dec; 23(8):635-9. View Abstract

  44. Very low birthweight Infant's placenta and its relation to pregnancy and fetal characteristics. Pediatr Dev Pathol. 2000 Sep-Oct; 3(5):419-30. View Abstract

  45. Very low birthweight placenta: clustering of morphologic characteristics. Pediatr Dev Pathol. 2000 Sep-Oct; 3(5):431-8. View Abstract

  46. Plasminogen activator inhibitor-1: defining characteristics in the cerebrospinal fluid of newborns. J Pediatr. 2000 Jul; 137(1):132-4. View Abstract

  47. Sonographically detected subarachnoid hemorrhage: an independent predictor of neonatal posthemorrhagic hydrocephalus? Clin Imaging. 2000 May-Jun; 24(3):121-9. View Abstract

  48. Thymic transplantation across an MHC class I barrier in swine. J Immunol. 1999 Oct 01; 163(7):3785-92. View Abstract

  49. Labor and delivery characteristics and risks of cranial ultrasonographic abnormalities among very-low-birth-weight infants. The Developmental Epidemiology Network Investigators. Am J Obstet Gynecol. 1999 Oct; 181(4):997-1006. View Abstract

  50. Medical management of neonatal posthemorrhagic hydrocephalus. Neurosurg Clin N Am. 1998 Jan; 9(1):95-104. View Abstract

  51. CNS fibrinolysis: a review of the literature with a pediatric emphasis. Pediatr Neurol. 1998 Jan; 18(1):15-21. View Abstract

  52. Intraventricular urokinase for the treatment of posthemorrhagic hydrocephalus. Pediatr Neurol. 1997 Oct; 17(3):213-7. View Abstract

  53. Predictors of ventriculoperitoneal shunt among babies with intraventricular hemorrhage. J Child Neurol. 1997 Sep; 12(6):381-6. View Abstract

  54. Cerebrospinal fluid plasminogen activator inhibitor-1: a prognostic factor in posthaemorrhagic hydrocephalus. Acta Paediatr. 1997 Sep; 86(9):995-8. View Abstract

  55. Central apnea in a child with congenital autonomic dysfunction and universal pain loss. J Child Neurol. 1996 Mar; 11(2):162-4. View Abstract

In the Boston Children’s Hospital (BCH) Neonatal Intensive Care Unit (NICU) our philosophy is to ensure that every patient receives the best care for the best possible outcomes. This requires a team based approach with all members being essential:

Families: We practice family-integrated care; we encourage families to be at the center of all we do, understanding and participating in the care of their baby.

Doctors: At BCH we have an enormous breadth and depth of world-class medical and surgical subspecialists who cover all aspects of pediatric medicine and who are continuously innovating new diagnostics and novel therapies to treat newborn diseases. The treatment of each patient is coordinated by our attending neonatologists.

Nurses: We have highly experienced neonatal nurses and nurse practitioners who devote themselves to the bedside care of babies and their families, working in a primary team model to promote consistency. We are the only NICU in the country to have received the Gold Level Beacon award, a testimony to the extraordinary performance of our nurses.

Ancillary staff: this includes respiratory therapists, nutritionists, lactation consultants, pharmacists, physical and occupational therapists, social workers and interpreters who all work with us to meet our patients’ needs.

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