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Neonatal Neurology and Neonatal Neurocritical Care Program

Contact number | 202-476-2120
A newborn at the NICU.

Cutting Edge Care for Expecting Families

Moving quickly matters most when something isn't right with an unborn baby. The Prenatal Pediatrics Institute gets diagnosis and treatment advances to families faster.

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Recognizing that a newborn's brain is very different than a child or adult brain, the Division of Neonatology and the Division of Neurology at Children’s National Hospital came together in 2004 to develop a dedicated Neonatal Neurology and Neurocritical Care program. The program offers access to neonatal neurologists who regularly monitor babies’ developmental progress and perform research in all areas of brain injury prevention and management.

Neonatal Neurology and Neonatal Neurocritical Care at Children's National

The Neonatal Neurology and Neurocritical Care Program at Children’s National is the only one of its kind in the mid-Atlantic region and a leader in advancing neurologic care to some of the most critically ill newborns. There are only about a dozen or so similar programs in the nation and Children's National has the Washington, D.C., metropolitan region’s only Level IV Neonatal Intensive Care Unit (NICU).

Our program consists of a multi-disciplinary team of neonatal neurologists/neurointensivists, neonatologists, pediatric epileptologists, pediatric neuroradiologists, pediatric neurosurgeons and physiatrists as well as prenatal neurologists and prenatal pediatrics specialists.

"We are one of only a handful of programs nationally that have neonatal neurologists working in the NICU in both clinical and research capacities," said Billie Short, M.D., Chief of the Division of Neonatology. "Our goal is to provide the latest treatments while also developing experimental therapies that we can move from the bench to the bedside, allowing us to significantly improve neonatal and pediatric neurological outcomes."

Specialized Care for Our Youngest Patients

Evaluation and management of neonatal issues include:

  • Arthrogryposis
  • Brain injury 
  • Cerebral dysgenesis and malformations 
  • Hypotonia 
  • Hypoxic ischemic encephalopathy (HIE)
  • Neonatal encephalopathy 
  • Neurogenetic disorders
  • Neuromuscular disorders 
  • Perinatal stroke 
  • Seizures

The Most Advanced Technology and Latest Research 

The Division of Neonatology not only employs advanced technology in the NICU, but also is at the forefront of technological developments that are revolutionizing the tools used nationwide to monitor neonatal blood flow in the brain and intestines. This includes near-infrared spectroscopy, which is utilized to help pinpoint infants who have the highest risk of developing necrotizing colitis. Researchers at Children’s National also are working to optimize the size and design of equipment used during extracorporeal membrane oxygenation (ECMO).

Neurodiagnostic studies include remote continuous video EEG monitoring, portable CT scanner and neonatal MRI imaging protocols. Neurotherapeutic protocols include therapeutic hypothermia (whole body cooling) for hypoxic ischemic encephalopathy, status epilepticus, neonatal seizures and epilepsy and perinatal strokes. Clinical trials are ongoing.  

The Neonatal Neurology Program and Neurocritical Care Program provides both Neonatal Neurology and Perinatal Brain Injury clinics for evaluation and ongoing care of newborns and infants with neurologic issues acquired in the neonatal period at both the Sheikh Zayed Campus for Advanced Children’s Medicine and the Pediatric Specialists of Virginia.

The Perinatal Brain Injury Clinic is a joint multidisciplinary clinic with neonatal neurology, pediatric rehabilitation medicine and physical therapy for our neurologic patients with cerebral palsy.

The Biomarker-Brain Injury Link

Ongoing research at Children’s National is identifying biomarkers, such as heart rate variability, that may help determine the extent of brain injury before, during and after whole-body hypothermia, the gold standard of treatment for perinatal hypoxic ischemic encephalopathy.

"Approximately half of infants with HIE experience poor outcomes following hypothermia," said An Massaro, M.D., Co-director of Research for the Division of Neonatology. "We hope to identify a method of routine monitoring to determine which patients are failing treatment. If we can pinpoint biomarkers that are early signs of impending injury, such as pattern changes in heart rate, we can intervene before the patient is compromised."

Using heart rate variability, researchers also hope to better diagnose brain injury and give parents an accurate glimpse at their child’s future neurological outcome. 

Placenta’s Role in Brain Injury

Premature birth and placental infection are major contributors to neonatal brain injuries. Fostering a greater understanding of the placental hormones and growth factors present in the normal prenatal environment may help physicians develop targeted therapies that prevent brain injury.

"The placenta is naturally optimized to aid brain development," said Anna Penn, M.D., Ph.D., investigator in the Center for Neuroscience Research and Co-director of the Board of Visitors Cerebral Palsy Prevention Program in the Division of Neonatology. "At this time, we don’t know how the hormones and growth factors released by the placenta influence fetal brain development. My goal is to gain greater understanding of what’s happening at a basic scientific level so we can create a cocktail of synthetic hormones that help normalize brain development following placental infection or premature birth."

Dr. Penn’s prior placental research has included monitoring hormone levels in experimental models, examining human placentas to see what hormones are produced under certain circumstances, and analyzing the cerebral spinal fluid of premature infants to see which hormones are present. Her ongoing research in both babies and mice focuses on determining which prenatal and newborn hormone levels correlate with normal development and improved neurological outcomes when there is risk of brain injury.

Clinical Training and Other Learning Opportunities

Our training programs offer top-notch medical education and experience complementing our commitment to excellence. Residents and Fellows participate in a rigorous curriculum providing many research, conference and learning opportunities such as our Child Neurology Fellowship and our Prenatal Neurology Research Fellowship Program headed by Adré J. du Plessis, MBChB, Director of the Prenatal Pediatrics Institute at Children's National.

Sadie's Story

Newborn Neurologic Disorders

Sadie leans over pastel-colored blanket

Sadie is one of hundreds of infants with acute encephalopathy who have received whole-body therapeutic hypothermia at the Children's National neonatal intensive care unit. Whole-body therapeutic hypothermia is offered in the first few hours of life to preserve brain cells and to stave off disability or death.

Sadie's Story

Neonatal Neurology and Neonatal Neurocritical Care Program Team

  • Tayyba Anwar, M.D.

    Tayyba Anwar
    Co-Director, Hemimegalencephaly Program
    Neonatal Neurologist

  • Adre duPlessis

    Adre Du Plessis
    Division Chief, Prenatal and Transitional Pediatrics
    Director, Prenatal Pediatrics Institute
    Director, Prenatal Brain Program

  • Youssef Kousa

    Youssef A. Kousa
    Prenatal and Neonatal Critical Care Neurologist
    Director, Zika Genetics Consortium

  • Sarah Mulkey

    Sarah Mulkey
    Co-Director, Congenital Infection Program
    Director, Prenatal and Neonatal Fellowship
    Prenatal and Neonatal Neurologist

  • Sarah Schlatterer

    Sarah Schlatterer
    Director, Neurocardiac Critical Care
    Prenatal and Neonatal Neurologist

  • Dr. Tammy Tsuchida

    Tammy Tsuchida
    Neonatal Neurologist

  • Nickie Andescavage

    Nickie Andescavage
    Director, Prenatal-Neonatal Continuity Program

  • Sudeepta Basu

    Sudeepta Basu

  • Panagiotis Kratimenos

    Panagiotis Kratimenos

  • Hallie Morris

    Hallie Morris
    Neonatal Lead, Complex Bronchopulmonary Dysplasia Program

  • Melissa O'Connell Liggett

    Melissa Liggett

  • Monica Pearl, M.D.

    Monica Pearl
    Director, Neurointerventional Radiology Program

  • Olga Morozova

    Olga Morozova
    Director, Education and Fellowship
    Pediatric Rehabilitation Specialist