Neonatology

Montreal Children's Hospital

The Division of Neonatology (Montreal Children's Hospital) regroups thirteen neonatologists with various clinical (transport, extremely low birth weight, quality improvement, congenital anomalies, global health), educational (simulation, outreach, neonatal resuscitation) and research (respiratory control, pulmonary hypertension, bronchopulmonary dysplasia, long term health outcomes, health economics, neonatal brain repair) interests, as well as five pediatricians with expertise in the follow up of neonates with special needs.

Our approach to care is interdisciplinary, bringing together nurses, respiratory therapists, pediatricians, pharmacists, nutritionists, occupational therapists, social workers, Neonatal Nurse Practitioners (NNP) and consultants who treat acutely ill newborn infants (premature infants and term infants with serious medical and surgical disorders). The Montreal Children's Hospital's NICU was a leader in housing the first NNP provincial training program in Québec.

The MCH NICU is a level 3C referral center for patients from the greater Montreal area and across the province. In addition, we provide training to many healthcare professionals and physicians originating from many countries (Brazil, Thailand, Lebanon, Israel, Mexico, etc…) under the umbrella of the Neonatal-Perinatal Medicine Residency Program at McGill.

History and Milestones

The Neonatal Intensive Care Unit (NICU) at the Montreal Children’s Hospital (MCH) was founded in 1957. It later expanded and gained a reputation for its research and treatment of respiratory diseases in newborns under the guidance of Dr. Mary Ellen Avery, who was Chief of Pediatrics in the 1970s. In 1958, Dr. Robert Usher, then Director of the Intensive Care Unit at the Royal Victoria Hospital (RVH), invented a needle to administer fluids to very tiny babies. Since then, these two units have collaborated on a number of therapeutic advances, such as the use of surfactant and nitric oxide, neonatal transport, extracorporeal membrane oxygenation, high-frequency ventilation, and body cooling, all of which changed the face of neonatology. The Montreal Children’s Hospital is where these technologies were first introduced for the care of newborns in Québec.

In 2015, the MCH and RVH NICUs, merged into one large Neonatal Intensive Care Unit (NICU) at the new Montreal Children’s Hospital which provides ultra-specialized intensive care to babies now adjacent to a specialized maternal and perinatal unit. The unit has 52 beds, with single rooms and 4 twin rooms allowing neonates to receive care in a quiet environment that reduces the spread of infection while ensuring families’ privacy.

The NICU is part of a perinatal center which is a referral center for the entire province of Quebec. The Maternal-Fetal Medicine team at the Royal Victoria Hospital, adjacent to the Children’s, treats a high proportion of high-risk pregnancies requiring immediate attention at birth by neonatologists and other pediatric medical or surgical specialists.

The MCH NICU is a reference center for neonates with a variety of conditions at birth. These neonates are transported by a specialized transport team. The NICU admits approximately 900 neonates per year and the Royal Victoria Hospital counts 3,000 deliveries per year, many being high-risk.

The MCH's NICU is equipped with the most recent technologies for ventilation, including high-frequency oscillatory ventilators, Jet ventilators, as well as non-invasive ventilation therapies, including NIV-NAVA and equipment for therapeutic hypothermia, hemodialysis and peritoneal dialysis.

Innovations

1990: Creation of the first neonatal transport team in Québec, dedicated to the ground transportation of unstable newborns.

1991: Start of the provincial extracorporeal membrane oxygenation program intended to assist newborns in severe respiratory distress who do not respond to conventional treatments.

1994: Start of the specialized neonatal nurse practitioners pilot project designed to provide advanced care to newborns in an interdisciplinary setting. This project led to the 2006 creation of the provincial training program for specialized neonatal nurse practitioners.

1995: First hospital in Québec to use nitric oxide to treat pulmonary hypertension and to use high-frequency ventilation to treat severe respiratory distress.

2000: First EXIT (ex-utero intrapartum treatment) procedure performed at the Montreal Children's Hospital on a newborn with a neck tumor compressing the airway.

2008: Start of the therapeutic hypothermia program to treat infants born with perinatal asphyxia after 36 weeks of gestation.

2010: Start of magnetic resonance imaging (MRI) scans without sedation.

2011: First hospital in Québec to use high-frequency jet ventilation to treat a newborn with severe lung disease.

2016: Introduction of Tecotherm in Neonatal transport

2017: Implementation of an on-site simulation room.

2022: Pilot phase of the SMART Hospital (wireless monitoring) at the MCH-NICU.

Research

2022 Montreal Children's Hospital NICU Research Achievements

2020 MCH Neonatology Research Publications

Programs and Services

High-Risk Pregnancies

In a high-risk pregnancy (premature labor, congenital fetal abnormality or health problem in the mother posing a risk to herself or the fetus), the family is followed by a team of obstetricians, neonatologists and other specialists who provide advice, treatment and follow-up during pregnancy and after delivery. When a birth defect is diagnosed early in the pregnancy, the Fetal Diagnostic and Treatment Group (FDTG) works closely with the parents to provide them with information about the diagnosis, prognosis, treatments, and possible procedures during the pregnancy or after the birth. This team is comprised of geneticists, surgeons, maternal-fetal medicine specialists, neonatologists, cardiologists, nephrologists, and nurses, who meet regularly to discuss various cases.

Neonatal Transport Team

The neonatal transport team of the Montreal Children’s Hospital is composted of a group of nurses and respiratory therapists who have advanced training in neonatal transport medicine. They are working in collaboration with consulting MDs at the Montreal Children’s Hospital’s NICU and they are covering the transport services 24/7. More than 400 babies are transported annually for emergent stabilization and consultation from more than 50 centers in Quebec. The transport admissions to the NICU represent more than 40% of all NICU admissions at the MCH. The transport team utilizes state of the art equipment specially designed for neonatal transport, mirroring the standards or care found in neonatal critical units as well as national and international recommendations for the neonatal transport. When a patient’s transport is requested from a referring center, the team is mobilized as fast as possible. The medical team from the NICU is also available to answer questions or to provide assistance regarding patient management.

The MCH Neonatal Transport Program is a participating member of the Canadian Neonatal Transport Network (CNTN) which integrates comparative data and benchmarking from many transport programs across Canada. The objective is to improve neonatal transport outcomes through sharing evidence based practice within the Canadian Neonatal Network (CNN).

Outreach Program

The Neonatal Outreach Program provides training and support to physicians, nurses, and respiratory therapists at referring centers. In additional to helping interested hospitals establish a neonatal resuscitation program (NRP) and reviewing pertinent referred cases, there is also a didactic curriculum about common neonatal presentations and emergencies. The Neonatal Outreach Program also uses in site simulations within interested sites to augment learning.

Activities include implementation of the neonatal resuscitation program (NRP), cases discussions, didactic learning about neonatal morbidities and emergencies, and on site simulations to facilitate learning about the care of unstable neonates.

Therapeutic Hypothermia

Since 2008, the MCH has offered therapeutic hypothermia to newborns born after 36 weeks with asphyxia who meet the eligibility criteria based on their neurological exam or their brain activity as seen on amplitude-integrated electroencephalography (aEEG). Since 2008, 1,054 patients have been referred to our centre, approximately 33% of whom were treated with body cooling. In 2016, our transport program has implemented the use of active cooling on transport.

Education and Training

Continuing Education

Each year since 2011 the McGill Neonatal Conference is held, at which a guest speaker lectures to professionals from referring centers throughout the province on an emerging topic.

2022:Neonatal Cardiac Issues. Guest speakers:Dr. William Benitz, Stanford, CA, USA; Dr Edgar Jaeggi, Ontario, Canada.
2021: Neurological Issues in the Neonate. Guest speakers: Dr. Steven Miller, Toronto, Canada.
2020: No conference due to COVID restrictions
2019: Neonatal Respiratory Care. Guest speakers: Dr Jen-Tien Wung, New Jersey, USA; Dr Hany Aly, Ohio, USA.
2018: Neonatal Hematological Problems. Guest speakers: Dr. Robert Christensen, Utah, USA; Dr Anthony Chan, Ontario, Canada.
2017: Perinatal Problems. Guest speakers: Dr. Nestor Vain, Argentina; Dr. Abbot Laptook, Rhode Island, USA; Dr. François Luks, Rhode Island, USA; Dr. Nicholas Embleton, New Castle, England and Dr. Monique De Paepe, Rhode Island, USA.
2016: Neonatal Infectious Problems. Guests speakers: Dr. Bosco Paes and Dr. Pablo Sanchez
2015: Neonatal Surgical Problems.
2014: Neonatal Cardiorespiratory Problems. Guest speaker: Dr. Martin Keszler, Brown University, Rhode Island
2013: Neonatal nutrition. Guest speaker: Dr. Josef Neu, Gainesville, Florida
2012: Extremely preterm neonates: From conception to childhood. Guest speaker: Dr. Peter Davis, Melbourne, Australia
2011: Therapeutic hypothermia. Guest speaker: Dr. Abbot Laptook, Brown University, Rhode Island

Each year, we also host a keynote speaker as part of the Dr. Robert Usher Lecture. This lecture is named after Dr. Usher: a pioneer in the field of neonatology. These have included

 

  • Dr. Christian F. Poets, Tuebingen University, Germany;
  • Dr. John Zupancic, Boston, Massachusetts;
  • Dr. Peter M. Dunn, University of Bristol;
  • Dr. Eduardo Bancalari, Miami University;
  • Dr. Joseph Volpe, Harvard Medical School;
  • Dr. Saroj Saigal, McMaster University;
  • Dr. Judy L. Aschner, Vanderbilt University;
  • Dr. Pablo Sanchez, University of Texas Southwestern, TX;
  • Dr. Wally Carlo, University of Birmingham, Alabama;
  • Dr. Vinod Bhutani, Stanford University;
  • Dr. Alan Jobe, Cincinnati, OH.

Other guest speakers who have visited our NICUs since 2009 include:

Dr. Colin Morley, Melbourne University, Australia
Dr. J. T. Wung, Columbia University, NY
Dr. Jeffrey Ferranti, Duke University, NC
Dr. Patrick McNamara, University of Toronto, ON
Dr. Brian Simmons, University of Toronto, ON
Dr. Roger Soll, University of Vermont College of Medicine, Burlington, VT
Dr. Robin Steinhorn, UC Davis, CA
Dr. Richard Martin, UH Cleveland Medical Center
Dr. Abbot Laptook, Brown University, RI
Dr. Lina Chalak, University of Texas Southwestern, Dallas, TX
Dr. George Little, Dartmouth, NH
Dr. Hannah Glass, UCSF
Dr. Richard Martin – Rainbow Babies, Cleveland
Dr. Emily Tan – Hospital for Sick Children, Toronto
Dr. Hany Aly - George Washington
Dr. Seetha Shankaran - Wayne State University
Dr. Jack Sinclair - McMaster University
Dr. Lex Doyle – University of Melbourne, Australia
Dr. Page Church - Hospital for Sick Children, Toronto
Dr. Brian Simmons – Sunnybrook, Toronto
Dr. Prakesh Shah – Mont-Sinai, Toronto
Dr. Bosco Paes – McMaster University
Dr. Ronald Clyman - UCSF
Dr. Jennifer Beck – St-Michael’s Hospital, Toronto
Dr. Cristopher Synderby - Toronto
Dr. Neil Finer - San Diego
Dr. Jacques Belik - Toronto
Dr. Summesh - McMaster - US course
Dr. Prashanth - McMaster - US course
Dr. Michael-Andrew Assad – Calgary
Dr. John Profit – Stanford
Dr. Kevin Dysart - CHOP, Pennsylvania
Nurses: Kathy Randall, Danielle and Kathy Overman

Postgraduate Medical Education

For more information about the Division of Neonatology's subspecialty residency or fellowship programs please visit Education and Training.

Training for Health Professionals

Graduate Diploma Nurse Practitioner Neonatology

In the early 1990s, a pioneer hospital based Neonatal Nurse Practitioners (NNP) training program was created at the Montreal Children’s Hospital under the leadership of Dr Eugene Outerbridge.

Since 2004, this hospital program became a maters program under the McGill School of Nursing. The MCH remains one of the main training sites of the program which has trained most NNPs in practice in the province of Quebéc.

For additional information, please visit the Faculty of Medicine and Health Sciences Ingram School of Nursing website

 

Division Members

Neonatologists
Dr. Gabriel Altit
Dr. Marc Beltempo, Associate Director, Research
Dr. Jessica Duby
Dr. Jarred Garfinkle, Co-Director, Neonatal Neuro-Critical Care Program
Dr. Richard Gosselin, Division Director Dr. Elizabeth Hailu
Dr. Francois Olivier, Associate Director, Clinical Operation
Dr. Katryn Paquette
Dr. Michelle Pepin
Dr. Michelle Ryan, Associate Director, Education
Dr. Bayane Sabsabi, Coordinator, Outreach Program
Dr. Guilherme Sant’Anna, Director, Neonatal Health Care Innovation and Technology Program
Dr. Wissam Shalish
Dr. Pia Wintermark, Co-Director, Neonatal Neuro-Critical Care Program

Neonatal Follow-Up Clinic
Dr. Elise Couture, Neonatal-Follow-Up Fellowship Program Director & Associate Director
Dr. Andreea Gorgos
Dr. May Khairy
Dr. Michelle Pepin

Nurse Clinicians, Neonatal Follow-Up Clinic
Josiane Pepin
Mélanie Hogue

Pediatric Nurse Practitioner, Neonatal Follow-Up Clinic
Jasmine Canse

Neonatal Nurse Practitioners - NICU
Martine Claveau
Philippe Lamer
Marie-Éve Moreau
Emilie St-Germain
Margarida Ribeiro da Silva
Andréa Martel-Bucci
Olga Kazantseva
Tiffany Mathieu
Laila Wazneh
Marco Zeid
Martine Chagnon

Nursing Leadership Team
Jessica Girard-Landry, Nurse Manager
Cassandre Marthone, Assistant Nurse Manager
Bao Tran Dang, Assistant Nurse Manager
Florence Casuar, Assistant Nurse Manager
Vanessa Kaanan, Assistant Nurse Manager
Elissa Remmer, Nursing Practice Development Educator
Stephanie Mardakis, Nursing Practice Development Educator
Patricia Grier, Liaison Nurse

Contact Us

Division Leadership

Division Director, MCH
Dr. Richard Gosselin

Associate Division Director, MCH
Dr. Marc Beltempo - Research
Dr. François Olivier - Clinical Operations
Dr. Michelle Ryan – Education
Dr. Elise Couture - Neonatal-Follow

Division Director, JGH
Dr. Lajos Kovacs

Postgraduate Medical Education

Residency Program Director
pd-neonatology.med [at] mcgill.ca (Dr. Nina Nouraeyan)

Neonatal Follow-up Fellowship Program Director
Dr. Elise Couture

Neonatal Hemodynamics Clinical Research Fellowship Program Director
gabriel.altit [at] mcgill.ca (Dr. Gabriel Altit)

Neonatal Perinatal Medicine Scholar Fellowship Program
marc.beltempo [at] mcgill.ca (Dr. Marc Beltempo)

Administrative Staff

MCH Administrative Assistant
tamara.slovick2 [at] muhc.mcgill.ca (Tamara Slovick)
514-412-4400 ext. 24452

MCH Administrative Assistant
programadmin-neonat.med [at] mcgill.ca
514-412-4400 ext. 24452

JGH Administrative Assistant
apo.papageorgiou [at] mcgill.ca (Judi Garon)
514-340-8222 ext. 25690

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