Neonatal surgeons are doctors who operate on babies less than four weeks old or babies still in the womb. It’s a specialized job that requires extensive training.
After completing their surgical residencies, neonatal surgeons must complete a specialty in pediatric surgery and a subspecialty in neonatal surgery.
What Does a Neonatal Surgeon Do?
Some babies are born prematurely, others may have breathing problems, infections, and birth defects. Neonatal surgeons can save the lives of babies born with these kinds of serious problems.
Typically, neonatal surgeons are part of a team caring for babies at risk. Other team members might be neonatologists, who specialize in newborns but aren’t surgeons; perinatologists, who specialize in high-risk pregnancies; pediatric anesthesiologists; and neonatal surgical nurses.
Sophisticated imaging has enabled doctors to find many issues before a baby is born. Often, the neonatal surgery team is standing by when a baby is born. Sometimes, doctors discover problems that need surgery before the baby is even born. In those cases, a surgeon will perform prenatal surgery, also called fetal surgery. It happens while the infant is still in the womb.
Education and Training
To be a neonatal surgeon, you must first have a four-year undergraduate degree. Then they must also have:
- Four years of medical school
- A five-year residency in general surgery
- Certification by the American Board of Surgery
- Two years or more of training in pediatric surgery
- Certification in pediatric surgery by the American Board of Surgery
- Additional training in the neonatal field
Neonatal surgeons with these letters F.A.C.S after their names have passed added evaluation of their training, skills and ethical conduct by the American College of Surgeons. F.A.C.S. stand for Fellow of the American College of Surgeons.
Reasons to See a Neonatal Surgeon
If your baby has a congenital heart defect, you’ll see a pediatric cardiovascular surgeon. For most other problems that need surgery, you’ll be referred to a neonatal surgeon. The conditions they treat include:
Esophageal Atresia
With this birth defect, the baby's esophagus is divided into two parts that don’t connect. Sometimes one or both of them connect to the windpipe instead. This condition is rarely diagnosed before birth. It becomes apparent when the baby can’t feed without choking or vomiting. About one in 4,100 babies born in the United States has this condition. A neonatal surgeon performs an operation that connects the two pieces of the esophagus so the baby can eat.
Omphalocele
Sometimes when a baby is born, parts of the intestines or other organs are outside the belly. Omphaloceles can be small or large, and they happen about once in every 4,200 births. Sometimes the condition is discovered before the baby's birth with an ultrasound or an abnormal test result. Other times the omphalocele isn't seen until the baby is born. In a single surgery or a series of surgeries, the neonatal surgeon will put the organ or organs back into the abdomen and close the belly.
Myelomeningocele
Spinal bifida is a birth defect that happens about once in every 2,758 births. In the most serious type, myelomeningocele, nerves are exposed through an opening at the base of the spine. Doctors usually diagnose this condition by ultrasound during pregnancy. If spina bifida is repaired before birth, the outcome for the baby can be better. A surgeon may open the mother's uterus with a large incision, or use an instrument called a fetoscope, which is less invasive.
What to Expect When you See the Neonatal Surgeon
The neonatal surgeon is just one member of the team that will care for your child. You may get most of your information from your obstetrician, if your baby hasn't been delivered, or from your baby's pediatrician. When you meet with the neonatal surgeon, you will have the chance to ask questions specifically about the procedure your baby will undergo.
What will happen depends on many factors, including:
- The seriousness of your baby's condition
- Whether the surgery must be done right away
- Whether your baby has been born or is still in the womb
The surgeon will explain your baby’s surgery, the risks, and what to expect afterward. There may be options to consider. For example, you might be able to have your baby's surgery before birth or after birth.
If you’re the mother of a baby having prenatal surgery, you’re also a patient. You’ll discuss your well-being and your ability to have children in the future.