Are Babies in the NICU Getting Too Many Unnecessary Tests and Treatments?

Infant mortality rates are on the decline, which is excellent news. But when it comes to newborn health, there's still room for improvement—and new Choosing Wisely recommendations developed by neonatologists from Beth Israel Deaconess Medical Center focus on improving the care of infants treated in neonatal intensive care units by avoiding unnecessary tests and treatments. The guidelines, which were published online in Pediatrics, were developed from a survey of more than 1,000 pediatricians, neonatologists, and pediatric medical and surgical specialists.

Of course, "advanced tests and treatments have been important factors in [the decline in infant mortality rates], but we need to use them more wisely," senior author of the recommendations, DeWayne Pursley, M.D., M.P.H., F.A.A.P., Chair of the Department of Neonatology and Pediatrician-in-Chief at BIDMC, said in a news release.

  • Avoid routine use of anti-reflux medications for treatment of symptomatic gastroesophageal reflux disease (GERD) or for treatment of apnea and desaturation in preterm infants.
  • Avoid use of antibiotics for longer than 48 hours in absence of bacterial infection.
  • Avoid routine use of pneumograms for pre-discharge assessment of ongoing and/or prolonged apneas of prematurity.
  • Avoid routine daily chest radiographs without an indication for intubated infants.
  • Avoid routine screening term-equivalent or discharge brain MRIs in pre-term infants.

"In general, newborn care providers do a good job communicating with families about the care of their babies, but there is always room to do better," added author Timmy Ho, M.D., FAAP, a neonatologist at BIDMC. "Our hope is that caregivers and families will use this list as a starting point in discussions about tests and treatments and whether or not they add value to a baby's care."

Caitlin St John is an Editorial Assistant for who splits her time between New York City and her hometown on Long Island. Follow her on Twitter: @CAITYstjohn

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Image: Newborn via Shutterstock


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