Small Baby Unit Outcomes: Big Improvements for the Littlest Patients


CHOC Small Baby Unit patient, Emma Faith, who weighed only 1 pound 4 ounces at birth.
CHOC Small Baby Unit patient, Emma Faith, who weighed only 1 pound 4 ounces at birth.

Weighing in at just 1 pound and 4 ounces at birth, baby Emma Faith received a special nickname from the nurses who cared for her inside CHOC Children’s Small Baby Unit (SBU): Mighty Mouse.

Three years later, Emma Faith is living up to that title as an energetic little girl, one of scores of children who have received treatment inside the SBU since it opened in 2010. Thriving and flourishing, she is the perfect embodiment of the impressive outcomes reported by the unit.

Recently released three-year data show a notable shift in outcomes for patients discharged in 2012, compared to those discharged in 2009, before the opening of the 12-bed unit for infants born at less than 28 weeks gestation or smaller than 1,000 grams:

• Weight and head circumference: In 2012, just 16 percent of all infants discharged from the unit were below the third percentile for weight and head circumference, while 39 percent were in 2009. These factors are linked to cognitive and physical disabilities.

• Oral feeding rates: In 2012, 84 percent of infants were being fed completely orally, rather than through a feeding tube, upon discharge, compared to 65 percent in 2009. CHOC’s SBU practices infant-driven feedings, wherein the baby drives her own advancement of nipple feeding – not staff.

• Infection rates: In 2012, 15 percent of infants suffered hospital-borne infections, while 41 percent did in 2009. The SBU attributes this dramatic shift to a team approach, a reduction in central lines and excellent hygiene among staff and families.

• Chronic lung disease rates: In 2012, 27 percent of infants left the unit with chronic lung disease, compared to 45

Emma Faith today.
Emma Faith today.

percent in 2009. This common condition for premature babies can have long-lasting ramifications including re-hospitalization and poor neurodevelopment. Related, in 2012, 11 percent of infants went home from CHOC’s SBU on oxygen support, while 32 percent did in 2009.

• Labs and X-rays: The numbers of labs and X-rays have each been reduced by about half since 2009.

The unit opened in 2010. Though preterm infants were already receiving exceptional care in the NICU, CHOC physicians recognized that increasing medical literature-based efforts could improve outcomes.

Specifically, research indicates that babies with extremely low birth weights (ELBW) could greatly benefit from guideline-driven care provided by dedicated and specially trained staff inside a low-stimulus environment.

Three years later, the SBU is doing just that.

There, patients lie inside shrouded incubators that keep light away from their underdeveloped eyes. Even a whisper is harsh for these babies’ ears, so families and staff members speak in a gentle “library voice.” The goal is to mimic the womb’s environment as closely as possible so that infants can focus on growing.

“We’ve created this really unique place that only a handful of hospitals have,” says Dr. Antoine Soliman, a CHOC neonatologist.

But the space is equally nurturing for the parents of these tiny babies. Here, they find solidarity and support as they bond over an experience most parents cannot understand.

“We grew a bond, and we’re still very close. They are my family,” says Emma Faith’s mother, Eunice, who became close with other parents during her time in the unit. “We understand each other.”

Moving forward, the SBU’s goal is to continue to improve patient outcomes, as well as family and staff satisfaction, while also becoming a destination for the care of extremely preterm infants.

More stories about the Small Baby Unit:

2 thoughts on “Small Baby Unit Outcomes: Big Improvements for the Littlest Patients”

  1. God has truly blessed NICU nurses with a special gift to be able to accomplish these miracles. My granddaughter is living proof.

  2. What a blessing you are to these precious little ones and their families. God bless you for your dedication and compassion.

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