What is neonatal surgery?

A surgeon’s introduction to Parent’s experiences of neonatal surgery

Being told that your baby will need surgery can be a frightening and worrying experience for parents. We spoke to a paediatric surgeon, Anna-May Long, to find out more about the range of conditions that could mean a baby might need surgery, how those conditions might be diagnosed and what parents might expect in hospital. We haven’t covered heart defects in this website, as we hope to cover it in another website at some point.

Anna explains that this website is about parent’s experiences of having a baby who needs surgery. These conditions are rare, and we felt it was important to hear ParentsÕ experiences.

The conditions that require surgery early in life represent a real spectrum from those that are relatively minor to some more major, complex conditions. Some conditions are detected during pregnancy, by routine scans, others are not obvious until after the baby has been born, or develop in the early weeks. Here Anna explains the main conditions.

Anna explains two conditions that can be picked up on a routine scan in pregnancy, exomphalos and gastroschisis.

Another condition that is often picked up in the womb is congenital diagphragmatic hernia, or CDH.

Hirschsprung’s disease is one of the conditions that are often only picked up after the baby has been born, when they start to feed and develop.

There is another range of conditions that can affect the baby after birth, and can present quite suddenly. These include a condition that affects premature babies in particular, necrotising enterocolitis or NEC, which is an inflammation and infection of the gut. Another is a condition called atresia which is a blockage somewhere in the bowels. Finally hernias in the groin, which can usually develop after birth and generally require only a minor operation to correct.

Anna explains a condition called necrotising enterocolitis (NEC), which can develop after a baby has been born.

Anna explains a condition called atresia, a blockage in the bowel.

Anna explains what a hernia in the groin is, and why it is important to operate on them.

Some conditions are detectable during pregnancy scans, and parents will be told by clinicians their baby has a condition that will need surgery after birth. Parents will meet with a range of health professionals to discuss the diagnosis, and plan the birth.

Some conditions can be diagnosed during pregnancy. Here Anna describes how an antenatal diagnosis is made.

Parents will discuss with health professionals plans for where, how and when the baby will be delivered.

Some conditions aren’t detectable until after the baby has been born, or develop after birth.

Anna describes how a diagnosis might be made after the baby has been born.

Babies who have complications that mean they need surgery will be cared for by specialist staff. Often babies need to be transferred to a specialist hospital after birth. There will be a number of teams involved.

Babies needing surgery are often transferred to a specialist centre and a number of teams will be involved in their care over time.

There is a very wide spectrum of procedures and operations that babies with these conditions might need. Anna gives us a general picture of what happens to the baby before and after surgery.

It is not always clear what the progress of the baby will be after their operation. The conditions vary, and while sometimes surgeons will have a good idea about the operation they plan to do, in other situations they will only know exactly what they have to do once they have started operating. There is unfortunately uncertainty at every stage for parents.

Anna explains that having a baby that needs surgical treatment can be a time of great uncertainty for parents.

In the rest of this resource you can hear parents’ voices, sharing their experiences of the neonatal surgery journey they have travelled with their babies. We hope you find it helpful and answers some of the questions you might have.