The Problem Baby: Too Much Information

The medical care of acutely ill neonates has become increasingly complex. Advances in virtually every basic science discipline have refined our understanding of the basic physiology underpinning the ever more complex therapy. This is especially true of breakthroughs in the subtleties of brain development, genetic and metabolic disease, epigenetic influences on fetal and early childhood organ maturation, pulmonary physiology, and the gastrointestinal tract, including nutrition, to name a few.

The medical literature has mushroomed beyond the capability of even the most avid reader to fully master. A search for the term newborn or neonate in PubMed yielded 378,177 citations, and a similar search in Google Scholar (the academic subset of the massive search engine) resulted in 411,000+ citations for neonate and 1,580,000+ hits for newborn. Even a limited topic such as neonatal necrotizing enterocolitis produced over 2800 PubMed responses. The most useful reference textbooks on Neonatology exceed 1500 pages written in the ever more technical language of neonatologese.

The authors of the articles in this issue were challenged to distill the vast amount of information to a subset of practical and useful concepts to assist the primary care provider. They bring over 300 years of combined experience in caring for critically ill newborns. In addition, they have authored over 1000 peer-reviewed publications, trained more than 3000 pediatricians, and have been mentors to at least 400 neonatal-perinatal fellows.

I thank the authors and their colleagues for their willingness to devote time from their hectic schedules to share their insights and experience in order to provide a handy, quick reference to the many “front-line” physicians evaluating neonates.

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