Newborn & Neonatal Care from Optimal Healthcare

Introducing Optimal Newborn & Neonatal Care

Newborn care in Cayman occupies a very special place in our heart (and services). After nurturing new life for hopefully nine months, it deserves nothing less than celebrating and cherishing. Our total focus and commitment is to ensure everything is as special as can be, without any avoidable complications, but with the absolute best of back up for when nature throws in a challenge. Discover how our services seamlessly address both aspects of newborn and neonatal care.

Dr Sara Watkin, Head of Newborn & Neonatal Care at Optimal Healthcare

I have provided routine newborn care in Cayman, as well as neonatal intensive care, for 8 years now. I have been a Consultant Neonatologist for 30 years, including as Chief of NICU for two of the most prestigious UK tertiary maternity centres. I’ve been involved in upwards of 10,000 episodes of newborn care.

Birth should be an occasion of joy. Properly planned, with parental wishes known, and a supportive paediatrician or neonatologist to ensure those wishes happen wherever possible, that’s how it is for the majority of births, evening though complications can happen at any point. I am passionate about ensuring our newborn care in Cayman is optimal, with safety at its heart.

Dr Sara Watkin

Head of Newborn Care & Medical Director, Optimal Healthcare Ltd

Newborn & Neonatal Care Services

We offer a super-comprehensive range of services underpinned by expertise and experience that is genuinely hard to match.  We are as focused on providing newborn care services that ensure your delivery is a special and joyous one, as we are passionate about making sure it’s a safe one too.

Regular Delivery & Newborn Care

We are truly passionate about ensuring our newborn care in Cayman offers a wonderful experience for Mum & Dad, handled with absolute compassion and safety, whilst adopting holistic care approaches and embracing parents wishes and preferences.

Conducting a baby check on a newborn

Attending Deliveries & Doing Baby Checks

Delivery & Hospital

We’re the calm, safe pair of hands on hand to both support but also to step in should a complication arise. Do you need a paediatrician in delivery? All c-section deliveries in Cayman need a paediatrician or neonatologist present, in case of complications. It’s optional for a normal vaginal delivery (but that could become a c-section in delivery itself) but the absolute majority of of parents want that safety net and support. We’ll conduct an immediate newborn assessment, address any immediate care needs and then we’ll conduct baby checks calmly later, but before you leave hospital.

Helping a mum enjoy skin to skin care

Supporting Birth Plans & Wishes

Listening in our DNA

There is a great deal happening at once in delivery and it is easy for a busy birth team to overlook specific wishes, like delayed cord clamping, or providing skin-to-skin immediately after birth. We’ll ensure these are kept to the fore and make sure they are both safe and joyous experiences. You’ll also find Optimal Paediatricians a calming influence always happy to keep you informed of what is going on around you.

Newborn baby being immunised

Newborn Screening & Immunisations

Expert Guidance

There’s a huge amount to think about and decide upon as part of your pregnancy journey. Much of it will be new too. We’ll help you every step of the way in making great choices, based on reliable guidance. We’ll ensure you baby receives its NeoGen newborn screening test at around 24 hours and we’ll guide you through the Cayman Islands Immunisation Schedule as it relates to newborns (we tend to discuss this ahead of delivery).

Early newborn feeding establishment

Early Support & Feeding Establishment

Baby & Mum Friendly

Very few disagree on the importance of breast feeding for the health and wellbeing of your baby. That doesn’t always make it easy, or even always possible. We’ll calmly support your efforts in a manner that recognises every mum, every baby and every circumstance is different. We’re proud supporters of the Baby Friendly Initiative but always in a manner that places mum and baby together as a priority, completely respecting that each scenario is unique (and special).

Newborn & Neonatal Care Challenges

Whereas the majority of pregnancies and births are uncomplicated. However, bringing new human life into the world, starting literally with the joining of just two cells, involves the most extraordinary set of biological process and development, before we consider the myriad of external influences exerting their effects. Inevitably, it does not always go according to plan all of the time for everyone. We truly embrace the joy of this amazing journey, but we’re also all about the best outcome too, with realism, careful planning and diligent care.

Based on 10,458,616 pregnancies in the United States, at least 1 unexpected complication occured in 46% of all pregnancies, with even the low-risk ones having a complication in 29% of pregnancies. With Optimal Healthcare, you get to enjoy your pregnancy knowing that decades of tertiary newborn and neonatal care expertise is behind you every step of the way. We are passionate about taking the worry out of newborn care in Cayman, but with substance, not just words.

Cayman Islands Neonatologist supporting a newborn with breathing difficulties

Newborn Resuscitation & Urgent Care

For Urgent Help

Based on the 10+ million birth study Unexpected complications of low-risk pregnancies in the United States, the rate of birth complications was 57% in high-risk pregnancies. However, what is more important is that in low risk pregnancies it was still 29%, nearly a third of all births, but certain neonatal complications were higher in the low-risk group, presuambly because they were less likely to be planned for and managed. Necessary intervention of a neonatologist in even low risk pregnancies is a possibility and when it is necessary, experience matters, whether its an infant needing a tiny amount of assistance to breath or the requirement for full resuscitation in a more urgent care situation. We always ensure our resuscitation and newborn urgent care skills are fully up-to-date.

Cannulated baby undergoing neonatal intensive care

Neonatal Intensive Care & Emergencies

Full NICU Care

We provide full neonatal intensive care for a wide variety of both term and preterm complications. In the UK, USA and most other similar systems, care in NICU is conducted by a dedicated, specifically accredited Neonatologist, a paediatrician with a far more in-depth training in this area. As an example, Dr Sara Watkin has 30 years of tertiary experience post-specialisation as a neonatologist, including use of advanced techniques such as therapeutic hypothermia (cooling) for birth asphyxia, or use of nitric oxide for hypoxemic respiratory failure (HRF) associated with persistent pulmonary hypertension of the newborn (PPHN). You don’t need to understand these, only that we do, with decades of experience in them. When these are needed, experience really matters, including the experience of when not to use them too.

Preterm infant needing support

Preterm (Premature) Delivery & Care

Care from 23 Weeks

In the UK, around 1 in every 13 babies (around 7.6% based on data published in 2021) will be born prematurely and the number is increasing. This figure is 8.7% when looking at data from the black ethnic group. Although data from the Cayman Islands is sparse, from our own practise we know that rates are at least similar. Whereas some preterm births come with notice, many do not and it is a reason we advocate not leaving your choice of newborn paediatrician to the last moment). Even moderately preterm infants (born between 32 and 37 weeks gestation) have an increased rate of breathing difficulties, more problems feeding, and more developmental problems. It’s important that all preterm infants get the right care, whether it’s what we used to call ‘special care’ or full on intensive case. Our team is led by Dr Sara Watkin, who has 30 years experience of caring for preterm infants from 23 weeks onwards.

Intubated baby with RDS

Respiratory Distress Syndrome & Ventilation

Breathing Problems

Respiratory Distress Syndrome (RDS) is a relatively common breathing disorder that occurs most frequently in preterm infants but can also occur in term babies too. In RDS, a baby is not getting sufficient oxygen to its tissues and organs, and thus frequently needs an urgent treatment called surfactant replacement therapy and then support with breathing. That support can require the use of a range of specialist equipment, including ventilation or nasal continuous positive airways pressure. We have this equipment in Cayman and we hold decades of experience in its use. Our focus is on managing this condition in an expert manner to reduce the chances of developing longer term lung complications.

Baby with jaundice undergoing phototherapy

Jaundice & Phototherapy

A Common Issue

Jaundice in newborn babies (neonatal jaundice) is common and something we see frequently here in Cayman. It causes a distinct yellowing of the skin and the whites of the eyes, although the skin changes can be more difficult to see in brown or black skin. We are expert in diagnosing jaundice and check for it specifically at around 72 hours of age, but it can occur later too and we always make sure our mums know just what to look for. Most will clear up without too much input from your paediatrician but where it does need treatment, that treatment is both important and fairly urgent, requiring re-admittance of your baby to NICU for something called phototherapy. We will manage all of this for you.

Baby with a newborn infection or allergic condition

Newborn Infections & Sepsis

Speed & Experience

This is another area of care where experience matters, espcially in recognising the signs of infection early. Delays in recognising a baby is not well, leading to treatment delays, can lead to more serious complications, including sepsis, which may be life-threatening. Your baby has a rapidly developing immune system but it’s also facing exposure to many bacteria and other pathogens that it has been protected from in utero, including bacteria like Group B Streptococcus commonly found in the birth canal. We take great care to assess any risk factors for a newborn infection, so that we can minimise risks ahead of birth and manage the approriate use of antibiotics and follow up afterwards too, where necessary. If this is an area that you wish to explore further, we recommend reading the excellent guide from our colleagues in Cambridge UK on Infection in Newborn Babies.

Baby receiving care in NICU

Seizures & Encephalopathy

Cause & Care

Neonatal seizures are sudden, abnormal electrical activities in a newborn’s brain, causing jerking or twitching movements, and are the result of a lack of oxygen and blood to the brain, called hypoxic ischemic encephalopathy (HIE). These are rare but can be extremely frightening to parents, and indeed to paediatricians not used to treating them too. Expert care, rapidly delivered, is crucial because seizures can indicate underlying problems that need immediate treatment to prevent brain damage and other complications. That’s especially important in Cayman, because tackling issues early can help prevent needing to transfer infacts overseas. We hold a particular expertise in this area, with Medical Director and Consultant Neonatologist, Dr Sara Watkin, having been NICU Chief of Service in one of the foremost UK centre’s for prevention and treatment of newborn brain injury – UCLH London – also one of the leading NICU’s for introducing therapeutic hypothermia or cooling.

Baby with microcephaly held by parent

Congenital & Genetic Conditions

Complex Issues

Congenital and genetic conditions, frequently referred to as birth defects and congenital abnormalities, are health issues present at birth, caused by abnormal development or inherited genetic factors. These conditions can range from physical anomalies to metabolic disorders. We try to diagnose or identify them before birth through prenatal screening, newborn exams, and genetic testing. Early detection is crucial for managing these conditions effectively. Expert management includes a multidisciplinary approach, involving paediatricians, geneticists, and specialists to develop a tailored care plan. Unfortunately, it isn’t always possible and some insurance plans don’t support the necessary tests, leaving parents to self pay if they can, or a degree of uncertainty if they can’t. With around 1 congenital abnormality for every 45 births, they are not overly rare but there is huge variation across conditions. Treatments can involve medications, surgeries, therapies, and ongoing monitoring. Support and counseling for families is also essential. These conditions are almost always complex, and the Optimal Healthcare approach is to comprehensively  help parents navigate medical, emotional, and practical challenges, including supporting off-Island referrals and management of infants back into Cayman life as early as feasible.

Proud of our Heritage in Caring for Newborn Brains

Our brains are the life-long super-computer that drives or coordinates almost every aspect of our successful existence. We are passionate about newborn neuroprotection and deeply proud of our focus in this aspect of newborn care.

Baby undergoing therapeutic hypothermia for hypoxic injury

Birth Asphxia

Birth asphyxia is a highly serious and potentially life-threatening condition that occurs when a newborn baby doesn’t receive an adequate supply of oxygen before, during, or immediately after birth. This lack of oxygen can lead to severe and irreversible damage to the baby’s vital organs, particularly the brain, and can result in long-term developmental issues or even death if not promptly addressed. Birth asphyxia demands immediate medical intervention to ensure the newborn’s survival and minimize the risk of long-term complications, making it a critical concern in neonatal care.

Dr Sara Watkin, our Head of Newborn & Neonatal Care, has significant experience of managing birth asphyxia, including head & body cooling as an intervention as former NICU Chief of Service at UCLH, which is famous for this. Her former colleague Professor Nicole Robertson discusses UCLH work on cooling:

More information on Hypoxic Injury

Bliss, a UK charity for babies born premature or sick, has an excellent parent guide to Hypoxic-ischaemic encephalopathy (HIE)

Meet our Newborn & Neonatal Care Team

Dr Sara Watkin

Dr Sara Watkin

MB ChB, MRCP (paeds), FRCPCH, MD

Paediatrician and Neonatologist
Consultant Paediatrician and Neonatologist with over 30 years’ experience.

Antenatal Appointment to Discuss us for Newborn Care

We’d be delighted to support your precious journey from a newborn, neonatal and paediatric perspective. Complete the form below to arrange to meet us, completely without charge, expectation or obligation.

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