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Since its inception July 1966, the Fetus and Newborn Committee has contributed to fetal and newborn health as the advisory committee of the Canadian Paediatric Society (CPS). Many society members have contributed effectively over the past 32 years, along with other liaison members and organizations.
In addition to five regular committee members appointed by the CPS Board, a member of the CPS Board of Directors is a committee member and provides liaison with the Board. Over the years, we have established effective liaisons with a number of organizations that support a representative on the committee. These include the American Academy of Pediatrics (AAP) Committee on Fetus and Newborn, the Society of Obstetricians and Gynecologists of Canada (SOGC) Maternal-Fetal Medicine Committee, Health Canada, National Association of Neonatal Nurses, CPS Section on Neonatal-Perinatal Medicine and the College of Family Physicians of Canada (CFPC). Often activities are coordinated with other CPS committees, either through input or through the production of joint guidelines and practice points. The Fetus and Newborn Committee works within the CPS; all activities and publications must be approved by the CPS Board of Directors.
A major goal of the committee and the CPS has been to influence policy and practice related to the fetus and the newborn. Efforts have ranged from “Management of the woman with threatened birth of an extremely low gestational infant” (produced in association with SOGC ) to “Retinopathy of prematurity: Recommendations for screening” (page 197) (in association with the Canadian Association of Pediatric Ophthalmologists). While these guidelines relate primarily to high risk neonates, guidelines for “Routine administration of vitamin K to newborns” (2) and “Approach to management of hyperbilirubinemia in healthy term infants” relate to normal newborn care. Statements were orginally published in the Canadian Medical Assocation Journal and are now published in Paediatrics & Child Health as they are completed. Guidelines and practice points are regularly reviewed, and revised or discarded. Through the years, two additional concepts have developed. The first is the use of expertise in other organizations through joint statements with the SOGC, AAP and CFPC. Secondly, as with other CPS guidelines and practice points, an increasing effort has been made to have the technical documents presented in a manner that might be better understood by parents and the public. Where relevant, each new guideline is accompanied by a one-page information sheet for parents, which is posted on the CPS website.
Although writing CPS guidelines and practice points is perhaps the most visible activity of the Fetus and Newborn Committee, there has always been a considerable amount of ‘behind the scenes’ work related to answering questions and addressing concerns of both health care professionals and the public. In some cases, these have stimulated production of a CPS statement or have helped promote specialized conferences with subsequent publication of proceedings such as Optimizing the Neonatal Intensive Care Environment, the 10th Canadian Ross Conference in Pediatrics (3). In addition to representation by the Chair of the CPS Fetus and Newborn Committee on SOGC Maternal-Fetal Medicine Committee and the AAP Committee on Fetus and Newborn, committee members have represented the CPS on other national committees, such as Canadian Perinatal Surveillance System Steering Committee, and at conferences such as 1998 Preterm Birth Prevention Consensus Conference. There has been an opportunity for CPS Fetus and Newborn Committee contributions to the AAP/American College of Obstetricians and Gynecologists 1997 Guidelines for Perinatal Care (4) as well as the Canadian Guidelines for Family Centred Maternal and Newborn Care to be published in 1998. The report from the Committee published at the time of the annual meeting provides more details of the committee’s current activities.
Commitee members endeavour to communicate with physicians and other health care professionals caring for babies in Canada. Members are selected by the Board for their anticipated expertise in dealing with issues that will be presented to the committee. Recognizing the need for a forum for others to express their opinion, the former chair of the CPS Fetus and Newborn Committee, Dr Alec Allen, was instrumental in helping to establish the CPS Section on Neonatal-Perinatal Medicine in 1990. The President-Elect of the Section serves as a liaison member of the CPS Fetus and Newborn Committee, and the Chair of the CPS Fetus and Newborn Committee is a liaison member of the Executive of the CPS Section on Neonatal-Perinatal Medicine. The importance and support of the activities of the Fetus and Newborn Committee is indicated by the strong response to a 1997 letter of request for expression of interest in potential membership on the Fetus and Newborn Committee.
Despite past successes, more needs to be done. Problems of a social as well as health care nature remain, and the CPS needs to address issues related to fetal and newborn care effectively on an ongoing basis. As I complete my term as committee chair in 1999, I appreciate the many fine people with whom I have worked (committee members and many others), and recognize that many others before me initiated processes and made important contributions to the care of Canadian children. Members of the CPS and related organizations will undoubtedly build upon past and present successes to make things even better for the future.