Preemie Doctors: The Role of Neonatologists

The Doctors Who Specialize in Treating Premature or High-Risk Newborns

premature babys hand in doctors
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When your preemie baby was born, you may have been introduced to a neonatologist, a pediatrician with additional training in treating newborn babies that need special care. Doctors working in the neonatal intensive care unit focus on babies four weeks or younger. What makes neonatoligists special is they are able to evaluate, stabilize, and treat infants who require medical intervention, including premature babies, babies who need breathing aid at birth, and babies born with life-threatening medical conditions.

Neonatologists typically work in hospitals, regional NICUs, or special care nurseries.

A Day in the Life of a Neonatologist

Neonatologists practice what is known as neonatal-perinatal medicine. Doctors caring for neonates average 60 hours of work per week and are generally the ones charged with counseling the family of a premature baby about his or her care by keeping them updated on the child's condition and sharing predictions about care moving forward.

Neonatologists also direct nurses and other medical staff according to the condition of the child and directs treatment accordingly. In addition to leading the neonatal staff, neonatologists are also responsible for surgeries or emergency care for critically ill infants. The intense pressure surrounding preemie care can be very stressful.

Neonatologists are charged with determining the viability and timing of when a premature baby is ready to go home.

Some of the things they look for in a baby is the ability to maintain their body temperature, the ability to suck, swallow and breathe while taking finishing an adequate feed, a consistent pattern of and maintenance of weight gain, demonstrated stability of heart and lung function, and freedom of the need for oxygen or supplemental breathing before discharge.

Number of Neonatologists in the US

There are 40% more neonatologists in the U.S. than in Australia despite the higher level of at-risk babies there. Some say the amount of neonatologists is unnecessary, but studies show experienced neonatologists do have better outcomes with preemies. Demand for neonatologists is high. In some areas, parents have to wait for months to be seen by a neonatologist, or have to be moved to a hospital far from their homes to find one.

Job Outlook for Neonatologists

Generally-speaking, neonatologists attend 4 years in medical school, a 3-year residency in general pediatrics, and spend an additional 3 years training in the NICU. A report by "Modern Healthcare" a salary range of $160,000 to $480,000 a year for experienced neonatologists with between $250,000 and $290,000 the median pay. The Bureau of Labor Statistics estimates demand for neonatologists will grow by 245 between 2010 and 2020, faster than the national average of all occupations combined. 

Neonatology Today reports great benefits for neonatologists as well including 6.6 weeks of vacation and employer paid healthcare.


Neonatology is a specialized field of medicine that requires over 14 years of education and experience as well as certification to practice.

The "echo boom" of women in child-bearing years is increasing the need for these highly skilled physicians.


Jeffrey H. Silber, Scott A. Lorch, Paul R. Rosenbaum, Barbara Medoff-Cooper, Susan Bakewell-Sachs, Andrea Millman, Lanyu Mi, Orit Even-Shoshan and Gabriel J. Escobar. Time to Send the Preemie Home? Additional Maturity at Discharge and Subsequent Health Care Costs and Outcomes. Health Services Research. 2009 Apr; 44(2 Pt 1): 444–463.

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