Patient clinical services

  • Babies and infants admitted to Butterfly - Newborn Intensive Care have a wide range of complex medical and surgical problems. These include severe respiratory failure particularly that associated with:

    • Cystic chronic lung disease and/or pulmonary hypertension, 
    • Congenital diaphragmatic hernia
    • Tracheo-oesophageal fistula and oesophageal atresia,
    • Pierre Robin Sequence
    • Gastroschisis and exomphalos
    • Necrotising enterocolitis
    • Premature babies with cardiac anomalies
    • Hypoxic ischaemiac encephalopathy
    • Complex seizure disorders
    • Bronchiolitis  
    • Meningitis  
    • Complex genetic and metabolic conditions

    Our team

    The management of our babies is overseen by a team of neonatologists, neonatal nurses and Allied Health specialists. The care of many of our babies also involves extensive cooperation with RCH surgical teams including:

    Sub-specialist paediatric teams are also involved, including:

    Particularly complex and/or long term patients are appointed a care manager to coordinate their care.

    Many of the babies in Butterfly - Newborn Intensive Care make use of the range of diagnostic services provided by the RCH. These include MRI, CT, digital angiography, fluoroscopy, endoscopy, bronchoscopy, laryngoscopy, electro-encephalography, echocardiography, complex metabolic and laboratory tests and cardiac catheterisation, many of which are unavailable at other hospitals.

    Respiratory support

    Butterfly - Newborn Intensive Care has the capacity to ventilate up to 14 babies. High Frequency Oscillatory Ventilation (HFOV) is a highly sophisticated form of artificial ventilation in which very sick babies are ventilated at rates of up to 900 breaths per minute.

    We were the first neonatal intensive care unit in Australia to introduce this technology in 1992; the result of a careful and strategic research and training programme. We now hold an annual training course for other HFOV users in Australia and New Zealand.

    We were the first neonatal intensive care unit in the country to use High Frequency Jet Ventilation (HFJV). This technology can be life saving for babies with the more severe forms of lung disease such as severe congenital diaphragmatic hernia, cystic chronic lung disease and other conditions with significant gas trapping.

    Vein of Galen Malformation

    Together with our interventional radiology colleagues at The Royal Melbourne Hospital we have led the way in the management of a rare form of cerebral aneurysm called Vein of Galen Malformation. Thus we have been able to improve survival and neuro-developmental outcomes to many babies who would otherwise have died or suffered severe brain injury.

    Mandibular Distraction 

    Our maxillofacial surgeons are performing jaw lengthening operations (mandibular distraction) for babies born with airway obstruction due to a small jaw (Pierre Robin Sequence). This surgery has produced stunningly successful outcomes and revolutionised the care of this condition. In Australia this operation is performed only at The Royal Children's Hospital.

    Neurology and the neonate

    Together with our Neurology colleagues, we are developing and investigating the role of advanced MRI techniques in the management of our sickest babies. Our understanding of MRI findings allows us to better predict neuro-developmental outcome in congenital brain abnormalities and acquired brain injury.

    We are also using amplitude-integrated Electro-Encephalography (EEG) as an assessment tool in patients with suspected seizures and as a research tool.


    Our nursing staff have pioneered research into the prevention and management of pain in babies; and have developed tools (Pain Assessment Tool) and interventions which are now being used in many other hospitals.

    Specialist clinics

    Once discharged from Butterfly - Newborn Intensive Care, babies are followed up by either their general practitioner, paediatrician or neonatologist. RCH neonatologists see their patients in the RCH Specialist Clinics (Outpatients), and appointments are arranged prior to discharge.