At 12 weeks, we see some clearing. Baby is finally off assisted ventilation. The heart is still pretty big, but there is still a lot of lung disease there. So this is what it looks like when you're 12 weeks old, and you used to be a 24-weeker. Even through you are not on the ventilator, you still have problems.

And I am going to stop there, because it's time to stop. So I hope you enjoyed this. I hope when you see the babies in the ICN with RDS, you will understand that it is more than lung disease, but it is certainly a lot better than it used to be.

Thank you.

Question : We are concerned about antenatal steroids, and I know that now you are using them postnatally, and I was wondering if you used them in your nursery, and if you do, then are there conerns?

Well that's a good question. Probably about 10-12 years ago, neonatologists went nuts with steroids because we found that these kids who have severe BPD and we couldn't get them off the ventilator, if we gave them some dexamethasone, within two or three days, they came off the ventilator. Everybody went crazy, and everybody got steroids. However, randomized controlled trials looking at babies' outcomes who got steroids and who didn't get steroids, showed extremely strong indications that the kids who got steroids postnatally had smaller head circumferences, had higher incidences of cerebral palsy and other kinds of CNS problems. They also had poor growth. They had higher incidence of hypertension. They had hyperglycemia from the steroids. So it wasn't the panacea that we thought. So the way it is now, in fact the American Academy came out about 18 months ago with a consensus statement which is that we will only use postnatal steroids if the infant is facing death on the ventilator. So, in our nursery, we have probably used it 2-3 times in the last year, average guess, on the smallest, most impossibly sick babies. And we meet with the parents first, we explain to them the risks. They have the right to refuse. Most of them don't because they are so tired of seeing their kid on a ventilator, that they just say "get this kid off". But we explain to them that it will carry the possibility of an increased risk of developmental problems down the road. So that has gone by the boards, it is not practiced any more at all.