HSA achieves neonatal milestone with first therapeutic hypothermia treatment for newborn

Baby Ella became the first newborn in the Cayman Islands to receive full therapeutic hypothermia treatment for hypoxic ischaemic encephalopathy (HIE) at the Health Services Authority’s (HSA) Neonatal Intensive Care Unit (NICU). This marks a significant advancement in local neonatal care, bringing comfort to expectant parents who can now access this important treatment on-island.s

HIE is a condition that may result in brain injury due to a lack of oxygenated blood around the time of birth, affecting approximately 1.5 per 1,000 live births in developed countries. Previously, babies born with moderate HIE in the Cayman Islands were airlifted to Miami, Florida, for treatment. Now, with the introduction of this treatment locally, parents can remain on the island, reducing the emotional and financial strain of overseas transfers.

The complex and well-coordinated efforts led by HSA’s newly appointed Consultant Neonatologist, Dr. Robert Bomont, included airlifting Baby Ella from Faith Hospital in Cayman Brac, where she was born, to the George Town Hospital for time-sensitive treatment. Dr. Bomont, the first neonatologist directly employed by HSA, expressed the significance of this milestone: “Having the ability to offer such specialised care on the island ensures that families can remain together during critical moments. It also allows us to provide the very highest quality, evidence-based neonatal care.”

For parents Lyzle and Lee, the expertise of Dr. Bomont and the NICU team proved to be significant factors in their daughter’s recovery. “We are so thankful that they have facilities to treat and care for this kind of situation. I am thankful and so blessed. Thanks to all those who helped us and the doctors who are well-trained to deal with these types of situations,” expressed Lyzle.

As part of her ongoing intensive care, Baby Ella underwent therapeutic hypothermia, also known as total body cooling. This treatment helps prevent ongoing brain injury by lowering the baby’s core body temperature to between 33 and 34 degrees Celsius for 72 hours. The process involves the use of a specialist cooling blanket that adjusts to small changes in the baby’s temperature and requires intensive nursing and medical oversight. Not expecting the diagnosis they received, Baby Ella’s father, Lee, recounted the relief he felt after interacting with the medical team:  “We were kind of scared at first, but we knew she was in good hands with Dr Bomont. He was very good and explained everything thoroughly. If we had any questions, he was there to answer and explain,” he said.

Following round-the-clock care by the NICU team, Baby Ella is now on a clear path to recovery. “Feeding is a complex action requiring the coordination of many muscle groups and reflexes. Being able to fully feed was her first big milestone achieved. Signs are positive that she will make a full recovery, but she will undergo close follow-up by the HSA’s Paediatric, Occupational Therapy, and Physiotherapy teams both on the Brac and on Grand Cayman,” noted Dr. Bomont.

At a recent check-up, Dr Bomont indicated that Baby Ella’s development remains normal and on track. “We are pleased with her ongoing progress. She is achieving her developmental milestones on time, and she continues to delight her parents with each new skill,” he expressed.

HSA’s Medical Director Dr. Delroy Jefferson emphasised that the Level 3 NICU facility and staff “affirms the HSA’s continued commitment to deliver the highest standard of neonatal care. The care extended to Baby Ella is a visible demonstration of our efforts to provide a safe and equipped space for newborns with complications. Indeed, we are thankful for the professionalism and the humanity demonstrated by our team in these instances”.

Dr. Bomont also expressed pride in his team’s collective efforts. “Anaesthetist Dr. Rebecca Mawer and her team at Faith Hospital provided initial resuscitation and stabilisation as Baby Ella needed extra help with her breathing and heartbeat immediately. This transitioned to Consultant Paediatrician Dr. Chela Lamsee-Ebanks and I undertaking the helicopter retrieval to provide intensive care at the NICU here in Grand Cayman. It is truly a team effort of many, including EMS and RCIPS Air Operations to ensure this life-saving continuity of care.”

Thanks to the dedication of the medical team, Baby Ella is continuing to show signs of improvement. While some babies with complex needs will still require transfer off-island, Dr. Bomont noted that this advancement means fewer babies will need to be airlifted to the U.S., allowing more families to stay together during challenging times.

Dr. Bomont, who trained in neonatology in the United Kingdom, added that while general paediatricians receive training in newborn care, neonatologists undergo additional years of specialised training to manage babies with more complex needs. “We look after babies from the very earliest gestations,” he explained. “For babies born at 27 or 28 weeks, we have the skills and equipment to provide care on the island. For those born early in Cayman, we deliver their initial care with plans to transfer to larger centres like Miami if necessary. Our NICU is also equipped to care for full-term babies who unexpectedly require significant care after birth.”

In recent years, HSA has been steadily updating its neonatal equipment to better serve newborns with complications. The NICU now has specialised neonatal ventilators designed for the smallest babies, the latest generation of LED phototherapy lights for treating jaundice, and cooling blankets for babies who have experienced oxygen deprivation at birth.

Dr. Bomont completed his undergraduate medical training at the University of Edinburgh, followed by postgraduate training in Paediatrics and sub-specialty training in Neonatology in the Oxford, Leicester, and Cambridge Deaneries in the United Kingdom. He served as a consultant neonatologist and joint lead clinician in a tertiary-level medical and surgical neonatal unit in Brighton, UK. There he cared for newborns of all gestations.