Historical Perspectives: Perinatal Profile: Bill Kitchen and Very Low-birthweight Infants

Lex W. Doyle

doi:10.1542/neo.10-12-e587

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Introduction

Bill Kitchen (Fig. 1) was born in Sydney, Australia, in 1926; went to school at Scotch College in Melbourne from 1938 to 1942; and received his medical education at the University of Melbourne, graduating in 1949 with First Class Honors in Obstetrics and Gynecology. He subsequently trained in pediatrics at the Royal Children's Hospital in Melbourne, obtaining both his MD and MRACP in 1954. After various positions, including a stint in private pediatric practice, Bill was appointed to the position of First Assistant in Neonatal Pediatrics at the Royal Women's Hospital and the University of Melbourne in 1965, replacing Kate Campbell, who had been the first ever pediatrician appointed to the Royal Women's Hospital. Prior to Kate Campbell's appointment in the 1940s, all pediatric care in the Royal Women's Hospital, from its founding in 1856, had been the responsibility of the obstetric staff.

Figure 1.

Dr Bill Kitchen in 2005.

The Introduction of Neonatal Intensive Care

In late 1965, “neonatal intensive care” was introduced to the Royal Women's Hospital. Bill was concerned that any new treatments or changes in neonatal care needed to be evaluated thoroughly, including consideration of the health of any survivors long after they were discharged from the hospital. Consequently, he initiated a trial of “neonatal intensive care” in infants whose birthweights were 1,000 to 1,500 g (infants whose birthweights were <1,000 g were considered “previable” at that time; although a few did manage to survive, they were not included in the trial). (1)(2) Eligible infants admitted to the nursery were allocated to either intensive care or routine care. The first baby's treatment was decided by the toss of a coin, and subsequent babies were allocated alternately to either routine care or intensive care. Babies who had major malformations or hydrops fetalis, who required surgery, or who were not breathing regularly were excluded. …