Meet Dr. Sevini Shahbaz Hallaian, a neonatologist who joined Cedars-Sinai in the middle of the COVID-19 pandemic. Working in the neonatal intensive care unit (NICU), Dr. Shahbaz Hallaian sees some of the most vulnerable patients who ever enter a hospital. We talked to her about what it's like to work with newborns at risk, the best thing about Cedars-Sinai and why her puppy is setting a good example for everyone.

Dr. Sevini Shahbaz Hallaian: After finishing a residency in pediatrics, neonatologists go on to complete a three-year fellowship in Neonatal-Perinatal Medicine, where we focus on helping newborns who are premature or facing especially high-risk situations. We work only in the NICU, where we're responsible for diagnosing the baby and making decisions about the treatment plan. We'll order tests and medications, perform procedures and manage the unique needs of each child.

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SSH: I work closely with neonatal nurses and the rest of the dedicated team, which can include all types of care providers, from respiratory therapists to lactation specialists. We always work as a team to make sure baby gets the best possible care.

Premature birth is one of the most common reasons a newborn ends up with us, but I see many higher-risk situations—congenital heart disease, brain malformations such as myelomeningocele, septic shock and respiratory distress requiring mechanical ventilation. Some of the procedures I perform are endotracheal intubation, central line placement, thoracentesis and chest tube placement.

If we know the baby will be born with a medical issue requiring prompt attention, I will work with the parents already during prenatal consultations. In those cases, we are prepared ahead of time. More often, the challenges faced by newborns are unexpected, and we have to act quickly to make sure they're stable as we determine next steps. Having a seamless, well-coordinated team can make all the difference.

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SSH: Newborn babies are not just smaller children, let alone smaller adults. If babies are born before their bodies are totally ready, major organs like the heart, lungs, stomach and skin might not be developed enough to work properly without a bit of help.

There are special challenges in working with such tiny, vulnerable people, such as using a mechanical ventilator on a child who may weigh less than 2 pounds. The years of training we get is what allows us to manage such complex, sensitive situations.

SSH: Knowing that I am saving a newborn's life, or sparing them pain that they can't fully express or explain to me, is a profound experience. You're making a difference for someone who has such limited ways of letting you know what's going on with them. It's also a time of great worry for the parents, and helping them through what can be the toughest days of their lives is very meaningful.

I sometimes form lasting relationships with families. Parents will come visit with their child years after, sometimes to introduce the little one to the doctors who saved their life, and sometimes just to say hi and let me know they are thriving. During the COVID-19 pandemic, parents can't bring their child in for a visit, but I've been getting many photos and even joined a few Zoom birthday parties!

The enduring bond with families is one of the most special things about working in neonatology. That's especially true at Cedars-Sinai because we have such a diverse population. I meet families from every imaginable walk of life. Along with my colleagues, that's the best part of being at the medical center.

SSH: Cedars-Sinai has rigorous policies in place to ensure safety. If mom tests positive for the coronavirus, we test the baby if they need to be admitted to the NICU, but to date we haven't had any newborns test positive. We haven't seen a case where the virus was transmitted to the newborn while staying with us, either.

Unfortunately, we do get moms who are very sick with COVID-19, enough to be intubated or in the ICU. In those cases, the OB-GYN team sometimes plans a premature birth via cesarean section. That way, the mother can get the care she needs while we also protect the baby.

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SSH: Sadly, that's been a growing problem in recent years. When the mother is addicted to an opiate, such as heroin, fentanyl or painkillers, a fetus can become dependent on the drug and go through neonatal abstinence syndrome when they're born. We have an effective protocol for that, which includes slowly weaning the newborn off, making sure there's little to no discomfort in the process.

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SSH: This year, my husband gave me a piano for my birthday. He knew that playing the piano had been one of my great joys in high school, but I didn't have time to play during medical school, my residency and my fellowship. His gift encouraged me to get back to it. I love playing Bach and Beethoven as well as themes from movies!

We also got an adorable puppy that bring us so much a joy. Sadie is an apricot mini goldendoodle. It's so fun to train her, play with her and take her on walks. And she is setting a good example for everyone—because she's got all her shots!