End of life (EOL) care is an emerging concept in Perinatology and has increasingly come into focus in Singapore as in many developed nations where babies born at the limits of viability, those with genetic conditions or potentially lethal malformations are surviving and where death may or may not be imminent but inevitable.

Clinicians and the wider care teams were encountering difficulties at their respective workplaces with decision making decisions around such scenarios and it was agreed that some training and education in emerging concepts around EOL care in Perinatology would be useful to ‘sow the seeds‘ of learning in our community and for people to become more embracing on palliation as a viable & acceptable option.

Lien Centre for Palliative Care (LCPC) was approached and agreed to support this initiative and a workgroup headed by Senior Neonatologist, Prof Roy Joseph from National University Hospital and chair of the National Ethics Committee and comprising of representatives from the 3 restructured NICUs and Star PALS was convened.

The group over a 12-month period has finalized a guideline entitled "Guidance on Supportive and Comfort Care in Vulnerable Babies". This document has been endorsed by The College of Paediatrics & Child Health, Singapore, The Perinatal Society of Singapore and Chapter of Neonatologists.

The guidance is divided into 2 sections. Section I describes the complex needs of vulnerable babies and the scope which supportive and comfort care covers. Section II is targeted at healthcare professionals managing vulnerable babies, with the goal of equipping them the knowledge and skills required to provide supportive and comfort care.

Download Guidance on Supportive and Comfort Care in Vulnerable Babies.

Symposium 8 @ SiPPAC 2018: Care of the Vulnerable Baby

The Guidance was officially launched at the 7th Singapore Paediatric and Perinatal Annual Congress (SiPPAC) on 28 July 2018.

The programme for the session included a brief glimpse into the journey over the past 24 months that has led to the creation of the guideline, an interactive forum whereby senior clinicians and nurses discussed how best to implement the guideline on the ground, and a talk by visiting speaker Prof. Neena Modi, immediate past-president of The Royal College of Paediatrics and Child Health UK (author of similar guidance in the UK), who shared with the audience her experience with the guideline formulation and dissemination across the UK.