High Risk Infant Follow-Up Program

The regional High Risk Infant Follow-Up (HRIF) Program at Valley Children’s Hospital assesses the developmental, medical, nutritional, and psychosocial needs of infants born prematurely or who have been hospitalized in a neonatal intensive care unit (NICU).

Our HRIF program is an extension of our NICU and integrates seamlessly with the Hospital’s more than 40 pediatric subspecialties to make sure premature newborns receive the best treatment possible. HRIF sees about 800 patients annually and serves a seven-county area, including Fresno, Madera, Merced and Tulare counties. A number of local hospitals and community providers depend on our program to provide the necessary developmental follow-up care high-risk neonates require.

Medically compromised newborns often are at risk for delays in growth, speech, motor, and cognitive development. Early intervention is important to reduce the effects of potential health and developmental issues. Our specialized staff has extensive experience identifying and managing these children’s ongoing needs to help them catch up with their full-term peers.

This monitoring, along with regular visits to the pediatrician, helps prevent long-term problems and provides caregivers vital information to enhance a child’s growth and development. If a developmental delay is detected, a referral is made to the appropriate agencies. If a health problem is detected, the team educates the family on how to seek care as well as notifies the primary care physician of concerns.

Services Offered and Conditions Treated

HRIF services begin shortly after discharge and continue up to 3 years of age. Children are seen for three visits: at approximately 4-6 months adjusted age, 12 months adjusted age, and 24 months chronological age. (The adjusted age is the age the baby would be if they had not been born early.)

Entry into the HRIF program is available to infants who meet specific criteria established by California Children’s Services (CCS) and/or who are at-risk for developmental delays and referred by a primary care provider.

Services Include:

  • Comprehensive history and physical exam with a neurologic assessment
  • Developmental  screening and testing
  • Family psychosocial assessment
  • Coordination of services with primary care provider and referrals to community intervention programs
  • Education to assist families in promoting the growth and development of their child

Multidisciplinary Services

HRIF services are provided by a multidisciplinary team which includes a board certified neonatologist, pediatric nurse practitioners, developmental specialists, HRIF nurse coordinator, and social worker. 

If a delay or health concern is identified, a referral is made to the appropriate pediatric subspecialist, including: