RNs undergo annual skills tests and are subject to additional training to maintain contemporary practice. History The problem of premature and congenitally ill infants is not a new one. As early as the 17th and 18th centuries, there were scholarly papers published that attempted to share knowledge of interventions. It was not until 1922, however, that hospitals started grouping the newborn infants into one area, now called the neonatal intensive care unit (NICU). Before the industrial revolution, premature and ill infants were born and cared for at home and either lived or died without medical intervention. In the mid-nineteenth century, the infant incubator was first developed, based on the incubators used for chicken eggs. Dr. Stephane Tarnier is generally considered to be the father of the incubator (or isolette as it is now known), having developed it to attempt to keep premature infants in a Paris maternity ward warm. Other methods had been used before, but this was the first closed model; in addition, he helped convince other physicians that the treatment helped premature infants. France became a forerunner in assisting premature infants, in part due to its concerns about a falling birth rate. After Tarnier retired, Dr. Pierre Budin, followed in his footsteps, noting the limitations of infants in incubators and the importance of breastmilk and the mother's attachment to the child. Budin is known as the father of modern perinatology, and his seminal work The Nursling (Le Nourisson in French) became the first major publication to deal with the care of the neonate. Another factor that contributed to the development of modern neonatology was Dr. Martin Couney and his permanent installment of premature babies in incubators at Coney Island. A more controversial figure, he studied under Dr. Budin and brought attention to premature babies and their plight through his display of infants as sideshow attractions at Coney Island and the World's Fair in New York and Chicago in 1933 and 1939, respectively. Infants had also previously been displayed in incubators at the 1897, 1898, 1901, and 1904 World Fairs. Early years Doctors took an increasing role in childbirth from the eighteenth century onward. However, the care of newborn babies, sick or well, remained largely in the hands of mothers and midwives. Some baby incubators, similar to those used for hatching chicks, were devised in the late nineteenth century. In the United States, these were shown at commercial exhibitions,