Prior to 1948, there was no pediatric department as such and the sick children were cared by general physicians. In the year 1948, the first pediatric department of Tamilndau was created in the Government General Hospital, Madras and Late Dr.S.T.Achar was appointed as Professor of Pediatrics of Madras Medical College. He was provided with 28 bedded ward posted from the various general medical wards. Initially the outpatient attendance was 40 per day. An assistant to the professor and a few house physicians were posted to the Pediatric Department. In 1949, Dr.Achar assumed additional charge of children ward (28 beds) of Women and Children Hospital, Egmore and a Honorary assistant physician was posted in the ward to assist him. Since 1949 department started attracting a number of medical graduates. They joined the Pediatric Department as voluntary postgraduates in order to get training in Pediatrics – first of its kind in our country.

In 1953, Pediatric Nursing was given recognition. World Health Organization assigned a specially trained nurse to conduct the course for Pediatric Nurses from all our India. It was a joint venture of UNICEF, WHO and Madras Government. In 1954, ward bed strength was increased to 48 beds in main ward and 12 beds in Isolation and Typhoid ward in Government General Hospital. One more assistant physician was posted for teaching and service activities.

In 1957, the department was upgraded and the professor was appointed as whole time Director and the staff strength rose to one Reader cum Pediatric physician, 3 assistant physicians and 4 honorary assistant physicians. UNICEF and WHO provided equipment and other aids through a project known as Madras Pediatric Project. Four peripheral pediatric clinics were started with the help of WHO visiting professor of child health. 3 assistant professors and 4 public health nurses were appointed separately to run these clinics and the necessary equipments were supplied by UNICEF.

Diploma in Child Health and M.D. Pediatrics courses were started in the year 1957 and 1961 respectively with 12 students for DCH and 4 for M.D. per year.In 1963, Government sanctioned a sum of Rs.26.36 lakhs for construction of Pediatric block in the Arni House compound attached to the Government Women and Children Hospital, Egmore for starting separate hospital for children. When the building was completed, bed strength was raised to 250 by transferring children beds from Govt. General Hospital and Women and Children Hospital. In addition necessary staff and other facilities were sanctioned. ICH started functioning in its new building at Halls Road, Egmore, (at present premises) with effect from 15.11.1968 with Dr.V.Balagopala Raju as the first Director and Superintendent.

In G.O.MS.NO.750 Health dated 1.4.1982 sanction was accorded for the construction of a 10 storied block for the hospital. When the building was completed bed strength was raised from 250 to 500 with necessary staff. Subsequently 37 cardio thoracic beds were transferred from Government General Hospital to organize pediatric cardio thoracic surgery department thus making the present bed strength of 537.