Rooming-In to Treat Neonatal Abstinence Syndrome: Improved Family-Centered Care at Lower Cost

Holmes et al, Pedi­atrics, 2016 Abstract BACKGROUND AND OBJECTIVE: The inci­dence and asso­ci­at­ed costs of neona­tal absti­nence syn­drome (NAS) have recent­ly risen sharply; new­borns with NAS occu­py 4% of NICU beds. We imple­ment­ed a coor­di­nat­ed pro­gram for NAS includ­ing stan­dard­ized pro­to­cols for scor­ing, med­ica­tions and wean­ing, and a calm room­ing-in…

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A double-blind randomised controlled trial of fish oil-based versus soy-based lipid preparations in the treatment of infants with parenteral nutrition-associated cholestasis.

Lam et al, Neona­tol­ogy, 2014 Abstract BACKGROUND: Infants receiv­ing pro­longed par­enter­al nutri­tion (PN) are at risk of PN-asso­ci­at­ed cholesta­sis (PNAC). This can progress to hepat­ic fail­ure and death if PN can­not be dis­con­tin­ued. Fish oil-based par­enter­al lipid prepa­ra­tion (FOLP) has been shown to be ben­e­fi­cial in case stud­ies. OBJECTIVES: (1)…

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Antimicrobial dressings attached to the central venous catheters in reducing catheter-related infections in newborn infants

Lai et al, 23 March 2016, Cochrane review Review ques­tion: In new­born infants who require a cen­tral venous catheter, does the use of anti­sep­tic or antibi­ot­ic catheter dress­ing, com­pared to no dress­ing, reduce catheter-relat­ed infec­tions? Back­ground: Cen­tral venous catheters (CVCs) are small tubes insert­ed into the vein to give flu­ids, med­ica­tion and intra­venous nutri­tion to sick patients. The risks of CVCs are…

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The use of the anticoagulant antithrombin to reduce the risk of intraventricular hemorrhage in very preterm infants

Bruschet­ti­ni et al, 21 March 2016, Cochrane review Review ques­tion: Does antithrom­bin reduce the risk of intra­ven­tric­u­lar hem­or­rhage (i.e. bleed­ing in the brain) and mor­tal­i­ty in very preterm infants? Back­ground: Antithrom­bin is a drug that mod­u­lates blood coag­u­la­tion togeth­er with oth­er fac­tors. Very low birth weight new­born infants (i.e. those neonates with a ges­ta­tion­al age less than 32…

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Effect of Early Prophylactic High-Dose Recombinant Human Erythropoietin in Very Preterm Infants on Neurodevelopmental Outcome at 2 Years

Impor­tance  Very preterm infants are at risk of devel­op­ing encephalopa­thy of pre­ma­tu­ri­ty and long-term neu­rode­vel­op­men­tal delay. Ery­thro­poi­etin treat­ment is neu­ro­pro­tec­tive in ani­mal exper­i­men­tal and human clin­i­cal stud­ies. Objec­tive  To deter­mine whether pro­phy­lac­tic ear­ly high-dose recom­bi­nant human ery­thro­poi­etin (rhE­PO) in preterm infants improves neu­rode­vel­op­men­tal out­come at 2 years’ cor­rect­ed age. Main…

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Frequency of suctioning inside the tube that is used to ventilate newborn babies

Bruschet­ti­ni et al, 6 March 2016, Cochrane review Review ques­tion: We reviewed the evi­dence about the effects of dif­fer­ent strate­gies in the fre­quen­cy of suc­tion­ing of new­born babies that are on ven­ti­la­tors. Our main inter­est was pre­ven­tion of lung dam­age. Back­ground: New­borns might need help with breath­ing as their lungs are still matur­ing.…

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The usefulness of protocols for reducing the time newborn infants spend on mechanical ventilation in the neonatal intensive care unit

Wie­len­ga et al, 21 March 2016, Cochrane review Review ques­tion: Are pro­to­cols use­ful for reduc­ing the time new­born infants spend on mechan­i­cal­ven­ti­la­tion in the neona­tal inten­sive care unit? Back­ground: Mechan­i­cal ven­ti­la­tion is used to help new­borns to breath when they are too sick or born too pre­ma­ture to breath on their own. How­ev­er, mechan­i­cal ven­ti­la­tion is not with­out risk, and can…

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Co-bedding of preterm twins to optimize growth and brain development

Lai et al, 14 April 2016, Cochrane review Review ques­tion: evi­dence on the ben­e­fits and harms of co-bed­ding sta­ble preterm twins and found six rel­e­vant stud­ies. Back­ground: Preterm twins are at high risk for prob­lems in growth and devel­op­ment. Co-bed­ding (place­ment of twins in the same cot or incu­ba­tor) has been pro­posed to ben­e­fit twins because…

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Propranolol in the Treatment of Infantile Haemangiomas

Wedge­worth et al, The British Jour­nal of Der­ma­tol­ogy. 2016 Abstract Back­ground Oral pro­pra­nolol is wide­ly pre­scribed as first-line treat­ment for infan­tile hae­man­giomas (IHs). Anec­do­tal­ly, pre­scrib­ing prac­tice dif­fers wide­ly between cen­tres. Objec­tives The Pro­pra­nolol In the Treat­ment of Com­pli­cat­ed Hae­man­giomas (PITCH) Task­force was found­ed to estab­lish pat­terns of use of pro­pra­nolol in IHs.…

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Association Between Laboratory Calibration of a Serum Bilirubin Assay, Neonatal Bilirubin Levels, and Phototherapy Use

Kuzniewicz et al, JAMA Pedi­atr. April 11, 2016 Impor­tance  The Amer­i­can Acad­e­my of Pedi­atrics treat­ment rec­om­men­da­tions for neona­tal jaun­dice are based on age-spe­cif­ic total serum biliru­bin (TSB) lev­els. In May 2012, Ortho Clin­i­cal Diag­nos­tics adjust­ed the cal­i­bra­tor val­ues for Vit­ros Chem­istry Prod­ucts BuBc Slides (Ortho Clin­i­cal Diag­nos­tics), a wide­ly used method…

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Impact of antenatal steroids on intraventricular hemorrhage in very-low-birth weight infants

Wei et al, Jour­nal of Peri­na­tol­ogy, March 2016 Objec­tive: To deter­mine the asso­ci­a­tion between ante­na­tal steroids admin­is­tra­tion and intra­ven­tric­u­lar hem­or­rhage rates. Results: In 25 979 very-low-birth weight infants, ante­na­tal steroid use was asso­ci­at­ed with a reduc­tion in inci­dence of any grade of intra­ven­tric­u­lar hem­or­rhage (odds ratio=0.68, 95% con­fi­dence inter­val: 0.62, 0.75) and a reduc­tion in…

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Neuroimaging identifies increased manganese deposition in infants receiving parenteral nutrition.

Aschn­er et al, Am J Clin Nutr. 2015 Dec Abstract BACKGROUND: Man­ganese, an essen­tial met­al for nor­mal growth and devel­op­ment, is neu­ro­tox­ic on exces­sive expo­sure. Stan­dard trace ele­ment-sup­ple­ment­ed neona­tal par­enter­al nutri­tion (PN) has a high man­ganese con­tent and bypass­es nor­mal gas­troin­testi­nal absorp­tive con­trol mech­a­nisms, which places infants at risk of man­ganese…

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Failed endotracheal intubation and adverse outcomes among extremely low birth weight infants.

Wal­len­stein et al, J Peri­na­tol. 2016 Feb Abstract OBJECTIVE: To quan­ti­fy the impor­tance of suc­cess­ful endo­tra­cheal intu­ba­tion on the first attempt among extreme­ly low birth weight (ELBW) infants who require resus­ci­ta­tion after deliv­ery. RESULTS: The study sam­ple includ­ed 88 ELBW infants. Forty per­cent were intu­bat­ed on the first attempt and 60%…

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Pathogen-Specific Clustering of Nosocomial Blood Stream Infections in Very Preterm Infants

Reichert et al, Pedi­atrics, March 2016 Abstract BACKGROUND AND OBJECTIVES: Noso­co­mi­al infec­tions in NICUs tend to clus­ter, some­times as dev­as­tat­ing out­breaks, but pathogen-spe­cif­ic trans­mis­sion prob­a­bil­i­ties are unknown. We aimed to quan­ti­fy the pathogen-spe­cif­ic risk of a blood stream infec­tion (BSI) in preterm infants after an index case with that pathogen…

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A Multifaceted Approach to Improving Outcomes in the NICU: The Pediatrix 100 000 Babies Campaign

Ells­bury et al, Pedi­atrics, April, 2016 Abstract BACKGROUND AND OBJECTIVE: Despite advances in neona­tal med­i­cine, infants requir­ing neona­tal inten­sive care con­tin­ue to expe­ri­ence sub­stan­tial mor­bid­i­ty and mor­tal­i­ty. The pur­pose of this ini­tia­tive was to gen­er­ate large-scale simul­ta­ne­ous improve­ments in mul­ti­ple domains of care in a large neona­tal net­work through a…

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Effect of early low-dose hydrocortisone on survival without bronchopulmonary dysplasia in extremely preterm infants (PREMILOC): a double-blind, placebo-controlled, multicentre, randomised trial

Baud et al, Lancet, Feb­ru­ary, 2016 Abstract BACKGROUND: Bron­chopul­monary dys­pla­sia, a major com­pli­ca­tion of extreme pre­ma­tu­ri­ty, has few treat­ment options. Post­na­tal steroid use is con­tro­ver­sial, but low-dose hydro­cor­ti­sone might pre­vent the harm­ful effects of inflam­ma­tion on the devel­op­ing lung. In this study, we aimed to assess whether low-dose hydro­cor­ti­sone improved…

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Rumpel-Leede Phenomenon Associated With Tourniquet-like Forces of Baby Carriers in Otherwise Healthy Infants Baby Carrier Purpura

Naguyen et al, JAMA Der­ma­tol. 2016 Feb 17. A case report described acute-onset low­er-extrem­i­ty petechi­ae and pur­pu­ra caused by der­mal cap­il­lary rup­ture from a baby car­ri­er in oth­er­wise healthy infants (Rumpel-Leede phe­nom­e­non). Acute-onset, local­ized petechi­ae and pur­pu­ra of the low­er extrem­i­ties occurred in 3 oth­er­wise healthy infants fol­low­ing recent expo­sure to baby…

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Impact of Donor Milk Availability on Breast Milk Use and Necrotizing Enterocolitis Rates

Abstract OBJECTIVES: To exam­ine the avail­abil­i­ty of donor human milk (DHM) in a pop­u­la­tion-based cohort and assess whether the avail­abil­i­ty of DHM was asso­ci­at­ed with rates of breast milk feed­ing at NICU dis­charge and rates of necro­tiz­ing ente­ro­col­i­tis (NEC). METHODS: Indi­vid­ual patient clin­i­cal data for very low birth weight infants…

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Benefits of Delayed Cord Clamping in Red Blood Cell Alloimmunization

Garabe­di­an et al, Pedi­atrics, March, 2016 Abstract BACKGROUND AND OBJECTIVE: Sev­er­al stud­ies have shown the ben­e­fits of delayed cord clamp­ing (DCC) in preterm and in healthy new­borns at short and long term. Our objec­tive was to eval­u­ate the poten­tials ben­e­fits and risks of DCC in red cell alloim­mu­niza­tion. RESULTS: We…

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Videolaryngoscope for Teaching Neonatal Endotracheal Intubation: A Randomized Controlled Trial

Mous­sa et al, Pedi­atrics, March, 2016 Abstract OBJECTIVE: To assess whether the vide­o­laryn­go­scope (VL) is supe­ri­or to the clas­sic laryn­go­scope (CL) in acquir­ing skill in neona­tal endo­tra­cheal intu­ba­tion (ETI) and, once acquired with the VL, whether the skill is trans­fer­able to the CL. RESULTS: In phase 1, 34 pedi­atric res­i­dents…

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Total Duration of Breastfeeding, Vitamin D Supplementation, and Serum Levels of 25-Hydroxyvitamin D

Dar­mawikar­ta et al, Am J Pub­lic Health. 2016 Apr OBJECTIVES: To deter­mine the asso­ci­a­tion between total breast­feed­ing dura­tion and serum 25-hydrox­yvi­t­a­min D (25-OHD) and to explore whethervi­t­a­min D sup­ple­men­ta­tion influ­ences this asso­ci­a­tion. RESULTS: Each 1-month increase in total breast­feed­ing dura­tion was asso­ci­at­ed with a 0.12 nanograms per mil­li­liter low­er medi­an serum…

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Early Inhaled Budesonide for the Prevention of Bronchopulmonary Dysplasia

Bassler et al; Neu­ro­sis Tri­al Group, N Engl J Med. 2015 Study Sum­ma­ry Bron­chopul­monary dys­pla­sia (BPD) is a com­mon comor­bid con­di­tion among infants born at less than 28 weeks’ ges­ta­tion. Pre­vi­ous attempts to pre­vent the devel­op­ment of BPD using sys­temic cor­ti­cos­teroids have been effec­tive in reduc­ing BPD, but at the expense…

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Neuroprotection of Skin-to-Skin Contact (SSC)

Bergman, New­born & Infant Nurs­ing Reviews, 2015 Back­ground Skin-to-skin con­tact (SSC) gained promi­nence from the work of Rey and Mar­tinez, who relied on this prac­tice in the con­text of insuf­fi­cient incu­ba­tors. They showed that the “Kan­ga­roo Posi­tion” pro­vid­ed good phys­i­o­log­i­cal con­trol of very small neonates, that breast­feed­ing start­ed much ear­li­er pro­vid­ing…

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Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study

Popovic et al, Eur Respir J. 2016 Mar Abstract The role of pre­na­tal antibi­ot­ic expo­sure in the devel­op­ment of child­hood wheez­ing is debat­ed. We eval­u­at­ed whether this asso­ci­a­tion could poten­tial­ly be explained by con­found­ing factors.Antibiotic use in the first and third trimester of preg­nan­cy, wheez­ing in chil­dren aged ≤18 months and con­found­ing…

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Predicting Nonhemolytic Neonatal Hyperbilirubinemia

Nor­man et al, Pedi­atrics, Novem­ber 2015 Abstract BACKGROUND: Before hos­pi­tal dis­charge, new­born infants should be assessed for the risk of exces­sive hyper­biliru­bine­mia. We deter­mined mater­nal and obstet­ric risk fac­tors for hyper­biliru­bine­mia in infants born at term (ges­ta­tion­al age ≥37 weeks) to form an indi­vid­u­al­ized risk assess­ment tool for clin­i­cal use.…

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