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Neonatology

Better Care and Better Business
 Better Care and Better Business 150 150 Dave Ghose
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The changing economics of health care are forcing hospitals to find solutions that are good for patients and for the bottom line. A puzzled neonatologist approached Richard McClead, MD, after he spoke at a conference in Boston. It was 2010, and Dr. McClead just finished detailing a new initiative at Nationwide Children’s Hospital to reduce the…

An Ethical Discussion of Parental Care Preference
 An Ethical Discussion of Parental Care Preference 150 150 Jan Arthur
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Two infants with the same prognosis have parents with different preferences in terms of care. What should the medical team do? The article, “Two Infants, Same Prognosis, Different Parental Preferences,” published in the May 2015 issue of Pediatrics, presents a challenging ethical dilemma that brings into question the best interest standard and quality-of-life value judgments among…

Delayed Umbilical Cord Clamping May Benefit Some High-Risk Newborns
 Delayed Umbilical Cord Clamping May Benefit Some High-Risk Newborns 150 150 Jeb Phillips
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Recent studies show the practice can offer circulatory advantages for infants born extremely preterm or with critical congenital heart disease. The practice of immediate or early umbilical cord clamping after birth has been the norm since research in the 1950s and 1960s showed that most blood volume for full term babies was achieved “within the…

What Do DALYs Mean for Pediatrics?
 What Do DALYs Mean for Pediatrics? 150 150 Dave Ghose
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An emerging, innovative metric could radically change childhood health policy. A new way of looking at illness is beginning to change how public health officials view life and death. The concept — called DALYs — offers a fuller view of disease that could have a big impact on pediatrics if embraced. Unlike death tolls —…

Conflicting Directions for BPD Treatment
 Conflicting Directions for BPD Treatment 150 150 Katie Brind'Amour, PhD, MS, CHES
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Treatment of bronchopulmonary dysplasia differs dramatically among institutions. But why does variation matter? Recent studies report extreme variation among hospitals ordering three common medications for chronic lung disease, or bronchopulmonary dysplasia, calling into question the appropriateness of their use and the reason for their prescription. “In the use of diuretics, inhaled bronchodilators and inhaled corticosteroids,…

Placental Transfusion Confusion
 Placental Transfusion Confusion 150 150 Katie Brind'Amour, PhD, MS, CHES
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Medical professional organizations cannot reach consensus regarding delayed cord clamping and umbilical cord “milking.” Nearly every relevant professional organization has its own recommendations for placental transfusion techniques known as delayed umbilical cord clamping and milking. But it’s unclear whether additional research will lead to consensus. The American Congress of Obstetricians and Gynecologists and American Academy of Pediatrics say there’s…

Study Finds Cow’s Milk is Added to Breast Milk and Sold to Parents Online
 Study Finds Cow’s Milk is Added to Breast Milk and Sold to Parents Online 150 150 Katie Brind'Amour, PhD, MS, CHES
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Deceptive Internet advertisements for human breast milk may put infants at risk. What do parents (and doctors) need to know about milk sharing? A study published yesterday on the safety of human breast milk bought over the Internet found that 10 percent of samples contained added cow’s milk. The discovery that purchased samples of human milk may…

Are We Properly Capturing the Maternal-Child Health Continuum?
 Are We Properly Capturing the Maternal-Child Health Continuum? 150 150 Irina Buhimschi
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An obstetrician doing research at a children’s hospital may seem out of place. But not according to one clinician-scientist, who believes that maternal health and child health are inextricably intertwined. Traditionally, doctors divide into those who practice adult medicine and those who practice pediatrics. With the exception of family physicians, there is little crossover in…

Using Zinc for Growth Delays in Babies Born Preterm
 Using Zinc for Growth Delays in Babies Born Preterm 150 150 Katie Brind'Amour, PhD, MS, CHES
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Zinc supplementation in extremely low birth-weight (ELBW) infants with chronic lung disease improves weight gain and linear growth, according to a retrospective study performed at Nationwide Children’s Hospital. The study is one of the first to look at the association between zinc supplementation and growth in ELBW babies with chronic lung disease, also known as bronchopulmonary dysplasia.…

Evolution of an Atlas
 Evolution of an Atlas 150 150 Katie Brind'Amour, PhD, MS, CHES
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Adult brain atlases have existed for years. Why is it so crucial — and so difficult — to build one for preemies? Even experts need maps. They give perspective, scale and orientation. They can show both current location and the final destination. And in the world of premature brains, they can offer vital information about…