Neonatology

Understanding Immune Responses to Build a Better Vaccine
Understanding Immune Responses to Build a Better Vaccine 1024 606 Abbie Roth

Researchers have used studies of respiratory syncytial virus and infant immune responses to develop a promising vaccine candidate. Respiratory syncytial virus (RSV) is an incredibly common yet potentially deadly pathogen. Almost everyone becomes infected with RSV during their first three years of life, but for certain populations — infants and elderly or immunocompromised people —…

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Global Study Highlights Antibiotic Overuse in the NICU
Global Study Highlights Antibiotic Overuse in the NICU 1024 683 Abbie Roth
Baby in NICU

Antimicrobial stewardship programs were associated with lower antibiotic use, regardless of the country’s income level. Excessive antibiotic use among infants born preterm in the newborn intensive care unit (NICU) is associated with poor patient outcomes, such as sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia and others, and contributes to the emergence of multi-drug resistant microbes. A new…

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No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants
No Evidence Supporting Prophylactic Indomethacin Treatment for Most Preterm Infants 1024 575 Lauren Dembeck

Inconsistency among studies prompted researchers to take a closer look at the drug’s effects. Despite limited evidence supporting its use, prophylactic indomethacin treatment is often administered to very preterm infants within the first 24-hours after birth to reduce the risks of intraventricular hemorrhage and longer-term neonatal morbidities, such as bronchopulmonary dysplasia (BPD). Data from a…

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Neurodevelopmental Trajectory in Infants With Neonatal Opioid Withdrawal Syndrome
Neurodevelopmental Trajectory in Infants With Neonatal Opioid Withdrawal Syndrome 1024 575 Mary Bates, PhD

Infants exposed to opioids in utero begin showing cognitive and language deficits in their second year. In a new study, researchers from Nationwide Children’s Hospital report the neurodevelopmental outcomes of infants with pharmacologically treated neonatal opioid withdrawal syndrome (NOWS, formerly called neonatal abstinence syndrome, or NAS) through 2 years of age. The results showed that…

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Polysomnography in Infants: How Much Total Sleep Time is Really Needed?
Polysomnography in Infants: How Much Total Sleep Time is Really Needed? 1024 575 Abbie Roth
small baby with nose canula

Study identifies factors affecting total sleep time and suggests shorter sleep times can be effective for accurate interpretation and clinical decision making. In a recent study published in American Journal of Perinatology, experts from Nationwide Children’s Hospital investigated factors that affect total sleep time(TST) during infant polysomnography (PSG) in an effort to determine how much TST is…

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Prematurity and Genomics: Can Complications For a Baby Born Preterm Be Predicted?
Prematurity and Genomics: Can Complications For a Baby Born Preterm Be Predicted? 1024 575 Eric Butterman
conceptual art of DNA

Complications from being born preterm are the number one cause of death in the world for children under the age of five, says Leif Nelin, MD, division chief of Neonatology at Nationwide Children’s Hospital and professor of Pediatrics at The Ohio State University . But why do some babies born preterm develop complications while many others seem…

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Fatty Acid Supplements May Improve Social and Emotional Wellbeing Even in Toddlers
Fatty Acid Supplements May Improve Social and Emotional Wellbeing Even in Toddlers 150 150 Natalie Wilson

Children who were given supplements of Docosahexaenoic acid (DHA), an omega-3 fatty acid that serves as an important building block in babies’ developing brains, were less likely to meet the threshold on a test that determines whether they should be further evaluated for Autism Spectrum Disorder. When children are born prematurely, they miss the opportunity…

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Advances in Neonatal GERD
Advances in Neonatal GERD 1024 683 Mary Bates, PhD
Dr. Jadcherla

New studies from the Jadcherla Lab provide insights into diagnosing, classifying and treating GERD in infants. Differentiating gastroesophageal reflux (GER), which is defined as the passage of gastric contents into the esophagus, from GER disease (GERD), when reflux is associated with troubling symptoms, remains a challenge in infants. Symptom-based diagnosis and treatment of GERD has…

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When Should Breastfed Babies Be Supplemented?
When Should Breastfed Babies Be Supplemented? 1024 575 Vanessa Shanks

This question has received increasing attention in the last several years, especially when considering supplementation for late preterm and early term babies. As more hospitals focus on promoting and supporting breastfeeding, supplementation rates have decreased for infants in the newborn nursery. However, there has been increasing awareness from primary care providers who may see these…

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Novel Intervention Helps Infants With Cerebral Palsy Develop Arm and Hand Function
Novel Intervention Helps Infants With Cerebral Palsy Develop Arm and Hand Function 1024 683 Abbie Roth

A new NIH-funded randomized controlled trial shows that an intervention combining a patented soft restraint harness, therapist coaching and parent training increases reach smoothness, fine motor skills and tactile sensation in the more-affected upper extremity. For the first time in infants with CP under 2, a clinical trial of this type of intervention was shown…

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Prevention and Treatment of Early-Onset Sepsis in Newborns
Prevention and Treatment of Early-Onset Sepsis in Newborns 1024 575 Mary Bates, PhD

Continued surveillance is needed to monitor pathogen distribution and antibiotic resistance. Early-onset sepsis remains a potentially fatal condition among newborns, particularly pre-term infants. According to a new study published in JAMA Pediatrics, ongoing surveillance is required to optimize prevention and treatment strategies. The study included data from 18 centers of the Eunice Kennedy Shriver National Institute…

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How a Network of Hospitals Reduced Average Age at Cerebral Palsy Diagnosis to 9.5 Months
How a Network of Hospitals Reduced Average Age at Cerebral Palsy Diagnosis to 9.5 Months 1024 683 Katie Brind'Amour, PhD, MS, CHES

In just one year, hospital teams working as part of a network to implement international cerebral palsy diagnosis guidelines successfully reduced average age at diagnosis from 19.5 months to 9.5 months. More than 50% of all eventual cerebral palsy (CP) cases spend time in the Neonatal Intensive Care Unit, making early CP evaluation a crucial…

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Systems Analyses Unravel Clinical Phenotypes in Infants with Respiratory Syncytial Virus Infection
Systems Analyses Unravel Clinical Phenotypes in Infants with Respiratory Syncytial Virus Infection 1024 575 Mary Bates, PhD

RSV disease severity is influenced by innate immune responses, viral loads and patient age. Respiratory syncytial virus (RSV) is a leading cause of hospitalization in children, although most cases result in mild disease. To develop effective antivirals and vaccines, a better understanding of the different clinical, immunologic and virologic factors present in infants with mild…

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Searching for a Predictive Biomarker of Pulmonary Hypertension in Babies With Bronchopulmonary Dysplasia
Searching for a Predictive Biomarker of Pulmonary Hypertension in Babies With Bronchopulmonary Dysplasia 1024 575 Abbie Roth

Pulmonary hypertension is high blood pressure in the lungs and is a comorbidity of bronchopulmonary dysplasia (BPD), which is the chronic lung disease of premature babies. When pulmonary hypertension is present in the context of BPD, the risk of death is significantly increased. As neonatologists continue to define the phenotype of severe BPD, Jennifer Trittmann, MD, MPH,…

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THRIVING After Severe Bronchopulmonary Dysplasia
THRIVING After Severe Bronchopulmonary Dysplasia 1024 731 Abbie Roth

Meet Willow. She was born via emergency C-section at just 22 weeks. Doctors at the delivering hospital told Willow’s mom Cortney that her baby’s chances of survival were low. But after a long journey through the newborn intensive care unit (NICU) at Nationwide Children’s Hospital, Willow is a vivacious 4-year-old looking forward to starting kindergarten…

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Timing Steroids to Maximize Lung Benefit and Avoid Brain Harm in Premature Infants
Timing Steroids to Maximize Lung Benefit and Avoid Brain Harm in Premature Infants 1024 575 Mary Bates, PhD

Treating infants early may decrease risk of lung disease with no added risk of neurodevelopmental impairment. Steroids are used to treat extremely premature babies with respiratory failure, yet they can be associated with delays in brain development. A recent study looked at the age of first steroid administration and the risks of lung disease and neurodevelopmental impairment…

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What is the Association Between Kidney Injury and Fluid Balance in Premature Newborns?
What is the Association Between Kidney Injury and Fluid Balance in Premature Newborns? 1024 575 Mary Bates, PhD

A positive fluid balance is associated with acute kidney injury and worse outcomes in a new study of premature infants. According to new research, there is an association between fluid balance and outcomes in preterm newborns, with a negative fluid balance during the first week of life emerging as a potential therapeutic target. Premature infants…

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Asymptomatic Infants With Congenital Cytomegalovirus May Still Have Detectable, Significant Abnormalities
Asymptomatic Infants With Congenital Cytomegalovirus May Still Have Detectable, Significant Abnormalities 1024 575 Katie Brind'Amour, PhD, MS, CHES
Color photo of Black father holding infant on shoulder in front of nursery background with clouds on the wall

More than half of high-risk CMV-positive newborns may have abnormalities not detected by a physical exam alone. A study in 34 infants with a normal physical exam despite a positive diagnosis of congenital cytomegalovirus (CMV) — a viral infection that can lead to neurodevelopmental delays and permanent hearing loss — found that in more than…

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Link Found Between Respiratory Syncytial Virus Infection and Asthma
Link Found Between Respiratory Syncytial Virus Infection and Asthma 800 533 Mary Bates, PhD

RSV infection early in life increases risk of subsequent wheezing or asthma. Respiratory syncytial virus (RSV) is the leading cause of hospitalization in infants all over the world. It can lead to serious acute infections, and new research from Nationwide Children’s shows RSV infection can also have long-term health consequences. In a new study, researchers…

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Percutaneous Occlusion Linked to Respiratory Improvements in Low-Weight Infants with PDA
Percutaneous Occlusion Linked to Respiratory Improvements in Low-Weight Infants with PDA 1024 575 Abbie Roth

Percutaneous occlusion for patent ductus arteriosus (PDA) in infants weighing less than 6 kg is associated with potential longer term improvements in respiratory health, research by investigators at Nationwide Children’s Hospital shows. “A new device for PDA closure recently approved by the FDA has potential to reduce the incidence of device-related complications. This important work…

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Does Newborn Screening Lead to Life-Span Benefits?
Does Newborn Screening Lead to Life-Span Benefits? 1024 678 Kevin Mayhood

To find the answer, researchers suggest data systems to track long-term care and outcomes are needed. Newborns in the United States are screened for a list of diseases, a practice that saves or improves 13,000 lives annually, the Centers for Disease Control and Prevention estimates. But, a group of health experts who helped build the…

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Rethinking Gastroesophageal Reflux Disease (GERD) in Infants
Rethinking Gastroesophageal Reflux Disease (GERD) in Infants 150 150 Lauren Dembeck

Novel use of existing technology points to other causes of GERD-like symptoms. While typically attributed to gastroesophageal reflux disease (GERD), supra-esophageal symptoms, such as cough, back arching and gagging, can be temporally associated with aerophagia, according to a new study by researchers at Nationwide Children’s Hospital. The findings come from the novel implementation of standard…

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Improving Medication Dosing Consistency for Infants With Neonatal Abstinence Syndrome
Improving Medication Dosing Consistency for Infants With Neonatal Abstinence Syndrome 150 150 Abbie Roth

A quality improvement initiative effectively increases the percentage of infants dosed according to birth weight. From 2000 to 2009, prenatal maternal opiate use increased from 1.2 to 5.6 per 1,000 births, with up to 80% of in utero exposed infants requiring pharmacotherapy for neonatal abstinence syndrome (NAS). In Ohio, home of Nationwide Children’s Hospital, the exposure rate…

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Surprise Finding in Respiratory Syncytial Virus Infection Viral Load Study
Surprise Finding in Respiratory Syncytial Virus Infection Viral Load Study 150 150 Lauren Dembeck

Understanding viral load dynamics can help inform treatment decisions Respiratory syncytial virus (RSV) lower respiratory tract infection is a leading cause of hospitalization and mortality in infants worldwide, but a licensed RSV vaccine has not yet been developed, in part due to the incomplete understanding of RSV pathogenesis. While investigating the relationship between RSV viral…

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Family Support Linked to Resilience in Kindergarteners Born Preterm
Family Support Linked to Resilience in Kindergarteners Born Preterm 150 150 Adelaide Feibel

Despite known adverse outcomes associated with prematurity, a large minority of kindergarteners born preterm exhibit none of them. For years, medical researchers have dedicated countless hours to studying the adverse outcomes of premature births. But in their attempts to illuminate the incidence of cognitive, behavioral and learning deficits in preterm and low-birth-weight infants, researchers have…

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Skin-to-Skin Care Safe for Infants After Surgery
Skin-to-Skin Care Safe for Infants After Surgery 150 150 Mary Bates, PhD

A quality improvement project shows that skin-to-skin care can be safely integrated into the treatment of infants who require surgery. Multiple barriers prevent routine skin-to-skin care for infants in the neonatal intensive care unit (NICU), particularly for infants requiring surgical consultation. A recent quality improvement project, published in the Journal of Pediatric Surgery, shows that routine…

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Optimal Use of an FDA-Approved Device for PDA Closure in Infants
Optimal Use of an FDA-Approved Device for PDA Closure in Infants 150 150 Mary Bates, PhD

Randomized, controlled clinical trials are needed to answer questions regarding when and with whom to use the device. In January 2019, the US Food and Drug Administration approved a novel device for patent ductus arteriosus (PDA) closure in infants. The Amplatzer Piccolo Occluder is indicated for catheter-based closure of PDA in infants weighing more than…

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CMV Testing: Why You Don’t Need Legislation to Make It a Good Idea
CMV Testing: Why You Don’t Need Legislation to Make It a Good Idea 1024 575 Samantha Morsink

CMV is the leading non-genetic cause of sensorineural hearing loss in infancy and childhood. Identification of newborns with congenital CMV infection can improve their outcomes by early intervention programs and/or antiviral treatment. Cytomegalovirus, or CMV, infects almost everyone at some point in time, and it is one of the most common congenital infections worldwide. While…

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Swallowing Functions Remain Worse in Preterm Infants Even at Full-Term Equivalent Age
Swallowing Functions Remain Worse in Preterm Infants Even at Full-Term Equivalent Age 150 150 Abbie Roth

Preterm infants exerted greater effort than full-term infants to consume less than half the volume in a recent study led by researchers at Nationwide Children’s Hospital. Preterm infants face many challenges as they enter the world too soon. One of the biggest challenges is learning the coordination of the suck-swallow refex that allows them to…

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What’s Next for NEC?
What’s Next for NEC? 898 504 Abbie Roth

Red. White. Black. These are the colors of necrotizing enterocolitis, or NEC. When surgeons open the distended abdomens of the tiny infants affected by NEC, they see a mottled mixture of red (inflamed), white (ischemic) and black (dead) tissue. Their first task is to assess whether or not there is enough viable tissue to save.…

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Acid Reflux Index Severity Alone Should Not Determine GERD Diagnosis
Acid Reflux Index Severity Alone Should Not Determine GERD Diagnosis 150 150 Kevin Mayhood

ARI severity plays little role in symptom generation, but symptoms alone are unreliable for diagnosing gastroesophageal reflux disease, researchers say. However, a new study from the Neonatal and Infant Feeding Disorders Program at Nationwide Children’s Hospital shows that stomach acid alone doesn’t appear to have much to do with GERD at all, and responses to esophageal stimulation…

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A Simple Measure to Help Early Detection of Hemiplegic Cerebral Palsy in Infants
A Simple Measure to Help Early Detection of Hemiplegic Cerebral Palsy in Infants 150 150 Jeb Phillips

An easily derived Hammersmith Infant Neurological Examination asymmetry score, in combination with the total HINE score, differentiates typically developing infants from those with hemiplegic CP. While cerebral palsy can now be diagnosed at 6 months of age – allowing for earlier interventions and better potential outcomes than ever before – evaluation can be difficult in…

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Prediction of Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension by Combining Clinical and Genetic Data
Prediction of Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension by Combining Clinical and Genetic Data 150 150 Lauren Dembeck
Prenatal Magnesium Sulfate May Not Reduce Cerebral Palsy Severity as Once Believed
Prenatal Magnesium Sulfate May Not Reduce Cerebral Palsy Severity as Once Believed 1024 575 Jeb Phillips

Improved neonatal care and earlier diagnosis and management may instead be reason for a decrease in cerebral palsy severity. A large randomized controlled trial showed in 2008 that when pregnant women at imminent risk of preterm delivery were given magnesium sulfate, their children had reduced rates of moderate or severe cerebral palsy. As a result…

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Researchers Identify Proteins Triggering Imbalance of Cells in Chronic Lung Disease
Researchers Identify Proteins Triggering Imbalance of Cells in Chronic Lung Disease 1024 575 Kevin Mayhood
Illustration of lungs on blue silhouette of upper chest on black background

A protein that triggers an imbalance of mucous and ciliated cells in patients with chronic lung disease could be a target for treatments to restore airways. Many chronic lung diseases in children and adults have one thing in common: the airway lining that normally traps and sweeps out bacteria, viruses and diesel particulates stops functioning…

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Neonatal Abstinence Syndrome: Transforming Care for Newborns and Their Families
Neonatal Abstinence Syndrome: Transforming Care for Newborns and Their Families 1024 575 Abbie Roth

If there’s a success story to be told at this point in the history of the opioid crisis, it’s in the newborn intensive care unit. From changing attitudes to standardizing treatment, clinical care for infants with neonatal abstinence syndrome (NAS) and their families is markedly different than it was 10 years ago.   CHANGING ATTITUDES…

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What Happens When Opioid-Exposed Babies Go Home?
What Happens When Opioid-Exposed Babies Go Home? 1024 575 Abbie Roth
Black and white image of an unsmiling White woman holding a young, awake infant in the right third of the frame

Follow-up for babies with NAS or prenatal opioid exposure is essential for understanding risks and outcomes.

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Feeding Difficulties in Opioid-Exposed Infants — Mechanics and Possible Causes
Feeding Difficulties in Opioid-Exposed Infants — Mechanics and Possible Causes 1024 575 Kevin Mayhood

A recent study suggests altered vagus nerve activity, creating resistance in the esophagus while swallowing. Infants exposed to opioids prenatally often show signs of gastroesophageal reflux disease. But a study by neonatologists at Nationwide Children’s Hospital found that feeding troubles are more likely due to excessive pressure and a lack of coordinated muscle contractions in…

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The PDA Conundrum
The PDA Conundrum 150 150 Jeb Phillips

A patent ductus arteriosus is associated with increased morbidity and mortality, but common treatments are associated with poor outcomes as well. What is a neonatologist to do? Until the mid-2000s, most neonatologists were pretty sure they knew how to handle a patent ductus arteriosus (PDA) in an infant born preterm – it needed to be…

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Can We Prevent Future Language Delays in the NICU?
Can We Prevent Future Language Delays in the NICU? 150 150 Abbie Roth

Researchers investigate the use of event related potentials to measure the effects of mother’s voice exposure on speech sound differentiation. Preterm infants are at high risk for neurosensory impairments and developmental delays, including hearing loss, which may have lasting consequences. Compared to babies born at term, preterm infants are twice as likely to have a…

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Care Bundles Can Reduce Hospital-Acquired Pressure Injuries
Care Bundles Can Reduce Hospital-Acquired Pressure Injuries 150 150 Brianne Moore

Reliable implementation of care bundles reduces the number of serious hospital-acquired pressure injuries Hospital-acquired pressure injuries (PI) are a significant cause of preventable harm that can increase hospitalization costs and length of stay. Up to 27 percent of pediatric intensive care unit (PICU) patients and up to 23 percent of neonatal intensive care unit (NICU)…

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On the Road to Eliminating RSV
On the Road to Eliminating RSV 150 150 Abbie Roth

With the recent publication of two papers, researchers shed light on factors that influence disease severity and immune response to respiratory syncytial virus infection in infants and young children. “RSV is a very common infection in infants and young children – almost everyone will be infected by age 2. In the United States, 2-3 percent…

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Mapping the Journey to Optimal Health for NICU Graduates
Mapping the Journey to Optimal Health for NICU Graduates 1024 683 Jeb Phillips

Babies born preterm need ongoing, specialized care to help them thrive after discharge from the hospital. Innovative programs are being designed to ensure that they get that care. In the early 1980s, only 10 percent of infants born before 28 weeks of gestational age survived to be discharged from the hospital. By 2015, 65 percent…

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Integrating Research Into the “Journeys”
Integrating Research Into the “Journeys” 1024 683 Jeb Phillips

Along with their work to build an innovative follow-up program, Nationwide Children’s faculty and staff members are international leaders in NICU follow-up research. A number of foundation and National Institutes of Health-funded follow-up studies are housed entirely or in part at the hospital, and The Research Institute at Nationwide Children’s is one of 17 member…

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In Extremely Preterm Babies, SNAP-II Score Predicts Brain Impairments at Age 10
In Extremely Preterm Babies, SNAP-II Score Predicts Brain Impairments at Age 10 150 150 Kevin Mayhood

Measures taken in first 12 hours of life are associated with a host of deficits. Children born extremely preterm are known to be at increased risk of neurodevelopmental impairments, but not all babies born the same early date and weight are equal. Researchers have found that for children born at less than 28 weeks, a…

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How to Solve Feeding Disorders Without a G-Tube
How to Solve Feeding Disorders Without a G-Tube 1024 575 Jeb Phillips

Babies in a neonatal intensive care unit must have a safe way of receiving nutrition in order to go home. Full oral feeding is ideal, of course. But for those patients with persistent difficulty feeding by mouth, there were two primary options before 2002 to guarantee nutrients by the time of discharge. Both had their…

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Best Practices in Severe BPD Treatment
Best Practices in Severe BPD Treatment 150 150 Jeb Phillips

To help standardize care, the Bronchopulmonary Dysplasia Collaborative has published a comprehensive review of evidence-based approaches for treatment of patients with severe forms of the disease. Infants with severe bronchopulmonary dysplasia (BPD) have high risks of late morbidities and mortality, but the best ways to manage these vulnerable patients are still debated. In fact, it’s…

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How a QI Intervention Lowered Breast Milk Errors in a Busy NICU
How a QI Intervention Lowered Breast Milk Errors in a Busy NICU 150 150 Kevin Mayhood

Bedside barcode scanners and dedicated milk preparation technicians helped drive the decline. A quality improvement (QI) initiative in the Neonatal Intensive Care Unit (NICU) at Nationwide Children’s Hospital has been associated with a substantial reduction in errors administering mother’s milk to these vulnerable infants. The total number of scanned errors declined from 97.1 per 1,000…

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