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Neonatology

Watchful Waiting: The New Recommendation for Most Preterm Infants With PDA
 Watchful Waiting: The New Recommendation for Most Preterm Infants With PDA 1024 683 Abbie Miller
By: Abbie Miller

A study published in JAMA found that treating patent ductus arteriosus with medication did not help with disease management but was associated with higher mortality.   A new study from the Neonatal Research Network, published in JAMA, found that treating patent ductus arteriosus (PDA) in preterm infants with nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen at…

Rethinking Neonatal HSV Management: A Less Aggressive, Evidence-Informed Approach
 Rethinking Neonatal HSV Management: A Less Aggressive, Evidence-Informed Approach 1024 593 Alaina Doklovic
By: Alaina Doklovic

An alternative approach to neonatal HSV management helps keep mom and baby together during the nursery stay.  Neonatal herpes simplex virus infection (HSV) is a rare but often fatal disease when not treated correctly or in a timely manner. This makes diagnosis and preventive strategies extremely important when expectant mothers have active genital HSV infection when they deliver.   Neonatal HSV is a result of vertical transmission from mother to newborn and most…

Prematurity Increases Morbidity and Mortality Risk in Preterm Neonates with Down Syndrome in the NICU
 Prematurity Increases Morbidity and Mortality Risk in Preterm Neonates with Down Syndrome in the NICU 1024 624 JoAnna Pendergrass, DVM
By: JoAnna Pendergrass, DVM

  Premature neonates with Down syndrome who are admitted to the neonatal intensive care unit experience higher rates of health complications and an increased mortality risk.   A retrospective study led by Emily Messick, DO, at Nationwide Children’s Hospital, reported the increased risk of adverse health outcomes in preterm neonates with Down syndrome in the…

Mode of Respiratory Support at 36 Weeks Predicts Weaning Timeline for Infants With Severe Bronchopulmonary Dysplasia
 Mode of Respiratory Support at 36 Weeks Predicts Weaning Timeline for Infants With Severe Bronchopulmonary Dysplasia 1024 683 Lauren Dembeck
By: Lauren Dembeck
Premature baby receiving respiratory support through a nasal cannula in a neonatal intensive care unit, monitored and cared for by a health care provider.

Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth, and its incidence is rising due to advances in neonatal care that have improved survival for extremely premature infants. Respiratory support is a cornerstone of management for these patients, yet the expected timeline for weaning in those with moderate-to-severe (grade 2/3) BPD is not…

Predicting Acute Kidney Injury in Neonates Using Machine Learning Algorithms
 Predicting Acute Kidney Injury in Neonates Using Machine Learning Algorithms 480 320 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

A new model accurately identifies neonates at risk of acute kidney injury (AKI) — and the factors physicians should address to prevent it — offering the first AKI prediction tool specific to this vulnerable population. Acute kidney injury (AKI) is common and irreversible, making preventive measures essential to maintaining health. Multiple risk prediction tools exist…

High Rates of Readmission and Airway Complications Found in Tracheostomy-Dependent Infants With BPD
 High Rates of Readmission and Airway Complications Found in Tracheostomy-Dependent Infants With BPD 1024 575 Lauren Dembeck
By: Lauren Dembeck

While tracheostomy can be lifesaving for infants with severe bronchopulmonary dysplasia, new data highlights the risks and outcomes that families and providers must be prepared to face. Infants with bronchopulmonary dysplasia (BPD), the most common morbidity of prematurity, often require long-term respiratory support. Severe BPD can necessitate tracheostomy that is often paired with mechanical ventilation,…

Hip Ultrasound Has Clinical Utility in Detecting Developmental Dysplasia of the Hip Among Preterm Infants
 Hip Ultrasound Has Clinical Utility in Detecting Developmental Dysplasia of the Hip Among Preterm Infants 1024 575 Jessica Nye, PhD
By: Jessica Nye, PhD
small baby with nose canula

A positive first hip ultrasound (HUS) is highly predictive of having developmental dysplasia of the hip (DDH) among preterm infants, according to results of a study published in the American Journal of Perinatology. “In term babies, more is known about the accuracy of ultrasounds for congenital or developmental hip dysplasia. But in preterm babies, there…

A Simple Intervention With Great Potential
 A Simple Intervention With Great Potential 1024 585 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

If the CORD-CHD Study meets even a single endpoint, it will represent one of the simplest and most accessible improvements in congenital heart disease management in recent history. The concept is elegant in its simplicity: delay clamping the umbilical cord for a minute or two after birth to allow a gentle increase in the baby’s…

Clinical Genomics: From Research to Reality
 Clinical Genomics: From Research to Reality 1024 716 Abbie Miller
By: Abbie Miller

Without genomic sequencing, many genetic diseases would never be diagnosed. Genomic testing — whole exome or whole genome sequencing — is vital to reducing the diagnostic odyssey for children with rare, undiagnosed disease. But is genetic analysis only useful in these cases? Experts across the country have long suggested that genomic testing can be even…

Direct Breastfeeding of Mother’s Own Milk Benefits Preterm Infants
 Direct Breastfeeding of Mother’s Own Milk Benefits Preterm Infants 1024 575 Mary Bates, PhD
By: Mary Bates, PhD

Despite benefits, new study finds low rates of breastfeeding among preterm infants discharged from the NICU. Mother’s own milk (MOM) and direct breastfeeding (DBF) are associated with numerous health and development advantages, especially for preterm infants. However, the rates of MOM feeding and DBF among infants admitted to neonatal intensive care units (NICUs) are low,…

Genomics Testing in the Neonatal Intensive Care Unit: Reducing Variability, Improving Utility
 Genomics Testing in the Neonatal Intensive Care Unit: Reducing Variability, Improving Utility 1024 575 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Genomics testing of infants in the neonatal intensive care unit (NICU) has the potential to improve care, but process improvement efforts require consideration of major differences in hospital resources. Babies with genetic conditions make up a significant number of the infants in pediatric and neonatal intensive care units (NICUs), but knowing which babies are sick…

Congenital Hypothyroidism: What Endocrinologists Need to Know
 Congenital Hypothyroidism: What Endocrinologists Need to Know 1024 585 Pam Georgiana
By: Pam Georgiana

Your top 10 questions are answered by Nationwide Children’s experts from the Division of Endocrinology. Congenital hypothyroidism (CH) is a common endocrine disorder, affecting approximately 1 in every 2,000 to 4,000 live births globally. Confusion regarding proper screening and follow-up protocols for this serious yet preventable condition impact clinical care and outcomes for children with…

Meet Amy Brown Schlegel, MD, Section Chief of Neonatology
 Meet Amy Brown Schlegel, MD, Section Chief of Neonatology 1024 603 Pam Georgiana
By: Pam Georgiana

After over a decade in Neonatology at Nationwide Children’s Hospital, Dr. Schlegel has been appointed section chief of Neonatology. We recently sat down to talk with Dr. Schlegel about her time at Nationwide Children’s and her plans for leading the next phase of growth in Neonatal care. Amy Brown Schlegel, MD, practices Neonatology in the…

Eat, Sleep, Console: Reducing NICU Admissions of Infants With Prenatal Opioid Exposure
 Eat, Sleep, Console: Reducing NICU Admissions of Infants With Prenatal Opioid Exposure 1024 575 Lauren Dembeck
By: Lauren Dembeck

Focusing on non-pharmacological care, emphasizing mother-baby bonding, and natural infant behaviors may keep infants out of the NICU, but other barriers may limit implementation. Infants exposed to opioids in utero may experience withdrawal symptoms after birth, which can vary in severity depending on many factors, such as length of exposure and type of opioid. In…

Updated Small Baby Care Guidelines Reflect 20 Years of Work Toward Improved Outcomes
 Updated Small Baby Care Guidelines Reflect 20 Years of Work Toward Improved Outcomes 1024 683 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Thorough management guidelines for babies born before 27 weeks’ gestation join the program’s long list of accomplishments in improving survival and standardizing care for this vulnerable population. As the Small Baby Program at Nationwide Children’s Hospital celebrates its 20th anniversary, it is also releasing its latest set of care guidelines for their tiny patients. Divided…

Subclinical Herpes Simplex Virus in Neonates: What to Do?
 Subclinical Herpes Simplex Virus in Neonates: What to Do? 1024 683 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Neonates can test positive for HSV without having visible lesions or other classic symptoms, leaving clinical uncertainty regarding appropriate antiviral treatment and testing protocols. Researchers at Nationwide Children’s Hospital have shared data on a sample of 17 neonates who tested positive for herpes simplex virus (HSV) at mucosal sites, without any mucosal lesions, positive blood…

Is Surfactant Treatment at Birth Associated With Severe Bronchopulmonary Dysplasia?
 Is Surfactant Treatment at Birth Associated With Severe Bronchopulmonary Dysplasia? 1024 683 Pam Georgiana
By: Pam Georgiana

An observational study reviews a contemporary cohort of preterm infants. Recently, Leif D. Nelin, MD, division chief of neonatology at Nationwide Children’s and a professor of pediatrics at The Ohio State University College of Medicine, and a team of doctors in the Bronchopulmonary Dysplasia (BPD) Collaborative Registry speculated that the use of surfactant treatment in…

Supporting Tracheostomy Decision-Making for Families and Providers
 Supporting Tracheostomy Decision-Making for Families and Providers 1024 683 Abbie Miller
By: Abbie Miller

The Trach Scoring Tool, developed by leaders in bronchopulmonary dysplasia (BPD) at Nationwide Children’s Hospital, offers support for physicians and families. The decision of when to do a tracheostomy on an infant is difficult, to say the least, says Leif Nelin, MD, division chief of Neonatology at Nationwide Children’s Hospital. “Every family has different knowledge,…

Study Reveals New Use for GER Tool in Neonates: Swallowing Analysis
 Study Reveals New Use for GER Tool in Neonates: Swallowing Analysis 1024 683 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES
Dr. Jadcherla

Investigators have repurposed a simple test for gastroesophageal reflux (GER) disease to provide valuable insight into multiple swallowing abnormalities in newborn babies. A tool used to diagnose gastroesophageal reflux disease (GERD) in hospitalized neonates now has another use: characterizing swallowing abilities. The researchers at Nationwide Children’s Hospital who pioneered the objective use of the test,…

Early Detection and Multidisciplinary Care: Successful Management of Duodenal Atresia
 Early Detection and Multidisciplinary Care: Successful Management of Duodenal Atresia 1024 737 Pam Georgiana
By: Pam Georgiana
person in scrubs holding a baby

The team in the Fetal Center at Nationwide Children’s Hospital shares their comprehensive approach for best possible outcomes.  When a routine ultrasound reveals two enlarged, fluid-filled bubbles in the baby’s abdomen, known as the “double bubble” sign, pregnant patients and their families often feel scared and concerned. These bubbles indicate duodenal atresia, a congenital condition…

Optimizing Prenatal and Neonatal Care for Infants With Treatable Rare Diseases
 Optimizing Prenatal and Neonatal Care for Infants With Treatable Rare Diseases 1024 619 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

As new treatments emerge and diagnostics improve, earlier interventions offer infants with rare metabolic and neurodegenerative conditions a future wildly different than ever before. Not long ago, a diagnosis of molybdenum cofactor deficiency (MoCD) type A meant death before kindergarten. Since the FDA approval of NULIBRY® (fosdenopterin) in 2021, however, children diagnosed with MoCD type…

Supporting Optimal Developmental Outcomes After Neonatal Opioid Withdrawal Syndrome
 Supporting Optimal Developmental Outcomes After Neonatal Opioid Withdrawal Syndrome 1024 575 Abbie Miller
By: Abbie Miller
Toddler playing with toys

Children with prenatal opioid exposure have a higher risk for developmental and behavioral concerns. Prenatal opioid exposure is still far too common. Experts estimate that one infant who has been exposed to opioids is born every 15 minutes in the United States.  While standard diagnostic criteria for neonatal opioid withdrawal syndrome (NOWS) were recently proposed,…

Improving UTI Detection in Neonates: Antimicrobial Peptides and Cotton Balls
 Improving UTI Detection in Neonates: Antimicrobial Peptides and Cotton Balls 1024 683 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

New research sets the stage for less-invasive urinary tract infection identification in neonates 22-37 weeks gestational age. A team of researchers driving the revolution in urinary tract infection (UTI) identification using antimicrobial peptides (AMPs) has now expanded their focus from adults and children to newborns – including those born prematurely. Their latest study, published in…

Higher Respiratory Severity Scores Associated with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension Risk
 Higher Respiratory Severity Scores Associated with Bronchopulmonary Dysplasia-Associated Pulmonary Hypertension Risk 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

The RSS score is noninvasive and may be clinically useful for risk stratification in extremely preterm infants. Researchers at Nationwide Children’s report that elevations in the respiratory severity score were correlated with an increased risk of bronchopulmonary dysplasia-associated pulmonary hypertension in preterm infants. This study identifies a pragmatic clinical risk score that can be measured…

RSV in Infants and High-Risk Children: A Commentary on the Roll-out of a New Preventive Medication
 RSV in Infants and High-Risk Children: A Commentary on the Roll-out of a New Preventive Medication 1024 575 Pam Georgiana
By: Pam Georgiana

According to the Centers for Disease Control and Prevention (CDC), respiratory syncytial virus (RSV) causes more than 2 million outpatient visits, as many as 80,000 hospitalizations, and 100 to 300 deaths in children under 5 years old annually. Infants under 6 months of age are at the most significant risk of hospitalization. Although the highest…

What Are the Risk Factors for Recurrent Wheezing in Late Preterm Infants?
 What Are the Risk Factors for Recurrent Wheezing in Late Preterm Infants? 1024 683 Pam Georgiana
By: Pam Georgiana

A collaboration between a pulmonary medicine fellow and allergy and immunology expert identifies four risk factors associated with recurrent wheezing in these patients.   When Brooke R. Gustafson, MD, a member of the Section of Pediatric Pulmonary Medicine at Nationwide Children’s and an assistant professor of pediatrics at The Ohio State University College of Medicine,…

GERD Less Likely Cause of Irritability and Back Arching in Infants
 GERD Less Likely Cause of Irritability and Back Arching in Infants 1024 683 Lauren Dembeck
By: Lauren Dembeck

In infants, frequent irritability and arching of the back can be concerning to parents and providers. These symptoms are often attributed to gastroesophageal reflux disease (GERD), a disease in which the lower esophageal sphincter does not close or opens at the wrong time. As a result, food and stomach acid can come back up into…

Expanding Access to Genomic Testing in Level IV Neonatal Intensive Care Units
 Expanding Access to Genomic Testing in Level IV Neonatal Intensive Care Units 1024 575 Pam Georgiana
By: Pam Georgiana
conceptual art of DNA

Recent study identifies variations in availability and highlights opportunities to improve access to genomic testing in the United States and Canada. In the Nationwide Children’s Hospital neonatal intensive care unit, patients needing rapid genome sequencing can get it on demand without administrative approval. However, that is not the case in all level IV neonatal intensive…

Probiotics Delivered in Biofilm State Protect the Intestines and Brain in NEC Model
 Probiotics Delivered in Biofilm State Protect the Intestines and Brain in NEC Model 898 504 Abbie Miller
By: Abbie Miller

Biofilm formulation of Limosilactobacillus reuteri protects against necrotizing enterocolitis in piglet model.  Necrotizing enterocolitis (NEC) is a debilitating and deadly condition affecting infants born preterm. In NEC cases, intestinal tissues become inflamed, and in severe cases, there is ischemia and death of the involved intestines. Treatment for NEC often involves surgery to remove the dying…

Ensuring Vulnerable Babies Receive the Benefits of Human Milk
 Ensuring Vulnerable Babies Receive the Benefits of Human Milk 1024 575 Mary Bates, PhD
By: Mary Bates, PhD
small baby with nose canula

A QI project increases human milk consumption among newborns hospitalized with congenital heart disease. The American Academy of Pediatrics and the World Health Organization recommend human milk for infants because of its important health benefits. However, most newborns with congenital heart disease (CHD) are separated from their mothers shortly after birth and admitted to a…

A Decade of Evidence: The SIMPLE Program Shows Continued Success
 A Decade of Evidence: The SIMPLE Program Shows Continued Success 1024 575 Pam Georgiana
By: Pam Georgiana

In 2010, Nationwide Children’s Hospitals NICU leaders observed that infant feeding practices varied depending on the provider, resulting in significant variations in milestones and length of hospital stays (LOHS). They asked Sudarshan R. Jadcherla, MD, and Erika Osborn, NNP, to partner with stakeholders, including nurses, physicians, nutritionists, lactation experts, and others, to develop an evidence-based…

Using Machine Learning to Classify Treatment Approaches for Infants with Bronchopulmonary Dysplasia
 Using Machine Learning to Classify Treatment Approaches for Infants with Bronchopulmonary Dysplasia 1024 683 Pam Georgiana
By: Pam Georgiana

We don’t yet know the best way to help infants with severe bronchopulmonary dysplasia (BPD) breathe using ventilators. Currently, doctors across the country and around the world use a variety of different approaches.  These variations depend on the severity of a patient’s medical condition, the ventilator settings used, and location-specific standards. Matthew Kielt, MD, a…

Assessing Respiratory Stability in Infants Hospitalized with Bronchopulmonary Dysplasia
 Assessing Respiratory Stability in Infants Hospitalized with Bronchopulmonary Dysplasia 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

The Behavioral Signs of Respiratory Instability Scale is a valid, reliable measure of respiratory status and developmental ability. In a new study, researchers at Nationwide Children’s evaluated the Behavioral Signs of Respiratory Instability (BSRI) Scale, which was developed as an objective measure of developmental capacity of infants with severe forms of bronchopulmonary dysplasia (BPD). The…

An Alternative Method for Diagnosing Central Adrenal Insufficiency in Newborns
 An Alternative Method for Diagnosing Central Adrenal Insufficiency in Newborns 1024 683 Mary Bates, PhD
By: Mary Bates, PhD
Baby in NICU

Researchers evaluate the utility of random cortisol levels to diagnose adrenal insufficiency. In infants with central adrenal insufficiency, adrenocorticotropic hormone (ACTH) fails to signal to the adrenal gland, leading to decreased cortisol levels. It is a potentially life-threatening condition requiring urgent diagnosis and treatment. Diagnosing central adrenal insufficiency typically involves a low-dose synthetic ACTH (cosyntropin)…

Kidney Support for Babies: Building a Comprehensive and Integrated Neonatal Kidney Support Therapy Program
 Kidney Support for Babies: Building a Comprehensive and Integrated Neonatal Kidney Support Therapy Program 1024 575 Lauren Dembeck
By: Lauren Dembeck
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

Kidney support therapy (KST), commonly referred to as dialysis, is a life-saving procedure used to manage complications associated with acute kidney injury and kidney failure, such as fluid overload and electrolyte imbalances, or to remove toxins, such as those in patients with inborn errors of metabolism. Most KST or dialysis machines are designed for adults…

Advancing Genomics-Driven Precision Medicine in the NICU
 Advancing Genomics-Driven Precision Medicine in the NICU 1024 683 Natalie Wilson
By: Natalie Wilson

According to the Children’s Hospitals Neonatal Consortium, as many as half of newborns hospitalized in level IV neonatal intensive care units (NICUs) due to critical illness have an underlying genetic condition. Most don’t get their diagnosis for months or even years. However, clinical assays, new testing modalities and clinical trials are improving their care. Advanced…

Preterm Birth Increases Health Vulnerabilities of Babies With Down Syndrome
 Preterm Birth Increases Health Vulnerabilities of Babies With Down Syndrome 1024 624 JoAnna Pendergrass, DVM
By: JoAnna Pendergrass, DVM

Babies with Down syndrome who are born preterm have higher prenatal morbidity and mortality rates than those in babies with Down syndrome born at term, suggesting pediatricians can lower their risk threshold for certain screenings or interventions. Compared with age-matched neonates without Down syndrome, babies with Down syndrome are more likely to experience developmental delay,…

Using Machine Learning in the Electronic Medical Record to Save Lives
 Using Machine Learning in the Electronic Medical Record to Save Lives 1024 683 Abbie Miller
By: Abbie Miller
physicians in white coats looking at a tablet

The deterioration risk index identifies patients at risk for deterioration and poor outcomes, triggering the care team to act before a crisis happens. In a report published in Pediatric Critical Care Medicine, a team from Nationwide Children’s Hospital describes a machine learning tool for timely identification of hospitalized children at risk for deterioration – a…

5 Things Neonatologists Should Know About Vitamin K Deficiency
 5 Things Neonatologists Should Know About Vitamin K Deficiency 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

Vitamin K prophylaxis is safe and effective. Why are more parents refusing it, and what can be done? In a new perspective paper in the Journal of Perinatology, researchers from Nationwide Children’s say that vitamin K prophylaxis is an essential component of newborn care and yet, parental refusal of the intervention is on the rise.…

Substantial Variation in Fluid Balance Among Preterm Neonates
 Substantial Variation in Fluid Balance Among Preterm Neonates 1024 575 Lauren Dembeck
By: Lauren Dembeck
Nurse caring for infant in Neonatal Intensive Care Unit (NICU)

In neonates, approximately 75 to 90% of the body weight consists of body fluid. The amount varies with gestational age, with higher total body fluid percentages in extremely preterm infants, those born at 22 to 28 weeks of gestation. These extremely preterm infants have immature skin and kidneys and thus immature fluid homeostasis regulatory mechanisms,…

Featured Researcher — Jonathan Slaughter, MD, MPH
 Featured Researcher — Jonathan Slaughter, MD, MPH 150 150 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

Jonathan Slaughter, MD, MPH, neonatologist and principal investigator in the Center for Perinatal Research at Nationwide Children’s Hospital, works to identify best practices and reduce treatment variation to improve neonatal clinical care and outcomes. His career took off when, after casually observing practice variation across the institutions where he received training, he noticed that preterm…

Low-Resource Screening Tool Demonstrates Superior Predictive Value for Cerebral Palsy in Infants
 Low-Resource Screening Tool Demonstrates Superior Predictive Value for Cerebral Palsy in Infants 1024 683 JoAnna Pendergrass, DVM
By: JoAnna Pendergrass, DVM

The use of lower-resource screening tools for cerebral palsy in infants can help increase early detection of the condition and promote access to early interventions.   A recent study reported that the Hammersmith Infant Neurological Examination (HINE), when compared with the Test of Infant Motor Performance (TIMP), had the better predictive value for detecting cerebral…

Development of Acute Kidney Injury as a Potential Biomarker of Necrotizing Enterocolitis in Preterm Infants
 Development of Acute Kidney Injury as a Potential Biomarker of Necrotizing Enterocolitis in Preterm Infants 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

Regular measurement of serum creatinine levels could help identify necrotizing enterocolitis sooner. Researchers at Nationwide Children’s neonatal intensive care unit (NICU) evaluated serum creatinine levels and the development of acute kidney injury as a potential biomarker of necrotizing enterocolitis in preterm infants. The retrospective chart review showed that acute kidney injury is more prevalent in…

American Academy of Pediatrics Updates Guidelines for the Management of Neonatal Hyperbilirubinemia
 American Academy of Pediatrics Updates Guidelines for the Management of Neonatal Hyperbilirubinemia 1024 737 Emily Siebenmorgen
By: Emily Siebenmorgen
person in scrubs holding a baby

Nationwide Children’s physicians collaborate on updates to testing, treatment and follow-up recommendations for preventing hazardous hyperbilirubinemia and possible brain damage. The American Academy of Pediatrics’ (AAP) recommendations for managing hyperbilirubinemia in infants 35 gestational weeks and older are among its most accessed sets of clinical practice guidelines. A team led by Alex Kemper, MD, MPH,…

Predicting Response to Bronchodilators in Infants with Bronchopulmonary Dysplasia
 Predicting Response to Bronchodilators in Infants with Bronchopulmonary Dysplasia 1024 683 Mary Bates, PhD
By: Mary Bates, PhD

Study emphasizes importance of identifying those patients who will respond to treatment. Certain pulmonary function test parameters in newborns with bronchopulmonary dysplasia are associated with bronchodilator response, according to a new study from researchers at Nationwide Children’s Hospital. The team also found that responders had evidence of greater dysanaptic lung growth than nonresponders. Bronchodilators are…

Do Symptom Scores and pH Impedance Correlate in Infants Treated for Gastroesophageal Reflux?
 Do Symptom Scores and pH Impedance Correlate in Infants Treated for Gastroesophageal Reflux? 1024 683 Lauren Dembeck
By: Lauren Dembeck

Gastroesophageal reflux (GER) — the passage of gastric contents into the esophagus — is a physiologic process that can be considered normal or abnormal depending on whether troublesome symptoms and/or complications also occur. In infants, it is difficult for clinicians to distinguish between GER and pathophysiologic GER disease (GERD). “Current diagnostic criteria for GERD are…

Quality Improvement Scorecard Enhances Safety for Newborns
 Quality Improvement Scorecard Enhances Safety for Newborns 1024 683 Emily Siebenmorgen
By: Emily Siebenmorgen

The collaborative program between academic and community hospitals improves neonatal care quality. In a recent study published in The Journal of Pediatrics, researchers from Nationwide Children’s Hospital and affiliated level one and two community hospital nurseries implemented a quality improvement (QI) scorecard and found improvements in important perinatal outcomes. “Roughly half of all newborns in…

Nafcillin is a Safe Alternative to Vancomycin for Empirical Treatment of Late-Onset Sepsis Among Infants in the NICU
 Nafcillin is a Safe Alternative to Vancomycin for Empirical Treatment of Late-Onset Sepsis Among Infants in the NICU 1024 681 Mary Bates, PhD
By: Mary Bates, PhD
sleeping infant

Guidelines to reduce vancomycin use at three Ohio NICUs did not impact mortality rate. In 2014, the Neonatal Antimicrobial Stewardship Program at Nationwide Children’s Hospital recommended nafcillin rather than vancomycin for empirical therapy of possible late-onset sepsis in infants without a history of methicillin-resistant Staphylococcus aureus (MRSA) infection or colonization. In a new study, researchers…

Improving Racial Diversity and Equity in Clinical Trials
 Improving Racial Diversity and Equity in Clinical Trials 1024 511 Jeb Phillips
By: Jeb Phillips

There is now broad consensus across medicine that clinical trials must be more representative of minority populations. How can that be achieved? Last year, a group of Nationwide Children’s Hospital neonatologists published an unusually pointed critique of racial and ethnic representation in neonatal clinical trials in the Journal of Perinatology. They wrote that the lack…

Multi-Disciplinary Team Develops Evidence-Based Guidelines for Acute Management of Persistent Pulmonary Hypertension in Newborns
 Multi-Disciplinary Team Develops Evidence-Based Guidelines for Acute Management of Persistent Pulmonary Hypertension in Newborns 200 133 Katie Brind'Amour, PhD, MS, CHES
By: Katie Brind'Amour, PhD, MS, CHES

What began as an internal effort to simplify practice has transformed into published evidence-based guidelines to standardize care for acute stabilization and management of newborns with pulmonary hypertension.   Persistent pulmonary hypertension of the newborn (PPHN) is a highly varied and changeable condition that presents a challenge for clinical management, even among tertiary care centers…