Neonatology

How to Reduce Necrotizing Enterocolitis in the NICU
How to Reduce Necrotizing Enterocolitis in the NICU 150 150 Jeb Phillips

A QI project with simple, inexpensive interventions significantly lowered the NEC rate in one of the country’s largest neonatal units. In 2011, a quality improvement team at Nationwide Children’s Hospital developed a short list of simple, economical strategies to limit necrotizing enterocolitis (NEC), one of the leading causes of morbidity and mortality in its associated…

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Diagnosing GERD in Neonates? Be Cautious
Diagnosing GERD in Neonates? Be Cautious 150 150 Jeb Phillips

Gastroesophageal reflux disease is likely over-diagnosed in neonates, leading to unnecessary and harmful treatment. Approximately 10 percent of infants born preterm in the United States are diagnosed with gastroesophageal reflux disease (GERD). But it’s almost certain that not all of those babies actually have GERD, say neonatologists at Nationwide Children’s Hospital. The probable over diagnosis leads to…

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One Dose Probiotic Biofilm Protects Against NEC
One Dose Probiotic Biofilm Protects Against NEC 150 150 Kevin Mayhood

Probiotic biofilm enables the beneficial bacteria to withstand stomach acid, promote microbial activity and decrease intestinal inflammation. A single dose of a probiotic biofilm grown on microspheres prevented or significantly reduced the severity of necrotizing enterocolitis (NEC) in animal models of the disease, researchers show. This delivery method not only appears to protect against NEC…

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Often-Unreported MRI Finding May Indicate Neurodevelopmental Impairment in Premature Infants
Often-Unreported MRI Finding May Indicate Neurodevelopmental Impairment in Premature Infants 150 150 Jeb Phillips

Moderate-to-severe gyral maturation delay emerged as a significant predictor of overall neurodevelopmental delay in premature infants with extremely low birth weights Magnetic resonance imaging of the brain is increasingly used to predict neurodevelopmental outcomes in premature infants, but the existing systems of scoring those MRIs rely heavily on expert opinion. A recent study led by…

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For Infants Born Very Preterm, Transcatheter Device Closure of Patent Ductus Arteriosus is Feasible
For Infants Born Very Preterm, Transcatheter Device Closure of Patent Ductus Arteriosus is Feasible 150 150 Jeb Phillips

Optimal timing of procedures and reduction of adverse events are avenues for future study. Approximately half of babies born at less than 32 weeks of gestational age have persistent patent ductus arteriosus (PDA), a condition associated with higher odds of death and respiratory morbidity. When doctors choose to close the ductus, a percutaneous approach is…

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Despite Safety Concerns, Nearly 1 in 4 Babies in the NICU Receive Acid Suppressing Medications
Despite Safety Concerns, Nearly 1 in 4 Babies in the NICU Receive Acid Suppressing Medications 150 150 Jeb Phillips

While use is dropping overall as doctors heed warnings, acid suppressing medication originally formulated for older children and adults is still being given to nearly 25 percent of babies in the NICU. Since 2006, several published studies have associated the use of some acid suppression medications in hospitalized high-risk babies with infections, necrotizing enterocolitis and…

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The Smallest Victims of the Opioid Crisis
The Smallest Victims of the Opioid Crisis 1024 575 Abbie Roth
Black and white photo of infant crying in hospital

Research, protocols and community connections lead to help infants with neonatal abstinence syndrome and their mothers. It’s a sound you’d never forget. The panicked, high-pitched cry of a newborn withdrawing from the drugs his mother took. All the sensations that drive an addict to use again and again just for the relief – shaking, vomiting,…

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Weaning Babies with NAS Better and Faster
Weaning Babies with NAS Better and Faster 150 150 Kevin Mayhood

Protocol enables babies born addicted to opioids to be weaned off the drugs faster. Adoption of a strict protocol has enabled six regional perinatal centers across Ohio to wean babies exposed to opioids in utero off drugs faster, send them home sooner and lower the use of adjunctive drugs, new research shows. In response to the skyrocketing…

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Better Care and Better Business
Better Care and Better Business 150 150 Dave Ghose

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…

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An Ethical Discussion of Parental Care Preference
An Ethical Discussion of Parental Care Preference 150 150 Jan Arthur

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…

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Delayed Umbilical Cord Clamping May Benefit Some High-Risk Newborns
Delayed Umbilical Cord Clamping May Benefit Some High-Risk Newborns 150 150 Jeb Phillips

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…

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What Do DALYs Mean for Pediatrics?
What Do DALYs Mean for Pediatrics? 150 150 Dave Ghose

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 —…

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Conflicting Directions for BPD Treatment
Conflicting Directions for BPD Treatment 150 150 Katie Brind'Amour, PhD, MS, CHES

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,…

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Placental Transfusion Confusion
Placental Transfusion Confusion 150 150 Katie Brind'Amour, PhD, MS, CHES

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…

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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

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…

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Are We Properly Capturing the Maternal-Child Health Continuum?
Are We Properly Capturing the Maternal-Child Health Continuum? 150 150 Irina Buhimschi

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…

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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

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.…

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Evolution of an Atlas
Evolution of an Atlas 150 150 Katie Brind'Amour, PhD, MS, CHES

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…

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