Mindful Kangaroo Care: mindfulness intervention for mothers during skin-to-skin care: a randomized control pilot study

Background Parents of babies admitted to the Newborn Intensive Care Unit (NICU) undergo considerable stress. There is evidence that mindfulness reduces stress in these parents. Kangaroo Care (KC) is practiced in NICUs across the world and is stress-relieving. Whether mindfulness practiced during KC in the NICU reduces parental distress has not yet been studied. The objective was to explore the feasibility and acceptability of teaching and practicing mindfulness during KC for mothers of premature babies. The objective was also to document preliminary outcomes of Mindful Kangaroo Care (MKC) on maternal stress, anxiety, depression, and mindful awareness. Methods In this pilot randomized controlled study, mothers of premature babies who were expected to stay in the NICU for at least four weeks were taught two mindfulness exercises to practice during KC and compared to mothers who received standard care with no mindfulness teaching. Mothers filled out stress, anxiety, depression and mindful awareness scales at recruitment and after four weeks. Acceptability and feasibility questionnaires were also completed. Results Fifteen mothers per group completed the study. The MKC group demonstrated a significant within-group reduction in anxiety (p = 0.003), depression (p = 0.02) and stress (p = 0.002), and a significant increase in both the curiosity (p = 0.008) and decentering (p = 0.01) scores of the Toronto Mindfulness Scale, all of which had medium to large effect sizes. Only the increases in curiosity and decentering were significant between groups. Fourteen mothers found the intervention acceptable, one neutral. Conclusion MKC was acceptable, feasible and led to a reduction in stress, anxiety and depression in mothers who practiced mindfulness exercises during KC.

Study Design for an Evaluation of Newborn Screening for SCID in the UK

Severe combined immunodeficiency is a rare inherited disorder, which, if untreated, invariably proves fatal in late infancy or early childhood. With treatment, the prognosis is much improved. Early treatment of the siblings of cases, before they become symptomatic, has shown considerable improvements in outcomes. Based on this and the development of a test that can be used on the whole population of neonates (measurement of T-cell receptor excision circles—TRECs), many countries have added it to their routine newborn bloodspot screening programmes. The UK National Screening Committee (UKNSC) has considered whether SCID should be added to the UK screening programme and concluded that it was likely to be cost effective, but that there were a number of uncertainties that should be resolved before a national roll-out could be recommended. These include some aspects of the test, such as: cost; the use of different assays and cut-off levels to reduce false positive rates, while maintaining sensitivity; the overall benefits of screening for disease outcome in patients with SCID and other identified disorders; the need for a separate pathway for premature babies; the acceptability of the screening programme to parents of babies who have normal and abnormal (both true and false positive) screening results. To achieve this, screening of two thirds of babies born in England over a two-year period has been planned, beginning in September 2021. The outcomes and costs of care of babies identified by the screening will be compared with those of babies identified with SCID in the rest of the UK. The effect of the screening programme on parents will form part of a separate research project.

Spontaneous changes of skull morphology in premature babies: A preliminary study using plagiocephalometric analysis

Aim — to develop a reliable protocol to study the spontaneous changes in te skull morphology, specifically plagiocephaly in premature infants.Materials and methods. Evaluation of the degree of asymmetry using a plagiocephalometric tool and passive motion assessment for axial rotation and clinical examination of the neck muscles in six preterm infants. All measures are taken four times over a two months period.Results. About the placement of thermoplastic bands, a maximal variability of 3 % and 5 % was found for intra-and inter- observations respectively for the indices of interest (ODDI, CPI, CVAI). The variability of measures taken on photocopies was less than 1 %. 67 % of children had a preferential position on the third measure (T3) and 83 % on the fourth measure (T4). The prevalence of plagiocephaly was 17, 67, 33 and 50 % at T1, T2, T3 and T4 respectively considering a threshold of oblique diameters difference (ODDI) of 104 % . No influence of gender, gestational age, primiparity or asymmetry in muscle tension and/or rotation has been highlighted. In comparison with previous data, a very highly significant difference (p=0,001) was found for the index head values.Conclusion. This study has demonstrated the feasibility of the method. More consistent data should be considered, with a broader sample in order to provide a relevant analysis of the morphometric changes of the skull base. According to the criteria of the literature, three premature infants out of six had a plagiocephaly at T4 and we observed a normalization of morphometric values was observed in two infants.

Prevalence and Risk Factors for Retinopathy of Prematurity in China: A Systematic Review and Meta-Analysis

Background The etiology of retinopathy of prematurity (ROP) is thought to be related to genetic susceptibility and environmental exposure factors. The purpose of this article was to estimate the prevalence of ROP in mainland China and to attempt to summarize the environmental risk factors for ROP in Chinese infants. Method We searched 9 databases for articles that were published before May 29, 2021, and studies describing the prevalence and risk factors for ROP in Chinese infants were included. The fixed-effects model and the random-effects model were applied to the effect sizes (ES) and their 95% confidence intervals (CIs) with I2≤50% and I2>50% in the heterogeneity tests, respectively. Results Twenty-two separate populations were included in the meta-analysis of the prevalence of ROP. The prevalence of ROP in mainland China was 9.284% (95% CI: 6.546-12.022%). It was negatively correlated with birth weight (BW) and gestational age (GA). Fifty independent meta-analyses were observed to be related to environmental exposure factors of ROP. Thirty of the 50 meta-analyses had results that were significant at p values less than 0.05. The first three risk factors with the largest combined effect size were GA≤34 w, bronchopulmonary dysplasia (BPD) and BW≤2,000 g. Conclusions Approximately one in ten immature infants suffered from ROP. More studies need to be included. Premature babies with diseases that cause hypoxia and irregular oxygen use should be paid more attention for ROP screening.

Is it possible to use a 100% Medical Grade Honey in the premature babies?

Le proprietà curative del miele sono sempre più affermate nella medicina moderna, soprattutto nel trattamento di lesioni cutanee di varia natura come piaghe da decubito, ustioni e stravaso di farmaci. Esistono diversi studi sull’uso del miele nei pazienti adulti ma non esistono linee guida universali nella popolazione pediatrica e soprattutto in quella neonatale. Presso l’Hevi Pediatric Teaching Hospital di Duhok, Iraq, un prematuro di peso estremamente basso alla nascita, con lesioni al piede da stravaso di farmaco, è stato trattato con il Medical Grade Honey al 100%. Dopo 28 giorni, la lesione è guarita, senza ricorrere alla rimozione chirurgica del tessuto e senza complicazioni allergiche per il paziente. L’uso del miele nei prematuri deve essere ulteriormente studiato e preso in considerazione.

Pengaruh Metode Kanguru terhadap Peningkatan Berat Badan Pada Bayi BBLR

ABSTRAK Kelahiran bayi prematur merupakan salah satu penyebab kematian terbesar saat ini. Tindakan perawatan bayi lahir dilakukan dengan menghangatkan tubuh bayi, secara konvensional menggunakan inkubator namun, teknologi inkubator relatif mahal. Perawatan Metode Kanguru (PMK) merupakan salah satu teknik perawatan yang efektif bagi bayi prematur. Tujuan penelitian ini adalah untuk mengetahui pengaruh metode kanguru terhadap peningkatan berat badan pada bayi BBLR di RSUD Provinsi Kepulauan Riau. Desain penelitian ini adalah quasi eksperimen dengan rancangan one group pretest posttest dengan sampel sebanyak 16 responden, pengambilan sampel menggunakan teknik purposif sampling. Hasil didapatkan rata-rata berat badan bayi sebelum perawatan metode kanguru adalah 1718,88 gram, dan setelah dilakukan perawatan metode kanguru rata-rata berat badan bayi meningkat menjadi 1844,38 gram, dengan peningkatan berat badan sebanyak 125,5 gram dimana p value = 0.000 (α< 0.05 ). Terdapat pengaruh perawatan metode kanguru terhadap peningkatan berat badan bayi BBLR di RSUD Provinsi Kepulauan Riau. Bagi ibu-ibu untuk melakukan perawatan metode kanguru secara rutin dan pemberian ASI yang cukup terhadap bayi BBLR. Kata kunci: metode kanguru; peningkatan berat badan; bayi BBLR ABSTRACTPremature birth is one of the biggest causes of death today. The act of caring for the newborn is carried out by warming the baby's body, conventionally using an incubator, however, incubator technology is relatively expensive. Kangaroo Treatment Method (PMK) is one of the effective treatment techniques for premature babies. The purpose of this study was to determine the effect of the kangaroo method on weight gain in LBW infants at the Riau Islands Province Hospital. The design of this research was a quasi-experimental design with one group pretest posttest with a sample of 16 respondents, sampling using purposive sampling technique. The results obtained that the average baby weight before the kangaroo method was 1718.88 grams, and after the kangaroo method treatment the average baby weight increased to 1844.38 grams, with an increase in body weight of 125.5 grams where p value = 0.000 (α< 0.05 ). There is an effect of kangaroo treatment method on increasing the weight of LBW babies in Riau Islands Provincial Hospital. For mothers to carry out routine kangaroo care and adequate breastfeeding for LBW babiesKeywords: kangaroo method; weight gain; LBW infant

Decrease in the Use of Parenteral Fluids in Premature Infants from 31 to 34 Weeks of Gestation at Birth

Introduction: Some of the practices in medicine are carried out of habit without proven benefits. This is the case of premature babies from 31 to 34 weeks of gestation who are always given parenteral fluids, even though this practice has been associated with an increase incidence of infection. In 2017, we started a protocol of parenteral fluid restriction. To administer nutrition/fluids, we used oral fluids by suction if this was possible or otherwise by oral/nasogastric tube at volumes of 15-20 mL intake every 3 hours, with 5 mL increments every 12-24 hours until 200 mL/K/day was achieved, always using breast milk when possible.Material and methods: The present study sought to compare cases before and after this new policy. For this work, we review all premature babies between 31-34 weeks of gestation discharged home in two periods of time, the first from 01/01/2012 to 12/31/2017 and the second from 01/01/2018 to 08/31/2021. The number of cases with and without parenteral fluids (PF), the incidence of infection, the weight at admission and discharge, and the fall in the weight Z score between birth and discharge were compared. Both the anthropometric and outcome variables were compared using the different statistical methods according to each variable.Results: 725 cases were found with the described characteristics. The groups before and after the intervention did not show significant differences in their general demographic characteristics. A lower use of PF was observed in the second period from 348 cases (79%) to 70 (24%), p &lt;0.001 and fewer days of use (4.1 days/case vs 1.3, p &lt;0.0001) of PF. The weight at discharge and the change in weight Z-score were the same in both groups. Infections went from three cases to zero but it was not statistically significant. There were no complications due to less use of PF.Discussion: This study showed that the use of PF is not associated with significant changes in outcomes of interest, which reinforces that its use does not generate any benefit for the patient. Larger number of cases is required to detect differences in low incidence events such as infections.

Laboratory Parameters of Bone Metabolism in Premature Infants and Children Born Using In Vitro Fertilization

Aim. To study the indicators of bone metabolism in premature babies born naturally and children born with IVF. Material and methods. The premature babies’ study was conducted, they were divided into 4 groups: depending on the method of birth and weight: 1st-children born with IVF, with very low weight; the second group – similar to the first, but children with extremely low weight; the third – children with very low weight, born naturally, with ; the fourth – similar to the 3rd, but with extremely low weight. The level of calcium, parathyroid hormone, calcitonin and C-terminal telopeptides of type I collagen was determined. Results and discussion. Diagnosis of vitamin D deficiency is possible only by measuring certain biochemical parameters, primarily the levels of its metabolites in the blood. Clinical symptoms of vitamin D deficiency in the form of rickets, osteomalacia, osteoporosis and extra-skeletal manifestations as a result of this vitamin deficiency occur over a long period of time. The most informative indicator of the body’s vitamin D supply is the content of calcidiol [25 (OH)D] in both serum and blood plasma. Vitamin D deficiency was detected in more than half (67.7±4.8%) of premature newborns in the first year of life. It seemed that in premature babies born in different ways, vitamin D deficiency was noted in 8 %, insufficiency – in 67.7 %, and the normal content in 27.5 %. In children at an early age, there is a violation of bone metabolism (an increase in the level of calcium, parathyroid hormone, calcitonin, on the one hand, and a decrease in the C-terminal telopeptides of type I collagen, on the other). These changes were associated with the weight of children, while aggressive disorders were noted in children with extremely low weight. In premature infants (with a body weight of less than 1500 g), monitoring of the level of vitamin D in the blood and C-terminal telopeptides of type 1 collagen should be recommended. Conclusion. Bone modeling has a great advantage due to the analysis of the blood serum biomarkers levels in premature infants, it enables to establish the features of osteogenesis.

ETIOLOGY AND PATHOGENESIS OF THE CONGENITAL PNEUMONIA IN NEWBORNS (LITERATURE REVIEW - PART 1)

This article focuses on the incidence of intrauterine pneumonia among newborns, with an emphasis on premature babies. So, at the beginning of the 21st century, there is a clear trend in all countries to an increase in the number of births of premature patients. Among the variety of intrauterine infections in premature infants, intrauterine pneumonia deserves close attention. The article presents the main risk factors for preterm birth. The modern views on the etiology of intrauterine pneumonia in newborn infants are presented in detail. The main causative agents of this pathological process are given. The causes of lung lesions in newborns, especially premature babies, are indicated. Clear parallels are drawn between low gestational age and newborn’s body weight with the consequences of previous hypoxia (acute and / or chronic), as well as with the emergence and rate of development of intrauterine infection and its influence on the formation and development of the fetal immune system. The combined effect of unfavorable factors subsequently leads to the manifestation of pronounced immunosuppression in the newborn and creates the preconditions for the generalization of the pathological process.

Transpiloric feeding in gastroesophageal reflux in neonatology

Optimizing nutritional support is essential for critically ill children, and premature infants are particularly vulnerable to the effects of prolonged fasting. There is a lot of evidence in the scientific literature for the benefits of enteral nutrition. It is known that premature babies need an individual approach to nutrition due to the prevalence of catabolic processes, while treatment in the intensive care unit requires a surplus of calories. Timely introduction of enteral nutrition helps to reduce morbidity and mortality in this population. Gastroesophageal reflux is common in preterm infants. When there is a decrease in tolerance to enteral feeding, doctors usually prefer parenteral nutrition. However, its use can be associated with metabolic, infectious and iatrogenic complications. A step-by-step therapeutic approach is recommended in the treatment of GER in preterm infants. Conservative treatment should be considered as first-line therapy in children without clinical complications. Feeding through a gastric tube is not always well tolerated by seriously ill people patients. As for the treatment of complicated GER, extensive studies show that the use of transpiloric feeding is comparable in effectiveness to fundoplication. Transpiloric feeding tube can be justified as a strategy for treating GER that is refractory to conservative therapy.