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"Pediatrics and Neonatal"
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Long-Term Outcomes of Infants with Neonatal Abstinence Syndrome
Abstract
Parents of infants with neonatal abstinence syndrome (NAS) in the NICU may have questions about the long-term consequences of prenatal exposure to methadone, both asked and unasked. Although the signs of withdrawal will abate relatively quickly, parents should be aware of potential vision, motor, and behavioral/cognitive problems, as well as sleeping disturbances and ear infections so their infants can be followed closely and monitored by their pediatrician with appropriate referrals made. Furthermore, this knowledge may inspire parents to enroll their infants in an early intervention program to help optimize their outcomes. There are still many unanswered questions about epigenetic consequences, risk for child abuse/neglect, and risk of future substance abuse in this population.
Journal Article
Music Therapy Research in the NICU: An Updated Meta-Analysis
Purpose: To provide an overview of developmental and medical benefits of music therapy for preterm infants.
Design: Meta-analysis.
Sample: Empirical music studies with preterm infants in the neonatal intensive care unit (NICU).
Main Outcome: Evidence-based NICU music therapy (NICU-MT) was highly beneficial with an overall large significant effect size (Cohen's d = 0.82). Effects because of music were consistently in a positive direction.
Results: Results of the current analysis replicated findings of a prior meta-analysis and included extended use of music.1 Benefits were greatest for live music therapy (MT) and for use early in the infant's NICU stay (birth weight <1,000 g, birth postmenstrual age <28 weeks). Results justify strong consideration for the inclusion of the following evidence-based NICU-MT protocols in best practice standards for NICU treatment of preterm infants: music listening for pacification, music reinforcement of sucking, and music pacification as the basis for multilayered, multimodal stimulation.
Journal Article
Social Support, Postpartum Depression, and Professional Assistance: A Survey of Mothers in the Midwestern United States
ABSTRACT
Transition into motherhood is generally a joyful life event; for some women, however, it is marked by emotional turmoil. Lack of support can be associated with postpartum depression and can compromise both the mother and infant. A descriptive, cross-sectional study (N = 61) was conducted to explore the relationship between social support and postpartum depression and to determine whether mothers overwhelmed with childcare, or overwhelmed with life in general since becoming a mother, sought professional help. The results revealed that screening for depression alone may not be sufficient, that mothers are willing to contact a professional for help in the postpartum period, and that assessments after birth should include a broader assessment of life's difficulties rather than focusing on childcare responsibilities alone.
Journal Article
The barriers and challenges of using health information technology in medication administration process for pediatrics and neonates: A qualitative study
Background and Aims Children and neonates are more susceptible to diseases and are a vulnerable group in medication administration (MA). Nurses interact directly with patients, ensuring safety and preventing unintended outcomes. Health Information Technology (HIT) has transformed health care, aiding nurses in decision‐making and treatment responses. Despite its benefits, technology presents challenges that must be overcome to facilitate the nursing practice. Therefore, the present study aimed to explore the barriers to HIT use in the process of MA in children and neonates in a developing country. Methods Semi‐structured face‐to‐face interviews were conducted with 22 health care professionals across seven pediatric and neonatal settings. Also, observations were made of these settings for 3 weeks. A qualitative analysis was performed using the conventional content analysis method, recommended by Colaizzi's seven‐step approach. Results The results showed that the most significant barriers to adopting technology in MA process could be classified into two main categories: “inappropriate management approaches” with two sub‐categories (“Managers' reluctance to adopt new technology”, “lack of adequate budget for hardware resources”), and “resistance to change” with two sub‐categories (“A desire to use conventional (traditional) approaches in care”, “cultural issues and impracticality of providing some specialized technology services”). Conclusion The findings revealed MA process complexities, which have been insufficiently examined in the current literature. We have highlighted the need for improved “effectiveness of HIT systems in administering medication processes, budget for hardware resources, and managers” interest in using new technology. The present findings can guide the development of more effective and user‐friendly HIT systems in pediatric and neonatal care settings.
Journal Article
Congenital Toxoplasmosis: A Review
Abstract
Acute infection of toxoplasmosis during pregnancy is detrimental to the developing fetus. In the United States, approximately 1 in 10,000 live births are affected by congenital toxoplasmosis. Although multifactorial in etiology, maternal infection is primarily attributed to the consumption of contaminated meat or water. Infection and transmission to the fetus may result in devastating neurologic impairment. Screening methods for all pregnant women should be implemented in routine prenatal care. This article will highlight the inherent dangers of congenital toxoplasmosis, while including general care of the fetus for prevention of transmission, medical management, and long-term outcomes.
Journal Article
Supporting Women with Substance Use Issues: Trauma-Informed Care as a Foundation for Practice in the NICU
ABSTRACT
Infants with neonatal abstinence syndrome and their mothers require extended support through health and social service systems. Practitioners are interested in exploring innovative approaches to caring for infants and mothers. There is now compelling evidence linking women's substance use to experiences of trauma and violence. A significant shift in the fields of addiction and mental health has been awareness of the impact of trauma and violence on infants and children, women, their families, and communities. In this article, the current state of knowledge of trauma-informed care is reviewed, in particular for application to practice within the NICU. Trauma survivors are at risk of being retraumatized because of health care providers' limited understanding of how to work effectively with them. Recognizing the impact of trauma and implementing evidence-based trauma-informed practices in the NICU holds promise for improving outcomes for women and their infants.
Journal Article
Parent-Infant Skin-to-Skin Contact Following Birth: History, Benefits, and Challenges
Abstract
It is a practice with strong roots in nature and has a significant influence on health outcomes, particularly for at-risk newborns in low-resource settings. In this comprehensive review, benefits of SSC for newborns, mothers, and fathers after vaginal and cesarean births are discussed as well as the benefits of SSC observed for infants in the NICU. Barriers to SSC practice implementation are discussed, and proposed solutions and recommendations are offered. By understanding the many benefits of SSC and strategies for implementation, health care providers can best support and promote this high-quality, evidence-based practice with mothers, newborns, and their families.
Journal Article
Cue-Based Feeding in the NICU: Using the Infant's Communication as a Guide
Although studies have shown cue-based feeding can lead to earlier achievement of full oral feeding, the successful implementation of cue-based feeding has been constrained by the volume-driven culture, which has existed for many years in the NICU. This culture was built on the notion that a \"better\" nurse is one who could \"get more in,\" and infants who are \"poor feeders\" are ones who \"can't take enough.\" The infant who feeds faster is often viewed as more skilled in this task-oriented approach.
The feeding relationship and the infant's communication about the experience of feeding may not be nurtured. This article will explain the central role of the preterm infant's communication in successful cue-based feeding. When the infant is perceived as having meaningful behavior (i.e., communicative intent), the focus changes from a volume-driven to a co-regulated approach, through which the infant guides the caregiver. This is cue-based feeding.
Journal Article
The Parental Experience of Having an Infant in the Newborn Intensive Care Unit
The purpose of this systematic review was to explore and describe the experience of parents with an infant in the newborn intensive care unit (NICU). A literature search covering the period 1998-2008 was conducted. Fourteen articles reporting qualitative studies describing parental experiences and meeting the inclusion criteria were evaluated and themes were identified. Findings revealed that parents with an infant in the NICU experience depression, anxiety, stress, and loss of control, and they vacillate between feelings of inclusion and exclusion related to the provision of health care to their neonate. Nursing interventions that promote positive psychosocial outcomes are needed to decrease parental feelings of stress, anxiety, and loss of control. Interventions need to focus on family-centered and developmentally supportive care.
Journal Article