Newborns In Neonatal Unit Research Articles

Estimation of blood pressure levels in healthy newborns

Abstract Background Adequate blood pressure (BP) parameters in newborns are essential indicators of clinical stability for neonates. Despite its importance, the BP measurement in the delivery room are mainly collected from sick newborns in neonatal units. Current normative values are pivotal. Methods A prospective observational [AOB1] study selected 1167 healthy-term newborns in a private hospital [AOB2] in Brazil from August 2019 to September 2022. The Ethics Committee approved the research The gestational age considered full-term was between 37 and 42 weeks. Blood pressures were measured in the delivery room within the first two hours of life using an MX-600 GE automatic oscillometer device, following the hospital's standardized protocol. Results The mean systolic blood pressure (SBP) values were 68,0 ± 12.1 mmHg, diastolic blood pressure (DBP) 49,0 ± 12.3 mmHg. The 5th percentile of SBP corresponded to 48 mmHg and DBP to 32 mmHg, while the 95th percentile was 90 mmHg of SBP and 73 of DBP mmHg.[AOB3] Conclusion This study provided current blood pressure values from healthy neonates along with systolic, diastolic, and mean blood pressure ranges. These parameters serve as a valuable reference for dealing with the management of heathy terms newborns.Systolic BP Diastolic BP Mean pressure

Methodological aspects of dried blood spot sampling for the determination of isoprostanoids and prostanoids

Dried Blood Spot (DBS) analysis is a well-established practice for monitoring newborns in neonatal units because of the non-invasive collection of a very limited blood volume. Unfortunately, the haematocrit level and the drop volume can adversely affect the quality of the analytical data. For this reason, we performed an in-depth comparison of non-volumetric and volumetric sampling (e.g. Minivette® POCT microcapillary, and the microfluidic-based systems HemaXisTM DB and Capitainer-B) for the DBS analysis of the isoprostanoids 8-iso prostaglandin F2α and 8-iso prostaglandin E2, and prostaglandin E2, which represent well recognized indexes of oxidative stress and inflammation.Results highlighted a significant impact of drop volume on the analytical performances for the non-volumetric approach due to the inhomogeneous distribution of the analytes across the DBS. The innovative addition of labelled internal standards (ISs) on the filter paper before sampling did not circumvent the problem, as ISs did not accurately mimic the spreading of analytes in the DBS. Differently from HemaXisTM DB and Capitainer-B, the Minivette® POCT device showed an almost quantitative recovery with an overall variability of about 15%, and resulted the best option for an easy and reliable DBS collection in the clinic. Our procedure was used for the determination of the three metabolites in preterm newborns suffering from Patent Ductus Arteriosus (PDA). During our longitudinal monitoring, most of the preterm newborns with PDA showed a marked decrease (40–60%) of target analytes upon ibuprofen therapy, suggesting the potential involvement of the isoprostanoids and prostanoids in promoting drug responsiveness and ductal closure.

BABY FRIENDLY HOSPITAL INITIATIVE: 25 YEARS OF EXPERIENCE IN BRAZIL.

ABSTRACTObjective: To describe the experience of the 25-year-old trajectory of the Baby Friendly Hospital Initiative (BFHI) in Brazil. The first unit was implemented in 1992.Methods: Information and data were collected from publications on the World Health Organization (WHO), the United Nations International Children’s Emergency Fund (UNICEF) and the Ministry of Health websites and in national and international journals, about the period 1990-2017. The descriptors used were: “iniciativa hospital amigo da criança”, “hospital amigo da criança”, “baby friendly initiative hospital”, “aleitamento materno” and “breastfeeding”. The number of hospitals in the 25 years, the course of the BFHI and its repercussions on breastfeeding in Brazil were evaluated.Results: The BFHI is an intervention strategy in hospital care at birth focused on the implementation of practices that promote exclusive breastfeeding from the first hours of life and with the support, among other measures of positive impact on breastfeeding, of the International Code of Marketing of Breastmilk Substitutes. Currently, the initiative has been revised, updated and expanded to integrate care for newborns in neonatal units and care for women since prenatal care. It can be concluded that, during these 25 years, the quantity of hospitals varied greatly, with numbers still below the capacity of hospital beds. BFHI shows higher rates of breastfeeding than non-accredited hospitals. However, the number of hospitals are still few when compared to other countries.Conclusions: The BFHI has contributed to breastfeeding in Brazil in recent decades. Greater support for public policies is needed to expand the number of accredited institutions in the country.

Review of guidelines on expression, storage and transport of breast milk for infants in hospital, to guide formulation of such recommendations in Sri Lanka

BackgroundSick newborns in neonatal units who are unable to breastfeed are fed expressed breast milk. In Sri Lanka, most mothers stay in hospital throughout baby’s stay to provide this milk freshly. In other countries mothers go home, express breast milk at home and bring it to hospital. There are concerns about the safety of transported expressed milk if used in a tropical middle-income country. The aim of this paper is to compare and contrast advice offered by different hospitals and organizations on how to express, store and transport breast milk safely.MethodsWe assessed guidelines used by hospital staff of the four Level 3 neonatal units in Melbourne, Australia, National Health Service UK, guidelines and training manuals of the Human Milk Banking Association of North America, the World Health Organization and an information leaflet from Family Health Bureau, Sri Lanka. Information on breast milk expression, storage and transport provided by the guidelines were tabulated under seven topics: general information; container for milk collection; hand expression; using a pump for expression; storage; thawing / warming; and transport of expressed breast milk. The AGREE II tool was used to assess the guidelines written for hospital staff.ResultsThere was considerable agreement on most recommendations provided by these sources, but no single source covered all topics in full. Most recommend hand expression as the initial method for expressing of breast milk, followed by breast pump use, except the Sri Lankan recommendations which strongly discourages the use of breast pumps. Durations of storage under various conditions are generally similar in the different recommendations. Most guidelines recommend a ‘cool box’ or container with ice or freezer packs for transportation of milk.ConclusionA single document containing recommendations on all aspects of expressing, storing and transporting breast milk should be available for each unit, with the same basic information for mothers and the healthcare staff and further technical details for staff if required. The Sri Lankan recommendations need to be updated based on current worldwide practices and further studies are needed to establish a safe method of transport of expressed breast milk in Sri Lanka.

Hospitalization of newborns in Neonatal Unit: the meaning for the mother

This study aimed to understanding the meaning of hospitalization of the newborn child in the Neonatal Intensive Care Unit. It is a descriptive research of a qualitative approach. The interviews were conducted from December 2010 to April 2011, with seven mothers of newborns admitted to teaching hospital in the State of Rio Grande do Sul, Brazil. The content analysis resulted in three categories: the admission in the Neonatal Intensive Care Unit generates concerns and difficulties; need for professional care and use of technologies; in routine between home and the hospital the mother feels tired, sad and insecure. So, we must consider that there are characteristics of each mother in adapting to the Neonatal Intensive Care Unit environment. Attentive, responsive and individualized listening enable the professional care meets the needs of care to mothers in their uniqueness.

PO-0597 A Nationwide Survey Of Neonatal Cow’s Milk Allergy In The Uk

<h3>Background and aims</h3> Cow’s Milk Allergy (CMA) is one of the most common food allergies in children. It can affect any age including the neonate. There is paucity of literature about its presentation in the newborn period and its management. The primary objective of this survey was to understand the level of awareness about CMA in Newborns in neonatal units in the UK. Our secondary objective was to estimate the incidence of Cow’s Milk Allergy in newborns in the UK. <h3>Methods</h3> This was an online survey of neonatologists identified through the BAPM and the Neonatal Networks. <h3>Results</h3> 64 responses were received from consultant neonatologists. 42 out of 63 (66.7%) level 3 units responded. 78% of the respondents believed that CMA exists in newborn. The number of newborns with CMA diagnosed in the last 2 years was more than 152. 50% of these babies were born preterm and at the time of diagnosis, 33% were still &lt; 37 weeks. 26% babies with CMA had birth weight &lt;1.5 kg. The most common symptoms of CMA were blood in stool, abdominal distension and diarrhoea. 84% were diagnosed on clinical features only. Equal proportions of babies were on breast milk and preterm formula at the time of diagnosis. <h3>Conclusions</h3> This survey demonstrates a high level of awareness in an otherwise poorly studied area in newborns. It highlights the need for systematic studies to facilitate decision making among clinicians.

Proxemic communication between undergraduate nursing students and newborns in neonatal unit: an exploratory-descriptive study

Proxemic communication between undergraduate nursing students and newborns is essential for effective nurse assistance between the binomial. It aimed to characterize the proxemic communication between undergraduate nursing students and newborns. Exploratory-descriptive study carried out at the neonatal medium care unit (NMCU) of a public hospital of Fortaleza-Cear&aacute;-Brazil, from November/2009 to May/2010. The subjects were 22 students and 22 newborns. Two ways of interaction between students and newborns were described: face to face (12), sideways (10). Students adopted personal (12), social (8), intimate (2) distance. Students showed expression of tranquility (15), smile (4), tranquility and smile (2), indifference (1). While the newborns presented expression of tranquility (13), cry (7), indifference (2). Twenty-one students looked at the newborns, six spoke quietly, eleven normally, five remained in silence. The proxemic factors allow assessing the communication in NMCU, improving the students' assistance to newborns.