Parents Of Newborns Research Articles

Exome sequencing in newborns with congenital deafness as a model for genomic newborn screening: the Baby Beyond Hearing project

PurposeGenomic newborn screening raises practical and ethical issues. Evidence is required to build a framework to introduce this technology safely and effectively. We investigated the choices made by a diverse group of parents with newborns when offered tiered genomic information from exome sequencing. MethodsThis population-derived cohort comprised infants with congenital deafness. Parents were offered exome sequencing and choice regarding the scope of analysis. Options were choice A, diagnostic analysis only; choice B, diagnostic analysis plus childhood-onset diseases with medical actionability; or choice C, diagnostic analysis plus childhood-onset diseases with or without medical actionability. ResultsOf the 106 participants, 72 (68%) consented to receive additional findings with 29 (27.4%) selecting choice B and 43 (40.6%) opting for choice C. Family size, ethnicity, and age of infant at time of recruitment were the significant predictors of choice. Parents who opted to have additional findings analysis demonstrated less anxiety and decisional conflict. ConclusionsThese data provide evidence from a culturally diverse population that choice around additional findings is important and the age of the infant when this choice is offered impacts on their decision. We found no evidence that offering different levels of genomic information to parents of newborns has a negative psychological impact.

Particular paraclinical indices in newborn sepsis patients whose parents constantly lived in different environmental conditions

Xenobiotics can have a variety of effects on the human body, and especially on the course of intrauterine development. Numerous researchers point out that it is the nature of the environment that can negatively affect the course of certain diseases in both children and adults. Neonatal sepsis is one of the most serious diseases in neonatology practice. And, in our opinion, the topic of the influence of adverse environmental factors on the features of sepsis in newborns depending on the ecological situation of their parents' habitats is unclarified.The research aims at the particular paraclinical indices in children with neonatal sepsis whose parents constantly lived in different environmental conditions.Material and methods. To study the aim, a comprehensive survey of 260 newborns who suffered from neonatal sepsis in 2016-2018 was conducted. The groups have been formed based on the complex evaluation of the prolonged influence of the anthropogenic pollution of air, water and soil on the body of parents of newborns in the parts of the region. The ecological risk coefficient (ERC) has been proposed concerning the environmental situation in the regional centers. Thus, the first clinical group (the main group) included neonatal sepsis patients whose parents permanently lived in parts with an ERC of 2.0 or more and with unfavorable environmental characteristics of the regional center. The second group (comparison) was formed by newborns with sepsis, whose parents permanently lived in areas with a low risk of adverse effects of these environmental factors on their body (ERC<2.0).Results and discussion. The content of interleukins-6, -8.-10, C-reactive protein, presepsin and procalcitonin in the blood serum of patients with neonatal sepsis showed the activity of the systemic inflammatory response of the body to an infectious agent. It should be noted that high serum levels of interleukin-10, which has an anti-inflammatory effect, was more often registered in patients of the I clinical group. Thus, the blood content of this interleukin 35.0 pg/ml occurred in the newborn of the main group in 23.7% of cases, and in children of the comparison group – in 18.1% of observations. Along with a clearer identification of high levels of anti-inflammatory interleukin-10 inpatients of the I group, a significant decrease in serum concentrations of immunoglobulins of classes A, G, M was observed in these newborns.Conclusions. The decrease in the level of the above serum immunoglobulins is probably due to the immunosuppressive effect of xenobiotics on the fetus, whose mother was under the conditions of long-term action of xenobiotics. This, in turn, reduces the resistance of the newborn body to infection and contributes to a more severe course of the infectious process. Probably, the more severe manifestations of neonatal sepsis in newborns of the I clinical group are partly due to a combination of decreased immunoglobulin synthesis and increased interleukin-10 production.

The unique social sense of puerperium: Increased empathy and Schadenfreude in parents of newborns

Pregnancy and puerperium are typified by marked biobehavioral changes. These changes, which are traceable in both mothers and fathers, play an important role in parenthood and may modulate social cognition abilities. However, the latter effects remain notably unexplored in parents of newborns (PNs). To bridge this gap, we assessed empathy and social emotions (envy and Schadenfreude) in 55 PNs and 60 controls (childless healthy participants without a romantic relationship or sexual intercourse in the previous 48 hours). We used facial electromyography to detect physiological signatures of social emotion processing. Results revealed higher levels of affective empathy and Schadenfreude in PNs, the latter pattern being accompanied by increased activity of the corrugator suppercilii region. These effects were not explained by potential confounding variables (educational level, executive functioning, depression, stress levels, hours of sleep). Our novel findings suggest that PNs might show social cognition changes crucial for parental bonding and newborn care.

Refusal of Intramuscular Vitamin K by Parents of Newborns: A Review.

In 2019, the American Academy of Pediatrics made public education about intramuscular vitamin K administration at birth a public health priority, partly in response to reports of refusal of intramuscular vitamin K by parents of newborns that led to vitamin K deficiency bleeding (VKDB). We reviewed the literature on the frequency of, reported reasons for, and factors associated with refusal of intramuscular vitamin K, incidence of VKDB in newborns who did not receive intramuscular vitamin K, and use of oral vitamin K to prevent VKDB. Without prophylaxis, estimates of the incidence per 100 000 births of VKDB range from 250 to 1700 for early VKDB and from 10.5 to 80 for late VKDB. The frequency of refusal of intramuscular vitamin K by parents ranged from 0% to 3.2% in US hospitals, up to 14.5% in home births, and up to 31.0% in birthing centers. Reported reasons for refusal were concern of harm from the injection, a desire to be natural, and a belief in alternative methods of prophylaxis. Parents who refused intramuscular vitamin K were more likely to refuse immunizations. Many different regimens were used for orally administered vitamin K; it is not clear which is best, but all are less effective than intramuscular vitamin K. VKDB is rare but can result in either neurologic sequelae or death. In addition to continued surveillance of the frequency of both refusal of intramuscular vitamin K and VKDB, a renewed focus on education of and collaboration with parents is needed to address this major public health threat.

Support offered to newborns’ parents by the nursing team

Abstract Objectives: to know the perception of parents of newborns regarding the support received from the nursing team during their child’s hospitalization. Methods: prospective study. Sample of 127 mothers and fathers of newborns hospitalized for at least 72 hours in neonatal units of a hospital in the southern region of Brazil. Data collected from May to September 2018 through application of a proposed questionnaire and consultation of medical records. Descriptive and analytical statistics were used. Results: participants were aged 28.2 (SD = 6.8) years, mostly composed of mothers (76.4%), primiparous (51.2%). Full support was declared by 66.0% of participants in the appreciative domain and 65.5% in the instrumental, 51.7% in the informational and 46.2% in the emotional domains. Mothers declared they felt supported mainly in the instrumental (p=0.009) and informational (p=0.039) domains. There was a positive correlation between the emotional, appreciative and informational domains (p<0.001). Conclusion: for most participants, in the informational domain, there was a demand for knowledge provided by the team, inclusion in decisions and encouragement to ask questions; in the emotional, there was concern for wellbeing and attention to anguish. Greater support for parents in the informational and emotional domains must be reinforced with the use of training strategies for the nursing team.

Kariological indicators of buccal epitelia in newborns under sepsis, which parents have constantly lived in the conditions of various ecological conditions

The generally accepted and accessible method of cytogenetic assessment of the mutagenic effect of factors of various nature is the micronucleus test. Now this test is one of the non-invasive methods of population survey, which are influenced by environmental pollution. Objective: to establish the characteristics of karyological indicators of buccal epithelium in children of patients with neonatal sepsis, whose parents constantly lived in different environmental conditions. Material and methods. To study this goal, a comprehensive examination of 260 newborns who underwent neonatal sepsis in 2015-2018 was carried out. A suggested feature of a comprehensive assessment of the long-term load on the body of parents of newborns of anthropogenic pollution of air, water and soil in the regions of the region was the proposed environmental risk coefficient (CER) taking into account the environmental situation in the regional centers. So, the first clinical group (the main one) included patients with neonatal sepsis, whose parents constantly lived for months with a CER of 2,0 or more and with an unfavorable ecological characterization of the regional center. The second group (comparisons) was formed by newborns with sepsis, whose parents lived permanently in areas with a low risk of adverse effects of these environmental factors on their bodies (CER<2,0). A micronuclear test of exfoliative buccal epithelium in patients with neonatal sepsis was performed and evaluated in the immunological laboratory of the Department of Pediatrics and Pediatric Infectious Diseases of the Bukovynian State Medical University according to the method of V.N. Kalaev. Results and its discussion. In the main group, children with a high risk of cytogenetic disorders significantly prevailed with a slight decrease in the quota of patients with low risk. So, in group I with a low risk of cytogenetic disorders there were 42,1 % of cases, with an average risk of 5,3 %, and with a high risk of 52,7 % of cases. In the comparison group, respectively, with a low risk of cytogenetic disorders there were 54,5 %, (P>0,05) cases, with an average risk of – 12,1 %, (P>0,05), and with a high risk of – 33,3 %, (P=0,05) cases. Conclusions. As a result of the karyological test of exfoliate buccal epithelium, it can be noted that in newborns of the main group, compared with children of the comparison group, cytogenetic disturbances and, in some cases, violation of cell kinetics in the form of proliferation and apoptosis were significantly more often detected. The accumulation index of cytogenetic disorders was also significantly higher in group I patients due to the predominance of patients with a high risk of cytogenetic disorders in them

Parents of newborns in the NICU enrolled in genome sequencing research: hopeful, but not naïve

PurposeIn 2014, our institution launched a randomized controlled trial (RCT) comparing rapid genome sequencing (GS) to standard clinical evaluations of infants with suspected genetic disorders. This study aimed to understand parental response to the use of GS for their newborn babies. MethodsTwenty-three of 128 parents whose infant had enrolled in the RCT completed a retrospective survey and interview addressing attitudes about GS and responses to receiving diagnostic information. We also collected information about participants’ genetic literacy, genetic knowledge, numeracy, and symptoms of anxiety and depression. ResultsThe majority reported positive (13; 56.5%) or neutral 4 (4; 17.4%) feelings when approached about GS for their infant and 100% felt that GS was generally beneficial. The 12 participants who had received a unifying diagnosis for their child’s symptoms described personal utility of the information. Some reported the diagnosis led to changes in medical care. Participants showed understanding of some of the psychological risks of GS. For example, 21 (91.3%) agreed or strongly agreed that genetic testing could reveal disturbing results. ConclusionsParents who enrolled their newborn in a RCT of GS demonstrated awareness of a psychological risk, but generally held positive beliefs about GS and perceived the benefits outweighed the risk.

Educational needs of parents towards a healthy newborn baby

Wprowadzenie: Narodziny dziecka to nie tylko jedno z najważniejszych wydarzeń życiowych dla rodziców, ale także wyzwanie w radzeniu sobie z wieloma trudnościami związanymi z podstawowymi etapami rozwoju i opieki nad noworodkiem. Często niewystarczająca wiedza i brak umiejętności w zakresie rozwoju i opieki nad dzieckiem są przyczyną znacznych trudności dla rodziców noworodka. Edukacja zdrowotna jest ważnym elementem wspierania działań w medycynie, zwłaszcza edukacji młodych rodziców. Powinien obejmować wiedzę na temat utrzymania higieny, stosowania odpowiednich produktów do pielęgnacji, ochrony kikuta pępowiny, karmienia, stymulowania dziecka, a także stosowania szczepionek. Jak wynika z wielu badań, wiedza na temat zdrowych zachowań i umiejętności rodziców w zakresie opieki i opieki nad noworodkiem determinuje zdrowie dziecka w szerokim znaczeniu.Celem badania była analiza stanu wiedzy rodziców na temat okresu noworodka i opieki nad dziećmi, a także analiza potrzeb edukacyjnych w tym zakresie.Materiał i metoda: W badaniu wzięło udział 80 rodziców noworodków. Metodą badawczą zastosowaną w pracy była ankieta diagnostyczna. Do przeprowadzenia badań wykorzystano technikę ankietową w formie kwestionariusza.Wyniki: W zakresie wiedzy przekazywanej na temat opieki zdrowotnej noworodkowej przez personel medyczny na oddziale położniczym reakcje mężczyzn i kobiet są mieszane. Tylko 37% kobiet zdobyło rozległą wiedzę, a 63% kobiet niewystarczających i wymaga suplementacji. Aż 70% mężczyzn nie otrzymało żadnych informacji o kontaktach, reszta (30%) mężczyzn otrzymała wiadomości, ale były niekompletne. Najczęściej wybierane formy zdobywania wiedzy przez respondentów kobiet, jak i mężczyźni byli rozmowa z personelem (63%) i instruktaż (43%). Dla zdecydowanej odpowiedzi respondentów (95%) pojęcie noworodka jest znaneWnioski: Wiedza rodziców jest jednak niepełna. Zebrane są ignorowani w edukacji rodzicielskiej. Większość respondentów zna zasady opieki nad dziećmi. Większość rodziców musi przekazywać wiedzę i umiejętności specjalistom.

Applying Qualitative Research to Develop a Guide for Parents of Newborns With Hypoxic-Ischemic Encephalopathy

Moderate-to-severe hypoxic-ischemic encephalopathy (HIE) is a significant cause of neonatal mortality and permanent disability in surviving newborns. Therapeutic hypothermia (TH) is the only effective intervention to reduce these outcomes. Being a parent of these babies is a traumatic and strenuous event. To address these difficulties, parents need information and support. The aim of this article is to describe a qualitative methodological process followed to develop a guide for parents of a newborn with HIE receiving TH as an addendum to clinical practice guidelines. The guide based on the experience of parents of newborns with HIE is presented as 16 meaningful questions and a glossary. It provides information to parents about HIE, treatment and care, future outcomes, and coping strategies. The final version, in Spanish and English, has a didactic format with simple wording, parents’ verbatim queries, and illustrations made expressly for the guide. Furthermore, we think showing the methodological process we followed to develop the guide, detailing the difficulties that arose in doing so, and making the reflexivity of the researchers explicit may provide support for other teams undertaking similar projects. Likewise, this article illustrates in a practical way how the perspective of family can be incorporated into clinical practice guidelines.

BREAKING BAD NEWS IN A NEONATAL INTENSIVE CARE: THE PARENT'S EVALUATION.

ABSTRACTObjective: To describe the reports of parents of newborns (NB) with congenital malformations hospitalized in a Neonatal Intensive Care Unit (NICU) who received bad news, in order to identify the issues related to the perception of bad news given adequately or inadequately.Methods: A cross-sectional study was conducted from January to October 2018, in which parents of newborns with congenital malformations hospitalized in NICUs were interviewed at visiting hours, according to inclusion criteria. The questionnaire had semi-structured questions related to reception of bad news. Analysis of the data was descriptive.Results: 28 mothers and two fathers were interviewed and 16 (53.3%) reported having had at least one bad news in the NICU. Of those, 10 (62.5%) considered appropriate the way in which the news was given. The justifications were: sincerity of the professional, delicacy to give the news, giving hope to the family, use of appropriate words and demonstration of caring about the newborn. Six participants (37.5%) considered inadequate the way of breaking bad news. The reasons were: unpreparedness and lack of knowledge about the child’s case, use of difficult language, haste or anxiety and discouragement of family hope. Most of the news was given by a professional alone, often by a medical resident.Conclusions: The communication of bad news was considered adequate by the parents, although this perception was not unanimous. This study, therefore, indicates that it is necessary to improve the communication of bad news in this NICU. Training professionals can assist in this process.

Parent-Targeted Education Regarding Infant Pain Management Delivered During the Perinatal Period: A Scoping Review.

All infants experience pain in early life from procedures. Parents recognize pain as a prevalent issue, reporting a strong desire for more information on infant pain. The aim of this study was to explore and map the current evidence of parent-targeted educational interventions about infant pain, delivered throughout the perinatal period. Records were identified in PubMed, CINAHL, EMBASE, and ERIC databases and hand searching recent publications in 3 relevant journals. Records in English that described or evaluated educational interventions on infant pain management aimed at parents during the perinatal period were eligible for review and those not related to pain or aimed at healthcare providers were excluded. Evaluation was completed following the Methodology for JBI Scoping Reviews and standardized critical appraisal instruments from the Joanna Briggs Institute. Initial search yielded 6946 records, with 9 included in analysis. Six studies were quantitative, 2 qualitative, and 1 mixed methods. Included interventions contained information about parent-led pain management strategies for infants in the neonatal intensive care unit (n = 4), full term (n = 4), or both (n = 1). Despite being an area of high concern for parents of newborns, few studies addressed parent-targeted education regarding infant pain. Future research examining the impact and efficacy of these interventions addressing parental and neonatal outcomes is warranted.

Dilemma of Reporting Incidental Findings in Newborn Screening Programs for SCID: Parents' Perspective on Ataxia Telangiectasia.

Background: Ataxia Telangiectasia (A-T) is a severe DNA repair disorder that leads to a broad range of symptoms including neurodegeneration and a variable immunodeficiency. A-T is one of the incidental findings that accompanies newborn screening (NBS) for severe combined immunodeficiency (SCID), leading to an early diagnosis of A-T at birth in a pre-symptomatic stage. While some countries embrace all incidental findings, the current policy in the Netherlands on reporting untreatable incidental findings is more conservative. We present parents' perspectives and considerations on the various advantages vs. disadvantages of early and late diagnosis of A-T.Methods: A questionnaire was developed and sent to 4,000 parents of healthy newborns who participated in the Dutch SONNET-study (implementation pilot for newborn screening for SCID). The questionnaire consisted of open-ended and scale questions on advantages and disadvantages of early and late diagnosis of A-T. To address potential bias, demographic characteristics of the study sample were compared to a reference population.Results: A total of 664 of 4,000 parents sent back the questionnaire (response rate 16.6%). The vast majority of parents (81.9%) favored early diagnosis of A-T over late diagnosis. Main arguments were to avoid a long period of uncertainty prior to diagnosis and to ensure the most optimal clinical care and guidance from the onset of symptoms. Parents who favored late diagnosis of A-T stated that early diagnosis would not lead to improved quality of life and preferred to enjoy the asymptomatic “golden years” with their child. The majority of parents (81.1%) stated that they would participate in newborn screening for A-T if a test was available.Conclusions: Reporting untreatable incidental findings remains a disputed topic worldwide. Although the current policy in the Netherlands is not to report untreatable incidental findings, unless the health advantage is clear, the majority of parents of healthy newborns are in favor of an early A-T diagnosis in the pre-symptomatic phase of the disorder. Our results as well as other studies that showed support for the screening of untreatable disorders may serve as valuable tools to inform policymakers in their considerations about NBS for untreatable disorders.

CERTAIN PARACLINICAL INDICATORS IN NEWBORN PATIENTS WITH SEPSIS, WHOSE PARENTS HAVE CONSTANTLY LIVED UNDER DIFFERENT ECOLOGICAL CONDITIONS

Xenobiotics can have various effects on the human body, and especially on the course of fetal development. Numerous researchers point out that the nature of the external environment can negatively affect the course of certain diseases in both children and adults. Neonatal sepsis is one of the most serious diseases in neonatological practice and in our opinion is a completely unexplained topic of the impact of adverse environmental factors on the characteristics of sepsis in newborns, depending on the environmental situation of their parents. The aim of the study was to investigate the features of individual indicators of a pair of clinical trials in children with neonatal sepsis, whose parents lived permanently in different environmental conditions. Material and methods. To study this goal, a comprehensive survey of 260 newborns who in 2015-2018 suffered from neonatal sepsis. The proposed environmental risk factor (ERF) was a group-forming feature of a comprehensive assessment of the long-term load on the body of parents of newborns of anthropogenic pollution of air, water and soil in the regions, taking into account the environmental situation in regional centers. Thus, the first clinical group (main) included patients with neonatal sepsis, whose parents lived permanently in months with ERF 2.0 and more and with unfavorable environmental characteristics of the regional center. The second group (comparison) was formed by newborns with sepsis, whose parents lived permanently in areas with a low risk of adverse effects of these environmental factors on their body (ERF<2.0). Results and discussion. The content in the serum of patients with neonatal sepsis interleukins-6, -8.-10, Creactive protein, presepsin and procalcitonin reflected the activity of the systemic inflammatory response of the body to the infectious agent. It should be noted that patients of clinical group I were more likely to have a high serum content of interleukin-10, which has an anti-inflammatory effect. Thus, the content of this interleukin .35.0 pg / ml in the blood occurred in the newborn of the main group in 23.7 % of cases, and in children of the comparison group – in 18.1 % of cases. Along with a clearer definition of patients with group I high levels of anti-inflammatory interleukin-10, in newborns found a significant decrease in serum concentrations of immunoglobulins of classes A, G, M. Conclusions. The decrease in the level of these serum immunoglobulins is probably due to the immunosuppressive effect of xenobiotics on the fetus, whose mother was in the conditions of long-term action of xenobiotics. This, in turn, reduces the body's resistance of the newborn to infection and contributes to a more severe course of the infectious process. Probably, more severe manifestations of neonatal sepsis in neonates of the I clinical group are partly due to a combination of decreased immunoglobulin synthesis and increased production of interleukin-10.

An Educational Module for Pavlik Harness Application for Developmental Dysplasia of the Hip: Study in a Greek Population.

The success of Pavlik harness therapy is based, among other things, upon the correct reapplication by parents. This prospective study assesses the effectiveness of a validated Objective Structured Assessment of Technical Skill (OSATS) educational module for Pavlik harness application among Greek parents. Forty consecutive parents of newborns with developmental dysplasia of the hip (DDH), who were treated with Pavlik harness, were divided into two groups. Twenty parents (group 1) were educated with the Greek OSATS version, while the rest (group 2) served as the control. The OSATS score, quality of the final product (Global Rating Scale - GRS) and sonographic imaging of the hips were evaluated during follow-up. Post-intervention evaluation revealed significant higher means of OSATS score (p<0.01), GRS of performance (p<0.05) and GRS of final product (p<0.05) for group 1. At every retention time point, OSATS was signifi cantly higher for group 1, however there were no significant differences between either GRS score between groups. There was no significant difference in radiographic evaluation and successful outcome. This educative module increased the parents' skill level on application of Pavlik harness. However, this module revealed no significant effect in clinical and radiological evaluation of the hips, in this population.

Sleep-related risk and worrying behaviours: a retrospective review of a tertiary centre's experience.

This retrospective study aims at helping physicians select babies considered at risk for fatal events during sleep. It does so by describing the clinical features and outcome of worrying infants' behaviour during sleep, with the activation of an emergency medical service and/or emergency department, subsequently referred to the Centre for Paediatric Sleep Medicine and sudden infant death syndrome, Regina Margherita Children's Hospital, Turin, Italy. We analysed the medical records of infants < 12months whose parents reported they had worrying behaviour during sleep in the period 1 January 2009- 31 December 2015. Regional guidelines suggest performing anamnesis and capillary blood gas analysis in case of apparent life-threatening events. There were 33 males, average age 55 ± 54.37days. On arrival at the emergency medical service/emergency department 97% infants were asymptomatic; 61% patients had a capillary blood gas analysis as suggested by the regional guidelines. A clear acid-base disorder was observed in two infants, asymptomatic at medical evaluation, that had assumed an unsafe sleeping position. Two patients presented recurrence of the episode at 3months.Conclusions: Most worrying infant behaviour during sleep can be related to paraphysiological phenomena; capillary blood gas analysis and anamnesis are pivotal to identify the cases at risk of fatal events.What is Known:• Events that happen during sleep often frighten the parents of newborns. This fear may be induced by the fact that Sudden Infant Death Syndrome typically occurs during sleep.• This tragic event is unpredictable by any clinical features or findings in instrumental examinations and cannot be prevented with an early resuscitation.What is New:• In our retrospective study, most worrying infant behaviour during sleep can be related to paraphysiological phenomena.• Capillary blood gas analysis and anamnesis collection were crucial to identify the only two life-threatening events.

Kinship analysis reveals reproductive success skewed toward overwintered Brandt's voles in semi-natural enclosures.

Age structure and seasonality influence the population fluctuations of small rodents. Age determines body weight and social experience, while seasonality regulates the duration of the breeding season and onset of sexual maturity in newborn offspring. Therefore, reproductive success and skew usually occur in different age groups. Brandt's vole (Lasiopodomys brandtii) is a social, short-lived and seasonal breeding small rodent with a dramatic seasonal population fluctuation, but reproductive skew is not fully understood in this species. In the present study, we determined kinship in semi-natural enclosure populations using microsatellite markers based on genotyping, analyzed the reproductive skew between sexes and between overwintered and newborn voles, and monitored variation in male reproductive activity by testing fecal testosterone levels throughout the year. Overwintered voles had the most reproductive success along with a striking increase in the population size in the enclosures, with all biological fathers and 77.8% of biological mothers, which had 100% and 87% of the total offspring, respectively. Compared to overwintered voles, reproductive skews were significantly higher in potential overwintered and newborn parents, implying the possible reproductive suppression of newborn voles by dominant overwintered voles. Moreover, both heavier body weight and higher testosterone levels in overwintered males supported their potential social status in the population. Our study provided new evidence for reproductive skew and differentiation of postnatal gonadal development patterns of different age groups in Brandt's vole.

Less Than Half of Pediatricians Educate Parents of Newborns on the Risks and Benefits of Swaddling

Background: Little is known about what counseling parents receive regarding safe swaddling practices and what training pediatricians are receiving. The purpose of this study is to determine what education parents of newborns are receiving on swaddling, and what training pediatricians are receiving. Methods: Parents of patients aged 0-12 months who presented to clinic for any evaluation without a diagnosis of hip dysplasia were administered an anonymous online survey. Parents were asked about their experiences …

Less Than Half of Pediatricians Educate Parents of Newborns on the Risks and Benefits of Swaddling

Less Than Half of Pediatricians Educate Parents of Newborns on the Risks and Benefits of Swaddling

Postpartum Nurses’ Experience Caring for Infants With Neonatal Abstinence Syndrome

In previous years, otherwise healthy infants with neonatal abstinence syndrome (NAS) in our hospital were transferred to the NICU and frequently treated with medication. Currently, infants with NAS room-in with their mothers and rarely require medication. We sought to understand the lived experience of nurses on maternity and well-newborn units caring for infants with NAS. We conducted focus groups of registered nurses on postpartum units at 2 hospitals using qualitative methodology. Themes were identified through consensus, and the focus groups were stopped when no new themes were identified. Seventeen postpartum nurses participated in 5 focus groups. The following major themes emerged: (1) managing the expectations of parents of newborns with NAS, (2) current NAS protocol (positive aspects of rooming-in and challenges with withdrawal scoring tool), (3) inconsistencies in care and communication, (4) perceived increase in nursing workload on the postpartum unit, and (5) nurses' emotional response to the care of infants with NAS. We highlight the perspectives of nursing staff on the well-newborn unit who were previously unaccustomed to caring for infants with NAS. With increasing numbers of infants with NAS and longer stays on the well-newborn unit, hospitals must prepare to better support staff and implement protocols that offer consistency in practice.

Nurse-Driven Initiative to Increase Exclusive Human Milk Feeding by Using Pasteurized Donor Human Milk to Treat Hypoglycemic Term Neonates

ObjectiveTo increase exclusive breastfeeding by offering pasteurized donor human milk (PDHM) to newborns with hypoglycemia. DesignQuality improvement project. Setting/Local ProblemA Baby-Friendly Hospital Initiative–designated urban academic medical center in the northeastern United States serving a diverse population where, by policy, virtually all newborns with hypoglycemia received supplemental infant formula. Approximately 85% of women cared for at this center initiate breastfeeding, but many struggle with exclusive breastfeeding during the hospital stay. ParticipantsAll staff members in the labor and delivery unit and the mother/baby unit, including registered nurses, unit clerks, patient care technicians, and lactation consultants. Term, breastfed newborns identified as being hypoglycemic per our guidelines were eligible to receive PDHM. Intervention/MeasurementsRegistered nurses provided education about PDHM to parents of newborns who were hypoglycemic, obtained consent, and initiated the order. We offered PDHM instead of infant formula when mother’s own milk was not available in sufficient quantity per our hypoglycemia guidelines. We measured newborns’ glucose levels and monitored breastfeeding outcomes, including continued breastfeeding. ResultsDuring the 4-month trial, 83 newborns were eligible for PDHM. Of those, 76% of parents opted for PDHM rather than formula. Most newborns in both groups were still breastfeeding at discharge, and 53% of those who received PDHM were fed human milk exclusively during their hospital stays. ConclusionA nurse-driven protocol offering PDHM to otherwise healthy newborns with hypoglycemia is a viable option for increasing exclusive breast milk feeding during the hospital stay.