Sunday, 05 February 2012 14:45

NICU Dr, Successful Communicators?

A group of researchers based in Canada sought to find out if the information content, process, and social interaction of the antenatal consultation satisfies the informational needs of women admitted to hospital in preterm and threatened preterm labor. Many hospitals have recently moved toward the family/patient centered care, which includes providing as much information to the patient/family as possible so that they might be more involved in decision-making. One of the major hurdles to this process is when patients are suffering high degrees of anxiety as it negatively affects their perception of the successfulness of communication between physician and patient. Since, preterm labor or threatened preterm labor is stressful for patients it is important to ascertain whether current communication strategies are successful when interacting with these patients.

The typical process – obstetricians request an antenatal consultation for patients admitted in preterm or threatened preterm labor. Consultation is usually provided by the attending neonatologist or could also be neonatal fellow, neonatal nurse practitioner, or paediatrician; the mother is visited by the attending neonatologist for follow-up.

Women included in this study were those with preterm or threatened preterm labor of between 25 and 32 weeks’ gestation. Participants completed a antenatal consultation questionnaire (ACQ); it included 30 questions about the content (type and amount of information given), process (how information was given) and social interaction of physicians. They also wanted to know whether the consultation process was helpful in relieving some of their worry and anxiety.

Results from the study found that study, respondents almost always recalled receiving information on the topics of survival, most likely regarding medical problems and treatments that the baby might need. Mothers reported that information on risk of disability was provided less consistently. Participants who recalled receiving information about disability were also less satisfied with the amount of information provided on this topic compared with other topics. Only 12% of participants disagreed that the consultation helped relieve their worry, suggesting that receiving information may contribute to increasing knowledge and understanding of the condition and risks, but it may also increase anxiety in some people.

Other researchers have suggested that patients want information, even in situations of uncertainty, like preterm labor, and that they feel more satisfied with the consultation if doctors share information about uncertainty. It is important for neonatologists to have frank and open discussions about uncertainty in prognosis, including the risk of disability.

Study conclusion –the mothers who responded to the antenatal consultation questionnaire were generally satisfied with the information provided during the antenatal consultation but remained highly anxious.

Published in Industry News
Friday, 11 February 2011 12:28

Preemie dances hip hop

In China, parents of a very small preemie sent their son to dance lessons after doctors suggested he move his limbs to music to help build up his weak muscles.  They didn't anticipate how much he'd love it, or how good he would be!

 

This little preemie is now world famous for imitating Michael Jackson's moves, he's appeared on the Ellen DeGeneres Show and performed at the World Expo in Shanghai, May 2010.

His name is Wang Yiming but is more popularly know as Xiao Bao, which means "little treasure".

 

Watch preemie Xiao Bao show off his hip hop dance moves below

Published in Fun clips for preemies
Friday, 10 May 2013 14:01

Preemies School-age

Extremely preterm babies or extremely small prems are still behind their term born counterparts in relation to intellectual, educational, and behavioral outcomes by the time they reach school-age.

A study conducted in Victoria led by the Royal Women's Hospital followed up 189 extremely preterm or extremely low birth weight babies (less than 28 weeks gestation or weighing less than 1,000g) and 173 term born children at school-age. The areas assessed were intellectual ability, spelling, reading, mathematics, and a range of behavioral outcomes.

They found that 71% of the preterm born children had a cognitive, educational, or behavioral impairment at 8 years of age. In addition, up to 47% showed multiple areas of concern. These rates are much higher than that of the term born group which was 42% and 16% respectively. The major areas of concern were reading and spelling impairment which were double the rates in preemies compared with children born full term. The researchers also reported that 15% of the prems had a significant neurosensory impairment such as cerebral palsy.

Parents also completed questionnaires about their children which revealed that the preterm group had more behavioral problems including higher rates of hyperactivity, inattention, emotional problems, and peer relationship problems.

The positive message from this research is that the majority of babies born so early and small are now surviving without major disabilities.

This research highlights the need for early identification of children likely to have difficulties and early intervention strategies need to be employed to help these children before school-age.

Published in Industry News
Friday, 02 December 2011 10:27

Breastfeeding & Pain in Preemies

Not only is pain in preemie babies upsetting annd stressful for parents, if pain is not managed well it can have serious negative consequences, both short- and long-term. It can affect preemie babies' ongoing sensitivity to pain, stress arousal systems, and brain development. In the neonatal intensive care unit (NICU) pain associated with procedures such as pricking for blood tests are managed with interventions such as skin-to-skin care, swaddling, nesting, pacifiers, nonnutritive sucking, and sweet tastes. Breastfeeding, a natural, simple alternative, offers simultaneously the pain-reducing components of familiar odor, maternal skin-to-skin contact, sucking, and the ingestion of breast milk. In babies who are born full term, it has been reported that breastfeeding during painful procedures can reduce the pain response by 80 to 90% without producing any negative side effects. This approach had not been evaluated in preemie babies, in part due to a concern preemie babies may associate breastfeeding with pain, which could affect their ability to feed effectively and gain weight, as well impact mother-baby bonding.

Recently, a randomized control trial conducted by investigators from the Child & Family Research Institute at BC Children's Hospital and The University of British Columbia in Vancouver, BC, had their results of a study investiagting this very issue in PAIN (which is a scientific journal).

This research study looked at whether breastfeeding during the painful procedure would have a negative impact on the development of breastfeeding skills, and whether preemie babies who had more mature breastfeeding behaviors would have lower pain scores and heart rates during blood collection than less experienced feeders.

The results from the study showed that for the preemie group as a whole, breastfeeding did not reduce either behavioral or physiological pain during blood collection. But importantly, there were negative affects on breastfeeding skill development either. Preemie babies who were more advanced in their ability to feed did have significantly lower behavioral pain scores.

Published in Industry News
Wednesday, 02 November 2011 12:26

NICU Stress

As parents of premature babies well know, their tiny immature baby is likely to spend at least some time in the neonatal intensive care unit (NICU). The NICU is where premature babies will receive specialized medical care allowing time for immature organs to develop sufficiently.

Although there are a number of factors that are associated with poorer developmental outcomes in very premature babies little is understood about the exposure to stress in the neonatal intensive care unit. A new study has focussed on this topic by examining neonatal infant stress and its effect on brain development.

This study involved 44 premature babies born less than 30 weeks gestation and trained nurses recorded procedures and cares. Stress was measured using a tool called the Neonatal Infant Stressor Scale (NISS), which consists of 36 interventions that contribute to infant stress. These premature babies then undertook a magnetic resonance imaging (MRI) scan to evaluate the relationship between brain structure and function and infant exposure to stress.

The findings of this study suggest that for premature babies exposure to stressors in the neonatal intensive care unit is associated with reduced brain size. It is not clear what the long-term consequences are and the authors suggest that further research of stress exposure on the premature baby brain is needed to improve outcomes for premature babies.

Published in Industry News
Friday, 23 March 2012 14:00

Families of Premmies; Going Green

After the resounding success of the first “Wear Green for Premmies” Day in 2011, Ms Julia Toivonen, founder of the L’il Aussie Prems website which hosted the inaugural event, is eagerly looking forward to this year’s fundraiser. The 2012 “Wear Green for Premmies” Day will be held on 4th April 2012.


Last year’s event attracted around 19,600 attendees and raised awareness of babies born prematurely. It raised much needed funds for five different charities all which support children.


In mid-January this year a Facebook event page was launched in an effort to reach as many families as possible in the lead up to April with over 6,000 already ‘attending’ the event. Word has spread through social networks of the fantastic work being done to raise funds through the “Wear Green for Premmies” Day. Ms Toivonen is expecting that this year’s event will attract an unprecedented number of attendees.


Funds will be raised through the sale of green wristbands sporting various premmie support messages chosen by the websites members. Funds will then be distributed amongst charities that support children throughout Australia. Attendees are also encouraged to fundraise on the day in support of the National Premmie Foundation.

Attendees do not attend a physical event but simply sign up to the event on the Wear Green for Premmies Day Facebook Page and encourage family and friends to wear something green on the 4th of April 2012.


Published in Industry News
Friday, 06 January 2012 13:44

Parent Talk: Important for Preemies

An article recently published in the journal of Pediatrics reported that preterm babies who are exposed to their parents’ voices while in the neonatal intensive care unit (NICU for short) have better vocalizations at 32 and 36 weeks gestational age.

A number of studies have reported that speech and language development can be delayed in preterm babies. The environment that a preterm baby is exposed to in the NICU is vastly different than that of a fetus of the same gestational age. The NICU exposes preterm babies to high levels of noise, yet while they are in the isolette little language is audible unless it is directed into the hole of the isolette. In contrast, while a fetus is in utero, mother’s voice is a major stimulus and this occurs during the development of the auditory system.

Numerous studies have reported on the importance of early language experience for normal development of speech and language processing; the more a parent talks to their children, the faster their vocabularies grow and the higher the child’s IQ. Since early language experience and exposure is important for language development and IQ, it is important to understand the experience of very preterm babies in the NICU because their sensory experience is so different to babies born full term.

Researchers from the Department of Pediatrics, Women and Infants Hospital, Providence, Rhode Island conducted a study to determine whether preterm babies exposed to more adult language would make more vocalizations. Vocalizations include any utterances, sounds made by the baby.

The study included 36 preterm babies with birth weights of 1250 grams or less and 16-hour recordings of the preterm baby’s environment in the NICU at 32 and 36 weeks’ gestational age were carried out. The researchers found that infant vocalizations were detected as early as 32 weeks and this increased significantly up to 36 weeks, this means that preterm babies start making vocalizations at least 8 weeks earlier than the typical starting date for a newborn baby. They also found that the number of conversational turns per hour were much higher when a parent was present.

The researchers conclude that for preterm babies, exposure to parental talk was a strong predictor of vocalizations at 32 weeks and conversational turns at 32 and 36 weeks than language from other adults. This highlights the importance of parent talk for preterm babies while in the NICU.

Published in Industry News
Monday, 09 May 2011 18:59

Oxygen Level & Preemies

Premature babies have underdeveloped lungs when they are born and so often require supplemental oxygen to survive. However, the level of oxygen needed to help preemies without causing other health problems has been a cause of much debate. A scientific publication in the New England Journal of Medicine has concluded that higher oxygen concentrations improve survival, but also note that this is not necessarily without risks.

 

Published in Industry News
Friday, 03 June 2011 13:40

Flu Shot and Preterm Birth

Having a flu shot may reduce the risk of having a preterm birth. A new study in the US reported that women who received the vaccine and gave birth during the flu season were 40% less likely to have a baby born prematurely.

 

Published in Industry News
Saturday, 27 October 2012 13:27

Caffeine & Preterm Infants

Caffeine therapy is frequently used to reduce apnea in infants born preterm. It has been shown to improve both short- and long-term outcomes in preemies born less than 1,250 grams. In an Australia study called Caffeine in Apnea of Prematurity (CAP for short) the proportion of infants with lung injury called bronchopulmonary dysplasia (BPD) was lower when caffeine treatment started within the first 10 days of life compared with a placebo. Additionally, these researchers found that at 18 months preemies were less likely to be developmentally delayed or have cerebral palsy.

It is thought that the improvement in neurological outcome for preterm babies who have received caffeine therapy is due to the effect on cerebral white matter. Researchers from the CAP study reported that preemies who received caffeine for apnea may have more mature cerebral white matter organization. They also suggest that caffeine may be exerting a direct neuroprotective effect

The CAP study is now in the process of looking at the long-term outcome following caffeine treatment and will perform neuropsychological, lung functioning, and imaging analyzes on these children at age 11 years.

Published in Industry News
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Preemie, Premmie, or Prem?

Most babies spend between 38 and 42 weeks in their mother’s uterus. So, technically a preterm birth, preemie, premmie, or prem, is an infant who is born less than 37 completed gestational weeks. 


Read More: Defining Preterm birth


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New Release - Preemie Development

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