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Neonatal Nursing Articles
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Small and sick newborn care (SSNC) is critical for national neonatal mortality reduction targets by 2030. Investment cases could inform implementation planning and enable coordinated resource mobilisation. We outline development of an investment case for Tanzania to estimate additional financing for scaling up SSNC to 80% of districts as part of health sector strategies to meet the country’s targets.
By Rosemary Kamuyu, Alice Tarus, Felix Bundala, Georgina Msemo, Donat Shamba, Catherine Paul, Robert Tillya, Sarah Murless-Collins, Maria Oden, Rebecca Richards-Kortum, Timothy Powell-Jackson, Meghan Bruce Kumar, Nahya Salim & Joy E Lawn (Open Access).
Resource Link: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04414-2
Narayanan, I., Litch, J. A., Srinivas, G. L., Onwona-Agyeman, K., Abdul-Mumin, A., Ramasethu, J. (2023, Open Access)
Resource Link: https://www.ghspjournal.org/content/ghsp/11/1/e2200099.full.pdf
Congenital disorders are also known as congenital abnormalities, congenital malformations or birth defects. They can be defined as structural or functional anomalies (for example, metabolic disorders) that occur during intrauterine life and can be identified prenatally, at birth, or sometimes may only be detected later in infancy, such as hearing defects. Broadly, congenital refers to the existence at or before birth.
Resource Link: https://www.who.int/news-room/fact-sheets/detail/birth-defects
Of 136 million babies born annually, around 10 million require assistance to breathe. Each year 814,000 neonatal deaths result from intrapartum-related events in term babies (previously “birth asphyxia”) and 1.03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published.
By Lee, A. CC., Cousens, S., Wall, S. N., Niermeyer, S., Darmstadt, G. L., Carol, W. A., Keena, W. J., Bhutta, Z. A., Gill, C., Lawn, J. E. (2011, Open Access)
Resource Link: https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-S3-S12
Increased survival of preterm infants in developing countries has often been accompanied by increased morbidity. A previous study found rates of severe retinopathy of prematurity varied widely between different neonatal units in Rio de Janeiro. Nurses have a key role in the care of high-risk infants but often do not have access to ongoing education programmes. We set out to design a quality improvement project that would provide nurses with the training and tools to decrease neonatal mortality and morbidity. The purpose of this report is to describe the methods and make the teaching package (POINTS of care–six modules addressing Pain control; optimal Oxygenation; Infection control; Nutrition interventions; Temperature control; Supportive care) available to others.
By Darlow, B. A., Zin, A. A., Beecroft, G., Moreira, M. EL., Gilbert, C. E. (2012, Open Access)
Resource Link: https://www.healthynewbornnetwork.org/hnn-content/uploads/Darlow_Brazil-Nurses.pdf
The purpose of this study is to develop nursing standard guidelines for nurses in a neonatal intensive care unit. The Delphi method was used in this study to elicit expert consensus. Thirteen experts who were nurses and pediatric adolescent specialists working in the neonatal intensive care unit participated in the study. In this study, 178 items were developed based on 5 nursing practice standards and 7 standards of professional practice. An additional 10 items were included based on observation in the neonatal intensive care unit. After expert validation, a final total of 184 items was developed. The standard guidelines for high-risk neonatal care developed in this study for practical clinical education in nursing are significant because they reflect the nursing practice standards in Korea and characteristics of nursing practice in the neonatal intensive unit.
By Lee H., Kim, D., Han, J. (2020, Open Acess)
Resource Link: https://www.mdpi.com/2227-9032/8/3/320
Background: Due to the progress in neonatology, in particular, in the past three decades, the mortality rate among patients of intensive care units has decreased. However, this is connected not only with newborns needing to stay longer in the unit, but also with the exposure of newborns to many painful procedures and stresses. Lack of or insufficient pain prevention has a negative impact on the sensory or locomotor development of newborns. Despite the presence of guidelines based on scientific evidence, the use of pharmacological and non-pharmacological pain-management methods in newborns is still insufficient. Aim: The aim of the study was to: identify the knowledge nurses/midwives have of recommended non-pharmacological and/or pharmacological methods, in particular, in relation to medical intervention procedures; assess the interventions for pain relief applied by midwives/nurses most often in their clinical practice; examine the role of age, general work experience, education level and years of work of medical professionals on a neonatal ward, as well as the referral level of a unit, versus the application of pharmacological and non-pharmacological methods. Methods: A descriptive and quantitative study conducted in 2019 among Polish nurses/midwives working at neonatal intensive care units. Results: The analysis of the material reflected the deficit of knowledge and the insufficient daily use of recommended pain-relief measures among the respondents. Conclusions: The interpretation of data indicates that despite the clear and easily available recommendations of scientific societies concerning the mode of conduct in particular medical procedures, medical personnel do not apply those recommendations in their everyday practice. It is necessary to plan and implement education strategies for nurses/midwives on standard pain-management interventions during painful medical procedures.
By Popowicz, H., Kwiecien-Jagus, K., Medrzycka-Dabrowska, W., Kopec, M., Dyk, D. (2022, Open Access)
Resource Link: https://www.mdpi.com/1660-4601/19/19/12075
By Linner, A., Westreup, B., Rettedal, S., Kawaza, K., Naburi, H., Newton, S., et al. (2023, Open Access)
Research priorities for preterm or low birth weight (LBW) infants were advanced in 2012, and other research priority-setting exercises since then have included more limited, context-specific research priorities pertaining to preterm infants. While developing new World Health Organization (WHO) guidelines for care of preterm or LBW infants, we conducted a complementary research prioritisation exercise. A diverse, globally representative guideline development group (GDG) of experts – all authors of this paper along with WHO steering group for preterm-LBW guidelines – was assembled by the WHO to examine evidence and consider a variety of factors in intervention effectiveness and implementation, leading to 25 new recommendations and one good practice statement for care of preterm or LBW infants. The GDG generated research questions (RQs) based on contributions to improvements in care and outcomes of preterm or LBW infants, public health impacts, answerability, knowledge gaps, feasibility of implementation, and promotion of equity, and then ranked the RQs based on their likelihood to further change or influence the WHO guidelines for the care of preterm or LBW infants in the future. Thirty-six priority RQs were identified, 32 (89%) of which focused on aspects of intervention effectiveness, and the remaining four addressed implementation (“how”) questions. Of the top 12 RQs, seven focused on further advancing new recommendations – such as family involvement and support in caring for preterm or LBW infants, emollient therapy, probiotics, immediate KMC for critically ill newborns, and home visits for post-discharge follow-up of preterm or LBW infants – and three RQs addressed issues of feeding (breastmilk promotion, milk banks, individualized feeding). RQs prioritised here will be critical for optimising the effectiveness and delivery of new WHO recommendations for care of preterm or LBW infants. The RQs encompass unanswered research priorities for preterm or LBW infants from prior prioritisation exercises which were conducted using Child Health and Nutrition Research Initiative (CHNRI) methodology.
By Gary L.Darmstadt, Nafisa HamoudAl Jaifi, ShabinaAriff, RajivBahl, MatsBlennow, VanessaCavallera, DorisChou, RogerChou, LizComrie-Thomson, KarenEdmond, QiFeng, Patricia FernandezRiera, LaurenceGrummer-Strawn, ShuchitaGupta, ZeleeHill, Ayede AdejumokeIdowu, CaroleKenner, Victoria NakibuukaKirabira, ReinhardKlinkott, SocorroDe Leon-Mendoza, SilkeMader, KarimManji, RhondaMarriott, MonicaMorgues, SushmaNangia, SumanRao, MohammodShahidullah, Hoang ThiTran, Andrew D.Weeks, BogaleWorku, KhalidYunis. (2023, Open Access)
Resource Link: https://www.sciencedirect.com/science/article/pii/S2589537023003036
Preterm and low birthweight infants are subject to poorer overall health, development, and survival with complications of preterm birth being the leading cause of under 5 mortality. New evidence has emerged on the effectiveness of interventions for care of these infants since previous guidelines were published in 2015. Following convening of an expert panel, WHO published “Recommendations for Care of the Preterm or Low Birthweight Infant” on World Prematurity Day in November 2022.
Now, in this new Series of two Health Policy pieces, we provide details on the 25 recommendations and research prioritisation. These new recommendations stress the importance of keeping preterm and low birthweight infants and mother together and the need to integrate families to care for their babies. (2023, Open Access)
Resource Link: https://www.thelancet.com/series/Preterm-LBW-care
Approximately 11% of infants are born preterm, and complications of prematurity are the most common cause of death in children aged under five years. Almost one million preterm infants die each year across low, high and middle income countries. In 2021, the World Health Organization (WHO) convened a Guideline Development Group (GDG) to examine evidence and formulate recommendations for care of preterm or low birthweight (LBW) infants according to WHO Guideline Review Committee (GRC) criteria. GRADE methods were used to assess the certainty of evidence and the GDG developed judgements using the DECIDE (Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence) framework. Twenty-five recommendations were made; 11 recommendations were new, and 16 were for preventive and promotive care. Kangaroo Mother Care (KMC) was recommended to start immmediately after birth as routine care for all preterm or LBW newborns (except for critically ill infants who are in shock, unable to breath spontaneously after resuscitation, or require ventilatory support) both in the facility and at home. New recommendations were also made for caffeine to treat apnoea and for extubation; family involvement in routine care for preterm or LBW infants; and for post-discharge home-visit follow-up care. New recommendations were also made to consider use of probiotics, emollient therapy, caffeine for prevention of apnoea, continuous positive airway pressure (CPAP) immediately after birth (with or without respiratory distress) in infants less than 32 weeks gestational age; and for family support to enable the care of preterm or LBW infants. The recommendations confirm the pivotal role of preventive and promotive care for preterm and LBW infants, especially the importance of keeping the baby and mother together, and empowering and supporting families to care for their preterm or LBW infant. WHO is now working to help scale up care for small and sick newborns, including organizational shifts in all ‘health system building blocks’ such as infrastructure, commodities, workforce and monitoring.
By Gary L.Darmstadt, Nafisa HamoudAl Jaifi, ShabinaArif, RajivBahl, MatsBlennow, VanessaCavallera, DorisChou, RogerChou, LizComrie-Thomson, KarenEdmond, QiFeng, Patricia FernandezRiera, LawrenceGrummer-Strawn, ShuchitaGupta, ZeleeHill, Ayede AdejumokeIdowu, CaroleKenner, Victoria NakibuukaKirabira, ReinhardKlinkott, SocorroDe Leon-Mendoza, SilkeMader, KarimManji, RhondaMarriott, MonicaMorgues, SushmaNangia, AnaydaPortela, SumanRao, MohammodShahidullah, Hoang ThiTran, Andrew D.Weeks, BogaleWorku, KhalidYunis (2023, Open Access)
Resource Link: https://www.sciencedirect.com/science/article/pii/S2589537023003322?via%3Dihub
Objective: To assess the impact of scaling up kangaroo mother care (KMC) on neonatal mortality among babies born with birth weight <2000 g across an entire district in southern India.
By Tinku Thomas,1 Arin Kar,2 Suman P N Rao,3 Swaroop Narayana,2 Maryann Washington,1 Shashidhar Rao,3 Krishnamurthy Jayanna,2 Prabhu Deva Gowda,4 Mohan Harnahalli Lakkappa,2 Prem Mony.
Resource Link: https://bmjpublichealth.bmj.com/content/bmjph/2/1/e000349.full.pdf
Small and sick newborn care (SSNC) is critical for national neonatal mortality reduction targets by 2030. Investment cases could inform implementation planning and enable coordinated resource mobilisation. We outline development of an investment case for Tanzania to estimate additional financing for scaling up SSNC to 80% of districts as part of health sector strategies to meet the country’s targets.
By Rosemary Kamuyu, Alice Tarus, Felix Bundala, Georgina Msemo, Donat Shamba, Catherine Paul, Robert Tillya, Sarah Murless-Collins, Maria Oden, Rebecca Richards-Kortum, Timothy Powell-Jackson, Meghan Bruce Kumar, Nahya Salim & Joy E Lawn (Open Access).
Resource Link: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04414-2
To implement the immediate Kangaroo mother care (iKMC) intervention in the previous multicentre, open-label, randomised controlled trial, the mother or a surrogate caregiver and neonate needed to be together continuously, which led to the concept of the Mother–Newborn Care Unit (MNCU). Health-care providers and administrators were concerned of the potential increase in infections caused by the continuous presence of mothers or surrogates in the MNCU. We aimed to assess the incidence of neonatal sepsis in sub-groups and the bacterial profile among intervention and control neonates in the study population.
By Arya, S., Chhabra, S., Singhal, R., Kumari, A., Wadhwa, N., Anand, P. et al. (2023). Effect on
neonatal sepsis following immediate kangaroo mater care in a newborn intensive care unit: a
post-hoc analysis of a multicentre, open-label, randomized controlled trial. The Lancet (Open
Access).
Resource Link: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00183-9/fulltext
Background: Kangaroo Mother Care (KMC) is an evidencebased intervention focused on premature and low-birthweight (LBW) infants. In different healthcare systems, outpatient KMC programmes (KMCPs) have been pioneers in the follow-up of these high-risk newborns. Here, we describe an overview analysis performed in an unprecedented data set comprising Colombian infants and spanning 28 years.
By Charpak, N., and Montealegre-Pomar, A. (2023).
Resource Link: https://gh.bmj.com/content/bmjgh/8/5/e011192.full.pdf
The protective effects of Kangaroo mother care (KMC) on the neurodevelopment of preterm infants are well established, but we do not know whether the benefits persist beyond infancy. Our aim was to determine whether providing KMC in infancy affected brain volumes in young adulthood.
By Charpak, N., Tessier, R., Ruiz, J. G., Uriza, F., Hernandez, J. T., Cortes, D., Montealegre-
Pomar, A. (2022, Open Access)
Resource Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303677/
Understanding the effect of early kangaroo mother care on survival of mild-moderately unstable neonates <2000 g is a high-priority evidence gap for small and sick newborn care.
By Helen Brotherton,a,b,⁎ Abdou Gai,b Bunja Kebbeh,b Yusupha Njie,b Georgia Walker,a Abdul K Muhammad,b Saffiatou Darboe,b Mamadou Jallow,b Buntung Ceesay,b Ahmadou Lamin Samateh,c Cally J Tann,a,d,e Simon Cousens,a Anna Roca,b and Joy E Lawn. (2021, Open Access)
Resource Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8358420/
Neonatal hyperbilirubinemia (NNH) is the most common clinical sign seen in neonatal practice. Kangaroo mother care (KMC), a new strategy has been tried for the management of hyperbilirubinemia.
By Garg, Bhawan Deep, MD, DNB Paediatrics, DNB Neonatology | Bansal, Anju, MS | Kabra, Nandkishor S., DM Neonatology.
Resource Link: https://connect.springerpub.com/content/sgrjpe/29/3/123
Neonatal mortality remains high in Sub-Saharan Africa. In this region, many nurses are assigned to care for small and sick newborns with little or no specialized training. This article described the three-phase training provided to nurses/midwives in Northern Ghana. The Council of International Neonatal Nurses, Inc. (COINN) developed the training based on the “train the trainer” to provide a standardized neonatal curriculum and associated bedside preceptorship. The training program was two months in length. The training was started at the teaching hospital and included two district hospitals.
By Geralyn Sue Prullage, Carolle Kernner, Mustapha Mahama, Victoria Awalenkak Agwiah, Mavis Suglo (2024, Open Access).
Resource Link: https://www.sciencedirect.com/science/article/abs/pii/S1355184124000772
With an increasing awareness of the importance of nurturing care and within a framework of Infant- and Family-Centred Developmental Care (IFCDC), zero separation, keeping parent and infant in continuous close physical and psychological proximity to each other, is key. In modern neonatology, high technological and pharmaceutical treatments are consistently integrated with caregiving considerations. Mother-Newborn Couplet Care is a concept of care where the dyad of the ill or prematurely born infant and the mother, needing medical care of her own, are cared for together, from the birth of the baby to its discharge. Mother-Newborn Couplet Care requires systems changes in both obstetrics and paediatrics considering planning and organisation of care, equipment and design of units. Accordingly, strong leadership setting clear goals and changing the professional mindset by providing targeted education and training is crucial to ensure the warranted high quality of care of all mother-baby dyads.
By Klemming, S., Lillieskolk, S., Westrup, B. (2021).Mother-Newbron Couplet Care From
Theory To Practice To Ensure Zero Separation For All Newborns (Open Access).
Resource Link: https://onlinelibrary.wiley.com/doi/10.1111/apa.15997
Newborn babies in need of critical medical attention are normally admitted to the neonatal intensive care unit (NICU). These infants tend to be preterm, have low birth weight, and/or have serious medical conditions. Neonatal survival varies, but progress in perinatal and neonatal care has notably diminished mortality rates. In this selected review, we examine and compare the NICU mortality rates and etiologies of death in different countries.
By Selina Chow1 | Ronald Chow1 | Mila Popovic1 | Michael Lam2 | Marko Popovic1 | Joav Merrick3 | Ruth Naomi Stashefsky Margalit4 | Henry Lam2 | Milica Milakovic1 | Edward Chow2 | Jelena Popovic
Resource Link: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2015.00225/full
What proportion of neonatal intensive care units in 2014 achieved the risk-adjusted rates from the best quartile and decile from 2005 for death and serious morbidities?
By Horbar, J. D., Edwards, E. M., Greenberg, M. S. et al (2017)
Resource Link: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2595570
How are neonatal intensive care unit (NICU) admission rates and NICU patient-days changing over time for various birth weight, gestational age, and acuity subgroups?
By Braun, D., Braun, E., Chiu, V. et al (2020)
Resource Link: https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2767258
In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hour of life. Prelacteal feeds are strongly associated with delayed initiation of breastfeeding. Self-reported insufficient milk continues to be one of the most common reasons for introducing commercial milk formula (CMF) and stopping breastfeeding. Parents and health professionals frequently misinterpret typical, unsettled baby behaviours as signs of milk insufficiency or inadequacy. In our market-driven world and in violation of the WHO International Code for Marketing of Breast-milk Substitutes, the CMF industry exploits concerns of parents about these behaviours with unfounded product claims and advertising messages. A synthesis of reviews between 2016 and 2021 and country-based case studies indicate that breastfeeding practices at a population level can be improved rapidly through multilevel and multicomponent interventions across the socioecological model and settings. Breastfeeding is not the sole responsibility of women and requires collective societal approaches that take gender inequities into consideration.
By Perez-Escamilla, R., Tomori, Cl, Hernandez-Cordero, S, Baker, P., Barros, A. J. D., Begin, F. etal (2023, Open Access)
Resource Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01932-8/fulltext
The World Health Organization recommends the use of donated human milk (HM) as the second-best option for mothers who are temporarily unable to provide sufficient breast milk to meet the needs of their infants. However, HM donation is yet to become an accepted practice in Uganda. We assessed the level of, and factors associated with acceptability to donate HM among postnatal mothers at St. Francis Hospital Nsambya (SFHN).
By Mohammed A. M. Ahmed, Charles Patrick Namisi, Nakibuuka Victoria Kirabira, Micheal Webba Lwetabe, Joseph Rujumba (2024, Open Acess)
Resource Link: https://link.springer.com/article/10.1186/s13006-024-00615-2
A women’s support group in South Kivu, Democratic Republic of the Congo, learns how to grow nutritious foods that they will use to cook and feed their family. Prior to USAID’s support, women in this community had to walk four hours to access foods that were not always nutritious. / Amy Cotter Fowler for USAID.
Article Link: https://medium.com/usaid-2030/seeds-of-change-db8efb42844c
In low- and middle-income countries (LMICs), neonatal bacterial infections are mainly caused by Enterobacterales species and Staphylococcus aureus, which are also the leading causes of mortality directly attributable to antimicrobial resistance. As bacterial colonization often precedes infection, better knowledge of colonization is crucial to prevent antibiotic-resistant neonatal sepsis.
By Anne-LiseBeaumont,MD;ElsaKermorvant-Duchemin,MD,PhD;SébastienBreurec,MD,PhD;Bich-TramHuynh,MD,PhD (2024, Open Access).
Resource Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825643
A systematic review and meta-analysis found that a "substantial" proportion of infants younger than 3 months in low-resource countries were colonized with antimicrobial-resistant bacteria, researchers reported today in JAMA Network Open.
Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus are leading causes of bacterial infections in newborns in LMICs and have been identified as the three main pathogens responsible for deaths attributable to antimicrobial resistance (AMR).
By Chris Dall, MA (2024).
Resource Link: https://www.cidrap.umn.edu/antimicrobial-stewardship/study-finds-high-prevalence-resistant-bacteria-infants-low-resource
Connective tissue disorders present with widespread manifestations involving the skin, joints, ligaments, blood vessels and other organ systems and can be associated with significant disability and life-threatening complications. Important disorders in this group include cutis laxa, wrinkly skin syndrome and geroderma osteodysplasticum. This article reports on a newborn baby with geroderma osteodysplasticum to raise awareness of this rare condition and the challenges faced by affected children and their families.
By Manjunatha, C. M., Abourahma, A., Ibhanesebhor, S. E., Mathews, A. Z. (2021, Open Access).
Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7220.pdf
This article reports on a case of a preterm baby who, post-routine insertion of a peripherally inserted central catheter (PICC), showed an unusual catheter route and tip placement revealing an unsuspected cardiac variant of persistent left superior vena cava (PLSVC). We discuss the condition, our management and its effects on vascular access in this unusual case.
By Van Rens, M., Hugill, K., El Fakharany, A. E. F., Garcia, K. L. (2021, Open Access)
Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7222.pdf
Oral mass in a newborn is rare but often quite daunting, leading to anxiety in parents. Very few hospitals have dental or maxillofacial facilities on site and this may lead to delayed diagnosis and intervention. A thorough clinical examination and knowledge of the oral mass is essential for precise diagnosis, management and parental reassurance. In this review article, we present a newborn baby with congenital epulis – an oral mass arising from the alveolar ridge. We also summarise the differential diagnoses based on location and consistency of the oral masses in this age group.
By Pahuja, A., James, H., D’Costa, W., Al-Jaddir, G., Kaur, D. (2021, Open Access)
Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7223.pdf
It is well known that the mental health of both parents, especially in the early post-partum period, can have a significant negative impact on the psychological wellbeing of an infant. There is growing evidence that fathers can experience trauma, potentially resulting in post-traumatic stress disorder (PTSD) following the complicated delivery of their child. Currently there is little research that has been conducted on the prevalence of PTSD in these fathers, or the need for them to be treated accordingly. An extensive literature review was conducted to assess the current status of the research in this field; the clinical implications of these findings are discussed.
By Thomas, B., Anderton, C. J. (2021, Open Access)
Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7224.pdf
Racial and ethnic disparities in health outcomes of newborns requiring care in the NICU setting have been reported. The contribution of NICU care to disparities in outcomes is unclear.
By Sigurdson, K., Mitchell, B., Liu, J., Morton, C., Gould, J. B.. Lee, H. C. et al. (2019, Open Access)
Background: Kernicterus resulting from severe neonatal hyperbilirubinaemia is a leading cause of preventable deaths and disabilities in low-income and middle-income countries, partly because high-quality intensive phototherapy is unavailable. Previously, we showed that filtered-sunlight phototherapy (FSPT) was efficacious and safe for treatment of mild-to-moderate neonatal hyperbilirubinaemia. We aimed to extend these studies to infants with moderate-to-severe hyperbilirubinaemia.
By Tina M Slusher 1, Hendrik J Vreman 2, Ann M Brearley 3, Yvonne E Vaucher 4, Ronald J Wong 2, David K Stevenson 2, Olumide T Adeleke 5, Ifelayo P Ojo 6, Grace Edowhorhu 5, Troy C Lund 6, Daniel A Gbadero5
Resource Link: https://pubmed.ncbi.nlm.nih.gov/30170894/
In some neonatal intensive care units (NICUs), conventional overhead phototherapy is the only phototherapy available, whereas others use fibreoptic blankets only. Several NICUs use both treatments interchangeably.
By Føreland, A.M.; Rosenberg, L:; Johannessen, B. (2016)
Resource Link: https://www.sciencedirect.com/science/article/abs/pii/S1355184116000028?via%3Dihub
Neonatal jaundice is one of the most common problems in neonates. Effective treatment of jaundice requires therapeutic intervention with high quality phototherapy. Over recent years, several studies reported fiberoptic phototherapy to be less effective than conventional phototherapy in term neonates. Our study aimed to compare the effectiveness of fiberoptic phototherapy with a larger illuminated area and higher irradiance to conventional phototherapy methods.
By Joel, H. N., Mchaile, D. N., Philemon, R. N., Mbwasi, R. M., & Msuya, L. (2021, Open Acess)
Resource Link: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02458-2
A breakthrough discovery 60 years ago by Cremer et al. has since changed the way we treat infants with hyperbilirubinemia and saved the lives of millions from death and disabilities. “Photobiology” has evolved by inquiry of diverse light sources: fluorescent tubes (wavelength range of 400–520 nm; halogen spotlights that emit circular footprints of light; fiberoptic pads/blankets (mostly, 400–550 nm range) that can be placed in direct contact with skin; and the current narrow-band blue light-emitting diode (LED) light (450–470 nm), which overlaps the peak absorption wavelength (458 nm) for bilirubin photoisomerization. Excessive bombardment with photons has raised concerns for oxidative stress in very low birthweight versus term infants treated aggressively with phototherapy. Increased emphasis on prescribing phototherapy as a “drug” that is dosed cautiously and judiciously is needed. In this historical review, we chronicled the basic to the neurotoxic components of severe neonatal hyperbilirubinemia and the use of standardized interventions.
By Hansen Thor, W. R., Jeffrey, M. M., Finn, E., Vreman, H. J., Stevenson, D. K., Wong, R. J., Bhutani, V. K. (2020)
Resource Link: https://www.nature.com/articles/s41372-019-0439-1
Approximately 11% of infants are born preterm, and complications of prematurity are the most common cause of death in children aged under five years. Almost one million preterm infants die each year across low, high and middle income countries. In 2021, the World Health Organization (WHO) convened a Guideline Development Group (GDG) to examine evidence and formulate recommendations for care of preterm or low birthweight (LBW) infants according to WHO Guideline Review Committee (GRC) criteria. GRADE methods were used to assess the certainty of evidence and the GDG developed judgements using the DECIDE (Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence) framework. Twenty-five recommendations were made; 11 recommendations were new, and 16 were for preventive and promotive care. Kangaroo Mother Care (KMC) was recommended to start immmediately after birth as routine care for all preterm or LBW newborns (except for critically ill infants who are in shock, unable to breath spontaneously after resuscitation, or require ventilatory support) both in the facility and at home. New recommendations were also made for caffeine to treat apnoea and for extubation; family involvement in routine care for preterm or LBW infants; and for post-discharge home-visit follow-up care. New recommendations were also made to consider use of probiotics, emollient therapy, caffeine for prevention of apnoea, continuous positive airway pressure (CPAP) immediately after birth (with or without respiratory distress) in infants less than 32 weeks gestational age; and for family support to enable the care of preterm or LBW infants. The recommendations confirm the pivotal role of preventive and promotive care for preterm and LBW infants, especially the importance of keeping the baby and mother together, and empowering and supporting families to care for their preterm or LBW infant. WHO is now working to help scale up care for small and sick newborns, including organizational shifts in all ‘health system building blocks’ such as infrastructure, commodities, workforce and monitoring.
Resource Link: https://www.sciencedirect.com/science/article/pii/S2589537023003322?via%3Dihub#sec6
Estimates of global prevalence of poor perinatal mental health (PMH) range from 13 to 30 percent, with higher prevalence in low- and middle-income countries.1 Defined as the period between pregnancy through two years postpartum, PMH includes clinical depression, anxiety, and psychosis, among other conditions. Myriad biological, socioeconomic, political factors, and gender inequalities can magnify the risk of poor PMH outcomes.
Resource Link: https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(24)00239-4/fulltext
Article Link: https://medium.com/usaid-2030/critical-care-a4582c14ed69