Human milk is the feeding strategy to prevent necrotizing enterocolitis!
Human milk is the preferred diet for preterm infants as it protects against a multitude of NICU challenges, specifically necrotizing enterocolitis. Infants who receive greater than 50% of mother ’s own milk (MOM) in the 2 weeks after birth have a significantly decreased risk of NEC. An additional factor in the recent declining rates of NEC is the increased utilization of donor human milk (DHM). This creates a bridge until MOM is readily available, thus decreasing the exposure to cow milk protein. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - November 7, 2016 Category: Perinatology & Neonatology Authors: Diana Maffei, Richard J. Schanler Source Type: research
Impact of probiotics on necrotizing enterocolitis
A large number of randomized placebo-controlled clinical trials and cohort studies have demonstrated a decrease in the incidence of necrotizing enterocolitis with administration of probiotic microbes. These studies have prompted many neonatologists to adopt routine prophylactic administration of probiotics while others await more definitive studies and/or probiotic products with demonstrated purity and stable numbers of live organisms. Cross-contamination and inadequate sample size limit the value of further traditional placebo-controlled randomized controlled trials. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - November 7, 2016 Category: Perinatology & Neonatology Authors: Mark A. Underwood Source Type: research
Cytokines and growth factors in the developing intestine and during necrotizing enterocolitis
This article reviews the dual, seemingly counter-intuitive roles of cytokines, where these agents play a “trophic” role and promote maturation of the uninflamed mucosa, but can also cause inflammation and promote intestinal injury during NEC. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - November 7, 2016 Category: Perinatology & Neonatology Authors: Krishnan MohanKumar, Kopperuncholan Namachivayam, Thao T.B. Ho, Benjamin A. Torres, Robin K. Ohls, Akhil Maheshwari Source Type: research
Genetic alterations in necrotizing enterocolitis
An underlying genetic predisposition to necrotizing enterocolitis (NEC) is increasingly being recognized. Candidate gene or pathway approaches as well as genome-wide approaches are beginning to identify potential pathogenic variants for NEC in premature infants. However, a majority of these studies have not yielded definitive results because of limited sample size and lack of validation. Despite these challenges, understanding the contribution of genetic variation to NEC is important for providing new insights into the pathogenesis of NEC as well as allowing for targeted care of infants with inherent susceptibility. (Sourc...
Source: Seminars in Perinatology - November 7, 2016 Category: Perinatology & Neonatology Authors: Alain Cuna, Venkatesh Sampath Source Type: research
Surgical necrotizing enterocolitis
Although currently available data are variable, it appears that the incidence of surgical necrotizing enterocolitis (NEC) has not decreased significantly over the past decade. Pneumoperitoneum and clinical deterioration despite maximal medical therapy remain the most common indications for operative treatment. Robust studies linking outcomes with specific indications for operation are lacking. Promising biomarkers for severe NEC include fecal calprotectin and S100A12; serum fatty acid-binding protein; and urine biomarkers. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - November 7, 2016 Category: Perinatology & Neonatology Authors: Jamie R. Robinson, Eric J. Rellinger, L. Dupree Hatch, Joern-Hendrik Weitkamp, K. Elizabeth Speck, Melissa Danko, Martin L. Blakely Source Type: research
Update on simulation for the Neonatal Resuscitation Program
The goal of the Neonatal Resuscitation Program is to have a trained provider in neonatal resuscitation at every delivery. The Neonatal Resuscitation Program develops its course content on review of the scientific evidence available for the resuscitation of newborns. Just as importantly, the educational structure and delivery of the course are based on evidence and educational theory. Thus, as simulation became a more accepted model in medical education and evidence was developing suggesting benefit of simulation, the Neonatal Resuscitation Program officially added simulation into its courses in 2010. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - November 3, 2016 Category: Perinatology & Neonatology Authors: Anne Ades, Henry C. Lee Source Type: research
Language and hearing outcomes of preterm infants
Multiple factors including degree of prematurity, neonatal morbidities, illness severity, hearing status, gender, language environment in the neonatal intensive care unit and in the home, maternal education level, social and environmental status of the family, and access to early intervention all contribute to the language outcomes of extremely preterm infants with and without hearing loss. Early screening, early diagnosis, and early intervention services by 6 months of age are necessary to optimize the language outcomes of preterm infants with permanent hearing loss. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - November 2, 2016 Category: Perinatology & Neonatology Authors: Betty R. Vohr Source Type: research
The role of early developmental intervention to influence neurobehavioral outcomes of children born preterm
Children who are born preterm are at risk of adverse long-term neurobehavioral outcomes, including cognitive, motor, and behavioral impairments. Early developmental interventions that commence within the first year after preterm birth have a preventative focus, with the aim to positively influence the developmental trajectory. While there is a great deal of heterogeneity in the research trials to date, there is evidence that early developmental interventions have a moderate effect on cognitive and behavioral outcomes up to preschool age, with some evidence for improved motor outcomes. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - November 2, 2016 Category: Perinatology & Neonatology Authors: Alicia Spittle, Karli Treyvaud Source Type: research
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Source: Seminars in Perinatology - October 31, 2016 Category: Perinatology & Neonatology Source Type: research
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Source: Seminars in Perinatology - October 31, 2016 Category: Perinatology & Neonatology Source Type: research
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Source: Seminars in Perinatology - October 31, 2016 Category: Perinatology & Neonatology Source Type: research
Table of Contents
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Source: Seminars in Perinatology - October 31, 2016 Category: Perinatology & Neonatology Source Type: research
Simulation training for primary caregivers in the neonatal intensive care unit
Simulation is a hands-on educational modality that creates a safe, confidential learning environment that is closely aligned with the principles of patient- and family-centered care. This makes it an ideal training tool for families and caregivers of medically complex infants as they prepare for their care at home. Multidisciplinary collaboration and participation is vital to the success of these simulations and encourages the development of needs assessments and learning objectives that are congruent with the family ’s goals, beliefs, and culture. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - October 30, 2016 Category: Perinatology & Neonatology Authors: Jennifer Arnold, Maria Carmen G. Diaz Source Type: research
Simulation and debriefing in neonatology 2016: Mission incomplete
Simulation can be an effective tool to facilitate the acquisition and maintenance of the cognitive, technical and behavioral skills necessary to carry out our mission in neonatology: the delivery of safe, effective and efficient care to our patients. Prominent examples of successful implementation of simulation within neonatology include the Neonatal Resuscitation Program, the International Pediatric Simulation Society, and the International Network for Simulation-Based Pediatric Innovation, Research and Education. (Source: Seminars in Perinatology)
Source: Seminars in Perinatology - October 30, 2016 Category: Perinatology & Neonatology Authors: Louis P. Halamek Source Type: research
Neonatology faculty development using simulation
The goal of faculty development activities is to supply the public with knowledgeable, skilled, and competent physicians who are prepared for high performance in the dynamic and complex healthcare environment. Current faculty development programs lack evidence-based support and are not sufficient to meet the professional needs of practicing physicians. Simulation activities for faculty development offer an alternative to traditional, teacher-centric educational offerings. Grounded in adult learning theory, simulation is a learner-centric, interactive, efficient, and effective method to train busy professionals. (Source: Se...
Source: Seminars in Perinatology - October 27, 2016 Category: Perinatology & Neonatology Authors: Heather M. French, Roberta L. Hales Source Type: research
