Category: Family-centered care

WWLST in VLBW Neonates

A retrospective 18-center analysis of data on very low birth weight infants found that discussions about withholding or withdrawal of life-sustaining therapy (WWLST) occurred more often in infants 22 – 24 weeks gestation (27%) than in those 27-28 weeks (6%). There…

Medically complex children and transition to home

In a qualitative study from one tertiary center, 23 family members of children with complex medical conditions and 16 health professionals were interviewed to identify needs when transitioning such children from hospital to home. Families had needs in 7 domains…

Improving the care of neonatal abstinence syndrome

A single-center study reported the results of a coordinated program for neonatal abstinence syndrome, including standardized protocols for scoring, medications and weaning, and a calm rooming-in environment. Otherwise healthy infants were treated on the inpatient pediatric unit instead of in…

Moral distress in intensive care

Moral distress is anguish experienced when an individual makes a clear moral judgment about an action to take but is unable to act accordingly due to societal, institutional or contextual constraints. A systematic review of 13 studies on moral distress…

Home influences on child development

The PHIME project (Public health impact of long-term, low-level, mixed element exposure in susceptible population strata) evaluated the association between low-level prenatal mercury (Hg) exposure through maternal fish consumption and child neurodevelopment in a coastal area of the north east…

Grief reactions of fathers of NICU babies

A study from Iran assessed 120 fathers of preterm babies who were hospitalized in the NICU. These fathers were administered an anticipatory grief scale. All reported anticipatory grief reactions, the most common being unremitting mental engagement with the infant and…

Ten tips for interacting with parents of NICU babies

The emotional and psychological needs of parents of NICU babies are often not addressed by NICU health professionals, even when the medical care of the infants is optimal. A checklist of ten items is offered in  a special article that…

Incidental discovery of nonparentage – to disclose or not?

When newborns and children undergo laboratory tests, the results occasionally indicate that one of the supposed parents cannot be the genetic parent that he or she is supposed to be. Such incidental findings of nonparentage can cause considerable distress to…

Maternal-child interaction and developmental outcome

A prospective study of 48 babies born before 28 weeks gestation assessed the association of maternal-child interactions with neurodevelopmental outcome. The maternal-infant interaction was assessed when the infants were two years of corrected age, in a structured play situation using…

Periviable birth: Workshop summary

The findings of a Joint Workshop held by leading organizations in obstetric and pediatric/neonatal care were recently published in multiple journals and contains summaries and recommendations about obstetric and neonatal management. Highlights of this report: The term perviable birth was…

The new paradigm of NICU care

A commentary argues that for too long we have thought of newborns as isolated organisms. In reality, neonates are dependent on their family for biopscyhosocial support that the medical system cannot substitute for. Over time the paradigm of neonatal care…

Persistent stress, anxiety and depression in parents of preterm infants

Parents of preterm infants were assessed seven years after the birth of the infant with scales and questionnaires to assess their psychological state and functioning.  Compared to parents of full-term infants, parents of infants born less than 30 weeks gestation…

Long-term benefits of kangaroo care

Maternal-newborn skin-to-skin contact (kangaroo care) was provided in 73 preterm infants for 14 days and the results compared to 73 matched controls receiving standard incubator care. Infants were followed for 10 years. Kangaroo care increased autonomic functioning and maternal attachment behavior…

Newborn odor and maternal-infant bonding

Using fMRI, investigators measured the brain responses of women when exposed to newborn infants’ body odors. The newborn odors were presented to the women using cotton undershirts worn by newborn infants for the first two days after birth. The odors…

The dying neonate – a mother’s perspective

An article written by the mother of a critically ill 24 week gestation infant describes the emotions that parents experience when in the throes of intensive care decisions. There are tips to NICU professionals on how best to interact with…

Dilemmas in the care of extremely preterm infants – an essay

An essay written by a neonatologist describes the dilemmas faced by NICU teams when faced with decisions about resuscitation of extremely preterm infants. In the ‘Gray Zone’. Suresh 2013 Listen to the podcast Tweet

Do Facebook pictures of babies violate their privacy?

An amusing but thought-provoking article describes how a baby has a brain, but not a mind. It does not have agency and has not yet developed personhood. So by posting pictures of a baby on Facebook, are parents violating the…

Closeness and separation in the NICU

There are two types of closeness between parents and their baby in the NICU – physical closeness and emotional closeness. The two often go together but not always – for example a parent may be physically close to the baby…

Baby hatches – beneficial or harmful?

A baby hatch is a location where parents can abandon an unwanted newborn baby (sometimes anonymously), and such hatches exist in 20 countries, often outside hospitals. They are intended to save the lives of fetuses and newborns. An article from…

Presenting information to help parents decide: how much detail and what order ?

When volunteers were presented a hypothetical scenario of a 23 week gestation infant and asked to choose either intensive care or comfort care, they chose similarly, irrespective of whether they were presented information in more detail or less, and whether…