First name
Committee
Middle name
on fetus and
Last name
newborn

Title

Donor Human Milk for the High-Risk Infant: Preparation, Safety, and Usage Options in the United States.

Year of Publication

2016

Number of Pages

Date Published

2016 Dec 19

ISSN Number

1098-4275

Abstract

<p>The use of donor human milk is increasing for high-risk infants, primarily for infants born weighing &lt;1500 g or those who have severe intestinal disorders. Pasteurized donor milk may be considered in situations in which the supply of maternal milk is insufficient. The use of pasteurized donor milk is safe when appropriate measures are used to screen donors and collect, store, and pasteurize the milk and then distribute it through established human milk banks. The use of nonpasteurized donor milk and other forms of direct, Internet-based, or informal human milk sharing does not involve this level of safety and is not recommended. It is important that health care providers counsel families considering milk sharing about the risks of bacterial or viral contamination of nonpasteurized human milk and about the possibilities of exposure to medications, drugs, or herbs in human milk. Currently, the use of pasteurized donor milk is limited by its availability and affordability. The development of public policy to improve and expand access to pasteurized donor milk, including policies that support improved governmental and private financial support for donor milk banks and the use of donor milk, is important.</p>

DOI

10.1542/peds.2016-3440

Alternate Title

Pediatrics

PMID

27994111
Inner Banner
Publication Image
Inner Banner
Publication Image

Title

Safe Sleep and Skin-to-Skin Care in the Neonatal Period for Healthy Term Newborns.

Year of Publication

2016

Number of Pages

Date Published

2016 Aug 22

ISSN Number

1098-4275

Abstract

<p>Skin-to-skin care (SSC) and rooming-in have become common practice in the newborn period for healthy newborns with the implementation of maternity care practices that support breastfeeding as delineated in the World Health Organization's "Ten Steps to Successful Breastfeeding." SSC and rooming-in are supported by evidence that indicates that the implementation of these practices increases overall and exclusive breastfeeding, safer and healthier transitions, and improved maternal-infant bonding. In some cases, however, the practice of SSC and rooming-in may pose safety concerns, particularly with regard to sleep. There have been several recent case reports and case series of severe and sudden unexpected postnatal collapse in the neonatal period among otherwise healthy newborns and near fatal or fatal events related to sleep, suffocation, and falls from adult hospital beds. Although these are largely case reports, there are potential dangers of unobserved SSC immediately after birth and throughout the postpartum hospital period as well as with unobserved rooming-in for at-risk situations. Moreover, behaviors that are modeled in the hospital after birth, such as sleep position, are likely to influence sleeping practices after discharge. Hospitals and birthing centers have found it difficult to develop policies that will allow SSC and rooming-in to continue in a safe manner. This clinical report is intended for birthing centers and delivery hospitals caring for healthy newborns to assist in the establishment of appropriate SSC and safe sleep policies.</p>

DOI

10.1542/peds.2016-1889

Alternate Title

Pediatrics

PMID

27550975
Inner Banner
Publication Image
Inner Banner
Publication Image

Title

Oxygen Targeting in Extremely Low Birth Weight Infants.

Year of Publication

2016

Number of Pages

Date Published

2016 Jul 25

ISSN Number

1098-4275

Abstract

<p>The use of supplemental oxygen plays a vital role in the care of the critically ill preterm infant, but the unrestricted use of oxygen can lead to unintended harms, such as chronic lung disease and retinopathy of prematurity. An overly restricted use of supplemental oxygen may have adverse effects as well. Ideally, continuous monitoring of tissue and cellular oxygen delivery would allow clinicians to better titrate the use of supplemental oxygen, but such monitoring is not currently feasible in the clinical setting. The introduction of pulse oximetry has greatly aided the clinician by providing a relatively easy and continuous estimate of arterial oxygen saturation, but pulse oximetry has several practical, technical, and physiologic limitations. Recent randomized clinical trials comparing different pulse oximetry targets have been conducted to better inform the practice of supplemental oxygen use. This clinical report discusses the benefits and limitations of pulse oximetry for assessing oxygenation, summarizes randomized clinical trials of oxygen saturation targeting, and addresses implications for practice.</p>

DOI

10.1542/peds.2016-1576

Alternate Title

Pediatrics

PMID

27456511
Inner Banner
Publication Image
Inner Banner
Publication Image

Title

Standard Terminology for Fetal, Infant, and Perinatal Deaths.

Year of Publication

2016

Number of Pages

Date Published

2016 May

ISSN Number

1098-4275

Abstract

<p>Accurately defining and reporting perinatal deaths (ie, fetal and infant deaths) is a critical first step in understanding the magnitude and causes of these important events. In addition to obstetric health care providers, neonatologists and pediatricians should have easy access to current and updated resources that clearly provide US definitions and reporting requirements for live births, fetal deaths, and infant deaths. Correct identification of these vital events will improve local, state, and national data so that these deaths can be better addressed and prevented.</p>

DOI

10.1542/peds.2016-0551

Alternate Title

Pediatrics

PMID

27244834
Inner Banner
Publication Image
Inner Banner
Publication Image

Title

Strategies for prevention of health care-associated infections in the NICU.

Year of Publication

2012

Number of Pages

e1085-93

Date Published

2012 Apr

ISSN Number

1098-4275

Abstract

<p>Health care-associated infections in the NICU result in increased morbidity and mortality, prolonged lengths of stay, and increased medical costs. Neonates are at high risk of acquiring health care-associated infections because of impaired host-defense mechanisms, limited amounts of protective endogenous flora on skin and mucosal surfaces at time of birth, reduced barrier function of their skin, use of invasive procedures and devices, and frequent exposure to broad-spectrum antibiotic agents. This clinical report reviews management and prevention of health care-associated infections in newborn infants.</p>

DOI

10.1542/peds.2012-0145

Alternate Title

Pediatrics

PMID

22451712
Inner Banner
Publication Image
Inner Banner
Publication Image

Title

Epidemiology and diagnosis of health care-associated infections in the NICU.

Year of Publication

2012

Number of Pages

e1104-9

Date Published

2012 Apr

ISSN Number

1098-4275

Abstract

<p>Health care-associated infections in the NICU are a major clinical problem resulting in increased morbidity and mortality, prolonged length of hospital stays, and increased medical costs. Neonates are at high risk for health care-associated infections because of impaired host defense mechanisms, limited amounts of protective endogenous flora on skin and mucosal surfaces at time of birth, reduced barrier function of neonatal skin, the use of invasive procedures and devices, and frequent exposure to broad-spectrum antibiotics. This statement will review the epidemiology and diagnosis of health care-associated infections in newborn infants.</p>

DOI

10.1542/peds.2012-0147

Alternate Title

Pediatrics

PMID

22451708
Inner Banner
Publication Image
Inner Banner
Publication Image

Title

Guidance on management of asymptomatic neonates born to women with active genital herpes lesions.

Year of Publication

2013

Number of Pages

e635-46

Date Published

2013 Feb

ISSN Number

1098-4275

Abstract

<p>Herpes simplex virus (HSV) infection of the neonate is uncommon, but genital herpes infections in adults are very common. Thus, although treating an infant with neonatal herpes is a relatively rare occurrence, managing infants potentially exposed to HSV at the time of delivery occurs more frequently. The risk of transmitting HSV to an infant during delivery is determined in part by the mother's previous immunity to HSV. Women with primary genital HSV infections who are shedding HSV at delivery are 10 to 30 times more likely to transmit the virus to their newborn infants than are women with recurrent HSV infection who are shedding virus at delivery. With the availability of commercial serological tests that reliably can distinguish type-specific HSV antibodies, it is now possible to determine the type of maternal infection and, thus, further refine management of infants delivered to women who have active genital HSV lesions. The management algorithm presented herein uses both serological and virological studies to determine the risk of HSV transmission to the neonate who is delivered to a mother with active herpetic genital lesions and tailors management accordingly. The algorithm does not address the approach to asymptomatic neonates delivered to women with a history of genital herpes but no active lesions at delivery.</p>

DOI

10.1542/peds.2012-3216

Alternate Title

Pediatrics

PMID

23359576
Inner Banner
Publication Image
Inner Banner
Publication Image