With recent rapid improvements in neonatal intensive care, the limit of viability has shifted downward to 22–23 weeks' gestation. The younger the gestational age of preterm infants, the higher the risk of survival despite severe neurodevelopmental impairments. For infants born at 22–23 weeks' gestation, the limit of viability, neurodevelopmental outcomes, and survival rates may be determined by the quality of... |
Background: Early development is characterized by considerable variability.
Purpose: To investigate the stability of the revised Korean Developmental Screening Test (K-DST) classification of the development of healthy term 4–6 and 10–12 month-old infants. Methods: This study used data from the Korean Children’s Environmental Health study, a nationwide prospective birth cohort study. Sixty-nine healthy term infants (26 boys, 43 girls) underwent... |
Despite neonatal intensive care advancements and quality improvements, preterm infants often experience delays in speech and language development during early childhood. The etiological pathway of language delays is multifactorial, including younger gestational age at birth, male sex, pregnancy complications including gestational diabetes mellitus and preeclampsia, organic pathology from neonatal morbidities, environmental factors of the neonatal intensive care unit (NICU) and... |
Question: Do interventions based on Meleis' transition theory affect mothers' readiness for baby care and breastfeeding? Findings: We found a statistically significant difference between the intervention and control groups in mothers' readiness for newborn care and breastfeeding (P<0.001). Meaning: This intervention increased breastfeeding rates while ensuring that mothers were ready to care for their babies and prepared for the role of motherhood. |
Question: How do structural and staffing characteristics of neonatal intensive care units (NICUs) influence the mortality rates of very low birth weight infants (VLBWIs)? Findings: NICUs with higher staffing levels, particularly with more neonatologists, and those offering advanced care levels were associated with lower mortality rates. Additionally, regional disparities were observed, with some areas demon-strating significantly higher survival rates. Meaning: Adequate staffing and equitable regional distribution of medical resources are crucial for improving survival outcomes in VLBWIs. Efforts to enhance NICU staffing and address regional healthcare disparities are essential for optimizing care quality and reducing mortality in this vulnerable population. |
Question: Does online responsive teaching (RT) impact children's and parents’ emotions and behaviors, and do parents find it satisfactory? Finding: Online RT significantly improved children's pivotal and problem behaviors, decreased parenting stress, and enhanced parental interactive styles with high satisfaction. Meaning: This pilot study's findings suggest that online RT can enhance child outcomes, offering accessible interventions amid challenges such as limited access and pandemics. |
Question: Is vitamin E a viable therapeutic option for managing neonatal hyperbilirubinemia? Finding: This randomized clinical trial examined the effects of oral vitamin E supplementation on bilirubin reduction (primary outcome), phototherapy duration, and length of hospital stay (secondary outcome) in 138 infants. Meaning: Infants administered vitamin E versus placebo demonstrated similar reductions in bilirubin levels and length of hospital stay. |
· Clinical studies of coronavirus disease 2019 (COVID-19) in infants should be supported by rigorous laboratory diagnostic criteria. · Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads to infants similarly to other viral respiratory infections. · Among infants ≤1 year of age beyond the immediate postpartum period, COVID-19 is relatively mild, but even the low risk of severe disease requires prevention. · Comorbidities increase infection vulnerability and complications in infants. · Clinical and laboratory data do not sufficiently distinguish COVID-19 from other respiratory viral infections. · Coinfection with SARS-CoV-2 is uncommon among infants. · Unique infection sequelae, including multi-inflammatory syndrome in children and neonates and long COVID require further study and refinement of diagnostic criteria. · Infection control standards applied to mother-infant dyads should be tempered by standard preventive strategies, maternal input, accommodation potential, and overall safety. · Maternal vaccination prevents disease in early infancy. |
· The infant gut microbiome is highly dynamic and individualized. · Microbes are vertically transmitted from mother to infant during delivery and throughout infancy. · Delivery mode, gestational age, diet, and antibiotic use influence infant microbiome composition and function. · In animal studies, the microbiome played critical roles in the structural and functional development of the infant gastrointestinal and immune systems. · Microbiome-targeted therapies have great potential to reduce infant morbidity and mortality. |
In neonatal resuscitation: · Laryngeal masks are recommended when endotracheal intubation or positive-pressure ventilation fails. · Laryngeal masks are useful even during chest compressions. · Laryngeal masks aid neonates >34 weeks’ gestation and/or with a birth weight >2 kg. · Main usage barriers include limited experience (81%), preference for endotracheal tubes (57%), and lack of awareness (56%). · Second-generation laryngeal masks have a built-in esophageal drainage tube that prevents regurgitation into the glottis, and an orogastric tube can be inserted within the esophageal drainage tube to protect against gastric inflation. |
· Concrete evidence exists of early parent-infant attachment supported by family-centered care (FCC) in the neonatal intensive care unit. · FCC involves the parents’ presence and participation in the infant’s care and decision-making. · A private and comfortable space should be provided. A single-family room is ideal; however, a quiet space with a recliner can be a good alternative. · Care culture changes and staff training are required. |
Question: What are the current palliative care protocols, palliative course, and implementable palliative care programs for hospitalized pediatric patients with neurological diseases in Italy? Finding: We studied 34 newborns with nervous system diseases, all of whom had a poor prognosis. Meaning: Despite current legislation in Italy, no palliative care network has been implemented. Given the vast number of patients with neurological conditions, standardized palliative care guidelines and protocols are required. |
· Question: What level of parenting stress is experienced by parents of children with developmental delays (DDs) without autism spectrum disorder, and what factors contribute to it? · Findings: Parents of children with DDs experienced high parenting stress that were significantly mediated by their children’s low interactive behaviors. · Meaning: The interactive behaviors of children with DDs mediate parenting stress. |
· Congenital hearing loss is common, with an approximate incidence of 1.5 per 1,000 newborns and affecting 1.2%–11% of preterm and 1.6%–13.7% of neonatal intensive care unit neonates. · Etiologies vary, and up to 80% of cases are genetic. · Newborn hearing screenings follow the 1-3-6 rule, and babies at high risk of hearing loss should be referred to otolaryngology for early detection and timely intervention. |
· Among survivors, 60.9% of infants born at 22 weeks’ gestation had moderate to severe impairments, whereas 50.3% born at 23 weeks’ and 42.2% at 24 weeks’ gestation had moderate to severe impairments. · Moderate and late preterm infants reportedly have less severe disease than very preterm infants, but they still experience adverse neurodevelopmental outcomes. · The careful follow-up and early detection of developmental problems in these patients are required. |
Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants? Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants. Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties. |
Question: Do probiotics added to maternal nutrition affect infantile colic symptoms and intestinal microbiota? Finding: Infants whose mothers ingested probiotics demonstrated decreased crying frequency and intensity and significantly increased bacterial diversity in the stools. The bacterial variety was substantially affected by the added probiotic product. Meaning: The addition of probiotics to maternal nutrition in early infancy could play an important role in preventing infantile colic. |
Some neonates, especially those who are premature, may experience hypertension while in the neonatal intensive care unit (NICU). The most common causes are prematurity-related and the hypertension usually resolves over the first 1–2 years of life. Unfortunately, the increasing population of NICU graduates is at risk for later cardiovascular and kidney disease in childhood and adulthood. This population requires careful attention to blood pressure and weight throughout their life course. |
Question: Plastic feeding bottles are used commonly to feed infants who cannot be breastfeed. Does plastic bottle feeding produce biochemical changes in infants? Finding: The plastic bottles leach out endocrine disruptors and affects bodily functions in terms of biochemical alterations like increased blood urea, raised creatine-kinase–MB levels, and altered lipid profile in infants exposed to bottle feeding. Meaning: Plastic bottles feeding alters bodily functions in infants. |
Nutrients are important in the developing immune system. Human milk supplies diverse bioactives to prevent acute infection or chronic inflammation. Immunoglobulins, lactoferrin, and glutamine in human milk decrease gastrointestinal and respiratory infection. Human milk oligosaccharides promote the growth of intestinal microbiota, the gut barrier, and antimicrobial or antiviral activity. Micronutrients act as anti-inflammatory immunonutrients, too. However, the toxicity of some nutrients from an overdose should be considered. |
∙ Microbial colonization primarily occurs after birth but there may be some colonization in utero, although this remains highly controversial. ∙ Maternal factors during pregnancy affect the infant microbiota: diet, weight, gestational weight gain, and antibiotic usage. ∙ Microbes are passed from mother-to-infant during and after birth. Delivery mode, breastfeeding, early life antibiotic, and proton pump inhibitor treatment have the largest effects on microbial composition in early life. ∙ The early life gut microbiome plays an important role in the development of the immune system and metabolism. |
∙ Exclusively breastfed infants are at risk of developing vitamin D deficiency associated with hypocalcemia, rickets, and various health outcomes. ∙ The prevalence of vitamin D deficiency in breastfed infants differs vastly between studies and nations at 0.6%–91.1%. ∙ The vitamin D content of breast milk does not meet the requirements of exclusively breastfed infants. ∙ Most international guidelines recommend that breastfed infants be supplemented with 400 IU/day of vitamin D during the first year of life. ∙ Vitamin D intake (milk+supplements) of 800 IU/day can be considered in preterm infants along with biochemical monitoring. |
Question: When is the best screening timing and what is the risk factor for developmental dysplasia of the hip (DDH) in preterm infants? Finding: Ultrasonography performed earlier than 38 weeks of postmenstrual age caused unnecessary subsequent ultrasonography. DDH did not occur predominantly on the left side or in breech infants. Meaning: The screening timing, etiology, and risk factors for DDH in preterm infants are somewhat different from those in term infants. |
· Thrombocytosis, common in newborns and infants (<2 years) (3%–13%), is caused by elevated thrombopoietin (TPO) concentrations. · Serum TPO levels are significantly higher immediately to 1 month postnatal and decrease with age. · Platelet counts are positively correlated with gestational age at birth and postnatal age. · Thrombocytosis is more common in preterm than in term infants. · Thrombocytosis in newborns is reactive and resolves spontaneously without complications. |
Question: Are the short-term outcomes of minimally invasive surfactant therapy (MIST) relatively superior to those of INtubation, SURfactant administration, and Extubation (INSURE) in preterm infants with respiratory distress syndrome (RDS)? Finding: MIST could be an appropriate substitution for INSURE in preterm infants with RDS since it reduced hospitalization time and number of side effects. Meaning: MIST is recommended for surfactant administration for its proven advantages over the INSURE technique. |
∙ The growth of preterm infants is a main focus of neonatology. ∙ Preterm infants in Korea, especially those with a very low birth weight, achieve retarded growth. ∙ Careful growth monitoring and early intervention will contribute to better development outcomes and quality of life for preterm infants and improve public health. |
∙ Diphtheria and tetanus toxoids and acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b-hepatitis B (DTaP-IPV-Hib-HepB) was licensed in Korea in April 2020. ∙ DTaP-IPV-Hib-HepB is indicated as a 3-dose primary series for infants aged 2, 4, and 6 months who received the standalone HepB vaccine at birth. ∙ Infants born to HepB surface antigen-positive mothers are currently recommended to be immunized with HepB immunoglobulin at birth and then monovalent HepB vaccine at 0, 1, and 6 months. |
Question: Do probiotics reduce colic symptoms? Finding: Probiotics reduced colic symptoms in colicky infants probably due to the anti-inflammatory properties. Meaning: Probiotics may be an effective and less noxious way to manage infantile colic. |
This national cohort study included all Korean children born in 2008 and 2009 observed over a period of more than 10 years. Our findings demonstrate that it is possible to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors by integrating National Health Insurance System data with national health screening data. |
· Very low birth weight infants remain at high risk of developing neurodevelopmental impairments in early childhood. · It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants. · All possible strategies should be employed to maintain good compliance after neonatal intensive care unit discharge. |