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1
Adjerid, Khaled, Christopher J. Mayerl, Francois D. H. Gould, Chloe E. Edmonds, Bethany M. Stricklen, Laura E. Bond, and Rebecca Z. German. "Does birth weight affect neonatal body weight, growth, and physiology in an animal model?" PLOS ONE 16, no. 2 (February 16, 2021): e0246954. http://dx.doi.org/10.1371/journal.pone.0246954.
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Infant birth weight affects neuromotor and biomechanical swallowing performance in infant pig models. Preterm infants are generally born low birth weight and suffer from delayed development and neuromotor deficits. These deficits include critical life skills such as swallowing and breathing. It is unclear whether these neuromotor and biomechanical deficits are a result of low birth weight or preterm birth. In this study we ask: are preterm infants simply low birth weight infants or do preterm infants differ from term infants in weight gain and swallowing behaviors independent of birth weight? We use a validated infant pig model to show that preterm and term infants gain weight differently and that birth weight is not a strong predictor of functional deficits in preterm infant swallowing. We found that preterm infants gained weight at a faster rate than term infants and with nearly three times the variation. Additionally, we found that the number of sucks per swallow, swallow duration, and the delay of the swallows relative to the suck cycles were not impacted by birth weight. These results suggest that any correlation of developmental or swallowing deficits with reduced birth weight are likely linked to underlying physiological immaturity of the preterm infant.
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Tauchi, H., K. Yahagi, T. Yamauchi, T. Hara, R. Yamaoka, N. Tsukuda, Y. Watanabe, et al. "Gut microbiota development of preterm infants hospitalised in intensive care units." Beneficial Microbes 10, no. 6 (July 10, 2019): 641–51. http://dx.doi.org/10.3920/bm2019.0003.
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Gut microbiome development affects infant health and postnatal physiology. The gut microbe assemblages of preterm infants have been reported to be different from that of healthy term infants. However, the patterns of ecosystem development and inter-individual differences remain poorly understood. We investigated hospitalised preterm infant gut microbiota development using 16S rRNA gene amplicons and the metabolic profiles of 268 stool samples obtained from 17 intensive care and 42 term infants to elucidate the dynamics and equilibria of the developing microbiota. Infant gut microbiota were predominated by Gram-positive cocci, Enterobacteriaceae or Bifidobacteriaceae, which showed sequential transitions to Bifidobacteriaceae-dominated microbiota. In neonatal intensive care unit preterm infants (NICU preterm infants), Staphylococcaceae abundance was higher immediately after birth than in healthy term infants, and Bifidobacteriaceae colonisation tended to be delayed. No specific NICU-cared infant enterotype-like cluster was observed, suggesting that the constrained environment only affected the pace of transition, but not infant gut microbiota equilibrium. Moreover, infants with Bifidobacteriaceae-dominated microbiota showed higher acetate concentrations and lower pH, which have been associated with host health. Our data provides an in-depth understanding of gut microbiota development in NICU preterm infants and complements earlier studies. Understanding the patterns and inter-individual differences of the preterm infant gut ecosystem is the first step towards controlling the risk of diseases in premature infants by targeting intestinal microbiota.
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Premru-Srsen, Tanja, Ivan Verdenik, Barbara Mihevc Ponikvar, Lili Steblovnik, Ksenija Geršak, and Lilijana Kornhauser Cerar. "Infant mortality and causes of death by birth weight for gestational age in non-malformed singleton infants: a 2002–2012 population-based study." Journal of Perinatal Medicine 46, no. 5 (July 26, 2018): 547–53. http://dx.doi.org/10.1515/jpm-2017-0103.
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Abstract Objective: To explore the associations between birth weight for gestational age (GA) and infant mortality as well as causes of infant death. Study design: A population-based observational study conducted between 2002 and 2012 included 203,620 non-malformed singleton live births from Slovenia. Poisson regression analyses were performed to estimate the crude relative risk (RR) and adjusted RR (aRR) for infant mortality by birth weight percentiles stratified by the GA subgroups term, moderate-to-late preterm, very preterm and extremely preterm. Results: Compared with appropriate for GA (AGA) term infants (referent-AGA), infant mortality was significantly higher in small for GA (SGA) term infants [aRR=2.79 (1.41–5.50)], with significant cause-specific infant mortality risk for neuromuscular disorders [RR=10.48 (2.62–41.91)]. The differences in infant mortality and cause-specific infant mortality in preterm subgroups between referent-AGA and SGA were insignificant. Conclusions: In the Slovenian population, birth weight for GA is significantly associated with infant mortality only in infants born at term.
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Beachy, Jodi. "Premature Infant Massage in the NICU." Neonatal Network 22, no. 3 (January 2003): 39–45. http://dx.doi.org/10.1891/0730-0832.22.3.39.
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Infant massage therapy is an inexpensive tool that should be utilized as part of the developmental care of the preterm infant. Nurses have been hesitant to begin massage therapy for fear of overstimulating the infant and because there has been insufficient research to prove its safety. Recent research, however, has shown that the significant benefits of infant massage therapy far outweigh the minimal risks. When infant massage therapy is properly applied to preterm infants, they respond with increased weight gains, improved developmental scores, and earlier discharge from the hospital. Parents of the preterm infant also benefit because infant massage enhances bonding with their child and increases confidence in their parenting skills. This article discusses the benefits and risks of massage for preterm infants and their families and explains how to implement massage therapy in the neonatal intensive care setting.
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Cho, June, and Diane Holditch-Davis. "Effects of Perinatal Testosterone on Infant Health, Mother–Infant Interactions, and Infant Development." Biological Research For Nursing 16, no. 2 (May 2, 2013): 228–36. http://dx.doi.org/10.1177/1099800413486340.
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Objective: Many researchers and health care providers have noticed male vulnerability in infant health, mother–infant interactions, and some infant cognitive development, especially among very low birth weight (VLBW) preterm infants. However, factors beyond gender that could explain these observed differences have not been clear. The purpose of this article is to review the literature on the subject and to introduce a conceptual framework relating these factors. Discussion: According to gender-difference theories, prenatal exposure to high levels of testosterone may influence infant health and mother–infant interactions by negatively affecting infant cognitive/motor/language development. We constructed a conceptual framework based on the associations among biological (perinatal testosterone), stress-related (perinatal and maternal cortisol), and developmental (infant cognitive/motor/language skills) factors. If research establishes these biological, environmental, and developmental associations in mother–VLBW preterm pairs, the results will highlight the importance of addressing gender differences in nursing research and encourage the development of nursing interventions designed to reduce stress among mothers of VLBW preterm infants, particularly male infants. Conclusion: From a psychobiosocial perspective, combining biophysiological factors such as perinatal testosterone and cortisol with socioenvironmental factors such as the quality of mother–infant interactions and infant temperament may provide a broader view of gender differences in infant health and development.
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Nielsen, Søren D., Robert L. Beverly, Mark A. Underwood, and David C. Dallas. "Differences and Similarities in the Peptide Profile of Preterm and Term Mother’s Milk, and Preterm and Term Infant Gastric Samples." Nutrients 12, no. 9 (September 15, 2020): 2825. http://dx.doi.org/10.3390/nu12092825.
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Our previous studies revealed that milk proteases begin to hydrolyze proteins in the mammary gland and that proteolytic digestion continues within the infant stomach. No research has measured how the release of milk peptides differs between the gastric aspirates of term and premature infants. This study examined the presence of milk peptides in milk and gastric samples from term and preterm infants using an Orbitrap Fusion Lumos mass spectrometer. Samples were collected from nine preterm-delivering and four term-delivering mother–infant pairs. Our study reveals an increased count and ion abundance of peptides and decreased peptide length from mother’s milk to the infant stomach, confirming that additional break-down of the milk proteins occurred in both preterm and term infants’ stomachs. Protein digestion occurred at a higher level in the gastric contents of term infants than in gastric contents of preterm infants. An amino acid cleavage site-based enzyme analysis suggested that the observed higher proteolysis in the term infants was due to higher pepsin/cathepsin D activity in the stomach. Additionally, there was a higher quantity of antimicrobial peptides in term infant gastric contents than in those of preterm infants, which could indicate that preterm infants benefit less from bioactive peptides in the gut.
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Fallah Rostami, Fatemeh, Farin Soleimani, Mehdi Norouzi, Nikta Hatamizadeh, Jamileh Mokhtarinouri, and Marjan Poshtmashhadi. "Preterm Infant Neurodevelopmental Care Training Program and Mother-Infant Attachment." International Journal of Women's Health and Reproduction Sciences 8, no. 2 (February 23, 2019): 192–97. http://dx.doi.org/10.15296/ijwhr.2020.30.
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Objectives: Preterm birth and admission to the neonatal intensive care unit (NICU) would disrupt mother-infant attachment. Neurodevelopmental care training and support of family programs are essential for the family of such infants. The purpose of this study was to investigate the effect of neurodevelopmental care training program for mothers with preterm infants on mother-infant attachment at one month’s age. Materials and Methods: Study population included all the mothers of preterm infants born in the hospitals of Tehran in 2018. The research was designed as a multicenter cluster clinical trial and four hospitals were randomly selected and divided into intervention and control groups. Before the intervention, the mother-infant attachment was measured by the Maternal-Postnatal Attachment Scale (MPAS). The mothers in the intervention group received a 12-session preterm infant neurodevelopmental care training program while the control group only received the routine care in the unit. Finally, the mother-infant attachment was re-measured in both groups at the one month corrected age. Results: No significant difference was observed in the attachment score before and after the intervention in the control group but the mother-infant attachment score was significantly different in the intervention group (57.75±11.09 vs. 78.27±4.54). Conclusions: The neurodevelopmental care training program was effective and increased the mother-infant attachment rate.
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MacDorman, Marian F., William M. Callaghan, T. J. Mathews, Donna L. Hoyert, and Kenneth D. Kochanek. "Trends in Preterm-Related Infant Mortality by Race and Ethnicity, United States, 1999–2004." International Journal of Health Services 37, no. 4 (October 2007): 635–41. http://dx.doi.org/10.2190/hs.37.4.c.
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Trends in preterm-related causes of death were examined by maternal race and ethnicity. A grouping of preterm-related causes of infant death was created by identifying causes that were a direct cause or consequence of preterm birth. Cause-of-death categories were considered to be preterm-related when 75 percent or more of total infant deaths attributed to that cause were deaths of infants born preterm, and the cause was considered to be a direct consequence of preterm birth based on a clinical evaluation and review of the literature. In 2004, 36.5 percent of all infant deaths in the United States were preterm-related, up from 35.4 percent in 1999. The preterm-related infant mortality rate for non-Hispanic black mothers was 3.5 times higher and the rate for Puerto Rican mothers was 75 percent higher than for non-Hispanic white mothers. The preterm-related infant mortality rate for non-Hispanic black mothers was higher than the total infant mortality rate for non-Hispanic white, Mexican, and Asian or Pacific Islander mothers. The leveling off of the U.S. infant mortality decline since 2000 has been attributed in part to an increase in preterm and low-birthweight births. Continued tracking of preterm-related causes of infant death will improve our understanding of trends in infant mortality in the United States.
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POEHLMANN, JULIE, and BARBARA H. FIESE. "The interaction of maternal and infant vulnerabilities on developing attachment relationships." Development and Psychopathology 13, no. 1 (March 2001): 1–11. http://dx.doi.org/10.1017/s0954579401001018.
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The present study sought to document an example of how maternal and infant vulnerabilities interact in contributing to the quality of early attachment relationships. Maternal depressive symptoms, neonatal health characteristics, and infant–mother attachment were assessed for 42 preterm, low birth weight infants and 42 full-term infants at 12 months postterm. Results indicated that preterm birth moderated the relation between maternal depressive symptoms and quality of infant–mother attachment, even controlling for level of neonatal health complications. Preterm infants with more symptomatic mothers were most likely to be classified as insecurely attached to their mothers, whereas no direct relation between subclinical depressive symptoms and attachment was found for full-term infants.
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Syrengelas, Dimitrios, Vassiliki Kalampoki, Paraskevi Kleisiouni, Vassiliki Manta, Stavros Mellos, Roser Pons, George P. Chrousos, and Tania Siahanidou. "Alberta Infant Motor Scale (AIMS) Performance of Greek Preterm Infants: Comparisons With Full-Term Infants of the Same Nationality and Impact of Prematurity-Related Morbidity Factors." Physical Therapy 96, no. 7 (July 1, 2016): 1102–8. http://dx.doi.org/10.2522/ptj.20140494.
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Abstract Background Only a few studies have been conducted with the objective of creating norms of the Alberta Infant Motor Scale (AIMS) for the assessment of gross motor development of preterm infants. The AIMS performance of preterm infants has been compared with that of the Canadian norms of full-term infants, but not with that of full-term infants of the same nationality. Moreover, the possible impact of prematurity-related morbidity factors on AIMS performance is unknown. Objectives The aims of this study were: (1) to evaluate AIMS trajectory in a large population of Greek preterm infants and create norms, (2) to compare it with the AIMS trajectory of Greek full-term infants, and (3) to examine the possible influence of neonatal morbidity on AIMS scores in the preterm sample. Design This was a cross-sectional study. Methods Mean AIMS scores were compared, per month (1–19), between 403 preterm infants (≤32 weeks of age, corrected for prematurity) and 1,038 full-term infants. In preterm infants, the association of AIMS scores with respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH) of grade ≤III, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and sepsis was assessed by hierarchical regression analysis. Results Alberta Infant Motor Scale scores were significantly lower in preterm infants than in full-term infants. Mean AIMS scores in preterm infants were significantly associated with RDS (b=−1.93; 95% CI=−2.70, −1.16), IVH (b=−0.97; 95% CI=−1.69, −0.25), and ROP (b=−1.12; 95% CI=−1.99, −0.24) but not with BPD or sepsis in hierarchical regression analysis. Conclusions Alberta Infant Motor Scale norms were created for Greek preterm infants. This study confirms that AIMS trajectories of preterm infants are below those of full-term infants of the same nationality. The influence of morbidity factors, including RDS, IVH, and ROP, should be taken into account when administering the AIMS in preterm infants.
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Healy, C. Mary, Marcia Rench, Laurie Swaim, Gowrisankar Rajam, Fiona Havers, Susan Hariri, Jarad Schiffer, and Carol J. Baker. "2902. Pertussis Antibody Levels in Preterm Infants After Maternal Tdap Immunization During Pregnancy." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S83. http://dx.doi.org/10.1093/ofid/ofz359.180.
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Abstract Background Maternal immunization with tetanus, diphtheria, acellular pertussis vaccine (Tdap) in the third trimester reduces infant pertussis, but data are lacking on how this strategy impacts pertussis antibody levels in large cohorts of preterm infants Methods We collected paired maternal delivery-cord sera from infants of women who received Tdap ≥7 days before birth. IgG to pertussis toxin (PT), filamentous hemagglutinin (FHA), fimbrial proteins (FIM) and pertactin (PRN) was quantified by Luminex assay (IU/mL). Geometric mean concentrations (GMC) with 95% confidence intervals (CI) for pertussis antibodies were calculated. Four infant groups were compared by weeks of gestation: very (<32), moderate (32–33) and late preterm (34–36), and term (≥37). Results 344 preterm and 688 term mother-infant pairs were included. Among preterm infants, mean maternal age was 31.2 years (range 15.1–39.3); 37% were white, 37% Hispanic, 17% Black, 8% Asian and 1% other. Fifty-six were very preterm infants (16%, mean gestation 30.5 weeks), 82 moderate (24%, 33.1 weeks), and 206 late (60%, 35.4 weeks); 17 (5%) were born at <30 weeks. For preterm infants, Tdap was administered at a mean gestation of 29.9 weeks (very 27.9; moderate 29.7; late 30.4; [P < .001]), and at a mean interval of 29.3 days before delivery (very 17.9; moderate 24; late 34.5 [P <.001]). Eleven (3%) women received Tdap during the second trimester (8 very, 2 moderate, 1 late). GMCs (95% CI) of pertussis-specific IgG at birth varied by gestation (table). Infant antibody levels as a proportion of maternal antibodies increased from 24 to 32% in infants < 30 weeks to 117 to 132% in those ≥37 weeks (P<.001). Conclusion Although levels are lower than in term infants, maternal immunization with Tdap results in substantial pertussis-specific antibodies in most preterm infants, especially late preterm infants. Disclosures All Authors: No reported Disclosures.
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Sauer, P. J. "Nutrition of the preterm infant." Pediatrician (St. Petersburg) 6, no. 2 (June 15, 2015): 4–11. http://dx.doi.org/10.17816/ped624-11.
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Nutrition is of great importance for the preterm infant. It is not only essential for survival, but also makes provision for rapid development of many organs outside the uterus which process normally takes place in the third trimester of pregnancy. It is for future life essential that all factors that might influence the development are as optimal as possible, including nutrition. However, there might also be an upper limit to the intake of some ingredients in the neonatal period. The rate of growth of the preterm infant is five times higher compared to term infants and the breast of the mother delivering preterm might yet be ready to produce the optimal composition of milk. Preterm infants receiving mothers milk only are known to show a lower gain in weight and length than the so called reference fetus. It is therefore at least questionable if preterm human milk can be used to define the nutritional needs of the preterm infant. To define the optimal composition and amounts of nutrients for the preterm infant a factorial approach can be used. The estimated requirements are calculated from the calculated requirements for maintenance and growth. Though some studies have shown that the protein content of milk from mothers who delivered preterm can be higher in the first few weeks after birth compared to milk of term delivering mothers, soon after there is a rapid decline in protein content after which period the content is not different from the term delivered mother. Providing exclusively mothers own milk leads to suboptimal growth and insufficient accretion of minerals. The needs of the preterm infant in energy, protein, lipids, carbohydrates, minerals, pro- and prebiotics to provide optimal nutrition in the first days after birth are discussed in the paper. It is concluded that nowadays early, aggressive nutrition directly after premature birth with the immediate introduction of amino acids and rapid introduction of lipids is advised. Enteral feeding should be started very soon after birth, preferably on the first day of life and increased in the days thereafter. The first choise for enteral feeding is mothers own milk, supplemented from the second week with a fortifier. Special preterm formula might serve as a good alternative in case when breast milk is not available.
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Beverly, Robert L., Robert K. Huston, Andi M. Markell, Elizabeth A. McCulley, Rachel L. Martin, and David C. Dallas. "Milk Peptides Survive In Vivo Gastrointestinal Digestion and Are Excreted in the Stool of Infants." Journal of Nutrition 150, no. 4 (December 28, 2019): 712–21. http://dx.doi.org/10.1093/jn/nxz326.
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ABSTRACT Background Human milk peptides released by gastrointestinal proteases have been identified with bioactivities that can benefit the infant but must first reach their respective sites of activity. Peptides in the stool either survived to or were released inside the intestinal tract, and thus had the opportunity to exert bioactivity there. However, it is unknown whether any milk peptides, bioactive or not, can survive in the stool of infants. Objective The aim of this study was primarily to identify milk peptides in infant stool samples and secondarily test the hypotheses that the milk peptide profiles of stools are different between preterm infants at different days of life and between preterm and term infants. Methods Infant stool samples were collected from 16 preterm infants (<34 weeks gestational age) at 8 or 9 and 21 or 22 days of life (DOL), and from 10 term infants (>34 weeks gestational age) at 8 or 9 DOL. Milk peptides were isolated from the stool samples and identified using tandem MS. The peptide counts and abundances were compared between infant groups. Results In total, 118 exclusively milk-derived peptides from the caseins and α-lactalbumin were present in the stool samples, including some peptides with known or potential bioactivity. The remaining 8014 identified peptides could be derived either from milk or endogenous proteins. Although many individual milk peptides were significantly different between preterm infants at 8/9 and 21/22 DOL and between preterm and term infants, total peptide abundance and count were similar for all 3 groups. Conclusions This is the first study to confirm the survival of milk peptides in the stool of infants. Some of the peptides had potential bioactivities that could influence infant gut development. These results are important to understand the physiological relevance of human milk peptides to the infant.
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Kissgen, Ruediger, Sebastian Franke, Nino Jorjadze, Bernhard Roth, and Angela Kribs. "Infant–Father Attachment in Infants Born Preterm - A Brief Report." International Journal of Developmental Science 15, no. 1-2 (August 20, 2021): 3–8. http://dx.doi.org/10.3233/dev-200299.
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This study examines the infant–father attachment in infants born preterm (< 1500 g at birth and/or < 37 weeks gestation) in comparison to full-term infants. The infant–father attachment was assessed using the Strange Situation Procedure at a (corrected) age of 15 months. We found at least half of preterm and full-term infants (50.0% and 56.5% respectively) securely attached to their fathers, and no significant overall difference was observed concerning the distribution of attachment quality comparing the two groups. In light of the fact that preterm infants tend to have numerous neurodevelopmental problems, it is encouraging that significant differences were not found in the distribution of the attachment quality among the groups. Therefore, from the perspective of attachment research, it would be highly beneficial to include fathers in the care of their preterm infants.
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Pundir, Shikha, Cameron J. Mitchell, Eric B. Thorstensen, Clare R. Wall, Sharon L. Perrella, Donna T. Geddes, and David Cameron-Smith. "Impact of Preterm Birth on Glucocorticoid Variability in Human Milk." Journal of Human Lactation 34, no. 1 (September 13, 2017): 130–36. http://dx.doi.org/10.1177/0890334417729339.
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Background: Preterm birth is a stressful event for both the mother and infant. Whereas the initiation of breastfeeding is important for preterm infant health, little is known of the glucocorticoid hormones (cortisol and cortisone) in human milk following preterm birth. Research aim: The aim of this study was to investigate the relationship between human milk glucocorticoid concentrations and preterm birth. Methods: Human milk was sampled weekly for up to 6 weeks from 22 women who delivered a preterm infant at 28 to 32 weeks’ gestation. Human milk was analyzed for total and free cortisol and cortisone concentrations using liquid chromatography-tandem mass spectrometry. Results: Milk sampled from mothers of preterm infants had more cortisone than cortisol ( p < .001), with a strong correlation between both hormones ( p = .001, r = .85). The cortisone was significantly higher in the milk of mothers who delivered infants after 30 weeks compared with those who delivered before 30 weeks of gestation ( p = .02). Glucocorticoid concentrations did not change over the sampling time (weeks 1 to 6 postpartum) and did not differ by infant gender. Conclusion: Glucocorticoids were present in all milk samples following preterm birth. Cortisone concentration tended to be higher in those who delivered after 30 weeks’ gestation but did not increase further over the weeks following birth.
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Wang, Ying, Carrie-Ellen Briere, Wanli Xu, and Xiaomei Cong. "Factors Affecting Breastfeeding Outcomes at Six Months in Preterm Infants." Journal of Human Lactation 35, no. 1 (May 3, 2018): 80–89. http://dx.doi.org/10.1177/0890334418771307.
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Background: Preterm mother-infant dyads often face many obstacles to breastfeeding. Preterm infants are at highest risk for low rates of exclusive breastfeeding. Research Aim: To determine the prevalence of breastfeeding at 6 months among preterm infants and to identify factors that influenced mothers’ breastfeeding practices. Methods: A longitudinal observational study was conducted in a metropolitan hospital in Beijing, China. Mothers ( N = 270) and their preterm infants ( N = 280) were included in the study. Characteristics of preterm mothers and their perceptions of breastfeeding self-efficacy, knowledge, social support, and postpartum depression symptoms were measured at the discharge of neonatal intensive care. Breastfeeding data were collected by phone interview at 6 months corrected age. Results: At discharge, mothers of very preterm infants perceived a lower level of breastfeeding self-efficacy (measured with the Breastfeeding Self-Efficacy Scale–Short Form) and had a higher level of depression symptoms (measured with the Edinburgh Postnatal Depression Scale [EPDS]) than mothers of moderate and late preterm infants ( p < .05-.01). Nearly half of all mothers had an elevated EPDS score, considered to be symptomatic of postpartum depression. At 6 months, only 22.5% of all infants were exclusively breastfeeding. Factors associated with exclusive breastfeeding, including younger maternal age, previous breastfeeding experience, shorter mother-infant separation time during intensive care, older infant gestational age, and a higher level of breastfeeding self-efficacy, significantly predicted exclusive breastfeeding practice ( p < .05-.001). Conclusion: The prevalence of breastfeeding at 6 months for preterm infants in this sample was low. Strategies to improve breastfeeding duration for preterm infants are needed, including support and education of mothers while in the hospital.
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Lober, Angela, Joan E. Dodgson, and Lesly Kelly. "Using the Preterm Infant Breastfeeding Behavior Scale With Late Preterm Infants." Clinical Lactation 11, no. 3 (June 24, 2020): 121–29. http://dx.doi.org/10.1891/clinlact-d-20-00001.
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BackgroundFeeding effectiveness of late preterm infants may vary between feedings and over time, creating confusion and frustration for parents and clinicians. An assessment tool for late preterm infants may assist mothers to recognize breastfeeding behavior more clearly. Although tools are available, none have been tested specifically with late preterm infants. We sought to determine the inter-rater reliability of the Preterm Infant Breastfeeding Behavior Scale scores for late preterm infants between mothers and a health professional.MethodsA one-group observational non-experimental design assessed inter-rater reliability (24 hours [n =23] and 48 hours [n =11] after birth).ResultsThe scale's six components were scored independently; agreement ranged from 81.8% to 100% for all components.ConclusionsThe tool was reliable and could be used to help clinicians and parents accurately understand feeding patterns and behaviors assisting with feeding decisions.
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Taylor, Sarah N., and Camilia R. Martin. "Evidence-based Discharge Nutrition to Optimize Preterm Infant Outcomes." NeoReviews 23, no. 2 (February 1, 2022): e108-e116. http://dx.doi.org/10.1542/neo.23-2-e108.
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Despite abundant research comparing postdischarge hospital diets for preterm infants, the ideal clinical approach has not been determined. Dilemmas persist because randomized controlled trials of preterm versus term infant formula have yielded equivocal results and because the predominant postdischarge diet for preterm infants has shifted from formula-based to a combination that includes maternal milk and increasingly includes a plan for breastfeeding. As the investigation of the influence of the post–hospital discharge diet on preterm infant outcomes evolves, factors to consider include the infant’s oral feeding ability and the maternal lactation goal. The maturation of the preterm infant’s oral feeding skills may at least partially explain why increased nutrient density appears to most benefit growth outcomes when given during the first 3 to 4 months after hospital discharge. At some point in maturation, the preterm infant may develop the ability to vary intake as needed to obtain sufficient nutrition no matter the density of the diet. In addition, attention to the maternal lactation goal is critical as intake of maternal milk likely influences neurodevelopmental outcomes as much or even to a greater extent than growth trajectory.
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MacDorman, Marian F., and T. J. Mathews. "The Challenge of Infant Mortality: Have We Reached a Plateau?" Public Health Reports 124, no. 5 (September 2009): 670–81. http://dx.doi.org/10.1177/003335490912400509.
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Objectives. Infant mortality is a major indicator of the health of a nation. We analyzed recent patterns and trends in U.S. infant mortality, with an emphasis on two of the greatest challenges: ( 1) persistent racial and ethnic disparities and ( 2) the impact of preterm and low birthweight delivery. Methods. Data from the national linked birth/infant death datasets were used to compute infant mortality rates per 100,000 live births by cause of death (COD), and per 1,000 live births for all other variables. Infant mortality rates and other measures of infant health were analyzed and compared. Leading and preterm-related CODs, and international comparisons of infant mortality rates were also examined. Results. Despite the rapid decline in infant mortality during the 20th century, the U.S. infant mortality rate did not decline from 2000 to 2005, and declined only marginally in 2006. Racial and ethnic disparities in infant mortality have persisted and increased, as have the percentages of preterm and low birthweight deliveries. After decades of improvement, the infant mortality rate for very low birthweight infants remained unchanged from 2000 to 2005. Infant mortality rates from congenital malformations and sudden infant death syndrome declined; however, rates for preterm-related CODs increased. The U.S. international ranking in infant mortality fell from 12th place in 1960 to 30th place in 2005. Conclusions. Infant mortality is a complex and multifactorial problem that has proved resistant to intervention efforts. Continued increases in preterm and low birthweight delivery present major challenges to further improvement in the infant mortality rate.
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Cleary, Jane, Sayne MC Dalton, Alexandra Harman, and Ian M. Wright. "Current practice in the introduction of solid foods for preterm infants." Public Health Nutrition 23, no. 1 (September 24, 2019): 94–101. http://dx.doi.org/10.1017/s1368980019002337.
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AbstractObjective:The present study compared the age of first solid foods in a cohort of preterm infants with term infants and identified factors influencing timing of solid food introduction.Design:Structured interviews on infant feeding practices, growth and medical status at term equivalence and at 3, 6, 9 and 12 months corrected postnatal age. The age of solid food introduction was compared between term and preterm infants, and the influence of maternal, infant and milk feeding factors was assessed.Setting:This prospective longitudinal study recruited primary carers of preterm and term infants from a regional metropolitan referral hospital in eastern Australia.Participants:One hundred and fifty infants (preterm, n 85; term, n 65).Results:When corrected for prematurity, preterm infants received solid foods before the recommended age for the introduction of solid foods for term infants. Median introduction of solid foods for preterm infants was 14 weeks corrected age (range 12–17 weeks). This was significantly less than 19 weeks (range 17–21 weeks) for term infants (P < 0·001). Lower maternal education and male gender were associated with earlier introduction of solid foods among preterm infants.Conclusions:Preterm infants are introduced to solid foods earlier than recommended for term infants, taking account of their corrected age. Further research is needed to assess any risk or benefit associated with this pattern and thus to develop clear evidence-based feeding guidelines for preterm infants.
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Sahu, Jitendra K., Sushma Nangia, Deepak Chawla, and Ramesh Agarwal. "Apnea following DTP Immunization in an Extremely Preterm Infant." Journal of Neonatology 21, no. 4 (December 2007): 279–80. http://dx.doi.org/10.1177/097321790702100417.
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A 26 week preterm infant developed recurrent apnea following diphtheria-tetanus-pertussis (DTP) immunization. The case underscored the need for a close observation during DTP vaccination in extremely preterm infants.
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Chiu, Teresa M. L., Susan Wehrmann, Denise Reid, and Gerry Sinclair. "Transforming Mother-Infant Interaction Within Cultural and Caregiving Contexts: Home-Based Occupational Therapy for Preterm Infants." Hong Kong Journal of Occupational Therapy 22, no. 1 (June 2012): 17–24. http://dx.doi.org/10.1016/j.hkjot.2012.04.003.
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Background Developing positive interaction between preterm infants and their mothers is known to be a challenge because preterm infants are more fussy and difficult to soothe. Yet, little is known about what happens to the mother-infant interaction as the babies grow older in their natural environment and when and how the mother-infant dyads continue to need support for home care. This study aimed to explore the changes in mother-infant interaction of preterm infants and their mothers who received home care occupational therapy. Methods We video-recorded the interaction of 12 dyads of mothers and preterm infants during free play, feeding, and the mother positioning the infants for different movements. The mothers then reviewed the video recording and participated in an in-depth interview. Six months later, each dyad repeated the video recording and interview. In addition, Chinese and Tamil-speaking mothers of well babies were interviewed in focus groups. The focus group findings inform us of the meaning of culture in caregiving. Results The findings showed that the quality of interaction is shaped by the specific cultural beliefs and caregiving contexts in the home. Central to the concept is the transformation of the baby that triggers the mother to respond and then transform together. The occupational therapist who plays the supporting role facilitates the dyads to interact more harmoniously. Conclusion This study proposes a new conceptualisation that allows us to unfold the process of change in mother-infant interaction for preterm infants and their mothers within the contexts of cultural values and the caregiving environment.
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Guržanova-Durnev, Liljana, Elizabeta Zisovska, and Božidarka Đošić-Markovska. "CORD BLOOD SUPEROXIDE DISMUTASE AND GLUTATHIONE PEROXIDASE ACTIVITY IN PREMATURE INFANTS / AKTIVNOST SUPEROKSID-DISMUTAZE I GLUTATION-PEROKSIDAZE KOD PREVREMENO RODENE DECE." Journal of Medical Biochemistry 33, no. 2 (April 1, 2013): 208–15. http://dx.doi.org/10.2478/jomb-2013-0042.
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Summary Background: Birth involves strong oxidative stress for the infant, implying an increased production of free radicals. The aims of this study were to assess the antioxidant response to oxidative insult at birth, by estimating the superoxide dismu- tase (SOD) and glutathione peroxidase (GPX) activity in umbilical cord blood, and to evaluate their dependency on the degree of maturation of the newborns. Methods: In the present study, 60 preterm infants (study group) as well as a full-term healthy reference group (A=53) were included. Additionally, the preterms were divided in 3 groups according to their condition at the end of the 1st week of life: preterm control (B=25), on oxygen support (C= 18), and ventilated group (D= 17). Results: The obtained results indicate markedly lower antioxidant capacity of the preterm infants: they had significantly lower SOD and GPX activity than the full-term infants (pcO.OOl, for both). Investigated antioxidants also showed significant differences between the groups of preterms. SOD activity was higher in preterms with postnatal respiratory fail- ure compared to preterm control (p<0.001). On the con- trary, GPX activity was decreased in the oxygen supported group (10%) and even more in the ventilated group (28.5%) (p< 0.001, for both). The newborns enzyme activities were also profoundly modulated by the gestational age and birth weight, specifically the GPX. Conclusions: Because of their deficient and inadequate antioxidant protection, preterm newborns are more suscep- tible to oxidant injury at birth.
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Tender, J. A. "Preterm Infant Nutrition." Pediatrics in Review 25, no. 9 (September 1, 2004): 328–29. http://dx.doi.org/10.1542/pir.25-9-328.
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Tender, Jennifer AF. "Preterm Infant Nutrition." Pediatrics In Review 25, no. 9 (September 1, 2004): 328–29. http://dx.doi.org/10.1542/pir.25.9.328.
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Paterson, Lynne, and Irene Redpath. "Preterm infant care." Nursing Standard 27, no. 49 (August 7, 2013): 19–21. http://dx.doi.org/10.7748/ns2013.08.27.49.19.s60.
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Kaplan, Michael, Cathy Hammerman, and Vinod K. Bhutani. "The Preterm Infant." Clinics in Perinatology 43, no. 2 (June 2016): 325–40. http://dx.doi.org/10.1016/j.clp.2016.01.008.
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Karki, Bipin, Varsha Verma, Ritesh Shrestha, and Suchita Shrestha Joshi. "Allergic proctocolitis causing hematochezia in preterm twins." Nepal Mediciti Medical Journal 1, no. 1 (December 1, 2020): 23–26. http://dx.doi.org/10.3126/nmmj.v1i1.34477.
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Allergic colitis due to cow’s milk or soy protein in commercially prepared infant formula or due to ingestion of breast-milk of mothers who are ingesting cow’s milk is a known cause of colitis occurring in infants. Allergic colitis can occur within days, weeks or months of birth and should be considered as a differential diagnosis in any infant presenting with hematochezia. Typically, there is a significant delay in the onset of milk allergy in premature infants compared to full term infants. We report a case of premature twin neonates who presented with profuse rectal bleeding during second week of life. The infants had been feeding expressed breast milk since birth and the nursing mother had been drinking cow’s milk. The infants had pneumatosis coli suggestive of inflammation of the colon while biochemical and hematological markers of inflammation were normal. Expressed breast milk was re-introduced after eliminating dairy from mother’s diet for 5 days. The infants were fed on mother’s milk and top up of hydrolyzed infant formula as required. Both the twins remained well.
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Henderickx, Jannie G. E., Esther J. d’Haens, Marieke A. C. Hemels, Mariëtte E. Schoorlemmer, Astrid Giezen, Richard A. van Lingen, Jan Knol, and Clara Belzer. "From Mum to Bum: An Observational Study Protocol to Follow Digestion of Human Milk Oligosaccharides and Glycoproteins from Mother to Preterm Infant." Nutrients 13, no. 10 (September 28, 2021): 3430. http://dx.doi.org/10.3390/nu13103430.
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The nutritional requirements of preterm infants are challenging to meet in neonatal care, yet crucial for their growth, development and health. Aberrant maturation of the gastrointestinal tract and the microbiota could affect the digestion of human milk and its nutritional value considerably. Therefore, the main objective of the proposed research is to investigate how the intestinal microbiota of preterm and full-term infants differ in their ability to extract energy and nutrients from oligosaccharides and glycoproteins in human milk. This pilot study will be an observational, single-center study performed at the Neonatal Intensive Care Unit at Isala Women and Children’s Hospital (Zwolle, The Netherlands). A cohort of thirty mother–infant pairs (preterm ≤30 weeks of gestation, n = 15; full-term 37–42 weeks of gestation, n = 15) will be followed during the first six postnatal weeks with follow-up at three- and six-months postnatal age. We will collect human milk of all mothers, gastric aspirates of preterm infants and fecal samples of all infants. A combination of 16S rRNA amplicon sequencing, proteomics, peptidomics, carbohydrate analysis and calorimetric measurements will be performed. The role of the microbiota in infant growth and development is often overlooked yet offers opportunities to advance neonatal care. The ‘From Mum to Bum’ study is the first study in which the effect of a preterm gut microbiota composition on its metabolic capacity and subsequent infant growth and development is investigated. By collecting human milk of all mothers, gastric aspirates of preterm infants and fecal samples of all infants at each timepoint, we can follow digestion of human milk from the breast of the mother throughout the gastrointestinal tract of the infant, or ‘From Mum to Bum’.
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LUTFULLIN, ILDUS YА, and ASIA I. SAFINA. "sudden infant death syndrom in preterm infants." Bulletin of Contemporary Clinical Medicine 7, no. 6 (2014): 81–84. http://dx.doi.org/10.20969/vskm.2014.7(6).81-84.
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Cleaveland, Karen. "Feeding Challenges in the Late Preterm Infant." Neonatal Network 29, no. 1 (January 2010): 37–41. http://dx.doi.org/10.1891/0730-0832.29.1.37.
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A late preterm infant is defined as one born between 34 and 36 6/7 weeks of completed gestation. The rate of late preterm births has risen 18 percent since the late 1990s. Data are beginning to emerge concerning morbidity rates and the risks these newborns face with regard to feeding difficulties, temperature instability, hypoglycemia, and hyperbilirubinemia. Feeding challenges place these vulnerable infants at risk for prolonged hospital stays and readmission after discharge. To better address the unique needs of late preterm infants, providers should establish individual feeding orders. This article offers research-based suggestions for caring for these infants in the newborn nursery and the postpartum unit as well as parent teaching guidelines.
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Jonathan, Elizabeth Beatrice, Ahmad Suryawan, and Mira Irmawati. "The Effect of Massage Stimulation on the General Movements Quality in Breastfed Preterm Infant." Folia Medica Indonesiana 56, no. 4 (January 14, 2021): 302. http://dx.doi.org/10.20473/fmi.v56i4.24644.
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General Movements (GMs) assessment is one of the modalities to detect abnormal infant development early, the examination of preterm infant development is very important. Preterm infant has a long-term health impact and the risk of neonatal morbidity and mortality, need breast milk as the best nutritionand also need stimulation, one of which is massage. This study aimto analyze massage stimulation effect on the general movements in breastfed preterm infant in Dr. Soetomo Hospital Surabaya.A randomize control group pre test post test design was conducted on preterm infant, 39 babies were enrolled. Massage stimulation was done for 10 consecutive days 3 times in the neonatal ward while observing the condition.The quality assessment of GMs is according to the standardization of the Prechtl method, through two stages, taking video recording and editing GMs, and analysis the video recordings of GMs.Statistical by comparison test.The quality of preterm GMs in massage group (85.7%) and control group(69.6%) with p=0.287. The quality of GMs writhing in the massage group was dominated by abnormal GMs (65%), in control group were dominated by normal (63.2%) with p=0,150. In the fidgety GMs, the massage group (75%) and not massage (78.9%) were dominated by normal GMs, with p=1,000.There were no differences in the quality of preterm GMs, writhingGMs and fidgetyGMs for preterm infants in both group.
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Jonathan, Elizabeth Beatrice, Ahmad Suryawan, and Mira Irmawati. "The Effect of Massage Stimulation on the General Movements Quality in Breastfed Preterm Infant." Folia Medica Indonesiana 56, no. 4 (November 25, 2020): 302. http://dx.doi.org/10.20473/fmi.v56i4.23416.
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General movements (GMs) assessment is one of the modalities to detect abnormal infant development early, the examination of preterm infant development is very important. Preterm infant has a long-term health impact and the risk of neonatal morbidity and mortality, need breast milk as the best nutrition and also need stimulation, one of which is massage. This study aim to analyze massage stimulation effect on the general movements in breastfed preterm infant in Dr. Soetomo Hospital, Surabaya. A randomize control group pre-test post-test design was conducted on preterm infant, 39 babies were enrolled. Massage stimulation was done for 10 consecutive days 3 times in the neonatal ward while observing the condition. The quality assessment of GMs is according to the standardization of the Prechtl method, through two stages, taking video recording and editing GMs, and analysis the video recordings of GMs. Statistical by comparison test. The quality of preterm GMs in massage group (85.7%) and control group (69.6%) with p=0.287. The quality of GMs writhing in the massage group was dominated by abnormal GMs (65%), in control group were dominated by normal (63.2%) with p=0.150. In the fidgety GMs, the massage group (75%) and not massage (78.9%) were dominated by normal GMs, with p=1.000. There were no differences in the quality of preterm GMs, writhing GMs and fidgety GMs for preterm infants in both group.
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Vittner, D., S. Butler, K. Smith, N. Makris, H. Samra, and J. McGrath. "Skin-to-Skin Contact Activates Oxytocin Release and Correlates to Parent Engagement." Developmental Observer 12, no. 1 (September 20, 2019): 12. http://dx.doi.org/10.14434/do.v12i1.27842.
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Over 15 million premature infants are born annually around the world. It has been optimistically yet incorrectly proposed, that healthy preterm infants without major complications eventually catch-up developmentally to term infants. Research shows these preterm infants remain increasingly disadvantaged on many neurodevelopmental outcomes. Parental touch, especially during skin-to-skin contact (SSC) has the potential to reduce the adverse consequences of prematurity. SSC is an evidenced based strategy that increases parental proximity and provides an interactive environment known to enhance infant physiologic stability and affective closeness between parent and infant. Evidence suggests SSC activates oxytocin release in mothers, fathers and infants.
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Thibeau, Shelley, and Karen D’Apolito. "Review of the Relationships Between Maternal Characteristics and Preterm Breastmilk Immune Components." Biological Research For Nursing 14, no. 2 (March 28, 2011): 207–16. http://dx.doi.org/10.1177/1099800411400064.
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The immune properties of breastmilk are the most effective preventative means of reducing infant mortality through both passive and active immunity. Breastmilk for term infants has been linked to decreased incidence of respiratory and ear infections and gastrointestinal distress. This protection is even more important for the preterm infant. Prematurity is one of the leading causes of infant death in the United States. Hospitalized infant outcomes associated with consumption of breastmilk are shorter length of stay and decreased incidence of nosocomial infections and necrotizing enterocolitis (NEC). The presence of nosocomial infections and necrotizing enterocolitis increases risk of preterm mortality and morbidity as well as healthcare expenditures. However, breastmilk immunological components such as secretory immunoglobulin A, lactoferrin (LFT), and cytokines provide a framework of immunity that, in conjunction with nutritional support, significantly improves neonatal health. The relationship between maternal characteristics and breastmilk immune properties is central to further the understanding of the impact of breastmilk on preterm infant morbidity and mortality. The purpose of this article is to review the numerous immune components in breastmilk, the moderators of the immune components, and the relevance of these components to preterm/infant health. Exploration of the complexity of breastmilk immune components may direct future development of interventions to improve and sustain the immunological benefits of preterm breastmilk.
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Anderson, Diane. "Feeding the Ill or Preterm Infant." Neonatal Network 21, no. 7 (January 2002): 7–14. http://dx.doi.org/10.1891/0730-0832.21.7.7.
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Illness and immaturity often interfere with a neonate’s ability to receive full enteral feedings during the first week of life. The goals of feeding in the NICU are to nourish the preterm infant for appropriate growth and development and to facilitate the earliest possible discharge from the NICU. Early, small-volume feedings, or trophic feedings, have been studied as a method for achieving these goals. The high-risk infant given such trophic feedings not only receives minimum enteral nutrition, but also attains earlier full nutritional feedings and, consequently, is discharged home earlier. Oro- or nasal-gastric gavage feedings are usually indicated for this group of infants because of their physiologic immaturity and the frequent presence of respiratory illness. Recent studies support the use of intermittent bolus feedings, which have long been used for the premature infant. Several authors have noted advantages to continuous infusions as well. Because the infant is unable to pace or refuse gavage feedings, the caretaker must determine the appropriate volume of each feeding. The optimal volume for initiation and advancement of trophic and nutritional feedings is still under investigation, but reports have demonstrated safe volumes for even the extremely premature infant.
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Rohsiswatmo, Rinawati. "Nutritional Management and Recommendation for Preterm Infants: A Narrative Review." Amerta Nutrition 5, no. 1SP (September 30, 2021): 1. http://dx.doi.org/10.20473/amnt.v5i1sp.2021.1-13.
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Background: Preterm birth is defined as birth before 37 completed weeks of pregnancy. It is the most important predictor of adverse health and development infant outcomes that extend into the early childhood and beyond. It is also the leading cause of childhood mortality under 5 years of age worldwide and responsible for approximately one million neonatal deaths. It is also a significant contributor to childhood morbidities, with many survivors are facing an increased risk of lifelong disability and poor quality of life. Purpose: In this article, we aimed to describe features of preterm infants, what makes them different from term infants, and what to consider in nutritional management of preterm infants through a traditional narrative literature review. Discussion: Preterm infants are predisposed to more health complications than term infants with higher morbidity and mortality. This morbidity and mortality can be reduced through timely interventions for the mother and the preterm infant. Maternal interventions, such as health education and administration of micronutrient supplementation, are given before or during pregnancy and at delivery, whereas appropriate care for the preterm infants should be initiated immediately after birth, which include early breastfeeding and optimalization of weight gain. Conclusion: Essential care of the preterm infants and early aggressive nutrition should be provided to support rapid growth that is associated with improved neurodevelopmental outcomes. The goal is not only about survival but making sure that these preterm infants grow and develop without any residual morbidity.
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Morawski Mew, Andea, Diane Holditch-Davis, Michael Belyea, Margaret Shandor Miles, and Anne Fishel. "Correlates of Depressive Symptoms in Mothers of Preterm Infants." Neonatal Network 22, no. 5 (January 2003): 51–60. http://dx.doi.org/10.1891/0730-0832.22.5.51.
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Purpose: To identify factors related to depressive symptoms in mothers of preterm infants and to changes in depressive symptoms between hospitalization and when the infant was six months corrected age and to determine whether these factors differentiate mothers at high risk for depression from mothers at low risk for depression.Design: Correlational.Sample: During hospitalization, 39 mothers of preterm infants and, at six months corrected infant age, 34 mothers of preterm infants.Main Outcome Variable: Depressive symptoms as measured on the Center for Epidemiological Studies Depression scale.Results: At enrollment, 19 mothers (48.7 percent) had elevated depressive symptom scores. When the infants were six months corrected age, mean scores had decreased by 36 percent, and only 20 percent of the mothers had elevated scores. During hospitalization, the correlates of depressive symptoms were similar to the factors that differentiated between mothers at high risk and those at low risk for depression. However, the correlates of depressive symptoms during hospitalization were different from correlates of changes in depressive symptoms between hospitalization and six months corrected infant age. Identifying correlates of maternal depressive symptoms may lead to earlier identification and treatment of women at risk for depression, thereby decreasing the negative effects on infant development.
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Baxter, Katherine J., and Amina M. Bhatia. "Hirschsprung's Disease in the Preterm Infant: Implications for Diagnosis and Outcome." American Surgeon 79, no. 7 (July 2013): 734–38. http://dx.doi.org/10.1177/000313481307900720.
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Hirschsprung's disease (HD), congenital absence of ganglion cells, is considered uncommon in preterm infants. The aim was to describe the frequency, presentation, and surgical outcomes of preterm infants with HD. A retrospective cohort study was conducted of all patients diagnosed with HD from 2002 to 2012 at a single children's hospital. Clinical presentation and surgical outcomes were obtained for term (37 weeks of gestation or greater) and preterm infants. One hundred twenty-nine subjects with HD were identified, 24 (19%) preterm and 105 (81%) term. Preterm infants were more likely to be diagnosed after 30 days of life (66.7 vs 37.1%, P < 0.01; median age 2.9 vs 0.3 months, P < 0.05) and to have associated major congenital anomalies (45.8 vs 20.0%, P < 0.01). Fewer preterm infants had primary pull-through operations (45.8 vs 76.2%, P < 0.005). Preterm infants were more likely to have an episode of Hirschsprung's-associated enterocolitis (45.8 vs 24.0%, P < 0.05) but were not more likely to die from any cause (8.3 vs 5.8%, P = 0.64). HD may be more common in preterm infants than previously recognized, and increased comorbidities in these patients may lead to delayed diagnosis and increased morbidity. HD should be considered in the preterm infant presenting with a bowel obstruction, especially when accompanied by associated anomalies.
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Brown, Gemma. "NICU Noise and the Preterm Infant." Neonatal Network 28, no. 3 (May 2009): 165–73. http://dx.doi.org/10.1891/0730-0832.28.3.165.
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Premature infants in the NICU are often exposed to continuous loud noise despite research documenting the presence and damaging effects of noise on the preterm infant’s development. Excessive auditory stimulation creates negative physiologic responses such as apnea and fluctuations in heart rate, blood pressure, and oxygen saturation. Preterm infants exposed to prolonged excessive noise are also at increased risk for hearing loss, abnormal brain and sensory development, and speech and language problems. Reducing noise levels in the NICU can improve the physiologic stability of sick neonates and therefore enlarge the potential for infant brain development. Recommendations include covering incubators with blankets, removing noisy equipment from the incubator environment, implementing a quiet hour, educating staff to raise awareness, and encouraging staff to limit conversation near infants.
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Behari, Priya, Janet Englund, Grace Alcasid, Sylvia Garcia-Houchins, and Stephen G. Weber. "Transmission of Methicillin-ResistantStaphylococcus aureusto Preterm Infants Through Breast Milk." Infection Control & Hospital Epidemiology 25, no. 9 (September 2004): 778–80. http://dx.doi.org/10.1086/502476.
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AbstractObjective:To determine a potential source of MRSA colonization and infection among preterm infants in a neonatal intensive care unit (NICU) using molecular analysis of breast milk samples.Design:Case report, outbreak investigation.Results:Preterm triplets were delivered at 26 weeks' gestation via cesarean section when routine active surveillance for MRSA was performed for all infants in a NICU. Surveillance consisted of swabbing the throat, nose, and umbilicus (TNU) weekly. Although infants A and B initially had negative TNU swabs, repeat cultures were positive for MRSA on day of life (DOL) 10 and DOL 18, respectively. Surveillance and clinical cultures for infant C were negative. Infant A developed sepsis, and multiple blood cultures were positive for MRSA beginning on DOL 14. Infant B developed conjunctivitis and a conjunctival exudate culture was positive for MRSA on DOL 70. Both infants were fed breast milk via nasogastric tube. Cultures of breast milk samples for infants A and B dated prior to either infant's first positive surveillance culture were positive for MRSA. All MRSA isolates had identical results on antibiotic susceptibility testing. PFGE demonstrated identical banding patterns for the MRSA isolates from the blood culture of infant A, breast milk for infants A and B, and a surveillance swab from infant B. At no time did the mother develop evidence of mastitis or other local breast infection.Conclusions:MRSA can be passed from mother to preterm infant through contaminated breast milk, even in the absence of maternal infection. Colonization and clinical disease can result.
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Fujinaga, Cristina Ide, Sabrina Maltauro, Suzelaine Taize Stadler, Eleidiele Rosa Cheffer, Sidelisa Aguiar, Nelma Ellen Zamberlan Amorin, and Cleomara Mocelin Salla. "Behavioral state and the premature’s readiness performance to begin oral feeding." Revista CEFAC 20, no. 1 (February 2018): 95–100. http://dx.doi.org/10.1590/1982-021620182015317.
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ABSTRACT Objective: to evaluate the influence of behavioral states on the readiness of the premature infant to initiate breastfeeding. Methods: the study was transversal, observational and descriptive with 51 premature infants, attended at the Neonatal Intensive Care Unit (NICU), from a Baby-Friendly Hospital. The infants were evaluated using the "Preterm Oral Feeding Readiness Assessment Scale". The evaluation occurred close to the feeding time and was performed in preterm infants in two behavioral states, in deep sleep and alertness. Thus, preterm infants were self-controlled. For the data analysis, the T-Test and the McNemar Test were applied, with a significance level of 0.05. Results: there was a statistically significant difference in the behavior of premature infants in alert behavior and deep sleep. In the alert state, preterm infants showed greater readiness for oral feeding in the breast. The results highlight the importance of the behavioral state of prematurity for professionals working in NICUs. Conclusion: the behavioral state influences the beginning of premature infant feeding. The alertness behavioral status of premature infants is essential during neonatal speech therapy assistence.
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Alexandre-Gouabau, Marie-Cécile, Thomas Moyon, Agnès David-Sochard, François Fenaille, Sophie Cholet, Anne-Lise Royer, Yann Guitton, et al. "Comprehensive Preterm Breast Milk Metabotype Associated with Optimal Infant Early Growth Pattern." Nutrients 11, no. 3 (February 28, 2019): 528. http://dx.doi.org/10.3390/nu11030528.
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Early nutrition impacts preterm infant early growth rate and brain development but can have long lasting effects as well. Although human milk is the gold standard for feeding new born full-term and preterm infants, little is known about the effects of its bioactive compounds on breastfed preterm infants’ growth outcomes. This study aims to determine whether breast milk metabolome, glycome, lipidome, and free-amino acids profiles analyzed by liquid chromatography-mass spectrometry had any impact on the early growth pattern of preterm infants. The study population consisted of the top tercile-Z score change in their weight between birth and hospital discharge (“faster grow”, n = 11) and lowest tercile (“slower grow”, n = 15) from a cohort of 138 premature infants (27–34 weeks gestation). This holistic approach combined with stringent clustering or classification statistical methods aims to discriminate groups of milks phenotype and identify specific metabolites associated with early growth of preterm infants. Their predictive reliability as biomarkers of infant growth was assessed using multiple linear regression and taking into account confounding clinical factors. Breast-milk associated with fast growth contained more branched-chain and insulino-trophic amino acid, lacto-N-fucopentaose, choline, and hydroxybutyrate, pointing to the critical role of energy utilization, protein synthesis, oxidative status, and gut epithelial cell maturity in prematurity.
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Rose, Graham, Alexander G. Shaw, Kathleen Sim, David J. Wooldridge, Ming-Shi Li, Saheer Gharbia, Raju Misra, and John Simon Kroll. "Antibiotic resistance potential of the healthy preterm infant gut microbiome." PeerJ 5 (January 25, 2017): e2928. http://dx.doi.org/10.7717/peerj.2928.
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Background Few studies have investigated the gut microbiome of infants, fewer still preterm infants. In this study we sought to quantify and interrogate the resistome within a cohort of premature infants using shotgun metagenomic sequencing. We describe the gut microbiomes from preterm but healthy infants, characterising the taxonomic diversity identified and frequency of antibiotic resistance genes detected. Results Dominant clinically important species identified within the microbiomes included C. perfringens, K. pneumoniae and members of the Staphylococci and Enterobacter genera. Screening at the gene level we identified an average of 13 antimicrobial resistance genes per preterm infant, ranging across eight different antibiotic classes, including aminoglycosides and fluoroquinolones. Some antibiotic resistance genes were associated with clinically relevant bacteria, including the identification of mecA and high levels of Staphylococci within some infants. We were able to demonstrate that in a third of the infants the S. aureus identified was unrelated using MLST or metagenome assembly, but low abundance prevented such analysis within the remaining samples. Conclusions We found that the healthy preterm infant gut microbiomes in this study harboured a significant diversity of antibiotic resistance genes. This broad picture of resistances and the wider taxonomic diversity identified raises further caution to the use of antibiotics without consideration of the resident microbial communities.
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Li, Shaoli, Shufang Liu, Xinchun Zhang, Yali Chen, and Xiaohong Ren. "Effectiveness of the PRECEDE-PROCEED model for improving the care knowledge, skill, and sense of competence in mothers of preterm infants." Journal of International Medical Research 50, no. 7 (July 2022): 030006052211106. http://dx.doi.org/10.1177/03000605221110699.
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Objective This quasi-randomized controlled trial was performed to evaluate the effects of the PRECEDE-PROCEED model (PPM) in enabling mothers of preterm infants to develop care knowledge, skill, and a sense of competence. Methods Among 116 mothers of preterm infants, 60 received traditional discharge education (control group) and 56 received PPM discharge education (PPM group). Improvement in knowledge and skills was transformed into the mothers’ routine daily care of infants. The primary outcome was knowledge of preterm infant care. The secondary outcomes were preterm infant care skills and a sense of competence, routine intervention compliance among mothers, and the readmission rate of infants 6 months after discharge. Results Six months after discharge, the mean knowledge score and mean skills score were significantly higher in the PPM group than in the control group. The mothers’ sense of competence with respect to both self-efficacy and satisfaction was also significantly better in the PPM group than in the control group. Moreover, intervention behavior compliance and the readmission rate were significantly better in the PPM group than in the control group. Conclusion Care knowledge, skills, and sense of competence in mothers of preterm infants improved after implementation of the PPM.
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van BEEK, Y., J. B. Hoeksma, and B. Hopkins. "The Development of Communication in Preterm Infant-Mother Dyads." Behaviour 129, no. 1-2 (1994): 35–61. http://dx.doi.org/10.1163/156853994x00343.
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AbstractThe present study examines the effects of gestational age and birthweight status on the development of infant and maternal behaviour as well as the (mutual) predictability between partners during face-to-face interaction at 6, 12 and 18 weeks of corrected age. Subjects are healthy fullterm infants (N = 6) and three groups of healthy preterm infants: small-for-gestational age (N = 6), and appropriate for gestational age, the latter being born after a pregnancy duration of less than 32 weeks (N = 6) or between 32 and 34 weeks (N = 6). Using dyadic sequential analyses, based on log-linear modelling and information statistics, for each individual infant-mother pair at each age, the effect of both partners on the behaviour of the other was quantified, while accounting for autocorrelational effects. In the majority of cases the interactions could be labelled as showing 'bidirectionality', particularly at 18 weeks. Mothers were more likely to be influenced by the previous behaviour of the infants than vice versa. No group differences were apparent in the way mothers were influenced by their infants. However, the small-for-gestational age preterm infants were less likely to be influenced by maternal behaviour, particularly at 6 and 12 weeks of age. A lower variability was the most common finding in infants who were not predictable from the previous behaviour of the mother. At 6 and 12 weeks they were less expressive and more often showed a monotonous behavioural pattern in which 'looking at mother's face without positive expressions' was shown during most of the interaction. As this lack of variability was more often found in SGA preterm infants, they were less predictable from their mother's behaviour than the fullterm and AGA preterm infants. These data suggest that having a low birthweight for gestational age may be a risk factor for a lack of 'bidirectionality' during early mother-infant interaction.
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Aiyengar, Apoorva, Claire Howarth, and Sujith Pereira. "Hypertrophic cardiomyopathy in an extremely preterm infant." BMJ Case Reports 14, no. 3 (March 2021): e239787. http://dx.doi.org/10.1136/bcr-2020-239787.
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We present a case of an extreme preterm infant (Baby X) born at 24-week gestation. The echocardiogram showed evidence of hypertrophic cardiomyopathy (HCM) and a patent ductus arteriosus (PDA). There are a number of well-known causes of neonatal HCM including genetic, metabolic and endocrine. PDA is commonly present in preterm infants, and this can contribute to cardiac remodelling and result in cardiac changes mimicking HCM. Furthermore, medications such as steroids can also cause HCM through various mechanisms. A careful consideration of all the different aetiologies for HCM is important for appropriate management of such cases. This report examines the evidence in the literature for the above differential diagnoses and highlights the challenges in diagnosing the underlying cause of HCM in a preterm infant.
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Carcavalli, Larissa, Carolina Castro Martins, Iury Almeida Rocha, Erika Maria Parlato, and Júnia Maria Serra-Negra. "Preterm Birth, Pacifier use and Breastfeeding: is there a Relationship?" Brazilian Dental Journal 29, no. 4 (August 2018): 388–94. http://dx.doi.org/10.1590/0103-6440201801962.
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Abstract The immaturity of born to preterm infants may predispose to sucking difficulties. This research aimed to evaluate if pacifier use is associated with preterm birth and influenced in type of infant feeding. This comparative cross-sectional study was conducted in Belo Horizonte, Brazil and evaluated 250 children aged 3 to 5 years. As a sample, two groups were established: the normal term children group (n=125) was selected at a day-care centre and the group of preterm children (125) was identified at a public university hospital with a preterm care project from birth to seven years of age. To collect data, a pre-tested questionnaire regarding information on gestational age, infant development, infant feeding and non-nutritive sucking habits was used for both groups. Bivariate and multivariate Poisson regression was used for the statistical analysis. Pacifier use was more prevalent in the preterm group (PR=1.20, 95% CI=1.02-1.42) who used the bottle (PR=1.38, 95% CI=1.15-1.64) and were breastfed for less than six months (PR=1.19, 95% CI=1.01-1.41). The majority of breastfed infants were of normal term birth (PR=1.14, 95% CI=1.04-1.20) and had monthly family income greater than USD 450.28 (RP= 1.10, 95% CI=1.01-1.20). In this study, pacifier use was more prevalent among preterm infants and associated with less than six months of breastfeeding and used of bottle. Monthly family income was associated with a prevalence of breastfeeding.
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Yakobson, Dana, Shmuel Arnon, Christian Gold, Cochavit Elefant, Ita Litmanovitz, and Bolette Daniels Beck. "Music Therapy for Preterm Infants and Their Parents: A Cluster-Randomized Controlled Trial Protocol." Journal of Music Therapy 57, no. 2 (2020): 219–42. http://dx.doi.org/10.1093/jmt/thaa002.
Full textAbstract:
Abstract Music therapy (MT) interventions and skin-to-skin care (SSC) both aim to address the varied needs of preterm infants, including sensory regulation and stress reduction, inclusion of parents in their infant’s care, support of parents’ emotional state, and enhancing the parent–infant attachment process. Few studies have investigated the combination of both modalities through randomized controlled trials. Evidence of longer-term effects is missing. This article presents a study protocol that will investigate the effects of combined family-centered MT intervention and SSC on preterm-infants’ autonomic nervous system (ANS) stability, parental anxiety levels, and parent–infant attachment quality. 12 clusters with a total of 72 preterm infants, with their parents, will be randomized to one of two conditions: MT combined with SSC or SSC alone. Each parent–infant dyad will participate in 3 sessions (2 in the hospital and a 3-month follow-up). The primary outcome of preterm infants’ ANS stability will be measured by the high frequency power of their heart rate variability. Secondary outcomes will be physiological measures and behavioral states in infants and anxiety and attachment levels of parents. This trial will provide important, evidence-based knowledge on the use of the “First Sounds: Rhythm, Breath, and Lullaby” model of MT in neonatal care, through an intervention that is in line with the Newborn Individualized Developmental Care and Assessment Program model for supportive developmental care of preterm infants and their parents. Ethical approval (no. 0283-15) was granted from the local Institutional Review Board in April 2017. This trial is registered in ClinicalTrials.gov, NCT03023267.
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Johnson, Samantha, Dieter Wolke, and Neil Marlow. "Outcome Monitoring in Preterm Populations." Zeitschrift für Psychologie / Journal of Psychology 216, no. 3 (January 2008): 135–46. http://dx.doi.org/10.1027/0044-3409.216.3.135.
Full textAbstract:
Routine neurodevelopmental follow-up is crucial in high-risk populations, such as those born very preterm. Even in the absence of severe neurosensory impairment, very preterm children are at risk for a range of long-term cognitive, motor, and learning deficits. Infant developmental assessments are typically carried out at 2 years of age for both clinical and research purposes, and they are crucial for outcome monitoring. We review psychometric tests of infant developmental functioning most widely used as outcome measures for very preterm infants and other high-risk populations. We also consider parent-based assessments and methodological issues pertaining to the use of these tools in large-scale research studies and in outcome monitoring in this population.