{"title":"The Ins and Outs of Neonatal Dermatology.","authors":"Curry Bordelon, Colleen Moss, Lela Baker, Michele Savin","doi":"10.1891/NN-2024-0030","DOIUrl":"10.1891/NN-2024-0030","url":null,"abstract":"<p><p>In the field of neonatal care, the integrity of an infant's skin is paramount yet often underestimated. This article provides a comprehensive review of neonatal skin, illuminating the critical necessity for tailored care practices. The authors explore the developmental variances, highlighting the premature skin's vulnerability to external insults and its role in physiological processes, such as thermoregulation and barrier function. This review synthesizes current best practices in neonatal skin care, including hygiene, protection, and treatment protocols. Furthermore, it addresses common dermatological conditions in infants, providing insights into their identification, implications, and management strategies.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"44 1","pages":"7-19"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Basics of Neonatal Hyperbilirubinemia.","authors":"Megan Falke","doi":"10.1891/NN-2024-0051","DOIUrl":"10.1891/NN-2024-0051","url":null,"abstract":"<p><p>Neonatal jaundice is a common condition affecting four out of five healthy newborns, characterized by the yellowing of the skin due to elevated bilirubin levels. This condition, known as hyperbilirubinemia, is typically benign and transient when properly managed but may progress to severe complications such as kernicterus-a permanent neurologic condition-if untreated. Newborns are particularly susceptible to jaundice due to increased red blood cell turnover, immature liver enzymes, and delayed stooling patterns. Preventive measures during pregnancy, such as maternal blood typing and Rh immunoglobulin administration, can mitigate the risk of hemolytic conditions leading to jaundice. Early detection through bilirubin screening and prompt treatment, including phototherapy, are critical to preventing neurotoxicity. Recent updates to the American Academy of Pediatrics guidelines emphasize higher thresholds for intervention, stratified by gestational age and risk factors. Effective management relies on thorough assessment, parental education, and close postdischarge follow-up. Understanding the pathophysiology, risk factors, and treatment protocols enables health care providers to optimize outcomes and prevent long-term sequelae in affected infants. This article will provide an overview of neonatal jaundice and neonatal hyperbilirubinemia, focusing on its pathophysiology, diagnostic methods, and the most recent treatment guidelines. The aim is to provide this guidance to support the bedside NICU nursing practice.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"44 1","pages":"61-67"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Britt F Pados, Grace Briceno, Victoria Feaster, Anna Pope, Michelle Chiu
{"title":"Prevalence and Predictors of Problematic Feeding at 1, 3, and 6 Months Corrected Age in Preterm Infants Born Prior to 34 Weeks.","authors":"Britt F Pados, Grace Briceno, Victoria Feaster, Anna Pope, Michelle Chiu","doi":"10.1891/NN-2024-0025","DOIUrl":"10.1891/NN-2024-0025","url":null,"abstract":"<p><p>The purpose of this study is to describe the prevalence of problematic feeding in the first 6 months of life in infants born preterm, the impact of feeding problems on the family and parent, and explore which factors known at the time of neonatal discharge predict later symptoms of problematic feeding. The study design is a longitudinal, observational study. The sample included 43 infants born at 28.3 (23.57-33.86) weeks postmenstrual age at 1, 3, and 6 months corrected gestational age. The Infant Eating Assessment Tool and Feeding Impact Scales provided the main outcome variables. Prevalence of problematic feeding was 64% at 1 month, 66% at 3 months, and 29% at 6 months. Diagnosis of gastroesophageal reflux disease while in the NICU was the greatest predictor of problematic feeding in the first 6 months. Families and parents were more negatively impacted when their infant had problematic feeding.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"44 1","pages":"42-53"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neonatal NetworkPub Date : 2025-03-01DOI: 10.1891/0730-0832.44.1.68
{"title":"Nursing Continuing Professional Development Activities: January/February 2025.","authors":"","doi":"10.1891/0730-0832.44.1.68","DOIUrl":"https://doi.org/10.1891/0730-0832.44.1.68","url":null,"abstract":"","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"44 1","pages":"68-69"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sweating It Out: When Meconium Ileus Is Not Cystic Fibrosis-A Case Report.","authors":"Mary Beth Whalen, Tiffany Gwartney","doi":"10.1891/NN-2024-0033","DOIUrl":"10.1891/NN-2024-0033","url":null,"abstract":"<p><p>Meconium ileus (MI) is the result of the accumulation of thick, dry, inspissated meconium that creates a bowel blockage, most commonly in the terminal ileum. These pockets of meconium prevent passage of stool beyond the point of obstruction, which leads to distention of the proximal bowel, bowel wall thickening, and distal microcolon. Occurring most commonly (90%) in conjunction with cystic fibrosis (CF), the occurrence of MI without CF is rare. The literature describes the incidence of MI associated with CF occurring in as many as 24.9% of those who have a pair (homozygous) of the most common CF gene mutation, Delta F508. The incidence of MI decreases with other CF mutations, of which there are over 2,000. The morbidity and mortality risks are related to whether the MI is simple or complex. Simple MI can be managed clinically with contrast enemas to relieve the obstruction and restore bowel function, while complex MI requires surgical intervention for possible bowel necrosis, perforation, peritonitis, strictures, and/or volvulus that can occur in utero or after birth. This article presents a case report of a 32-week-gestation female infant with gross abdominal distention beginning on day of life 1. The differential diagnosis, necessary testing, and required treatment that led to the final diagnosis will be presented. Additionally, radiographic modalities used to confirm the diagnosis are discussed. Finally, nursing management of the infant with simple or complex MI and short- and long-term challenges for infants and their families will be addressed.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"44 1","pages":"20-32"},"PeriodicalIF":0.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Concerns about NICU Infants and Sleep.","authors":"Deborah Discenza","doi":"10.1891/NN-2024-0017","DOIUrl":"10.1891/NN-2024-0017","url":null,"abstract":"<p><p>As a NICU parent, I was always wondering how my daughter could sleep through all of the noise in the NICU what with her very early birth. I was already concerned about her developmental outcomes due to the birth itself, but the alarms and noise in the NICU gave me incredible pause. So when I found about DREAMIES, a product that helps muffle the noise not only in the NICU but during transport and during an MRI, I was amazed.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 6","pages":"384-386"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meggan Butler-O'Hara, Mary Goldman, Taylor Aspenleiter, Caitlin Vanini, Rita Dadiz
{"title":"Comprehensive Program Redesign: Procedural Education, Quality Improvement, and Credentialing Needs for Advanced Practice Providers.","authors":"Meggan Butler-O'Hara, Mary Goldman, Taylor Aspenleiter, Caitlin Vanini, Rita Dadiz","doi":"10.1891/NN-2024-0020","DOIUrl":"10.1891/NN-2024-0020","url":null,"abstract":"<p><p>Advanced practice providers (APPs) experience limited clinical opportunities to perform neonatal procedures to maintain competency and hospital credentialing, especially high-acuity procedures that are extremely rare but crucial during patient emergencies. Incorporating simulation as part of continuing professional education can help APPs maintain clinical procedural competency and learn new procedural techniques to improve the quality and safety of procedures performed in the clinical setting. In 2013, we successfully developed and implemented an annual didactic and simulation-based neonatal procedural skills program. Since then, our APP group has experienced significant growth, which introduced challenges to sustain a high-quality program that would be valued by participants. These challenges presented the opportunity for a major program redesign addressing education, competency, credentialing, safety, and quality improvement. In this article, we describe the challenges that we uncovered from a comprehensive needs assessment that informed program redesign. We also present evaluation of the redesigned program, which includes learner, patient care, and systems-based outcomes.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 6","pages":"343-355"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rose L Horton, Michelle Kitchens, Michelle V Pratt
{"title":"Vulnerable Neonates (and Their Families) Deserve Respectful Care.","authors":"Rose L Horton, Michelle Kitchens, Michelle V Pratt","doi":"10.1891/NN-2024-0031","DOIUrl":"10.1891/NN-2024-0031","url":null,"abstract":"<p><p>Respectful maternity care (RMC) is a topic that has received increasing focus among clinicians, researchers, and the public in recent years. While clinicians recognize the importance of respectful care, patients report that they are not consistently receiving it. The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) created the RMC Framework, Evidence-Based Guidelines and Implementation Toolkit to provide nursing teams with the knowledge, tools, and structures they need to promote RMC. For true change to happen, the implementation of respectful care must be translated across the maternity care continuum, including in the NICU. This article shares a health care organization's journey toward respectful, equitable maternity care for women, neonates, and their families. This article outlines the AWHONN RMC Framework and the leverage of its components to promote RMC for neonates and their families in the NICU. The outcomes of these efforts are also highlighted.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 6","pages":"375-383"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Morning Assessment Monologue.","authors":"Sadie Crouch","doi":"10.1891/NN-2024-0034","DOIUrl":"10.1891/NN-2024-0034","url":null,"abstract":"<p><p>This piece was written as a letter of admiration for NICU parents from a NICU nurse. A NICU parent is a special person tasked with one of the most terrifying and burdensome paths possible. Allowing strangers to care for your vulnerable and miraculous child is asking a lot of a person. NICU nurses and staff know this and feel this. Parents should know that they are rock stars. They deserve so much credit. This letter is a small way to give that credit.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 6","pages":"387-388"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring Pacifier-Activated Music Systems in the NICU: Improving Outcomes and Shortening Length of Stay.","authors":"Betty A Holland, Edyta Lytle","doi":"10.1891/NN-2024-0011","DOIUrl":"10.1891/NN-2024-0011","url":null,"abstract":"<p><p>There is ample research discussing the benefits of a pacifier-activated music system with preterm and high-risk infants. Benefits include improving the quality of nonnutritive sucking (NNS) and increased feeding volume/attempts/endurance, which lead to decreased time to full oral feedings and shortened hospital stays. The use of pacifier-activated music systems supports a faster transition to oral feeding in preterm infants while learning to breastfeed or bottle feed in the NICU. When coupling pacifier-activated music systems with the NNS of a pacifier, the preterm infant gains efficacy in feeding strength and endurance. Benefits also include faster nipple feeding success, mother/infant stress reduction, fewer rehospitalizations, diminished length of stay, and other long-term benefits. This article will discuss how the benefits of using music in the NICU are widespread and should be implemented as a multidisciplinary approach in a variety of NICU settings. Several NICU patient populations can benefit from music using a music pacifier system dependent on the modes used.</p>","PeriodicalId":46706,"journal":{"name":"Neonatal Network","volume":"43 6","pages":"356-365"},"PeriodicalIF":0.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}