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committee on fetus and the newborn

Constance S Houck, Amy E Vinson
Almost 30 years ago, the American Academy of Pediatrics Committee on Fetus and Newborn coauthored a policy statement strongly advocating for the use of anaesthesia in all neonates stating 'local or systemic pharmacologic agents now available permit relatively safe administration of anesthesia or analgesia to neonates undergoing surgical procedures and that such administration is indicated according to the usual guidelines for the administration of anesthesia to high-risk, potentially unstable patients'. With current techniques and advanced monitoring, preterm and full-term infants routinely undergo surgical procedures under general anaesthesia to repair congenital defects that were lethal in years past...
March 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
(no author information available yet)
The use of donor human milk is increasing for high-risk infants, primarily for infants born weighing <1500 g or those who have severe intestinal disorders. Pasteurized donor milk may be considered in situations in which the supply of maternal milk is insufficient. The use of pasteurized donor milk is safe when appropriate measures are used to screen donors and collect, store, and pasteurize the milk and then distribute it through established human milk banks. The use of nonpasteurized donor milk and other forms of direct, Internet-based, or informal human milk sharing does not involve this level of safety and is not recommended...
2017: Pediatrics
Gemma L Crighton, Ri Scarborough, Zoe K McQuilten, Louise E Phillips, Helen F Savoia, Bronwyn Williams, Rhonda Holdsworth, Amanda Henry, Erica M Wood, Stephen A Cole
OBJECTIVE: To describe the natural history, antenatal and postnatal therapy, and clinical outcomes of Australian patients with fetomaternal/neonatal alloimmune thrombocytopenia (NAIT) recorded in the Australian NAIT registry. METHODS: Analysis of registry data of Australian mothers treated antenatally for NAIT and any fetus/newborn with thrombocytopenia (TCP) and maternal human platelet antigen (HPA) antibodies. RESULTS: Ninety four potential cases (91 pregnancies; three twin pregnancies) were registered between December 2004 and September 2015 with 76 confirmed or treated as NAIT...
November 24, 2016: Journal of Maternal-fetal & Neonatal Medicine
(no author information available yet)
Immersion in water during labor or delivery has been popularized over the past several decades. The prevalence of this practice in the United States is uncertain because it has not been studied in births outside of the home and birth centers, and the data are not recorded on birth certificates. Among randomized controlled trials included in a 2009 Cochrane systematic review that addressed immersion in the first stage of labor, results were inconsistent with regard to maternal benefits. Neither the Cochrane systematic review nor any individual trials included in that review reported any benefit to the newborn from maternal immersion during labor or delivery...
2016: Obstetrics and Gynecology
(no author information available yet)
Immersion in water during labor or delivery has been popularized over the past several decades. The prevalence of this practice in the United States is uncertain because it has not been studied in births outside of the home and birth centers, and the data are not recorded on birth certificates. Among randomized controlled trials included in a 2009 Cochrane systematic review that addressed immersion in the first stage of labor, results were inconsistent with regard to maternal benefits. Neither the Cochrane systematic review nor any individual trials included in that review reported any benefit to the newborn from maternal immersion during labor or delivery...
November 2016: Obstetrics and Gynecology
Dan Stewart, William Benitz
Postpartum infections remain a leading cause of neonatal morbidity and mortality worldwide. A high percentage of these infections may stem from bacterial colonization of the umbilicus, because cord care practices vary in reflection of cultural traditions within communities and disparities in health care practices globally. After birth, the devitalized umbilical cord often proves to be an ideal substrate for bacterial growth and also provides direct access to the bloodstream of the neonate. Bacterial colonization of the cord not infrequently leads to omphalitis and associated thrombophlebitis, cellulitis, or necrotizing fasciitis...
September 2016: Pediatrics
Lori Feldman-Winter, Jay P Goldsmith
Skin-to-skin care (SSC) and rooming-in have become common practice in the newborn period for healthy newborns with the implementation of maternity care practices that support breastfeeding as delineated in the World Health Organization's "Ten Steps to Successful Breastfeeding." SSC and rooming-in are supported by evidence that indicates that the implementation of these practices increases overall and exclusive breastfeeding, safer and healthier transitions, and improved maternal-infant bonding. In some cases, however, the practice of SSC and rooming-in may pose safety concerns, particularly with regard to sleep...
September 2016: Pediatrics
M Mendibe Bilbao, S Boyero Durán, J Bárcena Llona, A Rodriguez-Antigüedad
BACKGROUND: The course of multiple sclerosis (MS) is influenced by sex, pregnancy and hormonal factors. AIMS: To analyse the influence of the above factors in order to clarify the aetiopathogenic mechanisms involved in the disease. METHODS: We conducted a comprehensive review of scientific publications in the PubMed database using a keyword search for 'multiple sclerosis', 'MS', 'EAE', 'pregnancy', 'hormonal factors', 'treatment', and related terms...
August 18, 2016: Neurología: Publicación Oficial de la Sociedad Española de Neurología
James J Cummings, Richard A Polin
The use of supplemental oxygen plays a vital role in the care of the critically ill preterm infant, but the unrestricted use of oxygen can lead to unintended harms, such as chronic lung disease and retinopathy of prematurity. An overly restricted use of supplemental oxygen may have adverse effects as well. Ideally, continuous monitoring of tissue and cellular oxygen delivery would allow clinicians to better titrate the use of supplemental oxygen, but such monitoring is not currently feasible in the clinical setting...
August 2016: Pediatrics
Fernanda Cofre, Luis Delpiano, Yenis Labraña, Alejandra Reyes, Alejandra Sandoval, Giannina Izquierdo
There is a lot of bacterial, viral or parasite infections who are able to be transmitted vertically from the mother to the fetus or newborn which implicates an enormous risk for it. The TORCH acronym is used universally to refer to a fetus or newborn which presents clinical features compatible with a vertically acquired infection and allows a rational diagnostic and therapeutic approach. The traditional "TORCH test" is nowadays considered not appropriate and it has been replaced for specific test for specific pathogens under well defined circumstances...
April 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Wanda D Barfield
Accurately defining and reporting perinatal deaths (ie, fetal and infant deaths) is a critical first step in understanding the magnitude and causes of these important events. In addition to obstetric health care providers, neonatologists and pediatricians should have easy access to current and updated resources that clearly provide US definitions and reporting requirements for live births, fetal deaths, and infant deaths. Correct identification of these vital events will improve local, state, and national data so that these deaths can be better addressed and prevented...
May 2016: Pediatrics
Ann L Jefferies
Retinopathy of prematurity is a proliferative disorder of the developing retinal blood vessels in preterm infants. The present practice point reviews new information regarding screening and management for retinopathy of prematurity, including the role of risk factors in screening, optimal scheduling for screening examinations, pain management, digital retinal photography and antivascular endothelial growth factor therapy.
March 2016: Paediatrics & Child Health
(no author information available yet)
The prevention of pain in neonates should be the goal of all pediatricians and health care professionals who work with neonates, not only because it is ethical but also because repeated painful exposures have the potential for deleterious consequences. Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU. Although there are major gaps in knowledge regarding the most effective way to prevent and relieve pain in neonates, proven and safe therapies are currently underused for routine minor, yet painful procedures...
February 2016: Pediatrics
Jill Baley
“Kangaroo mother care” was first described as an alternative method of caring for low birth weight infants in resource-limited countries, where neonatal mortality and infection rates are high because of overcrowded nurseries, inadequate staffing, and lack of equipment. Intermittent skin-to-skin care (SSC), a modified version of kangaroo mother care, is now being offered in resource-rich countries to infants needing neonatal intensive care, including those who require ventilator support or are extremely premature...
September 2015: Pediatrics
James Cummings
The anticipated birth of an extremely low gestational age (,25 weeks) infant presents many difficult questions, and variations in practice continue to exist.Decisions regarding care of periviable infants should ideally be well informed,ethically sound, consistent within medical teams, and consonant with the parents' wishes. Each health care institution should consider having policies and procedures for antenatal counseling in these situations. Family counseling may be aided by the use of visual materials, which should take into consideration the intellectual, cultural, and other characteristics of the family members...
September 2015: Pediatrics
Caroline Chua, Marin Arnolds, Victoria Niklas
Herpes simplex virus (HSV) infection in the newborn carries a high mortality rate and can result in lifelong neurologic impairment. The severity of HSV infection in the newborn has always dictated conservative management when prodromal symptoms or active genital lesions (or those suggestive of genital herpes) are present during labor and delivery. The risk of intrapartum infection, however, is related to the presence or absence of maternal immunity (neutralizing antibody) to HSV. The most significant risk of transmission is in first-episode primary infections with active lesions at delivery...
May 2015: Pediatric Annals
William E Benitz
The hospital stay of the mother and her healthy term newborn infant should be long enough to allow identification of problems and to ensure that the mother is sufficiently recovered and prepared to care for herself and her newborn at home. The length of stay should be based on the unique characteristics of each mother-infant dyad, including the health of the mother, the health and stability of the newborn, the ability and confidence of the mother to care for herself and her newborn, the adequacy of support systems at home, and access to appropriate follow-up care in a medical home...
May 2015: Pediatrics
C Michael Cotten
In 2010, the Centers for Disease Control and Prevention (CDC) provided updated guidelines for prevention of perinatal group B streptococcus disease. In 2012, the American Academy of Pediatrics' Committee on the Fetus and Newborn (COFN) provided a clinical report which suggested approaches to infants with risk factors for EOS which would increase empirical antibiotic use beyond the CDC guidelines. This Clinics article reviews the CDC guidelines and 2012 COFN report, summarizes the 2014 commentary provided by COFN members which provided a revised clinical algorithm, and discusses mechanisms which could reduce the number of well-appearing term infants exposed to empirical antibiotics...
March 2015: Clinics in Perinatology
Brigitte Strizek, Jacques C Jani, Eugène Mucyo, Frederik De Keyzer, Inge Pauwels, Samir Ziane, Anne-Laure Mansbach, Paul Deltenre, Teresa Cos, Mieke M Cannie
PURPOSE: To evaluate the effects of exposure to routine magnetic resonance (MR) imaging at 1.5 T during pregnancy on fetal growth and neonatal hearing function in relation to the dose and timing of in utero exposure in a group of newborns at low risk for congenital hearing impairment or deafness. MATERIALS AND METHODS: This retrospective case-control study was approved by the local ethics committee, and written informed consent was waived. Between January 2008 and December 2012, a group of 751 neonates exposed to MR imaging in utero and a group of control subjects comprising 10 042 nonexposed neonates, both groups with no risk factors for hearing impairment at birth, were included...
May 2015: Radiology
Barbara Harper
The 2014 objection to birth in water voiced by both the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists (ACOG) in ACOG Bulletin #594 on immersion in water during labor and birth is nothing new. The Committee on Fetus and Newborn published the very same opinion in 2005, based on a case report that was published in 2002 in the journal Pediatrics. What has changed since 2002 is a growing body of evidence that reports on the safety and efficacy of labor and birth in water...
2014: Journal of Perinatal Education
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