Canadian NICU puts parents in charge

At Mount Sinai Hospital in Ontario, Canada, the NICU has implemented a new program putting parents in charge of their baby’s care. From an article at CTV News: Parents have long been encouraged to spend time with their babies in the NICU, but they were typically more observers than participants, often feeling helpless and lost as they sat by their child’s isolette watching every breath, trying to make sense of the monitors and startling at every bell or buzzer around them.”With family integrated care, we have done something quite different,” explains Dr. Shoo Lee, pediatrician-in-chief and director of the Maternal-Infant Care Research Centre.”What we’ve done is to say that for all babies in the NICU, the parents should be the primary …

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Action is needed now to lower the content of aluminium in infant formulas

Oct. 10, 2013 — New research from Keele University shows that infant formulas are still heavily contaminated with aluminium.In 2010 the group at Keele, headed by Professor Chris Exley, published a paper showing that the aluminium content of infant formulas was too high (http://www.biomedcentral.com/1471-2431/10/63).The Keele group has now followed up this research with an even more extensive study looking at the 30 most popular brands of infant formula in the United Kingdom.The results show high levels of aluminium in each of the 30 infant formulas.In the publication the aluminium content of the infant formulas are listed from lowest to highest so that parents might choose to use a product with the lowest content of aluminium.Professor Exley said: “Clearly the manufacturers of infant formulas are not concerned about reducing their content of aluminium and the extensive use of aluminium-based packaging for infant formulas seems to confirm this.”There are no adequate criteria upon which to base a safety level for aluminium in infant formulas and for this reason it would be sensible to take action to reduce the level of aluminium to a lowest practicable level.”Since manufacturers are not willing to address the aluminium content of infant formulas it must now be time for the government, through the Food Standards Agency, to provide guidance on this matter and to indicate a maximum allowable concentration, for example, 50 ppb (50 mg/L) aluminium in the product at point of use, as a precautionary step to protect infants against chronic aluminium intoxication during the earliest weeks, months and years of their lives.”The new paper is published by BMC Pediatrics.

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‘Kangaroo care’ offers developmental benefits for premature newborns

July 10, 2013 — New research in the Journal of Newborns & Infant Nursing Reviews concludes that so-called “kangaroo care” (KC), the skin-to-skin and chest-to-chest touching between baby and mother, offers developmentally appropriate therapy for hospitalized preterm infants.In the article, “Kangaroo Care as a Neonatal Therapy,” Susan Ludington-Hoe, RN, CNM, PhD, FAAN, from Case Western Reserve University’s Frances Payne Bolton School of Nursing, describes how KC delivers benefits beyond bonding and breastfeeding for a hospital’s tiniest newborns.”KC is now considered an essential therapy to promote growth and development of premature infants and their brain development,” Ludington-Hoe reports.But while KC’s benefits are known, its use is not widely promoted by hospitals, she says.Ludington-Hoe encourages hospitals to incorporate KC-type features by modifying neonatal intensive care units to make them calming places, positioning babies to promote physical and motor development, decreasing how much babies are handled to reduce their stress, improving wake-sleep cycles and promoting a newborn’s ability to stabilize important functions, like its heartbeat and to synchronize physiologic functions with his mother’s for optimal development.Kangaroo Care for preemies involves the mother nestling the baby on her chest for at least one hour at a time and ideally for 22 hours a day for the first six weeks, and about eight hours a day for the next year.Throughout Scandinavia and the Netherlands, KC is widely practiced, said the researcher. They practice 24/7 Kangaroo Care because mothers are told that they have to be their baby’s place of care, and they make arrangements so that someone else watches children at home so that the infant is always in maternal or paternal KC while hospitalized. It continues at home where mothers wear wraps that securely contain the infant on her chest to prevent falling.Ludington-Hoe reports that this approach is standard care in Scandinavia and Germany, where many preemies leave the hospital about three weeks earlier than in the United States. Also, KC is used in those countries after normal births and continues for three full months.In previous research, benefits of KC have extended from childbirth to age 16, showing improved cognitive and motor development in newborns that received KC during hospitalization.Neonatal intensive care units may adjust from open, brightly lighted nurseries to quieter single rooms, but such changes can’t offer Kangaroo Care’s scope of developmental benefits if the mothers aren’t also there to snuggle their babies, Ludington-Hoe concludes.Among the researcher’s findings: babies respond more positively to their mothers than nurses, and experience less pain and stress when receiving some medical procedures while in their mothers’ arms, and infant’s brains mature faster and have better connectivity if they have received KC versus not having received KC. Mothers make the difference in how quickly preemies grow and develop.Preemies held by their mothers in a prone position for an extended time tend to sleep better, which aids brain development. Infants adjust their heartbeats and body temperatures to their mother’s and absorb immune benefits from their mother’s skin, the researcher found.Ludington-Hoe wrote Kangaroo Care: The Best You Can Do To Help Your Preterm Infant, a go-to guide since its publication in 1993. She also co-authored How to Have a Smarter Baby: The Infant Stimulation Program For Enhancing Your Baby’s Natural Development with Susan K. Golant (1987).

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‘Back to sleep’ does not affect baby’s ability to roll

June 3, 2013 — Baby, keep on rolling. A campaign to put babies to bed on their backs to reduce the risk of sudden infant death syndrome has not impaired infants’ rolling abilities, according to University of Alberta research.Johanna Darrah, a professor of physical therapy in the Faculty of Rehabilitation Medicine, says infants develop the ability to roll much the same today as they did 20 years ago when the “back to sleep” campaign was introduced and successfully reduced the occurrence of SIDS. Her research answers fears that the back to sleep campaign, which recommends putting babies to bed on their back instead of their stomach, would hurt an infant’s gross motor development, specifically the ability to roll from tummy to back and vice versa.”Infant gross motor development hasn’t changed that much in 20 years,” says Darrah. “The thought that babies first roll from their tummy to their back, before they go from their back to their tummy, does not appear to be the case. For most babies, they happen very close together.”Darrah first studied infant motor development in the early 1990s as a graduate student of former dean Martha Cook Piper when the pair published the Alberta Infant Motor Scale, an observational assessment scale used throughout the world to measure infant motor skill development from birth to walking.More than 20 years later, Darrah revisited the work, studying the rolling abilities and motor skills development of 725 Canadian infants ranging in age from one week to eight months. One of her goals was to see whether the norms identified and developed 20 years ago still represent the age of emergence of gross motor skills.Darah notes there is some concern in the physical therapy community that babies develop movement skills like rolling from tummy to back at later ages because of reduced time spent on their stomachs. Those concerns appear to be unfounded, she says, explaining that her results are particularly valuable for health-care practitioners specializing in early childhood development.”Our results would suggest that gross motor skills emerge in the same order and at the same ages as 20 years ago. The environment is of course important to gross motor development, but the change in a sleeping position hasn’t made much difference as to when babies roll from stomach to back.”

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