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Introduction
Published in Michael van Manen, The Birth of Ethics, 2020
A newborn infant is born in an unexpected very poor condition. No breathing effort can be detected. No pulse can be felt. There are no signs of life. The delivery room nurses start mask ventilation and chest compressions. A ‘Code Pink’ is announced overhead, calling for help. The neonatal team arrives within minutes. The baby is intubated, and chest compressions are continued, umbilical lines inserted, and resuscitation medications administered. There is no response: The baby remains apneic and pulseless. More medications are given, and breathing support and chest compressions continue. The baby continues to appear lifeless. The parents are pale, their faces wet with sweat and tears. The doctor and nurses know this baby will not survive, that attempts at resuscitation ought to stop. The doctor looks to the parents, as she prepares them to accept it is time to stop. They are all strangers to each other.
Fetal and neonatal medicine
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
4.38. A newborn infant is cyanosed. The respiratory rate is 30/min. There are no cardiac murmurs or evidence of congestive cardiac failure. When given 100% oxygen the cyanosis remains unchanged. Blood gas analysis shows Po2 70 mmHg in air and 450 mmHg in 100% oxygen. The pH and Pco2 are normal. Which of the following statements is/are true?It is likely that the infant does not have congenital heart disease.The infant will benefit from oxygen therapy.The infant has normal lungs.The infant should be commenced on prostaglandin to prevent closure of the ductus arteriosus.The infant should be given methylene blue.
Motor development and postural control
Published in Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize, Developmental and Adapted Physical Education, 2019
Michael Horvat, Ronald V. Croce, Caterina Pesce, Ashley Fallaize
A newborn infant will move the head, arms, and legs when it is awake and alert, producing some apparently disorganized movement. In the developing infant, the movements of kicking the legs, waving the arms, and rocking the body appear to be more spontaneous than goal directed or reflexive. Although these movements appear spontaneous and unorganized, they are actually coordinated (Sugden & Keogh, 1990). From the recordings of infants’ muscular activity, we see that supine kicking movements are rhythmic and have a coordinated pattern. Although disorganized, the hip, ankle, and knee move cooperatively rather than independently and may be the infant’s first attempts to produce some purposeful movement (Gabbard, 2016; Haywood & Getchell, 2009). These movements are considered normal in healthy babies, whereas persistence in older children may be indicative of developmental or motor delay.
Factors Influencing Mothers’ Quality of Sleep during Their Infants’ NICU Hospitalization
Published in Behavioral Sleep Medicine, 2022
Valérie Lebel, Nancy Feeley, Stephanie Robins, Robyn Stremler
Mothers commonly experience sleep disturbances and sleep deprivation when their newborn infant is hospitalized in a NICU (Haddad et al., 2019). Actigraphy data indicate an average total sleep time of 6.3 hours per night, more sleep interruptions, and increased time to fall asleep while in their own homes for these mothers (Lee & Hsu, 2012). This sleep duration is insufficient as experts often recommend between seven to eight hours of sleep per night for adults (National Sleep Foundation, 2015). Additionally, studies using validated sleep quality questionnaires (i.e., General Sleep Disturbance Scale – GSDS, Patient Reported Outcomes Measurement Information System – PROMIS or Pittsburgh Sleep Quality Index – PSQI) report poor sleep quality in mothers with an infant in the NICU (Busse et al., 2013; Lee & Hsu, 2012; Schaffer et al., 2013).
Examining Patient Feedback and the Role of Cognitive Arousal in Treatment Non-response to Digital Cognitive-behavioral Therapy for Insomnia during Pregnancy
Published in Behavioral Sleep Medicine, 2022
David A. Kalmbach, Philip Cheng, Thomas Roth, Leslie M Swanson, Andrea Cuamatzi-Castelan, Andrea Roth, Christopher L Drake
Owing in part to unconsolidated newborn infant sleep, maternal sleep is often short and highly disrupted in early postpartum, which can increase daytime sleepiness and fatigue (Insana & Montgomery-Downs, 2010). Behavioral sleep strategies to offset daytime sleepiness may involve incorporating napping into CBTI for perinatal insomnia. In Swanson’s prior CBTI trial in postpartum women, patients were permitted short naps (≤30 minutes), which patients identified as helpful. Timing naps in a CBTI regiment must be carefully considered. For non-perinatal patients, guidance for timing the nap has been 7–9 hours after wake time, so that napping coincides with the natural dipping of the circadian alerting system (Manber et al., 2014). However, women in early postpartum are often limited in the opportunity to nap based on the infant’s napping and feeding needs, and the availability of caregiving assistance from a partner or other individuals. A short nap in the morning or afternoon may be sufficient to offset daytime sleepiness without disrupting nocturnal sleep, whereas evening napping runs the risk of reducing sleep drive in close proximity to bedtime, which may disrupt nocturnal sleep.
Early life gut microbiota is associated with rapid infant growth in Hispanics from Southern California
Published in Gut Microbes, 2021
Tanya L. Alderete, Roshonda B. Jones, Justin P. Shaffer, Elizabeth A. Holzhausen, William B. Patterson, Elham Kazemian, Lida Chatzi, Rob Knight, Jasmine F. Plows, Paige K. Berger, Michael I. Goran
The adjusted abundances of important taxa were significantly associated with additional measures of infant growth (Table 4). For example, the adjusted abundances of important taxa were associated with a greater increase in WAZ (β = 0.08, CI: 0.01, 0.15; p = .03) from birth to 12-months of age. Additionally, the composition of the newborn infant gut microbiota using these differential rankings was associated with a greater infant weight (β = 0.06, CI: 0.01, 0.12; p = .03) and skinfold thickness measures at 12-months. This included tricep (β = 0.13, CI: 0.0003, 0.26; p < .05), subscapular (β = 0.10, CI: 0.002, 0.21; p < .05), suprailiac (β = 0.10, CI: 0.02, 0.18; p = .02), and midthigh (β = 0.23, CI: −0.01, 0.47; p = .06) skinfold thickness measures. Among the subset of infants with available sequencing data at 6-months of age (n = 92), the adjusted abundances of taxa identified as important with respect to rapid growth 1-month of age were not associated with additional measures of infant growth (Supplemental Table 9).