Information and interaction opportunities: Experiences of mothers of babies at the neonatal intensive care unit,Accra, Ghana: A qualitative study

Despite calls to improve information and interaction opportunities between preterm mothers and healthcare workers in order to enhance optimal care in the neonatal intensive care unit (NICU), evidence is lacking in lower and middle-income countries like Ghana. Therefore, this paper attempts to address this knowledge gap by exploring mothers' experiences of information and interaction opportunities with healthcare workers about their preterm at the neonatal intensive care unit in the 37 Military Hospital, Ghana. A qualitative research investigation was used for the study. The authors further employed the narrative inquiry qualitative approach. A purposive sampling technique was used to select an estimated number of 18 participants to participate in the study. However, after saturation was reached where new themes no longer emerged, (15) participants were allowed to participate in the study. Thus, fifteen (15) in-depth interviews (IDIs) were conducted for the mothers, as well as (2) focus group discussions (FGDs). The authors discovered that a mother's socioeconomic status influenced information and interaction opportunities between mothers and health care workers. Second, the mood of the healthcare worker at a given time shaped information and interaction about their babies at the NICU; and lastly, doctors were in possession of more adequate information about babies than nurses, which sometimes affected mothers' access to information about their babies. To enhance information and interaction opportunities, there is a need to address the shortfalls in delivering optimal care at the NICU.     

Impact of human milk odor on respiratory distress and oxygen saturation in preterm neonates

Backgroundand purpose: Human milk is the most typical and accessible way of improving a neonate's respiratory status. The present study was conducted to examine the impact of human milk odor on respiratory distress and oxygen saturation in preterm neonates in the intensive care unit.MethodsThis clinical trial included 96 premature neonates divided into three groups, including human milk odor, formula odor, and a control group. The human milk group received 3 ml of human milk at 8 a.m. and 12 p.m. on a daily basis for four days. The human milk and formula were prepared and used under the same conditions. The control group did not receive any interventions. The research instruments were a demographic questionnaire and the Downes score that was completed daily by the researcher.ResultsThe results indicated no significant differences in the blood oxygen saturation and respiratory distress between the human milk odor, formula odor, and the control group (P > 0.05). It was also found that preterm neonates in the human milk group show less respiratory distress compared to the control group on the third day. In addition, the heart and respiratory rates did not show any significant difference between the study groups. However, the heart rate decreased more in the human milk group compared to the other two groups.Implication for practice and researchIt seems that oxygen saturation increased from the third day in the human milk group. It is suggested that the duration of aromatherapy increase in future studies to evaluate its possible effects more accurately.     

Neonatal euthanasia in the context of palliative and EoL care

Neonatal deaths can be categorized in 5 modes along the dimension of intervention and physiology. This classification can be helpful to analyze the choices that can be made in end-of-life care in the NICU. In the Netherlands, neonatal euthanasia became an optional 6th mode of death since publication and legalization of the Groningen Protocol. This paper summarizes the history, legal status and ethical justification of the Groningen Protocol, and describes end-of-life practice in the subsequent years. Since the implementation of the Groningen Protocol, the practice of neonatal euthanasia has almost disappeared. Simultaneously, there has been spectacular growth in neonatal palliative care programs in the Netherlands. Is there still a need for this last-resort option?     

Assessment of a hearing protection device on infant sleep in the neonatal intensive care unit

Premature infants often require prolonged hospitalisation in the neonatal intensive care unit (NICU) where they are exposed to adverse noise that may disrupt sleep and further compromise recovery and developmental outcomes. This single-session trial assessed the effects of a novel circumaural hearing protection device (DREAMIES®; NEATCAP Medical LLC) on sleep in 10 premature infants (mean 34.1 weeks GA) in a Level III NICU. Using polysomnography (PSG), the infant's sleep was compared between three interfeed periods throughout which DREAMIES® was ON or OFF. Each infant received the same condition order, OFF1-ON-OFF2. The PSG 30 s epochs were scored by a rater masked to the condition as Quiet Sleep, Active Sleep, Indeterminate Sleep, and Wake. There was a 14.1% increase in sleep from OFF1 to ON (p = 0.05) and an 18.4% decrease in sleep from ON to OFF2 (p = 0.02); an analogous inverse effect was observed for wake (χ² = 5.03, p = 0.08). There was a main effect of DREAMIES on active sleep (χ² = 7.4, p = 0.025) due to more active sleep for ON1 (46%) compared with OFF2 (32%; p = 0.074). No significant effect was observed for quiet sleep or indeterminate sleep. On average, the sound level was 51 dBA (range 36–113 dBA) and did not differ significantly among the three periods. The strongest relationship between the minute-by-minute maximum sound level and movement actigraphy was observed for the OFF1 condition (ρ0.301, p < 0.001). These findings suggest that DREAMIES® may augment sleep in premature infants by reducing acute episodes of adverse noise in the NICU.     

Transmission of SARS-CoV-2 from mother to fetus or neonate: What to know and what to do?

SARS-CoV-2 can be vertically transmitted from the mother to the fetus and the neonate. This transmission route is rare compared to the environmental or horizontal spread and therefore, the risk can be deemed inconsequential by some medical providers. However, severe, although just as rare, feto-neonatal consequences are possible: fetal demise, severe/critical neonatal COVID-19 and multi-inflammatory syndrome (MIS-N) have been described. Therefore, it is important for the clinicians to know the mechanism of vertical transmission, how to recognize this, and how to deal with neonatal COVID-19 and MIS-N. Our knowledge about this field has significantly increased in the last three years. This is a summary of the pathophysiology, diagnostics, and therapeutics of vertical SARS-CoV-2 transmission that clinicians apply in their clinical practice.