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Friday, July 24th, 2015
Infant mortality rates are on the decline, which is excellent news. But when it comes to newborn health, there’s still room for improvement—and new Choosing Wisely recommendations developed by neonatologists from Beth Israel Deaconess Medical Center focus on improving the care of infants treated in neonatal intensive care units by avoiding unnecessary tests and treatments. The guidelines, which were published online in Pediatrics, were developed from a survey of more than 1,000 pediatricians, neonatologists, and pediatric medical and surgical specialists.
Of course, “advanced tests and treatments have been important factors in [the decline in infant mortality rates], but we need to use them more wisely,” senior author of the recommendations, DeWayne Pursley, M.D., M.P.H., F.A.A.P., Chair of the Department of Neonatology and Pediatrician-in-Chief at BIDMC, said in a news release.
An expert panel identified five of the most important guidelines, which include:
- Avoid routine use of anti-reflux medications for treatment of symptomatic gastroesophageal reflux disease (GERD) or for treatment of apnea and desaturation in preterm infants.
- Avoid use of antibiotics for longer than 48 hours in absence of bacterial infection.
- Avoid routine use of pneumograms for pre-discharge assessment of ongoing and/or prolonged apneas of prematurity.
- Avoid routine daily chest radiographs without an indication for intubated infants.
- Avoid routine screening term-equivalent or discharge brain MRIs in pre-term infants.
“In general, newborn care providers do a good job communicating with families about the care of their babies, but there is always room to do better,” added author Timmy Ho, M.D., FAAP, a neonatologist at BIDMC. “Our hope is that caregivers and families will use this list as a starting point in discussions about tests and treatments and whether or not they add value to a baby’s care.”
Related: 5 Essential Health Screenings Your Baby Needs
Caitlin St John is an Editorial Assistant for Parents.com who splits her time between New York City and her hometown on Long Island. Follow her on Twitter: @CAITYstjohn
Image: Newborn via Shutterstock
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Thursday, February 20th, 2014
A Mississippi woman and her husband were prepared for identical triplet girls–a rarity especially given that the couple conceived naturally–but as she delivered her babies by Cesarean section, a surprised doctor discovered “more feet.” Triplets were actually quadruplets! Today.com reports:
Born early by C-section at 28 weeks and a day at the University of Mississippi Medical Center, the babies were whisked off for care. That’s when [Kimberly] Fugate overheard the unlikely discovery of another baby, one who had evaded detection on ultrasound imaging during Fugate’s pregnancy.
“They had delivered three and I heard the doctor say, ‘I have more feet,’ and I just hollered ‘No,’” said Fugate, 42. “If it was more feet, I knew it was another baby.”
In that moment of shock, she went from being the mother to 10-year-old Katelyn, to the new mother of rare identical quadruplets, all from a pregnancy that the Fugates had not planned.
“I wasn’t trying to have another child, but a child is God’s blessing so that was his will,” she said. “I feel like God has truly blessed me.”
The girls, Kenleigh Rosa, Kristen Sue, Kayleigh Pearl and Kelsey Roxanne, each weighed between 2 and 2 ½ pounds when they were born by cesarean section on Feb. 8. They are likely to remain in the neonatal intensive care unit until about Fugate’s due date of May 2.
For help finding the right pediatrician, download our cheat sheet with all the right questions to ask her.
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Tuesday, February 11th, 2014
Tim Armstrong, the chief executive officer of AOL, is at the center of a media firestorm after remarks at a company-wide town hall meeting in which he explained cuts in retirement benefits by saying employees with “distressed babies” had taxed the system and necessitated the cuts.
“Two things that happened in 2012,” Armstrong said. “We had two AOL-ers that had distressed babies that were born that we paid a million dollars each to make sure those babies were OK in general. And those are the things that add up into our benefits cost. So when we had the final decision about what benefits to cut because of the increased healthcare costs, we made the decision, and I made the decision, to basically change the 401(k) plan.”
Twitter, Facebook, and blogs lit up with comments and outrage over the comment, and Monday Armstrong reversed course and says he will not pursue the 401(k) plan that had gotten employees so upset in the first place because it proposed annual payments to retirees, as opposed to payments throughout the year.
“I made a mistake,” Time.com reports that Armstrong wrote in a note to employees on Saturday. “I apologize for my comments last week at the town hall when I mentioned specific health care examples in trying to explain our decision-making process around our employee benefit programs.”
Meanwhile, Deanna Fei, whose child is one of the two babies Armstrong was referencing, went public with an essay on Slate.com in which she said Armstrong’s apology didn’t soothe her family’s disappointment and upset over the matter. She writes:
[Armstrong's apology] is commendable, but the damage to my family had already been done.
Here is how we supposedly became a drain on AOL’s coffers. On Oct. 9, 2012, when I woke up in pain, my husband was at the airport about to board a flight for a work trip. I was home alone with our 1-year-old son and barely able to comprehend that I could be in labor. By the time I arrived at the hospital, my husband a few minutes behind, I was fully dilated and my baby’s heartbeat was slowing. Within 20 minutes, my daughter was delivered via emergency cesarean, resuscitated, and placed in the neonatal intensive care unit.
She weighed 1 pound, 9 ounces. Her skin was reddish-purple, bloody and bruised all over. One doctor, visibly shaken, described it as “gelatinous.” I couldn’t hold my daughter or nurse her or hear her cries, which were silenced by the ventilator. Without it, she couldn’t breathe.
That day, we were told that she had roughly a one-third chance of dying before we could bring her home. That she might not survive one month or one week or one day. She also had at least a one-third chance of being severely disabled, unable to ever lead an independent life.
As shell-shocked and stricken as we were, my husband and I were not oblivious to the staggering tolls, emotional and financial, attached to a baby like ours. Watching her tiny, battered body struggle to carry out the simplest functions, we couldn’t help wondering at what point the level of her suffering might outweigh the imperative to keep her alive at all costs.
For longer than I can bear to remember, we were too terrified to name her, to know her, to love her. In my lowest moments—when she suffered a brain hemorrhage, when her right lung collapsed, when she stopped breathing altogether one morning—I found myself wishing that I could simply mourn her loss and go home to take care of my strapping, exuberant, fat-cheeked son.
But the neonatologists also described my daughter as “feisty” and “amazing.” And over the next weeks, she fought for every minute of her young life, as did her doctors and nurses, and we could only strive to do the same.
My daughter had to spend three months in the NICU, dependent on many high-tech medical apparatuses and round-the-clock care. She endured more procedures than I can count: blood transfusions, head ultrasounds, the insertion of breathing tubes, feeding tubes, and a central line extending nearly to her heart.
Some commentators have questioned the implausibility of “million-dollar babies.” I have no expertise in health care costs, but I have a 3-inch thick folder of hospital bills that range from a few dollars and cents to the high six figures (before insurance adjustments). So even though it’s unlikely that AOL directly paid out those sums, I don’t take issue with Armstrong’s number.
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I take issue with how he reduced my daughter to a “distressed baby” who cost the company too much money. How he blamed the saving of her life for his decision to scale back employee benefits. How he exposed the most searing experience of our lives, one that my husband and I still struggle to discuss with anyone but each other, for no other purpose than an absurd justification for corporate cost-cutting.
Image: Tim Armstrong, via Albert H. Teich / Shutterstock.com
Thursday, May 9th, 2013
The drug Pitocin, which is used to induce labor or keep labor going when it has slowed or stopped, has been found in a new study to have adverse effects on newborn babies. The study, which was presented this week at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists, was the first to report a negative effect of the widely-used drug.
The study was based on data collected from 3,000 women who gave birth between 2009 and 2011. The results showed that women who were given oxytocin (Pitocin is the most common brand name of this type of drug) were more likely to deliver babies who were unexpectedly admitted to the NICU after birth, and that those babies were more likely to remain in the NICU for more than 24 hours. Babies born from Pitocin-augmented labors were also more likely to score less than 7 on the Apgar test, the standard test that evaluates a newborn’s physical condition at one and five minutes after birth based on appearance (skin coloration), pulse (heart rate), grimace response (medically known as “reflex irritability”), activity and muscle tone, and respiration (breathing rate and effort). An Apgar score of 8 or higher is generally regarded as the standard for a baby in good health.
Researchers insist that they are not advocating for Pitocin to be eliminated from the labor room, but instead that the drug should be used only when strongly indicated, not, for example, for an elective labor induction.
“We don’t want to discourage the use of Pitocin, but simply want a more systematic and conscientious approach to the indications for its use,” Dr. Michael S. Tsimis, the study’s primary investigator, said in a statement.
Image: Woman with IV in hospital, via Shutterstock
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Monday, August 27th, 2012
Actors Anna Faris and Chris Pratt have welcomed a baby boy, People.com reports.
Faris, 35, and “Parks and Recreation” star Pratt, 33, named their son Jack. The baby was born prematurely; Faris had been due this fall.
“He arrived earlier than expected and will be spending some time in the NICU. The happy parents thank you for your warm wishes and ask that you honor their privacy during this time,” their rep told People.com.
Faris, who recently starred in the film “The Dictator,” wed Pratt in 2009.
Image: Chris Pratt and Anna Faris via s_bukley / Shutterstock.
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