Educational Plans & Checklists.

A post-diploma program is a course that can be 1 to 2 years in length. Can be a specialization, for example, Post Diploma Program in Neonatal Nursing. COINN statement: All nurses and midwives can work at the bedside of the small and sick newborn following completion of a structured neonatal education and competency-based mentorship. https://www.conpcommunityofpractice.org/neonatal-externship

This is a university awarded degree (undergraduate level) for registered nurses or midwives. Programs and acronyms vary: Bachelor of Science in Nursing (BSc or BSN), Bachelor of Nursing Science (BNSc). Some countries have programs where Bachelor in Neonatal Nursing is awarded. A nurse/midwife with a Bachelor’s degree can work at the bedside of the small or sick neonate following completion of structured neonatal education and competency-based mentorship. (https://www.conpcommunityofpractice.org/neonatal-externship). They may also work as administrator in the neonatal unit, clinical educator, clinical preceptor.

This is a university awarded graduate degree; this degree can be a specialty-recognized Master’s degree (in neonatal nursing). Programs and acronyms vary reflecting Master of Science degree in Nursing: MSc or MSN. There are several roles for nurses with Masters’ degre. Advanced Practice Nurse (APN), Nurse Practitioner (NP) or Clinical Nurse Specialist (CNS). Advanced Nurse Practitioners (APN, NP) as autonomous clinicians can manage, diagnose, and prescribe for the small and sick newborn as well as conduct referrals for acute and chronic health issues based on evidence informed guidelines (ICN, 2020, Section 3.4). Country-specific regulations apply to ability/authority to diagnose, prescribe medications, refer clients/patients to other services. Clinical Nurse Specialist (sometimes called Neonatal Nurse Specialist) is an expert nurse, a clinical educator and faculty/clinical preceptor working within the multi-disciplinary team in the care of the care of the small and sick newborn with an established diagnosis; a nurse who ensures evidence-based quality in nursing care and provides leadership in advancing nursing practice via research and interdisciplinary education (ICN, 2020, Section 2.3). CNS may or may not have prescribing authority in their specialty (country specific regulations apply). International Council of Nurses (2020). Guidelines on Advanced Practice Nursing 2020. Retrieved from: https://www.icn.ch/node/1287

A university-awarded doctoral degree which is the terminal (final or highest) degree in nursing. There are two tracks: Doctor of Philosophy in Nursing (PhD, a ‘doing-a-research and finding evidence’ oriented degree) and Doctor of Nursing Practice (DNP, an ‘implementing-evidence and finding best practices’ oriented degree). DNP training is to provide the nurse/midwife to be a leader in the clinical settings to advance clinical practice. Ph.D. training is to provide the nurse/midwife to be a leader in the academic/research-based positions to advance clinical practice.

The American Academy of Pediatrics (AAP) through funding from the Bill and Melinda Gates Foundation, and in collaboration with the World Health Organization, other implementing organizations and several national professional societies, is excited to showcase a series of webinars aimed at promoting new evidence on immediate Kangaroo Mother Care (iKMC), supporting a paradigm shift to zero separation between mothers and their newborn babies with a goal to improve quality of care and outcomes for small and sick newborns. Resource Link: https://www.aap.org/en/aap-global/immediate-kangaroo-mother-care-ikmc/

The KMC implementation strategy targets a broad audience. These include policy-makers and programme managers at national, regional and local levels, government and nongovernmental organizations working in the area of maternal and newborn care, global and national professional associations, public and private hospital management at all levels of care, and facility- and community-based maternal and infant care providers. Resource Link: https://www.who.int/publications/i/item/9789240071636

Resource Link: https://www.kznhealth.gov.za/neonates/records/KMC%20score%20sheet.pdf

Resource Link: https://www.kznhealth.gov.za/neonates/records/KMC%20Follow%20Up.pdf

Resource Link: https://www.kznhealth.gov.za/neonates/ess-pack/KMC%20audit%20(Tool%209).pdf

Suck is a relatively mature ororhythmic motor behavior in a full-term infant and is integral to competent oral feeds. However, preterm infants often demonstrate oromotor discoordination and are unable to suck and feed orally (Comrie & Helm, 1997; Lau, 2006; Barlow, 2009a). This inability represents a serious challenge to both the neonatal intensive care unit (NICU) “graduates” and the physician-provider-parent teams. By Steven M. Barlow, PhD, Meredith A. Poore, ABD, Emily A. Zimmerman, ABD, CCC-SLP and Don S. Finan, PhD. Resource Link: https://leader.pubs.asha.org/doi/10.1044/leader.FTR3.15072010.22

This checklist is to be used to guide the transition from nasogastric (NG) to breastfeeds. Resource Link: https://www.kznhealth.gov.za/neonates/records/Oral%20feeding%20transitionchecklist%202.pdf

These two Toolkits support the implementation of ten core elements to optimise the provision of Maternal Breast Milk (MBM) for preterm babies throughout the neonatal journey, to discharge and beyond. Part One covers the foundational first five elements, focussing on the initiation of lactation. Part Two delivers the subsequent five elements, focusing on sustaining lactation and transitioning to breastfeeding through the neonatal stay, to discharge and beyond. Resource Link: https://www.bapm.org/pages/196-maternal-breast-milk-toolkit

Because of its unique nutritional composition, breast milk is the optimal nutrition for almost all infants, and it should be available immediately after birth - in particular for preterm infants. Breast milk is ideally adapted to an infant’s needs, contains an ideal combination of nutrients, and making it without a doubt the best and most natural form of food for infants in the first months of life. Resource Link: https://www.efcni.org/wp-content/uploads/2018/05/2018_05_08_EFCNI_Milkbank_Toolkit_web.pdf

An interprofessional committee of neonatal experts has convened for more than 5 years, to study the science, evidence, and best practice of developmental care; and the associated outcomes to the baby and family. The purpose was to establish a document of standardized practice to implement collaborative team management with babies and families through the continuum of hospital to home care. The committee identified gaps in care management/practice to include: a) lack of collaborative function of health care providers and caregivers to perform neurodevelopmental management of the baby, b) failure to consistently include the parents/family as members of the team, c) variation in the application of interventions to satisfy mutual goals for the health and wellbeing of babies, families, and staff, d) inability to recognize the communication of the baby in response to intervention, and e) inadequate education and mentoring to guide effective interaction with the baby. It is vital that care be managed “with” the baby, instead of “to” the baby. By Erin Ross, PhD, CCC-SLP, Joan C. Arvedson, PhD, CCC-SLP, BCS-S, ASHA Honors & Fellow, Jacqueline McGrath, PhD, RN, FANP, FAAN Resource Link: https://nicudesign.nd.edu/nicu-care-standards/introduction/

Enteral feeds are advanced with the goal of optimizing nutrition, reducing need for TPN and central lines, to reduce line related infection/ Late onset sepsis. In turn to increase enteral feeds quickly and safely to avoid NEC, a diagnosis with high morbidity and mortality in preterm infants. Studies have shown benefits to implementing a standardized protocol to advance and fortify enteral feeds. These benefits include reducing days on TPN, reducing days with central lines, and reducing NEC. Resource Link: https://kcprematurebabies.com/wp-content/uploads/2020/pdf/NICU%20FEEDING%20PROTOCOL.pdf

By Susan J. Carlson, MMSc, RD, CSP, LD, CNSD and Ekhard E. Ziegler, MD Resource Link: https://uihc.org/childrens/educational-resources/feeding-nicu-handbook

Resource Link: https://www.brighamandwomens.org/assets/bwh/pediatric-newborn-medicine/pdfs/dpnm-enteral-nutrition-clinical-practice-guideline-final.pdf

This guideline is applicable to all medical and nursing staff caring for preterm infants in neonatal units in the West of Scotland. It aims to describe safe feeding practices for preterm infants, especially those at increased risk of feed intolerance and necrotising enterocolitis. It is not applicable to babies with congenital abnormalities of the GI tract or babies commencing enteral feeds after GI surgery or following a conservatively managed episode of necrotising enterocolitis. This guidance must always be used in conjunction with careful, individualised, clinical assessment. Resource Link: https://www.clinicalguidelines.scot.nhs.uk/nhsggc-guidelines/nhsggc-guidelines/neonatology/enteral-feeding-of-preterm-infants/

Feeding babies enterally with expressed breast milk has many benefits for their short and long term health. Babies of all gestations and ages should be provided with enteral milk within 6 hours of birth unless there is a specific contraindication discussed with a consultant and documented clearly. By Samantha Edwards, Vennila Ponnusamy and Catherine Casewell Resource Link: https://ashfordstpeters.net/Guidelines_Neonatal/Risk%20Stratified%20Approach%20to%20Enteral%20Feeding%20Mar%202023.pdf

Resource Link: https://www.cahs.health.wa.gov.au/-/media/HSPs/CAHS/Documents/Health-Professionals/Neonatology-guidelines/Enteral-Feeding-Initiation-and-Progression.pdf

Babies have the right to be protected from injury and infection, to breathe normally, to be warm and to be fed. All newborns should have access to essential newborn care, which is the critical care for all babies in the first days after birth. Essential newborn care involves immediate care at the time of birth, and essential care during the entire newborn period. It is needed both in the health facility and at home. Resource Link: https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/newborn-health/essential-newborn-care

Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including disability, learning difficulties, and visual and hearing problems. Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive. Today, (November 2020) on World Prematurity Day, WHO launched a new Roadmap on human resource strategies to improve newborn care in health facilities in low- and middle-income countries, aimed at improving quality of care for newborns, including small and sick babies, and supporting countries to achieve the SDG target to reduce neonatal mortality to less than 12 per 1000 live births by 2030. Resource Link: https://www.who.int/news/item/17-11-2020-who-launches-new-roadmap-on-human-resource-strategies-to-ensure-that-all-newborns-survive-and-thrive

The recommendations in this guideline are intended to inform development of national and subnational health policies, clinical protocols and programmatic guides. The target audience includes national and subnational public health policy-makers, implementers and managers of maternal, newborn and child health programmes, health-care facility managers, supervisors/instructors for in-service training, health workers (including midwives, auxiliary nurse-midwives, nurses, paediatricians, neonatologists, general medical practitioners and community health workers), nongovernmental organizations, professional societies involved in the planning and management of maternal, newborn and child health services, academic staff involved in research and in the pre-service education and training of health workers, and those involved in the education of parents. Resource Link: https://www.who.int/publications/i/item/9789240058262

This campaign is supported by more than 140 national and international parent- and patient organisations, international healthcare professionals and medical societies including the World Health Organization (WHO). Download their statement for your communication to advocate a zero separation policy in neonatal care. Resource Link: https://www.glance-network.org/zero-separation-statements/

UNICEF is committed to providing affordable, high-quality health care to mothers and newborns before, during, and after pregnancy. To achieve this goal, UNICEF and partners have adopted the Every Newborn Action Plan, which provides a roadmap for reducing newborn mortality and stillbirths and improving maternal and newborn health by 2030. The updated targets and milestones for 2020-2025 include ensuring that every pregnant woman has four or more antenatal care contacts, every birth is attended by skilled health personnel, every woman and newborn receives early routine postnatal care within two days, and every small and sick newborn receives care. UNICEF is supporting countries in implementing these recommendations and reaching these goals by providing essential packages of high-quality maternal and newborn services, such as home visits, small and sick newborn care, and kangaroo care. Four indicators have been identified to track progress towards these goals: antenatal care, births attended by skilled health personnel, postnatal care within two days, and care for small and sick newborns. Currently, data on these indicators are derived from population-based household surveys, but efforts are underway to strengthen routine health information systems to capture this information rapidly at the subnational level. Resource Link: https://data.unicef.org/resources/ending-preventable-newborn-deaths-and-stillbirths-by-2030/

The purpose of this framework is to give a career pathway to ANNPs working in any level or unit or within the transport setting. This model makes clear how ANNPs can progress outside the limitations of the clinical rota by setting out a variety of career development pathways using the four pillars of advanced practice: clinical practice, leadership and management, education and research. The framework sets out the capabilities expected under each of these pillars at the level of ANNP, Senior ANNP and Consultant Nurse. Resource Link: https://www.bapm.org/resources/300-advanced-neonatal-nurse-practitioner-capabilities-framework

Hypoglycaemia is a leading cause of term admission to neonatal units. In 2016 NHS Improvement and BAPM convened a working group to develop a Framework for Practice to address variation in practices in the definition of hypoglycaemia, the identification, management and admission thresholds of babies admitted to neonatal units for hypoglycaemia, and to promote safer practices that avoid unnecessary separation of mother and baby. This update of the Framework is to ensure alignment of recommended clinical practice with the most up-to-date scientific evidence. This document is aimed at all healthcare professionals involved in the care of infants born at term during the first 48 - 72 hours after birth. The framework should be delivered in partnership with parents. We welcome your comments on the update of this Framework for Practice. Resource Link: https://www.bapm.org/resources/identification-and-management-of-neonatal-hypoglycaemia-in-the-full-term-infant-birth-72-hours

Resuscitation Council UK (RCUK) has produced these Newborn Life Support Guidelines, based on the International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support. [NLS CoSTR’s 2019 and 2020], and the European Resuscitation Council Guidelines for Newborn resuscitation and support of transition of infants at birth. The guidelines cover the management of the term and preterm infant.  By Joe Fawke, Jonathan Wyllie, John Madar, Sean Ainsworth, Robert Tinnion, Rachel Chittick, Nicola Wenlock, Jonathan Cusack, Victoria Monnelly, Andrew Lockey, Sue Hampshire, Published May 2021. Resource Link: https://www.resus.org.uk/library/2021-resuscitation-guidelines/newborn-resuscitation-and-support-transition-infants-birth

Resource Link: https://fgiguidelines.org/wp-content/uploads/2020/08/Recommended-NICU-Standards_2020-08-31.pdf

Establishment of risk-appropriate care was first proposed in 1976 when leaders in perinatal health proposed a model system of regionalized care for obstetrical and neonatal patients, including definitions of graded levels of hospital care.1 Risk-appropriate care, in which infants with mild to complex critical illness or physiologic immaturity are cared for in a facility with the personnel and resources appropriate for their needs and condition, results in improved outcomes. This concept is supported by the American Academy of Pediatrics (AAP) policy statement “Levels of Neonatal Care,” which provides a review of data supporting a tiered provision of neonatal care and reaffirms the need for nationally consistent standards of care to improve neonatal outcomes. By Ann R. Stark, MD, FAAP; DeWayne M. Pursley, MD, MPH, FAAP; Lu-Ann Papile, MD, FAAP; Eric C. Eichenwald, MD, FAAP; Charles T. Hankins, MD, MBA, FAAP; Rosanne K. Buck, RN, MS, NNP-BC, C-ONQS; Tamara J. Wallace, DNP, APRN, NNP-BC; Patricia G. Bondurant, DNP, RN; Nicole E. Faster, MSN, RN, RNC-NIC (Open Acess) Resource Link: https://publications.aap.org/pediatrics/article/151/6/e2023061957/191305/Standards-for-Levels-of-Neonatal-Care-II-III-and?autologincheck=redirected

The Toolkit for High-Quality Neonatal Services was published by the Department of Health in 2009, as guidance to help the NHS improve neonatal care. Eight principles cover the major areas of the neonatal pathway. There is a family-centred focus aiming to ensure the psychological and physiological needs are considered. The challenge now is for the NHS to implement this at a time of financial constraint. Resource Link: https://www.infantjournal.co.uk/pdf/inf_032_hqs.pdf

In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hour of life. Prelacteal feeds are strongly associated with delayed initiation of breastfeeding. Self-reported insufficient milk continues to be one of the most common reasons for introducing commercial milk formula (CMF) and stopping breastfeeding. Parents and health professionals frequently misinterpret typical, unsettled baby behaviours as signs of milk insufficiency or inadequacy. In our market-driven world and in violation of the WHO International Code for Marketing of Breast-milk Substitutes, the CMF industry exploits concerns of parents about these behaviours with unfounded product claims and advertising messages. A synthesis of reviews between 2016 and 2021 and country-based case studies indicate that breastfeeding practices at a population level can be improved rapidly through multilevel and multicomponent interventions across the socioecological model and settings. Breastfeeding is not the sole responsibility of women and requires collective societal approaches that take gender inequities into consideration. By Perez-Escamilla, R., Tomori, Cl, Hernandez-Cordero, S, Baker, P., Barros, A. J. D., Begin, F. etal (2023, Open Access) Resource Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01932-8/fulltext

The World Health Organization recommends the use of donated human milk (HM) as the second-best option for mothers who are temporarily unable to provide sufficient breast milk to meet the needs of their infants. However, HM donation is yet to become an accepted practice in Uganda. We assessed the level of, and factors associated with acceptability to donate HM among postnatal mothers at St. Francis Hospital Nsambya (SFHN). By Mohammed A. M. Ahmed, Charles Patrick Namisi, Nakibuuka Victoria Kirabira, Micheal Webba Lwetabe, Joseph Rujumba (2024, Open Acess) Resource Link: https://link.springer.com/article/10.1186/s13006-024-00615-2

Neonatal mortality remains high in Sub-Saharan Africa. In this region, many nurses are assigned to care for small and sick newborns with little or no specialized training. This article described the three-phase training provided to nurses/midwives in Northern Ghana. The Council of International Neonatal Nurses, Inc. (COINN) developed the training based on the “train the trainer” to provide a standardized neonatal curriculum and associated bedside preceptorship. The training program was two months in length. The training was started at the teaching hospital and included two district hospitals. By Geralyn Sue Prullage, Carolle Kernner, Mustapha Mahama, Victoria Awalenkak Agwiah, Mavis Suglo (2024, Open Access). Resource Link: https://www.sciencedirect.com/science/article/abs/pii/S1355184124000772

With an increasing awareness of the importance of nurturing care and within a framework of Infant- and Family-Centred Developmental Care (IFCDC), zero separation, keeping parent and infant in continuous close physical and psychological proximity to each other, is key. In modern neonatology, high technological and pharmaceutical treatments are consistently integrated with caregiving considerations. Mother-Newborn Couplet Care is a concept of care where the dyad of the ill or prematurely born infant and the mother, needing medical care of her own, are cared for together, from the birth of the baby to its discharge. Mother-Newborn Couplet Care requires systems changes in both obstetrics and paediatrics considering planning and organisation of care, equipment and design of units. Accordingly, strong leadership setting clear goals and changing the professional mindset by providing targeted education and training is crucial to ensure the warranted high quality of care of all mother-baby dyads. By Klemming, S., Lillieskolk, S., Westrup, B. (2021).Mother-Newbron Couplet Care From Theory To Practice To Ensure Zero Separation For All Newborns (Open Access). Resource Link: https://onlinelibrary.wiley.com/doi/10.1111/apa.15997

Newborn babies in need of critical medical attention are normally admitted to the neonatal intensive care unit (NICU). These infants tend to be preterm, have low birth weight, and/or have serious medical conditions. Neonatal survival varies, but progress in perinatal and neonatal care has notably diminished mortality rates. In this selected review, we examine and compare the NICU mortality rates and etiologies of death in different countries. By Selina Chow1 | Ronald Chow1 | Mila Popovic1 | Michael Lam2 | Marko Popovic1 | Joav Merrick3 | Ruth Naomi Stashefsky Margalit4 | Henry Lam2 | Milica Milakovic1 | Edward Chow2 | Jelena Popovic Resource Link: https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2015.00225/full

What proportion of neonatal intensive care units in 2014 achieved the risk-adjusted rates from the best quartile and decile from 2005 for death and serious morbidities? By Horbar, J. D., Edwards, E. M., Greenberg, M. S. et al (2017) Resource Link: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2595570

How are neonatal intensive care unit (NICU) admission rates and NICU patient-days changing over time for various birth weight, gestational age, and acuity subgroups? By Braun, D., Braun, E., Chiu, V. et al (2020) Resource Link: https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2767258

In low- and middle-income countries (LMICs), neonatal bacterial infections are mainly caused by Enterobacterales species and Staphylococcus aureus, which are also the leading causes of mortality directly attributable to antimicrobial resistance. As bacterial colonization often precedes infection, better knowledge of colonization is crucial to prevent antibiotic-resistant neonatal sepsis. By Anne-LiseBeaumont,MD;ElsaKermorvant-Duchemin,MD,PhD;SébastienBreurec,MD,PhD;Bich-TramHuynh,MD,PhD (2024, Open Access). Resource Link: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825643

A systematic review and meta-analysis found that a "substantial" proportion of infants younger than 3 months in low-resource countries were colonized with antimicrobial-resistant bacteria, researchers reported today in JAMA Network Open. Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus are leading causes of bacterial infections in newborns in LMICs and have been identified as the three main pathogens responsible for deaths attributable to antimicrobial resistance (AMR). By Chris Dall, MA (2024). Resource Link: https://www.cidrap.umn.edu/antimicrobial-stewardship/study-finds-high-prevalence-resistant-bacteria-infants-low-resource

Connective tissue disorders present with widespread manifestations involving the skin, joints, ligaments, blood vessels and other organ systems and can be associated with significant disability and life-threatening complications. Important disorders in this group include cutis laxa, wrinkly skin syndrome and geroderma osteodysplasticum. This article reports on a newborn baby with geroderma osteodysplasticum to raise awareness of this rare condition and the challenges faced by affected children and their families. By Manjunatha, C. M., Abourahma, A., Ibhanesebhor, S. E., Mathews, A. Z. (2021, Open Access). Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7220.pdf

This article reports on a case of a preterm baby who, post-routine insertion of a peripherally inserted central catheter (PICC), showed an unusual catheter route and tip placement revealing an unsuspected cardiac variant of persistent left superior vena cava (PLSVC). We discuss the condition, our management and its effects on vascular access in this unusual case. By Van Rens, M., Hugill, K., El Fakharany, A. E. F., Garcia, K. L. (2021, Open Access) Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7222.pdf

Oral mass in a newborn is rare but often quite daunting, leading to anxiety in parents. Very few hospitals have dental or maxillofacial facilities on site and this may lead to delayed diagnosis and intervention. A thorough clinical examination and knowledge of the oral mass is essential for precise diagnosis, management and parental reassurance. In this review article, we present a newborn baby with congenital epulis – an oral mass arising from the alveolar ridge. We also summarise the differential diagnoses based on location and consistency of the oral masses in this age group. By Pahuja, A., James, H., D’Costa, W., Al-Jaddir, G., Kaur, D. (2021, Open Access) Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7223.pdf

It is well known that the mental health of both parents, especially in the early post-partum period, can have a significant negative impact on the psychological wellbeing of an infant. There is growing evidence that fathers can experience trauma, potentially resulting in post-traumatic stress disorder (PTSD) following the complicated delivery of their child. Currently there is little research that has been conducted on the prevalence of PTSD in these fathers, or the need for them to be treated accordingly. An extensive literature review was conducted to assess the current status of the research in this field; the clinical implications of these findings are discussed. By Thomas, B., Anderton, C. J. (2021, Open Access) Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7224.pdf

Racial and ethnic disparities in health outcomes of newborns requiring care in the NICU setting have been reported. The contribution of NICU care to disparities in outcomes is unclear. By Sigurdson, K., Mitchell, B., Liu, J., Morton, C., Gould, J. B.. Lee, H. C. et al. (2019, Open Access) Resource Link: https://publications.aap.org/pediatrics/article/144/2/e20183114/76884/Racial-Ethnic-Disparities-in-Neonatal-Intensive?autologincheck=redirected

Background: Kernicterus resulting from severe neonatal hyperbilirubinaemia is a leading cause of preventable deaths and disabilities in low-income and middle-income countries, partly because high-quality intensive phototherapy is unavailable. Previously, we showed that filtered-sunlight phototherapy (FSPT) was efficacious and safe for treatment of mild-to-moderate neonatal hyperbilirubinaemia. We aimed to extend these studies to infants with moderate-to-severe hyperbilirubinaemia. By Tina M Slusher 1, Hendrik J Vreman 2, Ann M Brearley 3, Yvonne E Vaucher 4, Ronald J Wong 2, David K Stevenson 2, Olumide T Adeleke 5, Ifelayo P Ojo 6, Grace Edowhorhu 5, Troy C Lund 6, Daniel A Gbadero5 Resource Link: https://pubmed.ncbi.nlm.nih.gov/30170894/

In some neonatal intensive care units (NICUs), conventional overhead phototherapy is the only phototherapy available, whereas others use fibreoptic blankets only. Several NICUs use both treatments interchangeably. By Føreland, A.M.; Rosenberg, L:; Johannessen, B. (2016) Resource Link: https://www.sciencedirect.com/science/article/abs/pii/S1355184116000028?via%3Dihub

Neonatal jaundice is one of the most common problems in neonates. Effective treatment of jaundice requires therapeutic intervention with high quality phototherapy. Over recent years, several studies reported fiberoptic phototherapy to be less effective than conventional phototherapy in term neonates. Our study aimed to compare the effectiveness of fiberoptic phototherapy with a larger illuminated area and higher irradiance to conventional phototherapy methods. By Joel, H. N., Mchaile, D. N., Philemon, R. N., Mbwasi, R. M., & Msuya, L. (2021, Open Acess) Resource Link: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-020-02458-2

A breakthrough discovery 60 years ago by Cremer et al. has since changed the way we treat infants with hyperbilirubinemia and saved the lives of millions from death and disabilities. “Photobiology” has evolved by inquiry of diverse light sources: fluorescent tubes (wavelength range of 400–520 nm; halogen spotlights that emit circular footprints of light; fiberoptic pads/blankets (mostly, 400–550 nm range) that can be placed in direct contact with skin; and the current narrow-band blue light-emitting diode (LED) light (450–470 nm), which overlaps the peak absorption wavelength (458 nm) for bilirubin photoisomerization. Excessive bombardment with photons has raised concerns for oxidative stress in very low birthweight versus term infants treated aggressively with phototherapy. Increased emphasis on prescribing phototherapy as a “drug” that is dosed cautiously and judiciously is needed. In this historical review, we chronicled the basic to the neurotoxic components of severe neonatal hyperbilirubinemia and the use of standardized interventions. By Hansen Thor, W. R., Jeffrey, M. M., Finn, E., Vreman, H. J., Stevenson, D. K., Wong, R. J., Bhutani, V. K. (2020) Resource Link: https://www.nature.com/articles/s41372-019-0439-1

Approximately 11% of infants are born preterm, and complications of prematurity are the most common cause of death in children aged under five years. Almost one million preterm infants die each year across low, high and middle income countries. In 2021, the World Health Organization (WHO) convened a Guideline Development Group (GDG) to examine evidence and formulate recommendations for care of preterm or low birthweight (LBW) infants according to WHO Guideline Review Committee (GRC) criteria. GRADE methods were used to assess the certainty of evidence and the GDG developed judgements using the DECIDE (Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence) framework. Twenty-five recommendations were made; 11 recommendations were new, and 16 were for preventive and promotive care. Kangaroo Mother Care (KMC) was recommended to start immmediately after birth as routine care for all preterm or LBW newborns (except for critically ill infants who are in shock, unable to breath spontaneously after resuscitation, or require ventilatory support) both in the facility and at home. New recommendations were also made for caffeine to treat apnoea and for extubation; family involvement in routine care for preterm or LBW infants; and for post-discharge home-visit follow-up care. New recommendations were also made to consider use of probiotics, emollient therapy, caffeine for prevention of apnoea, continuous positive airway pressure (CPAP) immediately after birth (with or without respiratory distress) in infants less than 32 weeks gestational age; and for family support to enable the care of preterm or LBW infants. The recommendations confirm the pivotal role of preventive and promotive care for preterm and LBW infants, especially the importance of keeping the baby and mother together, and empowering and supporting families to care for their preterm or LBW infant. WHO is now working to help scale up care for small and sick newborns, including organizational shifts in all ‘health system building blocks’ such as infrastructure, commodities, workforce and monitoring. Resource Link: https://www.sciencedirect.com/science/article/pii/S2589537023003322?via%3Dihub#sec6

Estimates of global prevalence of poor perinatal mental health (PMH) range from 13 to 30 percent, with higher prevalence in low- and middle-income countries.1 Defined as the period between pregnancy through two years postpartum, PMH includes clinical depression, anxiety, and psychosis, among other conditions. Myriad biological, socioeconomic, political factors, and gender inequalities can magnify the risk of poor PMH outcomes. Resource Link: https://www.thelancet.com/journals/lanam/article/PIIS2667-193X(24)00239-4/fulltext

Objective: To assess the impact of scaling up kangaroo mother care (KMC) on neonatal mortality among babies born with birth weight <2000 g across an entire district in southern India. By Tinku Thomas,1 Arin Kar,2 Suman P N Rao,3 Swaroop Narayana,2 Maryann Washington,1 Shashidhar Rao,3 Krishnamurthy Jayanna,2 Prabhu Deva Gowda,4 Mohan Harnahalli Lakkappa,2 Prem Mony. Resource Link: https://bmjpublichealth.bmj.com/content/bmjph/2/1/e000349.full.pdf

Small and sick newborn care (SSNC) is critical for national neonatal mortality reduction targets by 2030. Investment cases could inform implementation planning and enable coordinated resource mobilisation. We outline development of an investment case for Tanzania to estimate additional financing for scaling up SSNC to 80% of districts as part of health sector strategies to meet the country’s targets. By Rosemary Kamuyu, Alice Tarus, Felix Bundala, Georgina Msemo, Donat Shamba, Catherine Paul, Robert Tillya, Sarah Murless-Collins, Maria Oden, Rebecca Richards-Kortum, Timothy Powell-Jackson, Meghan Bruce Kumar, Nahya Salim & Joy E Lawn (Open Access). Resource Link: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04414-2

To implement the immediate Kangaroo mother care (iKMC) intervention in the previous multicentre, open-label, randomised controlled trial, the mother or a surrogate caregiver and neonate needed to be together continuously, which led to the concept of the Mother–Newborn Care Unit (MNCU). Health-care providers and administrators were concerned of the potential increase in infections caused by the continuous presence of mothers or surrogates in the MNCU. We aimed to assess the incidence of neonatal sepsis in sub-groups and the bacterial profile among intervention and control neonates in the study population. By Arya, S., Chhabra, S., Singhal, R., Kumari, A., Wadhwa, N., Anand, P. et al. (2023). Effect on neonatal sepsis following immediate kangaroo mater care in a newborn intensive care unit: a post-hoc analysis of a multicentre, open-label, randomized controlled trial. The Lancet (Open Access). Resource Link: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00183-9/fulltext

Background: Kangaroo Mother Care (KMC) is an evidencebased intervention focused on premature and low-birthweight (LBW) infants. In different healthcare systems, outpatient KMC programmes (KMCPs) have been pioneers in the follow-up of these high-risk newborns. Here, we describe an overview analysis performed in an unprecedented data set comprising Colombian infants and spanning 28 years. By Charpak, N., and Montealegre-Pomar, A. (2023). Resource Link: https://gh.bmj.com/content/bmjgh/8/5/e011192.full.pdf

The protective effects of Kangaroo mother care (KMC) on the neurodevelopment of preterm infants are well established, but we do not know whether the benefits persist beyond infancy. Our aim was to determine whether providing KMC in infancy affected brain volumes in young adulthood. By Charpak, N., Tessier, R., Ruiz, J. G., Uriza, F., Hernandez, J. T., Cortes, D., Montealegre- Pomar, A. (2022, Open Access) Resource Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9303677/

Understanding the effect of early kangaroo mother care on survival of mild-moderately unstable neonates <2000 g is a high-priority evidence gap for small and sick newborn care. By Helen Brotherton,a,b,⁎ Abdou Gai,b Bunja Kebbeh,b Yusupha Njie,b Georgia Walker,a Abdul K Muhammad,b Saffiatou Darboe,b Mamadou Jallow,b Buntung Ceesay,b Ahmadou Lamin Samateh,c Cally J Tann,a,d,e Simon Cousens,a Anna Roca,b and Joy E Lawn. (2021, Open Access) Resource Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8358420/

Neonatal hyperbilirubinemia (NNH) is the most common clinical sign seen in neonatal practice. Kangaroo mother care (KMC), a new strategy has been tried for the management of hyperbilirubinemia. By Garg, Bhawan Deep, MD, DNB Paediatrics, DNB Neonatology | Bansal, Anju, MS | Kabra, Nandkishor S., DM Neonatology. Resource Link: https://connect.springerpub.com/content/sgrjpe/29/3/123

Small and sick newborn care (SSNC) is critical for national neonatal mortality reduction targets by 2030. Investment cases could inform implementation planning and enable coordinated resource mobilisation. We outline development of an investment case for Tanzania to estimate additional financing for scaling up SSNC to 80% of districts as part of health sector strategies to meet the country’s targets. By Rosemary Kamuyu, Alice Tarus, Felix Bundala, Georgina Msemo, Donat Shamba, Catherine Paul, Robert Tillya, Sarah Murless-Collins, Maria Oden, Rebecca Richards-Kortum, Timothy Powell-Jackson, Meghan Bruce Kumar, Nahya Salim & Joy E Lawn (Open Access). Resource Link: https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-023-04414-2

Narayanan, I., Litch, J. A., Srinivas, G. L., Onwona-Agyeman, K., Abdul-Mumin, A., Ramasethu, J. (2023, Open Access) Resource Link: https://www.ghspjournal.org/content/ghsp/11/1/e2200099.full.pdf

Congenital disorders are also known as congenital abnormalities, congenital malformations or birth defects. They can be defined as structural or functional anomalies (for example, metabolic disorders) that occur during intrauterine life and can be identified prenatally, at birth, or sometimes may only be detected later in infancy, such as hearing defects. Broadly, congenital refers to the existence at or before birth. Resource Link: https://www.who.int/news-room/fact-sheets/detail/birth-defects

Of 136 million babies born annually, around 10 million require assistance to breathe. Each year 814,000 neonatal deaths result from intrapartum-related events in term babies (previously “birth asphyxia”) and 1.03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published. By Lee, A. CC., Cousens, S., Wall, S. N., Niermeyer, S., Darmstadt, G. L., Carol, W. A., Keena, W. J., Bhutta, Z. A., Gill, C., Lawn, J. E. (2011, Open Access) Resource Link: https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-S3-S12

Increased survival of preterm infants in developing countries has often been accompanied by increased morbidity. A previous study found rates of severe retinopathy of prematurity varied widely between different neonatal units in Rio de Janeiro. Nurses have a key role in the care of high-risk infants but often do not have access to ongoing education programmes. We set out to design a quality improvement project that would provide nurses with the training and tools to decrease neonatal mortality and morbidity. The purpose of this report is to describe the methods and make the teaching package (POINTS of care–six modules addressing Pain control; optimal Oxygenation; Infection control; Nutrition interventions; Temperature control; Supportive care) available to others. By Darlow, B. A., Zin, A. A., Beecroft, G., Moreira, M. EL., Gilbert, C. E. (2012, Open Access) Resource Link: https://www.healthynewbornnetwork.org/hnn-content/uploads/Darlow_Brazil-Nurses.pdf

The purpose of this study is to develop nursing standard guidelines for nurses in a neonatal intensive care unit. The Delphi method was used in this study to elicit expert consensus. Thirteen experts who were nurses and pediatric adolescent specialists working in the neonatal intensive care unit participated in the study. In this study, 178 items were developed based on 5 nursing practice standards and 7 standards of professional practice. An additional 10 items were included based on observation in the neonatal intensive care unit. After expert validation, a final total of 184 items was developed. The standard guidelines for high-risk neonatal care developed in this study for practical clinical education in nursing are significant because they reflect the nursing practice standards in Korea and characteristics of nursing practice in the neonatal intensive unit. By Lee H., Kim, D., Han, J. (2020, Open Acess) Resource Link: https://www.mdpi.com/2227-9032/8/3/320

Background: Due to the progress in neonatology, in particular, in the past three decades, the mortality rate among patients of intensive care units has decreased. However, this is connected not only with newborns needing to stay longer in the unit, but also with the exposure of newborns to many painful procedures and stresses. Lack of or insufficient pain prevention has a negative impact on the sensory or locomotor development of newborns. Despite the presence of guidelines based on scientific evidence, the use of pharmacological and non-pharmacological pain-management methods in newborns is still insufficient. Aim: The aim of the study was to: identify the knowledge nurses/midwives have of recommended non-pharmacological and/or pharmacological methods, in particular, in relation to medical intervention procedures; assess the interventions for pain relief applied by midwives/nurses most often in their clinical practice; examine the role of age, general work experience, education level and years of work of medical professionals on a neonatal ward, as well as the referral level of a unit, versus the application of pharmacological and non-pharmacological methods. Methods: A descriptive and quantitative study conducted in 2019 among Polish nurses/midwives working at neonatal intensive care units. Results: The analysis of the material reflected the deficit of knowledge and the insufficient daily use of recommended pain-relief measures among the respondents. Conclusions: The interpretation of data indicates that despite the clear and easily available recommendations of scientific societies concerning the mode of conduct in particular medical procedures, medical personnel do not apply those recommendations in their everyday practice. It is necessary to plan and implement education strategies for nurses/midwives on standard pain-management interventions during painful medical procedures. By Popowicz, H., Kwiecien-Jagus, K., Medrzycka-Dabrowska, W., Kopec, M., Dyk, D. (2022, Open Access) Resource Link: https://www.mdpi.com/1660-4601/19/19/12075

By Linner, A., Westreup, B., Rettedal, S., Kawaza, K., Naburi, H., Newton, S., et al. (2023, Open Access) Resource Link: https://www.researchgate.net/publication/366716935_Immediate_skin-to-skin_contact_for_low_birth_weight_infants_is_safe_in_terms_of_cardiorespiratory_stability_in_limited-resource_settings

Research priorities for preterm or low birth weight (LBW) infants were advanced in 2012, and other research priority-setting exercises since then have included more limited, context-specific research priorities pertaining to preterm infants. While developing new World Health Organization (WHO) guidelines for care of preterm or LBW infants, we conducted a complementary research prioritisation exercise. A diverse, globally representative guideline development group (GDG) of experts – all authors of this paper along with WHO steering group for preterm-LBW guidelines – was assembled by the WHO to examine evidence and consider a variety of factors in intervention effectiveness and implementation, leading to 25 new recommendations and one good practice statement for care of preterm or LBW infants. The GDG generated research questions (RQs) based on contributions to improvements in care and outcomes of preterm or LBW infants, public health impacts, answerability, knowledge gaps, feasibility of implementation, and promotion of equity, and then ranked the RQs based on their likelihood to further change or influence the WHO guidelines for the care of preterm or LBW infants in the future. Thirty-six priority RQs were identified, 32 (89%) of which focused on aspects of intervention effectiveness, and the remaining four addressed implementation (“how”) questions. Of the top 12 RQs, seven focused on further advancing new recommendations – such as family involvement and support in caring for preterm or LBW infants, emollient therapy, probiotics, immediate KMC for critically ill newborns, and home visits for post-discharge follow-up of preterm or LBW infants – and three RQs addressed issues of feeding (breastmilk promotion, milk banks, individualized feeding). RQs prioritised here will be critical for optimising the effectiveness and delivery of new WHO recommendations for care of preterm or LBW infants. The RQs encompass unanswered research priorities for preterm or LBW infants from prior prioritisation exercises which were conducted using Child Health and Nutrition Research Initiative (CHNRI) methodology. By Gary L.Darmstadt, Nafisa HamoudAl Jaifi, ShabinaAriff, RajivBahl, MatsBlennow, VanessaCavallera, DorisChou, RogerChou, LizComrie-Thomson, KarenEdmond, QiFeng, Patricia FernandezRiera, LaurenceGrummer-Strawn, ShuchitaGupta, ZeleeHill, Ayede AdejumokeIdowu, CaroleKenner, Victoria NakibuukaKirabira, ReinhardKlinkott, SocorroDe Leon-Mendoza, SilkeMader, KarimManji, RhondaMarriott, MonicaMorgues, SushmaNangia, SumanRao, MohammodShahidullah, Hoang ThiTran, Andrew D.Weeks, BogaleWorku, KhalidYunis. (2023, Open Access) Resource Link: https://www.sciencedirect.com/science/article/pii/S2589537023003036

Preterm and low birthweight infants are subject to poorer overall health, development, and survival with complications of preterm birth being the leading cause of under 5 mortality. New evidence has emerged on the effectiveness of interventions for care of these infants since previous guidelines were published in 2015. Following convening of an expert panel, WHO published “Recommendations for Care of the Preterm or Low Birthweight Infant” on World Prematurity Day in November 2022. Now, in this new Series of two Health Policy pieces, we provide details on the 25 recommendations and research prioritisation. These new recommendations stress the importance of keeping preterm and low birthweight infants and mother together and the need to integrate families to care for their babies. (2023, Open Access) Resource Link: https://www.thelancet.com/series/Preterm-LBW-care

Approximately 11% of infants are born preterm, and complications of prematurity are the most common cause of death in children aged under five years. Almost one million preterm infants die each year across low, high and middle income countries. In 2021, the World Health Organization (WHO) convened a Guideline Development Group (GDG) to examine evidence and formulate recommendations for care of preterm or low birthweight (LBW) infants according to WHO Guideline Review Committee (GRC) criteria. GRADE methods were used to assess the certainty of evidence and the GDG developed judgements using the DECIDE (Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence) framework. Twenty-five recommendations were made; 11 recommendations were new, and 16 were for preventive and promotive care. Kangaroo Mother Care (KMC) was recommended to start immmediately after birth as routine care for all preterm or LBW newborns (except for critically ill infants who are in shock, unable to breath spontaneously after resuscitation, or require ventilatory support) both in the facility and at home. New recommendations were also made for caffeine to treat apnoea and for extubation; family involvement in routine care for preterm or LBW infants; and for post-discharge home-visit follow-up care. New recommendations were also made to consider use of probiotics, emollient therapy, caffeine for prevention of apnoea, continuous positive airway pressure (CPAP) immediately after birth (with or without respiratory distress) in infants less than 32 weeks gestational age; and for family support to enable the care of preterm or LBW infants. The recommendations confirm the pivotal role of preventive and promotive care for preterm and LBW infants, especially the importance of keeping the baby and mother together, and empowering and supporting families to care for their preterm or LBW infant. WHO is now working to help scale up care for small and sick newborns, including organizational shifts in all ‘health system building blocks’ such as infrastructure, commodities, workforce and monitoring. By Gary L.Darmstadt, Nafisa HamoudAl Jaifi, ShabinaArif, RajivBahl, MatsBlennow, VanessaCavallera, DorisChou, RogerChou, LizComrie-Thomson, KarenEdmond, QiFeng, Patricia FernandezRiera, LawrenceGrummer-Strawn, ShuchitaGupta, ZeleeHill, Ayede AdejumokeIdowu, CaroleKenner, Victoria NakibuukaKirabira, ReinhardKlinkott, SocorroDe Leon-Mendoza, SilkeMader, KarimManji, RhondaMarriott, MonicaMorgues, SushmaNangia, AnaydaPortela, SumanRao, MohammodShahidullah, Hoang ThiTran, Andrew D.Weeks, BogaleWorku, KhalidYunis (2023, Open Access) Resource Link: https://www.sciencedirect.com/science/article/pii/S2589537023003322?via%3Dihub

A comprehensive model for scaling up care for small and/or sick newborns at district level-based on country experiences presented at a WHO-UNICEF expert consultation. Current trends indicate that 63 countries are not on track to achieve the 2030 Sustainable Development Goals (SDG) target of a neonatal mortality rate ≤12 per 1000 live births, with 55 needing to double the annual rate of decline in neonatal mortality to do so [1]. By WHO-UNICEF expert consultation. J Glob Health 2023;11:03023 (Open Access) Resource Link: https://jogh.org/wp-content/uploads/2023/04/jogh-13-03023.pdf

An Evolving Approach to Newborn Care Between 1990 and 2017, the global under-5 mortality rate declined by 58% and the neonatal mortality rate by 51%, [1] but both measures remain well above the Sustainable Development Goal targets for 2030. [2] In many low- and middle-income countries (LMICs), major challenges persist, hindering the achievement of Sustainable Development Goal 3.2, in particular, of reducing preventable deaths of newborns to at least 12 deaths per 1,000 live births by the year 2030.[2] By Narayanan, I., Litch, J. A., Srinivas, G. L., Onwona-Agyeman, K., Abdul-Mumin, A., Ramasethu, J. (Open Access) Resource Link: https://www.ghspjournal.org/content/ghsp/11/1/e2200099.full.pdf

In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. By Perez-Escamilla, R., Tomori, Cl, Hernandez-Cordero, S, Baker, P., Barros, A. J. D., Begin, F. etal (Open Access) Resource Link: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01932-8/fulltext

Congenital disorders are also known as congenital abnormalities, congenital malformations or birth defects. They can be defined as structural or functional anomalies (for example, metabolic disorders) that occur during intrauterine life and can be identified prenatally, at birth, or sometimes may only be detected later in infancy, such as hearing defects. Broadly, congenital refers to the existence at or before birth. By World Health Organization Resource Link: https://www.who.int/news-room/fact-sheets/detail/birth-defects

To implement the immediate Kangaroo mother care (iKMC) intervention in the previous multicentre, open-label, randomised controlled trial, the mother or a surrogate caregiver and neonate needed to be together continuously, which led to the concept of the Mother–Newborn Care Unit (MNCU). Health-care providers and administrators were concerned of the potential increase in infections caused by the continuous presence of mothers or surrogates in the MNCU. We aimed to assess the incidence of neonatal sepsis in sub-groups and the bacterial profile among intervention and control neonates in the study population. By Arya, S., Chhabra, S., Singhal, R., Kumari, A., Wadhwa, N., Anand, P. et al. (Open Access) Resource Link: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00183-9/fulltext#%20

Kangaroo Mother Care (KMC) is an evidencebased intervention focused on premature and low-birthweight (LBW) infants. In different healthcare systems, outpatient KMC programmes (KMCPs) have been pioneers in the follow-up of these high-risk newborns. Here, we describe an overview analysis performed in an unprecedented data set comprising Colombian infants and spanning 28 years. By Charpak, N., and Montealegre-Pomar, A. (Open Access) Resource Link: https://gh.bmj.com/content/bmjgh/8/5/e011192.full.pdf

The aim is to investigate the safety of skin-to-skin contact initiated immediately after birth on cardiorespiratory parameters in unstable low birth weight infants. By Linner, A., Westreup, B., Rettedal, S., Kawaza, K., Naburi, H., Newton, S., et al. (Open Access) Resource Link: https://www.researchgate.net/publication/366716935_Immediate_skin-to-skin_contact_for_low_birth_weight_infants_is_safe_in_terms_of_cardiorespiratory_stability_in_limited-resource_settings

The American Academy of Pediatrics (AAP) through funding from the Bill and Melinda Gates Foundation, and in collaboration with the World Health Organization, other implementing organizations and several national professional societies, is excited to showcase a series of webinars aimed at promoting new evidence on immediate Kangaroo Mother Care (iKMC), supporting a paradigm shift to zero separation between mothers and their newborn babies with a goal to improve quality of care and outcomes for small and sick newborns. By American Academy of Pediatrics Resource Link: https://www.aap.org/en/aap-global/immediate-kangaroo-mother-care-ikmc/

Due to the progress in neonatology, in particular, in the past three decades, the mortality rate among patients of intensive care units has decreased. However, this is connected not only with newborns needing to stay longer in the unit, but also with the exposure of newborns to many painful procedures and stresses. Lack of or insufficient pain prevention has a negative impact on the sensory or locomotor development of newborns. Despite the presence of guidelines based on scientific evidence, the use of pharmacological and non-pharmacological pain-management methods in newborns is still insufficient. By Popowicz, H., Kwiecien-Jagus, K., Medrzycka-Dabrowska, W., Kopec, M., Dyk, D. (Open Access) Resource Link: https://www.mdpi.com/1660-4601/19/19/12075

Connective tissue disorders present with widespread manifestations involving the skin, joints, ligaments, blood vessels and other organ systems and can be associated with significant disability and life threatening complications. Important disorders in this group include cutis laxa, wrinkly skin syndrome and geroderma osteodysplasticum. This article reports on a newborn baby with geroderma steodysplasticum to raise awareness of this rare condition and the challenges faced by affected children and their families By Manjunatha, C. M., Abourahma, A., Ibhanesebhor, S. E., Mathews, A. Z. Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7220.pdf

This article reports on a case of a preterm baby who, post-routine insertion of a peripherally inserted central catheter (PICC), showed an unusual catheter route and tip placement revealing an unsuspected cardiac variant of persistent left superior vena cava (PLSVC). We discuss the condition, our management and its effects on vascular access in this unusual case. By Van Rens, M., Hugill, K., El Fakharany, A. E. F., Garcia, K. L. Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7222.pdf

Oral mass in a newborn is rare but often quite daunting, leading to anxiety in parents. Very few hospitals have dental or maxillofacial facilities on site and this may lead to delayed diagnosis and intervention. A thorough clinical examination and knowledge of the oral mass is essential for precise diagnosis, management and parental reassurance. In this review article, we present a newborn baby with congenital epulis – an oral mass arising from the alveolar ridge. We also summarise the differential diagnoses based on location and consistency of the oral masses in this age group. By Pahuja, A., James, H., D’Costa, W., Al-Jaddir, G., Kaur, D. Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7223.pdf

It is well known that the mental health of both parents, especially in the early post-partum period, can have a significant negative impact on the psychological wellbeing of an infant. There is growing evidence that fathers can experience trauma, potentially resulting in post-traumatic stress disorder (PTSD) following the complicated delivery of their child. Currently there is little research that has been conducted on the prevalence of PTSD in these fathers, or the need for them to be treated accordingly. An extensive literature review was conducted to assess the current status of the research in this field; the clinical implications of these findings are discussed. By Thomas, B., Anderton, C. J. Resource Link: https://www.infantjournal.co.uk/pdf/inf_099_7224.pdf

Neonatal jaundice is one of the most common problems in neonates. Effective treatment of jaundice requires therapeutic intervention with high quality phototherapy. Over recent years, several studies reported fiberoptic phototherapy to be less effective than conventional phototherapy in term neonates. Our study aimed to compare the effectiveness of fiberoptic phototherapy with a larger illuminated area and higher irradiance to conventional phototherapy methods. By Joel, H. N., Mchaile, D. N., Philemon, R. N., Mbwasi, R. M., & Msuya, L. Resource Link: https://doi.org/10.1186/s12887-020-02458-2

Neonatal hyperbilirubinemia (NNH) is the most common clinical sign seen in neonatal practice. Kangaroo mother care (KMC), a new strategy has been tried for the management of hyperbilirubinemia. By Garg, B. D., Bansal, A., & Kabra, N. S. Resource Link: https://www.healthynewbornnetwork.org/hnn-content/uploads/Darlow_Brazil-Nurses.pdf

The purpose of this study is to develop nursing standard guidelines for nurses in a neonatal intensive care unit. The Delphi method was used in this study to elicit expert consensus. Thirteen experts who were nurses and pediatric adolescent specialists working in the neonatal intensive care unit participated in the study. In this study, 178 items were developed based on 5 nursing practice standards and 7 standards of professional practice. An additional 10 items were included based on observation in the neonatal intensive care unit. By Lee H., Kim, D., Han, J. (Open Access) Resource Link: https://www.mdpi.com/2227-9032/8/3/320

Admission rates to the NICU and numbers of NICU patient-days decreased over the study period without an increase in readmissions or mortality. The observed decrease was associated with the high GA and BW newborn population. How much of this decrease is attributable to intercurrent health care systemwide quality improvement initiatives would require further investigation. The remaining unexplained variation suggests that further changes are also possible. By Braun, D., Braun, E., Chiu, V. et al Resource Link: https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2767258

A breakthrough discovery 60 years ago by Cremer et al. has since changed the way we treat infants with hyperbilirubinemia and saved the lives of millions from death and disabilities. “Photobiology” has evolved by inquiry of diverse light sources: fluorescent tubes (wavelength range of 400–520 nm; halogen spotlights that emit circular footprints of light; fiberoptic pads/blankets (mostly, 400–550 nm range) that can be placed in direct contact with skin; and the current narrow-band blue light-emitting diode (LED) light (450–47 By Hansen Thor, W. R., Jeffrey, M. M., Finn, E., Vreman, H. J., Stevenson, D. K., Wong, R. J., & Bhutani, V. K. Resource Link: https://www.nature.com/articles/s41372-019-0439-1

Overall, this systematic review revealed complex racial and/or ethnic disparities in structure, process, and outcome measures, most often disadvantaging infants of color, especially African American infants. There are some exceptions to this pattern and each area merits its own analysis and discussion. By Sigurdson, K., Mitchell, B., Liu, J., Morton, C., Gould, J. B.. Lee, H. C. et al. Resource Link:https://publications.aap.org/pediatrics/article/144/2/e20183114/76884/Racial-Ethnic-Disparities-in-Neonatal-Intensive

Kernicterus resulting from severe neonatal hyperbilirubinaemia is a leading cause of preventable deaths and disabilities in low-income and middle-income countries, partly because high-quality intensive phototherapy is unavailable. Previously, we showed that filtered-sunlight phototherapy (FSPT) was efficacious and safe for treatment of mild-to-moderate neonatal hyperbilirubinaemia. We aimed to extend these studies to infants with moderate-to-severe hyperbilirubinaemia By Tina M Slusher, Hendrik J Vreman, Ann M Brearley, Yvonne E Vaucher, Ronald J Wong, David K Stevenson, Olumide T Adeleke, Ifelayo P Ojo, Grace Edowhorhu, Troy C Lund, Daniel A Gbadero (Open Access) Resource Link: https://www.healthynewbornnetwork.org/hnn-content/uploads/Darlow_Brazil-Nurses.pdf

In this observational study, we calculated the 10th, 25th, 50th, 75th, and 90th percentiles of risk-adjusted neonatal intensive care unit rates for death and serious morbidities from 2005 to 2014 at US Vermont Oxford Network member neonatal intensive care units. By Horbar, J. D., Edwards, E. M., Greenberg, M. S. et al Resource Link: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2595570

In some neonatal intensive care units (NICUs), conventional overhead phototherapy is the only phototherapy available, whereas others use fibreoptic blankets only. Several NICUs use both treatments interchangeably. By Føreland, A.M.; Rosenberg, L:; Johannessen, B. Resource Link: Journal of Neonatal Nursing. ISSN: 1355-1841. 22 (3). s 108 - 114. doi:10.1016/j.jnn.2016.01.001.

Newborn babies in need of critical medical attention are normally admitted to the neonatal intensive care unit (NICU). These infants tend to be preterm, have low birth weight, and/or have serious medical conditions. Neonatal survival varies, but progress in perinatal and neonatal care has notably diminished mortality rates. In this selected review, we examine and compare the NICU mortality rates and etiologies of death in different countries. By Chow, S., Chow, R., Popovic, M., Lam, M., Popovic, M., Merrick, J., et al Resource Link: https://www.frontiersin.org/articles/10.3389/fpubh.2015.00225/full

Increased survival of preterm infants in developing countries has often been accompanied by increased morbidity. A previous study found rates of severe retinopathy of prematurity varied widely between different neonatal units in Rio de Janeiro. Nurses have a key role in the care of high-risk infants but often do not have access to ongoing education programmes. We set out to design a quality improvement project that would provide nurses with the training and tools to decrease neonatal mortality and morbidity. By Darlow, B. A., Zin, A. A., Beecroft, G., Moreira, M. EL., Gilbert, C. E. (Open Access) Resource Link: https://www.healthynewbornnetwork.org/hnn-content/uploads/Darlow_Brazil-Nurses.pdf

A comprehensive model for scaling up care for small and/or sick newborns at district level-based on country experiences presented at a WHO-UNICEF expert consultation. Current trends indicate that 63 countries are not on track to achieve the 2030 Sustainable Development Goals (SDG) target of a neonatal mortality rate ≤12 per 1000 live births, with 55 needing to double the annual rate of decline in neonatal mortality to do so [1]. WHO-UNICEF expert consultation. J Glob Health 2023;11:03023 (Open Access) Resource Link: https://jogh.org/wp-content/uploads/2023/04/jogh-13-03023.pdf

Preterm babies are at particular risk of hypothermia with associated adverse effects including an increased risk of hypoglycaemia, hypoxia and metabolic acidosis, respiratory distress and chronic lung disease, necrotising enterocolitis, intraventricular haemorrhage, late-onset sepsis and death. (Open Access) By The British Association of Perinatal Medicine in collaboration with the NNAP Resource Link: https://www.bapm.org/pages/105-normothermia-toolkit

Oxygen is important in the care of newborn infants because many conditions that affect babies in the first days of life can result in low levels of oxygen in the body. Hypoxemia, or low level of oxygen in the blood, is a life-threatening condition that results in increased mortality and morbidity. Prematurity and respiratory distress syndrome (surfactant deficiency), pneumonia and other severe infections, asphyxia and difficulties in the transition from fetal to neonatal life can all result in hypoxemia. Supplemental oxygen is an essential lifesaving treatment. (Open Access) Resource Link: https://www.healthynewbornnetwork.org/hnn-content/uploads/DNH_TechBrief_Oxygen_7.6.17-1.pdf

When cared for in a nurturing environment, babies not only survive, they are also helped to thrive. However, too many infants are deprived of their right to receive nurturing care, including when they require inpatient hospital care. (Open Access) Resource Link: https://iris.who.int/bitstream/handle/10665/345297/9789240035201-eng.pdf

The purpose of this framework is to give a career pathway to ANNPs working in any level or unit or within the transport setting. This model makes clear how ANNPs can progress outside the limitations of the clinical rota by setting out a variety of career development pathways using the four pillars of advanced practice: clinical practice, leadership and management, education and research. The framework sets out the capabilities expected under each of these pillars at the level of ANNP, Senior ANNP and Consultant Nurse. (2021, Open Access) Resource Link: https://www.bapm.org/resources/300-advanced-neonatal-nurse-practitioner-capabilities-framework

Hypoglycaemia is a leading cause of term admission to neonatal units. In 2016 NHS Improvement and BAPM convened a working group to develop a Framework for Practice to address variation in practices in the definition of hypoglycaemia, the identification, management and admission thresholds of babies admitted to neonatal units for hypoglycaemia, and to promote safer practices that avoid unnecessary separation of mother and baby. This document is aimed at all healthcare professionals involved in the care of infants born at term during the first 48 - 72 hours after birth. The framework should be delivered in partnership with parents. (2024, Open Access) Resource Link: https://www.bapm.org/resources/identification-and-management-of-neonatal-hypoglycaemia-in-the-full-term-infant-birth-72-hours

Resuscitation Council UK (RCUK) has produced these Newborn Life Support Guidelines, based on the International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support. [NLS CoSTR’s 2019 and 2020], and the European Resuscitation Council Guidelines for Newborn resuscitation and support of transition of infants at birth. The guidelines cover the management of the term and preterm infant.   By Joe Fawke, Jonathan Wyllie, John Madar, Sean Ainsworth, Robert Tinnion, Rachel Chittick, Nicola Wenlock, Jonathan Cusack, Victoria Monnelly, Andrew Lockey, Sue Hampshire, Published May 2021. Resource Link: https://www.resus.org.uk/library/2021-resuscitation-guidelines/newborn-resuscitation-and-support-transition-infants-birth

Clinically significant neonatal hypoglycemia (NH) is the result of an imbalance between glucose supply and other fuels such as ketone bodies, and lactate. As part of the physiological adaptation to extra uterine life, blood glucose concentrations often dip to 30 mg/dL (1.6mmol/L) within 1 to 2 hours after birth in healthy neonates, but they typically return to more than 45 mg/dL (2.5 mmol/L) with normal feeding within 12 hours. There is no evidence that this is in anyway harmful. Resource Link: https://platform.who.int/docs/default-source/mca-documents/policy-documents/operational-guidance/ARE-MN-62-01-OPERATIONALGUIDANCE-2015-eng-Neonatal-Hypoglycemia-Guideline.pdf

This LOP is developed to guide clinical practice at the Royal Hospital for Women. Individual patient circumstances may mean that practice diverges from this LOP. Resource Link: https://www.seslhd.health.nsw.gov.au/sites/default/files/documents/Hypoglycaemianeonate_0.pdf

Protecting your baby from low blood glucose Resource Link: https://www.ruh.nhs.uk/patients/patient_information/NIC012_Neonatal_Hypoglycaemia.pdf

Hypoglycemia is low level of plasma or blood glucose in the neonate. In healthy term neonates, there is a transient, physiological fall in the blood glucose concentration with a nadir at 60–90 minutes after birth, without any symptoms later rising to levels above 60 mg/dL by 4 hours. Breastfed infants may tolerate lower blood sugar levels because of bioavailable alternate fuels like ketone bodies, thus facilitating adaptation during transition. Resource Link: https://iapindia.org/pdf/X9ceMoHV2pAF6UR_STG-NEONATAL-HYPOGLYCEMIA.pdf

The Kingdom of Eswatini is a lower middle-income country with an estimated population of approximately 1.1 million people (Population Census 2017). The fertility rate is 3.14 children per woman of childbearing age. The proportion of births attended by skilled personnel is approximately 88% (MICS 2014), with a neonatal mortality rate of 20 deaths per 1,000 live births (compared to the infant mortality rate of 85 deaths per 1,000 live births). In 2016, neonatal deaths ranked 12th in the list of childhood mortality in Swaziland and ranked 6th of all causes of years of life lost in 2016. Preterm births composed about 1 out of 9 births and ranked 7th of all causes of death and disability combined in Eswatini. By Unicef & WHO Resource Link: https://www.unicef.org/eswatini/media/631/file/UNICEF-Sd-Neonatal-Guidelines-report-2018.pdf

This is a clinical practice guideline. While the guideline is useful in approaching the care of the neonate at risk for hypoglycemia, clinical judgment and / or new evidence may favor an alternative plan of care, the rationale for which should be documented in the medical record. Resource Link: https://www.brighamandwomens.org/assets/bwh/pediatric-newborn-medicine/pdfs/dpnm-hypoglycemia-revised-12-19-16.pdf

These guidelines have been developed, at the request of the Ministry of Health, as an aidememoire for all staff concerned with the management of neonates to work towards a better and more uniform standard of neonatal care across the country of Belize. The topics selected are the major and most frequent issues encountered in neonatology. The guidelines are based on the best available evidence and opinions from the most recent published literature and at points, directly from experts. It is quite straight forward, easy to read and understand. At the end of each topic, a further reading section is clearly highlighted for additional reference and in-depth explanation. Most articles stated are open access. Resource Link: https://platform.who.int/docs/default-source/mca-documents/policy-documents/guideline/blz-mn-32-02-guideline-2018-eng-neonatal-clinical-guidelines-2018-2021.pdf

This new compendium gives you a single place to look for the most recent and trustworthy recommendations on quality care of pregnant women and their newborn infants. Resource Link: https://publications.aap.org/aapbooks/book/563/Neonatal-Care-A-Compendium-of-AAP-Clinical?autologincheck=redirected

Assessment is a key component of nursing practice, required for planning and provision of patient and family centered care. The Nursing and Midwifery Board of Australia (NMBA) in the national competency standard four for registered nurses' highlights that nurses conduct a comprehensive and systematic nursing assessment in order to plan holistic and patient family centered nursing care and responds effectively to unexpected or rapidly changing situations. Resource Link: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Nursing_Assessment/

This Comprehensive Newborn Care Protocols provide guidance on newborn care to clinicians and nurses. These protocols in this handbook are underpinned on the ‘Newborn Care Quality Statements’ outlined in this handbook. Resource Link: https://paediatrics.uonbi.ac.ke/sites/paediatrics.uonbi.ac.ke/files/2023-04/Comprehensive%20Newborn%20Care%20Protocols%20Book%20November%202022.pdf

This pocket book consists of guidelines on triage, assessment & classification of illness severity, criteria for admission, and inpatient management of the major causes of childhood morbidity & mortality such as pneumonia, diarrhea, malaria, severe acute malnutrition, meningitis, HIV, TB and neonatal conditions. The guidelines target management of the seriously ill newborn or child in the first 24 - 48 hours of arrival at a health facility. Resource Link: https://paediatrics.uonbi.ac.ke/sites/paediatrics.uonbi.ac.ke/files/2023-04/Basic%20Paediatric%20protocol%205th%20edition%20FOR%20PRINT%2031st%20Oct%202022.pdf

The third trimester of gestation is a period of intense growth and development for the fetal central nervous system. Preterm birth disrupts this delicate process and forces fetal development to continue within the potentially noxious extrauterine environment of the NICU. Parents and professional caregivers can work together to minimize the negative impact of the NICU experience, hopefully reducing subsequent impairment and disability. Resource Link: https://cdn-links.lww.com/permalink/mcn/a/mcn_43_2_2017_12_18_lockeridge_0040_sdc01.pdf

Introduction Neurodevelopmental outcomes of preterm infant are still a contemporary concern. To counter the detrimental effects resulting from the hospitalisation in the neonatal intensive care unit (NICU), developmental care (DC) interventions have emerged as a philosophy of care aimed at protecting and enhancing preterm infant’s development and promoting parental outcomes. In the past two decades, many authors have suggested DC models, core measures, practice guidelines and standards of care but outlined different groupings of interventions rather than specific interventions that can be used in NICU clinical practice. Moreover, as these DC interventions are mostly implemented by neonatal nurses, it would be strategic and valuable to identify specific outcome indicators to make visible the contribution of NICU nurses to DC. By Marjolaine Héon ,1,2 Marilyn Aita ,1,2,3 Andréane Lavallée ,1,3 Gwenaëlle De Clifford-Faugère ,1,3 Geneviève Laporte ,1,3 Annie Boisvert,1,4 Nancy Feeley. Resource Link: https://bmjopen.bmj.com/content/bmjopen/12/1/e046807.full.pdf

This document has been developed for neonates cared for in critical care settings across the Sydney Children’s Hospital Network including the Children’s Intensive Care Unit (CICU - SCH), Edgar Stephens Ward (ESW-CHW), Grace Centre for Newborn Intensive Care (GCNIC – CHW) and Paediatric Intensive Care Unit (PICU – CHW). However neonates cared for throughout the hospital would benefit from this approach to underpin their care. Resource Link: https://resources.schn.health.nsw.gov.au/policies/policies/pdf/2006-0027.pdf

To provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU. Resource Link: https://journals.lww.com/ccmjournal/Fulltext/2017/01000/Guidelines_for_Family_Centered_Care_in_the.12.aspx

This guideline provides recommendations for the skin care of neonates (birth to 28 days of age) of all gestational ages. Additional considerations for preterm neonates and product suggestions are identified in the boxes below each section. Resource Link: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Neonatal___infant_skin_care/

The following neonatal skin care guidelines are based on the 4th Edition of the Association of Women’s Health, Obstetric, and Neonatal Nursing (AWHONN) Neonatal Skin Care Guidelines (2018). Summary information regarding skin assessment, bathing, cord and circumcision care, disinfectants, water loss, use of skin care products and adhesives, skin breakdown and intravenous infiltration are included below. More information can be found in the AWHONN Skin Care Guideline manuals, which are available in the NICU tea. Resource Link: https://www.brighamandwomens.org/assets/BWH/pediatric-newborn-medicine/pdfs/skincare-guidelines.pdfTRILIBIS_EMULATOR_UA=nsclpfpr%2cnsclpfpr%2cnsclpfpr%2cnsclpfpr%2cnsclpfpr%2cnsclpfpr%2cnsclpfpr%2cnsclpfpr

This statement amalgamates and updates two previous Canadian Paediatric Society documents: ‘Going home: Facilitating discharge of the preterm infant’ and ‘Safe discharge of the late preterm infant’ [1][2]. Resource Link: https://cps.ca/en/documents/position/discharge-planning-of-the-preterm-infant

Evidence for engaging patients and families in discharge planning. Resource Link: https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy4/Strat4_Tool_1_IDEAL_chklst_508.pdf

In this section, we present Interdisciplinary Guidelines and Recommendations for Neonatal Intensive Care Unit (NICU) Discharge Preparation and Transition Planning. The foundation for these guidelines and recommendations is based on existing literature, practice, available policy statements, and expert opinions. These guidelines and recommendations are divided into the following sections: Basic Information, Anticipatory Guidance, Family and Home Needs Assessment, Transfer and Coordination of Care, and Other Important Considerations. Each section includes brief introductory comments, followed by the text of the guidelines and recommendations in table format. After each table, there may be further details or descriptions that support a guideline or recommendation. Our goal was to create recommendations that are both general and adaptable while also being specific and actionable. Each NICU’s implementation of this guidance will be dependent on the unique makeup and skills of their team, as well as the availability of local programs and resources. The recommendations based only on expert opinion could be topics for future research. By Vincent C. Smith, Kristin Love and Erika Goyer Resource Link: https://downloads.aap.org/AAP/PDF/NPA%20discharge%20Guidelines%20Final.pdf

This Framework describes the overarching principles to support the delivery of the specific recommendations within Best Start. A number of appendices are included to support implementation, sharing of resources and consistency of practice. It is envisaged that Health Boards and individual units will use this framework to support local service delivery recognising that some variation will occur as a consequence of demographics, and geography. Resource Link: https://perinatalnetwork.scot/neonatal/neonatal-discharge/

This guideline provides advice for neonates above 32 weeks and outside of a neonatal intensive care setting. Resource Link: https://www.rch.org.au/clinicalguide/guideline_index/Neonatal_intravenous_fluids/

Careful fluid and electrolyte management is essential for the well being of the sick neonate. Inadequate administration of fluids can result in hypovolemia, hypersomolarity, metabolic abnormalities and renal failure. In the near term and term neonate excess fluid administration results in generalized edema and abnormalities of pulmonary function. Excess fluid administration in the very low birth weight infant is associated with patent ductus arteriosis and congestive heart failure, intraventricular hemorrhage, necrotizing enterocolitis and bronchopulmonary dysplasia. A rational approach to the management of fluid and electrolyte therapy in term and preterm neonates requires the understanding of several physiologic principles. Resource Link: https://uihc.org/childrens/educational-resources/fluid-management-nicu-handbook

The Florida Neonatal Neurologic Network support the following management guidelines for infants with HIE. We acknowledge a variety of management styles, consensus statements and scientific data exist in this area, however, these Modification 4 State Meeting August 1, 2015 3 guidelines are based on the best available evidence and pooled expert opinions at the time of this document’s creation. Resource Link: https://fn3.sites.medinfo.ufl.edu/files/2015/10/HIE-Supportive-Care-Management-Guidelines-08-1-2015-final1.pdf

Treatment of the sick neonate in specialized neonatal intensive care units (NICU) has been associated with decrease in mortality and morbidity. In the early 1960s, neonatal transport was first used to make intensive care accessible to those neonates who needed it.1 Subsequently, organized emergency neonatal transport systems developed and became an important component in the regionalization of perinatal care.2-5 In utero transfer is the safest transfer but unfortunately, preterm delivery, perinatal illness and congenital malformations cannot always be anticipated, resulting in a continued need for transfer of babies after delivery.6 These babies are often critically ill, and the outcome is partly dependent on the effectiveness of the transport system.7 Facilities for neonatal transport in India are dismal. Most neonates are transported without any pre-transport stabilization or care during transport. Any available vehicle is used, which often takes long hours and place where to take the baby is also not well recognized. There is an acute shortage of neonatal beds and majority of the sick neonate in need of urgent admission are dumped in pediatric wards with inadequate infrastructure. Often, these neonates are shunted from one health facility to another. Resource Link: https://www.ontop-in.org/ontop-pen/Week-12-13/Transport%20of%20sick%20NB%20.pdf

Oxygen is important in the care of newborn infants because many conditions that affect babies in the first days of life can result in low levels of oxygen in the body. Hypoxemia, or low level of oxygen in the blood, is a life-threatening condition that results in increased mortality and morbidity. Prematurity and respiratory distress syndrome (surfactant deficiency), pneumonia and other severe infections, asphyxia and difficulties in the transition from fetal to neonatal life can all result in hypoxemia. Supplemental oxygen is an essential lifesaving treatment. Resource Link: https://www.everypreemie.org/wp-content/uploads/2019/09/SafeOxygen_english_7.6.17.pdf

The aim of this guideline is to describe the indications and procedure for the use of oxygen therapy, and its modes of delivery. Resource Link: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Oxygen_delivery/

Over the past few years there have been significant changes, based on high quality research, in our understanding of how to give the right amount of oxygen to babies, although most research has been in the preterm population. What has emerged is that too little oxygen and too much oxygen can both be harmful, and that ex-preterm babies who are more mature should not be considered to be the same as term babies born at term. Resource Link: https://www.ashfordstpeters.net/Guidelines_Neonatal/Oxygen%20Guideline%20June%202015.pdf

UK guidance for blood services, including component specification, preparation, testing and donor selection for blood and tissues. Aims to define guidelines for all materials produced by the UK Blood Transfusion Services for both therapeutic and diagnostic use, and to reflect an expert view of current best practice, provide specifications of products, and describe technical details of processes. Resource Link: https://www.transfusionguidelines.org/

An exchange transfusion involves removing aliquots of patient blood and replacing with donor blood in order to remove abnormal blood components and circulating toxins whilst maintaining adequate circulating blood volume. It is primarily performed to remove antibodies and excess bilirubin in isoimmune disease, the incidence of exchange transfusion is decreasing secondary to the prevention, and improved prenatal management of alloimmune haemolytic disease and improvements in the management of neonatal hyperbilirubinaemia. Resource Link: https://www.rch.org.au/uploadedFiles/Main/Content/neonatal_rch/EXCHANGE_TRANSFUSION.pdf

Subjects: Evidence-Based Medicine, Hyperbilirubinemia Topics: hyperbilirubinemia, phototherapy, bilirubin, exchange transfusion, whole blood More than 80% of newborn infants will have some degree of jaundice.1,2 Careful monitoring of all newborn infants and the application of appropriate treatments are essential, because high bilirubin concentrations can cause acute bilirubin encephalopathy and kernicterus.3 Kernicterus is a permanent disabling neurologic condition characterized by some or all of the following: choreoathetoid cerebral palsy, upward gaze paresis, enamel dysplasia of deciduous teeth, sensorineural hearing loss or auditory neuropathy or dyssynchrony spectrum disorder, and characteristic findings on brain MRI.4 A description of kernicterus nomenclature is provided in Appendix A. Central to this guideline is having systems in place including policies in hospitals and other types of birthing locations to provide the care necessary to minimize the risk of kernicterus. This article updates and replaces the 2004 American Academy of Pediatrics (AAP) clinical practice guideline for the management and prevention of hyperbilirubinemia in the newborn infant ≥35 weeks’ gestation.3 This clinical practice guideline, like the previous one, addresses issues of prevention, risk assessment, monitoring, and treatment. Resource Link: https://publications.aap.org/pediatrics/article/150/3/e2022058859/188726/Clinical-Practice-Guideline-Revision-Management-of

The purpose of this framework is to give a career pathway to ANNPs working in any level or unit or within the transport setting. This model makes clear how ANNPs can progress outside the limitations of the clinical rota by setting out a variety of career development pathways using the four pillars of advanced practice: clinical practice, leadership and management, education and research. The framework sets out the capabilities expected under each of these pillars at the level of ANNP, Senior ANNP and Consultant Nurse. Resource Link: https://www.bapm.org/resources/300-advanced-neonatal-nurse-practitioner-capabilities-framework

Hypoglycaemia is a leading cause of term admission to neonatal units. In 2016 NHS Improvement and BAPM convened a working group to develop a Framework for Practice to address variation in practices in the definition of hypoglycaemia, the identification, management and admission thresholds of babies admitted to neonatal units for hypoglycaemia, and to promote safer practices that avoid unnecessary separation of mother and baby. This document is aimed at all healthcare professionals involved in the care of infants born at term during the first 48 - 72 hours after birth. The framework should be delivered in partnership with parents. Resource Link: https://www.bapm.org/resources/identification-and-management-of-neonatal-hypoglycaemia-in-the-full-term-infant-birth-72-hours

Resuscitation Council UK (RCUK) has produced these Newborn Life Support Guidelines, based on the International Liaison Committee on Resuscitation (ILCOR) 2020 Consensus on Science and Treatment Recommendations (CoSTR) for Neonatal Life Support. [NLS CoSTR’s 2019 and 2020], and the European Resuscitation Council Guidelines for Newborn resuscitation and support of transition of infants at birth. The guidelines cover the management of the term and preterm infant.   By Joe Fawke Jonathan Wyllie John Madar Sean Ainsworth Robert Tinnion Rachel Chittick Nicola Wenlock Jonathan Cusack Victoria Monnelly Andrew Lockey Sue Hampshire Published May 2021. Resource Link: https://www.resus.org.uk/library/2021-resuscitation-guidelines/newborn-resuscitation-and-support-transition-infants-birth

99nicu provides a platform for sharing expertise and experience regardless of geographical boundaries and time zones. Membership: Open Access Resource - https://99nicu.org

Becoming a trauma informed professional (TIP) begins with unbundling one’s passion, mission, and noble purpose from the myriad of tasks, rituals and routines that often overshadow and overpower one’s presence in the caring moment. The attributes provide a road map for personal and professional growth and development that is the cornerstone for cultural transformation within healthcare and across our global society. ​Membership: Open Access Resources: https://www.courses-caringessentials.net/store/A4b3ZynV Contact: info@caringessentials.net

Our future, anywhere in the world, depends on how well we take care of our newborn and young infants. Health care professionals cannot do this alone. We need a ‘social movement’ to bring together families, medical professionals, charities, government agencies, policy makers, and every member of our society whose heart beats for babies. Membership: Open Access Resource: https://www.globalnewbornsociety.org/

The International Council of Nurses (ICN) is a federation of more than 130 national nurses’ associations (NNAs), representing 28 million nurses worldwide. Founded in 1899, ICN is the world’s first and widest reaching international organization for health professionals. ​Membership: No individual membership must be member of National Organization Access Resource: https://www.icn.ch

The Association is established to promote high quality standards of neonatal practice and care for the benefit of the global public. ​Membership: Fee Access Resource: https://worldneonatology.com/2024/

To enhance the quality of neonatal screening and medical services through dissemination of information, guidelines and best practices that benefit all family members and their babies by helping to ensure protection of babies from life-quality threatening conditions, such as phenylketonuria, congenital hypothyroidism, severe combined immunodeficiency, cystic fibrosis, hemoglobinopathies and many others. Membership: Tiered Fee Access Resource: https://www.isns-neoscreening.org

ISA’s mission is to raise awareness and promote global collaboration for the prevention of stillbirth and newborn death and provision of appropriate respectful care for all those affected. ​Membership: Tiered Fee Access Resource: https://www.stillbirthalliance.org/organization_card/sands-stillbirth-and-neonatal-death-society/

The National Association of Neonatal Therapist (NANT) is the professional organization that serves neonatal occupational therapists, physical therapists, and speech-language pathologist. ​Membership: Fee Access Resource: https://neonataltherapists.com/#

We are an international alliance united to end preventable newborn deaths in African hospitals. Membership: Open Access Resource: https://nest360.org/

Based on a mnemonic to optimize learning, retention and recall of information, S.T.A.B.L.E. stands for the six assessment and care modules in the program: Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support. A seventh module, Quality Improvement, stresses communication and teamwork as well as the professional responsibility of evaluating care provided to sick infants, with the ultimate goal of improving future care. First introduced in 1996 in the US and Canada, S.T.A.B.L.E. has grown internationally to include instructor training and courses in more than 45 countries. Currently, there are more than 722,762 neonatal healthcare providers have completed a S.T.A.B.L.E. Learner course. ​Membership: Must pay for training Access resource: https://stableprogram.org/about/s-t-a-b-l-e-program-modules/ Contact: Kristine Karlsen, PhD, APRN, NNP-BC, FAAN. Send an inquiry

The Quality Improvement integrated Kangaroo Mother Care (QIiKMC) learning program enables an interactive process to assist healthcare professionals implement a program to help mothers (and other family members) learn how to provide kangaroo mother care with their small baby. Further information available by clicking on https://www.cnf-fnc.ca/programs/quality-improvement-integrated-kangaroo-mother-care includes an introductory video and learning materials which are available without charge and which may be shared with others. ​Access Resource: https://www.cnf-fnc.ca/programs/quality-improvement-integrated-kangaroo-mother-care

ABM is a global community of medical doctors and affiliates with diverse backgrounds, experiences, perspectives, and specialties. Through its worldwide membership, peer-reviewed journal, Fellowship in Breastfeeding Medicine, Annual International Meeting, and partnerships with other organizations, ABM has created a network of experts and advocates to drive medicine forward in this crucial area. ​Membership: Cost Access Resource: https://www.bfmed.org/

improves the future for all infants in hospitals and their families with individualized, developmental, family-centered, research-based NIDCAP care. Membership: Cost Access Resource: https://nidcap.org

With our work we are calling attention to the growing challenge of preterm birth and its significant impact on the children, families and our society. We want to reduce the enormous health and social inequalities linked to preterm birth. ​Membership: Free Access Resource: https://www.efcni.org/activities/projects/escnh/

The iKMC News series by the American Academy of Pediatrics through funding from the Bill and Melinda Gates Foundation, and in collaboration with the World Health Organization, other implementing organisations and several national professional societies, showcases a series of webinars aimed at promoting new evidence on immediate Kangaroo Mother Care (iKMC). This series features global experts in iKMC and small and sick newborn care supporting a global paradigm shift of zero separation for mothers and babies with a goal to improve quality of care and outcomes for small and sick newborns. Access resource: https://www.aap.org/en/aap-global/immediate-kangaroo-mother-care-ikmc/

To highlight the benefits and planning required for implementing effective KMC initiatives, we encourage you to read through the KMC related material collated by the Newborn toolkit team. ​Access resource in English: https://newborntoolkit.org/toolkit?language=en Access resource in French: https://www.newborntoolkit.org/toolkit?language=fr

Following the WHO iKMC study, India introduced the first ward to provide iKMC health services at the hospital where the trial was conducted in new Dehli. ​Access resource: https://www.youtube.com/watch?v=TlV6B1y4Fs4

This action-focused guide brings together existing resources and practical guidance to inform planning, investments and programmes aimed at ending preventable stillbirths and improving care for all women and families who experience stillbirth. It also highlights case studies from a wide range of contexts to showcase what can be achieved. Access resource: https://www.stillbirthalliance.org/global-advocacy-and-implementation-guide/

One place for all our frameworks, resources and policies. ​Access resources: https://www.bapm.org/pages/191-resources

We’re here to support parents and families of premature or sick babies ​Access website: https://www.bliss.org.uk/

USAID envisions a world where all women, newborns, and children survive, are healthy, and able to develop and reach their full potential, contributing to the development of their communities and countries. ​Access resources: https://www.usaid.gov/PreventingChildAndMaternalDeaths 'Where We Work' map: https://www.usaid.gov/global-health/health-areas/maternal-and-child-health/priority-countries

INVESTING IN THE NURSING WORKFORCE FOR HEALTH SYSTEM EFFECTIVENESS ​Access resources: https://www.icn.ch/sites/default/files/2023-07/ICN_Recover-to-Rebuild_report_EN.pdf

THE GLOBAL NURSING WORKFORCE AND THE COVID-19 PANDEMIC ​Access resources: https://www.icn.ch/sites/default/files/2023-04/Sustain%20and%20Retain%20in%202022%20and%20Beyond-%20The%20global%20nursing%20workforce%20and%20the%20COVID-19%20pandemic.pdf

Investing in education, jobs and leadership. Access resources: https://www.icn.ch/sites/default/files/2023-04/WHO-SoWN-English%20Report-0402-WEB-LOW%20RES_2020.pdf

Adopted in 2015 by the United Nations, the 17 Sustainable Development Goals (SDGs) encompass a broad range of sustainable development issues for the world, such as ending poverty, hunger, improving health and education, combating climate change and many others. ​Access resources: https://www.icnvoicetolead.com/sdgs/#:~:text=Adopted%20in%202015%20by%20the,climate%20change%20and%20many%20others.

WHO is the United Nations agency that connects nations, partners and people to promote health, keep the world safe and serve the vulnerable – so everyone, everywhere can attain the highest level of health. Access: https://www.who.int ​Global Patient Safety Plan - https://www.who.int/teams/integrated-health-services/patient-safety/policy/global-patient-safety-action-plan The WHO Global Strategic Directions for Nursing and Midwifery (2021-25) - https://www.who.int/publications/i/item/9789240033863

This toolkit brings together readings, tools and learnings for implementers to act, use, share and learn. ​Access resource: https://newborntoolkit.org/?language=en

Each newborn requires respectful and quality care, according to their health condition. This course is aimed at those professionals with the capacity to make decisions related to healthcare management of newborns, based on evidence, at the different levels of supervision, direction and stewardship of the service network. ​Access resource in Spanish: https://campus.paho.org/es/curso/calidad-cuidado-recien-nacidos

For the past six years, USAID’s flagship global maternal, newborn, and child health project, MOMENTUM, has been on the frontlines, shifting the design and implementation of health solutions to those best equipped to drive positive change within their own communities. MOMENTUM channels funding directly to local partners, promotes space for local actors in global dialogues and forums, and prioritizes strengthening the capacity of local institutions—truly putting our localization policy into practice. Read five lessons on what makes locally led development truly work—and what doesn’t, from USAID’s MOMENTUM Project Partners. ​Read the story: https://www.workwithusaid.gov/blog/five-lessons-in-locally-led-development-perspectives-from-usaid-s-momentum-project-partners Related resources Explore Localization at USAID: The Vision and Approach Read the FY 22 Localization Progress Report: Moving Toward a Model of Locally Led Development Learn more about USAID MOMENTUM: Explore the website

The Council of International Neonatal Nurses (COINN) and Project HOPE have collaborated on the development of a Landscape Analysis that attempts to examine the extent of specialized neonatal nursing education programs across Africa. This analysis is aligned with the WHO strategy 4: Create and train a new cadre of specialized neonatal nurses and examine the extent to which Neonatal Bachelor and Master degree programs are in existence or in development that aim to prepare this cadre in sub-Saharan Africa. With the establishment of the COINN Global Technical Advisory Committee (GTAC) and Community of Practice (CoP)-specifically the Community of Neonatal Nursing Practice (CoNP), funded by the Gates Foundation, it was recommended that GTAC, in collaboration with Project HOPE, provide an update anddescription on the existing neonatal nursing degrees as well as identification of developing programs in Africa. A previous analysis was initiated in 2021 by Project HOPE and COINN but was limited due to existing resources. The experience from this earlier analysis was helpful to meeting the challenges of the current more extensive analysis. ​ Results Report: Download