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Objective This study aimed to characterize the spiritual beliefs, practices, and needs of parents of very preterm infants, those born <32 weeks of gestation, in a level-III NICU and to characterize parental perception of the spiritual support received in the neonatal intensive care unit (NICU). Study Design Within 14 days of their infants' birth, parents underwent a recorded semistructured interview. Responses were organized into unique themes using standard qualitative methods. Parents completed the Spiritual Involvement and Beliefs Scale (SIBS) and Spiritual Needs Inventory (SNI). Results Twenty-six parents from 17 families were interviewed and provided SIBS and SNI surveys. Interviews yielded seven major themes describing parents' spirituality and support. Most parents identified themselves as spiritual (n = 14) or sometimes spiritual (n = 2). A high SIBS score was associated with Christian religion (p = 0.007) and non-White race (p = 0.02). The SNI showed ≥80% of parents reported a "frequent" or "always" need for laughter, being with family, thinking happy thoughts, and talking about day-to-day things. The most commonly mentioned sources of spiritual support were parents' connection with a higher power through their faith (n = 12) or religious activities (n = 8). Many parents reported receiving sufficient spiritual support outside of the hospital during their unique experience in the NICU. Conclusion Parents of infants born <32 weeks of gestation in our NICU commonly self-identified themselves as spiritual. Many parents have similar spiritual needs which are often met by sources outside of the hospital. Key Points Parents of infants born <32 weeks of gestation in our NICU commonly self-identify as spiritual. Many parents of preterm infants describe their spirituality as a personal experience. Many parents of preterm infants have similar spiritual needs. Many parents of preterm infants have their spiritual needs met outside of the hospital. [ABSTRACT FROM AUTHOR]

Objective The study aimed to assess in a prospective randomized study the effect of Mozart's music on time to regain birth weight (BW) and development of oral feeding skills in babies born between 28 0/7 and 31 6/7 weeks of gestation. Study Design Healthy premature infants born between 28 0/7 and 31 6/7 completed weeks of gestation were randomized within 3 days of birth to either music or no music exposure. Infants in the music group were exposed to Mozart's double piano sonata twice per day for 14 days. The primary outcome was time to regain birth weight. The secondary outcome was development of oral feeding skills as evaluated by a speech/language pathologist blinded to the intervention. We hypothesized that exposure to Mozart's double piano sonata would decrease time to regain BW and improve feeding skills. A total of 32 newborns were needed to detect a 3-day difference in time to regain BW. Results Forty infants were enrolled and randomized. There were no significant differences between the two groups regarding the time to regain BW (p = 0.181) and the time to achievement of full oral feeds (p = 0.809). Conclusion Exposure to Mozart's double piano sonata for 14 days after birth did not significantly improve time to regain BW or time to achieve full oral feedings in very premature infants. It is possible that Mozart's music has no effect or that the duration of music exposure was not sufficient to have a physiologic effect on growth and oral feeding skills. Key Points Classical music improves the medical condition of adults. Music decreases neonatal resting energy expenditure. Music exposure did not significantly impact weight gain. This clinical relevance warrants further evaluation. [ABSTRACT FROM AUTHOR]

Objective  This study aimed to determine if formula selection, low lactose versus standard term formula, has an effect on outcomes with a comparison to breastfed infants. Study Design  Retrospective cohort study of neonates ≥35 weeks gestation born with Neonatal Abstinence Syndrome (NAS) was conducted from July 2014 to November 2016. Primary outcomes included length of pharmacologic treatment (LOT), and length of stay (LOS), and weight change per day comparing term standard and low lactose formula majority feeding infants with secondary outcomes comparing breast fed majority feeding infants. Results  After investigating feeding methods for 249 NAS infants, a direct comparison of formula groups showed no differences in LOS (3, 95% confidence interval [CI]: −1.1 to 7 days), LOT (3.9, 95% CI: −0.4 to 8.1 days), or weight change per day (−2.4, 95% CI: −11.7 to 6.9 g/day). Breastfeeding improved LOT by 6.9 (95% CI: 3.4–10.5) and 10.8 days (95% CI: 5.9–15.6) and LOS by 7.4 (95% CI: 4.1–10.7) and 10.3 (95% CI: 5.8–14.9) days all reaching significance, in comparison to term and low lactose formula groups, respectively. Weight change per day was greater in the breast versus formula feeding groups when compared individually. Conclusion  We detected no benefit to low lactose formula in NAS infants. Breastfeeding is associated with clinical reduction in LOS and LOT but is associated with increased weight loss. Key Points Best formula choice for a neonatal abstinence syndrome (NAS) infant is unknown. Many NAS moms cannot breastfeed. Low lactose formula has no impact on NAS outcomes. [ABSTRACT FROM AUTHOR]

Abstract Background The purpose of this study was to characterize total homocysteine (tHcy) levels at birth in preterm and term infants and identify associations with intraventricular hemorrhage (IVH) and other neonatal outcomes such as mortality, sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and thrombocytopenia. Methods 123 infants < 32 weeks gestation admitted to our Level III nursery were enrolled. A group of 25 term infants were enrolled for comparison. Two blood spots collected on filter paper with admission blood drawing were analyzed by a high performance liquid chromatography (HPLC) method. Statistical analysis included ANOVA, Spearman's Rank Order Correlation and Mann-Whitney U test. Results The median tHcy was 2.75 μmol/L with an interquartile range of 1.34 – 4.96 μmol/L. There was no difference between preterm and term tHcy (median 2.76, IQR 1.25 – 4.8 μmol/L vs median 2.54, IQR 1.55 – 7.85 μmol/L, p = 0.07). There was no statistically significant difference in tHcy in 31 preterm infants with IVH compared to infants without IVH (median 1.96, IQR 1.09 – 4.35 μmol/L vs median 2.96, IQR 1.51 – 4.84 μmol/L, p = 0.43). There was also no statistically significant difference in tHcy in 7 infants with periventricular leukomalacia (PVL) compared to infants without PVL (median 1.55, IQR 0.25 – 3.45 μmol/L vs median 2.85, IQR 1.34 – 4.82 μmol/L, p = 0.07). Male infants had lower tHcy compared to female; prenatal steroids were associated with a higher tHcy. Conclusion In our population of preterm infants, there is no association between IVH and tHcy. Male gender, prenatal steroids and preeclampsia were associated with differences in tHcy levels.

Objective: To determine if infants diagnosed with urinary tract infection (UTI) in the neonatal intensive care unit (NICU) require a routine voiding cystourethrogram (VCUG).Study Design: Retrospective data analysis from three centers for infants admitted to the NICU born between 2000 and 2013 and diagnosed with UTI.Results: One hundred twenty-six infants from three centers were diagnosed with UTI during their hospitalization. Renal ultrasound (RUS) was performed in 115 infants (91.2%), of which 69 (60%) were abnormal. Mild to moderate hydronephrosis or pelviectasis were the most common abnormalities identified (n = 34, 30%). There were 14 infants (12%) with severe abnormalities on RUS. VCUG was performed in 71 infants (56%), of which 3 (4%) were interpreted as abnormal with grade 2 vesicoureteral reflux (VUR) or less (two infants were with normal RUS and one infant was with abnormal RUS).Conclusions: More than 50% of infants with a UTI had an abnormal RUS but severe abnormalities were found only in 11% of infants. Only 4% of infants with UTI had VUR; none of these infants had severe VUR on VCUG. A routine VCUG after UTI in the NICU has a low yield and may be reserved for infants with severe or persistent abnormalities on RUS. [ABSTRACT FROM AUTHOR]