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Care and outcomes of infants admitted to neonatal intensive care vary and differences in family-centered care may contribute. The objective of this study was to understand families' experiences of neonatal care within a framework of family-centered care. We conducted focus groups and interviews with 18 family members whose infants were cared for in California neonatal intensive care units (NICUs) using a grounded theory approach and centering the accounts of families of color and/or of low socioeconomic status. Families identified the following challenges that indicated a gap in mutual trust and power sharing: conflict with or lack of knowledge about social work; staff judgment of, or unwillingness to address barriers to family presence at bedside; need for nurse continuity and meaningful relationship with nurses and inconsistent access to translation services. These unmet needs for partnership in care or support were particularly experienced by parents of color or of low socioeconomic status.

The National Perinatal Association (NPA) is an interdisciplinary organization that strives to be a leading voice for perinatal care in the United States. Our diverse membership is comprised of healthcare providers, parents & caregivers, educators, and service providers, all driven by their desire to give voice to and support babies and families at risk across the country. Members of the NPA write a regular peer-reviewed column in Neonatology Today. [ABSTRACT FROM AUTHOR]

The article focuses on the National Perinatal Association that is an interdisciplinary organization that strives to be a leading voice for perinatal care in the United States. Topics include examines diverse membership is comprised of healthcare providers, parents & caregivers, educators and service providers all driven by their desire to give voice to and support babies and families at risk across the country.

The article focuses on new strategies to prevent Respiratory Syncytial Virus (RSV) infection in infants, particularly the FDA-approved RSV monoclonal antibody, nirsevimab, and maternal vaccination during the last trimester. Topics include the duration and benefits of nirsevimab, comparison with Synagis™, and the importance of preventive measures like good handwashing and isolation to defend against RSV.

Recruitment is now actively taking place for a study of an online educational program for Neonatal Fellows being conducted through an interprofessional collaboration between teams from the National Perinatal Association, Stanford University Medical School Division of Neonatology and Department of Child Psychiatry, and the NICU Parent Network. The goal of the 2-hour program is to meet the recommendations issued by both the American Board of Pediatrics (ABP) and the Accreditation Council in Graduate Medical Education (ACGME) with respect to trainee education in behavioral and mental health. The development team from Stanford includes Dr. Melissa Scala, neonatologist; Dr. Soudabeh Givrad, mother-infant dyadic psychiatrist; and Dr. LaTrice Dowtin, NICU psychologist. Together with Dr. Sue Hall of NPA and Keira Sorrells of the NICU Parent Network, they revised NPA's original Caring for Babies and Their Families course, which was recently shown to be effective at improving nurses' knowledge and confidence in providing psychosocial support to NICU families. (1) The redesigned course for Neonatal Fellows, NICU attending physicians, and Neonatal Nurse Practitioners is both shorter than the original course, and more dense, with virtually each learning point footnoted with a reference from current literature. Comprehensive bibliographies accompany each course. There are also interactive cases which encourage learners to put their skills into practice in common bedside communication scenarios with distressed parents. [ABSTRACT FROM AUTHOR]

Background: Early speech experiences have been proposed to contribute to the development of brain structures involved in processing spoken language. However, previous research has been limited to correlational studies. Here, we conducted an RCT with preterm neonates to determine whether increased exposure to maternal speech during NICU hospitalization is causally linked to structural white matter maturation., Methods: We enrolled 46 preterm neonates (24-31 weeks gestational age). Participants were randomly assigned to receive increased (T: n=21) or routine (C: n=25) exposure to mother's speech. The T-group heard 10-minute audio recordings of their mothers reading a children's story two times/hour between 10pm-6am, increasing speech exposure by 2.67 hours/day. At near-term-equivalent age, we obtained two high-angular resolution diffusion MRI (scan 1 bvalue=700, scan 2 bvalue=1500) and quantitative T1 relaxometry scans. We assessed mean diffusivity (MD), pre-registered primary outcome ( NCT02847689 ), of the left and right arcuate fasciculus, tracts implicated in language processing. Secondary outcomes included fractional anisotropy (FA) and R1 (1/T1)., Findings: T- and C-groups were equivalent on medical and demographic variables. Compared to the C- group, the T-group demonstrated significantly lower MD in the left (scan 1: mean difference Δ = 0.11, 95% CI:0.03 - 0.19; scan 2: Δ = 0.13, 95% CI:0.04 - 0.21) but not right arcuate (scan 1: Δ = 0.06, 95% CI: -0.23 - 0.15; scan 2: Δ = 0.05, 95% CI:-0.05 - 0.13). The T-group also demonstrated significantly higher FA (scan 1: Δ = - 0.02, 95% CI:-0.04 - -0.00; scan 2: Δ = -0.03, 95% CI:-0.06 - -0.00) and R1 ( Δ = -0.02, 95% CI:-0.04 - -0.01) in the left but not right arcuate., Interpretation: Preterm neonates who experienced increased exposure to maternal speech during hospitalization demonstrated more mature microstructure of the left arcuate. Findings provide evidence for a causal link between speech experiences and brain development. Increasing speech exposure in the NICU may benefit preterm children., Research in Context Panel: Evidence before this study: Observational studies document the importance of early speech experience for language learning and brain development in term and preterm children. Children born preterm are at-risk for adverse language outcomes that have been attributed to alterations in brain development from limited exposure to speech in the neonatal intensive care unit (NICU). However, evidence that early speech experiences causally effect the development of brain structures relevant for language is lacking. Added value of this study: The Listening to Mom in NICU study is the first randomized controlled trial specifically designed to test the causal effects of maternal speech exposure on white matter brain development in neonates born preterm. This study demonstrates that speech experiences during neonatal development directly contribute to the maturation of the left arcuate fasciculus, a white matter tract implicated in language. Implications of all the available evidence: Study findings advance understandings for how early speech experiences contribute to neonatal brain development. This study also demonstrates that increasing exposure to speech via audio recordings among infants born preterm could serve as an inexpensive and scalable intervention to support recovery from alterations in brain development related to the NICU experience.

Objective: Children born preterm, especially those born very preterm (<32 weeks of gestational age [GA]) are at risk for poor growth and adverse neurodevelopmental outcomes. Adverse growth and neurodevelopmental outcomes in preterm children have been attributed, in part, to the aversive sounds and relative speech paucity of the neonatal intensive care unit (NICU). Experimental studies that directly expose preterm infants to speech sounds in the NICU find significant improvements in health factors relevant to neurodevelopment. Few studies have examined whether natural variations in the speech environment of the NICU are related to short-term health outcomes in preterm infants. Such data are important for optimizing the sound environment of the NICU. Our objective was to examine relations between the NICU speech environment and the rate of weight gain during hospitalization., Study Design: Participants were infants born very preterm ( n  = 20). The speech environment of each infant was assessed at 32 to 36 weeks of postmenstrual age using an automatic speech-counting device. Average rates of weight gain (g/kg/d) were ascertained over the same period. Calories were derived from charted intake (kcals/kg/d). Linear regressions examined caloric intake and speech counts as predictors of infant weight gain., Results: Infant weight gain was significantly predicted by caloric intake and speech exposure, each uniquely accounting for approximately 27% variance (total R 2  = 60.2%; p  < 0.001). Speech counts were uncorrelated with rates of family visitation, time in incubator, or health acuity., Conclusion: While future research should establish causality and direction of effects, enhancing speech exposure in the NICU may be beneficial for physical growth. NICU care plans should consider opportunities to increase speech exposure., Key Points: · Preterm infants who experienced greater amounts of speech in the NICU gained significantly more weight than preterm infants who were exposed to lower amounts of speech during the same developmental period (32-36 weeks of postmenstrual age).. · Caloric intake and speech counts accounted for almost 60% of variance in infant weight gain between 32 and 36 weeks of postmenstrual age.. · Speech counts were not significantly correlated with family visitation, how long infants resided in incubators, or health acuity.. · Findings suggest that the NICU speech environment may play an important role in the physical health of preterm infants; however, more studies are needed to determine the directionality of the observed associations.., Competing Interests: None declared., (Thieme. All rights reserved.)

Objective: This article evaluates the morbidity of infants born via assisted reproductive technology (ART) compared with matched naturally conceived infants., Study Design: This is a retrospective review of maternal and infant data among inborn infants conceived via ART and matched control infants born at 30 to 34 weeks' gestational age (GA) between 2006 and 2012. Data were analyzed using paired t -test or Wilcoxo-Mann-Whitney test for continuous and Fisher's exact test for categorical variables. p -Value of < 0.05 was considered significant., Result: Of 120 study infants, 60 were conceived via ART and 60 naturally. Control infants were matched for GA, gender, race, and multiple gestations. ART infants required more respiratory support and took longer to reach full feeds compared with control infants., Conclusion: Infants born via ART are physiologically more immature with more intensive care needs than naturally conceived infants of similar gestation, potentially increasing health care costs. This immaturity should be considered when planning early delivery in these pregnancies., Competing Interests: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)