%0 Journal Article %J J Perinat Neonatal Nurs %D 2017 %T Longitudinal Responses to Weighing and Bathing Procedures in Preterm Infants. %A Bembich, Stefano %A Fiani, Giulia %A Strajn, Tamara %A Sanesi, Cecilia %A Demarini, Sergio %A Sanson, Gianfranco %K Baths %K Body Weight %K Female %K Humans %K Infant Behavior %K Infant Care %K Infant, Newborn %K Infant, Premature %K Male %K Neonatal Nursing %X

Knowledge of the effects of nursing-induced stress on short-term outcomes in preterm infants is limited. Effects of 2 standard nursing procedures-weighing and bathing-on autonomic and motor stability of preterm infants were studied during their hospitalization. Outcomes were evaluated during and after the procedures. Eleven preterm infants were observed between 32 and 35 weeks' postmenstrual age (PMA) (postnatal days range: 4-63). Neonatal responses were assessed according to the Synactive Theory of Development and nursing was performed taking into account Newborn Individualized Developmental Care and Assessment Program (NIDCAP) principles. Effects of the studied nursing procedures on infants' stability during and after their execution were evaluated by nonparametric statistics. During monitored procedures, stress responses in autonomic and motor systems were observed at all PMAs. However, after 32 weeks' PMA, preterm infants also showed an autonomic and motor stability recovery 5 minutes after procedure completion. Contrary to our hypothesis, preterm infants showed to be stressed by weighing and bathing procedures up to 35 weeks' PMA. However, if facilitated and supported after nursing conclusion by interventions such as swaddling and nesting, according to NIDCAP principles, they recovered autonomic and motor stability by 5 minutes after ending procedures.

%B J Perinat Neonatal Nurs %V 31 %P 67-74 %8 2017 Jan/Mar %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/28121761?dopt=Abstract %R 10.1097/JPN.0000000000000228 %0 Journal Article %J Arch Dis Child Fetal Neonatal Ed %D 2015 %T Cerebral oxygenation with different nasal continuous positive airway pressure levels in preterm infants. %A Bembich, Stefano %A Travan, Laura %A Cont, Gabriele %A Bua, Jenny %A Strajn, Tamara %A Demarini, Sergio %K Cerebrovascular Circulation %K Continuous Positive Airway Pressure %K Female %K Hemoglobins %K Humans %K Infant, Newborn %K Infant, Premature %K Intensive Care, Neonatal %K Male %K Nasal Cavity %K Oxygen %K Oxygen Consumption %K Oxyhemoglobins %K Spectroscopy, Near-Infrared %X

OBJECTIVES: This study evaluates the effect of varying nasal continuous positive airway pressure (NCPAP) level on cerebral blood flow (CBF) and oxygenation in preterm infants.

METHODS: Oxy-haemoglobin (HbO2) and total haemoglobin (HbTot), as CBF estimates, and the ratio between HbO2 and HbTot (HbO2/HbTot), as cerebral oxygenation estimate, were assessed by near-infrared spectroscopy in 26 stable preterm newborns at a postmenstrual age between 26 and 33 weeks. Baseline HbO2, HbTot and HbO2/HbTot values were initially collected with NCPAP at 5 cm H2O and then compared with values obtained with NCPAP levels at both 3 and 8 cm H2O.

RESULTS: Compared with 5 cm H2O, cerebral HbO2, HbTot and HbO2/HbTot remained unchanged both after increasing (to 8 cm H2O) and decreasing (to 3 cm H2O) the NCPAP level. This result was observed both in regional areas (24 sites) and in the overall monitored area (frontal and parietal cortex). Compared with 8 cm H2O, peripheral oxygen saturation significantly decreased at 3 cm H2O (p=0.021). Heart rate did not change.

CONCLUSIONS: No differences in CBF and cerebral oxygenation were observed with NCPAP levels in the range 3-8 cm H2O despite a decrease in peripheral oxygenation with 3 cm H2O.

%B Arch Dis Child Fetal Neonatal Ed %V 100 %P F165-8 %8 2015 Mar %G eng %N 2 %1 http://www.ncbi.nlm.nih.gov/pubmed/25336677?dopt=Abstract %R 10.1136/archdischild-2014-306356 %0 Journal Article %J J Hum Lact %D 2015 %T Making the first days of life safer: preventing sudden unexpected postnatal collapse while promoting breastfeeding. %A Davanzo, Riccardo %A De Cunto, Angela %A Paviotti, Giulia %A Travan, Laura %A Inglese, Stefania %A Brovedani, Pierpaolo %A Crocetta, Anna %A Calligaris, Chiara %A Corubolo, Elisa %A Dussich, Valentina %A Verardi, Giuseppa %A Causin, Enrica %A Kennedy, Jaquelyn %A Marrazzo, Francesca %A Strajn, Tamara %A Sanesi, Cecilia %A Demarini, Sergio %X

Early and prolonged skin-to-skin contact (SSC) after birth between a mother and her newborn has been shown to generate beneficial effects on the mother-infant relationship and breastfeeding. Close mother-infant body contact immediately after birth positively enhances exclusive breastfeeding during the hospital stay, with a dose-response relationship. Skin-to-skin contact may ease the infant's transition to extra-uterine life and helps regulate the infant's body temperature and nursing behavior. However, reports of sudden unexpected postnatal collapse (SUPC) soon after birth, in healthy term neonates, in association with SSC, have raised concerns about the safety of this practice. Based on available evidence, we developed a surveillance protocol in the delivery room and postnatal ward of the Institute for Maternal and Child Health of Trieste (Italy). The aim of our protocol is (a) to promote safe mother and infant bonding and (b) to establish successful breastfeeding, without increasing the risk of SUPC. As there is no known effective intervention to prevent SUPC, our protocol has been conceived as a potential best practice.

%B J Hum Lact %V 31 %P 47-52 %8 2015 Feb %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/25339551?dopt=Abstract %R 10.1177/0890334414554927 %0 Journal Article %J J Hum Lact %D 2014 %T From tube to breast: the bridging role of semi-demand breastfeeding. %A Davanzo, Riccardo %A Strajn, Tamara %A Kennedy, Jacqueline %A Crocetta, Anna %A De Cunto, Angela %X

Determination of the optimal timing of breastfeeding initiation for preterm infants is still a challenge for health professionals. Often unjustified delays and restrictions of breastfeeding occur due to non-evidence-based current opinions about preterm infants' feeding capacity. Semi-demand feeding has been proposed for preterm infants during the transition from scheduled to full demand feeding, to promote the establishment of self-regulated oral feeding. Although semi-demand feeding has been shown to be safe and effective in reducing time to reaching oral feeding, the implementation of this feeding pattern for preterm infants in the neonatal intensive care unit (NICU) is still limited. We developed a protocol for the application of semi-demand feeding in preterm infants based on the existing knowledge of preterm infant neurodevelopment and NICU organization and staff experience. The protocol's aim is to attain successful transition from tube feeding to breastfeeding. In this article, we describe the protocol used in the neonatal unit of the Maternal and Child Health Institute of Trieste, a third level care center in northeastern Italy.

%B J Hum Lact %V 30 %P 405-9 %8 2014 Nov %G eng %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/25172892?dopt=Abstract %R 10.1177/0890334414548697