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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-sleep.pdf
December 13, 2013 - NICU Family Information Packet, Appendix B, Sleep in Preterm Infants
Sleep in Preterm Infants
SIDS … ■ Newborn infant spends 2/3 of each day asleep; by 6 months only half of each day is spent
asleep … Cognitive Development
■ Development of sleep-wake cycles likely has major impact on development of most infant … ■ Term infants who sleep for long, quiet periods early in the night and infants who sleep for
longer … ■ To help the infant’s state regulation, swaddle the infant, keeping the infant’s arms and legs
close
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www.cpsi.ahrq.gov/research/findings/nhqrdr/chartbooks/blackhealth/part2-infmat.html
June 01, 2018 - Groups With Disparities:
In all years, Black infants were more likely than White infants to be low … Among all maternal age groups, Black infants were more likely than White infants to be low birth weight … Live-Born Infants With Very Low Birth Weight
Live-born infants with very low birth weight (less than … Infant Mortality
Infant mortality per 1,000 live births, all birth weights, by race, 2003-2012, and … White infants.
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-nephro.pdf
December 13, 2013 - ■ Incidence in very low-birthweight infants (BW<1500g) ranges from 16-64%. … in healthy infants … ■ Blood pressure: Not higher in infants with nephrocalcinosis, but overall higher in preterm
infants … than in healthy term infants … ■ Do NOT stop the use of high-calcium containing infant formulas.
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-growth.pdf
December 13, 2013 - ■ After infant reaches term corrected gestational age, a standard growth chart may be used. … Catch-up growth usually occurs when an infant
reaches between 5th to 10th percentile on growth chart … – Catch-up growth minimizes the differences between term and preterm infant, usually by
12-18 months … ■ Premature infants who are IUGR or infants who are SGA demonstrate less catch-up growth
and higher … Weight
■ Weight gain of 20-30 g/day is desirable in preterm infants (>2 kg).
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-formula.pdf
December 13, 2013 - Information Packet, Appendix B, Formula Feedings
Formula Feedings
We recommend breastfeeding for all infants … ■ Soy formulas are not recommended for preterm infants due to an increased incidence of
osteopenia … ■ Preterm infants on iron fortified premature transitional formula should be given multivitamin
( … ■ Preterm infants receiving an iron fortified term formula should be given multivitamin (0.5mL/
day … Transitional formula may result in greater weight gain, linear growth, and bone mineralization
than term infant
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-anemia.pdf
December 13, 2013 - ■ Anemia is more profound and occurs earlier in premature infants due to:
– Blood loss from sampling … – Short survival time of RBC’s (40-60 days compared to adult 120 days, and term infant
60-80 days … – Relatively more rapid rate of growth than in term infants. … ■ Infants with significant respiratory disease or congenital heart disease may need a hematocrit … ■ Infants with a hematocrit <25 gm% and symptoms may require red blood cell transfusion.
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www.cpsi.ahrq.gov/patient-safety/settings/hospital/resource/nicu/packet/apb3.html
December 01, 2013 - Keep the tube open for a short time after feedings, to allow infant to "burp." … After infant reaches term corrected gestational age, a standard growth chart may be used. … Catch-up growth usually occurs when an infant reaches between 5 th to 10 th percentile on growth chart … Catch-up growth minimizes the differences between term and preterm infant, usually by 12-18 months of … Fetal-Infant Growth Chart for Preterm Infants
©2003 Fenton; licensee BioMed Central Ltd.
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-breastmilk.pdf
December 13, 2013 - Information Packet, Appendix B, Breast Milk
Breast Milk
Benefits
■ Optimal food for almost all infants … ■ Has been shown to improve subsequent mental development in term/preterm infants as well
as provide … ■ Premature infants with BW<1800-2000g are supplemented with human milk fortifier while
hospitalized … ■ Infants <34 weeks or BW<1800g should receive a multivitamin (1mL/day) and an iron
supplement (2 … ■ All term breastfeeding infants should receive Vitamin D (400 IU/day) as 1mL of MVI.
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-apnea.pdf
December 13, 2013 - seconds, or a pause that is accompanied by bradycardia (heart
rate <100 bpm), cyanosis, or pallor in an infant … ■ Can persist for many weeks in very preterm infants, although resolution typically occurs by 37- … 43 weeks PMA (resolution tends to be later for extremely low-birthweight infants) … Home Treatment
■ Most infants still having apnea are kept hospitalized; few may be discharged home. … after discontinuing
methylxanthine therapy before sending an infant home without a monitor
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www.cpsi.ahrq.gov/patient-safety/settings/hospital/resource/nicu/packet/apb.html
December 01, 2013 - Short survival time of RBC's (40-60 days compared to adult 120 days, and term infant 60-80 days). … seconds, or a pause that is accompanied by bradycardia (heart rate <100 bpm), cyanosis, or pallor in an infant … after discontinuing methylxanthine therapy before sending an infant home without a monitor. … in healthy infants. … Do NOT stop the use of high-calcium containing infant formulas.
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb.pdf
December 10, 2013 - – Short survival time of RBC’s (40-60 days compared to adult 120 days, and term infant
60-80 days … after discontinuing
methylxanthine therapy before sending an infant home without a monitor … ■ Do NOT stop the use of high-calcium containing infant formulas. … – Bayley Infant Neurodevelopmental Screener.
– Battelle Developmental Inventory. … – Keep the tube open for a short time after feedings, to allow infant to “burp.
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www.cpsi.ahrq.gov/patient-safety/settings/hospital/resource/nicu/packet/apb2.html
December 01, 2013 - Screening tests requiring direct examination of the infant:
Denver-II Screening Test. … Bayley Infant Neurodevelopmental Screener.
Battelle Developmental Inventory. … Position infant with blanket under shoulders to extend neck slightly for visualization. … Keep the tube open for a short time after feedings, to allow infant to "burp." … Fetal-Infant Growth Chart for Preterm Infants
©2003 Fenton; licensee BioMed Central Ltd.
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-neurodevt.pdf
December 13, 2013 - ■ Infants with low birth weight who live in an underprivileged (i.e., low socioeconomic)
environment … ■ Screening tests requiring direct examination of the infant:
– Denver-II Screening Test. … – Bayley Infant Neurodevelopmental Screener.
– Battelle Developmental Inventory. … ■ Err on the side of caution, and refer the infant for formal testing early rather than waiting. … ■ Intervention referrals should be made early for infants or children younger than 3 years who
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/hospitals/nicupacket.pdf
December 01, 2013 - Your Health Coach will work with your family to teach you to care for your infant, connect with the … ■ “SIDS” stands for Sudden Infant Death Syndrome. … ■ Sudden, unexplained death of an infant less than 1
year old. … – Bayley Infant Neurodevelopmental Screener.
– Battelle Developmental Inventory. … – Keep the tube open for a short time after feedings, to allow infant to “burp.
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket.pdf
December 01, 2013 - ■ “SIDS” stands for Sudden Infant Death Syndrome. … in healthy infants … ■ Do NOT stop the use of high-calcium containing infant formulas. … – Bayley Infant Neurodevelopmental Screener.
– Battelle Developmental Inventory. … – Keep the tube open for a short time after feedings, to allow infant to “burp.
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-vision.pdf
December 13, 2013 - and Retinopathy
Vision Screening and Retinopathy of
Prematurity
Visual Deficits Seen in Preterm Infants … ■ High-risk infants are more likely to have permanent visual deficits and/or show a delay in
visual … of Prematurity
■ Abnormal blood vessel growth in the incompletely vascularized retinas of premature infants … Screening/Monitoring
■ All infants <1500 grams or <30 weeks estimated gestational age (EGA) should be
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-weaning.pdf
December 13, 2013 - ■ Shared pleasure in eating and feeding enhances the relationship between infants and their
caregivers … Considerations
■ Very low-birthweight infants are at risk for developing aversions to feeding. … ■ Premature infants may feed more slowly due to weaker global tone, limited energy, and a lack
of
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/hospitals/nicutoolkit.pdf
January 01, 2004 - Overview: Improving the Quality of the
Transition Home from the NICU
Infants … This manual is designed to be adapted for any institution that cares for fragile newborn infants. … and families, so that caregivers recognize and respond appropriately to common problems that
infants … records management
system in use)
■ Well-informed PCP
Key outcomes include:
■ Healthy, safe infants … ■ Interviewing families to assess their understanding of their infants’ medical conditions,
procedures
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-ger.pdf
December 13, 2013 - , Gastroesophageal Reflux
Gastroesophageal Reflux
Characteristics
■ Common problem in premature infants … ■ Failure to thrive is usually NOT associated with physiologic GER in premature infants. … ■ Some infants may experience aspiration, cyanosis, and vomiting.
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www.cpsi.ahrq.gov/patient-safety/settings/hospital/resource/nicu/components.html
December 01, 2013 - health record (PHR) and specific instructions, including handouts tailored to the needs of individual infants … and families, so that caregivers recognize and respond appropriately to common problems that infants … Key outcomes include:
Healthy, safe infants. … Coaching families/caregivers to positively care and advocate for their infant. … Interviewing families to assess their understanding of their infants' medical conditions, procedures,