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Infant, Volume 4/Issue 1, January 2008

The articles in this issue are available to online subscribers as Adobe Acrobat PDF files, or in the printed back issue. Please follow the link to our online store.

Management of infants born with a cleft lip and palate. Part 1 -- free download

Supporting neonatal research – the Medicines for Children Research Network -- free download

Posttraumatic stress disorder and the NICU graduate mother -- free download

What’s new for ROP? An outline review of the revised guideline for the screening and treatment of retinopathy of prematurity -- free download

Neonatal transport – the comfort zone -- free download

Self harm in utero? -- free download

Neonatal globalisation – a celebration -- free download
Barbara Weller

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Management of infants born with a cleft lip and palate. Part 1
Patricia Bannister
Free download

Cleft lip and/or palate is a relatively common facial anomaly occurring in babies, which varies in frequency according to racial or ethnic group. A holistic approach to care for the family and child involves many professionals at different times throughout the childhood years. This is the first of two articles which will look at nationally agreed standards of care for the immediate postnatal period, some of the problems which may occur in early infancy for both babies born with a cleft involving the lip and those born with an isolated cleft of the palate, and the specialist support services available to local healthcare professionals and parents.

Bannister P. Management of infants born with a cleft lip and palate. Part 1. Infant 2008; 4(1): 5-8.
  1. National standards have been agreed by the Nurse Special Interest Group, Cleft Lip & Palate to provide an informed response for families following the birth of a baby with an oral cleft.
  2. Cleft lip is often diagnosed during pregnancy and is immediately identified at birth, but cleft palate is more difficult to diagnose and may be missed at the initial birth examination.
  3. Cleft lip or palate can be associated with other anomalies, which may affect the management of the baby.
  4. Parents are profoundly affected by the attitudes of staff caring for their baby and require a lot of sensitive support in the immediate postpartum period.

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Supporting neonatal research – the Medicines for Children Research Network
Mark A Turner
Free download

There is a distinct lack of information regarding medicine appropriate for administration to children, particularly neonates. This article describes the Medicines for Children Research Network and the Extended Neonatal Network, including a summary of how the networks fit in with the recent changes in the way that the NHS supports neonatal research in the UK. These new initiatives should help to fill the information gap.

Turner M.A. Supporting neonatal research – the Medicines for Children Research Network. Infant 2008; 4(1): 10-13.
  1. The Medicines for Children Research Network(MCRN) and the Extended Neonatal Network have been set up to encourage high quality research in neonatal units.
  2. In future money that Trusts receive from the NHS for research will be tied to specific projects adopted by the MCRN and similar organisations.
  3. Research will need to meet guidelines for Good Clinical Practice.
  4. All new medications licensed in Europe now have to be tested in children of all ages, unless the pharmaceutical company applies for a waiver.
  5. The new initiatives should help to redress the dearth of relevant infor-mation about medicines for infants, particularly neonates.

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Posttraumatic stress disorder and the NICU graduate mother
Cathy P Ringland
Free download

The birth of a premature baby represents a time of significant psychological stress for parents. Maternal psychological discord can severely impact on a baby’s cognitive and emotional development, interrupt the parent-infant bonding process and indirectly affect patient care and outcomes. This paper will describe posttraumatic stress disorder and its associated symptoms, look at the evidence for this condition among mothers of premature infants and outline the implications and recommendations for clinical practice.

Ringland, C. P. Posttraumatic stress disorder and the NICU graduate mother. Infant 2008; 4(1): 14-17.
  1. Maternal psychological wellbeing can impact on neonatal development.
  2. Posttraumatic stress disorder can last for many years and its associated impairment and societal costs are comparable to other serious chronic mental illnesses.
  3. This paper provides an insight into the trauma experienced by NICU graduate mothers.
  4. It assists health professionals in identifying mothers at risk of the development of PTSD and makes recommendations for clinical practice.

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What’s new for ROP? An outline review of the revised guideline for the screening and treatment of retinopathy of prematurity
Clare M Wilson, Karen S Head, Alistair R Fielder and Andrew R Wilkinson
Free download

This year sees the introduction of an updated Guideline on retinopathy of prematurity (ROP) written by a multidisciplinary Guideline Development Group. The Guideline outlines recommendations for screening newborn babies who are at risk of developing ROP in the UK, and their subsequent treatment. In this article the focus is on the importance of screening for ROP, the need for multiprofessional service provision, and evidence-based treatment.

Wilson C.M., Head K.S., Fielder A.R., Wilk-inson A.R. What’s new for ROP? An outline review of the revised guideline for the screening and treatment of retinopathy of prematurity. Infant 2008; 4(1): 20-24.
  1. ROP is a potentially preventable cause of blindness in children.
  2. The incidence of severe ROP has decreased, despite a growing population of low gestational age babies, indicating the usefulness of the previous ROP screening Guideline.
  3. All units must have an ROP screening protocol for all infants born at <32 weeks gestational age (GA) and/or <1501g birthweight (BW).
  4. The success of a multi-disciplinary screening programme requires a locally developed integrated care pathway.

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Neonatal transport – the comfort zone
Caron Watts, Emma Trim, Julie Metherall and Erica Lightfoot
Free download

Neonatal transport creates many challenges for the neonatal nurse by the sheer nature of the isolation of the transport environment. Babies should be offered the same level of care during transport that can be expected from the NICU, including individual care assessment needs. This article will discuss the developmental care needs of the baby and how they have been incorporated into the North Trent Neonatal Transport Service.

Watts C., Trim E., Metherall J., Lightfoot E. Neonatal transport – the comfort zone. Infant 2008; 4(1): 27-30.
  1. The North Trent Neonatal Transport Service (NTNTS) aims to provide high quality, safe, efficient and comfortable transfers for all babies.
  2. NTNTS works towards meeting the developmental care needs of individual infants who are being transferred to and from hospitals.
  3. During transport the team are able to facilitate a nested, contained environment, ensuring the babies feel safe and secure.

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Self harm in utero?
Narayana Murthy Indana and Bibian Ofoegbu
Free download

Neonates often present with skin lesions most of which are self limiting. The aetiology of these lesions can be due to various causes – some of them are congenital and are present at birth, some develop later and are transient, some are due to infections and others may be related to the mode of delivery. Fortunately most of these lesions can be diagnosed clinically and very few would need further investigation. This case report describes a self-inflicted benign lesion which, once diagnosed, required no additional treatment.

Indana, N.M., Ofoegbu, B. Self harm in utero? Case report. Infant 2008; 4(1): 32.
  1. Recognising these benign lesions avoids unnecessary investigations.
  2. Vigorous sucking can be induced by moving the affected limb to the infant’s
  3. Good history and examination is essential to rule out other causes of neonatal blister-like lesions.

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