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Acta Paediatrica

Helping babies breathe, oxygen, maternal voice and pain, and how nipple temperature may guide newborns to breastfeed

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Acta Paediatrica October 2017

We have highlighted some of October issue's articles and most of them you can access freely in the journal below.

Helping Babies Breathe training can improve neonatal resuscitation

Helpin59cb623735e6b_Pagesfromapa_v106_i10_covercroppednewsletter.jpg.497fbf4cf00f63e5372221d5ff3637a5.jpgg Babies Breathe (HBB) is a neonatal resuscitation programme that is designed to train health professionals in low-resource settings. A study by Amy Rule et al showed that 10 months after HBB training in a rural referral hospital in Kenya, the suspected hypoxic–ischaemic encephalopathy (SHIE) rate had decreased by 53% to 7.1/1000. However, the rates increased after the initial decline and investigations revealed that half of the midwives who received HBB training had been transferred. When the data were presented to healthcare administration personnel, this improved staff retention and the SHIE rate then decreased again. Christabel Enweronu-Laryea and Nicola Robertson comment on the study. Readers may also be interested in the editorial by Susan Niermeyer, who comments on Johan Wrammert et al’s paper on an HBB project in Nepal, which was published in a previous issue.


Nipple temperature may help guide newborns to breastfeed
afcdcc79-6b0c-47e1-9945-9058044d0be5.jpgNewborn babies instinctively have the ability to crawl to the breast when placed skin-to-skin on the mother's abdomen. A new Italian study by Vincenzo Zanardo et al indicates that a higher temperature around the mother’s nipple with respect to the surrounding breast skin may facilitate this process.  The study conducted on 41 full-term infants and their mothers showed that a temperature gradient may support mother-infant thermal identification and communication in the breast crawl process.

One breath of oxygen may shorten the return to spontaneous circulation
3afc8f38-f7a7-45ea-bd54-f0ca5aa2287f.jpgAsphyxiated newborn infants should be resuscitated with air, but it has been unclear whether supplementary oxygen is needed when effective ventilation cannot be provided immediately during resuscitation. In this study, Rikard Linner et al found that one single breath of oxygen shortened the time to return of spontaneous circulation in asphyxiated newborn piglets. Small but critical amounts of oxygen was essential for sustained circulatory recovery in this experimental model of asphyxia. The clinical applicability of these findings should be further investigated, according to the accompanying editorial by Anne Lee Solevåg and Georg Schmölzer.

Recorded maternal voices reduced pain in preterm infants undergoing heel lance procedures
ff8a44da-56e4-4dda-9d76-4ce0418d5714.jpgThis study evaluated whether recorded maternal voices limited pain in preterm infants undergoing heel lance procedures. Gaetano Chirico et al enrolled 40 preterm infants at a gestational age of 26–36 weeks and randomised them to listen to, or not listen to, a recording of their mother’s voice during the procedure. Infants in the intervention group had significantly lower pain scores and fewer decreases in oxygen saturation, with no significant side effects. Readers may also be interested in the brief article by Ellyn Hamm et al, who report that a parent–infant music therapy intervention improved neurodevelopment after neonatal intensive care.

Using a standardised protocol reduced hospitalisation for childhood immune thrombocytopenia
deef8d71-7493-4698-bdfd-9c4edb1efd41.jpgChildhood immune thrombocytopenia (ITP) is an immune-mediated disorder, with a platelet count of less than 100 9 109/L an no underlying cause. Although current guidelines suggest that most patients are just observed, children still receive platelet-enhancing therapy because of
concerns about complications related to bleeding. Roxane Labrosse et al report that introducing a standardised protocol with a step-down approach reduced hospitalisation and the length of prednisolone treatment in children with newly diagnosed ITP, without any increase in disease complications. Ljung comments on the findings.

Severe postwar malnutrition did not have a negative impact on subsequent earnings and pensions
196caf7c-6d92-4f3e-ae39-53934878e1a0.jpgHermanussen et al explored whether German men born and raised shortly after World War Two, during severe and long-standing nationwide malnutrition, had lower earnings and subsequent pension payments. They found that being born in postwar Germany in 1945–1948 was only associated with a tiny impairment in work-related earnings, which was not visible in the at-riskof-poverty rates. The findings question previous statements associating early childhood malnutrition and lower lifetime earnings.

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