piatkat

We are beyond thrilled to congratulate our colleague @Vicky Payne on receiving the Outstanding Contribution to Neonatal Nursing Award 2025 from the Neonatal Nurses Association in the UK. Vicky is outstanding in every sense of the word—not only exceptional, but truly standing out from conventional boundaries. Operating at the edges of traditional nursing roles, never quite fitting into a single box, and that's precisely what makes her extraordinary. Her willingness to be an outlier—to stand outside the expected—is what allows her to see and achieve what others might miss. Vicky, we couldn't be more proud to see your uniqueness recognized beyond our 99nicu community. Well deserved!

I’ve just stumbled upon this paper: „Seeing beyond the obvious: pragmatic skin care guidance for infants 22–24 weeks gestational age”https://www.nature.com/articles/s41372-025-02375-1 It’s in the Journal of Perinatology, published in September 2025, and it’s from the Tiny Baby Collaborative!

Preemie Voices is hands down my favorite neo project. I've seen these movies several times, each time cried like a baby. It gives you a reality check - everything we do or not do as clinicians matter in the long term health of these individuals. They do their best to thrive with what was given to them. Quality of life, just like beauty, is in the eye of the beholder. It always makes me think about the importance of qualitative research and inclusion of affected individuals and their families in the conversation. I'm really excited about an upcoming thesis defense at the University of Turku- my colleague Anniina Väliaho is going to present her thesis titled "MY MIRACLE CHILD” – EXPERIENCES OF FAMILIES WITH CHILDREN BORN AT 23–24 WEEKS OF GESTATION A Qualitative Descriptive Study. You can access the full thesis here: https://www.utupub.fi/bitstream/handle/10024/194126/Annales%20B%20738%20V%c3%a4liaho%20DISS_ilman%20artikkeleja.pdf?sequence=1&isAllowed=y and you can watch the defense live here; https://echo360.org.uk/section/0346ee72-7361-48ad-872d-77b96d61f482/public

I was looking for some current evidence , because I read recently this paper reporting (consistently with the previous knowledge) increased odds of apneic events following 2-month vaccinations in preterm infants (TL,DR "In hospitalized preterm infants, the odds of apnea within 48 hours were higher after 2-month vaccinations vs after no vaccinations. The similar number and duration of apneic events and lack of serious adverse events suggest that current vaccination recommendations for hospitalized preterm infants are appropriate. Neonatal clinicians should continue providing evidence-based anticipatory guidance about postvaccination apnea risk. https://jamanetwork.com/journals/jamapediatrics/article-abstract/2828426). However, the only paper I found, which reports increased irritability after pertussis vaccination, is from1985 : https://pubmed.ncbi.nlm.nih.gov/3874942/ Response of preterm infants to diphtheria-tetanus-pertussis immunizations - so that was whole-cell pertussis vaccine. Do you have any more current reading material on this topic?

World Breastfeeding Week is approaching, and we'd like to invite you to join this live event organized by the Canadian Premature Babies Foundation, in collaboration with the Canadian Association of Neonatal Nurses and FiCare. Join on August 1 at 1 PM ET for a special Preemie Chat featuring expert talks from Dr. Marianna Gonzalez @Mariana Oliveira , presenting the Brazilian POP-MOM protocol for early oral exposure to mother’s milk; Dr. Erin Hamilton Spence, who will explore the clinical and emotional impact of milk as medicine; Dr. Sharon Unger who will focus on the foundational role of human milk in shaping the early microbiome of preterm infants. and Dr. Prakeshkumar Shah, who will share new data on neurodevelopmental outcomes related to feeding practices in the NICU. Join live on CPBF's YouTube, Facebook, or X channels (recording available here https://www.youtube.com/watch?v=Wgxy9oMVhTg)

I will ping here my dear colleague @Ryo to kindly share his insights (Ryo, I remember you included skincare part in your talk in Rzeszow, haven't you?). I think there are some highlights included in this amazing document Neonatal Intensive Care Manual for the infants born less than 28 weeks of gestation (Ver. 1.1) from the Neonatal Research Network of Japan <https://plaza.umin.ac.jp/nrndata/pdf/NICUManual.pdf>. You will also find some interesting points in this case report Respiratory and Gastrointestinal Management of an Infant with a Birth Weight of 258 Grams <https://www.thieme-connect.de/products/ejournals/html/10.1055/a-1678-3755> There's this review article Skin Care for the Extremely Low-Birthweight Infant < https://publications-aap-org.ezproxy.utu.fi/neoreviews/article/24/4/e229/190914/Skin-Care-for-the-Extremely-Low-Birthweight-Infant >

Hi @josephine powell you can sign up for the webinar here: https://bit.ly/ARA-DHA-webinar-1-april

Building Bridges Between Parents and Neonatal Care Professionals: An Interview with Sari Ahlqvist-BjörkrothThe Close Collaboration with Parents training program has been transforming neonatal care across multiple countries. As the program prepares for its first international conference in Lithuania, we spoke with Sari Ahlqvist-Björkroth, one of the program's creators, about its origins, evolution, and future. What inspired the creation of the Close Collaboration with Parents program?"Three things inspired the creation of the program," Sari explains. "First was my professional commitment to infant mental health. I started researching this field in the 90's for my master's thesis, which helped me understand the power of early parent-infant relationships. Second was my personal experience—the birth of my third son as a preemie. And third was meeting Professor Zack Boukydis and Liisa Lehtonen, who shared the same passion to improve infant and parent care in the NICU context." Could you explain the core principles of the program and how it has evolved since its inception at Turku University Hospital?"The Close Collaboration with Parents is a systematic educational program that transforms how neonatal professionals communicate with parents and support the parent-infant relationship," Sari explains. "What makes our approach unique is that we train entire units rather than individual staff members.” The program unfolds through four evidence-based phases: Sari Ahlqvist-Björkroth, PhD Sari Ahlqvist-Björkroth is a psychologist, Associate Professor of clinical and developmental psychology, and the driving force behind the Close Collaboration with Parents training program. Her research focuses on early parent-child relationships and the development of family-centered interventions in neonatal care, combining her professional expertise with personal experience as a parent of a premature infant. " First, staff develop skills in infant observation, learning to recognize each baby's unique preferences and needs, and communicating their observations with colleagues. Second, we introduce joint staff-parent observations to create collaborative care plans. Staff learn active listening techniques that help them value parents' insights about their babies. Third, staff learn to conduct semi-structured CLIP-I discussion that explore parents' journeys to parenthood. This fosters empathy and enables truly personalized support for each parent-infant relationship. Finally, we integrate parents into all aspects of decision-making—from daily care to medical rounds and discharge planning. We begin preparing for the transition home early, tailoring the process to each family's specific situation." Sari emphasizes the program's practical approach: "While we provide theoretical content through e-learning and lectures, the heart of our method is experiential learning. Staff practice their new skills at the bedside with real families under the guidance of local mentors who have completed the training themselves. These mentors, alongside unit leadership, drive the implementation process." Since its development at Turku University Hospital (2009-2012), the program has evolved significantly: "The program has undergone several key refinements," Sari explains. " Supervision has been streamlined to focus on mentors and leadership rather than the entire staff, making better use of resources. The shared decision-making component has been strengthened through the incorporation of medical round observations. Documentation requirements have been added to ensure program fidelity, along with systems for continuous support to local mentors and leaders. For international implementation, an e-learning platform now standardizes theoretical content across different settings. Perhaps most exciting is our newest development—establishing our first designated training center, enabling one unit to train others within their country. This represents a significant step toward sustainable growth and wider adoption of family-centered care practices." What motivated you to organize this first international conference in Lithuania?"Before COVID-19, we organized annual national seminars for units that had implemented the program or were interested in it," Sari recalls. "When thinking about restarting these gatherings, we realized that since the intervention has expanded internationally, our 'seminar' should be international as well. Our Finnish Rotary partners also encouraged us by offering financial support. Rotary International has supported the training of two NICUs—one in Riga, Latvia, and one in Pardubice, Czech Republic. They recognized that our program shares their values and wanted to continue their support by sponsoring this conference, which is why it's free of charge." How many countries have participated in the program, and is it adaptable to different healthcare systems and cultural contexts?"To date, units from 10 countries have implemented the program," Sari states proudly. "It has been implemented in 25 NICUs and six labor and delivery units. Its successful implementation in diverse cultural contexts, from South Korea to Norway, demonstrates its adaptability. What makes the program so flexible is its structure. We provide the bedside practice and reflection framework that helps unit staff become aware of their family-centered practices and encourages them to innovate better approaches. A key aspect of our philosophy is that we don't impose standardized solutions from the outside. Instead, the program creates a framework where staff can discover what works best in their specific environment. "One of our core principles," Sari emphasizes, "is that the program does not dictate change on the unit. The practice changes are decided by the staff themselves, based on the feedback they receive from parents during bedside practices. This bottom-up approach ensures new practices are directly adapted to each unit's unique context and cultural setting, making them more likely to be embraced and sustained over time." At the conference, we'll have presentations from many different cultural settings, including Japan, South Korea, Israel, Czech Republic, Norway, Finland, and the Baltic countries." What specific challenges do neonatal units face when implementing family-centered care practices, and how will the conference address them?"Resources are probably the biggest challenge for most units," Sari acknowledges. "The implementation is based on the whole multiprofessional staff receiving training or, more accurately, mentoring from local mentors. This mentoring, which is mostly one-on-one, requires additional resources. At the conference, you'll hear about different implementation solutions. Sustainability of change is also a common concern. This will be one of the main topics at the conference. Units that have been implementing for some time will report on how they've sustained desired changes and continued to develop." How did the partnership between Finnish, Lithuanian, and other Baltic institutions develop for this conference?"I hope this event will strengthen cooperation and support among countries in the field of family-centered neonatal care," Sari says. "The idea for the second day of the conference is to share good family-centered practices and learn from each other." Is the conference exclusively for units who have undergone the Close Collaboration with Parents training, or would it be valuable for all professionals interested in family-centered care?"The conference is open to all professionals interested in family-centered care," Sari emphasizes. "Our program is only one way to implement family-centered care; there are many others. Anyone can gain new perspectives and ideas from the conference without participating in our specific program. Of course, if someone wants to know more about Close Collaboration with Parents, this is a perfect event for them." Conference Info The first international Close Collaboration with Parents conference will take place in Lithuania and is open to all neonatal care professionals interested in family-centered approaches. For more information about the conference and registration details, please visit www.tyks.fi/node/4287.

Hi Kartika! You chose quite an interesting topic for your research! Have you considered factors like antibiotic exposure- infants of mothers with PAS are usually born via c-section, which are often secured with prophylactic antibiotics. May this also affect the microbiota of studied infants? I can also imagine that poor post c-section condition of the mother might be affecting her ability to have the baby skin-to-skin or breastfeed, which can further affect newborns microbiota - just some thoughts, correct me please if I'm wrong! From what I understand, collection of stool samples for sIgA can be quite challenging, as the levels vary throughout infancy and especially considering transition in diet and immune development. Do you already have some protocol or is there some established method published that you are planning to follow?

As we step into 2025, many of you have already noticed the major updates rolling out across our 99nicu forum. These improvements are designed to enhance usability and foster connections within our community. While we continue refining the platform, we also want to take a moment to appreciate the incredible projects of 2024. That’s why we’re revisiting this wrap-up—to celebrate the progress we’ve made together and set the stage for another impactful year ahead. 2024: It's a Wrap! The Future of Neonatal Care: More Than Technology Following the success of our previous conferences in Stockholm (2017), Vienna (2018), and Copenhagen (2019), our flagship event, "The 99nicu Meetup: The Future of Neonatal Care," made its return in the beautiful city of Lisbon, Portugal. After the long pause due to COVID, it was incredibly rewarding to once again facilitate face-to-face connections among our community members. While cutting-edge technologies and AI-based innovations were certainly on display, we discovered something even more profound: the future of neonatal care isn't just about advancing technology—it's about strengthening our human connections. We were particularly touched by the blend of scientific excellence and genuine warmth exhibited by our attendees and speakers—brilliant researchers who are, above all, compassionate and engaging individuals. Expanding Horizons: The APAN Webinar Series November brought an exciting collaboration with the Adult Preemie Advocacy Network (APAN) as we launched "Adults Born Preterm: The Honesty Sessions." This five-part webinar series created a unique platform where experts, advocates, and individuals with lived experience came together to explore the lifelong impact of preterm birth. From advocacy and communication to lung health and personal insights, these sessions highlighted the connection between NICU care and long-term outcomes. Digital Evolution: Finding Our True Home 2024 also marked a thoughtful evolution in how we connect with our community. We made the conscious decision to leave Twitter/X, choosing to focus our energy on platforms that better align with our core values of inclusivity, collaboration, and meaningful dialogue. You can now find us on our moderated forums at 99nicu.org, our Mastodon server (the NICUVERSE), LinkedIn, and BlueSky—spaces where authentic professional connections can truly flourish. Looking Forward As we reflect on this year, we're grateful to every member of our community who has contributed to making 2024 a year of growth, learning, and fostering connections. We would also like to thank our collaborators, partners and supporters- you made many things possible. Together, we're building a stronger future of neonatal care—one that combines innovation with the irreplaceable human touch.

Interesting discussion here! I would also think that depleted energy storages (fat and glycogen) due to post- term pregnancy plus some perinatal stress or increased metabolic demand could be responsible: "Infants experiencing perinatal stress (e.g., fetal distress, perinatal ischemia, maternal preeclampsia/eclampsia, sepsis, hypothermia) or those with congenital heart disease have increased metabolic energy requirements, which puts them at risk for hypoglycemia. Perinatal stress causes a state of 'hypoglycemic hyperinsulinism' that can persist for days to weeks, resulting in persistently low glucose concentrations requiring ongoing interventions to maintain euglycemia." https://www.ncbi.nlm.nih.gov/books/NBK537105/#:~:text=Infants are at risk for,excessive insulin production or increased Were there any difficulties with feeding? Do you know what was the interval between feeding and the occurrence of seizures? What was the mode of birth?

@sallest Thank you for bringing up this important study! I'm curious whether units have implemented specific protocols for assessing vaccination readiness, particularly regarding cardiorespiratory stability criteria. No significant events for 48 - 72 hours? Anything else you consider?

Yes, you can find the Webinars here: https://m.youtube.com/@99nicu

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I recognize that you are asking about our units policies, but as I primarily do clinical research, I have stumbled upon these two papers regarding the topic of transitioning from NPT to PALS. So for everybody looking for current evidence, you don't have to google anymore- this is what is out there 1) brief communication in Journal of Perinatology, 2021, team from Wisconsin describing their strategy of transitioning from NPR to PALS "Utilization of PALS for infants was based on the following criteria: >44 weeks post menstrual age (PMA), previous non-PDA cardiac surgery or intervention, or obvious identified cardiac arrhythmia. Each week, the care team leader identified which patients qualified for PALS and ensured appropriate signage was posted in each patient’s room." https://pmc.ncbi.nlm.nih.gov/articles/PMC9617750/ 2) "Considerations on the Use of Neonatal and Pediatric Resuscitation Guidelines for Hospitalized Neonates and Infants" from AAP, 2023 : "When Should Teams Transition From Neonatal to Pediatric Resuscitation Guidelines? As the cardiopulmonary physiology of the newborn transitions to that of the neonate and infant, the evidence upon which the neonatal resuscitation guidelines are based becomes less applicable. Therefore, it makes sense to transition from neonatal to pediatric resuscitation guidelines at some point during the first days, weeks, or months after birth. (...) There are no scientific data to answer the question of when to transition from neonatal to pediatric resuscitation guidelines." However, they mention that studies are needed on optimal resuscitation protocols for infants with certain conditions, including BPD. https://publications.aap.org/pediatrics/article/153/1/e2023064681/196216/Considerations-on-the-Use-of-Neonatal-and 3) And actually, a similar topic has appeared here- almost 15 years ago. It seems these questions are still valid! I haven't found a single answer regarding the NPR vs PALS management for infants with severe BPD though.

There's one paper that I'm aware of Hayashi A, Suresh S, Kevat A, Robinson J, Kapur N. Central sleep apnea in otherwise healthy term infants. J Clin Sleep Med. 2022 describing application of oxygen supplementation as a treatment for central sleep apnea in a population of term infants with central sleep apnea, with normal neuro and cardiac imaging. They were able to wean off these infants in majority within the first year of life. They discuss that supplemental oxygen abolishes periodic breathing and reduces frequency of apnea episodes in these infants. IMHO worth reading hayashi-et-al-2022-central-sleep-apnea-in-otherwise-healthy-term-infants.pdf

Hi, no protocol from me as I'm not working clinically right now, but in clinical research with actually a focus on apnea! As a very research-oriented person my first question is- how do you know it is a central apnea? If you are sure it is central, and it happens only during sleep- this is super interesting-- read here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900881/) Infants born at term still go trough maturation of their central nervous system, and that also includes maturation of the breathing pattern. They might present periodic breathing and short apnea, but their ability to cope with the heart rate and saturation control is much better, therefore they might be less vulnerable to apnea events and their consequences. I would definitely consider potential causes, depending on the time of presentation of apnea (perinatal injury? infection? metabolic disease? cns anomalies? medications? and of course rare but exists: central hypoventilation syndrome). In this paper from 2017 (Patrinos ME, Martin RJ. Apnea in the term infant. Semin Fetal Neonatal Med. 2017, see attached) they describe BRUE (brief resolved unexplained event): A BRUE is an event occurring in infants <1 year of age with one or more of the following: (i) cyanosis or pallor; (ii) absent, decreased, or irregular breathing; (iii) marked change in tone (hyper- or hypotonia); and (iv) altered level of responsiveness. The diagnosis of BRUE should only be applied when there is no explanation for a qualifying event after a thorough history and physical examination. Box 2 Serious conditions presenting with BRUE (brief resolved unexplained event)-like symptoms: Gastroesophageal reflux Respiratory tract infection [respiratory syncytial virus] Seizure or central nervous system disorder Child abuse Other (Poisoning, Bilirubin encephalopathy, Cardiac disease, Structural Conduction or ion channel (channelopathies) defects, Cardiomyopathies, Arrhythmias, Metabolic disorders/inborn errors of metabolism, Anaphylaxis, Bacterial infections (including urinary tract infection), Upper airway obstruction/obstructive sleep apnea, Anemia) When it comes to the evaluation and management of such infant, authors of that paper recommend laboratory tests including glucose levels, electrolytes, calcium, a complete blood count, and blood gas analyses. It's advisable for the infant to be monitored in a NICU with cardiorespiratory and pulse oximetry observation. Depending on the history, consider neuroimaging, an electroencephalogram, ENT consult, and a genetics assessment. So yadda yadda yadda, hopefully some clinicians here will say something more straightforward, but yeah I think you need to think about everything, but lets keep in mind that even term infants can have some (central) apnea. 1-s2.0-S1744165X17300446-main (1).pdf

I heard a fantastic talk in a recent conference by dr Ryo Itoshima from Nagano Children's Hospital in Japan. He shared plenty of insights into their practice (eg. prophylactic antifungal medicine, does anybody practice it?), and shared this manual of Neonatal Research Network of Japan describing handling of infants born <28 weeks of GA: https://plaza.umin.ac.jp/nrndata/pdf/NICUManual.pdf It's freely available online, almost 100 pages of knowledge Enjoy!