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piatkat

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Blog Entries posted by piatkat

  1. The interactive scientific programme for CEPAS 2026 is now online, and if you haven't explored it yet — check out https://www.cepas.org/scientific-programme. Built on more than 15 years of collaboration between the European Academy of Paediatrics, the European Society for Paediatric Research, and GFCNI, the CEPAS programme brings together science, clinical practice, advocacy and paediatric training in one place. Sessions, topics, networking opportunities — it's all there, and it's a lot.
    Which brings us to a question we've been thinking about. With a programme this rich, how do you actually navigate a conference? Do you plan every session in advance or follow your instincts on the day? Do you wander beyond neonatology or stick to what you know? Paper programme or app — or both, just in case?
    We're genuinely curious how the 99nicu community does it. We've put together a quick poll — it takes two minutes, the results are live, and we'll be sharing them at our session at CEPAS in October.
    Because let's be honest - everyone has their own system. Or complete lack of one...
    Share your approach in the comments too — we want to know if the 99nicu community is a meticulous-colour-coded-schedule crowd or a go-where-the-wind-takes-you crowd. Probably both. Probably at the same time.
    Hope to see you in Lyon!
    - Kat from 99nicu.org
  2. Neonatal sepsis remains one of the leading causes of death and harm in newborns worldwide, and it disproportionately affects babies in low- and middle-income settings.
    This week at the PAS 2026 conference, a new global initiative took its first formal step: the Newborn Sepsis Society held its founding meeting.
    The Society brings together clinicians, researchers, and partner organizations across disciplines and borders, with a shared mission: to improve outcomes for newborns worldwide by advancing the prevention, diagnosis, and treatment of neonatal sepsis. They explicitly prioritize representation from diverse regions, especially where the burden of neonatal sepsis is greatest.
    👉 Learn more and join at https://newbornsepsissociety.org/
    And as 99nicu, we are excited to see this initiative take off, and keeping our fingers crossed for the growth and good ideas to come. And being the grassroot community we are, we are always open for sepsis discussions- so bring them on!
    Kat from 99nicu

  3. We are excited to share news that 99nicu.org has begun collaborating with NeoIPC, a European Union-funded initiative addressing hospital-acquired infections and antimicrobial resistance in neonatal units.
    What is NeoIPC?
    Nearly 1 in 10 European newborns requires NICU admission in their first days of life, which can expose them to antibiotic-resistant bacteria.
    NeoIPC is a European Union-funded research initiative focused on improving infection prevention and control (IPC) in NICUs. The project brings together an international network of clinicians and researchers to develop innovative, evidence-based strategies to reduce the transmission of resistant bacteria in premature newborns. It integrates clinical research, implementation science and surveillance to better understand infection patterns and improve IPC practices across neonatal care settings.
    Moreover, through an innovative study named NeoDeco, NeoIPC is also evaluating if the implementation of optimised kangaroo care can reduce severe neonatal infection, sepsis and resistant bacterial colonisation in high-risk newborns in the neonatal intensive care unit.
    NeoIPC has also developed standardised surveillance methods focused on healthcare-associated infections, multidrug-resistant organisms and antibiotic use in neonatal care. Participation in the NeoIPC Surveillance is completely free and open to neonatal care sites worldwide. The NeoIPC Surveillance Network already includes 25 partner sites across Europe and Africa, working together to improve infection prevention and surveillance in neonatal care. More about the NeoIPC surveillance
    Finally, NeoIPC places strong emphasis on the perspectives of families. "NICU Journeys" is a video series that captures and amplifies the voices of parents, sharing their experiences, concerns and hopes, and highlighting their essential role in the care of their premature babies. More about NICU Journeys
    Why This Matters to Our Community
    NeoIPC aims to connect units together in a global Clinical Practice Network, encouraging greater involvement of units in infection prevention planning and delivery. This aligns well with what we do at 99nicu.org—connecting professionals across borders to share practices, learn from each other, and improve neonatal care.
    Meet the NeoIPC Leadership
    The project is led by :
    Julia Bielicki, NeoIPC Scientific Coordinator, University Children’s Hospital Basel (UKBB), Switzerland; City St George’s, University of London, UK
    Tuuli Metsvaht, Chair of the NeoIPC Clinical Practice Network, Professor of pediatric and neonatal intensive care, Head of the Clinic of Paediatrics Tartu University Childern’s Hospital (Estonia)
    Annika Tiit-Vesingi, Deputy Chair of the NeoIPC Clinical Practice Network, Head of the Neonatology department Tartu University Children’s Hospital (Estonia)
    Brar Piening, NeoIPC Surveillance lead, Member of the NeoIPC Clinical Practice Network Steering Board, Deputy director of the Institute of Hygiene and Environmental Medicine at Charité – Universitätsmedizin Berlin (Germany) 
    Chiara Minotti, Member of NeoIPC, MD, Paediatrician, PhD candidate in Clinical Research (University Children's Hospital Basel, Switzerland)

    You can learn more about NeoIPC in the club space they are hosting in the 99nicu NeoIPC Club. You can freely join the club to stay in touch and get notified when new content is being shared.
    Join us in warmly welcoming NeoIPC to 99nicu!
    Kat from 99nicu

    Julia Bielicki
    Professor Julia Anna Bielicki is a Professor of Paediatric Infectious Diseases at City St George’s, University of London, Professor of Paediatric Clinical Pharmacology at the University of Basel. Julia trained in Social and Political Sciences and Medicine at the University of Cambridge, where she graduated top of her year, and holds a Medical Doctorate from the University of Zurich, as well as an MPH and PhD from the London School of Hygiene and Tropical Medicine. Her research focuses on optimising antibiotic use in neonates and children and developing innovative infection prevention and control strategies across high-income and low- and middle-income country settings. She has led and co-led multiple randomised controlled trials, including cluster and platform trials, funded by organisations such as NIHR, Horizon 2020, EDCTP, IMI and the Wellcome Trust, with the aim of generating robust evidence to inform clinical practice and health policy in the context of rising antimicrobial resistance.

    Tuuli Metsvaht
    Tuuli Metsvaht is a paediatric and neonatal intensive care doctor in Tartu University Hospital, Estonia, with over 25 years of experience in the field. She is also Professor of paediatric and neonatal intensive care and pharmacotherapy in the University of Tartu, Estonia. Her interest has been in developemntal pharmacology with specific focus on PK and efficacy studies of antimicrobial therapy in neonates. She has worked in several EU-funded International projects like NeoMero, NeoVanc, ALBINO. Other fields of interest include early cardiovascular support in postnatal adaptation,  excipients use in neonatal drug formulations (Era-Net funded International Project ESNEE). Currently she is involved in postnatal colonisation studies in NICU with specific focus on family centred care and development and implementation of novel infection prevention and control measures in NICU in the NeoIPC Project.

    Annika Tiit-Vesingi
    Annika Tiit-Vesingi is a paediatrician at Tartu University Hospital in Estonia with over 20 years of experience in the field of neonatology. She currently serves as the Head of the Neonatology Department at the University of Tartu, where she plays a key role in both clinical care and academic development. Her main areas of interest include neonatal feeding, family-integrated care, and advancing the concept of the “golden first hour” for all newborns to improve outcomes. In addition to her clinical and leadership work, she is actively involved in research on postnatal colonisation in neonatal intensive care units, with a special focus on promoting family-centred care practices.

    Brar Piening
    Brar Piening is a senior physician and deputy director of Charité's Institute of Hygiene and Environmental Medicine, board-certified in hygiene and environmental medicine. He is responsible for infection prevention and control at Charité's Campus Virchow-Klinikum and has worked in HAI surveillance, antimicrobial resistance, and antibiotic use for more than 20 years. He is the scientific coordinator of NEO-KISS, Germany's national surveillance system for nosocomial infections in very low birth weight infants and leads the MEASURE work package of the EU-funded NeoIPC project, where he coordinates the development and operation of a multinational HAI surveillance system for high-risk neonates. His research spans the epidemiology of healthcare-associated infections in vulnerable patient populations, with a focus on neonatal infection outcomes, antibiotic use, and the design and evaluation of surveillance systems.
     

    Chiara Minotti
    Chiara Minotti is an MD and a NICU‑trained, board‑certified paediatrician (University of Bologna and Padova University Hospital, Department of Women's and Children's Health, Italy). She previously worked as a neonatologist and clinical researcher at the Department of Neonatology, Modena University Hospital, Italy, and was involved in large, EU‑funded international projects (PedMERMAIDS, GBS‑PREPARE). She is currently a PhD candidate in Clinical Research at the University Children’s Hospital Basel, Switzerland. Her research focuses on innovative strategies for the prevention and management of infections in neonatal intensive care units, within the NeoIPC and NeoSep ADAPT projects.
     

  4. How long have you been a member of 99nicu? A year? Five years? Longer than some of your colleagues have been qualified? You might be surprised how far back this community goes.
    Our 99nicu community has more than 7,000 members from 76 countries. We have been around longer than Facebook has been in Europe, and almost as long as Twitter has existed at all — and despite being "old school", we have persevered. Many predicted that forums would disappear once social media took over. But looking at where the world is going, it feels more and more like we need spaces we can rely on — grassroots, independent, and not subject to the whims of algorithms or platform owners.
    And honestly? Sometimes we all just need a place that isn't endless doom scrolling. Yes, you can justify it with "but there's educational content there too" — but what is your actual retention of something you had less than three seconds to grasp before the next thing came along?
    We love meeting you in person — whether at 99nicu meetups or other conferences. It matters, putting faces to usernames. Over the years we have had the chance to meet many of you, whether wearing our academic, clinical, or entrepreneurial hats. Later this year we will meet some of you in France, where we are partnering with the CEPAS conference — and we are genuinely looking forward to what we have planned there.
    But our global village is much bigger than whoever can make it to a conference. We span continents, and not everyone can travel all the time — after all, somebody has to stay on call. So this year, we want to connect more.
    As part of our 20th anniversary, we want to organize a few informal online meetings. We want to hear from you — your thoughts on where 99nicu should go, projects we could take on together, and how you can get involved.
    The first meeting is on May 7th. Details are available in our Community Calendar. Save the date!
    - Kat from 99nicu

  5. Why We're Asking You to Log In

    News · piatkat · 03/17/2026 08:22 PM

    TL;DR: What's Changed and Why
    You might have noticed while browsing 99nicu recently: reading the full discussions now requires you to be logged in.

    The first post of any thread remain visible to everyone, like the news updates and feeds. But to read replies and join the conversation, you'll need to log in as a member.
    We know this adds a step. Here's why we're doing it, and how we're working to make it worthwhile.
    ________________________________________
    Why This Matters?
    For 20 years, 99nicu is built on professional exchange by NICU staff. When you contribute here, you're part of a community where many members use their real names and affiliations when sharing their clinical experience, knowledge, and personal insights. Our members are willing to be known, and we believe the readers should be, too.

    ________________________________________
    What You Need to Know
    Registration is free and always will be. No fees, no paywalls, no corporate gatekeeping. Just a basic account, that takes one minute to register for, and then you just need to await our manual approval of your account (usually within 24 hours).
    Homepage News , Blogs and Calendar remain open. Many sections remain open/public for browsing without logging in, including the Homepage, the Latest Research feed.
    Discussion Forum Topics are visible to everyone. You can see the first post in all Discussions, what colleagues are asking, but to read answers and expert responses, you need to log in.
    Posting and commenting requires login. Only members can contribute to discussions.
    We don't verify institutional emails. You can register with any email address. We trust you to be part of this professional community in good faith, but please remember to be thoughtful about what and how you post. Your profile information is visible to other members.
    Be mindful when sharing patient-related information. While clinical discussions are essential to our community, you must respect patient confidentiality and integrity. Never include information that could potentially identify a patient or family. When discussing specific cases, parental consent is recommended. You are responsible for ensuring your posts comply with your national laws and regulations regarding patient privacy. See our [privacy policy] and [registration terms] for details.
    Stay logged in with the 99nicu app. Available for iOS and Android, the app keeps you connected without needing to sign in every time. If you visit us with your mobile browser, you'll see a prompt: "View in the app: a better way to browse." It's a simple, browser-style app that lets you keep 99nicu on your phone homescreen — no notifications, no instant messages. Just at the reach of your tap when you want to browse and interact.
    ________________________________________

    The Platform Grows When Your Activity Grows
    99nicu thrives when you participate!
    The value of this community isn't just in what you can read — the value is built from people sharing their questions, comments and expertise. Therefore we encourage you to ask questions and share your experiences.
    Remember: what seems like a "basic, normal thing" to you might be genuinely eye-opening for another clinician somewhere else in the world. We all have unique perspectives shaped by the context where we work, what we've seen, and who we've learned from. So don't hold back!

    ________________________________________
    Help Us Get This Right
    We want to make this transition as smooth as possible. So we're asking:
    What can we do to make logging in easier for you? Is the registration process clear? Do you have any issues recovering your password?
    Let us know in the comments, or send us a message- we're here for you!
    See you inside!
    Kat from the 99nicu Team


  6. Dear 99nicu friends,
    Some of you might have already noticed our 99nicu page has been going through small improvements. We keep thinking about how to make this page more friendly for you, our users. What would it take to make us a page you visit often, or maybe even your starting page?
    Last week I implemented an RSS feed with the newest papers in neonatal medicine. As 99nicu, we cannot guarantee you access to full texts, but at least we can show you new research being published every single day—for the betterment of neonatal care.
    Living in Europe and communicating in English almost everywhere, I never even considered that 99nicu might not be accessible enough for people who simply don't use English. I'm thankful to our dear @Mariana Oliveira who opened my eyes and encouraged me to find solutions to make our page more accessible for non-English speakers.
    So, first of all—in the bottom right corner, you will find a blue "Translate" button. This is a whole page translation powered by Google Translate that will allow you to browse the page in any language you choose. Roam around and explore our content in the language you feel most comfortable with—you're welcome.

    Second—underneath each post and reply to a post, you will find a button "Translate", which will give you an opportunity to choose a language. This will translate that post to your chosen language. This way, you can participate in the conversation in any language you feel comfortable with, and other users can translate your post to their language of preference. Right now the languages to choose from are limited to 12 (Spanish, French, German, Italian, Portuguese, Dutch, Polish, Russian, Japanese, Chinese, Arabic and English), but we can add as many as you like—just let us know.

    We're doing our best here, without an army of social media, IT and marketing experts—but honestly, it's been fun figuring out these improvements for you. I'd love to hear your feedback: what else can we do to make 99nicu work better for you? Drop your ideas in the comments or send me a message. You can help us in this mission by visiting our page, being an active part of our community, and telling us what you need. And if you like what we do, you can become a 99nicu Society Member (https://99nicu.org/subscriptions/) for 10 EUR/year to keep our servers alive.
    All the best,
    Kat
  7. 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!


  8. 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)

  9. Building Bridges Between Parents and Neonatal Care Professionals: An Interview with Sari Ahlqvist-Björkroth
    The 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.

  10. I would like to introduce to you doctor Angela Gregoraci, a Spanish neonatologist, who has just completed a two-month observership in our NICU in Turku, Finland. Our unit here in Turku, is a tertiary center, with single-family rooms and- even more importantly- with families having the possibility to stay with and care for their sick or premature infant throughout the day and night. The objective of this short training was to learn how to facilitate the implementation of family-centered care in dr Gregoraci's unit in Spain. After the internship, she decided to describe her experiences in an essay and I'm grateful she gave me the permission to publish it also here. I hope that this well-thought and beautifully written text will warm your heart on this cold, fall evening. Enjoy the read! KP
     
    FROM TARREGA'S MEMORIES OF THE ALHAMBRA TO SIBELIUS' TUONELA SWAN: EXPERIENCE OF A SPANISH NEONATOLOGIST IN TURKU
     
    I remember very well the first time I heard about developmental and family-centred care, back in 2010, when I was just a neonatologist in training, looking in awe at the pictures of the Uppsala Unit. I knew then that this was the path I wanted to follow, although at that time it seemed utopian... Years later my boss and mentor, Dr. Perapoch, told me a similar anecdote when in 2003 his colleagues visited a Danish neonatal unit: that visit opened their minds. They were there to learn about CPAP and what they brought back with them was a discovery that had an equal or greater impact on the health of the infants and their families: the kangaroo care and the supportive environment.  That was more than a decade ago and I am still walking in that direction, convinced, despite the obstacles, that there is no other possible horizon in modern Neonatology.
    In 2018, European expert group recommendations defined eight principles for newborn-centred and family-integrated care1 consistent with the European Research Network on Early Developmental Care (European Science Foundation)2. In Spain, there are two Newborn Individualized Developmental Care and Assessment Program (NIDCAP) training centres and seven neonatal units that include NIDCAP-certified professionals. Moreover, several units have started to work on different training programmes for developmental and family-centred care3.  A survey examining the eight principles previously published was sent to all Spanish level-III public neonatal units in 2018. Results indicated that none of the Spanish NICUs surveyed had completely implemented the eight principles3. Principles related to the family (parental presence and psychological support) were implemented significantly more often in units with a greater number of very low birth weight (VLBW) infants. Free 24/7 parental access with no limitations is essential for a real infant and family-centred developmental care implementation. In Spain, free parental access was present in 11% of Spanish NICUs in 20064, which increased to 82% in 20125 and 95.4% in 20183. However, although most of the units defined themselves as having an open-access visitation policy for parents, many of them imposed restrictions so that access was not in fact unlimited6,7. Indeed, even if the number of neonatal units with 24/7 access has increased in the last decade, it is not enough. We should still make an effort to remove barriers and promote facilitators to encourage parents' presence and participation during medical procedures or ward rounds. Another unresolved key point, according to the survey findings, was the scarce availability of health care professionals to provide psychological support to parents during and after their infant's admission. Skin-to-skin contact was fulfilled by almost 70% of the NICUs3.
    I came to Turku determined to find a way to overcome these barriers, not knowing that what I would find would be the closest thing to l'isola che non c'é, by the Italian singer E.Bennato. It was as if I had returned to the future and found myself looking through the eyehole of the door at what I would like to be my NICU ten years from now at the latest.
    I was convinced that in order to achieve real and sustainable change in care, the intervention should aim to change the attitudes and beliefs of each professional who work with newborns and their families rather than aiming to change single care practices of the unit. Empowering professionals to empower families, that was the challenge. And here in Turku, they had achieved it, it was not a utopia!
    Sometimes it is enough to change the direction of your gaze to see more clearly, said the French writer Saint-Exupéry. It was as easy as looking for the pole star, guided by the Chariot, as Ulysses tried to do on his return journey to Ithaca, or where the moss grows, or where the compass tells you... north.  During these two months in the NICU of the Turku University Hospital, I have had the opportunity to see with my own eyes the revolutionary power of critical training based fundamentally on practice and reflection to bring about change. Nine years after the group led by Sari Ahlqvist-Björkroth, Zack Boukydis, Anna Axelin, and Liisa Lehtonen successfully implemented and extended their training Close Collaboration with Parents Programme, the "revolutionary" idea that parents are the main facilitators of the proper development of their baby, whether healthy or sick or born prematurely, had become indisputable and inherent in the mindset of both professionals and families in this Finnish unit. I spoke with nurses, with paediatricians, with families, I observed the babies admitted there, and all of them transmitted me unequivocally the same mantra: the participation of families is indispensable in neonatal care, a critical stage of life for both newborns and parents.  How to achieve this is perhaps the next biggest challenge and it is clear that Finland is one of the countries with the most supportive and enviable social policies to do so, but it is not the only thing that is needed. Teamwork, good communication, active listening, and respect for diversity and otherness among professionals and between professionals and families are essential.
    One of the biggest lessons I learned from humanitarian work is that the necessary ingredients for a successful action are: humility, respect, and collaborative work. Without asking beneficiaries about their real needs and capacities, without empowering the development of their skills and making them active subjects of intervention and care, aid will never be sustainable over time. As the indigenous activist and artist Lila Watson said: "If you have come here to help me, you are wasting your time. But if you come here because your liberation is bound up with mine, then let us work together".
    Moving from a care model centred on the professional who relates to the patient in a vertical way, seeing and treating them as vulnerable and lacking in decision-making capacity or autonomy, to a model centred on the patient (and family in the case of neonatal care) endowed with capacities and skills, who relates to the professional in a horizontal and collaborative way, is possible and imperative for all of us to enjoy greater physical and mental health. And Turku is a clear example that it is possible.
    In my personal journey to Ithaca I have been accompanied by extraordinary people: the nurses and Sanna and Helena, with whom I had the opportunity to get to know their training programme in depth, carrying out the individual practice sessions as bedside practice, and sharing their experience as trainer-mentors from the difficult beginnings in their own unit to their current challenge to continue extending to more Finnish and European units; the psychologist Sari, one of the promoters of the programme, with whom I shared knowledge and exercised the incredible and exciting art of critical reflection in a relaxed and, at the same time, professional atmosphere; the families of N. , S., J., O., who allowed me to enter and stir emotions, memories and thoughts at such a critical and difficult time in their lives, and who confirmed to me that parents also have a voice that wants to be heard, because we need them to take better care of their babies and they need us to be able to feel and act as parents. And finally my two bosses, the one over there (Josep Perapoch) and the one over here (Liisa Lehtonen) who gave me the chance to enjoy this experience in my own way and whom I deeply admire for their tenacity and love for Neonatology in general and for families and their babies in particular.
    All these people have facilitated (and I am sure that they will continue to do so with their example and support) my particular process of gestation as a neonatologist, woman, and mother, as well as that of all neonatologists, fathers, and mothers of the present and future, because utopia is not far away, as Galeano said, but is ever closer.
    Kiitos
     
    "In dark times we are helped by those who have been able to walk in the night, showing us that the obstacle does not prevent history. Only those who are capable of embodying utopia will be fit for the decisive combat, that of recovering what humanity we have lost" (Ernesto Sabato)
     
    Angela Gregoraci, Neonatologist
    Hospital Dr. Josep Trueta, Girona, Spain
     
     
    References:
    1-Roué J-M, Khun P, Lopez-Maestro M,et al. Eight principles for patient-centred and family-centred care for newborns in the neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed. 2017;102(4):F364-F368
    2-Research on Early Developmental Care for Extremely Premature Babies in Neonatal Intensive Care (EDC). Secondary research on early care for extremely premature babies in neonatal intensive care units (EDC). http://www.esf.org/index.php?xml:id=1514. Accessed October 10,2019
    3- López-Maestro M, De la Cruz J, Perapoch López J, et al. Eight principles for newborn care in neonatal units: Findings from a national survey. Acta Paediatr.2020;109:1361-1368
    4- Perapoch López J, pallás Alonso CR, Linde Sillo MA, et al. Developmental centred care. Evaluation of spanish neonatal units. An Pediatr (Barc).2006;64:132-139
    5- López-Maestro M, Melgar Bonis A, de la Cruz-Bertolo J, Perapoch López J, Mosqueda Peña R, Pallás Alonso C. Developmental centred care. Situation in Spanish neonatal units. An Pediatr (Barc).2014;81:232-240
    6- Raiskila S, Axelin A, Toome L, et al. Parents' presence and parent-infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries. Acta Paediatr.2017;106:878-888
    7- Greisen G, Mirante N, Haumont D, et al. Parents, siblings and grandparents in the neonatal intensive care unit. A survey of policies in eight European countries. Acta Paediatr.2009;98:1744-1750
     

  11. Dear fellow Ph.D. students, full-time researchers, and other fellow scientists,
    please #staythefuckhome. In many grant proposals, we write "this research has the potential to save lives, because... ". Let's face it- most of our research won't save lives (or at least not at once)*. No matter how fantastic our research projects are, science takes time. But what can actually save lives immediately is US STAYING HOME. This way we - the (relatively) young people in big academic campuses- won't be spreading the virus that might be deadly for others: for an old lady in the shop (who takes care of her ill husband at home), our senior supervisor (who is also an attending in the unit, so in case he gets sick, they would be running understaffed), a young mother (who will have only moderate symptoms, but will have to arrange some care for her children- possibly transferring them to her own parents, exposing them to an infection).
    Let's think outside of our own bubble. I don't know if there's much more we can do, but if we are lucky, it might be just enough.
    Work from home, write from home, think from home, read from home. We always complain that there's not enough time to read and learn- here's your chance!
    And if your main area of interest is neonatology, there's a fantastic treat for you- if you stay home. Karolinska NIDCAP Training and Research Center organizes a *fabulous* online conference. Go to their  pages, write an email (stina.klemming@sll.se) and get your link to access this amazing event. 
    Kind regards,
    Katarzyna #staythefuckhome Piatek
    *unless you're actually working on the vaccine or new drug for coronavirus- then just keep working ❤️ 
  12. It’s been some time since I last posted here. Many things have changed in my life since then- the most important transition being my decision to move to Finland to work as a research fellow with the Baby-friendly Ventilation Study Group in Turku. The life of a beginning clinical researcher deserves a separate post here (it may even come at some point). To celebrate my first anniversary in Finland I would like to share 3 things I wish somebody had told me before I moved here. Enjoy!
    1.Get nylon pants. 
    The weather in Finland is truly whimsical. We have had a kind spring, warm summer, and lovely, colorful autumn. I was able to enjoy each of these seasons, biking in the Archipelago, watching sun that never sets, traveling north to see ruska, and finally seeing Northern Lights for the first time in my life. My only concern here is rain. It doesn’t follow laws of gravity AT ALL. How is that possible, that those raindrops are not falling DOWN from the sky, but they are literally attacking you from every direction? It took me some time to overcome my frustration and find a solution. I have closely observed (relatively) happy Finns and discovered that the most important clothing item here is… nylon waterproof pants. The trick is they have to be big enough that you can pull them over your regular pants to keep you dry and warm when it rains. This small thing has definitely improved my comfort here. It has also created that precious feeling of belongingness- I could finally proudly join the rustling and swishing sisterhood of waterproof pants.
    2. Drop in the fertility rate is a real thing.
    Ok, I am a doctor and I KNOW it is a real thing. I know that statistics don’t lie. I know. But I kind of didn’t want to acknowledge that it may actually impact my study. We have had a fairly good start of the patient recruitment, which had kept me busy in spring. But then summer had arrived, and the recruitment slowed down. I kept thinking that maybe it’s just because of the summertime in general (like preemies would be able to pick a season when they want to arrive early, right?). But then autumn has come, and it was time to face the music- I have a problem. In order to recruit the desired number of infants, I may either stay here forever OR I need to come up with a clever solution very soon. Thankfully, I have amazingly supportive supervisors here and we decided- we are expanding! That means more traveling for me (and possibly more blog posts for you)!
    3. Compulsive talking about 99nicu may help you to dance more salsa.
    That statement may seem rather weird, but there is a logical explanation.
    Very recently I’ve had a chance to attend a regional neonatal meeting in Finland. I was asked to present highlights from the 99nicu Meetup in Copenhagen. Since I like the whole concept of 99nicu.org and loved two conferences I had attended, I took that task very seriously- meticulously prepared my PowerPoint presentation and practiced my performance out loud at home. I decided to tell participants about lectures I remembered the best- neonatal transports, simulations in the NICU and infants surviving at the limit of viability. You may argue that there were more important lectures there, but those were the ones that still “spark joy” after all these months. Do you remember that sim scenario of postpartum seizures in a birthing pool that Ruth Gottstein talked about? I’ve discussed it with so many people in so many places already, that it might have become my favorite topic of random conversations with strangers. Anyways, I think the presentation went well- participants awarded me the prize for the best presentation of the evening! I received a gift card that I can use for cultural or fitness activities in Turku- including more salsa classes in my favorite dance school. Voila! Thank you 99nicu!

  13. July was very eventful for me and that had caused my on-line silence. I had a chance to visit again my beloved Finland and now I'm back with fresh thoughts and ideas (and also hundreds of photos). Enjoy!
    Kotiloma is a word in Finnish that means „vacation at home”. But in some NICUs around Finland it has grown into a bit different meaning. Kotiloma is a practice of arranging a little vacation at home for NICU patients before their final discharge. 
    The routine is quite simple. On the kotiloma day parents come to the unit with a car seat and a set of clothes. When the seat is warm and the baby is ready, they just simply take their baby home for a day. Before they leave, they inform the staff about the time of their return. If they would feel insecure, they can always return to the unit sooner and their room will be waiting for them. The duration of the stay away from the unit can last from a couple of hours up to a whole weekend. Sounds interesting?
    There are two basic conditions: parents' willingness and staff's trust in parents' abilities. Parents need to be confident when it comes to securing baby’s needs. Since kotiloma applies mostly to preemies, parents are generally well prepared (hello Family Centered Care!) and very eager to take the baby home for this vacation. It’s like a free trial of full-time parenthood and you can still bring the baby back  But seriously speaking, after spending several weeks in the unit with the baby, they really just want to change the surroundings and go out for a while. If the home is too far away, or if the thing is just logistically too difficult, they can take their child for a long walk in a baby stroller instead. Since parents are in the unit every day, taking care of their little one, it is quite simple for the medical staff (especially for the fantastic nurses!) to assess their preparedness, encourage them and prepare them also technically for kotiloma.
    Basically there are two types of kids who go for a vacation to home. The first one is when the baby is being fed by a feeding tube and getting close to the discharge date. Parents generally feel quite comfortable with using the tube and since they are practically living in the unit, it’s not a big hassle for them to take the baby home with this tube. The second group of babies are the ones on an "apnea countdown" . Those are sent home with saturation monitors and parents are specifically educated by nurses to interpret heart rate and SatO2. They are additionally trained in infant resuscitation. This whole „crash course” takes no more than 1 hour. If the parents are eager for the kotiloma and the staff is ready to train them, they can take the baby home for the daytime (so they can observe the monitors, but those babies have to return to the Unit for the nighttime.)
    If you are even a bit like me, and I know many of you are, you will ask „BUT WHO IS LEGALLY RESPONSIBLE FOR THAT BABY? WHO IS IN CHARGE IF ANYTHING HAPPENS?”. Well, since the kid is not really discharged from the hospital, that would be you. I know it sounds tricky, but my (not-so-)confidential informant Samuli Rautava from the TYKS NICU says, that since they’ve been doing that (already 5 years!), nothing has ever happened. If the family has any questions or concerns during the kotiloma, they are encouraged to call the nursing station. They are never left alone with their worries. When it comes to financial issues, I would say (naively) that nobody pays anything extra for that vacation. Since the kid hasn’t been discharged, the healthcare fund pays for the day in the unit. Parents provide their own car, clothes and the car seat. No more costs are involved. Easy as that  
    Is it safe? Generally life is known to be a dangerous adventure  But it’s easy to notice, that this practice is based on a mutual trust agreement. "You- The Parents- trust us- The Medical Staff- every day, that we perform medical procedures based on our best knowledge and best available evidence. So WE trust YOU, that you will not idle away our efforts and do your best to provide the best possible care to your baby". This cooperation is working well. Parents are properly educated in their baby’s needs (thanks to Close Collaboration with Parents Training Program). They learn how to perform CPR and call 112 in case of emergency. The nursing staff always gets the information about the condition of other siblings and cohabitants (to avoid infections etc).
    Okay, but what are the benefits? Besides empowerment of the parents (which is a huge thing, especially since they are on-their-way to the discharge date), it actually makes the whole discharge process easier. After the kotiloma parents' confidence grows. It is like a short trial of full stay-at-home parenthood. When you take your precious, fragile baby home, some questions may arise in your head. It feels good to know, that you will be able to ask them to your own pediatrician and nurses when you return to the unit.
    This practice enables parents to observe their child in a home setting. They notice how the baby looks around and curiously contemplates the new environment. It is also a good chance for other cohabitants (those furry ones too!) to get to know their future housemate. Kotiloma is simply a joy for parents, baby and whole family. A sign saying „our baby is doing fine”. Some happy moment to cherish. We all need those sometimes!

  14. When it comes to inserting tubes, NICU staff is probably the most experienced in the world. Intubation is one of the first procedures we learn as young doctors in NICU. Some of us perform it through nose, some through mouth. But who performs it on mother’s or father’s chest?
    Well, I’ve seen it only once or twice, but that is a practice in Uppsala University Hospital. 
    What do you need to perform it? An intubation set. A baby, that actually needs that intubation. It can be a planned or an acute one. And then you need that special thing- a parent (or a caregiver), that is willing to help you with the procedure.
    When I came back from Sweden, I shared this crazy idea with one neonatal nurse. She told me, that it must be extremely stressful for the parent and that she considers it inhumane to push parents to do that. Well, I can say that I partly agree with her, giving the specification of the unit she worked in at that time. It was a medium size NICU of the highest reference, where parents were welcome to visit the baby, but there were no beds for them, and the chairs for the kangaroo care were each time brought in for that short „session” of skin-to-skin care. LET’S TALK ABOUT SPONTANEITY THERE! 
    But in Uppsala University Hospital this procedure is possible, because you have parents there all the time. They basically never leave the unit. If they are not doing skin-to-skin with their baby (watching a movie on a little player approved by the unit or reading a book), they are cooking or eating in the parent’s area or taking shower in their bathroom. They are not patients there, but they are staying there overnight, so in the morning you can see some of them sneaking out to the bathroom in their pyjamas. So in that situation, you don’t just have a scared parent, who is there from time to time, smiling nervously to his or her child through the plastic incubator. You have a semi-professional companion, who knows his or her baby’s needs best and who is there to care for their own infant.
    So back to the main topic. Intubation on parent’s chest. Ok, you may say- that sounds okay, but what are the benefits? Why should we risk intubating on an unstable ground? I asked Erik Normann, the Head of the Department of Neonatology in Akademiska Hospital in Uppsala the same question. His opinion is, that in that way child stays in it’s preferred care site during this stressful moment. And in case of spontaneous extubation during skin-to-skin care, you don’t have to move the child back to the incubator to place the tube, so this is quicker. And that skin-to-skin care just continues after the procedure. There’s no special technique or limitations for that procedure, but he admits, that it creates some logistic problems with the staff position around the bed. Also, bending over parent’s chest is not the most optimal working position (especially for taller doctors 😉). But what you get in return for that effort is a happier baby, supported and stabilized by their parents hands.
    I’m not sure if all of us are „there yet”. What is the more important, is that we are heading in that direction- to this mental NICUland, where parents are there for the baby all the time, to offer warmth of their skin and delicacy of their touch, and where medical staff is ready to accept their help and presence. Together we can do more!
    So hands up guys- who does that too in their unit? Who would like to try?✋✋✋

  15. The Finnish way of caring

    · piatkat · 05/26/2018 08:43 AM

    I had an amazing opportunity to visit NICU in the Turku University Hospital in 2016. They admit around 550 problematic newborns per year. About 10% of them are born below 30 weeks of gestation. The whole unit is practically based on 11 family rooms (single family rooms when possible) and additionally one larger room for 4 patients. The larger room is usually used for babies who are admitted due to transient issues (tachypnea, hypoglycemia, hyperbilirubinemia etc). Single family rooms are equipped with an incubator/open warmer bed/cot, one adult bed, one reclining armchair and a nappy changing station. There is also a breast pump and a refrigerator for breast milk in the room. Parents are constantly involved in the care of their preterm baby and are welcome to stay and care for their child all day and night. That’s the theory. So what is the reality?
     
    Entering the unit for the first time, the word that came to my mind was „serenity”. 
    The unit welcomes you with knitted octopuses and tiny socks everywhere.  The whole design of the unit is somehow soft, warm and calming. Each family room is „protected” by a closed door with a window in them - and the window is also covered with a pastel-color quilt. If you want to enter the room, or you’re just looking for your co-worker, you can just „peek in” and check without disturbing the family much. Then you can knock on the door and enter the room. This way you are giving the family the maximum privacy we can offer in those special circumstances.
    Well, you have those tiny, „problematic” children in those private family rooms, with their parents being their primary caretakers, guardians and gate-keepers. Yet, nobody feels that their access to the patient is limited. How is that even possible? Maybe this is what we call „the change of the caring culture”? When you’re „letting go” of some of your duties and delegating them to the parents, you also learn to trust them with your little patient. After all, we all have the same goal- and the parents are personally and emotionally interested in their own child’s well-being, so they have even stronger motivation to perform well.
    Visiting you patient in the single family room feels like visiting your friends, who had just brought their newborn back from the hospital. Imagine the situation, that you’re paying them that first visit, with a little gift wrapped in a pink paper and a big pink balloon. What will you expect? I think it’s quite normal that their room will be a bit messy and everybody will be whispering around the sleeping baby. It’s normal that the mother will be breastfeeding (or pumping milk) in your presence. And again- it’s normal that parents will be touching and cuddling the baby.
    I’ve visited several neonatal intensive care units around the Europe. They all announce proudly, that they are „family centered units”. They all know that skin-to-skin care is a recommended, good and beneficial procedure. Yet in the same time, they actually treat it like a medical procedure - which is time-limited and full of exclusion criteria. That procedure also seems to be quite stressful for the medical staff, because they feel like they can’t access their patient anymore. What if something happens, what if we need to react, how to save that baby when the baby is outside the cot? How can we be medical professionals, when the patient is out of reach?
    It comes straight to the question: what exactly is skin-to-skin care for you? Is it a medical procedure, which is performed once or twice a week, for one hour, when the baby (and the parent!) is fully dressed? Or do you consider mother’s and father’s bare chest as a new space of care for your patient? A safe surrounding, stabilizing baby’s body temperature, breathing and heart rate?  And what do you consider a contraindication for skin-to-skin care? 
    Recently I’ve heard from my friend that in their NICU (highest reference centre) kangaroo care is performed only after the baby reaches 1600g. In other place, I’ve seen a healthy 31-weeker in his second week of life, on full enteral feeds, happily kicking in a closed incubator, who couldn’t be kangarooed or even touched by his parents, just because there was a PICC-line placed in his arm. I still remember those sad parents, wearing plastic gowns, standing by that closed incubator, not being able to even touch their own baby, just because it was a preemie. 
    Prematurity is a diagnosis, but it’s not a sentence! If we are treating similar babies with similar equipment and similarly trained staff - why does our practice differ so much? Leave your comment and join the discussion!
     
     

  16. Launching into 2025: Community First

    Wrap · piatkat · 02/10/2025 10:02 AM

    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.

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