Accuracy of a user-friendly centrifuge for measuring creamatocrits on mothers' milk in the clinical setting.

The creamatocrit (CRCT), a simple, accurate, and inexpensive technique for the estimation of lipid and caloric content in mothers' milk, has been used extensively in lactation research, but has not been integrated into the routine management of clinical lactation problems such as slow weight gain in mothers' milk-fed preterm and term infants. The Creamatocrit Plus is a lightweight, noiseless centrifuge with an embedded reader that automatically calculates lipid and calories from the CRCT value, making it ideal for use in the clinical setting. This study compared intra-user and inter-user reliability, the equivalence of the CRCT values obtained with the Creamatocrit Plus to the two standard techniques for performing CRCTs: the standard laboratory centrifuge with a hematocrit reader and the standard laboratory centrifuge with digital calipers, and the predictive accuracy of the Creamatocrit Plus for estimating the lipid and caloric content in mothers' milk.

Sex differences in high-risk premature infants' asymmetric movement development.

High-risk premature infants are likely to show altered patterns in the development of reflexes and postural reactions. This study used the Modified-Measure of Behavioral Laterality (M-MOBL) neonatal assessment to explore differences in reflex and postural reactions among 26 male and female high-risk, premature infants born between 23 and 26 weeks gestational age. M-MOBL scores at 33-36.

Mothers' milk feedings in the neonatal intensive care unit: accuracy of the creamatocrit technique.

Objective: To establish the accuracy of the creamatocrit (CRCT) for estimating lipid and calories in a heterogeneous sample of own mothers' milk (OMM) in the neonatal intensive care unit (NICU), using a hematocrit reader, rather than fine vernier calipers.

Study Design: In this blinded study, CRCT techniques were performed on 32 fresh OMM samples (7 foremilk, 12 hindmilk, 13 composite milk) that were also analyzed for total lipid and caloric concentration.

Results: Mean lipid and caloric concentrations for the OMM samples were 50.

Effect of auditory, tactile, visual, and vestibular intervention on length of stay, alertness, and feeding progression in preterm infants.

This study determined whether an auditory, tactile, visual, and vestibular intervention (ATVV) reduced the length of hospitalization of 37 preterm infants by increasing the proportion of alert behavioral states, thereby improving their feeding progression. Participants comprised 12 infants born between 23 and 26 weeks' gestation with normal head ultrasounds and 25 CNS-injured infants born between 23 and 31 weeks' gestation. Infants were randomly assigned to the control group (11 males, five females) or study group (seven males, 14 females) at 32 weeks' postconceptional age.

One-year outcome of auditory-tactile-visual-vestibular intervention in the neonatal intensive care unit: effects of severe prematurity and central nervous system injury.

Thirty-seven infants with severe central nervous system injury or extreme prematurity were randomly assigned to a multisensory (auditory-tactile-visual-vestibular) intervention or control group. Intervention began in the hospital at 33 weeks' postconceptional age and continued twice daily in the home until 2 months' corrected age. Mother-infant interactions during feedings were videotaped, and the Bayley Scales of Infant Development were administered.

Heart rate variability in preterm brain-injured and very-low-birth-weight infants.

Heart rate variability (HRV) reflects the complex interplay of the sympathetic and parasympathetic innervation of the heart. Developmental maturation of the fetus and newborn results in predictable alterations in the neural cardiac control of heart rate. Furthermore, patterns of HRV are closely correlated to clinical outcome in several pathologic situations.

Developmental intervention for preterm infants diagnosed with periventricular leukomalacia.

Preterm infants with periventricular leukomalacia (PVL) were evaluated to determine whether multi-sensory stimulation is safe and to assess whether it improved neurobehavior and neurodevelopment. Thirty preterm infants with documented PVL were randomly assigned to control (n= 15) or experimental (Group E) (n= 15) groups at 33 weeks post-conceptional age. Group E infants received 15 minutes of auditory, tactile, visual, and vestibular (ATVV) intervention twice a day, five days a week, for four weeks during hospitalization.

Prevention of neonatal necrotizing enterocolitis.

There are a number of promising strategies to prevent necrotizing enterocolitis (NEC). These included induction of intestinal maturation with prenatal or postnatal steroids, passive immunization with oral immunoglobulin, modification of enteral feedings, administration of oral antibiotics to decrease bacterial overgrowth while avoiding the development of resistant strains, and acidification of oral fluids to prevent bacterial overgrowth. The initial results need to be confirmed, but it is likely that one or more of these prevention measures will lower the incidence of NEC in the future.

Intravenous immune globulin for the prevention of nosocomial infection in low-birth-weight neonates. The Multicenter Group for the Study of Immune Globulin in Neonates.

Background: Nosocomial infection is a major risk for premature infants with very low birth weights. One reason for their susceptibility to infection may be antibody deficiency, since there is little transfer of maternal IgG to the fetus before 32 weeks' gestation.

Methods: We conducted a multicenter, double-blind study of neonates weighing 500 to 1750 g at birth.

Bronchopulmonary dysplasia and postnatal growth in extremely premature black infants.

Bronchopulmonary dysplasia (BPD) may adversely affect the postnatal growth of the extremely premature infant; however, most studies have not controlled for birth weight. We studied 90 Black premature infants (mean birth weight 989 +/- 148 g). Weight was recorded biweekly until discharge and at 4, 8, and 12 months of age corrected for prematurity.

Cranial ultrasonography and the prediction of cerebral palsy in infants weighing less than or equal to 1200 grams at birth.

The rôle of serial cranial ultrasonography in the prediction of cerebral palsy was examined in 116 surviving infants with birthweights less than or equal to 1200 g. All underwent serial real-time sonographic examinations of the brain on days one, five and 21, then monthly, until term corrected age. Intraventricular hemorrhage (IVH) was diagnosed in 48 infants, and three had periventricular leukomalacia.

Prolonged mechanical ventilation and intracranial hemorrhage: impact on developmental progress through 18 months in infants weighing 1,200 grams or less at birth.

In this prospective, longitudinal study, the relative impact of intracranial hemorrhage and prolonged mechanical ventilation on developmental progress during the first 18 months of life of infants weighing 1,200 g or less at birth was examined. A total of 159 surviving infants were divided into two groups: infants with and those without intracranial hemorrhage. These groups were then subdivided into groups of infants receiving prolonged mechanical ventilation (greater than 21 days) and those mechanically ventilated for 21 days or less, thus creating four subgroups.

Intravenous indomethacin and changes of renal function in premature infants with patent ductus arteriosus.

Selected parameters of renal function were studied in premature infants with a significant patent ductus arteriosus who were treated with intravenous indomethacin according to a specific protocol. Urine volume, glomerular filtration rate, urine sodium, and the fractional excretion of sodium were analyzed in 17; osmolar, sodium, and free water clearances in 8; and indomethacin pharmacokinetics in 7 premature infants. All renal function parameters analyzed decreased during indomethacin therapy: urine volume and glomerular filtration rate returned to normal, while urine sodium, fractional excretion of sodium, and the osmolar, sodium, and free water clearances remained low 24 hours after cessation of therapy.

Teratoma of the tonsil in a premature infant. Case report and review of the literature.

Among the causes of respiratory distress in the neonatal period, a tumor involving the oropharyngeal area is rare. The present case report describes a premature infant with a teratoma of the tonsil and reviews the clinical presentation and management of this tumor in the neonatal period.

Nemaline (rod) myopathy: a possible cause of rapidly fatal infantile hypotonia.

Two infant siblings (male and female) manifested extreme hypotonia and flaccidity at birth and had a rapidly fatal course. In each, rod-like structures were demonstrated within a variety of skeletal muscles, and accumulations of thin filaments were seen in numerous muscle fibers. The possibility exists that this represents a severe and rapidly fatal form of nemaline myopathy that should be included in the differential diagnosis of infantile hypotonias.

Sodium balance in very low-birth-weight infants.

Sodium balance was studied in 17 consecutively admitted neonates weighing less than 1,200 gm at birth. Infants whose gestation was less than or equal to 30 weeks were sicker and were in markedly negative sodium balance on day 3 (-9.25 mEq/kg day), despite a high sodium intake (7.