PURPOSE: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. METHOD: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. RESULTS: A significant difference was identified among the mean scores in CRIES(F(2, 91)=47.847, p=.000), FLACC(F(2, 91)=41.249, p=.000) and PIPP(F(2, 91)=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. CONCLUSIONS: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.
Pain Measurement/*methods ; Male ; *Intensive Care Units, Neonatal ; *Infant, Newborn ; Infant Behavior ; Humans ; Female

PURPOSE: To investigate factors that may affect the method of feeding among preterm infants at 4 weeks after discharge. METHODS: This study included 222 mother-infant dyads born before a gestational age of 37 weeks. The feeding method and general medical characteristics of the participants were assessed at 4 weeks after discharge using a structured questionnaire. Multinomial logistic regression analysis was used to examine which factors were associated with breastfeeding at home. RESULTS: Of the 222 infants who qualified for the study, 71 (32.9%) continued to receive breastmilk at 4 weeks post-discharge. Multinomial logistic regression analysis showed that breastfeeding at 4 weeks post-discharge was associated with higher breastfeeding self-efficacy, vaginal delivery (experience), direct breastfeeding in the neonatal intensive care unit (NICU), gestational age between 30 and 34 weeks, and breastmilk consumption in the NICU. The following factors were associated with mixed feeding at 4 weeks post-discharge: being employed, having higher breastfeeding self-efficacy, and direct breastfeeding in the NICU. CONCLUSION: NICU nurses should provide opportunities for direct breastfeeding during hospitalization and support breastfeeding to enhance breastfeeding self-efficacy. These factors may help to ensure the continuation of breastfeeding after discharge. Moreover, factors that affect breastfeeding should be considered when providing interventions.
Breast Feeding ; Feeding Methods ; Gestational Age ; Hospitalization ; Humans ; Infant ; Infant Formula ; Infant, Newborn ; Infant, Premature* ; Intensive Care, Neonatal ; Logistic Models ; Methods* ; Patient Discharge ; Premature Birth

In the early postnatal period, prematurely born infants, especially those born at the earliest limits of viability, face a nutritional crisis. A lack of essential nutrients may result in substantial developmental morbidity. In particular, because this period is crucial to proper neurodevelopment, a central concern must be providing essential nutrition for proper neurodevelopment, and the prevention of long-term neuro-deficits. Therefore, providing appropriate nutrition for growth and development is one of the most essential concerns in the care of preterm infants. The optimal goal for providing nutrition in the preterm infant is to achieve a postnatal growth rate approximating that of the normal fetus at the same gestational age. However, extra-uterine growth restriction develops during the course of care for most very low birth weight infants admitted to the neonatal intensive care unit. Herein, the optimal nutrient requirements and most recently recommended total parenteral and enteral feeding strategies are reviewed to provide neonatal clinicians with current guidelines for nutritional care that can improve neurodevelopmental outcomes in preterm infants during and after treatment in the neonatal intensive care unit.
Enteral Nutrition ; Feeding Methods ; Fetus ; Gestational Age ; Growth and Development ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Nutritional Status ; Nutritional Support

PURPOSE: The purpose of this study was to explore and describe the meaning and essence of a mother's experience of hospitalization of her newborn in the neonatal intensive care unit (NICU). METHODS: This study employed a qualitative research design. An interview was conducted with a mother whose newborn was hospitalized in the NICU, and the data were analyzed using Giorgi's phenomenological method. RESULTS: Five main themes and 19 formulated meanings were indentified. The 5 themes were ‘drowning in pain’, ‘just look outside the glass door’, ‘being a pillar’, ‘a deepening attachment’, and ‘prepare for nurturing with hope’. CONCLUSION: The results of this study provided an in-depth understanding of the experience of a mother with a newborn in the NICU. These results can be used in the development of a nursing intervention program that provides psychological and emotional support to the mother and family.
Glass ; Hospitalization* ; Humans ; Infant, Newborn* ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal* ; Methods ; Mothers ; Nursing ; Qualitative Research

PURPOSE: The purpose of this study was to identify breastfeeding practice with late preterm infants (LPIs), and to determine predictors of exclusive breastfeeding at the 12th week after discharge. METHODS: The participants were 106 mothers of LPIs hospitalized in neonatal intensive care units at two university hospitals. Data were collected between February and October, 2013. Questionnaires included characteristics of LPIs, their mothers, and feeding-related characteristics. Feeding methods were exclusive breastfeeding, mixed feeding, and formula feeding. RESULTS: Exclusive breastfeeding steadily increased from 5.7% at the 1st week to 19.8% at the 12th week, as did formula feeding from 27.3% to 67.9%. Contrarily, mixed feeding decreased from 67.0% at the 1st week to 12.3% at the 12th week. The ratio of formula feeding was higher than that of exclusive breastfeeding over time. Predictors for exclusive breastfeeding were the following: type of delivery (OR=2.96, 95%CI=1.07-8.14), feeding intolerance (OR=3.03, 95%CI=1.26-7.25) and feeding method during hospitalization (OR=7.84, 95%CI=3.15-19.53). CONCLUSION: In order to increase breastfeeding opportunities for LPIs, educational programs for gestational age-appropriate breastfeeding should be developed. The focus of breastfeeding education needs to be on mothers who delivered their LPIs through Cesarean-section and LPIs who had feeding intolerance or were fed only formula during hospitalization.
Breast Feeding* ; Education ; Feeding Methods ; Hospitalization ; Hospitals, University ; Humans ; Infant, Newborn ; Infant, Premature* ; Intensive Care Units, Neonatal ; Mothers ; Prevalence*

Adolescent ; Bronchoscopy ; methods ; Child ; Child, Preschool ; Female ; Fiber Optic Technology ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male

Follow-Up Studies ; Humans ; Infant, Newborn ; Infant, Premature, Diseases ; therapy ; Intensive Care, Neonatal ; methods ; Patient Outcome Assessment ; Risk Factors

PURPOSE: This study is aimed to confirm the effects of Yakson therapy on the growth and physical response of preterm infants, and maternal attachment to them compared with GHT therapy. METHOD: The design of this study is nonequivalent control group with repeated measuring by quasi experimental study. The subjects are preterm infants in 26 - 34 gestational age hospitalized in the NICU of 4 university hospitals with an experimental group of 15 and a control group of 14. Yakson therapy consists of three phases: laying a hand, caressing by hand, and laying a hand again taking 5 minutes for each phase. RESULT: As a result of administering Yakson therapy to preterm infants; the average weight gain of the Yakson group was higher than that of the GHT group, but there is no significant difference between groups. The oxygen saturation and maternal attachment difference between the Yakson and the GHT group were not significant. Significant differences in the average daily increase of oral intake and apical pulse rate were observed between the Yakson group and GHT group. CONCLUSION: These data suggested that Yakson therapy may be an effective nursing intervention which can facilitate growth and physical response of preterm infants.
Child Development ; Female ; Humans ; Infant, Newborn ; Infant, Premature/*growth & development/physiology ; Intensive Care, Neonatal/*methods ; Male ; Mother-Child Relations ; Neonatal Nursing/*methods ; Pregnancy ; Therapeutic Touch/*methods

OBJECTIVETo investigate the value of electronic bronchoscopy in the etiological diagnosis and treatment of pediatric intensive care patients with difficult ventilator weaning.

METHODSA retrospective analysis was performed for the clinical data of 92 pediatric intensive care patients with difficult ventilator weaning and underwent electronic bronchoscopy.

RESULTSAmong all the 92 children, the most common underlying disease was respiratory system disease (39 children). Electronic bronchoscopy found abnormalities in 87 children (95%), mainly excessive airway secretions and abnormal airway structure. There was no difference in the severity of tracheobronchial stenosis and tracheobronchomalacia shown by electronic bronchoscopy in children suffering from congenital heart disease (CHD), with and without difficult ventilator weaning. When used to predict difficult ventilator weaning in children with CHD, tracheobronchial stenosis or tracheobronchomalacia had a sensitivity of 68.4% and a specificity of 66.7%. Among the 36 children with atelectasis caused by excessive secretion or phlegm-induced airway obstruction, 23 achieved full or partial re-expansion after bronchial lavage and/or one-lung ventilation.

CONCLUSIONSElectronic bronchoscopy helps to clarify the cause of difficult ventilator weaning and perform treatment under an electronic bronchoscope accordingly in pediatric intensive care patients with difficult ventilator weaning. Tracheobronchial stenosis and tracheobronchomalacia shown by electronic bronchoscopy cannot not be used as an index for the prediction of ventilator weaning in children with CHD.

Adolescent ; Bronchoscopy ; Child ; Child, Preschool ; Critical Care ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Ventilator Weaning ; methods

Child ; Child, Preschool ; Enterostomy ; methods ; Female ; Humans ; Infant ; Male ; Postoperative Care ; Time Factors