PURPOSE: The study was done to investigate behavioral problems in toddlers who were born prematurely and to analyze related factors. METHODS: A cross-sectional explorative study was conducted with 72 preterm birth (PTB) children at 24 to 41 months of corrected age who were born at 28 to 37 weeks' gestation. During home visits, behavior problems were assessed using the Behavior Rating Index for Children (BRIC). Using a BRIC score of > or =30, children with suspected behavior problems were grouped in the non-regular behavior group. RESULTS: Of the children, 38.9% belong to the non-regular behavior group. The mental development index score for the Korean-Bayley Scale of Infant Development-II was higher for the non-regular behavior group compared to the regular behavior group (t=2.26, p=.027). Logistic regression analysis showed that lower maternal attachment (<96, OR=3.4, 95% CI[1.1, 10.4]) and higher parenting stress (> or =97, OR=4.8, 95% CI[1.3, 17.3]) were independently related to non-regular behavior. CONCLUSION: PTB Toddlers are at risk for behavior problems which are associated with low cognitive performance. Maternal-child attachment and maternal parenting stress were strongly related to behavior problems in these children. More attention is needed to understand possible behavior problems in young children with PTB, particularly focusing on maternal-child interaction and maternal mental well-being.
Child ; House Calls ; Humans ; Infant ; Logistic Models ; Parenting ; Parents ; Pregnancy ; Premature Birth

The goal of respiratory management in high risk infants is to maintain proper oxygenation by supporting respiration, therefore to minimize the secondary complications and to promote the maximum growth and development. While on artificial ventilator to achieve this goal, the infants require endotracheal suctioning(ETS) to remove lung secretions. however, the negative effects of ETS in neoates have been documented and include hypoxia, bradycardia, mucosal damage, increased intracranial pressure, and death result. The purpose of the study was to investigate how ETS is currently performed in NICU, which would be beneficial to develop the standardized ETS protocol and to apply it to these population. A national-wide survey on clinical protocol of ETS was performed to 149 neonatal nurses with the average of 3 years and 6 months experience in neonatal nursing, 34.2% of whom was bachelor in nursing. The results showed that about 89% of the nurses initiate ETS primarily based on the need of the subjects. The aseptic regulation on ETS was used in 83.9% of the subjects. There was no regulation on the length of catheter in 32.9% and on ID/OD ratio in 17.4%. Many nurses administered hyperoygenation/hyperinflation/hyperventilation based on personal knowhow, rather than scientific rationals(77.2%, 40.9%, 75.2%, retrospectively). About 41% of the nurse regulate subjectively the suction power, while 73.8% of them rotate the subject's head during suctioning and the half of the nurses was favorable in adapting the closed-suctioning protocol. With the findings of the study, the current clinical application of ETS in neonates appears to be based on adult care practices, or personal preference, rather than scientific validation of the safety and effectiveness of the procedure. This study support the needs for developing and applying the standardized ETS protocolin conjunction with the consideration given to the physiologic characteristics of the neonates in respiratory distress.
Adult ; Anoxia ; Bradycardia ; Catheters ; Clinical Protocols ; Growth and Development ; Head ; Humans ; Infant* ; Infant, Newborn ; Intracranial Pressure ; Lung ; Neonatal Nursing ; Nursing ; Oxygen ; Respiration ; Suction* ; Ventilators, Mechanical ; Child Health

PURPOSE: Study purpose were to describe growth patterns of premature infants in weight, length and head circumference from birth to 40th week of corrected ages (CA) and to explore factors affecting patterns. METHODS: A longitudinal descriptive study was conducted with 267 premature infants. They were categorized into 2 groups; GA group with measurements at birth and the CA group with measurements at CA, which was categorized into 3 groups (group 1-3) by WHO guideline for gestational age (GA) at birth. RESULTS: GA group presented greater measures in all than CA group at same week of life. Among CA groups, group 3 showed the highest measurements, up to 37 weeks of life, though this disappeared at 38-40 weeks. Reversely, group 1 revealed the highest growth rates in all measures, followed by group 2 and group 3. Significant interaction was observed in all measures between week of life and any type of groups. CONCLUSION: Higher measures in GA group, as well group 3 among CA groups, supported the superiority of intra-uterine environment overriding quality of regimen from NICU. Regardless of growth acceleration, smaller infants remain smaller, indicating that intra-uterine thrifty phenotype may continue at least up to the 40th week of CA.
Adult ; Anthropometry ; Birth Weight ; Body Height ; Body Weight ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature/*growth & development ; Infant, Small for Gestational Age/growth & development ; Longitudinal Studies ; Male

The major purpose of this study was to develop the nutrition education contents and material through the basic data from the service provider and the consumer. And also, to find out the differences of attitude and needs between the service provider (SP, breastfeeding specialist), present consumer (PC, pregnant or lactating women) and future consumer (FC, college women). There were types of questionnaires, which consisted of needs and attitudes toward child and maternal nutrition, as well as the personal characteristics of the study subjects. The subjects consisted of 113 breastfeeding specialists who served at medical related institutions, 197 pregnant or lactating women and 309 college women. The self-administered questionnaires from subjects were collected from October to November 2005 in Seoul and Kyunggi Province. The data was analysed by SPSS Win 12.0, ANOVA and Kruskal-Wallis test. The results of this study were as following: 1) The most important determining factors on breastfeeding was 'medical specialist's support' (3.51) and the next one was 'knowledge of maternity care practice' (3.39). And the importance score of determinating factors on breastfeeding was significantly different between each group (p<0.001). The groups of consumer (3.50 at PC and 3.59 at FC) considered the service provider (3.32) more important. The service providers considered a more effective determining factor to be "husband and family support" and "peer support" than the others (p<0.001). 2) To compare the effective factors of breastfeeding practices between the three groups, the service providers were more significantly considered than the others such as "attendance of intervention program" (p<0.001). But the PC group considered the most effective factors was "mother's job after delivery". 3) The self-evaluated score of the breastfeeding knowledge was the most high in SP; the score was significantly different between groups. The knowledge score of nutritional aspects in human milk was most highly evaluated. But maternity care practice and public acceptance marked the lower evaluation score than other issues. 4) The desirable types of educational material was mass media, and the next was printed matter such as booklets. Two kinds of consumers preferred DVD or VCR tapes than and the service provider group (p<0.001). 5) The priority contents of nutrition service PC group wanted the information about infant care more than maternal care (p<0.05), but FC group's priority was significantly different compared with PC group (p<0.001). The priority of SP group pointed out the information of practical child care methods. The results showed the needs of nutrition service, education channels, and perception toward effective factors on consumer behavior changes were significantly different between each group. Thus the result of this study may suggest that consumer oriented nutrition service programs must be developed.
Breast Feeding ; Child ; Child Care ; Education* ; Female ; Gyeonggi-do ; Humans ; Infant ; Infant Care ; Mass Media ; Milk, Human ; Pamphlets ; Seoul ; Specialization*

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: The study was conducted to investigate the skin hydration level in various body sites and identify the influencing factors in neonates. METHODS: An exploratory comparison study was designed to measure the stratum corneum hydration, using a National DM-R2 on the forehead, abdomen, buttocks, and the back of the hands and feet of 198 neonates including 92 premature infants. RESULTS: The results showed 32.7%-36.5% of stratum corneum hydration for all sites. Premature infants revealed a higher hydration level on the peripheral sites (dorsal hand and feet) than those of the full-term infants, possibly resulting from therapeutic regimens including an incubator or radiant warmer. Infants in an incubator showed a higher hydration level than those in radiant warmers, suggesting more attention to fluid management for infants in the open environment. In addition, all stratum corneum hydration measurements except one, from the forehead, showed a positive correlation with postnatal age in full-term infants while showing no relation to any measurements in premature infants. CONCLUSION: The study demonstrated the very low skin hydration levels in hospitalized neonates, particularly in premature neonates with more susceptible skin hydration instability despite therapeutic interventions for fluid balance. More vigilant fluid management is imperative in neonates, particularly those in the open environment.
Body Water/*metabolism ; Demography ; Epidermis/*metabolism ; Female ; Humans ; Incubators, Infant ; Infant, Newborn ; Infant, Premature ; Male ; Phototherapy/methods ; *Skin Physiological Phenomena ; Water Loss, Insensible

PURPOSE: Oral glucose and pH are known as critical indicators for the growth of microorganism inside the oral cavity. This study was performed to identify oral glucose and pH variances in the early postnatal days of newborns. METHODS: An explorative study which included 67 newborns was conducted to measure the oral glucose and pH during the first three days of life. Oral secretions were collected every 8 hours for three days or 6 to 9 times immediately after birth up to discharge. Oral glucose and pH variances during the three days were analyzed using the SPSS 22.0. RESULTS: Oral glucose was 30.66±22.01mg/dl at birth then increased to 54.77±27.96mg/dl at the third day of life (F=8.04, p<.001) while oral pH decreased from 7.35±0.36 to 5.53±0.39 during the three days (F=113.35, p<.001). Oral glucose and pH were related to gestational age, regurgitation, and maternal diabetic mellitus. A negative correlation was found between oral glucose and pH (r=-.34, p<.001). CONCLUSION: Oral glucose and pH can be utilized for oral health assessment in newborns. Further study is needed to explore the factors which influence oral glucose and pH in high-risk newborns.
Gestational Age ; Glucose* ; Humans ; Hydrogen-Ion Concentration* ; Infant, Newborn* ; Mouth ; Oral Health ; Parturition

PURPOSE: This study was conducted to measure adiposity and to investigate related factors in preschoolers born prematurely. METHODS: A longitudinal follow-up study was conducted with 52 preschoolers at 5 years of corrected age among 343 preterm infants. Their adiposity status was evaluated based on measurements of body mass index, subscapular and triceps skin fold thickness (SFT), waist circumference, waist-to-height ratio, and mid-arm circumference at a home visit. RESULTS: The findings showed that SFT measurements, particularly at the triceps, reflected the degree of adiposity more accurately than other conventional measures. A shorter gestation, older maternal age, and the mother having more years of formal education were associated with higher levels of adiposity in the preschoolers. CONCLUSION: The adiposity of children born prematurely needs to be thoroughly monitored with additional SFT measurements, considering the risk of accelerated growth patterns overriding regular catch-up growth in children born prematurely.
Adiposity* ; Body Mass Index ; Child* ; Child, Preschool ; Education ; Follow-Up Studies ; House Calls ; Humans ; Infant, Newborn ; Infant, Premature ; Maternal Age ; Mothers ; Pregnancy ; Premature Birth ; Skin ; Skinfold Thickness ; Waist Circumference

PURPOSE: This study was performed to explore the weight variations in high-risk term newborns hospitalized during the early postnatal period. METHODS: A retrospective explorative study was performed with 64 term newborns who were hospitalized in the NICU after birth. Data on daily weight, birth information, and clinical features such as phototherapy, placements, nutritional status were reviewed through medical records for 14 days of life. General Linear Model, GLM was applied to analyze the weight variation by clinical features of these high-risk term newborns for 14 days of life. RESULTS: Newborns at 40 weeks of gestation showed little weight loss during the few days after birth then steadily gained weight to 7.6% at the 14th day. Infants born at 37-39 gestation showed little weight gain for 14 days though the weight loss itself was not apparent. As well, return to birthweight was not observed in newborns with phototherapy, infants placed on a warmer or infants having gastrointestinal dysfunction for 14 days of life. CONCLUSION: Even for term newborns, physiologic weight loss may not be warranted even if newborn is born at less than 40 week of gestation, or with high-risk conditions that warrant admission to NICU.
Birth Weight ; Humans ; Infant ; Infant, Newborn* ; Intensive Care Units, Neonatal ; Linear Models ; Medical Records ; Nutritional Status ; Parturition ; Phototherapy ; Pregnancy ; Retrospective Studies ; Term Birth ; Weight Gain ; Weight Loss

PURPOSE: The study was done to explore variations in physiologic parameters of the stratum corneum (SC) of the dorsal hand and cord area during early days of life in high-risk newborns. METHODS: In this longitudinal study, a total of 77 high-risk newborns were assessed for pH, temperature and hydration of the SC of the dorsal hand and the cord area on the 1st, 2nd, 3rd, 5th and 7th days of life. RESULTS: Results showed that an acid mantle (AM) was formed in 57.1% for dorsal hand and 35.1% for cord area, implying significant delay regardless of decrease in pH (F=103.60, p<.001), and hydration (F=4.00, p=.003) across days in both areas. Peripheral hypothermia with low hydration level was also observed in both areas. There was a positive relation between hydration and temperature (.14 Anti-Bacterial Agents/pharmacology ; Birth Weight ; Body Water ; Epidermis/drug effects/*physiology ; Female ; Hand ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Longitudinal Studies ; Male ; Temperature ; Time Factors ; Umbilical Cord/drug effects/*physiology