Neonatal Infant Follow-Up Program Analysis

There are more than 70% of premature babies that are born between 34 and 36 weeks gestation a year. When a baby is born early, or born with birth defects, the Neonatal Intensive Care unit is its first home. The nurse’s in the NICU have the difficult job of preparing baby’s and parents for a health life together. A baby who has been put into the NICU will stay there until it is healthy enough to go home.

Childbirth is one of the greatest privileges on the earth anyone could have and we, as women, should feel proud to be major contributors for it. Thus, a mother has to play a key role in aiding the healthcare workers to mitigate the health crisis associated with childbirth by performing her duties faithfully. One such associated health crisis is “Premature (preterm) birth” which occurs when the baby is born too early, before 37 weeks of gestational period (CDC, 2015). The rate of preterm birth ranges from 5% to 18% of babies born across 184 countries (WHO, 2015).

Infant deaths in the neonatal period are caused by complications arising from preterm births, birth defects, maternal health conditions, complications of labor and delivery, and lack of access to appropriate care at the time of delivery. Infant deaths in the post-neonatal period are driven by sudden unexpected infant death (SUID) (including sudden infant death syndrome [SIDS]), injury, and infection (MMRW, 2013). An increasing proportion of post-neonatal infant deaths occur among infants who were born preterm but survived the neonatal period (Callaghan, 2006). On the other hand there is lesser knowledge of the incidence and etilogy of fetal mortality which according to MacDorman et al, makes fetal mortality an overlooked public health issue. Lee et al, echoed the same idea when they said infant mortality has been the main focus of public health programming while fetal deaths have gone untargeted. However, with the decrease in infant mortality rates there have been recent approaches such as perinatal period of risk analysis framework (PPOR) that highlight the need to include fetal

By launching the “Prematurity Campaign” in which it reports the crisis and help families have to what is consider normal full-term, healthy babies. By launching the Prematurity Campaign to address the crisis and help families have full-term, healthy babies. From depth research has shown prematurity can cause long-term health problems for babies. Premature infants may have a tougher time while learning in school. Most of the post problems arise from incomplete development. The effect of premature birth on language development plays a key role to highlight a series of deficits in preterm low-birth-weight children. Language development problems are among these

The APN leader interviewed for this paper is a Board Certified Nurse Practitioner (CNP), Chery Arnett works in the Neonatal Intensive Care Unit for Memorial Hospital of Carbondale. She began as a registered nurse in 1981, then in 2001earned her CNP title. She manages and cares for the ill neonate, collaborates with Neonatologist and Pediatricians to improve overall health outcomes. She provides support and assists ventilation, assists with deliveries both “normal” and high risk infants, provides care for the healthy newborns, also providing guidance to parents for caring for the “neonate” or healthy newborns. She is also responsible for assessments, orders, treatment plans, medications, and discharge of the infant. CNP’s provide initial, ongoing and comprehensive care, including managing patients with acute and chronic illness and diseases for both premature infants and term infants.

According to the World Health Organisation [WHO] (2014) pre-term babies are at increased risk of illness, disability and death. It also states that globally 15 million babies are born pre-term and the figures are rising. In England and Wales during 2012 7.3% of live births were pre-term under 37 weeks nearly 85% of all babies born prematurely will have a very low birth weight (Office for National Statistics, 2012). Pre-term birth is associated with respiratory complications and lung disease, long-tern neurological damage and problems with bowel function (Henderson & Macdonald, 2011). Neonatal services provide care to babies who are born prematurely or are ill and require specialist care. It is seen that sixty per cent of infant deaths occur in the neonatal period (DH,

For the past two decades, the limit of gestational viability has been 22-24 weeks (Bhat, Weinberger, & Hanna, 2012). Around 50 years ago, a premature infant born between 22-24 weeks was not considered viable and resuscitation was only considered at 27-28 weeks (Kushchel & Kent, 2011). Medicine and technology advances have improved neonatology drastically and infants are surviving at lower gestational ages. However, many studies show very low survival rates of 22-week neonates and some physician refuse to resuscitate and provide only comfort care. In the NICHD Neonatal Network between 2003 and 2007, infants that were incubated and resuscitated had a 6% survival rate at 22 weeks and a 55% survival rate at 24 weeks (Bhat et al, 2012). Another study followed a hospital for many years were they delivered 85 infants at 22-week

This article talks about the readiness of feeding in preterm infants and how families can be prepared for early discharge of these infants from hospitals if proper cue based feeding is done.

Now, medical advances make it possible for even the most severe premature babies to survive. As in case of Preterm babies as young as 22 to 23 weeks ( Micro preemies), level 3 NICU offers a wide range of neonatal services including special imaging techniques, advanced ventilation procedures, and special surgeries (Bird, 2014). Advanced technology has helped to increase the survival rate for even the most severe preterm babies, but the costs associated with them is high (Kornhauser & Schneiderman, 2010). The average cost for treating the micro preemie has been estimated to be more than $ 2 million (Kornhauser & Schneiderman, 2010). Nevertheless, this projected cost is excluding the cost of treating long term outcomes in the micro preemies. The

In 2005, hospital received the international recognition as a baby friendly birth facility from the World Health Organization (unknown author, 2007). The hospital is eligible to participate in Medicare and Medic aid and is in compliant with the program requirements.

Newborn intensive care is care for critically ill newborns requiring constant nursing, complicated surgical procedures, regular respiratory support, or other intensive interventions. An infant is considered premature if he or she is born before 37 weeks of gestation and weighs less than 2,500 grams (g). A very low birth weight (VLBW) infant is a child born weighing under 1,500 g

When one thinks of a baby born prematurely many imagine a tiny one-pound baby barely able to live even with all the ventilators and machines hooked up to it. They imagine a baby that will be under weight and unable to leave the hospital for many months to come. Few will know the risk factors that come along with being preterm, and even less will know that preterm babies are just as capable of living healthy and normal lives. “Every child develops in their own unique way, and your baby 's development will depend on a range of factors, including his genetic make-up, and the environment and influences around him” (https://www.tommys.org).

Prematurity is the prime cause of infants’ morbidity and mortality in the United States. Premature infants (preemies) invariably experience immediate health complications that may negatively affect their survival. Now medical advances make it possible for even the most severe premature babies to survive. However, the cost associated to treat preemies is significantly high. The cost of the stay considerably influenced by the length of the hospital stay (LOS). Although, many follow-up programs with a definitive goal to abbreviate LOS and its associated costs, have been introduced in the different regions of the U.S. Yet, it is vital to compare the post program LOS with the baseline data to determine if these programs shortened the hospital

NNS is the repetitive mouthing by an infant on a blind nipple or a pacifier (Hill, 2005). It is thought that NNS enhances feeding performance and successful achievement of exclusive oral feedings in preterm infants (Kish, 2015). Asadollahpour, Yadegari, Soleimani, Khalesi (2015), Kish (2015), Hill (2015), Younesian et al. (2015), and Bache et al. (2014) implemented experimental groups and control groups to conduct trials to determine if NNS was an effective protocol to use in the NICU. A number of inclusion-exclusion criteria were determined for these trials such as, a premature newborn that was anywhere between 26 to 35 weeks and that was appropriate weight and length for their gestational age (GA). The infants could also have no congenital abnormalities or medical disorders known to affect feeding ability such as third or fourth degree hemorrhage, necrotizing enterocolitis, or asphyxia, the infants also had to be fed by a tube and not have any oxygen supplementation.

While some women who received no prenatal care had normal, uncomplicated births, others did not. Most of the women who did not receive adequate prenatal care gave birth to an underweight and underdeveloped infant. Among the benefits of early, comprehensive prenatal care are decreased risk of preterm deliveries and low birth weight (LBW)-both major predictors of infant morbidity and mortality. (Dixon, Cobb, Clarke, 2000). Preterm deliveries, deliveries prior to 37 weeks of gestation, have risen. Since the studies in 1987, which showed the rate of preterm deliveries as 6.9% of births, the 1997 rate shows an increase to 7.5%. Low birth weight, defined as an infant weighing less than 2500 grams (5lbs. 5oz) is often preceded by preterm delivery. Low