In our study sample, PRBC transfusion was associated with increased odds of NEC. The rate of NEC after transfusion was 1.4%. From our data we could not determine if PRBC transfusions were part of the causal pathway for NEC or were indicative of other factors that may be causal for NEC.

Ghrelin, but not CCK, is present in breast milk. Since the mammary gland produces ghrelin message, and ghrelin levels in breast milk are higher than those found in plasma, we conclude that ghrelin is produced and secreted by the breast.

Objectives:To determine what sources of information are most helpful for neonatal intensive care unit (NICU) parents, who provides NICU parents with the information, and also what expectations parents have regarding obtaining information.Study design: A 19-item questionnaire was given to the parents of infants 32 weeks or younger prior to discharge from the NICU.Results: Out of the 101 parents who consented, almost all of the parents (96%) felt that 'the medical team gave them the information they needed about their baby' and that the 'neonatologist did a good job of communicating' with them (91%). However, the nurse was chosen as 'the person who spent the most time explaining the baby's condition, 'the best source of information,' and the person who told them 'about important changes in their baby's condition' (P<0.01). Conclusion:Although the neonatologist's role in parent education is satisfactory, the parents identified the nurses as the primary source of information. Journal of Perinatology (2006) IntroductionOne out of every eight babies is born prematurely in the United States. The birth of a premature infant is a stressful event. The major concerns of neonatal intensive care unit (NICU) parents' during this stressful time are their informational needs, their grief response, their parent-child role development, stress and coping, and social support. [1][2][3][4] In most studies, parents communicated that their need for information was one of their most important concerns. Parents want 'clear and honest information,' 3,5 and have commented that they have had 'difficulty in obtaining accurate and up-to-date information'. 6 Obtaining information is important because it helps parents assume their parenting role, gives them some sense of involvement and control while decreasing their feelings of stress, and helps them cope with the fear and uncertainty of the situation.2,7 Without adequate communication with the medical team and adequate teaching, parents are at risk for maladjustment and preterm infants are at risk for abuse and neglect, failure to thrive and poor social adjustment. 2,7,8 Owing to the profound consequences of poor doctor--patient communication and the concerns of NICU parents, communication was made one of the priorities of the 'Principles of Family Centered Care' published in 1993. 9 The number one principle states that 'family centered neonatal care should be based on open and honest communication between parents and professionals on medical and ethical issues'. Although previous research has focused on parent education, 10 the times for teaching, 5,7 and the internet as a source of information, 12 there has been little research in regards to the specifics of 'open and honest communication'. It is not known from whom or from what source parents want to receive the 'clear and honest information'.The objectives of this study were to determine what sources of medical information are most helpful for NICU parents, who provides parents with the medical information, and also what expectations ...

BackgroundThe National Institutes of Health reported in 2007 that approximately 38% of United States adults have used at least one type of Complementary and Alternative Medicine (CAM). There are no studies available that assess general CAM use in US pregnant women.The objectives of our study were to determine the prevalence and type of CAM use during pregnancy at one medical center; understand who is using CAM and why they are using it; and assess the state of patients’ CAM use disclosure to their obstetrical providers.MethodsA cross-sectional survey study of post-partum women was done to assess self-reported CAM use during pregnancy. Results of this survey were compared to results from a previous survey performed by this research team in 2006. Data were analyzed using binary logistic regression.ResultsIn 2013, 153 women completed the survey, yielding a response rate of 74.3%. Seventy-two percent and 68.5% of participants reported CAM use during their pregnancies in 2006 and 2013 respectively. The percentage of participants who reported discussing CAM use with their obstetrical providers was less than 1% in 2006 and 50% in 2013. Increased use of different CAM therapies was associated with increased maternal age, primagravida, being US-born, and having a college education (p ≤ 0.05). However, these factors were poor predictors of CAM use.ConclusionsGiven the frequency of CAM use and the difficulty in predicting who is using it, obstetrical providers should consider being informed about CAM and incorporating discussions about its use into routine patient assessments.

OBJECTIVE To compare work of breathing (WOB) indices between two nCPAP settings and two levels of HFNC in a crossover study. STUDY DESIGN Infants with a CGA 28–40 weeks, baseline of HFNC 3–5 lpm or nCPAP 5–6 cmH2O and fraction of inspired oxygen ≤40% were eligible. WOB was analyzed using respiratory inductive plethysmography (RIP) for each of the four modalities: HFNC 3 and 5 lpm, nCPAP 5 and 6 cmH2O. N = 20; Study weight 1516 g (±40 g). RESULT Approximately 12 000 breaths were analyzed indicating a high degree of asynchronous breathing and elevated WOB indices at all four levels of support. Phase angle values (means) (P<0.01): HFNC 3 lpm (114.7°), HFNC 5 lpm (96.7°), nCPAP 5 cmH2O (87.2°), nCPAP 6 cmH2O (80.5°). The mean phase relation of total breath (PhRTB) (means) (P<0.01): HFNC 3 lpm (63.2%), HFNC 5 lpm (55.3%), nCPAP 5 cmH2O (49.3%), nCPAP 6 cmH2O (48.0%). The relative labored breathing index (LBI) (means) (P≤0.001): HFNC 3 lpm (1.39), HFNC 5 lpm (1.31), nCPAP 5 cmH2O (1.29), nCPAP 6 cmH2O (1.26). Eighty-two percent of the study subjects—respiratory mode combinations displayed clustering, in which a proportion of breaths either occurred predominantly out-of-phase (relative asynchrony) or in-phase (relative synchrony). CONCLUSION In this study, WOB indices were statistically different, yet clinically similar in that they were elevated with respect to normal values. These infants with mild-to-moderate respiratory insufficiency demonstrate a meaningful elevation in WOB indices and continue to require non-invasive respiratory support. Patient variability exists with regard to biphasic clustered breathing patterns and the level of supplemental fraction of inspired oxygen ≤40% alone does not provide guidance to the optimal matching of WOB indices and non-invasive respiratory support.