Beyond the First Wave: Consequences of COVID-19 on High-Risk Infants and Families.

The novel coronavirus disease 2019 (COVID-19) pandemic is affecting care for high-risk newborns in ways that will likely be sustained beyond the initial pandemic response. These novel challenges present an urgent imperative to understand how COVID-19 impacts parent, family, and infant outcomes. We highlight three areas that warrant targeted attention: (1) inpatient care: visitation policies, developmental care, and communication practices; (2) outpatient care: high-risk infant follow-up and early intervention programs; and (3) parent psychosocial distress: mental health, social support, and financial toxicity. Changes to care delivery in these areas provide an opportunity to identify and implement novel strategies to provide family-centered care during COVID-19 and beyond. KEY POINTS: · The COVID-19 pandemic is influencing care delivery for high-risk newborns and their families.. · Rapid changes to care delivery are likely to be sustained beyond the initial pandemic response.. · We have an urgent imperative to understand how COVID-19 impacts infant, parent, and family outcomes..

Applying Developmentally Supportive Principles to Diapering in the NICU: What We Know.

Developmental care measures are integrated in the NICU, but these measures are largely overlooked when it comes to standard care activities such as diapering. This general review of developmental care in the NICU discusses how caregivers can apply appropriate, individualized developmental care measures to diapering regimens. Numerous opportunities to expand developmental care measures into diapering care are identified; these opportunities can protect and promote sleep for hospitalized infants, enhance the diapering environment, minimize stress that infants may experience with diapering, improve infant skin health outcomes through use of evidence-based skin care practices, and foster family involvement during diapering care in the NICU. A developmental approach to diapering offers hospitalized infants regular opportunities to reach their neurodevelopmental potential.

Seizures and Antiseizure Medications are Important to Parents of Newborns With Seizures.

BACKGROUND: Neonatal seizures and antiseizure medications both have potentially serious consequences on the developing brain. As such, optimal treatment of neonatal seizures remains unclear. Moreover, little is known about parental experiences, concerns, or unanswered questions. We conducted an online survey to assess parental perspectives regarding neonatal seizures and their management, along with their suggestions for specific high priority research topics. METHODS: Parents whose children had neonatal seizures were recruited through social media support groups to complete an online survey. Respondents progressed through a tiered series of questions about their experiences with neonatal seizures and antiseizure medications. RESULTS: There were 126 eligible respondents. On a Likert scale, parents reported that neonatal seizures had a major effect on their families (median 10 of 10; interquartile range 3; n = 85). They also reported that antiseizure medications had a significant impact on their families (median 7 of 10; interquartile range 5.5; n = 75). The emotional impact of the uncertainty regarding seizures and medications was highlighted. Effects on neurodevelopment, continued seizures, and adverse effects of medications were some of the most commonly reported parental concerns and their highest priority research topics. CONCLUSIONS: Both neonatal seizures and the medications used to treat them contribute to parental worries and have major impact on families. Patient-centered outcomes research should focus on the risk-benefit ratio of neonatal seizures and antiseizure medication. The emotional impact on parents related to the uncertainty regarding both immediate and long-term neonatal seizure management is important to address in the clinical setting.