A different kind of battle: the effects of NICU admission on military parent mental health.

OBJECTIVE: To determine the incidence of mental health symptoms in military families after prolonged NICU admission. STUDY DESIGN: Prospective cohort study of military-affiliated NICU parents participating in serial electronic surveys, which included validated screening tools for acute stress (ASD), post-traumatic stress (PTSD), and depression disorders. RESULTS: Among 106 military parents surveyed after NICU admission, 24.5% screened positive for ASD and 28.3% for depression. 77 (72.6%) parents continued participation beyond discharge, with 7.8% screening positive for PTSD and 15.6% for late depression. Positive ASD correlated with later symptoms of PTSD (OR 8.4 [2.4-30]) and early depression with both PTSD symptoms (OR 5.7 [1.7-18.8]) and late depression (OR 8.4 [2.4-30]) after discharge. Secondary analysis determined these findings were independent of deployment and other military related factors. CONCLUSION: This study highlights the potential mental health burden experienced by military-affiliated NICU parents. Early ASD and depression screening may identify parents at risk for mental health symptoms after discharge.

Supplementation-based hypoglycemia guidelines including donor breast milk reduce NICU admission.

OBJECTIVE: To study the effects of a supplementation-based hypoglycemia guideline including donor (DM) on NICU admission, exclusive breastfeeding, and blood glucose concentrations in infants at-risk for neonatal hypoglycemia (NH). PROJECT DESIGN: We integrated DM, feeding supplementation, and reduced frequency of blood glucose testing into an NH bundle for term and late-preterm newborns. We then examined NICU admission rates and rates of exclusive breastfeeding at discharge. RESULTS: NICU admission rates were reduced to 6% (-10%). Exclusive breastfeeding rates increased to 55% (+22%). Median cost of DM utilization was $13.73 per patient with an average volume of 50.8 ml/infant. DM supplementation resulted in similar times to last hypoglycemic episode and greater increases in blood glucose compared to expressed breast milk or breastfeeding alone (+9.6 mg/dL, p < 0.05). CONCLUSIONS: A supplementation-based hypoglycemia guideline including donor milk may be an effective way to reduce NICU admissions for asymptomatic hypoglycemia and support mothers in achieving breastfeeding goals.