Neonatal Network
January/February 2005
Vol. 24, No. 1

ABSTRACTS

Holding the Very Low Birth Weight Infant: Skin-to-Skin Techniques
Theresa Kledzik, RN

Skin-to-skin holding has been reported as a valuable intervention for preterm infants for over a decade. However, many neonatal intensive care units are not practicing this therapy and cite lack of protocols and techniques as a barrier. This article describes in detail the nursing considerations and techniques involved to successfully implement skin-to-skin holding for very low birth weight, technology-dependent infants. NICU protocols can be derived from this article.

The Premie-Neuro: A Clinical Neurologic Examination of Premature Infants
Donna Kathryn Daily, MD
Patricia H. Ellison, MD

Purpose: To develop a neurologic assessment tool, the Premie-Neuro, for very low birth weight (VLBW) infants.
Instrument Development: Neurologic data were collected during the course of the NICU stay. Factor analysis was utilized to determine the strength of relationships between items and to reduce the initial number of test items.

Sample: An NICU cohort of 86 preterm infants was enrolled. Mean birth weight was 1,165.8 ± 446.7 grams, and mean gestational age at birth was 28.8 ± 3.2 weeks.

Method: Seventy-five neurologic and behavioral characteristics were assessed in week 1 of life and every 2 weeks thereafter until 38 weeks postconceptional age.

Main Outcome Variable: Three factors, the Neurologic Scale, the Movement Scale, and the Responsiveness Scale, described the neurologic examination.

Results: Factor reliability was calculated for internal consistency (Cronbach alpha coefficient) and ranged from .73 to .82. The Premie-Neuro can be utilized with VLBW infants to monitor neurologic development during NICU care.

Use of Sleep Studies in the Neonatal Intensive Care Unit
Tina Di Fiore, RN, CNNP, MSN

Although early hospital discharge of infants can be both cost-effective and better for developmental care and parent-infant bonding, neonatal caregivers need to ensure infant safety. One of the concerns of early discharge is the risk that premature babies may continue to have apnea, bradycardia, and oxygen desaturation after discharge and that these events can be serious enough to increase morbidity and mortality. The discharging provider bears the responsibility of assessing each infant's risk for persistent apnea and providing the care and monitoring appropriate for his presumed risk level. Presently there is no universally accepted testing method that can accurately predict which infants will experience significant apnea. Neonatal sleep studies are one of the objective methods being evaluated to identify infants at risk for persistent apnea. This article addresses arguments for and against the use of sleep studies to determine the risk of apnea in neonates about to be discharged, types of sleep studies and what they test, and how sleep studies can be useful in determining infant care.

Mongolian Spots in the Newborn: Do They Mean Anything?
A CEU Offering
Timothy M. Snow, RNC, MSN

Mongolian spots are the most frequently seen birthmarks in infants. They have almost universally been regarded as benign cutaneous manifestations that have no clinical significance. Recently, however, there have been studies suggesting that Mongolian spots manifest more often in children with certain inborn errors of metabolism, including mucopolysaccharidosis and GM1 gangliosidosis.