Neonatal Resources, the Podcast

Guest Tricia is a Neonatal Nurse Practitioner certified in Palliative Care.  Darla and Tricia discuss Palliative Care in the Neonatal settings and the differences between Palliative and Hospice/End of Life Care with the Neonatal Population. FinServ PodcastThe FinServ Podcast brings together legends and leaders in financial servicesListen on: Apple Podcasts SpotifySupport the Show.

Join Rebecca, Michelle, and Darla on the topic of pulmonary hypoplasia. Neonatal Resources, the Podcast (nicu-resources.com) & so much moreA bi-monthly podcast where we share the stories of our Caregivers, patients and...Listen on: Apple Podcasts SpotifySupport the show

Bronchopulmonary Dysplasia. This is a long one. Rebecca joins us as we discuss BPD in this episode. Support the show

Darla and Michelle discuss congenital diaphragmatic hernia. Support the show

Join Michelle and Darla while they discuss pulmonary surfactant. Support the show

Michelle and Darla discuss the effects of gestational diabetes on the newborn!Support the show

Darla chats with Author and NICU dad, Adam Wood about his experience in the NICU and his books! Check out Premie Adventures here HOME | Preemie AdventuresSupport the show

Join us while we discuss common newborn screens!Support the show

Michelle and Darla discuss congenital viral infections which were once common and are not uncommon.neonatalresourcespodcast@gmail.comNeonatal Resources, the Podcast (nicu-resources.com)Support the show

Michelle, Darla, and Rebecca discuss congenitally acquired infections, what are the most common TORCH infections, and what have we seen. For more information about us and our podcast visit our website at Neonatal Resources, the Podcast (nicu-resources.com)Support the show

Michelle, Rebecca, and Darla discuss neonatal sepsis.  

Joining Darla to discuss Eat Sleep Console are Lisa a Neonatal Nurse Practitioner in Arizona and Jocelyn a Registered Nurse in Arizona. Lisa and Jocelyn are part of an outreach program which follows substance exposed infants and their families through their abstinence journeys. 

Darla gave the reins to Michelle and Rebcca for this episode. Join them while they discuss a head to toe NICU assessment and reporting findings. 

Rebecca and Darla talk head to toe assessment!!! 

Join us while Rebecca leads the discussion on Intraventricular Hemorrhage. 

We discuss from the outside in common cranial bleeds we see in our neonates. 

Fetal circulation and the transition to extrauterine life are extraordinary events. Rebecca, Darla and Michelle talk fetal shunts, fetal blood flow, and the neonates transition to extrauterine life.  

We are back! Join us while we discuss PPHN! 

Darla and Michele discuss the care of infants who have an omphalocele. Neonatal Resources, the Podcast (nicu-resources.com)

Join Michelle and Darla as they discuss the care of infants who have gastroschisis. Neonatal Resources, the Podcast (nicu-resources.com)

Rebecca and Darla discuss Neonatal Hyperbilirubinemia, also referred to as jaundice. 

Michelle, Darla, and Rebecca talk about their favorite NICU milestones and celebrating holidays in the NICU!! Neonatal Resources, the Podcast (nicu-resources.com)

Hosted by Darla, this episode features Sarah Ward Author of "Our NICU Journey" and a NICU mom. Sarah discusses her experiences, her motivation behind writing her book, and some hopes for the future of NICU. Join us on our website, where we have shared some amazing resources for NICU families and professionals! Littlewardbooks.com is where you can find more information about Sarah, her family's journey through the NICU, and other amazing resources!  Darla - "This may be my favorite episode!" Get your own copy of "Our NICU Journey: Tiny Keepsake for Tiny Miracles," find definitions, and explore amazing links on the episode page at www.nicu-resources.com.

Episode Notes:TTN vs RDSNeonatal Resources, the Podcast Listen to Michelle and Darla compare and contrast transient tachypnea of the newborn with respiratory distress syndrome. They talk about:Risk factorsWho is most likely to be impactedThe importance of developmental careClinical managementThere is quite a bit of surfactant discussion, and to be fair, surfactant is often a huge component of NICU management. Check out the Get Your Pens blog To Surf or Not to Surf (if you don't see a hyperlink, check back, it's still in process) for a deep dive into methods of surfactant administration, what makes artificial surfactants work, and how the types of surfactant differ.For visual folks and side by side comparison…Get Your Pens.References:Amitai Komem, D., Meyer, R., Yinon, Y., & Levin, G. (2021). Prediction of meconium aspiration syndrome by data available before delivery. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.14034 Alhassen, Z., Vali, P., Guglani, L., Lakshminrusimha, S., & Ryan, R. M. (2021). Recent Advances in Pathophysiology and Management of Transient Tachypnea of Newborn. Journal of Perinatology, 41(1), 6–16. https://doi.org/10.1038/s41372-020-0757-3Bonk, M. P., & Reilly, J. P. (2019). Clear as Mud: Diagnostic Uncertainty in Acute Respiratory Distress Syndrome. Annals of the American Thoracic Society, 16(2), 197–199. https://doi.org/10.1513/AnnalsATS.201810-697EDGomella, T. L., Eyal, F. G., & Bany-Mohammed, F. (2020). Neonatology; Management, Procedures, on-call problems, diseases, and drugs. (8th Ed).  McGraw Hill Lange. Chapter 106Jnah, A. J., & Trembath, A. N. (2019). Fetal and neonatal physiology for the advanced practice nurse. Springer Publishing Company. Chapter 4Jobe, A. H. (2019). Why, when, and how to give surfactant. Pediatric Research, 86(1), 15–16. https://doi.org/10.1038/s41390-019-0372-1Ng, E. H., & Shah, V. (2021). Guidelines for surfactant replacement therapy in neonates. Paediatrics & child health, 26(1), 35–49. https://doi.org/10.1093/pch/pxaa116Razak, A. (2022). Minimally Invasive Surfactant Therapy vs Sham Treatment and Death or Bronchopulmonary Dysplasia in Preterm Infants With Respiratory Distress Syndrome. JAMA: Journal of the American Medical Association, 327(16), 1613. https://doi.org/10.1001/jama.2022.2923For definitions of the terms we used, check out the full episode page at TTN vs RDS

The last in our gestational age series and a favorite of ours join us while we discuss the tiny babies!!

Perhaps the cutest of the ages, the “almost grown enough to skip the NICU” moderate preterm babies are the topic this week. These babies are 32 and 0/7-weeks to 33 and 6/7-weeks but the discussion extends to the late pretermers who find themselves in a NICU. There has been so much research in the last few years about these babies and the things that impact them both short and long term! Join us as we discuss:Cue based feeding in the moderate/late pretermBetamethasone and Magnesium sulfate in this group and how it impacts infants at deliveryWhat it means to support an infant's natural ability vs impose medical standards Early neonatal research (the name wouldn't come during our recording but, if you want to know, it was Dr. Edgar Rey Sanabria in 1978)As if all of that wasn't fun enough…we also talk about jaundice, the plague…and zombies?!?! Honestly, we haven't laughed that hard in a long time! We hope you will laugh along with us. If our suspicions are correct, this won't be the last time this comes up!Bibliography:Bulut,  A., Cundubey, C., Ceyhan, V., & Aydin, E. (2022). Comparison of neonatal  outcomes with and without the administration of betamethasone in late preterm  births. International Journal of Gynecology and Obstetrics, 349-354.  doi:10.1002/ijgo.14028Chollat, C.,  Sentilhes, L., & Marret, S. (2018). Fetal neuroprotection by magnesium  sulfate: from translational research to clinical application. Frontiers in  Neurology, 247.Conde-Agudelo,  A., & Diaz-Rossello, J. (2016). Kangaroo mother care to reduce morbidity  and mortality in low birth weight infants. Cochrane Database of Systematic  Reviews(8), Art. No.: CD002771. doi:10.1002/14651858.CD002771.pub4Kamran, F.,  Khatoonabadi, A. R., Aghajanzadeh, M., Ebadi, A., Faryadras, Y., & Sagheb,  S. (2020). Effectiveness of cue-based feeding versus scheduled feeding in  preterm infants using comprehensive feeding assessment scales: a randomized  clinical trial. Iran Journal of Pediatrics, :e107475.  doi:10.5812/ijp.107475.Woythaler MS, DO,  M. (2019). Neurodevelopmental outcomes of the late preterm infant. Seminars  in Fetal and Neonatal Medicine, 54-59. doi:10.1016/j.siny.2018.10.002Notes:EDC – Estimated date of confinement, also call the estimated  date of delivery (EDD) or the due date. This uses the date of the last  menstrual period to estimate the date of a 40-week, full term delivery. The calculation  is based on Naegele's rule. If you want a  cheat try this calculator.  Gestational Age – The number of completed weeks of a  pregnancy at the time of delivery. Clinically, the gestational age assessment  is based on the EDC, fetal ultrasound measurements, and gestational age  scoring done at delivery. Check out this Get Your Pens for an in-depth look

In this week's gestational age episode, we talk about late preterm babies…you know, those “not-sure-how-I-am-gonna-act-just-yet” 34-36 weekers (and why they scare Michelle). We explore:·       Betamethasone for mom and how recommendations have changed·       Cold stress and bathing·       How to use your resources (like this podcast!)·       Why these babies are never a “sure thing” as far as their NICU stay is concerned.BibliographyBlackman, I. H. (2014). Factors influencing why nursing care is missed. Journal of Clinical Nursing, 24(1-2), 47-56. doi:10.1111/jocn.12688Centers for Disease Control and Prevention. (2020). Infant Health. Retrieved from National Center for Health Statistics: https://www.cdc.gov/nchs/fastats/infant-health.htmChamberlain, J., McCarty, S., Sorce, J., Leesman, B., Schmidt, S., Meyrick, E., . . . Coultas, L. (2019). Impact on delayed newborn bathing on exclusive breastfeeding rates, glucose and temperature stability, and weight loss. Journal of Neonatal Nursing, 74-77.Data USA. (n.d.). Hospitals: DataUSA. Retrieved from Data USA: Explore, Map, Compare, and DOwnload US Data: https://datausa.io/profile/naics/hospitals#aboutGoodman, D., Little , G., & Harrison, W. (2019). The Dartmouth Atlas of Neonatal Intensive Care. Hanover: The Trustees of Dartmouth College.Ogboenyiya, A., Tubbs-Cooley, H., Miller, E., Johnson, K., & Bakas, T. (2020). Missed nursing care in pediatric and noenatal care settings: an integrative review. American Journal of Maternal/Child Nursing, 254-264.Warren, S., Midodzi, W., Newhook, L., Murphy, P., & Twells, L. (2020). Effects of delayed newborn bathing on breastfeeding, hypothermia, and hypoglycemia. JOGNN, 181-189. doi:10.1016/j.jogn.2019.12.004 Notes:ACOG – American College of Obstetricians and Gynecologists. Want to see their betamethasone recommendation for this population for yourself? It's here.Chorioamnionitis (Chorio) – A bacterial infection of the chorion, amnion, and amniotic fluid. Often indicated by a high maternal fever, tender uterus, or foul-smelling amniotic fluid.Cold Stress – Hypothermia (axillary temperature of less than 97.5° F) which causes an infant to have increased metabolic demands, often leading them to develop hypoxia, acidosis, and hypoglycemia.Rationing Care – A term used to describe the situation where the nurse must decide which interventions to perform (and which to withhold) in order to accommodate their patient assignment. Read more about it in (Ogboenyiya, Tubbs-Cooley, Miller, Johnson, & Bakas, 2020)

The second episode in our gestational age series, today we talk about early-term (near-term)/term infants in the NICU. These are babies born between 37 0/7-weeks and 40 6/7-weeks. We talk about:What on Earth brings these babies to the NICU?!Assessment findings and expectations for uncomplicated newbornsWhat findings should make you really suspiciousHow recent practice changes have impacted the care these babies receive (baby-friendly, antibiotic stewardship, etc.)What normal newborn care looks like, including discharge testingWe also break down APGAR scoring…though the one thing we didn't specifically say is that APGAR scores are determined at one minute of life, 5 minutes of life. Additional APGAR scores are given every 5 minutes for 20 minutes or until a score of 7 or better is achieved. As promised, a better look at the Baby-Friendly Hospital Initiative.BibliographyHealth Resources and Services Administration. (2022,  March). Critical congenital heart disease. Retrieved from Health  Resources and Services Administration: newborn screening:  https://newbornscreening.hrsa.gov/conditions/critical-congenital-heart-diseaseKorang, S. K., Safi, S., Gluud, C., Lausten-Thomsen,  U., & Jakobsen, J. C. (2019). Antibiotic regimens for neonatal sepsis - a  protocol for a systematic review with meta-analysis. Systematic Reviews, 8,  Article number: 306. doi:10.1186/s13643-019-1207-1Martin, M. G., Ewer, M. A., Gaviglio, M. L., Horn, R.  E., Saarinen, M. A., Sontag, P. M., . . . Oster, M. M. (2020). Updated  strategies for pulse oximetry screening for critical congenital heart disease.  Pediatrics, e20191650. doi:10.1542/peds.2019-1650National Organization for Rare Diseases, Inc. (2007).  Aplasia cutis congenita. Retrieved from NORD Rare Diseases Database:  https://rarediseases.org/rare-diseases/aplasia-cutis-congenita/Neonatal early‐onset sepsis calculator recommended  significantly less empiric antibiotic treatment than national guidelines.  (2020, Dec). Acta Paediatrica, 2549-2551.Ramasethu, J., & Kawakita, T. (2017, October).  Antibiotic stewardship in perinatal and neonatal care. Seminars in Fetal and Neonatal Medicine, 278-283. doi:10.1016/j.siny.2017.07.001 For definitions of terms used, visit Early-Term/Term Babies — Neonatal Resources, the Podcast (nicu-resources.com) and view our notes. 

Episode Description:The first in a series of episodes looking at gestational age in the neonatal population. In this episode, we look at late-term and post-term babies, defined as 41+0/7-weeks or greater. Always the dyad expert, (and the only one of us not intimidated by these babies,) Darla helps us break down:What a late-term/post-term pregnancy looks likeRisks for both mom and babyAssessment findings and expectationsDevelopmental care for this gestational age groupWe also get into the psychosocial implications for late-term/post-term deliveries that end up in a NICU stay as well as some of the “sticky bits” like, how much can we trust the dates we are being told and what does it mean for parents to have access to so much information?BibliographyBannour, L., Bannour, R., Chahed, S., & Khairi, H. (2021). Prolonged pregnancy, incidence andmorbidity....14th European Public Health Conference (Virtual), Public health features in a changing world, November 10-12, 2021. European Journal of Public Health, Supplement, iii538-iii539.Centers for Disease Control and Prevention. (2020). Infant Health. Retrieved from National Center for Health Statistics: https://www.cdc.gov/nchs/fastats/infant-health.htmGoodman, D., Little , G., & Harrison, W. (2019). The Dartmouth Atlas of Neonatal Intensive Care. Hanover: The Trustees of Dartmouth College.Kliegman MD, R. M., St. Geme MD, J. W., Blum MD, N. J., Shah MD, M. S., Tasker, M. M., & Wilson MD, M. K. (2020). Nelson Textbook of Pediatrics, Twenty-First Edition. Philadelphia, PA: Elsevier.Latif, S., & Aiken, C. (2021). Prolonged Pregnancy. Obstetrics, Gynaecology & Reproductive Medicine, 170-174.Majola, L., Budhram, S., Govender, V., Naidoo, M., Godlwana, Z., Lombard, C., & Moodley, D. (2021). Reliability of last menstrual period recall, an early ultrasound and a Smartphone App in predicting date of delivery and classification of preterm and postterm births. BMC Pregnancy & Childbirth, 1-9. Notes:AGA (Average for gestational age) - A baby who falls between the 10th and 90th percentile on the growth chartCooling - A term used to describe therapeutic hypothermia, a process which brings the baby's core temperature down, allowing the brain a chance to heal from hypoxic/ischemic injuryDubowitz - A scoring tool used at delivery to estimate the baby's gestational age. EEG (Electroencephalograph) - A test which uses electrodes to measure electric activity in the brainGrowth Chart - A tool used to determine a baby's weight, head circumference, and length in relation to other babies of the same age and gestation. There are several different growth charts, all of which may vary slightly, but your facility will have one that they use for their standard, allowing for an accurate assessment of growth over time.IUGR (Intrauterine Growth Restriction) - A baby who measures below the 4th percentile on the growth chartLGA (Large for Gestation) - A baby that measures above the 90th percentile on the growth chartSGA (Small for Gestation) - A baby that measures between the 4th and 10th percentile on the growth chart.

Nursing school prepares you for caring for patients in the best way possible...unless you decide to work in the NICU! The pediatric knowledge-base focuses on newborn through adolescence and maternity is geared towards conception to delivery. So what does that mean for those of us who choose to dedicate our careers to the span in-between?In this episode, we talk about what it's like to embark on a nursing career in the NICU. From the struggle to reframe everything you thought you knew to navigating the often-difficult politics, join us for a discussion of the semester that nursing school forgot.

Thanks for joining us for our pilot episode of Neonatal Resources, the Podcast! We are so excited to get to share with you our passion for this incredible population. We hope that, as the show grows, we can grow together and share practices, insights, and stories. We are nurses, but this isn't limited to nursing. This podcast is aimed at anyone practicing in, or hoping to practice in, the neonatal world. In this episode, you'll get to hear a little about each of us, what brought us to the NICU, and what keeps us invested. Each of us, Darla, Michelle, and I (Rebecca - it'll usually be this nerdy girl who writes these things!) has a different background and a different approach. For me, our differences have helped me grow, taught me to question myself, and improved my practice.  In such a specialized environment, it can be difficult to find the kind of support and encouragement that is required to really flourish in your practice. We hope you'll find some of that here.What bonds us is a genuine love for what we do. I'm so lucky (can't speak for Darla and Michelle) to have found my life-calling and two of my very best friends in the same place! We are truly grateful to get to share that love and comradery with you and hope that you'll share with us as well. The BIG DREAM for us is to use this platform as a way to grow a community of NICU specialists who want to collaborate and ultimately make the care we provide these vulnerable patients the best it can be.