Infant care review committees: the response to federal guidelines

Article Abstract:

In 1985, the federal government issued "Infant Doe" child protection regulations and additional voluntary guidelines regarding the care and treatment of handicapped infants. These guidelines suggested that hospitals develop Infant Care Review Committees (ICRC), which would: (1) educate hospital staff and families of disabled infants with life-threatening illness about the availability of services, counseling, and resources; (2) recommend institutional policies regarding the withholding of essential medical treatment from these children; and (3) offer counsel and review in the cases of these children. This study reviewed the status of ICRCs, what kind of institution establishes them, what they do and how they do it. Hospitals with neonatal intensive care units and those delivering 1,500 or more babies annually were included in the survey, since they would most likely be caring for the seriously ill, handicapped child. Factors that predicted formation of an ICRC were: having a residency program; association with a medical school; availability of specialty services; and not-for-profit status. Approximately 52 percent of Level III institutions had an ICRC and another 8 percent were in the process of developing one. Those hospitals that had ICRCs in operation were surveyed to determine whether the committee reviewed cases, the number of cases reviewed, and the ICRC's involvement with decisions to withdraw or withhold treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Reports, Disabled children, Ethical aspects, Neonatal intensive care, Baby Doe regulations

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Gowning on a postpartum ward fails to decrease colonization in the newborn infant

Article Abstract:

It was postulated that if visitors and personnel on a postpartum hospital ward wear gowns, there will be less colonization of bacteria in newborns. The effects of gowning on a postpartum ward were evaluated by measuring the incidence of bacterial infection in the nose and umbilicus of newborns. Infants were assigned to gowning and nongowning groups, and cultures or samples of bacterial growth were obtained from their nostrils and umbilicus six hours after birth and at the time of discharge from the nursery. The gowning group consisted of 102 infants and the nongowning group included 100 infants. The groups did not differ with respect to sex, duration of hospital stay, method of delivery, weight, or conditions of bacterial growth at admission to the nursery. The results demonstrated that the use of gowns did not prevent the growth of bacteria in the nose and umbilicus of the newborns. Seventy of 102 infants of the gowning group and 65 of 100 infants of the nongowning group had no evidence of bacteria upon admission to the nursery, but developed bacterial growth by the time they were discharged. The health status of the two groups was similar on follow-up examination. Infection developed in one infant of each group within the first four weeks of life. Thus, the use of gowns on postpartum wards is ineffective in preventing bacterial growth in the nose and umbilicus of the healthy newborn, and is also costly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Infection, Prevention, Infants (Newborn), Newborn infants, Protection and preservation, Bacterial infections, Postnatal care

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Infant sleep and bedtime cereal

Article Abstract:

In has long been held that starting infants on solid foods at an early age improves nighttime sleep patterns. In an effort to promote uninterrupted nighttime sleep, parents start giving solid evening meals during the first few months of life. The American Academy of Pediatrics suggests introducing solid foods between four and six months of age. This recommendation is based on the fact that waiting to introduce solids prevents an overloading immature kidneys, overfeeding and force feeding by parents, and allergic reactions to food. To evaluate whether an evening feeding improves nighttime sleep, 106 infants were fed one tablespoon of rice cereal in milk bottles before bedtime at either five weeks or four months of age. The early introduction of solid foods did not improve the ability of infants to sleep through the night. It is suggested that sleeping through the night is a developmental and adaptive process having nothing to do with the introduction of solid foods. Most of the infants in this study slept six consecutive hours by 12 weeks of age and eight consecutive hours by 20 weeks of age. There was no observable relationship between the introduction of solids and sleep. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Usage, Baby foods, Infants, Sleep, Cereal products, Weaning, Sleep-wake cycle

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