• 아동학회지
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• 제33권3호
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• pp.63-81
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• 2012

This study aims to investigate any differences which exist in the early adaptation of infants at child care center according to the characteristics of the infants themselves, their mothers and their child care teachers. The subjects consisted of the infants themselves, their mothers, and teachers at 11 child care centers in Chung-nam and Daejeon cities. Data were collected by means of the PAQ (The Preschool Adjustment Questionnaire) and questionnaires regarding the rearing attitudes of the mothers. For the purpose of data analysis, a T-test and one-way ANOVA were used. The results were as follows. First, there were significant differences in terms of the early adaptation of infants according to their ages and their length of experience in child care centers. Second, there were no significant differences in the early adaptation of infants according to the child rearing attitudes of the mothers and between unemployed mothers and the employed mothers. Third, there were significant differences in the early adaptation of infants according to the child care teachers' level of career experience and their ages.

• Clinical and Experimental Pediatrics
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• 제58권3호
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• pp.77-83
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• 2015

Relative to a fetus of the same gestational age, very low birth weight (VLBW) infants are more likely to be underfed and to undergo growth restriction during their early hospital stay. The current trend towards "early and aggressive" nutritional strategies in VLBW infants aims to overcome the early nutritional deficiency and thereby boost postnatal catch-up growth, simultaneously improving long-term neurodevelopmental outcomes. Although the minimum starting amino acid (AA) dose to prevent negative nitrogen balance is well established, the upper limit and the rate of increase of early AA doses are controversial. Most randomized controlled trials show that early and high-dose (target, 3.5 to 4.9 g/kg/day) AA regimens, with or without high nonprotein calories, do not improve long-term growth and neurodevelopment. High-dose AA supplementation may lead to early metabolic disturbances and excessive or disproportionate plasma AA levels, particularly in infants of very low gestational age. Further large studies are needed to clarify the optimal strategy for early administration of parenteral AA doses in VLBW infants.

• 중환자간호학회지
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• 제4권1호
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• pp.25-35
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• 2011

Purpose: The purpose of this study was to evaluate the actual outcomes of early discharge program for extremely low birth weight (ELBW) infants. Methods: Medical records of 122 ELBW infants admitted in the neonatal intensive care unit from January 2000 to June 2006 and those of their 112 mothers were analyzed retrospectively. Results: After being applied early discharge program to ELBW infants' mothers, their infants' lengths of stay, gestational age and body weight at discharge, duration of completion of oral feeding, number of emergency room visits after discharge were decreased and number of breast milk feeding was increased. Conclusion: Early discharge program for ELBW infants can be an effective intervention for parents and their ELBW infants contributing to neonatal nursing practices.

• Neonatal Medicine
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• 제16권2호
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• pp.101-109
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• 2009

Pulmonary surfactant (PS) therapy in premature infants has a remarkable impact on improving survival and outcomes in neonatal respiratory distress syndrome (RDS). Early PS therapy involves instillation of PS upon delivery of very premature infants or if there is evidence of RDS, such as an increased requirement of oxygen 2 hours after birth, especially in infants <30 weeks gestation. Early PS treatment in very premature infants results in a significant reduction in the severity of RDS, mortality, and incidence of pneumothorax, pulmonary interstitial emphysema, and bronchopulmonary dysplasia in comparison with late PS treatment. According to European and American consensus guidelines on the management of neonatal RDS, early PS instillation should be considered for infants <30 weeks gestation, infants with a birth weight <1,250 g, or if the mother has not received antepartum corticosteroids. We suggest that the Korean health insurance policy on RDS be modified so that PS can be used for better clinical outcomes of very premature infants.

• Journal of the Korean Data and Information Science Society
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• 제24권4호
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• pp.713-721
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• 2013

모유는 아기에게 필요한 풍부한 영양분을 고루 갖춘 우수한 영양 공급원으로 특히 미숙아의 성장발달에 매우 중요하지만 미숙아의 모유수유 실천정도는 매우 저조한 실정이다. 본 연구는 재태 연령을 기준으로 34주 미만 미숙아, 34주 0일에서 36주 6일의 후기 미숙아, 37주 0일에서 38주 6일의 조기 만삭아를 분만한 어머니를 대상으로 모유수유 실천율과 모유수유 임파워먼트를 비교 분석하기 위함이다. 병원 퇴원 당시 모유수유 실천율은 세 군 간에 유의한 차이가 있었다. 즉, 후기 미숙아와 34주 미만 미숙아의 모유수유 실천율은 조기 만삭아의 모유수유 실천율보다 낮았다. 또 모유수유 임파워먼트 총점에서도 34주 미만 미숙아 모와 후기 미숙아 모는 조기 만삭아 모보다 더 낮은 것으로 나타났다. 이는 국내 모유수유 실천율을 향상시키기 위해 미숙아 모를 대상으로 한 모유수유 증진 방안이 마련되어야 하고 이 때 모유수유 실천에 대한 자신감 부여가 필요함을 나타내는 결과이다.

• 대한지역사회영양학회지
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• 제27권4호
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• pp.273-285
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• 2022

Objectives: This study compared the nutritional intakes of early and late preterm infants in a neonatal intensive care unit (NICU) and at home. The dietary problems and the need for community care services for premature infants were further investigated. Methods: This is a cross-sectional and descriptive study on 125 preterm infants and their parents (Early preterm n = 70, Late preterm n = 55). The data were collected by surveying the parents of preterm infants and from hospital medical records. Results: No significant differences were obtained between the early and late preterm infant groups when considering the proportion of feeding types in the NICU and at home. Early preterm infants were fed with a greater amount of additional calories at home and had more hours of tube feeding (P = 0.022). Most preterm infants had feeding problems. However, there was no significant difference between early and late preterm infants in the mental pain of parents, sleeping, feeding, and weaning problems at home. Many parents of preterm babies had no external support, and more than half the parents required community care to take care of their preterm babies. Conclusions: Regardless of the gestational age, most preterm infants have several problems with dietary intake. Our study indicates the need to establish community care services for preterm infants.

• Neonatal Medicine
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• 제25권3호
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• pp.96-101
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• 2018

Purpose: We aimed to evaluate the respiratory illness-related hospital visits (out-patient clinics, emergency room, and re-admission) of preterm infants, and compare them according to corrected age and prematurity. Methods: We reviewed the medical records of preterm infants born at <37 weeks of gestation admitted to the neonatal intensive care unit (NICU) at Inha University Hospital between January 2012 and June 2015. Infant follow-up appointments in both neonatology and pulmonology out-patient clinics occurred for at least 2 years after NICU discharge. Results: The proportion of infants who visited the hospital due to any respiratory illness was as high as 50% until 12 months of corrected age, and subsequently decreased over time. Hospital admission was significantly higher in early preterm infants (<34 weeks of gestation) compared to late preterm infants (${\geq}34$ and <37 weeks of gestation). The proportion of infants who were re-admitted due to lower respiratory tract illness was significantly higher until 6 months of corrected age compared to the later, and did not differ between early and late preterm infants. Conclusion: The proportion of hospital visits of preterm infants due to respiratory disease was high until 12 months of corrected age. Most notably, the re-admission proportion from lower respiratory tract illness was high under 6 months in both early and late preterm infants. Preterm infants within this age that are visiting the hospital with respiratory symptoms should be carefully observed and followed up.

• Clinical and Experimental Pediatrics
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• 제55권11호
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• pp.414-419
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• 2012

Purpose: This study aimed to assess early development in very low birth weight (VLBW) infants with mild intraventricular hemorrhage (IVH) or those without IVH and to identify the perinatal morbidities affecting early neurodevelopmental outcome. Methods: Bayley Scales of Infant Development-II was used for assessing neurological development in 49 infants with a birth weight <1,500 g and with low grade IVH (${\leq}$grade II) or those without IVH at a corrected age of 12 months. Results: Among the 49 infants, 19 infants (38.8%) showed normal development and 14 (28.6%) showed abnormal mental and psychomotor development. Infants with abnormal mental development (n=14) were mostly male and had a longer hospitalization, a higher prevalence of patent ductus arteriosus (PDA) and bronchopulmonary dysplasia (BPD), and were under more frequent postnatal systemic steroid treatment compared with infants with normal mental development (n=35, P<0.05). Infants with abnormal psychomotor development (n=29) had a longer hospitalization and more associated PDA compared to infants with normal psychomotor development (n=20, P<0.05). Infants with abnormal mental and psychomotor development were mostly male and had a longer hospitalization and a higher prevalence of PDA and BPD compared to infants with normal mental and psychomotor development (n=19, P<0.05). Using multiple logistic regression analysis, a longer duration of hospitalization and male gender were found to be significant risk factors. Conclusion: Approximately 62% of VLBW infants with low grade IVH or those without IVH had impaired early development.

• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.237-242
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• 2008

To investigate the trends in the survival rate (SR) for very low birth weight infants (VLBW) and extremely low birth weight infants (ELBWI) in Korea, a total of 43 articles pertaining to SR were analyzed, covering the years from 1967 to 2007. The changes in SR were compared using 5 year periods. The SR for VLBWI has increased remarkably, from 31.8% in early 1960 to 65.8% in early 1990 and 78.8% in early 2000. The SR for ELBWI has increased from 8.2% in early 1960 to 37.4% in early 1990 and 62.4% in early 2000. The SR has improved steeply since early 1990. When the SRs for VLBWI in Korea were compared with those in the U.S.A. and Japan, the figures were 40%, 72%, and 79% in 1985; 65.8%, 82%, and 86% in 1990; 71.3%, 86%, and 88% in 1995; 78.8%, 86%, and 89% in 2000, respectively. Although the recent SRs for VLBWI and ELBWI in Korea has improved rapidly, they have not yet reached the levels in these highly developed countries. To obtain accurate statistics that could be represented as an SR for premature infants in Korea, we have to develop a nationwide network database project.

• Neonatal Medicine
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• 제16권2호
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• pp.121-130
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• 2009

Over the past 20 years, neonatal mortality rates for preterm infants, particularly those born extremely preterm and with a very low birth weight, have decreased steadily. As more very immature preterm infants survive, provision of enteral feeding has become a major focus of concern. According to many experts on neonatal nutrition, the goal for the nutrition of preterm infants should be to achieve a postnatal growth rate approximating that of a normal fetus of the same gestational age. Total parenteral nutrition for maintaining nutritional integrity is mandatory before successful transition to enteral feeding. Early initiation of trophic enteral feeding is vital for postnatal adaptation. Recently published randomized controlled trials provide no evidence to support the practice of postponing enteral feeding to reduce the incidence of necrotizing enterocolitis. Early trophic feeding yields demonstrable benefits and there is currently no evidence of any adverse effects following early feeding. Preterm milk from the infant's own mother is the milk of choice, which can always be supplemented with a human milk fortifier. Here we review over 50 randomized controlled trials and over seven systematic reviews published on neonatal parenteral and enteral feeding of preterm infants. Neonatologists must make use of the evidence from these studies as a reference for feeding protocols for preterm infants in their NICUs are to be based.