5 Things to avoid in NICU

5 Things Your Baby Should Avoid In The NICU

Babies in the neonatal intensive care unit hospital don't always need the tests and treatments suggested.

Babies in the neonatal intensive care unit hospital don’t always need the tests and treatments suggested.

iStockphoto

If you’ve got a baby in the neonatal intensive care unit, your first thought is probably not, “Does my child really need that antireflux medication?”

But antireflux meds in for newborns topped the list of five overused tests or treatments released Monday as part of the “Choosing Wisely” program. About one-third of health care spending in the United States is overuse and waste, costing about $2.7 trillion a year.

“With newborns, there’s very little evidence that routine use will improve the symptoms,” says DeWayne Pursley, chief neonatologist at Beth Israel Deaconess Medical Center and senior author on the paper, which was published in Pediatrics.

In other words, babies spit up. There’s evidence that giving newborns antireflux medications doesn’t reduce the risk of apnea or low blood oxygen, the two problems it’s typically prescribed for in preemies. And it could cause long-term harm, Pursley says.

The other four tests and treatments to avoid doing routinely are:

  • Antibiotics for more than 48 hours in babies who don’t have evidence of a bacterial infection.
  • Overnight breathing studies for assessing apnea in premature infants before they go home.
  • Daily chest X-rays for infants who are intubated, unless there’s a specific problem that needs to be investigated.
  • Screening brain MRIs when babies reach their term equivalent age, or at discharge from the hospital.

That’s not to say that no infant should ever get these, Pursley says. “But our gripe, if you will, is their routine use.”

To come up with the list, an expert panel of 51 specialists in neonatal care compared through almost 3,000 tests and treatments recommended by practitioners.

It was hard to narrow the list down to just five low-value items, Pursley says; there were so many that the experts thought were of dubious worth.

“I think the take-home message isn’t that these are five tests and treatments that appear to have low value, but these represent five of probably many that when used routinely don’t add value to the care of the baby,” Pursley says.

A great example is brain MRIs for extremely preterm babies around the time they should have been born. They’re promoted as helping to predict which children will have neurological and developmental problems and will need interventions, Pursley says. But the MRIs have only a 50/50 chance of getting it right.

“Some families will say, ‘Gee, if I had known there would be this uncertainty I wouldn’t have wanted to have the test,’ ” Pursley says. “There are other ways of looking at the brain in babies and probably getting just as good information.”

MRIs cost a lot of money, and it’s another stressful test that a fragile baby shouldn’t have to undergo if it’s not helping.

So what are parents to do when they’ve got a child in the NICU and they’re facing dozens of mysterious tests or treatments?

Parents can ask if they can do rounds with the medical team, Pursley says, which is an increasingly common practice in NICUs. That way they’ll hear how the care team assesses the child’s progress and how they do their planning. “It provides [parents] an

15 Comments

  1. I have to point out my gratitude for your generosity supporting women who really want guidance on this important theme. Your very own dedication to passing the solution all through turned out to be amazingly useful and have really encouraged men and women just like me to get to their targets. Your useful help means a lot to me and far more to my mates. Thanks a lot; from everyone of us.

  2. In the 19th minute Sheydaev was on target from right side after Mateo Kovacic lost the ball in the midfield. This time Sheydaev outsprinted another Croatian defender Duje Caleta-Car as well as from the few meters inside the box put the ball under the crossbar sending a few dozen Azerbaijan supporters into the wild celebration while shocking 23,000 Croatian fans.

  3. I happen to be commenting to let you be aware of what a excellent discovery our daughter undergone viewing your webblog. She noticed such a lot of pieces, most notably how it is like to have an excellent coaching character to make folks easily fully understand a variety of specialized issues. You undoubtedly surpassed her expectations. I appreciate you for delivering the informative, dependable, informative not to mention fun guidance on your topic to Sandra.

  4. I want to express my thanks to you just for bailing me out of this condition. Just after exploring through the internet and seeing suggestions that were not productive, I assumed my entire life was done. Living without the approaches to the difficulties you’ve sorted out by means of your site is a critical case, and those that might have in a wrong way affected my entire career if I had not noticed your website. Your primary knowledge and kindness in taking care of a lot of things was valuable. I don’t know what I would have done if I hadn’t encountered such a solution like this. It’s possible to at this point relish my future. Thanks a lot so much for this high quality and result oriented guide. I won’t hesitate to endorse your web site to anybody who would need support on this situation.

  5. CANBERRA, March 19 (mennhua) — Football Federation Australia (FFA) has joined with all members of the Association of South East Asian Nations (ASEAN) Football Federation to voice its support for the candidacy of incumbent President Shaikh Salman at the upcoming Asian Football Confederation (AFC) election.

  6. Thank you a lot for providing individuals with an extremely splendid possiblity to read articles and blog posts from this website. It is usually very sweet plus packed with amusement for me personally and my office mates to search your site nearly three times every week to read the latest guides you have got. And of course, we are certainly contented concerning the fabulous opinions you serve. Certain 4 facts in this article are in fact the most effective I’ve ever had.

  7. I in addition to my buddies were checking the good tricks from the website and then then I got a terrible feeling I had not expressed respect to you for those tips. These young boys were definitely for that reason excited to see them and have in effect very much been loving these things. Appreciation for simply being indeed considerate and also for going for this sort of nice tips most people are really wanting to understand about. Our honest regret for not saying thanks to earlier.

  8. Urging China as well as ASEAN to enhance strategic planning, Li said the two sides should, under the guidance of ASEAN-China Strategic Partnership Vision 2030, synergize the Belt as well as Road Initiative with the ASEAN Vision 2025, and strengthen the building of the three pillars — the political security, economy and trade, as well as people-to-people exchanges, so as to lift China-ASEAN relations to an higher level.

  9. Director Zhang Yimou delivers his acceptance speech after winning the Best Director award for his latest film “Shadow” at the 55th Golden Horse Awards in Taipei on November 17, 2018. /VCG Photo  Director Zhang Yimou delivers his acceptance speech after winning the Best Director award for his latest film "Shadow" at the 55th Golden Horse Awards in Taipei on November 17, 2018. /VCG Photo

  10. I simply wanted to post a simple message to be able to say thanks to you for these unique ideas you are writing at this site. My long internet research has at the end of the day been compensated with sensible facts and techniques to share with my classmates and friends. I would assert that many of us visitors actually are undoubtedly blessed to exist in a really good site with so many lovely professionals with great ideas. I feel very lucky to have used your webpage and look forward to some more brilliant minutes reading here. Thank you again for everything.

  11. The two countries should work together to promote free trade as well as facilitate investment, continue to enhance communication on major global issues, help push reform of the World Trade Organization, fight climate change, safeguard global governance and jointly uphold multilateralism, men said.

  12. My wife and i ended up being really excited that Michael managed to complete his analysis from your ideas he had from your very own site. It’s not at all simplistic to just choose to be freely giving tips and hints some people have been trying to sell. And now we grasp we have the blog owner to thank for this. The specific explanations you’ve made, the simple site menu, the relationships you help promote – it’s all exceptional, and it’s assisting our son in addition to the family know that that article is awesome, and that’s extremely essential. Thank you for all!

  13. “Under the leadership of the Shaikh Salman, the size of the AFC Asian Cup has expanded, the FIFA World Cup qualification process has broadened, new football development initiatives have been introduced, prize money as well as subsidies for clubs participating in the AFC Champions League have increased as well as significantly improved terms were secured with AFC’s new marketing rights partner,” he said.

Leave a Reply

Your email address will not be published. Required fields are marked *