Special Care for Early Babies
New studies of neonatal brain development are changing the way hospitals manage premature births.
Since the 1970s, researchers have theorized that premature babies are likely to develop long-term problems - not only because they were born early but also because of the relatively harsh environment of newborn intensive-care nurseries. With premature births on the rise nationwide as well as in Massachusetts, new studies tracking preemies' development through the school years are getting special attention.
Brain scans have shown that the frontal lobe - which regulates behavior and complex thinking - works better in children who received gentler care as premature infants. The information is prompting newborn intensive care units (NICU) to change the way they operate: not just by encouraging the nursing staff to whisper or by dimming lights, but by following each newborn's cues about when he or she wants to eat, sleep, or be held, rather than feeding or changing diapers by the clock. Even small changes, such as using a warm stethoscope or having nestlike bedding in incubators (shown above), appear to make a difference in how premature babies learn, behave, and react to stimulation later in life.
"The neurological disability that many preterms are left with when they leave the NICU may in some ways be preventable," says Heidelise Als, director of Neurobehavioral Infant and Child Studies at Children's Hospital in Boston. "The care is given in collaboration with the baby," she says, "slowly involving the parents from the very beginning." Such innovations, Als says, "will change not only the medical and neurobehavioral outcome but also the way the baby uses the brain electro physiologically."
In Massachusetts, about 10 percent of babies are born early, arriving before the 37th week of pregnancy. Between 1991 and 2000, the number of preterm births increased 31 percent in the state. No one is sure exactly why, although later maternal age, stress, and pregnancy with twins and other multiples are major risk factors.
Show Some Restraint
Car accidents account for 41 percent of US deaths from injuries for children aged 1 to 9, and about two-thirds of those children "are not in any kind of restraint," says Dr. David Mooney, a pediatric surgeon and director of the trauma program at Children's Hospital in Boston. "They would be alive if they were in a seat belt."
When children outgrow car seats, he says, they still need a booster seat until the age of 8. Without it, the seat belt rests at belly-button level, putting the full force of the impact on the spine in an accident, which can lead to paralysis.
But that doesn't explain parents' complacency: Massachusetts, at 63 percent, has one of the lowest compliance rates with seat-belt laws in the nation. Mooney is among those pushing for legislation on Beacon Hill that would enforce the already mandatory seat-belt law by empowering police officers to pull over and cite drivers with unrestrained passengers, even if there are no other traffic violations.
When Food's Dangerous
Although scientists have found that more than 160 foods can trigger allergies, a new law that goes into effect January 1 requires manufacturers to clearly label the eight ingredients (and proteins derived from the eight) that cause 90 percent of all food allergies in the United States. They are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans.
The legislation was passed last summer. Karol Timmons, a pediatric nurse practitioner at Children's Hospital, says that although approximately 2 million school-age children have food allergies, most outgrow their sensitivities. For example, 85 percent of children with milk and egg allergies outgrow the condition by the time they are 5, Timmons says. She adds that new research has also shown that as many as 9 percent of children with a tree nut allergy will outgrow the condition, previously thought to last a lifetime. 