Tuesday October 23, 2018

Premature Babies And Their Care In Hospitals

Judy Campbell, a lactation consultant, says because of the team's success, calls from mothers with preemies has nearly quadrupled.

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Premature babies
Low Cost Study Has High Impact Results For Premature Babies. VOA
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No one knows exactly why some babies are born prematurely, but some of the smallest premature babies weigh under 1,500 grams. These tiny babies — called micro preemies — can’t afford to lose an ounce. At Children’s National Medical Center in Washington, a team of specialists has come up with a plan to give these babies the best chance to live and thrive.

When Vanessa Ohakam gave birth to her son, she was only 24 weeks pregnant. Vanessa was terrified. Her newborn J.C. weighed just a little more than 736 grams or about one and a half pounds.

“I couldn’t even change a diaper I was so nervous and anxious. He just looked so frail. But the nurses were very supportive and encouraging.”

Ohakam and J.C. were lucky. J.C. was in the neonatal intensive care unit at Children’s National Medical Center in Washington during the course of a nutritional study.

A team of specialists at the hospital’s NICU, the neo-natal intensive care unit, wanted to see if they could help J.C. and other very small premature babies boost their weight and improve their chances to thrive.

Michelande Ridore is a health care administrator who leads the team.

“Preemies, in particular, have high incidents of malnutrition as well as poor development,” Ridore said.

As Ridore explained, these premature babies have so little body fat, they can’t afford to waste energy. Some are in blanketed incubators to encourage sleep so they don’t move around and burn calories. The team focused on what — and when — the babies ate.

Caitlin Forsythe is the lead nurse on the study.

Tokophobia, premature babies
The team emphasized mother’s milk.Flickr

“We noticed that a lot of our practitioners (doctors) and the way that they were providing feedings for very low birth weight babies, those are babies weighing 1500 grams or less, that they were being fed different ways,” Forsythe said.

The team wanted to standardize the nutrients in what the babies are fed because medical literature shows it helps babies thrive. Wherever possible, Forsythe said the team emphasized mother’s milk.

“That’s what’s best for the premature babies. They tolerate it better, and it has great antibodies,” Forsythe explained.

Judy Campbell, a lactation consultant, says because of the team’s success, calls from mothers with preemies has nearly quadrupled.

“We know that mother’s milk has growth factors in it that can’t be replaced with any other substance,” Campbell said.

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Maternity benefits under PMMVY are given to all pregnant and lactating mothers. (VOA)

The team standardized nutrition practices to include fortified donor breast milk for babies whose mothers couldn’t provide their own, fortified mother’s milk and formula, depending on each baby’s needs. Forsythe said she is pleased with the results so far.

“We have been able to put protocols in place so that there’s a standardization of care. We’ve also increased the amount of mother’s own milk we’ve been providing for the babies which is great,” Forsythe continued.

Also Read: Novel Blood Test May Predict Autism Risk in Babies During Pregnancy

Ridore said there’s a marked improvement in the babies ability to thrive, “We were able to improve their weight by 30 percent.”

The team isn’t quite done. They want to tweak the existing nutrition practices to see if they can improve their results. Once they are finished, they will publish the results so other micro-preemies can benefit, too. (VOA)

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A New Virus Typhus Rises In Los Angeles

Officials in Los Angeles say they are working toward housing for the county’s 53,000 homeless residents to relieve conditions that help give rise to typhus and other diseases.

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Retired coal miner James Marcum, who has black lung disease, takes a pulmonary function test at the Stone Mountain Health Center in St. Charles, Virginia, U.S., May 18, 2018. (VOA)

Typhus, a bacterial infection that is sometimes life threatening, is on the rise in Los Angeles and several other U.S. cities. Public health officials say homelessness is making the problem worse and that the disease, which is associated with poverty and poor sanitation, is making a comeback in the United States.

Los Angeles County has seen 64 cases of typhus this year, compared with 53 at the same point last year and double the typical number, with a six-case cluster among the homeless in L.A. this year. Two cities in the county that have separate counts are also seeing higher numbers: Long Beach with 13 cases, up from five last year, and Pasadena with 20, a more than three-fold increase from 2017.

At a clinic in the L.A. neighborhood called Skid Row, Dr. Lisa Abdishoo of Los Angeles Christian Health Centers is on the lookout for symptoms.

“It’s a nonspecific fever,” she said, “body aches, sometimes a headache, sometimes a rash.”

This kind of typhus is spread by fleas on rats, opossums, or even pets and is known as murine typhus, from the Latin word for “mouse.”

The risk is higher when people live on the streets in proximity to garbage, but the disease seems to be spreading through the Southern United States.

Not the typhus of WWI

“It’s never been considered a very common disease,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, “but we seem to see it more frequently. And it seems to be extending across from Southern California all along the Mexican border into southeastern Texas and then into the Gulf Coast in Florida.”

 

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A homeless man sits at his street-side tent along Interstate 110 along downtown Los Angeles’ skyline, May 10, 2018. Thousands of homeless people sleep on the streets of Los Angeles County.. VOA

 

Texas had 519 cases last year, said spokeswoman Lara Anton of the Texas Department of State Health Services. That’s more than three times the number in 2010, with clusters in Houston and Galveston. No figures for this year have been released.

This is a separate disease from typhoid fever and is not the epidemic form of typhus that caused hundreds of thousands of deaths in war time. That type, called epidemic typhus, is carried by body lice and often spreads in conflict zones. It led to millions of deaths in World War I alone.

Flea-borne typhus, the kind seen in California and Texas, is serious but often clears up on its own and responds to an antibiotic, Abdishoo said.

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Dr. Peter Hotez, dean of the Baylor College of Tropical Medicine, shows Associated Press journalists areas of Houston’s 5th Ward that may be at high risk for mosquitoes capable of transmitting the Zika virus in Houston.. VOA

“It seems to get better a little faster if you have the treatment,” she said. “But there are cases where people have had more severe complications — it’s rare, but getting meningitis, and even death,” she cautioned.

Migration, urbanization, climate change

The reason for increased typhus numbers is uncertain, but it may be linked to migration, urbanization and climate change, said Hotez, the disease specialist. In some parts of the world, typhus is still linked to war and instability, “in the conflict zones in the Middle East, in North Africa, Central Asia, East Africa, Venezuela, for instance with the political instability there,” he said.

Murine typhus is one of several diseases on the rise in the southern United States, Hotez said.

Typhus
People line up on Skid Row in Los Angeles to receive food, water, clothing and other basic necessities from Humanitarian Day Muslim volunteers.. VOA

“Others include dengue, now emerging in southern Texas and Florida, the Zika virus infection, Chikungunya. We have a huge problem with West Nile virus,” he added, and Chagas disease, a condition usually seen in Latin America.

A report in May from the U.S. Centers for Disease Control and Prevention found that such “vector-borne” diseases, transmitted by ticks, fleas or mosquitoes, more than doubled in the United States between 2004 and 2016.

Hotez says they are on the rise in many industrial nations with crowded cities and pockets of poverty.

Also Read: A Full Guide To Public Health Disease Hepatitis

Skid Row physician Abdishoo says flea-borne typhus is still uncommon on the streets of Los Angeles, but “it has us all on high alert for this illness that we don’t necessarily think too much about. We want to be vigilant,” she added, “when you see a communicable disease on the rise.”

Officials in Los Angeles say they are working toward housing for the county’s 53,000 homeless residents to relieve conditions that help give rise to typhus and other diseases. Voters approved funding in 2016 and 2017 to finance the efforts. (VOA)