Purpose
Nursing protocols for glucose management are well known for both healthy term newborns and high-risk newborns. However, for less risky newborns who are under only observation surveillance, hypoglycemia could be overlooked unless clinical symptoms develop.
Methods
A retrospective study was performed to explore factors influencing variations in glucose levels in 91 newborns who did not require any interventions, but were under nursing surveillance, at a level II neonatal intensive care unit. Data were retrieved from electrical medical records on glucose levels, demographic characteristics, and other clinical characteristics of newborns in their first day of life from January 2016 to May 2019.
Results
Glucose levels tended to stabilize within the normal range (60~80 mg/dL) as time passed during the first day of life. Cesarean section, multiple gestation, abnormal growth, and later preterm birth were associated with low glucose levels in the first 2 hours of life. Thirty-one newborns experienced a hypoglycemic episode (< 45 mg/dL) during the first 24 hours of life.
Conclusion
The findings of this study support the active encouragement of early feeding within 2 hours of birth and urgent adoption of a structural protocol for glucose surveillance in newborns with potential health problems immediately after birth.

Purpose
The study was conducted to measure stratum corneum hydration (SCH) and pH (SCP) in high-risk newborns in the early postnatal period and to explore the features related to patterns of change in those parameters.
Methods
SCH and SCP were measured on the dorsal hand in 99 hospitalized newborns during the first 14 days of life and the results were analyzed using a general linear model.
Results
The mean hydration was 42.9% on day 1, which decreased to 34.6% by 2 weeks (F=15.61, p=<.001). An association was observed between SCH and prematurity (F=21.12, p<.001), as well as for their interaction (F=8.11, p<.001). The mean SCP was 6.2±0.3 on day 1, and decreased to 5.7±0.2 (F=95.75, p<.001), with no association with prematurity. After adjusting for birth weight, SCH was higher in newborns with vaginal delivery (F=9.07, p=.023) and who received phototherapy (F=11.81, p=.011). For SCP, only delivery type had a significant influence (F=6.40, p=.044).
Conclusion
This study suggests that SCH is typically in the 30% range during the early postnatal period, and that an acid mantle on the SC surface is very unlikely to form; these findings could be applied to the nursing process for promoting skin integrity in high-risk neonates.

Citations

• The Effect of Sunflower Seed and Almond Oil on Preterm Infant Skin: A Randomized Controlled Trial
  Seda Caglar, Gizem Kerimoglu Yildiz, Ilkay Bakoglu, Ozgul Salihoglu
  Advances in Skin & Wound Care.2020; 33(8): 1.     CrossRef

Purpose
Maintaining body temperature is a key vital function of human beings, but little is known about how body temperature of high-risk infants is sustained during early life after birth. The aim of this study was to describe hypothermia in high-risk infants during their first week of life and examine demographic, environmental, and clinical attributors of hypothermia.
Methods
A retrospective longitudinal study was done from January 1, 2013 to December 31, 2015. Medical records of 570 high-risk infants hospitalized at Neonatal Intensive Care Units (NICU) of a university affiliated hospital were examined. Body temperature and related factors were assessed for seven days after birth.
Results
A total of 336 events of hypothermia (212 mild and 124 moderate) occurred in 280 neonates (49.1%) and most events (84.5%) occurred within 24 hours after birth. Logistic regression analysis revealed that phototherapy (aOR=0.28, 95% CI=0.10-0.78), Apgar score at 5 minute (aOR=2.20, 95% CI=1.17-4.12), and intra-uterine growth retardation or small for gestational age (aOR=3.58, 95% CI=1.69-7.58) were statistically significant contributors to hypothermia.
Conclusion
Findings indicate that high-risk infants are at risk for hypothermia even when in the NICU. More advanced nursing interventions are necessary to prevent hypothermia of high-risk infants.

Citations

• Using a Plastic Drape to Reduce Hypothermia in Premature Neonates During Peripherally Inserted Central Catheter Placement
  Huong (Kelle) T. Phan, Teresa M. McIntyre
  Advances in Neonatal Care.2022; 22(3): 193.     CrossRef

Purpose
The aim of this study was to analyze Neonatal Intensive Care Unit nurses’ behaviors while soothing newborns with bronchopulmonary dysplasia.
Methods
An observational study was used to assess nurses’soothing behaviors. Data were collected from September, 2012 to March, 2013 using an audio-video recording system. Participants were eight babies and 12 nurses caring for those babies. After obtaining parental permission, the overall process of each episode from nurses’engagement in soothing to the end of soothing was recorded. Then a researcher interviewed each participating nurse. Data from 18 episodes were transcribed as verbal and nonverbal nursing behaviors and then categorized by two researchers.
Results
There were 177 observed soothing behaviors which were classified with the five sensory-based categories (tactile, oral, visual, auditory, vestibular). Most frequently observed soothing behavior was ‘Gently talking’ followed by ‘Removing irritant’, and ‘Providing non-nutritive sucking’. Nurses’ perceived soothing behaviors were similar to the observed soothing behaviors except for ‘Gently talking’.
Conclusion
Nurses used diverse and mixed soothing behaviors as well as recognizing those behaviors as essential nursing skills. Nurses’ soothing behaviors identified in this study can be used to comfort babies and to enhance their developmental potential in accordance with individual characterstics or cues.

Citations

• Factors influencing nursing care competences in neonatal intensive care units: Generalized equation estimation analysis
  Eun Sook Kim, Hyoyeong Kim, Heemoon Lim, Jungwoo Hwang, Hyejung Lee
  Journal of Neonatal Nursing.2025; 31(3): 101668.     CrossRef

Purpose
Oral glucose and pH are known as critical indicators for the growth of microorganism inside the oral cavity. This study was performed to identify oral glucose and pH variances in the early postnatal days of newborns.
Methods
An explorative study which included 67 newborns was conducted to measure the oral glucose and pH during the first three days of life. Oral secretions were collected every 8 hours for three days or 6 to 9 times immediately after birth up to discharge. Oral glucose and pH variances during the three days were analyzed using the SPSS 22.0.
Results
Oral glucose was 30.66±22.01mg/dl at birth then increased to 54.77±27.96mg/dl at the third day of life (F=8.04, p<.001) while oral pH decreased from 7.35±0.36 to 5.53±0.39 during the three days (F=113.35, p<.001). Oral glucose and pH were related to gestational age, regurgitation, and maternal diabetic mellitus. A negative correlation was found between oral glucose and pH (r=-.34, p<.001).
Conclusion
Oral glucose and pH can be utilized for oral health assessment in newborns. Further study is needed to explore the factors which influence oral glucose and pH in high-risk newborns.