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Collaboration between maternal-fetal medicine and neonatology when Counseling at extreme prematurity

Enhanced communication between maternal-fetal medicine (MFM)/obstetrics and neonatology regarding counseling at extreme prematurity remains an essential element of prenatal consultations. Together, the obstetrician and neonatologist can collaborate to provide timely and synergistic information to affected couples during a dynamic period, combining their expertise to elucidate values and formulate a plan that best supports the pregnant person and partner’s goals. Such collaboration can help resolve differing perspectives between specialties, minimize redundancy and inconsistencies, and mitigate the impact of clinician bias. Best practices for joint-specialty collaboration include a precounseling clinician huddle, contemporaneous counseling by MFM specialists/obstetricians and neonatologists with the expectant parents or individualized sequential counseling if preferred by the couple, and a postcounseling clinician debrief. This approach can help establish a trusting relationship with families facing possible extremely preterm delivery and optimize the overall counseling experience. Future efforts focused on education and research, including a standardized approach to educational curricula among fellowship programs, should be emphasized.

Abstract available in NeoReviews, March 2023, vol. 24 iss 3, pps. e137-143
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Congenital cutaneous candidiasis in preterm infants

ongenital cutaneous candidiasis (CCC) is a rare condition, which typically affects premature and very low birthweight neonates. Affected infants present with a diffuse rash of variable morphology, which can appear as peeling, sloughing desquamation; maculopapular lesions; or, less commonly, pustules, vesicles, or bullae. Due to the varied nature of the clinical presentation, the diagnosis of CCC can be quite difficult but critically important because early treatment with intravenous fluconazole can prevent disease progression. In this review, we summarize the epidemiology, pathogenesis, clinical presentation, evaluation, and management of CCC.

Abstract available in NeoReviews, March 2023, vol. 24 iss. 3, pps. e175-e180
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The human milk metabolome: a scoping literature review

Human milk is a complex source of nutrition and other bioactives that protects infants from disease, holding a lifetime of beneficial effects. The field of metabolomics provides a robust platform through which we can better understand human milk at a level rarely examined.

Research aim: To Identify, describe, synthesize, and critically analyze the literature within the past 5 years related to the human milk metabolome.

Abstract available in Journal of Human Lactation March 16 2023
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A comparison of audio-only and audio-visual tele-lactation consultation services: a mixed methods approach

The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of life; however, a lack of access to breastfeeding resources influences breastfeeding initiation and continuation. Tele-lactation services may reduce some of these barriers to access.

Research aims: To identify facilitators and barriers of two modes of tele-health service utilization and to compare the differences between two modes of providing tele-lactation services on breastfeeding knowledge, breastfeeding intention, perceived social support, and 3-month breastfeeding continuation behavior.

Abstract available in Journal of Human Lactation, February 2023, Vo. 39 Iss. 1
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