Countdown to Childx: Global health expert Gary Darmstadt on improving newborn survival

Dr. Gary Darmstadt spoke on the 'Health Ecosystem' panel at Stanford’s Childx conference. In this Q & A for Stanford Medicine's Scope blog, he discusses what he learned while visiting developing countries on behalf of newborn health. Engaging communities in finding solutions is key, he says. Read more>>

New system aims to simplify patient transfers in emergency

Triage by Resource Allocation for Inpatients (or TRAIN) provides guidelines to quickly identify patient transportation needs and allocate the appropriate resources in the event of an evacuation or mass casualty. First piloted by Dr. Ron Cohen, TRAIN is now built into the EMR at Lucile Packard Children's Hospital Stanford. The program has evolved to deal with external and internal disaster scenarios and is designed to provide safe and efficient transfers. Medical Design Technology reports. Read more>>

The Patient Protection and Affordable Care Act of 2010 and children and youth with special health care needs

Drs. Heidi Feldman, Lynne Huffman and Irene Loe along with the DBP fellows, Drs. Christina Buysse and Lauren Hubner, author an article about how the Affordable Care Act (ACA) is impacting children and youth with special health care needs and disabilities (CYSHCN). In the Journal of Developmental and Behavioral Pediatrics, they discuss ACA's benefits and limitations. While ACA promises universal, continuous, affordable, and adequate coverage, the authors stress developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models that will ensure high-quality, cost-effective care for CYSHCN. Read the full article, here.

Meena's Story: Triumph to tragedy and the call to action for you and me in support of healthy timing and spacing of births

Dr. Gary Darmstadt calls for increased resources to support family planning, arguing that it needs to be a public health priority. In the Huffington Post, he recalls a trip he made to India where he met a young woman, Meena, who had just given birth to her fifth child. Meena’s story – characterized by agnoizing despair to the point of wanting to give away her children so that they might have the chance of a better future – prompts Darmstadt to review opportunities for global improvements in maternal and child health. Read more>>

Kernicterus: A diagnosis lost and found

Kernicterus is a form of brain damage that can occur when there is too much bilirubin in a baby's blood. While it is preventable, blood testing was rare in the 90s, resulting in many cases of kernicterus going undiagnosed. The newsletter Improve Dx, distributed by the Society to Improve Diagnosis in Medicine, tells the story of a parent advocacy group that worked to change national guidelines for the diagnosis of kernicterus. Dr. Vinod Bhutani provided the empirical evidence. Read more>>

Tiny balloon-like vesicles carry cellular chatter with remarkable specificity, say Stanford researchers

Drs. Chris Contag and Masamitsu Kanada published a recent finding on extracellular vesicles in the Proceedings of the National Academy of Sciences. Aiming to determine under controlled conditions which biomolecules within vesicles carry the most information most efficiently to recipient cells, they discovered a very complex process that’s dependent on vesicle type and function. Vesicles derived from the cell’s external plasma membrane (aka: micro-vesicles) handidly delivered both protein and DNA. Stanford Medicine's Scope blog reports. Read more>>

The Newborn Book

Director of the Well Baby Nursery, Dr. Janelle Aby, publishes her first book on newborn care, discussing physical findings in newborns. Order a copy of her book, here.

DBP Fellow named Western Section AMFR Scholar

The Western Section of the American Federation for Medical Research (AFMR) selects our fellow, Dr. Lauren Hubner, as a Western Section AFMR Scholar. She receives this recognition for her research in shared decision-making on behalf of children with neurodevelopmental disorders.

Many of the state's smallest babies not referred for follow-up care, study finds

California babies born weighing less than 3.3 pounds, nearly all of whom are preemies, should be referred to a state-supported high-risk infant follow-up program. But data collected from 2010 and 2011 show gaps in care. A study finds thousands of infants (20 percent) were not enrolled in such programs, with smaller NICUs less likely to make referrals as compared to larger NICUs. This Stanford Medicine story quotes Dr. Susan Hintz, who was the lead author of the study published in the Journal of Pediatrics. Read more>>

Helping families navigate the NICU

The NICU Family Support Program provides written and digital materials to the parents of neonates, helping to guide them through what is often a very stressful experience. The program supports about 90,000 families nationwide and represents another partnership between Lucile Packard Children’s Hospital Stanford and the March of Dimes. Stanford Medicine's Scope blog reports. Read more>>

‘Miracle’ baby survives birth with massive tumor

After receiving the news that her unborn child had a large tumor growing on his lung, an East Bay mother came to Lucile Packard Children’s Hospital Stanford seeking treatment. Comprehensive care was provided by members of the Division who are part of a perinatal multidisciplinary team. Dr. Jonathan Palma comments in this KTVU news story, saying regional care centers have been shown to offer the best outcomes for complex pregnancies.  Read more>>

Designing the Future Neonatal Intensive Care Unit

Partnering with the Institute of Design at Stanford, Dr. William Rhine developed a course called “Redesigning the Neonatal ICU.” After learning about the current environment of a NICU, students from various disciplines were tasked with developing a product, system or service that would improve the NICU experience. They presented their ideas in December 2014. Read more >>

Bay Area hospitals seeing birthrates inching up after recession

Many hospitals throughout the Bay Area have reported increases in birthrates, and Lucile Packard Children’s Hospital Stanford has seen about 100 more births per year in the past two years. Hospital administrators and spokespersons attribute the recent baby bump to economic improvements following the recession. Our colleague Yasser El-Sayad, obstetrician and co-director of the Johnson Center for Pregnancy and Newborn Services, is quoted in this San Jose Mercury News story. Read more>>

Tiny spheres of human cells mimic the brain, researchers say

Researchers have devised a way to create spheres of neuronal cells resembling the cerebral cortex. They hope that tracking the development of the cortex-like spheroids over time and observing the interactions of their cells may shed light on human brain development and the molecular causes of neuropsychiatric disorders such as autism and schizophrenia. Neonatal-Perinatal Medicine Fellow Dr. Anca Pasca is a lead author on the paper published in Nature Methods. Stanford Medicine reports on the study's key findings. Read more>>

Paul Wise on the evaporation of child health policy in the U.S.

Dr. Paul Wise warns that preoccupation with systems of care for adults and the elderly has led us to neglect the specific needs of children. In this 1:2:1 podcast, Wise urges us to revise current health policy by thinking about what American childhood will look like in an aging society.

Study of outcomes for early preemies highlights complex choices for families and doctors

A new study published in The New England Journal of Medicine finds variations between hospitals in the active treatment and resuscitation of extremely premature infants – those born at 22, 23 and 24 weeks. Dr. Henry Lee comments, saying the results highlight doctors’ difficulty in letting parents make decisions regarding the care of their child. He says it’s important to balance statistics with a family’s individual situation. Stanford Medicine's Scope blog reports. Read more>>

Counseling parents of the earliest-born preemies: A Mom and two physicians talk about the challenges

Prematurity was discussed at the American Association of Health Care Journalism, where editor and writer Kelley Benham French spoke about her daughter’s fight to survive after she was born extremely premature. Dr. Henry Lee talked about the challenges of counseling parents, often upon first meeting. Micropreemies (those born at 22-25 weeks of gestation) are at significant risk for mortality, early life complications, and long-term morbidities. Stanford Medicine's Scope blog reports. Read more>>

Antibiotic use in California neonatal intensive care units varies widely, study finds

Antibiotic use in neonatal intensive care units varies 40-fold in hospitals throughout California, and research suggests that more antibiotics may not lead to better outcomes for newborns. Variations in antibiotic use can be attributed to differences in how clinicians manage unproven infections; however, risks and costs may be reduced through more judicious use. Research was spearheaded by the California Perinatal Quality Care Collaborative, and Dr. Jeffery Gould is quoted in this article for Stanford Medicine's Scope blog. Read more>>

Treatment recommendations for ADHD are not simple

A national study finds less than half of children diagnosed with attention-deficit hyperactivity disorder (ADHD) in 2009 and 2010 received behavioral therapy as part of treatment. While clinical guidelines recommend that behavioral therapy be paired with medication, a study of nearly 10,000 children showed that 74 percent had taken medication in the last week whereas 44 percent had received behavioral therapy in the past year; about 31 percent had received combination therapy. Dr. Heidi Feldman is quoted in this Scientific American story, saying that while medication effectively reduces core symptoms of ADHD, it may be limited in terms of providing long-term functional benefits. Read more >>

Rare gene variants help explain preemies' lung disease, Stanford study shows

The risk factors for broncopulmonary dysplasia (BPD) are difficult to determine. A recent Stanford study published in the American Journal for Respiratory and Critical Care Medicine identified over 250 rare gene variants linked to cell proceses possibly involved in broncopulmonary dysplasia (BPD). Current research indicates that bronchopulmonary dysplasia (BPD) may be in part a fetal disease influenced by prenatal environment and genetic factors. Scope blog reports, and Department Chair Dr. Hugh O’Brodovich is quoted. Read more>>

Including parents in the care of premature babies

Dr. Henry Lee writes a feature for U.S. News and World Report where he talks about the importance of parents partnering with medical staff in the care of their preterm infant. Parents can support the health, growth and healing of their newborn by engaging in kangaroo care and providing the baby with breast milk. Read more>>

Microbe mix may play a role in preterm birth during pregnancy

NPR (and several other news outlets) reports on an ongoing study conducted by the March of Dimes Prematurity Research Center at Stanford; Dr. David Relman is the team leader. Relman’s group found that a change in vaginal microbiome during pregnancy—one marked by a diverse array of bacteria, particularly Gardnerella—was associated with preterm birth. They also found a notable shift in the vaginal microbiome takes place at the time of delivery in virtually all women and persists for months thereafter. Read more>>

Additional coverage:

Bioscience Technology

Time.com

FoxNews.com

WebMD.com

medicalnewstoday.com

Life with conjoined twins: Antelope family faces rare challenges

The Sacramento Bee features a story on conjoined twins who were delivered at Lucile Packard Children’s Hospital Stanford. Once it was confirmed that Aida Sandoval would be giving birth to the twins, Dr. Susan Hintz and colleagues in Fetal and Pregnancy Health Program began preparing for the birth, taking into account the different scenarios that may occur. The girls were delivered by C-section at 33 weeks gestational age, and separation surgery is slated for 2016. Read more>>

Bigger babies filling NICU beds

A recent study examining national vital statistics from 2007-2012 found that NICU admission rates have significantly increased, with nearly half of all beds filled by infants of normal birth weight. Dr. Henry Lee is quoted in this article for MedPage Today, saying that he’s not surprised by the uptick. With medical advancements, he says, we can now treat babies with previously fatal congenital anomolies. Lee also cites an earlier Stanford study that found antibiotic use to vary greatly, noting some admissions may have been unnecessary. Read more>>

El-Sayed appointed associate dean for maternal and child health

Yasser El-Sayed, MD, is appointed the associate dean for maternal and child health by David Stevenson, MD, who was named senior associate dean for maternal and child health in 2014. Dr. Stevenson is quoted in this article for Stanford Medicine. Read more>>