Dr. Allen Cherer is a neonatal care expert with over 30 years of medical accomplishments to his name.

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Investment Podcasts 2021 Jeffrey Althoff

Top Podcasts for Pregnancy and Birth

Navigating pregnancy and infancy is complex and very taxing. There are many things you need to be aware of at all times. If you are a first-time mother, it can be even more difficult and stressful. There is no one-size-fits-all how-to manual on entering motherhood, but there are helpful resources that exist to help put minds at ease. One of the best resources for those who are busy and do not have time to read a book or attend a class is listening to a podcast. You can play them in the background, on the go, and when you’re multitasking. Let’s take a look at some of the best pregnancy and birth podcasts available, as featured in an article on Big City Moms.

 

The Birth Hour

This podcast is a saving grace for those who are interested in everything related to birth stories. There are many experiences told by special guest speakers who have all had to go through the process of giving birth; some examples include giving birth in an RV, delivering breech twins, natural births, water births, and c-sections. Their website provides a quiz on which birth setting might be the best for you. Listeners have described this podcast as extremely helpful, and some have said it opened their eyes up to birthing possibilities they did not consider at first. 

 

Informed Pregnancy

Hosted by doula Dr. Elliot Berlin, this podcast contains large amounts of information that new moms should take into consideration. Berlin is a chiropractic doctor and childbirth educator, so it is safe to say that she definitely knows what she is talking about. One of the best episodes on the show is her interview with Ricki Lake. She delves into a wide range of topics such as birth plans, CPR safety tips, and vaccinations so that moms can keep themselves and their babies safe.

 

40 Weeks Pregnancy

This podcast might be the coolest on our list. You can listen to an episode of this show every week throughout your pregnancy, and it updates you on what to expect and how to deal with particular challenges you might be experiencing. Each week you can tune in to how your baby is likely developing and how to guide yourself through the journey.

Nutrition Newborns Allen Cherer

Exploring Total Parenteral Nutrition in Newborns

Infants rely on their parents or caretakers to provide them with adequate nutrition needed for healthful physical and mental growth. Some babies aren’t able to receive nutrition via a bottle or a feeding tube due to developmental problems, disease or extreme prematurity. Parenteral nutrition may be necessary to help these infants get the calories and nutrients they need to thrive.

 

What is Total Parenteral Nutrition?

Parenteral nutrition was first given to babies more than 50 years ago. It has saved thousands of infants’ lives who are unable to take in enough calories and nutrients. The term parenteral refers to bypassing the digestive tract. Total parenteral nutrition means that all of the infants nutrition is delivered in this manner.

Nutrition in the form of carbohydrates, protein, fat, minerals, vitamins and electrolytes are given intravenously in total parenteral nutrition. This can be done by using an injection, but it typically requires that an IV be placed in the navel, hand, scalp or foot.

 

Emergency versus Ongoing Total Parenteral Nutrition

Preterm infants are often given parenteral nutrition immediately following their birth. This can give these babies the boost of nutrients they need to adjust to life outside of the womb. Total parenteral nutrition may continue to be given as the baby learns to use a bottle or breastfeed. When total parenteral nutrition is going to occur for a short time, medical professionals use smaller veins in a central location on the infant’s body to deliver the nutrients.

In some cases, an infant will need to receive total parenteral nutrition on an ongoing basis. This may be due to kidney or digestive tract problems. If ongoing parenteral nutrition is needed then a central line may be placed in the infant. This allows a larger amount of nutrients to quickly flow to the baby.

 

Success of Total Parenteral Nutrition in Newborns

Though there are some risks of continuing total parenteral nutrition in newborns, most do extremely well. Several studies have been done that compare the effect of milk feedings versus total parenteral nutrition in preterm infants with very low birthweights. Studies showed that these infants fared extremely well with total parenteral nutrition. The infants receiving total parenteral nurtiion were able to take in larger amounts of protein and carbohydrates versus the infants who were fed a milk diet.

Heart Murmur Newborns Allen Cherer

Heart Murmur in Newborns: An Overview

The heart has the important job of distributing blood throughout the body. While you typically cannot hear the heart working, there are times when blood can be heard swirling in the heart. This is known as a heart murmur. It is very common for newborn babies to have heart murmurs, which can create a lot of fears for the parents. These are the most important things you need to know about heart murmurs in newborns.

 

How Is It Diagnosed?

The doctor will be able to diagnose a heart murmur by listening to your child’s chest with a stethoscope. They will likely have to check several spots on the chest to get an accurate diagnosis. It is easiest to diagnose this condition when the baby is not making any noise because the murmurs are very quiet. Once a heart murmur is found, the doctor will grade it based on the volume. A few imaging tests of the heart may also be done.

 

Is It Dangerous?

There are two distinct types of heart murmurs in newborns. Innocent heart murmurs are completely safe. Some babies are just born with a strong heart that makes a little noise when pumping blood. Most innocent heart murmurs eventually go away as your child gets older.

There is also a chance that the murmur is caused by a congenital heart defect. This occurs when there is a structural problem in your newborn’s heart. This is far less common than innocent heart murmurs. There is a chance that this heart defect will cause your child to experience a few other troubling symptoms. Catching the problem shortly after birth will make treatment much easier.

 

How Is It Treated?

Since they will not cause any issues, innocent heart murmurs require no treatment. You will not have to change anything about your child’s life when they have an innocent heart murmur. If the extra noises are caused by a heart defect, then you will need to get the issue treated by a medical professional. The form of treatment used will ultimately be determined by a variety of different factors including your child’s age and the severity of the issue. Medications and surgery are the most common forms of treatment for a dangerous murmur.

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Neonatal Septal Defects: An Overview

Ventricular septal defects, or VSD, refers to an opening in the wall that separates the lower ventricles of the heart. The condition occurs naturally in neonates at a rate of one out of every 250 to 330 births. Normally, the hole closes before the infant is born, which prevents oxygenated blood from combining with unoxygenated blood.

 

Under normal circumstances, blood enters the right side of the heart and continues into the lungs to receive oxygen. The blood then travels to the left side of the heart and is pumped through the body. But, when VSD occurs, more blood enters the lungs than normal, which stresses the heart and the lungs.

 

If the hole is small, physicians might hear a murmur when listening to the heart using a stethoscope. Otherwise, the child exhibits no symptoms. The opening is not large enough to add stress. However, if the hole is large, the infant breathes faster and harder than normal secondary to the stress on the heart and lungs. They may also exhibit difficulties when suckling and gasp for breath. Symptoms may occur shortly after the birth of the child. Or, the signs may not appear until weeks later when the lungs become hypertensive. If the child does not receive medical intervention, the lungs and blood vessels may endure irreversible damage.

 

Small hole defects commonly close without intervention. However, if the defect is deemed to be large, surgical repair is required. The procedure used depends on the size of the defect. Some are easily corrected in a cath lab. If the hole is not extremely large, surgeons may simply sew the detector closed. Other options include surgically applying a fabric or tissue patch over the hole. The patch is later naturally covered by normal tissue that lines the heart.

 

Banding the pulmonary artery is another option, which reduces the amount of blood that flows into the lungs. The scheduled surgery takes place anytime from early infancy into later childhood depending on the severity of the condition and accompanying symptoms.

 

Once the defect is medically corrected, the infant or child may resume a normal life. A pediatric cardiologist may advise that the child undergo periodic evaluations to ensure the ongoing health and detect possible complications. In rare cases, a heart valve may develop a leak once the child is older, which also requires intervention.

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COVID-19’s Potential Impact on Newborns

COVID-19 produces victims of all ages. Concern grows for pregnant women and unborn children. Facilities around the world continue studying the microbe and reveal their findings thus far. Some studies suggest that infants born to mothers having the virus have a high risk of suffering ill effects.

From January 20 to February 5, nine women gave birth to 10 infants in five different hospitals in China’s Hubei province. Eight of the expectant mothers tested positive for COVID-19 before delivery. One mother tested negative. However, a fever and a CT scan of her chest revealed pneumonia that could not be contributed to any other underlying cause but the virus.

The women suffered a variety of prenatal complications that included intrauterine distress, ruptured members prior to the onset of labor, amniotic fluid abnormalities and placenta previa. Seven of the mothers delivered their babies via cesarean section. The other two women had normal vaginal deliveries.

The mothers were treated with Tamiflu or a combination of the antiviral plus interferon following delivery. After birth, all of the infants were tested for COVID-19 via oral swabs. All of the tests were negative. Four of the babies were full-term and six were premature. All of the infants exhibited unusual symptoms that included fevers, difficulty breathing, elevated heart rates, inability to feed, vomiting, gastric bleeding and bloating from liver malfunction. Seven of the infants exhibited abnormal chest X-rays. Two of the premature babies died nine days after birth.

A team of researchers from Northwestern University in Illinois recently discovered that the virus damages the placenta in expectant mothers. The study involved 16 pregnant women who tested positive for COVID-19. Following delivery, the placenta tissues were evaluated. The team discovered that the blood vessels within the placentas exhibited abnormal development or were otherwise damaged. However, all of the infants tested negative for the virus and were in reported good health.

Researchers from the University of California San Diego expanded the MotherToBaby program to gain a better understand the short- and long-term effects of the virus on expectant mothers and infants. Previously, the program was designed to evaluate medications and environmental factors that might affect pregnant women, newborns and breastfeeding.

The study will involve the examination of medical records and phone calls to women who volunteer for the research. The program also includes monitoring the neurological development of children to determine possible emotional, learning or memory issues.

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Coronavirus and Pregnancy: What to Know

Historically, viral illnesses become more serious in the very young, the elderly and in individuals having a weakened immune system. Given that victims of all ages have become infected with the coronavirus, many are understandably concerned about the effect the illness may have on expectant mothers.

Pregnancy and Covid-19

The World Health Organization reports that in a study of 147 pregnant women, eight percent developed more severe forms of the illness. One percent required critical care.

A study of nine afflicted women who gave birth indicated that none of the infants tested positive for the virus. But, the women all became infected during the last trimester of pregnancy. It remains yet unknown how the virus might affect a fetus during the early months of development.

Another study involved 10 newborn infants who developed serious forms of the illness. According to a physician from the Northwestern University Feinberg School of Medicine, the amniotic fluid, breast milk, and cord blood were tested. But, all of the fluid was negative for Covid-19. So, physicians do not believe that the illness passes from the mother to the developing infant. Theories revolving how the babies became infected include that the women may not have undergone testing and found to be afflicted before delivery. The babies may have come in contact with their infected mothers shortly after birth.

An obstetrician affiliated with the American College of Obstetricians and Gynecologists advises that pregnant women should undergo testing at their initial appointment and separated from patients who tested negative. Pregnant women are advised to use the same precautions recommended for the general public.

About Covid-19

After exposure, individuals may develop symptoms in two days to two weeks. The majority of afflicted individuals suffer symptoms that are equated with the common flu. The experience may include fever, generalized fatigue and upper respiratory symptoms. Others suffer muscle aches and diarrhea. The World Health Organization reports that the virus causes serious illness in one out of every six patients. More severe cases exhibit difficulty breathing and shortness of breath. Individuals experiencing more serious symptoms are advised to seek medical attention.

Scientists recently revealed that the virus has two strains, one of which is more aggressive than the other. Health care providers also report that it is possible for individuals to suffer a relapse, which is often more serious.

Transmission occurs through airborne droplets or coming in contact with infected animals, surfaces or fecal matter. 

 

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Becoming a Neonatal Professional: The Basics

Neonatal professionals are skilled and trained to properly care for newborn infants, specifically within their first twenty-eight days of life. Neonatal nurses specialize in caring for healthy newborns, while neonatal nurse practitioners specialize in caring for infants that may need special care and attention. These infants may include those in the Neonatal Intensive Care Unit (NICU), emergency rooms, delivery rooms or specialty clinics. During the first twenty-eight days of life, infants are at high risk of infections and possibly developing abnormalities. It is the extensive training and education that neonatal professionals are required to have that prepares them for this line of work.

One of the first steps in becoming a neonatal professional is to earn a high school diploma or GED, this is a key requirement to begin a registered nursing program. A registered nursing program will set the foundation of a career as a neonatal professional. Nursing students may obtain an associate degree or a bachelor’s degree in nursing, this could take 2-4 years. Typically, the curriculum for these degrees focuses on anatomy and physiology, lifespan development, microbiology, community health nursing, and principles of ethics among other studies.

After the successful completion of a registered nursing program, registered nurses (RNs) need to pursue a suitable master’s program. This can be a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) program. Generally, an MSN program may require the completion of approximately 550 clinical hours and a DNP program may require the completion of 1,000 clinical hours. MSN programs are usually completed in two years, while DNP programs can take between 3-4 years for completion. During this time nurses experience working in neonatal settings with infants and their families.

With years of studying, training, experience and successfully completing an accredited master’s program, it is important to obtain proper licensing and certification. There are multiple ways to obtain national certification and state licensing. The American Nursing Credentialing Council offers a pediatric nursing certification, while most neonatal credentials are administered by the National Certification Corporation (NCC). Proper certification and licensing for practicing may vary from state to state. These certification requirements typically include a three-year revision. Maintaining certification also includes a “continuing competency specialty assessment”, which will determine the number of continuing education hours needed. Becoming a neonatal professional is a process and can take years of hard work and dedication but is also very rewarding.

 

dr-allen-cherer-burnout

Neonatal Intensive Care Burnout: An Overview of a Growing Issue

Nurses who work in the Neonatal Intensive Care Unit (NICU) have a unique and demanding responsibility. Caring for the tiniest, most vulnerable patients new to life requires a genuine heart, individual attention, and authentic nurturing.

A NICU Podcast interview sheds light on the day-to-day challenges NICU nurses face. In addition to providing round the clock service to life-clinging babies, NICU nurses are also the support to and for parents, who, in their own way, are emotionally fragile and sensitive. To these parents, the critical state of their child calls for heightened attention and empathy. The nurses’ position is both guardian and savior, and this can take a toll on nurses who themselves are only human.

On top of normal stresses that come with the job is a growing demand to implement sophisticated technology. On the one hand, technology is bettering our lives every day, making it easier to complete tasks faster and more smoothly. However, research shows this increase in digitization is taking a toll on medical staff. Nurses are now required to maintain reports and data in ways their jobs did not involve before. This learning curve calls for specialized training, which is yet another level of duties for nurses to cover.

As essential as the NICU nurse’s position is in the livelihood of their most precious patients, many times, their efforts and care go unnoticed. Physicians‘ status gets much attention, but the backbone of care and service falls on the nurse staff.

Research among NICU nurses found burnout rates among nurses in NICU are much higher than physicians. In fact, burnout was prevalent for non-physician, day-time, and veteran nurses of more than five years.

The effects of burnout are significant. Emotional suffering, physical exhaustion, depression, weight gain or loss, and reduction in job performance are just a few. Burnout affects work-life balance, socialization, relationships, and one’s perspective on life.

According to the World Health Organization (WHO), burnout is now recognized as a chronic health condition. Unfortunately, many NICU nurses are falling victim to this condition as a result of their working environment.

NICU staff carry the burden of high standards, critically positioned babies, and anxious parents. On top of all this, an enthusiastic spirit that wants to be available, do their best at providing care, and occasional loss of an infant makes for extremely stressful conditions. Burnout is not a myth, but a reality, and one that needs immediate attention — sooner than later.

Jaundice Phototherapy

A Closer Look at Neonatal Jaundice

Neonatal jaundice is caused by unconjugated bilirubin in a newborn’s body. It’s presently the most common condition that requires medical attention or hospital readmission for newborns. This condition can have dire consequences, so early detection and treatment is crucial.

Symptoms Of Neonatal Jaundice

It’s common practice for hospitals to check newborns for jaundice before release,however parents should be aware of what to look for. Some symptoms of jaundice in infants include:

  • Yellow sclera (white part of the eyes)
  • Yellow skin, especially the abdomen and limbs
  • Baby is hard to awaken or lethargic
  • Baby is not gaining weight

If these symptoms appear after a child has been sent home from the hospital, it may be advisable to bring them back in for medical treatment.

Causes Of Neonatal Jaundice

Jaundice in infants can often be caused by the liver being underdeveloped. This leads to an inability for the liver to properly break down the bilirubin in their bodies. Besides immature livers, some other causes of this condition include:

  • Blood infection (sepsis)
  • Viral or bacterial infection
  • Malfunction of the liver
  • Deficient enzymes
  • Internal bleeding
  • Abnormal red blood cells

If symptoms of jaundice appear, the child will need to be checked for underlying causes to form a treatment plan.

Factors That Increase Risk Of Neonatal Jaundice

There are some factors that make jaundice more likely in infants. These factors include:

  • Bruising during birth
  • Mother and child’s blood types are different
  • Birth before 38 weeks
  • Breastfeeding difficulties

If a child has these risk factors, their parents and medical team will need to monitor them.

Treatment Of Neonatal Jaundice

To avoid acute or chronic complications, jaundice needs early treatment. Some ways it can be treated include:

  • Light therapy
  • Intravenous immunoglobulin
  • Exchange transfusion

These methods focus on diluting pathogenic antibodies in the child’s blood that cause jaundice or, in the case of light therapy, help the child’s body to more easily break down and excrete the excess bilirubin.

 

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A Closer Look at Neonatal Macrosomia

Neonatal macrosomia refers to babies weighing more than eight pounds and 13 ounces at birth. Approximately nine percent of infants are born with the condition. The larger the baby, the greater the risks to the mother and the infant. There are a variety of causes and risk factorsYour text to link… that lead to overweight newborns. Some causes are preventable.

Causes and Risks

  • Diabetes-Expectant mothers may have been diagnosed with diabetes before becoming pregnant. Others develop gestational diabetes during pregnancy. Blood sugars must be monitored and controlled otherwise, the infant develops with a larger amount of body fat.
  • Previous history-Women who have given birth to overly large infants in the past have a greater risk of having large babies in the future.
  • Obesity-There is a greater chance of having a baby with neonatal macrosomia if the mother is obese. Gaining too much weight during pregnancy also increases the risk.
  • Male infants-Neonatal macrosomia occurs more often in boy babies.
  • Overdue pregnancies-Pregnancies that extend two or more weeks beyond the estimated due date increase the chance that the infant will be overly large.
  • Mother’s age-Pregnant women over the age of 35 are more likely to have abnormally large babies.

Maternal Complications

  • Difficult labor-When an infant is too large, there is a likelihood that the baby becomes stuck in the birth canal, which may necessitate a C-section delivery.
  • Internal injuries-During the birthing process, the mother may suffer laceration or tearing of the vaginal tissues and perineal muscles.
  • Hemorrhaging-Internal injuries combined with the uterus’ inability to contract properly may lead to severe bleeding.
  • Uterine damage-Women who previously gave birth via C-section or had gynecological surgery have an increased risk of suffering from a uterine rupture.

Infant Complications

  • Hypoglycemia-Babies born with neonatal macrosomia have an increased risk of suffering from abnormally low blood sugars.
  • Obesity-Overly large infants are at a greater risk of becoming obese during childhood.
  • Metabolic syndrome-Neonatal macrosomia infants are likely to have metabolic syndrome. The condition is associated with hypertension, hyperglycemia, elevated cholesterol and excess body fat.

Prevention

Women must maintain a healthy weight before during and after pregnancy. While pregnant women should not gain ore than 35 pounds. Women diagnosed with diabetes must have their blood sugar continually monitored and controlled.

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