Vitamin D deficiency during pregnancy connected to elevated risk of ADHD

The risk of ADHD was 34 percent higher in children whose mother had a vitamin D deficiency during pregnancy than in those children whose mother's vitamin D level was sufficient during the first and second trimesters. The result was adjusted for maternal age, socioeconomic status and psychiatric history. Read ScienceDaily article here

NIHR Signal Delayed umbilical cord clamping reduces hospital mortality for preterm infants

Delays to clamping the umbilical cord of about a minute can reduce hospital mortality for preterm infants by around 32%. Delayed clamping also reduced the proportion of infants needing a blood transfusion by 10%.


This review adds more precise data on survival from new trials including a large Australian trial (over 1,600 babies) to a previous Cochrane 2012 review of trails including 738 infants and provides new more precise data on the survival benefit.


From the NIHR Dissemination Centre

Newborn hearing screening programme (NHSP) operational guidance

This Public Health England guidance supports healthcare professionals and stakeholders delivering and managing newborn hearing screening programmes in England.

Newborn blood spot screening: code of practice for residual spots

Guidance from Public Health England which Provides the code of practice for the retention and storage of residual spots after newborn blood spot testing.

Families should feel supported when their child is born preterm, says NICE

Children born preterm should be offered developmental check-ups to help identify any problems or disorders early on, NICE has said in its latest draft quality standard. 

The draft standard aims to improve the follow-up care that is provided to families from when they start planning the discharge of their preterm child from hospital.

Group B Streptococcus (GBS) in pregnancy and newborn babies

This RCOG patient information leaflet provides advice for women who are pregnant or planning to become pregnant about Group B Streptococcus (GBS) infection in newborn babies.

Newborn hearing screening programme (NHSP) operational guidance

This PHE guidance supports healthcare professionals and stakeholders delivering and managing newborn hearing screening programmes in England has been updated.

An uncommon approach: four organisations selected to replicate health and social care interventions

Four organisations have each been awarded £145,000 by the Health Foundation to replicate successful health and care interventions using social franchising and licensing techniques. Social franchising and licensing are methods to replicate and scale interventions that have not yet been used widely in health care in the UK.

The projects are:

Scaling and replicating IRIS through social franchising

Lead organisation: IRISi

IRIS is a successful general practice-based training, support and referral programme that improves the identification and support offered to people with experience of domestic violence and abuse (DVA). One in four women and one in six men will experience DVA during their lifetime, with DVA against women being more frequent and more severe, with long-lasting effects that also have an impact on children. IRIS will be replicated through social franchising so that the programme can be implemented more widely, and more people can be supported. IRISi, a social enterprise set up to house the programme, will support other sites to engage commissioners, and recruit and train staff.

Replicating Pathway’s homeless health hospital team model to towns and cities experiencing significant homelessness

Lead organisation: Pathway

Homeless patients attend emergency departments four times more often than the general population, are admitted eight times more often and stay three times as long. Ten hospitals have implemented Pathway’s integrated care model ensuring that homeless patients admitted to hospital have access to the health care they need and support to recover. Pathway will use social franchising or licensing to replicate the model in places with significant homeless populations that would benefit from adopting it.

Scale up, replication and licensing of the PINCER intervention

Lead organisation: The University of Nottingham

In a recent study, prescribing errors were identified in 5% of prescription items, with one in 550 items containing a severe (potentially life threatening) error. This equates to around 1.8 million serious prescribing errors in English general practices each year. PINCER is a successful pharmacist-led information technology intervention for reducing common medication errors in general practice prescribing, and has been incorporated into national guidelines to support medicines optimisation. PINCER will be replicated in GP surgeries across the country; helping them to protect patients at risk of errors, and reduce medication-related hospital admissions and deaths.

Developing a licensed, social franchising model for regional hubs to roll out effective local multi-professional maternity training

Lead organisation: PROMPT Maternity Foundation

The PRactical Obstetric Multi-Professional Training (PROMPT) programme has been associated with a significant reduction in the number of babies with a low oxygen level at birth and also babies born with a permanent nerve injury following difficulties with their shoulders. Through social franchising and using a regional hub system, it is hoped that this improved implementation model will ensure that PROMPT training may be associated with the same improvements in outcomes across the country.

The new projects are currently subject to contracts being finalised.

The investigation of stillbirth

This House of Commons briefing discusses the way that stillbirth is investigated at present and the government announcement about independent investigations in future.

MBRRACE-UK Perinatal Confidential Enquiry: term, singleton, intrapartum stillbirth and intrapartum-related neonatal death

This report finds that the rate of term, singleton, intrapartum stillbirth and intrapartum-related neonatal death has more than halved since these deaths were last reviewed nationally in 1993. This represents a reduction of about 220 intrapartum deaths per year. It concludes that despite the fall in the mortality rate these deaths remain an important group for concern because, in the vast majority, the mother was directly receiving maternity care when the baby died or when the event in labour or birth occurred which led to the baby’s death.

NIHR Signal Blood test could shorten antibiotic treatment in newborns with suspected sepsis

Measuring procalcitonin levels in newborns with suspected sepsis in the first days of life reduced antibiotic duration by 10 hours compared with standard care. There was no increase in the risk of re-infection or death.

Systemic infection can be rapidly life-threatening in newborn babies, so those with risk factors are often treated pre-emptively with intravenous antibiotics. If sepsis is not confirmed by blood culture the decision whether to discontinue antibiotics needs to be made, but results of the blood culture takes time.

From the NIHR Dissemination Centre

New maternity strategy to reduce the number of stillbirths

The government has announced a new maternity strategy to reduce the number of stillbirths as part of plans to make the NHS the safest place in the world to give birth.

Families who suffer stillbirth or life-changing injuries to their babies will be offered an independent investigation to find out what went wrong and why. Full-term stillbirths will be investigated by coroners.

Safe, sustainable and productive staffing for neonatal care and children and young people's services

Draft resources from NHS Improvement to help standardise safe, sustainable and productive staffing decisions in neonatal care and children and young people's services.

A review of breastfeeding training intervention studies that evaluate staff knowledge outcomes in NICU

Journal of Neonatal Nursing : http://dx.doi.org/10.1016/j.jnn.2017.10.002

The NICU environment presents many barriers for mothers to provide breast milk for their infants. In order to succeed, mothers require advice and assistance from healthcare staff, however some staff lack the necessary knowledge and skills to support them. This review evaluates studies of breastfeeding education interventions on staff knowledge outcomes.

UHCW Research: Amber Dunlop

New materials on prevention and diagnosis of FASD

The National Organisation for Foetal Alcohol Syndrome-UK (NOFAS-UK) has launched new materials designed to increase awareness about the risk of prenatal exposure to alcohol. The new materials include posters and a pre-release version of a booklet, which explains how to identify possible cases of fetal alcohol spectrum disorders (FASD).

Each Baby Counts full 2015 report

The Royal College of Obstetricians and Gynecologists (RCOG) has published the first full Each Baby Counts report into all stillbirths, neonatal deaths and brain injuries that occurred during childbirth in 2015.

Risk of severe harm and death from infusing total parenteral nutrition too rapidly in babies

A warning alert has been issued by NHS Improvement on the risk of harm and death from infusing total parenteral nutrition too rapidly in babies.

Persistent pain in neonates: challenges in assessment without the aid of a clinical tool

Acta Paediatr. Accepted Author Manuscript. doi:10.1111/apa.14081

Evaluation of comfort and pain in neonates is important for management. Specific signs of persistent pain in neonates remain undefined; few validated clinical tools assess persistent pain. We sought to determine (i) difficulty perceived by staff and parents in assessing comfort/persistent pain in babies, (ii) strategies employed when no clinical tool is used (iii) variation between clinicians’ assessments.

Pain assessment is challenging for staff. Most parents feel confident in assessing their babies’ comfort, but may overestimate the ease with which staff can do so. Indicators of persistent pain/comfort are poorly defined; staff use differing, subjective assessments, which may complicate communication between carers.

UHCW Research: Joanna Bradshaw and Kathryn I Blake

Identification and Management of Neonatal Hypoglycaemia in the Full Term Infant – A Framework for Practice

Guidance from the British Association of Perinatal Medicine on the Identification and Management of Neonatal Hypoglycaemia in the Full Term Infant.

Occupational therapy in neonatal services and early intervention

This publication from the Royal College of Occupational Therapists, provides specific evidence-based recommendations which describe the best and most effective practice for occupational therapy for high-risk infants in neonatal and early intervention settings.