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From the Editors for 2021(5) -​

In this issue of Advances in Neonatal Care, we are pleased to introduce a special series on necrotizing enterocolitis (NEC) led by series editors Drs. Gephart and Quinn. The issue begins with an editorial on scope of the problem and the inequity that exists around the incidence and mortality of NEC. The four series articles contained in this issue are varied and include: 1) the impact of donor milk on the incidence of NEC, 2) the clinical presentation and multifactorial pathogenesis of NEC, 3) feeding practices and effects on transfusion-associated with NEC, and 4) use of abdominal ultrasound to assist in the diagnosis and management of NEC.

Also in this issue NANN introduces the executive summary of the clinical practice guideline “Thermoregulation in the Care of Infants". This guideline examines the state of the science around thermoregulation to provide recommendations for thermal management of all NICU infants. Similarly, a clinical quality improvement article titled “Engaging Frontline Providers Prevents Hypothermia and Improves Communication in the Postoperative Neonate" highlights how development of a hypothermia guideline and standardizing temperature monitoring can significantly decrease hypothermia following neonatal surgery.

The issue is rounded out by several practice improvement, professional development and research articles covering a wide range of topics. We hope the new issues will be rewarding and informative.​

*NEW from Issue 5! Availability of Donor Human Milk Decreases the Incidence of Necrotizing Enterocolitis in VLBW Infants
In this article Dr. Cohen, and colleagues used a convergent observational study with over 9,000 infants to evaluate the impact of the availability of human milk on NEC. They found that with development of a large NICU collaborative and increased availability of human milk the incidence of NEC was significantly reduced.​

*NEW from Issue 5! Feeding practices and effects on transfusion-associated necrotizing enterocolitis in premature neonates​
In this article Ms. Killion provides a review of the available literature on the relationship between the feeding practice of withholding a feeding or not withholding a feeding for red blood cell transfusion on the development of necrotizing enterocolitis (NEC). The evidence around withholding feedings to prevent transfusion-associated NEC was inconclusive. 

Neonatal Thermoregulation: A Golden Hour Protocol Update

Thermoregulation during the Golden Hour is important not during just those first few hours but also has implications for the days and weeks beyond that time. This article provides a protocol and evaluation that could be useful in your unit.

Preterm Infant Incubator Humidity Levels: A Systematic Review

Incubator humidity has long been a debated issue, how much and for how long has implications for caregiving. This systematic review provides answers to many of these questions.

Having Skin in the Game: A Case Study of Necrotizing Fasciitis in the Neonate Treated With Cultured Epidermal Autografts
This article presents a case of a rare but often fatal infection, necrotizing fasciitis and the successful novel treatment with cultured epidermal autographts.

This research describes the attributes and beliefs of NICU healthcare professionals about family-centered care and the professional characteristics that might influence those views.

Neonatal Abstinence Syndrome and the Preterm Infant: A Look at Current Practice​
This study explored the current state of practice for preterm infants born less than 34 weeks gestational age exposed to intrauterine drugs. Great variability in practice exists across the country supports the need for a validated preterm infant.

Neonatal Alloimmune Thrombocytopenia: A Concise Review
This article provides an overview of Neonatal alloimmune thrombocytopenia (NAIT). NAIT is an uncommon platelet disorder caused by maternal alloimmunization to human specific antigens (HPA) that are paternally inherited. Nursing and medical care are explored. ​

Current Issue Highlights

Necrotizing Enterocolitis

A Cross-sectional Survey of Enteral Feeding Tube Placement and Gastric Residual Aspiration Practices: Need for an Evidence-Based Clinical Practice Guideline

Perumbil Pathrose, Sheeja; Spence, Kaye; Taylor, Christine; More

Advances in Neonatal Care. 21(5):418-424, October 2021.

Self-Report and Biological Indexes of Work-Related Stress in Neonatal Healthcare Professionals: A Repeated-Measures Observational Study

Fumagalli, Monica; Provenzi, Livio; Sorrentino, Gabriele; More

Advances in Neonatal Care. 21(5):E120-E128, October 2021.