ABSTRACT
There is limited information about newborns with confirmed or suspected COVID-19. Particularly in the hospital after delivery, clinicians have refined practices in order to prevent secondary infection. While guidance from international associations is continuously being updated, all facets of care of neonates born to women with confirmed or suspected COVID-19 are center-specific, given local customs, building infrastructure constraints, and availability of protective equipment. Based on anecdotal reports from institutions in the epicenter of the COVID-19 pandemic close to our hospital, together with our limited experience, in anticipation of increasing numbers of exposed newborns, we have developed a triage algorithm at the Penn State Hospital at Milton S. Hershey Medical Center that may be useful for other centers anticipating a similar surge. We discuss several care practices that have changed in the COVID-19 era including the use of antenatal steroids, delayed cord clamping (DCC), mother-newborn separation, and breastfeeding. Moreover, this paper provides comprehensive guidance on the most suitable respiratory support for newborns during the COVID-19 pandemic. We also present detailed recommendations about the discharge process and beyond, including providing scales and home phototherapy to families, parental teaching via telehealth and in-person education at the doors of the hospital, and telehealth newborn follow-up.
Subject(s)
Coronavirus Infections , Infant Care/methods , Pandemics , Pneumonia, Viral , Postnatal Care/organization & administration , Pregnancy Complications, Infectious , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/diagnosis , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Evidence-Based Practice , Female , Humans , Infant Care/organization & administration , Infant, Newborn , Infectious Disease Transmission, Vertical , Pneumonia, Viral/diagnosis , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Practice Guidelines as Topic , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/virology , SARS-CoV-2 , Triage/methods , Triage/organization & administrationABSTRACT
Recommended treatment of adolescent eating disorders includes active parental involvement. The purpose of this study was to assess baseline parental knowledge and understanding of eating disorders and how it is affected by participation in treatment. A cross-sectional and prospective cohort study comparing the parents of children ages 8 to 18 years seeking initial evaluation for an eating disorder at an adolescent medicine clinic (ED) to those attending appointments at a general pediatrics clinic (GP) was performed utilizing a 20-item questionnaire. There was no difference in mean scores at baseline, however after 2 months, the mean score of the ED group was significantly higher, while that of the GP group was not. The change in mean score from the first to second survey was significantly greater for the ED group than the GP group. Increased knowledge may improve self-efficacy, which plays a critical role in parents' ability to adopt eating disorder treatments.
