Guest Editorial

Article Outline

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The topic of the near term infant hits close to home since nine years ago, I delivered a 35 weeker weighing in at 1680 grams. At that time she was just termed SGA and early. Near term or late pre-term were not in our vocabulary. Those two weeks in the NICU were the longest two weeks of my life. It opened up a whole new perspective in my career. Now, as health care professionals it is essential for as to acknowledge these infants and recognize that they come to us at risk for many problems. These issues include: problems with thermoregulation, hypoglycemia, respiratory distress, hyperbilirubinemia, apnea and bradycardia, and feeding difficulty. After careful assessment, we must identify these infants at risk and care for them in the appropriate settings whether it is the newborn nursery or the NICU. This allows us to provide the best possible care with the best outcomes.

The journal will open with an article by Bakewell-Sachs discussing the recognition of the Near Term Infant Initiative launched by The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) in June 2005. She also discusses the clinical risks associated with these infants. This is followed by Susan Ludwig who discusses oral feeding issues in the near term infant. Ludwig focuses on the maturational/developmental problems that affect oral feeding success. She also reviews education techniques for parents. The next article by Waitzman addresses the unique needs of the near term infant in regards to neuromotor maturation, positioning, and safe sleep practices, as well as how healthcare professionals can alter daily care practices and discharge teaching when working with this population.

The next group of articles takes a closer look at the risks these infants face. Beauman and Morris review Neonatal Resuscitation Guidelines. This population does not need resuscitation measures that differ from their term counterparts, but in fact may require some measure of support after delivery. The next article on Safe Sleep looks at how to implement the American Academy of Pediatrics recommendations for safe sleep and how to educate parents. This article reviews the literature on safe sleep practices and describes one organizations experience with an adverse patient event. Hillman takes a look at hyperbilirubinemia being the leading cause for re-hospitalization in the near term infant. He will look at the issues leading to hyperbilirubinemia in this population. Thoerner discusses a new treatment option known as Neonatal Induced Hypothermia for those infants who have experienced a neurologic injury in the perinatal period. The article reviews the condition Hypoxic-Ischemic Encephalopathy. The following article by Tedeschi looks at the challenges related to positional car seat testing in healthy near term infants. She discusses policy development, education and cost containment in regards to this issue.

Pados' article on Safe Transition to Home: Preparing the Near Term Infant for Discharge looks at the importance of tailoring discharge education to this specific population. The goal is a safe transition to home and preventing complications and the need for re-hospitalization. The final article shares an example of a near term clinical pathway. This can improve consistency of care in this population. As always, the NAINR column authors share a variety of topics.