(1) Background: Cerebral MRI plays a significant role in assessing the extent of brain injury in neonates with neonatal encephalopathy after perinatal asphyxia. Over the last decades, several MRI scoring systems were developed to enhance the predictive accuracy of MRI. The aim of this study was to validate the correlation of four established MRI scoring systems with cognitive long-term outcomes in cooled asphyxiated newborns. (2) Methods: Forty neonates with neonatal encephalopathy treated with therapeutic hypothermia were included in this retrospective study. The MRI scans from the second week of life were scored using four existing MRI scoring systems (Barkovich, NICHD, Rutherford, and Weeke). The patients’ outcome was assessed with the Bayley Scales of Infant Development (BSID-III) at the age of 2 years. To evaluate the correlation between the MRI scoring system with the cognitive scores of BSID-III, the correlation coefficient was calculated for each scoring system. (3) Results: All four MRI scoring systems showed a significant correlation with the cognitive scores of BSID-III. The strongest correlation was found between the Weeke Score (r² = 0.43), followed by the Rutherford score (r² = 0.39), the NICHD score (r² = 0.22), and the Barkovich score (r² = 0.17). (4) Conclusion: Our study confirms previously published results in an independent cohort and indicates that the Weeke and Rutherford scores have the strongest correlation with the cognitive score of BSID-III in cooled asphyxiated newborns.

Background: Therapeutic hypothermia is the standard treatment for neonates with hypoxic–ischemic encephalopathy. Preclinical evidence indicates that the time to initiate therapeutic hypothermia correlates with its therapeutic success. This study aims to explore whether there is a correlation between the early initiation of therapeutic hypothermia and improved short-term neurological outcomes in cooled asphyxiated newborns. Methods: A retrospective analysis was conducted, involving 68 neonates from two different neonatal intensive care units. The impact of time to initiate treatment, time to reach the target temperature, and time between initiation and target temperature was correlated with short-term outcomes on MRI. Results: We did not find a significant difference between outcomes regarding the time to start treatment and the time to achieve the target temperature. Interestingly, neonates with a poor outcome were treated on average earlier than neonates with a favorable outcome but required more time to reach the target temperature. Additionally, the study results did not support the hypothesis that a shorter time to initiate treatment would lead to shorter times to achieve the target temperature. Conclusion: Based on our findings, it is recommended to prioritize a thorough evaluation of neonatal encephalopathy before initiating therapeutic hypothermia. Early initiation of treatment should be balanced with the time required for precise assessment to ensure better outcomes.

Infants born with a very low birth weight (VLBW, < = 1.500 g) have an increased risk for medical complications and long‐term impairments. Feeding these infants with their mother's own milk (MOM) reduces the risk for adverse outcomes, but many VLBW infants are not fed with MOM for the recommended duration of at least 6 months postpartum. This study examines factors associated with early cessation during the VLBW infants' neonatal intensive care unit (NICU) stay and after discharge. Data were collected from an anonymous, nationwide survey as part of the Neo‐MILK study. Logistic regressions and Cox proportional hazard models were used to identify factors associated with early cessation of MOM feeding. Among the 304 mothers analysed, 19.4% of all mothers ceased MOM feeding during the infants' NICU stay. The total cessation rate before 6 months was 53.9%. An early milk volume of over 500 mL/day compared to less or equal to 500 mL/day was negatively associated with MOM feeding cessation during the infants' NICU stay (Adjusted OR: 0.14). Exclusive pumping was associated with a higher cessation rate after discharge (Adjusted HR: 2.01). Early sufficient milk volume and mixed feeding (pumping and breastfeeding) inform longer MOM feeding duration. Interventions targeting early lactation practices and promoting direct breastfeeding while helping with the transition from pumping to breastfeeding are essential for improving MOM feeding outcomes in VLBW infants.Trial Registration: German Register of Clinical Trials, ID: DRKS00024799, https://drks.de/search/en/trial/DRKS00024799.

Zusammenfassung Hintergrund Die Arbeitszufriedenheit wie auch das Wohlbefinden der ärztlichen und pflegerischen Mitarbeiter*innen sind zum einen relevant zur Mitarbeiter*innenbindung, aber auch zur Aufrechterhaltung einer qualitativ hochwertigen Patient*innenversorgung. Aufgrund des Personalmangels in der Neonatologie ist es wichtig, mehr über den aktuellen Stand der Arbeitsplatzzufriedenheit, der Work-Life Balance wie auch der Wechselabsichten zu erfahren. Methode Hierzu sind insgesamt 389 Ärzt*innen und Pflegekräfte befragt worden. Ergebnisse Insgesamt arbeiten 74 % der Ärzt*innen in Vollzeit (≥ 38 h/Woche) (Ärzte: 80 %, Ärztinnen: 69 %), wobei dies jedoch nur von 49 % der befragten Ärzt*innen (Ärzte: 57 %, Ärztinnen: 41 %) gewünscht ist. Mit 56 % an Ärzt*innen mit einem klinisch auffälligen WHO-5-Wohlbefindens Index zeigt sich auch hier Handlungsbedarf. Circa 44 % der befragten Ärzt*innen unter 60 Jahren planen, in den nächsten 5 Jahren ihren Arbeitgeber zu wechseln. Dies steht im signifikanten Zusammenhang zu Burn-out und Work-Life-Balance-Konflikten. Diskussion Insgesamt zeigen sich große Herausforderungen in der Vereinbarkeit von Arbeit und Familie und hierdurch der vermehrte Wunsch nach Teilzeit.

Background: Mothers of sick and preterm infants need support to establish and maintain lactation. Although many health technologies on breastfeeding are available, most lack in evidence-based information and are therefore not appropriate for educating mothers. Furthermore, they do not focus on the special challenges of mother-infant separation during lactation in mothers of sick or preterm infants. Objective: The aim of this study is to examine the usability and perceived usefulness of the evidence-based information about lactation and documentation tools contained in the Neo-MILK web app. Methods: A cross-sectional online survey was conducted among mothers of sick and preterm infants admitted to a neonatal intensive care unit in Germany. Descriptive statistics were calculated for the System Usability Scale (SUS) and for self-developed items pertaining to overall satisfaction and perceived usefulness of the app. These included items on evidence-based information and the usability of tracking functions. Results: Of 341 mothers who were contacted, 80 responded (response rate, 23.4%), and data from 63 mothers were analyzed. The mean SUS score was 76.4. The overall satisfaction rate was high, with 84% (n=53) of respondents indicating that they were either satisfied or very satisfied. Further, 82% (n=52) were inclined to recommend the web app to other parents. On average, the evidence-based information was perceived as helpful, more detailed, and not contradictory compared to information provided at the hospital. At the same time, most of the users reported that the Neo-MILK web app did not exert pressure to provide breast milk to their infants. Approximately 71% (n=45) of the mothers used the documentation tool in the web app several times per week to track their milk volumes. Conclusions: By combining evidence-based information and useful tools to document milk volume, the Neo-MILK web app was high rated in usability and perceived usefulness. Considering the limitations of the study, this web app appears to be a valuable tool for educating and supporting pump-dependent mothers of sick and preterm infants during lactation.