Background The preferential response to mother’s voice in the fetus and term newborn is well documented. However, the response of preterm neonates is not well understood and more difficult to interpret due to the intensive clinical care and range of medical complications. Aim This study examined the physiological response to maternal sounds and its sustainability in the first month of life in infants born very pretermaturely. Methods Heart rate changes were monitored in 20 hospitalized preterm infants born between 25 and 32 weeks of gestation during 30-minute exposure vs. non-exposure periods of recorded maternal sounds played inside the Neonatal incubator. A total of 13,680 min of HR data was sampled throughout the first month of life during gavage feeds Heart rate with and without exposure to maternal sounds. Results During exposure periods, infants had significantly lower heart rate compared to matched periods of care Auditory without exposure on the same day (p < .0001). This effect was observed in all infants, across the first month of life, irrespective of day of life, gestational age at birth, birth weight, age at testing, Apgar score, caffeine therapy, and requirement for respiratory support. No adverse effects were observed. Conclusion Preterm newborns responded to maternal sounds with decreased heart rate throughout the first month of life. It is possible that maternal sounds improve autonomic stability and provide a more relaxing environment for this population of newborns. Further studies are needed to determine the therapeutic implications of maternal sound exposure for optimizing care practices and developmental outcomes.

WHAT'S KNOWN ON THIS SUBJECT: Studies have shown that reciprocal vocalizations between mother and infant have positive effects on language development. It has been shown that girls acquire vocabulary and language skills earlier than boys.WHAT THIS STUDY ADDS: Mothers more readily respond to their infant' s vocal cues than fathers, and infants show a preferential vocal response to their mothers in the first months of life. Mothers respond preferentially to infant girls versus boys at birth and 44 weeks. abstract OBJECTIVES: To evaluate the verbal interactions of parents with their infants in the first months of life and to test the hypothesis that reciprocal vocalizations of mother-infant dyads would be more frequent than those of father-infant dyads.METHODS: This prospective cohort study included 33 late preterm and term infants. Sixteen-hour language recordings during the birth hospitalization and in the home at 44 weeks' postmenstrual age (PMA) and 7 months were analyzed for adult word count, infant vocalizations, and conversational exchanges.RESULTS: Infants were exposed to more female adult speech than male adult speech from birth through 7 months (P , .0001). Compared with male adults, female adults responded more frequently to their infant' s vocalizations from birth through 7 months (P , .0001). Infants preferentially responded to female adult speech compared with male adult speech (P = .01 at birth, P , .0001 at 44 weeks PMA and 7 months). Mothers responded preferentially to girls versus boys at birth (P = .04) and 44 weeks PMA (P = .0003) with a trend at 7 months (P = .15), and there were trends for fathers to respond preferentially to boys at 44 weeks PMA (P = .10) and 7 months (P = .15). CONCLUSIONS:Mothers provide the majority of language input and respond more readily to their infant' s vocal cues than fathers; infants show a preferential vocal response to their mothers in the first months. Findings also suggest that parents may also respond preferentially to infants based on gender. Informing parents of the power of early talking with their young infants is recommended.

Confirmed neonatal infection heightens VPT infants' risk for neurodevelopmental impairment. WMA appears to be an important intervening factor linking infection and severe motor and IQ impairments. Further analysis of the neurologic mechanism accounting for ADHD in infants with infection is needed.

Further research is needed to identify evidence-based design solutions for providing preterm infants with a healthier linguistic hospital environment that aids growth and development.

Infections (including sepsis, meningitis, pneumonia and tetanus) stand as a major contributor to neonatal mortality in Haiti (22%). Infants acquire bacteria that cause neonatal sepsis directly from the mother's blood, skin or vaginal tract either before or during delivery. Nosocomial and environmental pathogens introduce further risk after delivery. The absence of cohesive medical systems and methods for collecting information limits the available data in countries such as Haiti. This study seeks to add more information on the burden of severe bacterial infections and their etiology in neonates of Haiti. Researchers conducted a secondary retrospective analysis of a de-identified database from the Neonatal Intensive Care Unit (NICU) at Nos Petit Frères et Soeurs-St. Damien Hospital (NPFS-SDH). Records from 1292 neonates admitted to the NICU at NPFS-SDH in Port-au-Prince Haiti from 2013 to 2015 were reviewed. Sepsis accounted for 708 of 1292 (54.8%) of all admissions to the NICU. Infants admitted for sepsis had a mortality rate of 23% (163 of 708 infants admitted for sepsis). The most common organism cultured was Streptococcus agalactiae, followed by Klebsiella pneumoniae, Pseudomonas aeroginusa, Enterobacter aerogenes, Staphylococcus aureus and Proteus mirabillis Failure to order or obtain a culture was associated with an increased fatality (odds ratio 2.4) for infants with sepsis. Resistance should be a concern when treating empirically.

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A 7-year-old boy with recent left elbow septic arthritis and osteomyelitis presented with new left knee swelling. The patient was recovering from recurrence of traumainduced left elbow septic arthritis and osteomyelitis, which had resulted in 2 admissions within the preceding 2 months. Approximately 1 month into his antibiotic treatment for these conditions, he had developed Clostridioides difficile (C difficile) enterocolitis and was treated with metronidazole. Presenting symptoms began with left knee pain 3 days prior to presentation, with subsequent redness, swelling, pain, and refusal to ambulate, prompting a visit to the Emergency Department. At this time, he was still completing a 6-week course of cephalexin 3 times daily for prior diagnosis. He had experienced mild back pain for approximately 2 weeks prior to admission but had no other significant musculoskeletal complaints. He had no rashes, no visual symptoms, no urogenital symptoms, and no current complaints of diarrhea, after his C difficile diagnosis and treatment 3 weeks prior.At the Emergency Department, he was afebrile (T 36.7°C), had tachycardia to 125 bpm, with normal respiratory rate (26 bpm), blood pressure (102/77 mm Hg), and oxygen saturating 98% on room air. Physical examination was notable for erythema of the left knee, with warmth, swelling, and tenderness to palpation, as well as a palpable effusion. Patient preferred to keep the left leg flexed at the knee and reported pain with full extension. Neurovascular examination was intact. He had negative examination at all other joints, except his left elbow which showed only mild swelling, but no tenderness or limited range of motion, felt to be secondary to improving previous infection.Diagnostic testing showed evidence of inflammation, with white blood cell (WBC) count of 14 000/uL, elevated platelets to 627 000/uL, erythrocyte sedimentation rate to 60 mm/h, C-reactive protein (CRP) reaching a peak of 15.9 mg/dL. Comprehensive metabolic panel was within normal limits. He was SARS-COv-2 PCR 1098977C PJXXX10.