There is insufficient evidence to recommend routine use of opioids in mechanically ventilated newborns. Opioids should be used selectively, when indicated by clinical judgment and evaluation of pain indicators. If sedation is required, morphine is safer than midazolam.

Pre-term birth has a significant impact on infants' social and emotional competence, however, little is known about regulatory processes in pre-term mother-infant dyads during normal or stressful interactions. The primary goals of this study were to investigate the differences in infant and caregiver interactive behaviour and dyadic coordination of clinically healthy pre-term compared to full-term infant-mother dyads and to examine pre-term infants' capacity for coping with stress using the face-to-face still-face paradigm (FFSF). Fifty mother-infant dyads, including 25 pre-term infants and 25 full-term infants were videotaped during the FFSF. All infants were 6-9 months of age (corrected for gestational age in the pre-term group). Infant and maternal socio-emotional expressivity and self-regulatory behaviours were coded and measures of dyadic coordination (Matching, Reparation Rate, and Synchrony) were calculated. There were no significant differences in infant and caregiver socio-emotional behaviours between the two groups and both groups demonstrated the still-face (SF) effect and the reunion effect. There was a difference in self-regulatory behaviour. Pre-term infants were more likely than full-term infants to use distancing (e.g., by turning away, twisting, or arching) from their mothers during the FFSF. Additionally, during the Reunion episode of the FFSF pre-term infants showed more social monitoring compared to full-term infants. Regardless of the birth status, the dyads showed less coordination and a slower rate of reparation during the Reunion episode than during the Play episode. The higher proportion of distancing in the pre-term group and the increase in social monitoring suggest that even in normal interactions pre-term infants may experience a higher level of stress and have less capacity for self-regulation compared to the full-terms and that pre-term infants appear to use a compensatory strategy of increased social monitoring to cope with the stress of renegotiating the interaction during Reunion. The findings suggest that pre-term infants have different regulatory and interactive capacities than full-term infants.

Our analysis suggests as some risk factors do not influence RDS incidence in the same way at different gestational age.

Aim: To investigate to what extent formula milk and stored breast milk, commonly used in hospitals, could be pro‐oxidant sources for newborn babies. Methods: We determined total anti‐oxidant capacity and lipid peroxidation products, such as lipid peroxides, TBARS and conjugated dienes, in fresh and stored (at ‐20°C) samples of breast milk and in different brands of formula milk. Results: There were notable differences in the oxidation parameters in several brands of formula milk, particularly concerning the levels of lipid peroxides and total antioxidant capacity. No difference was found in the mean total antioxidant capacity between formula and breast milk, even if the vitamin content is much higher in formula milk than in breast milk. On the contrary, all the considered lipid peroxidation products were higher in human milk (HM) than formula milk (FM), and lipid peroxides were much higher in HM stored at ‐20°C. Many differences were found between different formula milks. Conclusion: There was a conspicuous formation of lipid peroxides in HM stored at ‐20°C, which was probably caused by an increased presence of free fatty acids due to lipoprotein lipase activity during storage. Unexpectedly, even fresh HM had a higher concentration of lipid peroxidation products when compared to FM. This could be ascribed to the higher susceptibility of HM to degradation during analysis because of manipulation and light exposure. However, it is also interesting that the high content of lipid peroxides did not correspond to a low total antioxidant capacity in either breast or formula milk. This could signify that such levels of lipid peroxidation products might be present naturally in milk and HM after expression is subject to a strong peroxidation either at room temperature or at ‐20°C.

There is insufficient evidence to recommend routine use of opioids in mechanically ventilated newborns. Opioids should be used selectively, when indicated by clinical judgment and evaluation of pain indicators. If sedation is required, morphine is safer than midazolam. Further research is needed.