SAMMANFATTNING Bakgrund: Kängurumetoden, även kallat Kangaroo Mother Care (KMC) är en omvårdnadsmetod som främjar hudkontakten mellan förälder och barn, särskilt prematura eller underviktiga. KMC har positiva effekter för både föräldrar och barn. Därför är det väsentligt att ta reda på föräldrars upplevelse av KMC för att kunna optimera vården då metoden är essentiell för det nyfödda barnet.  Syfte: Syftet med denna litteraturöversikt var att undersöka föräldrars upplevelser av kängurumetoden med barn som vårdas på neonatalavdelningen.  Metod: En litteraturöversikt med kvalitativ design där 10 kvalitativa artiklar samlades in från databaserna PubMed och Cinahl.  Resultat: Föräldrars upplevelse av KMC uttrycktes i fyra kategorier och åtta subkategorier. Kategorierna som presenteras är Insikten om att ha blivit förälder, Emotionell upplevelse av kängurumetoden hos föräldrarna, Växande ansvar som förälder och Kommunikation med vårdpersonal under KMC. Upplevelsen av KMC var i helhet positiv, inklusive ökad lycka och lugn men även negativa upplevelser av KMC uttrycktes, såsom rädsla för att skada sitt barn och att kommunikationen med vårdpersonalen var påverkad.  Slutsats: Resultaten visar en mångfald av mestadels positiva men även negativa erfarenheter, däribland; förstärkt föräldraroll, ökad känsla av kompetens och ansvar för barnet. KMC kunde ge känslan av att känna sig som ett verktyg, men deltagandet i vården möjliggör för föräldrar att känna sig betydelsefulla vilket gör en positiv skillnad för sitt barn. Genom att lyssna på och integrera föräldrarnas perspektiv kan neonatalvården fortsätta att utvecklas och anpassas för att möta både barnets och föräldrarnas behov. / ABSTRACT Background: Kangaroo method, also called Kangaroo Mother Care (KMC) is a nursing method that promotes skin-to-skin contact between parent and child, especially for children born prematurely or underweight. KMC has positive effects for both parent and child. Therefore, it is important to find out parents' experience of KMC to optimize the care as the method is essential for the newborn child. Aim: The purpose was to investigate parents’ experience of Kangaroo Mother care with children in the neonatal unit. Method: A literature review with qualitative design where 10 qualitative articles were collected in databases PubMed and Cinahl.  Results: Parents' experience of KMC was expressed in four categories and eight subcategories that answered the purpose of this literature review. The categories presented are The realization that one has become a parent, Emotional experience of the kangaroo method by the parents, Increasing parental responsibility and Communication with healthcare staff during KMC. The experience of KMC was overall positive, including increased happiness and calmness but also negative experiences of KMC, such as fear of harming their child and that communication with healthcare professionals was affected. Conclusion: The results show a diversity of mostly positive but also negative experiences, including; strengthened parental role, increased sense of competence and responsibility for the child. KMC could give a sense of being used as a device, but participating in the care enables parents to feel meaningful for their child. By listening to parents' perspectives, neonatal care can continue to develop and adapt to meet needs of both children and parents

Die doel van hierdie studie is die ontwikkeling van 'n ouerleidingsprogram vir moeders wat hul premature babas in 'n kangaroemoedersorgprogram versorg. Die program het ten doel om die moeders in die onmiddelikke versorging, sowel as die toekomstige begeleiding van hut kinders, toe te rus. 'n Literatuuroorsig word gegee van prematuriteit as fenomeen en van kangaroemoedersorg (KMS) as versorgingswyse, met spesifieke verwysing na die toepassing daarvan in Kalafonghospitaal. Die grondslae van ouerteiding word uit die literatuur opgesom en riglyne word ook gestef vir die samestelling van 'n ouerfeidingprogram. Die kwalitatiewe navorsingsmetode word gebruik om die inhoud van die ouerfeidingsprogram te bepaal en om ondersoek in te stel na die mees geskikte aanbiedingswyses. Die verslag word afgesluit met riglyne vir die samestelling van 'n prakties-toepasbare ouerleidingsprogram waarin inhoudsmoontlikhede, idees vir aanbieding en wyses vir die bepaling van gestelde uitkomste uiteengesit word. / The aim of this study is the development of parental guidance for mothers who take care of their premature babies in a programme of Kangaroo Mother Care. The programme aims to equip mothers for immediate and future care of their children. A literature review of prematurity as phenomenon and of kangaroo mother care as care method is presented with specifK: reference to the way it is applied in Kalafong-hospital. The basics of parental care are summated from literature and guidelines are set to design a parental guidance programme. The qualitative research method is put into operation to determine the content of the parental guidance programme and to investigate the most appropriate method of presentation. The report is concluded with guidelines for setting up a practical and applicable parental guidance programme in which subject possibilities, ideas for presentation and means for determining set outcomes are explained. / Educational Studies / M.Ed.(Spesialisering in voorligting)

<p>Kangaroo mother care (KMC) was first initiated in Colombia due to shortages of incubators and the incidence of severe hospital infections of new-born infants during hospital stay (Feldman, 2004). Currently it is identified by UNICEF as a universally available and biologically sound method of care for all new-borns, particularly for low birth weight infants (Department of Reproductive Health and Research, 2003) in both developed and developing countries. The Western Cape Provincial Government implemented a policy on KMC as part of their strategy to decrease the morbidity and mortality of premature infants in 2003 (Kangaroo Mother Care Provincial task team, 2003). Essential components of KMC are: skin-to-skin contact for 24 hours per day (or as great a part of the day as possible), exclusive breastfeeding and support to the motherinfant dyad. Successful implementation of KMC requires relevant education of nurses, education of mothers on KMC by nursing staff, monitoring of the implementation of KMC by nurses, planning for a staff mix with varying levels of skill and experience with KMC, the identification of institution specific barriers to the implementation of KMC, and the implementation of institution specific strategies to overcome these barriers (Wallin,et al., 2005 / Bergman &amp / Jurisco, 1994 / Cattaneo, et al., 1998). This study aims to determine the knowledge of and attitude towards kangaroo mother care, of nursing staff and kangaroo mothers in the Eastern sub-district of Cape Town.</p>

<p>Kangaroo mother care (KMC) was first initiated in Colombia due to shortages of incubators and the incidence of severe hospital infections of new-born infants during hospital stay (Feldman, 2004). Currently it is identified by UNICEF as a universally available and biologically sound method of care for all new-borns, particularly for low birth weight infants (Department of Reproductive Health and Research, 2003) in both developed and developing countries. The Western Cape Provincial Government implemented a policy on KMC as part of their strategy to decrease the morbidity and mortality of premature infants in 2003 (Kangaroo Mother Care Provincial task team, 2003). Essential components of KMC are: skin-to-skin contact for 24 hours per day (or as great a part of the day as possible), exclusive breastfeeding and support to the motherinfant dyad. Successful implementation of KMC requires relevant education of nurses, education of mothers on KMC by nursing staff, monitoring of the implementation of KMC by nurses, planning for a staff mix with varying levels of skill and experience with KMC, the identification of institution specific barriers to the implementation of KMC, and the implementation of institution specific strategies to overcome these barriers (Wallin,et al., 2005 / Bergman &amp / Jurisco, 1994 / Cattaneo, et al., 1998). This study aims to determine the knowledge of and attitude towards kangaroo mother care, of nursing staff and kangaroo mothers in the Eastern sub-district of Cape Town.</p>

Die doel van hierdie studie is die ontwikkeling van 'n ouerleidingsprogram vir moeders wat hul premature babas in 'n kangaroemoedersorgprogram versorg. Die program het ten doel om die moeders in die onmiddelikke versorging, sowel as die toekomstige begeleiding van hut kinders, toe te rus. 'n Literatuuroorsig word gegee van prematuriteit as fenomeen en van kangaroemoedersorg (KMS) as versorgingswyse, met spesifieke verwysing na die toepassing daarvan in Kalafonghospitaal. Die grondslae van ouerteiding word uit die literatuur opgesom en riglyne word ook gestef vir die samestelling van 'n ouerfeidingprogram. Die kwalitatiewe navorsingsmetode word gebruik om die inhoud van die ouerfeidingsprogram te bepaal en om ondersoek in te stel na die mees geskikte aanbiedingswyses. Die verslag word afgesluit met riglyne vir die samestelling van 'n prakties-toepasbare ouerleidingsprogram waarin inhoudsmoontlikhede, idees vir aanbieding en wyses vir die bepaling van gestelde uitkomste uiteengesit word. / The aim of this study is the development of parental guidance for mothers who take care of their premature babies in a programme of Kangaroo Mother Care. The programme aims to equip mothers for immediate and future care of their children. A literature review of prematurity as phenomenon and of kangaroo mother care as care method is presented with specifK: reference to the way it is applied in Kalafong-hospital. The basics of parental care are summated from literature and guidelines are set to design a parental guidance programme. The qualitative research method is put into operation to determine the content of the parental guidance programme and to investigate the most appropriate method of presentation. The report is concluded with guidelines for setting up a practical and applicable parental guidance programme in which subject possibilities, ideas for presentation and means for determining set outcomes are explained. / Educational Studies / M.Ed.(Spesialisering in voorligting)

Submitted by Fernando Souza (fernandoafsou@gmail.com) on 2017-09-08T14:42:01Z No. of bitstreams: 1 arquivototal.pdf: 3017374 bytes, checksum: 992b3bd4f1ee14178ecc46c753714ca0 (MD5) / Made available in DSpace on 2017-09-08T14:42:01Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 3017374 bytes, checksum: 992b3bd4f1ee14178ecc46c753714ca0 (MD5) Previous issue date: 2017-04-18 / Introduction: In recent years, the Ministry of Health has been carrying out actions to contain the fragmentation of care provided to pregnant women and newborn babies and reduce the neonatal morbidity and mortality in Brazil. The Kangaroo Mother Method was incorporated as a health policy for improving care to the newborn premature, with active participation of Primary Health Care. Objective: To analyze the maternal care with the newborn in the third step of the Kangaroo Mother Method and the assistance given by professionals of the Family Health Strategy to the mother-baby kangaroo. Method: This is a qualitative research, descriptive-exploratory, submitted to the Research Ethics Committee at the Lauro Wanderley University Hospital, getting opinion 1,515,237 CAAE 54391316.7.0000.5183.The participants were 10 mothers of newborn infants whose parturition was performed in one of the maternities entered the study. The data were collected by means of interviews, in the months of May and June of 2016, analyzed from the content analysis technique proposed by Bardin. Had as its backdrop the obstetrical clinic of a university hospital and a public maternity hospital that meet the preterm and/or low birth weight babies, in addition to Family Health Units in the city of João Pessoa, PB. Results: The reports of mothers-kangaroo show feelings like fear, insecurity and tiredness, to take care of the child in the household; experienced lack of family support and professionals for continuity of method, resulting in weakness of the assistance to the mother-baby at this stage of the kangaroo mother method. Conclusion: To continue to provide care to the mother-baby kangaroo, it is necessary to train professionals in the Family Health Strategy in relation to the method, strengthen the bond of family healthcare team with the community, establish a home visit to this dual, in the routine of teams, and propitiate the comprehensiveness of care. / Introducción: En los últimos años, el Ministerio de Salud ha venido llevando a cabo acciones para contener la fragmentación de la atención prestada a las mujeres embarazadas y los niños recién nacidos y reducir la morbilidad y mortalidad neonatal en Brasil. El Método Madre Canguro fue incorporado como una política de salud para mejorar la atención al recién nacido prematuro, con la activa participación de la Atención Primaria de la Salud. Objetivo: Analizar la atención materna con el recién nacido en el tercer paso del método madre canguro y la ayuda prestada por profesionales de la Estrategia Salud de la Familia a la madre-bebé canguro. Método: Se trata de una investigación cualitativa, descriptiva-exploratoria, presentada a la Comisión de Ética en Investigación del Hospital Universitario Lauro Wanderley, obtención de opinión 1,515,237 CAAE 54391316.7.0000.5183. Los participantes fueron 10 madres de recién nacidos, cuyo parto se realiza en una de las maternidades que entraron en el estudio. Los datos fueron recolectados por medio de entrevistas, en los meses de mayo y junio de 2016, analizó a partir de la técnica de análisis de contenido propuesto por Bardin. Tuvo como telón de fondo la clínica obstétrica de un hospital universitario y un hospital público de maternidad que cumplen los recién nacidos prematuros o de bajo peso al nacer, además de unidades de salud familiar en la ciudad de João Pessoa, Paraíba. Resultados: Los informes de las madres-canguro muestran sentimientos como el miedo, la inseguridad y el cansancio, a cuidar al niño en el hogar; el experimentado falta de apoyo familiar y profesionales para la continuidad del método, resultando en debilidad de la atención a la madre-bebé en esta etapa del método madre canguro. Conclusión: En seguir prestando atención a la madre-bebé canguro, es necesario capacitar a los profesionales de la Estrategia Salud de la Familia en relación con el método, fortalecer el vínculo de la familia con el equipo de salud de la comunidad, establecer una visita a la casa a este doble, en la rutina de los equipos, y propiciar la integralidad de la atención. / Introdução: Nos últimos anos, o Ministério da Saúde vem realizando ações para conter a fragmentação da assistência prestada às gestantes e aos recém-nascidos e reduzir a morbimortalidade neonatal no Brasil. O Método Canguru foi incorporado como política de saúde para melhorar a assistência ao recém-nascido prematuro, com participação ativa da Atenção Primária à Saúde. Objetivo: Analisar o cuidado materno com o recém-nascido na terceira etapa do Método Canguru e a assistência dada pelos profissionais da Estratégia Saúde da Família ao binômio mãe-bebê canguru. Método: Trata-se de uma pesquisa qualitativa, descritivo-exploratória, submetida ao Comitê de Ética em Pesquisa do Hospital Universitário Lauro Wanderley, obtendo parecer 1.515.237 CAAE 54391316.7.0000.5183. Participaram da pesquisa dez mães de recém-nascidos, cujo parto foi realizado em uma das maternidades inseridas no estudo. Os dados foram coletados por meio de entrevista semiestruturada, nos meses de maio e junho de 2016, analisados a partir da técnica de análise de conteúdo proposta por Bardin. Teve como cenário a Clínica Obstétrica de um Hospital Universitário e uma maternidade pública que atendem a recém-nascidos pré-termo e/ou de baixo peso, além de Unidades de Saúde da Família do município de João Pessoa-PB. Resultados: Os relatos das mães-canguru evidenciam sentimentos como medo, insegurança e cansaço, ao assumir os cuidados com o filho no domicílio; vivenciaram falta de apoio familiar e de profissionais para continuidade do método, resultando em fragilidade da assistência ao binômio mãe-bebê nessa etapa do método canguru. Conclusão: Para continuar a prestar cuidados ao binômio mãe-bebê canguru, é necessário capacitar os profissionais da Estratégia Saúde da Família em relação ao método, fortalecer o vínculo da equipe de saúde da família com a comunidade, instituir visita domiciliar para essa dupla, na rotina das equipes, e propiciar a integralidade da assistência.

Magister Public Health - MPH / Kangaroo mother care (KMC) was first initiated in Colombia due to shortages of incubators and the incidence of severe hospital infections of new-born infants during hospital stay (Feldman, 2004). Currently it is identified by UNICEF as a universally available and biologically sound method of care for all new-borns, particularly for low birth weight infants (Department of Reproductive Health and Research, 2003) in both developed and developing countries. The Western Cape Provincial Government implemented a policy on KMC as part of their strategy to decrease the morbidity and mortality of premature infants in 2003 (Kangaroo Mother Care Provincial task team, 2003). Essential components of KMC are: skin-to-skin contact for 24 hours per day (or as great a part of the day as possible), exclusive breastfeeding and support to the motherinfant dyad. Successful implementation of KMC requires relevant education of nurses, education of mothers on KMC by nursing staff, monitoring of the implementation of KMC by nurses, planning for a staff mix with varying levels of skill and experience with KMC, the identification of institution specific barriers to the implementation of KMC, and the implementation of institution specific strategies to overcome these barriers (Wallin,et al., 2005; Bergman & Jurisco, 1994; Cattaneo, et al., 1998). This study aims to determine the knowledge of and attitude towards kangaroo mother care, of nursing staff and kangaroo mothers in the Eastern sub-district of Cape Town. / South Africa

MCur / Department of Advanced Nursing Science / Each year, an estimated 3.6 million infants die worldwide in the first four weeks of life due to complications of premature birth. One-third of Low Birth Weight (LBW) babies die within the first 12 hours after delivery. The main reasons premature babies are at greater risk of illness and death is that they lack the ability to control their body temperature meaning that they get cold or hypothermic very quickly. Kangaroo Mother Care reduces mortality and if widely applied it could reduce deaths in premature newborn babies. The purpose of this study is to explore and describe the lived experiences of mothers when providing Kangaroo Mother Care at the hospitals in Vhembe District of Limpopo province. Qualitative approach with explorative descriptive, contextual and phenomenological designs were employed to explore the experiences of mothers when providing Kangaroo Mother Care. The study population consisted of all mothers who were providing Kangaroo Mother Care. A non-probability convenience sampling method was used to determine the sample of the study. The size of the sample was determined by data saturation. In-depth individual interviews were conducted using a central question. The Tesch’s eight steps of open-coding model guided the process to analyse data. Trustworthiness was ensured throughout by employing the principles of credibility, dependability, conformability, and transferability. Ethical considerations were followed to protect the participants. Recommendations were made based on the research findings. The findings of the study revealed that mothers who provide Kangaroo Mother Care experience challenges. They received inconsistent information about the practice of Kangaroo Mother Care from nurses. The relationship between mothers and nurses was good. Recomendations were made based on the findings and relevant structures in order to ensure that mothers challenges are addressed. The study revealed ineffective support provided to mothers by nurses and family members. / NRF

Comprehensive management in the neonatal nursery involves medical treatment of the infant, as well as developmental care and the provision of guidance, counselling and information to the family who are part of the decision-making process regarding the infant’s care. Neonatal communication intervention is of utmost importance in a country such as South Africa, which has an increased prevalence of infants at risk for disabilities and where the majority of these infants live in poverty. Speech-language therapists fulfil an important role in the neonatal nursery and are an integral part of the team involved with the high risk neonatal population. Local literature showed a dearth of information on the current service delivery and roles of speech-language therapists and audiologists in neonatal nurseries in the South African context. From an asset-based perspective it appears that the South African population receiving services in neonatal nurseries have unique characteristics. This provides speech-language therapists with ample opportunity to intervene, providing that intervention is well-timed in the neonatal nursery context. The country-wide initiative to implement the evidence-based technique of kangaroo mother care indicates that speech-language therapists should recognise its importance and develop communication based materials and tools to complement this successful neonatal intervention. The aim of the research was to establish whether speech-language therapists have needs for assessment and intervention tools/materials in this context. The study furthermore aimed to compile a locally relevant neonatal communication intervention instrument/tool for use by speech-language therapists in the neonatal nurseries of public hospitals in South Africa in order to propose a solution to address the shortage of tools in the public health context. The study entailed descriptive, exploratory research. During Phase 1, a survey was received back from 39 speech-language therapists and two audiologists in six provinces. The data revealed that participants performed different roles in neonatal nurseries, which were determined by the environment, tools, materials and instrumentation available to them. Many participants were inexperienced, but were resourceful in their attempts to develop and adapt tools/materials. Participants expressed a need for culturally appropriate and user-friendly instruments for parent guidance and staff/team training on the topic of developmental care. During Phase 2 a tool for parent guidance titled “Neonatal communication intervention programme for parents” was compiled for use by speech-language therapists and justified by participants’ roles and needs as well as current early communication intervention (ECI) literature. The programme was piloted by three participants. Certain suggestions for enhancements of the programme were made such as providing a glossary of terms, adapting the programme’s language and terminology, and providing more illustrations. The programme complied with the guiding principles for best practice in ECI (ASHA, 2008) and can therefore contribute to neonatal care of high risk infants in South Africa. Speech-language therapists and audiologists must contribute to neonatal care of high risk infants to facilitate optimal health and development and to support their families. AFRIKAANS : Omvattende intervensie in die neonatale sorgeenheid behels mediese behandeling van die neonaat, sowel as ontwikkelingstoepaslike sorg en die verskaffing van leiding, berading en inligting aan die gesin wat deel is van die besluitnemingsproses rakende die baba se sorg. Neonatale kommunikasie intervensie is van uiterste belang in Suid-Afrika aangesien daar ‘n hoër prevalensie van babas is wat ‘n risiko het vir ontwikkelingsafwykings en aangesien die meerderheid van hierdie babas in armoede leef. Spraak-taalterapeute vervul ‘n belangrike rol in die neonatale sorgeenheid en is ‘n integrale deel van die span wat betrokke is by die hoërisiko neonatale populasie. Plaaslike literatuur dui op ‘n tekort aan inligting rakende die huidige dienslewering van die spraak-taalterapeut en oudioloog in neonatale sorgeenhede in die Suid-Afrikaanse konteks. Vanuit ‘n bate-benadering kom dit voor of die Suid-Afrikaanse populasie wat dienste in neonatale sorgeenhede ontvang, unieke eienskappe het. Dit bied genoegsame geleenthede aan spraak-taalterapeute om intervensie te verskaf, solank die behandeling betyds in die neonatale sorgeenheid konteks aanvang neem. Daar is ‘n landswye inisiatief om die bewysgerigte tegniek van kangeroe moedersorg toe te pas. Spraak-taalterapeute moet dus die belang daarvan herken en kommunikasie gebasseerde terapiemateriaal ontwikkel om hierdie suksesvolle neonatale intervensie te komplementeer. Die navorsing se doel was om vas te stel hoe wyd spraak-taalterapeute en oudioloe ‘n behoefte aan evaluasie en intervensie instrumente en –materiaal in hierdie konteks het. Die navorsing het verder ten doel gestel om ‘n relevante terapie instrument saam te stel vir spraak-taalterapeute in die neonatale sorgeenhede as ‘n moontlike oplossing vir die tekort aan relevante terapiemateriaal in die plaaslike publieke gesondheidsorgkonteks. Die studie het beskrywende, eksplorerende navorsing behels. Gedurende Fase 1 is ‘n vraelys terug ontvang van 39 spraak-taalterapeute en twee oudioloë in ses provinsies. Die data het aangedui dat deelnemers verskillende rolle in hierdie konteks vervul, wat beïnvloed was deur die omgewing, die instrumentasie en materiaal wat tot hulle beskikking was. Die meerderheid van die deelnemers was onervare, maar was vindingryk in hulle pogings om terapiemateriaal aan te pas en te ontwikkel. Deelnemers het ‘n behoefte vir kultureel toepaslike- en gebruikersvriendelike instrumente en materiaal uitgedruk met die oog op ouerleiding en personeel/span opleiding oor die onderwerp van ontwikkelingstoepaslike sorg. Gedurende Fase 2 is ‘n terapie instrument naamlik “Neonatale kommunikasie intervensie program vir ouers” saamgestel vir die gebruik in die neonatale sorgeenhede deur spraak-taalterapeute. Die samestelling van hierdie program is verantwoord deur die deelnemers se rolbeskrywing en behoeftebepaling van Fase 1, sowel as deur huidige vroeë kommunikasie intervensie (VKI) literatuur. Die program is deur drie deelnemers in ‘n loodsstudie geëvalueer. Voorstelle vir die verbetering van die program is verskaf, naamlik die byvoeging van ‘n terminologielys, aanpassing van die program se taalgebruik en terminologie en verskaffing van meer illustrasies. Die program het ooreengestem met die beginsels vir beste praktyk in VKI (ASHA, 2008) en kan daarom tot neonatale sorg van hoërisikobabas in Suid-Afrika bydra. Spraak-taalterapeute en oudioloë moet bydra tot neonatale sorg van hoërisiko neonate om sodoende optimale gesondheidsorg en ontwikkeling te fasiliteer en gesinne te ondersteun. Copyright / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / unrestricted

v anglickém jazyce The thesis deals with the care of premature newborns. The structure of the thesis is divided into several chapters, which focus on the definition of neonatology and development of the neonatal care in the Czech Republic and abroad and on the definition of premature newborn and their most common diseases. Substantial part is devoted to development of the care of premature newborn and its current status. The final part of the thesis is devoted to interviews with the nurses, who have been working in the neonatal intensive care unit for long time. The thesis is formed by description and used it in written and electronic resources. The aim of the thesis is overview of the development of care of premature newborn in the past and present. Key words: Neonatalogy, development of neonatalogy, Oxygen therapy, Kangaroo mother care, history of incubators, Virginie Apgar, UPMD history, classification of the newborn, resuscitation of the newborn, congenial defects, history of Gynaecology and Obstetric Clinic VFN, history of the Institute for the care for mother and child, newborn screening, newborn nutrition