To compare the procedural efficiency of bedside versus operating-room external ventricular drainage (EVD) insertion in a neonatal intensive care unit (NICU) and to describe culture-positive EVD-associated infections. We performed a retrospective single-center cohort study of NICU infants who underwent EVD insertion between 2011 and 2025. Operative time and insertion characteristics were analyzed at the insertion level. Culture-positive EVD-associated infections acquired at the study hospital were described, and annual infection incidence was explored in relation to unit methicillin-resistant Staphylococcus aureus (MRSA) acquisition rates. Sixty-six infants underwent 161 EVD insertions (115 bedside, 28 operating room, 18 outside hospital). Among 140 study-hospital insertions with documented operative time, bedside insertion was faster than operating-room insertion (24.5 (11.4) vs 57.4 (35.2) min; adjusted difference, 32.5 min; 95

Purpose:This study aimed to examine trends in the incidence, risk factors, and clinical features of retinopathy of prematurity (ROP) among high-risk preterm infants in a South Korean neonatal intensive care unit over 13 years. Methods:A retrospective study included 1114 high-risk preterm infants with gestational age (GA) < 32 weeks or birthweight (BW) < 1500 g, admitted to Seoul National University Children's Hospital from January 2009 to December 2021. Follow-up eye examinations were conducted at 3 years postnatal age. Trends in ROP incidence, risk factors, and ophthalmic complications were analyzed. Results:The overall ROP incidence was 37.1% (413/1114), and 17.9% (199/1114) required treatment. Over the study period, GA and BW significantly increased (p<0.05), but no trends were observed for ROP incidence or laser treatment rates. Lower GA, lower BW, and moderate to severe bronchopulmonary dysplasia (BPD) were significant risk factors for treated ROP (p<0.001). Infants treated with laser therapy showed a higher incidence of myopia, astigmatism, anisometropia, strabismus, and cataract at 3 years compared to those with mild or no ROP. Conclusions:Although mean GA and BW increased over the 13-year period, the incidence of ROP and the proportion requiring treatment did not show a statistically significant temporal decline and exhibited substantial year-to-year variation. Lower GA, lower BW, and moderate to severe BPD were key risk factors for severe ROP. Laser-treated infants experienced more ophthalmic complications, emphasizing the need for long-term ophthalmic monitoring of high-risk preterm infants.

BACKGROUND:Bronchopulmonary dysplasia (BPD) is the most common complication of preterm birth and may lead to difficulties with oxygen control even at home. How oxygenation is managed outside the hospital and in high and low resourced settings is unclear. AIMS:To determine clinician perspectives for managing oxygenation after hospital discharge in infants with BPD. METHODS:An opportunistic, anonymous, online survey was developed in English and translated into Mandarin, Vietnamese and Korean. The survey was disseminated three times to neonatal clinicians between December 2022 and August 2023. Responses were classified using the World Bank Income Classification. RESULTS:Overall, 610 clinicians from 44 countries responded, with 453 (74%, 453/610) from high- and upper-middle-income countries (HMIC) and 153 (25%, 153/610) from low- and lower-middle-income countries (LMIC). Most clinicians (84%, 510/610) would advocate discharge on home oxygen therapy (HOT), but this was less possible in LMIC (65% vs. 91%, p < 0.001). Most clinicians perceived HOT to improve growth (73%, 370/510) and neurodevelopment (72%, 366/510). HMIC respondents were more likely to use home oximetry (78% vs. LMIC 67%, p = 0.012). There were wide variations in oxygen saturation targets, pre-discharge oximetry use, and parameters for weaning. Most clinicians perceived novel technologies such as wearable oximetry with parent-led oxygen control as important (77%, 460/596) and useful (84%, 499/595) for improving oxygen management at home. CONCLUSION:Most neonatal clinicians would prescribe HOT for infants with BPD but are limited by barriers to sufficient resourcing, especially in LMIC. Evaluation of cost-effective novel monitoring techniques may improve accessibility and control of HOT.

This study evaluated the factors affecting the short-term efficacy of systemic corticosteroid (CS) therapy, focusing on pulmonary hypertension (PH) and other clinical conditions in preterm infants with evolving or established bronchopulmonary dysplasia (BPD). A retrospective review was conducted on preterm infants (< 32 weeks of gestation and/or < 1,500 g birth weight) who received systemic CS therapy for BPD. Responders were defined as infants who were extubated within 14 days and/or achieved a ≥ 60

Purpose: This study investigated the associations between early-life perinatal risk factors, postnatal weight-growth trajectories, and pulmonary function at early school age in children born very preterm.Methods: This longitudinal cohort study included 72 children born before 30 weeks of gestation or with a birth weight below 1,250 g who completed spirometry at 6–7 years of age. Multiple linear and logistic regression analyses (n=69) were performed to examine the associations of gestational age, sex, birth weight z-score, antenatal corticosteroid exposure, Jensen 2019 bronchopulmonary dysplasia severity grade as an adjustment covariate, and two postnatal weight z-score change variables (birth to 36 weeks postmenstrual age [PMA], and 36 weeks PMA to the time of pulmonary function test [PFT]) with forced expiratory volume in 1 second (FEV₁) z-score and FEV₁/forced vital capacity (FVC) z-score.Results: Lower gestational age (β=0.18, P=0.026), male sex (β=−0.57, P=0.038), lower birth weight z-score (β=0.48, P<0.001), and smaller post-discharge weight gain (β= 0.19, P=0.048) were independently associated with lower FEV₁ z-score. For FEV₁/FVC z-score, higher birth weight z-score (β=−0.47, P=0.005), greater in-hospital weight gain PMA (β=−0.63, P=0.009), and higher Jensen BPD grade (β=−0.52, P=0.036) were inversely associated with FEV₁/FVC in multiple linear regression. In logistic regression, higher birth weight z-score (odds ratio [OR], 2.39, P=0.007) and greater in-hospital weight gain (OR, 3.97, P=0.002) were associated with higher odds of FEV₁/FVC.Conclusion: Lower gestational age, male sex, lower birth weight z-score, and smaller post-discharge weight gain were independently associated with lower school-age FEV₁. In contrast, higher birth weight z-score and greater early postnatal weight gain from birth to 36 weeks PMA were associated with lower FEV₁/FVC, consistent with a dysanaptic growth pattern.

BACKGROUND:Retinopathy of prematurity (ROP) is influenced by factors, including gestational age (GA), oxygen exposure, and chorioamnionitis. However, the association between histologic chorioamnionitis (HCA) and ROP remains controversial. This study aimed to investigate the association between HCA and severe ROP. METHODS:This retrospective cohort study utilized data from the National Korean Neonatal Network registry, focusing on infants with birthweights < 1500 g and GA < 32 weeks. Univariate and multivariate logistic regression analyses assessed the association between HCA and severe ROP. Sub-cohort analyses were performed to evaluate the effect of HCA on severe ROP across different GA groups. RESULTS:Infants in the HCA cohort had lower GA and birth weights, with a higher prevalence of any-stage and severe ROP compared to those in the without-HCA cohort. However, multivariate logistic regression showed an inverse association between HCA and severe ROP. Sub-cohort analyses revealed that HCA was associated with an increased risk of severe ROP in infants born at 26-28 and 28-31 weeks, while no significant association was observed in infants born at 23-25 weeks. CONCLUSIONS:HCA may reduce the risk of severe ROP, suggesting that intrauterine inflammation could play a protective role. Further research is needed to elucidate underlying mechanisms. IMPACT:Retinopathy of prematurity (ROP) is influenced by numerous perinatal and postnatal factors, including low gestational age, oxygen exposure, and chorioamnionitis. However, the association between chorioamnionitis and ROP remains controversial. Our study showed that histologic chorioamnionitis (HCA) was negatively correlated with severe ROP in preterm infants, even after adjusting for confounding factors such as gestational age and birth weight. These findings suggest that HCA may have a protective effect against severe ROP, potentially mediated by inflammatory markers.

We hypothesized that incorporating postnatal dynamic factors would enhance the prediction accuracy of bronchopulmonary dysplasia in preterm infants. This retrospective cohort study included neonates born before 32 weeks of gestation at Seoul National University Hospital between 2013 and 2022. The primary outcome was moderate or severe bronchopulmonary dysplasia. We assessed both static perinatal risk factors and dynamic factors, such as respiratory support type, inspired oxygen concentration, and blood gas analysis results within the first 7 days. The model was developed using data from 546 infants born between 2013 and 2021, with internal validation on 75 infants born in 2022. External validation was based on 105 infants recruited at the Boramae Medical Center. The integrated prediction model, combining static and dynamic factors, showed superior predictive performance, with an area under the receiver operating characteristic curve (AUROC) of 0.841 in the development set, outperforming the static perinatal factor model. Internal validation confirmed the robustness of the integrated model (AUROC: 0.912 vs. 0.805, p < 0.0001). The performance was maintained in the external validation (AUROC: 0.814). Incorporating early respiratory support and blood gas analysis into predictive models substantially improved the accuracy of bronchopulmonary dysplasia prediction in preterm infants.

Background Bronchopulmonary dysplasia (BPD) is a major complication in extremely preterm (EP) infants. Postnatal systemic corticosteroids reduce inflammation and may help prevent or treat BPD. However, their use is limited because of concerns regarding neurodevelopmental outcomes. However, the optimal timing and criteria for steroid therapy initiation remain unclear. Purpose This study aimed to evaluate the effect of a respiratory severity score (RSS)-guided postnatal systemic corticosteroid protocol on BPD and neurodevelopmental outcomes in mechanically ventilated infants with EP. Methods A historical comparative study was conducted to compare the preprotocol (2010–2014; phase I) and postprotocol (2016–2022; phase II) periods. Infants born at <28 weeks’ gestation and ventilated on postnatal day 14 were included in the study. The protocol implemented in 2015 used the RSS to guide corticosteroid initiation. Clinical outcomes including BPD severity and severe neurodevelopmental impairment (NDI) were compared. Results Among the 208 infants, those in phase II had higher dexamethasone use (17.6% vs. 33.0%, P=0.017) and earlier initiation (postmenstrual age, 31.1 vs. 29.0 weeks; P=0.027). In phase II, Jensen grade 0 was significantly increased (15.2% vs. 30.2%; adjusted odds ratio [aOR], 2.31; P=0.024), particularly among patients who did not receive steroids. In steroid-treated infants, Jensen grade 3 BPD was decreased (47.4% vs. 21.2%; aOR, 0.26; P=0.050), whereas grade 1 BPD was increased (5.3% vs. 33.3%; aOR, 12.22; P=0.035) in phase II. There were no significant intergroup differences in mortality or NDI. Conclusion The RSS-guided protocol enabled more targeted and earlier steroid administration, reducing severe BPD without worsening neurodevelopmental outcomes. This approach may refine postnatal corticosteroid treatment strategies for infants with EP.

BACKGROUND:Systemic inflammation in preterm infants is associated with an increased risk of adverse neurodevelopmental outcomes. This study aimed to investigate the impact of single versus multiple episodes of sepsis and/or necrotizing enterocolitis (NEC) on neurodevelopmental impairment (NDI) in this population. METHODS:This cohort study used data from a nationwide registry, including very low-birth-weight infants born before 32 weeks of gestation from 2013 to 2020. The study population was categorized according to the occurrence of sepsis and/or NEC. Neurodevelopmental assessments at 18-24 months of corrected age were performed using various tools. Any NDI or death was used as the primary outcome. RESULTS:In the multivariate logistic regression analysis, infants with multiple episodes of sepsis (aOR = 1.43; 95% CI [1.02-2.01]) or both sepsis and NEC (aOR = 1.91; 95% CI [1.26-2.90]) had a significantly higher risk of NDI compared to those without sepsis and NEC. A single sepsis episode without NEC was not associated with an increased risk of NDI. CONCLUSION:Multiple episodes of sepsis and/or NEC significantly increased the risk of NDI in VLBW infants, whereas a single episode of sepsis did not. These findings highlight the need to distinguish between single and multiple episodes of systemic inflammation when assessing neurodevelopmental outcomes. IMPACT:Multiple episodes of sepsis and/or necrotizing enterocolitis (NEC) significantly increase the risk of neurodevelopmental impairment (NDI) and death in preterm infants. However, a single episode of sepsis alone was not associated with the risk of NDI and NDI or death in the study population. When evaluating the neurodevelopmental outcomes of preterm infants, it is crucial to recognize that a single episode of sepsis may have a lesser impact on NDI compared to recurrent systemic inflammation or NEC episodes.

Childhood cancer is a significant public health issue, and growing evidence suggests that perinatal factors such as birth weight and neonatal complications may influence cancer risk. However, the potential impact of neonatal interventions on subsequent cancer development remains poorly understood. This study aimed to investigate the association between birth weight and childhood cancer risk, and how this relationship may be modulated by neonatal morbidities and interventions. We conducted a nationwide population-based cohort study using the National Health Insurance Service database in South Korea. All live births between 2008 and 2014 were included and categorized by birth weight. Cancer incidence was identified through 2018 using ICD-10 codes. Associations between birth weight, neonatal conditions, neonatal interventions, and cancer outcomes were analyzed. Among over 2.9 million children, low birth weight (LBW) infants—particularly those weighing < 1.0 kg—had a significantly increased risk of childhood cancer (adjusted odds ratio [aOR], 4.03). Distinct cancer patterns were observed by birth weight category: hepatoblastoma was most common in infants < 1.5 kg, central nervous system malignancies in those 1.5–2.4 kg, and leukemia in those > 4.0 kg. In LBW infants, bronchopulmonary dysplasia (aOR, 2.21), sepsis (aOR, 1.56), oxygen exposure ≥ 4 days (aOR, 1.32), and ≥ 3 red blood cell transfusions (aOR, 4.03) were significantly associated with increased cancer risk. In contrast, phototherapy and radiography were not found to be associated with cancer development. These findings demonstrate that both birth weight extremes and neonatal exposures contribute to childhood cancer risk. In particular, conditions such as bronchopulmonary dysplasia and sepsis—and interventions including oxygen therapy and transfusions—may influence oncogenic pathways in LBW infants. Long-term follow-up in high-risk neonatal populations is warranted, along with further research into underlying biological mechanisms.

BACKGROUND:Preterm infants with hemodynamically significant patent ductus arteriosus (PDA) may require surgical ligation. Following the surgery, some infants may encounter a deterioration in respiratory status. This study aimed to evaluate the risk factors that can predict worsened respiratory outcomes after PDA surgical ligation. METHODS:A retrospective cohort study was performed on 57 preterm infants born at less than 32 weeks of gestational age and in whom the PDA was surgically ligated between January 2014 and December 2018 at Seoul National University Children's Hospital. Participants were divided into two groups: infants with worsened respiratory outcomes 14 days after ligation and control. Worsened respiratory outcome was defined as an increase in respiratory severity score (RSS) by 30% or more at 14 days after ligation compared to RSS before ligation, or death at 14 days after ligation. RESULTS:Among the 57 PDA-ligated infants, 12 had worsened respiratory outcomes and 45 did not. The worsened respiratory outcomes were associated with oligohydramnios (adjusted OR 1.38, 95% CI 1.1-1.73, p < 0.01) and lower weight at surgery (adjusted OR 0.99, 95% CI 0.99-0.99, p = 0.02), compared to the control. CONCLUSION:Worsened respiratory outcomes after PDA ligation appeared to be associated with oligohydramnios, and lower weight on the day of surgery.

Background: Early onset hypocalcemia, occurring within 3 days of birth, is prevalent among preterm infants. A central line is required to deliver calcium (Ca). The prediction of hypocalcemia is therefore clinically important when the requirement for initial intravascular calcium administration is anticipated. Methods: This retrospective study included preterm infants born between 2019 and 2023 with a birthweight <1500 g or a gestational age (GA) <32 weeks in a single tertiary center. Hypocalcemia was defined as serum Ca <7 mg/dL or ionized calcium (iCa) <0.8 mmol/L within 72 h after birth. Perinatal factors and laboratory test results associated with hypocalcemia were collected and analyzed. Results: Of the 348 infants, 20 died within 7 postnatal days, 22 were transferred to other hospitals, and eight were transferred from other hospitals and were thus excluded. Of 298 enrolled infants, 20 were diagnosed with hypocalcemia. In multivariate analysis, male sex, elevated day 1 phosphorus (d1P), magnesium (d1Mg) levels, and maternal premature rupture of membranes (PROM) were significant risk factors for early onset hypocalcemia. These factors, along with birthweight, a widely recognized risk factor, were used to develop predictive models for early onset hypocalcemia. Among the six suggested models, logistic regression exhibited the highest accuracy. Conversely, the random forest model outperformed others in the Youden index and area under the receiver operating characteristic curve. Conclusions: In our cohort, early onset hypocalcemia was linked to male sex, lower GA, higher d1P and d1Mg, and maternal PROM. Notably, higher d1P has not been previously reported as a risk factor.

Abstract Umbilical cord milking (UCM) may serve as an alternative to delayed umbilical cord clamping (DCC) in preterm infants. This study was planned as a non-inferiority randomized trial to compare the rates of death or severe intraventricular hemorrhage (IVH) in preterm infants receiving UCM versus those receiving DCC. The trial was terminated early for safety, precluding a non-inferiority analysis. A post hoc analysis of 474 infants <32 weeks’ gestation showed no difference in the preplanned composite primary outcome (12% versus 8%; 95% confidence interval [CI] –0.02 to 0.09, p = 0.16), but the UCM group had a higher incidence of severe IVH than the DCC group (8% versus 3%; 95% CI 0.01 to 0.09, p = 0.02), which prompted early stopping.

Purpose Radiographic examinations are frequently performed for diagnostic and therapeutic purposes in neonatal intensive care units (NICUs). However, concerns are emerging regarding the safety of radiation exposure, especially in vulnerable preterm infants in periods of rapid cellular division. This quality improvement (QI) project aimed to reduce radiation hazards in level-IV NICU. Methods We established an "X-ray prescription protocol" and educated the physicians to ensure that only essential radiographs were obtained. Additionally, we discouraged full-body infantograms and emphasized the prescription of targeted radiographs, such as chest or abdominal radiographs. Furthermore, to reduce the dose-area product (DAP, Gy·cm2) values, which act as a surrogate for radiation exposure, we provided training to radiologic technologists on meticulous collimation for each radiography session. We aimed to achieve a 30% reduction in the average monthly cumulative DAP per patient, which was calculated by dividing the total monthly DAP from radiographs in the NICU by the monthly average of patient admissions. Retrospective baseline data were collected 8 months pre-intervention and prospectively for 4 months post-interventions. Results The average monthly X-ray count per patient was 28.3 in the pre-intervention period (October 2022 to May 2023), which decreased to 25.4 in the post-intervention period (June 2023 to September 2023), reflecting a 10.2% reduction (p=0.109). The average monthly infantogram count per patient showed an 18.0% reduction (25.9% to 21.2%, p=0.016), and the proportion of infantograms in the total X-ray counts decreased from 91.5% to 83.3% (p=0.017). The DAP value per X-ray decreased by 42.6%, from an average of 0.25 to 0.14 (p=0.011). The primary outcome, the average monthly cumulative DAP value per patient, showed a substantial reduction of 48.6%, dropping from 7.00 to 3.60 (p=0.004). The baseline characteristics and short-term morbidities of the patients did not differ significantly between the pre- and post-intervention period. Conclusion Our QI approach, which included discouraging excessive prescriptions of infantograms and promoting optimal collimation, significantly reduced the average monthly radiation exposure in the NICU, benefiting both patients and healthcare workers.

BackgroundThe definition of bronchopulmonary dysplasia (BPD) has been evolved recently from definition by the National Institute of Child Health and Human Development in 2001 (NICHD 2001) to the definition reported in 2018 (NICHD 2018) and that proposed by Jensen et al. in 2019 (NICHD 2019). The definition was developed based on the evolution of non-invasive respiratory support and to achieve better prediction of later outcomes. Our objective was to evaluate the association between different definitions of BPD and occurrence of pulmonary hypertension (PHN) and long term outcomes.MethodsThis retrospective study enrolled preterm infants born at < 32 weeks of gestation between 2014 and 2018. The association between re-hospitalization owing to a respiratory illness until a corrected age (CA) of 24 months, neurodevelopmental impairment (NDI) at a CA of 18–24 months, and PHN at a postmenstrual age (PMA) of 36 weeks was evaluated, with the severity of BPD defined based on these three definitions.ResultsAmong 354 infants, the gestational age and birth weight were the lowest in severe BPD based on the NICHD 2019 definition. In total, 14.1% of the study population experienced NDI and 19.0% were re-hospitalized owing to a respiratory illness. At a PMA of 36 weeks, PHN was identified in 9.2% of infants with any BPD. Multiple logistic regression analysis showed that the adjusted odds ratio (OR) for re-hospitalization was the highest for Grade 3 BPD of the NICHD 2019 criteria (5.72, 95% confidence interval [CI]: 1.37–23.92), while the adjusted OR of Grade 3 BPD was 4.96 (95% CI: 1.73–14.23) in the NICHD 2018 definition. Moreover, no association of the severity of BPD was found in the NICHD 2001 definition. The adjusted ORs for NDI (12.09, 95% CI: 2.52–58.05) and PHN (40.37, 95% CI: 5.15–316.34) were also the highest for Grade 3 of the NICHD 2019 criteria.ConclusionBased on recently suggested criteria by the NICHD in 2019, BPD severity is associated with long-term outcomes and PHN at a PMA of 36 weeks in preterm infants.

Abstract Background Vancomycin (VCM) is a widely used antibiotic for the treatment of gram-positive microorganisms, with some nephrotoxic effects. Recent studies have suggested that piperacillin-tazobactam (TZP) aggravates VCM-induced nephrotoxicity in adults and adolescents. However, there is a lack of research investigating these effects in the newborn population. Therefore, this study investigates whether the concomitant use of TZP with VCM use increases the risk of acute kidney injury (AKI) and to explore the factors associated with AKI in preterm infants treated with VCM. Methods This retrospective study included preterm infants with birth weight < 1,500 g in a single tertiary center who were born between 2018 and 2021 and received VCM for a minimum of 3 days. AKI was defined as an increase in serum creatinine (SCr) of at least 0.3 mg/dL and an increase in SCr of at least 1.5 times baseline during and up to 1 week after discontinuation of VCM. The study population was categorized as those with or without concomitant use of TZP. Data on perinatal and postnatal factors associated with AKI were collected and analyzed. Results Of the 70 infants, 17 died before 7 postnatal days or antecedent AKI and were excluded, while among the remaining participants, 25 received VCM with TZP (VCM + TZP) and 28 VCM without TZP (VCM—TZP). Gestational age (GA) at birth (26.4 ± 2.8 weeks vs. 26.5 ± 2.6 weeks, p = 0.859) and birthweight (750.4 ± 232.2 g vs. 838.1 ± 268.7 g, p = 0.212) were comparable between the two groups. There were no significant differences in the incidence of AKI between groups. Multivariate analysis showed that GA (adjusted OR: 0.58, 95% CI: 0.35–0.98, p = 0.042), patent ductus arteriosus (PDA) (adjusted OR: 5.23, 95% CI: 0.67–41.05, p = 0.115), and necrotizing enterocolitis (NEC) (adjusted OR: 37.65, 95% CI: 3.08–459.96, p = 0.005) were associated with AKI in the study population. Conclusions In very low birthweight infants, concomitant use of TZP did not increase the risk of AKI during VCM administration. Instead, a lower GA, and NEC were associated with AKI in this population.

We would like to thank Harding et al for their comments on our paper. However, contrary to their understanding, the combined direct swallowing training (DST) and oral sensorimotor stimulation group in our study reached independent oral feeding at 35 weeks’ postmenstrual age (PMA), which was earlier than the DST group of our study as well as that of Lau and Smith’s study. And even when only the DST groups of the two studies were compared, the DST group of our study reached the independent oral feeding earlier than that of Lau and Smith’s study. These results might be related to the timing of initiation of interventions, as they mentioned. In our study, interventions were initiated around PMA 32 weeks, prior to starting oral feeding. From a developmental point of view, these prefeeding interventions are thought to be more effective in improving infants’ oral feeding skills. The system of care and personnel for pharyngeal dysfunction may differ from country to country. In some countries, speech and language pathologist is, without doubt, the key personnel in the treatment of swallowing disorders. In Korea, however, occupational therapists are in charge. Education and practice for dysphagia evaluation and management are sufficiently implemented in the curriculum of most occupational therapy programmes in colleges or universities in Korea. In line with this, the National Health Insurance of Korea covers swallowing treatment only by occupational therapists, not by speech and language pathologists. The occupational therapists in our hospital are highly qualified personnel for the treatment of pharyngeal disorders. We fully agree with Harding et al’s opinion that developmental care and parental involvement in the infants’ feeding are critical. However, the application and extent of familycentred care may vary by unit or country. In Korea, familycentred care in the neonatal intensive care unit (NICU) has not been universally adopted. Unrestricted parental visits to the NICU are being implemented in our hospital, but parents are not directly involved in the routine care of their infants. Healthcare professionals are in charge of feedingrelated care and interventions. Ultimately, familycentred care including parental involvement in feedingrelated interventions is an important issue and ideal direction for NICU care. Further studies are required to evaluate the effects of this issue.