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NICE publishes guidelines to tackle premature birth and manage breathing disorders in children

The National Institute for Health and Care Excellence (NICE) is developing a set of recommendations to help the NHS reduce the number of babies born prematurely.

NICE has also published a separate final guideline on treating one of the most common breathing disorders in young babies: bronchiolitis.

Premature labour and birth

Premature birth – when babies are born before the 37th week of pregnancy - is the leading cause of death in newborn babies and the second most common cause of death in children under the age of 5. In 2012, slightly more than 52,000 babies in England and Wales – nearly 1 in 10 – were born prematurely1.

As well as the risk to their lives, infants who are born early are more prone to serious long-term health problems like heart defects, lung disorders and neurological conditions such as cerebral palsy2. They may also reach developmental milestones later and can struggle at school.

NICE has published a draft guideline for consultation which sets out the extra care a woman at risk of, or in suspected or confirmed preterm labour should receive before and during birth. Its intention is to prevent or delay early labour and reduce the associated risks to the baby.

Christine Carson, NICE clinical practice programme director, said: “Despite medical advances, rates of premature birth have remained constant over the last 10 years. An early labour – one that occurs before the pregnancy reaches 37 weeks – can pose numerous health risks to the baby, and these risks increase the earlier that child is born.

“Although more premature babies are surviving, rates of disability among these children remain largely unchanged. The way to tackle this is to provide consistent and high-quality care to prevent early labour, which is what our draft guideline outlines. Reducing the numbers of babies born early will go a long way towards giving infants the best possible start in life.”

Important draft recommendations include:

  • When to offer progesterone (given as a vaginal suppository) or a cervical ‘stitch’ (cerclage) to prevent or delay the onset of preterm labour
  • How to diagnose if a woman’s waters have broken prematurely before labour has begun and which antibiotics to offer to avoid infection.
  • Which drugs will help to delay labour and to whom they should be offered.
  • When to safely clamp and cut a premature baby’s umbilical cord.

The public consultation for this draft guideline will continue until 2 July 2015. The final guideline is expected to publish towards the end of the year.

Bronchiolitis in children

Bronchiolitis affects around 1 in 3 babies in their first year of life. It is caused by a viral infection in the lungs which leads to breathing and feeding difficulties. In most cases symptoms are mild, lasting only a few days, and the best way to support recovery is to interfere as little as possible.

The newly-published NICE guideline includes advice for healthcare professionals on how to thoroughly assess the condition and make sure that unnecessary tests and treatments, such as X-rays and antibiotics are not used. It also includes safety information for parents on how to avoid their child’s symptoms worsening - for instance smoking in the home should be avoided - and which specific symptoms mean they should get immediate help.   

Professor Mark Baker, director of clinical practice at NICE, said: “For the majority of children who develop bronchiolitis, symptoms are mild and will only last a few days, but in some cases it can lead to serious illness. It is very important that parents and carers, as well as doctors, nurses and health visitors know how to correctly diagnose and manage symptoms and know when to seek help from specialist care. This new guideline will assist anyone caring for children with bronchiolitis to ensure they are thoroughly assessed, closely monitored and well looked after.”

For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.

Notes to Editors

Explanation of terms

  1. According to the Office for National Statistics, 52,160 babies - 7.3% of live births – in England and Wales were born prematurely during 2012:http://www.ons.gov.uk/ons/rel/child-health/gestation-specific-infant-mortality-in-england-and-wales/2012/index.html
  2. Henderson C, Macdonald S. Mayes midwifery: a textbook for midwives. Philadelphia: Bailliere Tindall, 2011.

About the guidance

To find out more about what we do, visit our website:www.nice.org.uk and follow us on Twitter: @NICEComms.

 

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