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Clinical Innovation
Neuroprotective Developmental Care
Neuroprotective Developmental Care

Clinical innovation checklist: leading the way in early life care

NDC position statement 

Relevant NDC publications

Corroborating publications

Mainstreamed

Studies of interventions for unsettled infant behaviour are compromised by omitted variable bias, due to unidentified clinical breastfeeding problems Douglas 2005 Med Hyp; Douglas et al 2011 AJPH; Douglas & Hill 2011 Curr Op Ped; Douglas et al 2011 Arch Dis Child; Douglas & Hill 2011 BMJ; Douglas 2013 JPCH; Douglas & Hill 2013 Med Hyp;    
Functional lactose overload, a breastfeeding management problem, is commonly misdiagnosed and inappropriately treated as reflux, allergy, secondary lactose intolerance, or oral connective tissue restriction Douglas 2005 Med Hyp; Douglas & Hiscock JPCH 2010; Douglas & Hill 2011 BMJ; Douglas ‘Re: Managing …’ 2012 BMJ; Douglas 2013 JPCH; Douglas & Hill 2013 Med Hyp; Smillie 2005  
Maternal mental health in the first months post-birth should not be considered separately from, and has bi-directional relationships with, clinical problems of breastfeeding, infant sleep and crying, which disrupt mother-baby neurohormonal synchrony Douglas 2014 The discontented little baby book Stein et al 2014; Tsivos et al 2015  

Overdiagnosis of allergy in unsettled breastfed infants and associated maternal elimination diets has increased the risk of allergy in later infancy or childhood

Douglas 2014 The discontented little baby book

Joneja 2012; Longo et al 2013; Muraro et al 2014; Ierodiakonou et al 2016

2017

Prescription of anti-secretory medications (e.g. Losec) for unsettled infants doesn't improve behaviour and increases risk of health problems, e.g. infection, allergy in later infancy and childhood, bone fracture

Douglas & Hiscock 2010; Douglas 2011Griff Rev; Douglas & Hill 2011 Curr Op Ped; Douglas 2013 JPCH

Merwat & Spencer 2009; Trikha et al 2013; Rimer & Hiscock 2014; Quitadamo et al 2014; Gieruszczak-Bialek et al 2015; Kirby 2015; Orel et al 2016; Lyon JAMA 2017

 

Infant crying and fussing is substantially moderated by neuroprotective cultural or clinical practices, including breastfeeding  and cued care

Douglas & Hill 2011 BMJ; Douglas & Hill 2011 Curr Op Ped; Douglas et al AJPH 2013

St James-Roberts et al 2006, Wolke et al 2017

 

Conditioned sympathetic nervous system hyperarousal at the breast is commonly inappropriately medicalised

Douglas 2005 MH; Douglas & Hill Med Hyp 2013; Douglas JPCH 2013; Douglas & Geddes Midwifery 2018

 

 

Back-arching, fussing at the breast, and crying due to poor satiety commonly result from undiagnosed fit and hold (‘latch and positioning’) problems

Douglas 2005 Med Hyp; Douglas 2011 Griff Rev; Douglas et al 2011 Arch Dis Child; Douglas & Hill 2011 Curr Op Ped; Douglas & Hill Douglas JPCH 2013; Douglas & Geddes Midwifery 2018

 

 

Babies showing signs of suboptimal fit and hold, impaired milk transfer and positional instability during breastfeeding are receiving unnecessary frenotomies in the absence of classic tongue-tie, risking unintended outcomes

Douglas 2013 Breast Med; Douglas Griff Rev 2016; Douglas 2016 Convers; Wattis et al 2017 Breast Rev; Douglas 2017 Breast Med; Douglas 2017 'Making sense' JHL; Douglas 2017 'Gestalt' JHL; Douglas & Geddes Midwifery 2018; Douglas et al ACIOR Position Statement 2018

O'Shea 2017; Francis 2015; Power 2015

 

First wave behavioural approaches (‘sleep training’) do not decrease infant night-waking or improve maternal mood

Douglas & Hill 2013 JDBP; Douglas & Whittingham 2015 JPCH; Douglas 2016 Sleep Med Rev

Bryanton 2013; Kempler 2016; NHMRC 2017

 

First wave behavioural approaches (‘sleep training’) cause parent-baby communication confusion, increasing the risk of developmental and sleep problems in vulnerable individuals

Douglas & Hill 2013 JDBP; Whittingham & Douglas 2015 IMHJ

Simard 2017

 

First wave behavioural approaches (‘sleep training’) disrupt the infant’s circadian clock, risking increased night-waking

Douglas & Hill 2013 JDBP; Whittingham & Douglas 2015 IMHJ

Thomas 2014

 

First wave behavioural advice ('sleep training') that babies must not be overstimulated results in infants spending large parts of each day in low sensory environments, increasing the risk of developmental problems in vulnerable infants

Douglas 2005 Med Hyp; Douglas & Hill 2011 Curr Op Ped; Douglas et al AJPH 2011; Douglas & Hill 2011 BMJ; Douglas & Hill 2013 Med Hyp; Douglas 2014 The discontented little baby book; Whittingham & Douglas 2015 IMHJ

 

 

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