As artificial intelligence (AI) rapidly enters neonatal care, it brings both promise and concern. New technologies offer the chance to better predict and monitor health outcomes for newborns, especially for those born preterm. However, this progress also raises deep ethical questions about fairness, transparency, and informed decision-making. A recent review explored how AI impacts four core principles of medical ethics – beneficence, non-maleficence, autonomy, and justice – in the context of neonatology. This study emphasises that without proper safeguards, AI may unintentionally reinforce existing health disparities or hinder parental involvement in decisions. To ensure ethical and equitable care for all newborns, clear guidelines and collaboration across disciplines are essential.   Across the world, there is a growing need to ensure every newborn receives fair, high-quality care. In neonatal units, where the smallest and most vulnerable lives are supported, artificial intelligence is beginning to influence decision-making. From monitoring vital signs to predicting complications like bronchopulmonary dysplasia (BPD), AI can help identify health risks earlier and support faster intervention. But because these decisions affect infants who cannot speak for themselves, the stakes are especially high. The reviewed study examines how AI must align with four ethical principles to support – not compromise – neonatal health. These are: doing good (beneficence), avoiding harm (non-maleficence), ensuring fairness (justice), and respecting families’ rights to make decisions (autonomy). When implemented thoughtfully, AI can improve care. But if systems are not transparent or based on biased data, they may risk doing harm instead of good.   Ethics cannot be an afterthought in neonatal AI Beneficence demands that AI systems bring real benefit to newborns. When trained with accurate, diverse data, AI can help personalise care and reduce medical errors. For instance, some algorithms use early-life data to predict a child’s risk of developing BPD, enabling earlier interventions. However, non-maleficence highlights the risks when algorithms are not fully understood or validated. Many AI systems are “black boxes,” meaning even clinicians can’t explain how decisions are made. This lack of clarity can lead to confusion or incorrect care, especially if AI models are used in different settings without adjustment. Adding to this, AI can unintentionally reflect and even worsen existing healthcare inequalities. This is especially concerning in neonatology, where past disparities in care have affected children from different backgrounds. The study stresses that AI tools must be trained on data from varied populations to ensure they work fairly. Otherwise, decisions might benefit some groups more than others – a direct violation of justice in healthcare.   Putting families first in a digital era Autonomy, or the right to make informed decisions, is particularly complex in neonatal care. Since infants cannot speak for themselves, parents and clinicians must decide together what’s best. When AI systems are too complex to explain, or when recommendations come from algorithms instead of people, this shared decision-making can suffer. Families deserve to know when AI is influencing care and to fully understand its role. Ultimately, AI must support – not replace – the human relationships that are vital in neonatal care. The study urges ongoing collaboration among healthcare providers, parents, ethicists, and data scientists to make sure AI tools are safe, clear, and fair. By focusing on ethical standards, we can harness AI’s potential while protecting the rights and futures of every newborn.   Paper available at: Preserving medical ethics in the era of artificial intelligence: Challenges and opportunities in neonatology Full list of authors: Arora, T.; Muhammad-Kamal, H.; Beam, K. DOI: https://doi.org/10.1016/j.semperi.2025.152100

© Pexels For women living with HIV, the decision to breastfeed comes with medical, emotional, and legal complexity. Although effective antiretroviral therapy (ART) significantly reduces the risk of HIV transmission, breastfeeding remains a debated issue, especially in countries with access to safe alternatives. A new European survey study, coordinated by WAVE under the European AIDS Clinical Society, looked at how national guidelines vary, how many women breastfeed, and what support is offered across 25 countries. The study revealed wide variations in policies—yet also a growing number of women living with HIV who choose to breastfeed. In many parts of the world, breastfeeding is both a cultural norm and a medical recommendation. For mothers living with HIV, however, this everyday choice becomes much more complicated. While the World Health Organization (WHO) supports breastfeeding alongside ART, most national guidelines in high-income settings continue to advise against it. These conflicting messages often leave women feeling unsupported or judged, especially when they wish to make informed, personal choices. This European survey explored national practices, trends, and laws regarding breastfeeding in women living with HIV. It gathered input from 25 countries, asking about guideline recommendations, current practices, and research activities. The aim was to understand how policies align with women’s real-life experiences—and to identify opportunities for better support.   A divided landscape with growing numbers of breastfeeding mothers Nearly half of the surveyed countries reported an increase in breastfeeding among women living with HIV. However, recommendations were split: 52% of countries advise against breastfeeding, while 48% allow it under strict conditions, such as undetectable maternal viral load. Notably, no country currently recommends breastfeeding as a routine option for all women living with HIV. In practice, however, some healthcare providers support women who choose to breastfeed, even when national guidelines discourage it. The study also found that maternal viral load monitoring, infant post-exposure prophylaxis, and education around breastfeeding vary widely between countries. Less than one-third of countries have dedicated staff to counsel women on this topic, and only a few provide clear patient information resources.   What this means for families and care providers For families navigating this decision, support depends heavily on where they live and which healthcare professionals they encounter. The study underscores the need for open, respectful conversations between providers and parents, acknowledging the emotional importance of breastfeeding while also addressing medical risks. A collaborative, informed approach can empower women to make safe, supported choices. This European-wide initiative will now help form a collaborative network focused on data sharing, research, and policy development. The goal is not only to fill knowledge gaps but to ensure that women living with HIV receive consistent, respectful care—no matter where they live.     Paper available at: Guidelines and practice of breastfeeding in women living with HIV—Results from the European INSURE survey – Keane – 2024 – HIV Medicine – Wiley Online Library Full list of authors: Keane, A.; Lyons, F.; Aebi-Popp, K.; Feiterna-Sperling, C.; Lyall, H.; Martínez Hoffart, A.; Scherpbier, H.; Thorne, C.; Albayrak Ucak, H.; Haberl, A. DOI: 10.1111/hiv.13583

When newborns require intensive care, closeness between parents and infants can be difficult to maintain—especially in traditional open bay units. Research has long suggested that skin-to-skin contact and physical presence are vital for a newborn’s development and for fostering the emotional bond with their parents. A recent Dutch cohort study explored whether switching from an open bay unit to single-family rooms could support more parent-infant closeness. Based on observations from over 800 families, the results show that architectural changes led to longer daily presence of both mothers and partners, and increased physical contact with their infants. While the transition had measurable benefits, the study also emphasizes that further improvements are needed to meet current care standards. When a newborn is admitted to a neonatal intensive care unit (NICU), the environment can either support or limit the connection between infants and their parents. In open bay units (OBUs), care is often efficient for staff but leaves little space for privacy, intimacy, or prolonged parental involvement. Emotional and physical closeness—like skin-to-skin care or holding—are essential to reduce stress, strengthen attachment, and promote healthy development in preterm or critically ill infants. To investigate how architecture influences this closeness, researchers followed families before and after a Dutch NICU transitioned from OBUs to single-family rooms (SFRs). These rooms allow parents to stay with their child throughout the day and night, offering more privacy and comfort. The study measured how often parents were present, how long they held their infants, and how much skin-to-skin contact occurred.   More time, more contact: A space that fosters bonding The results were clear: SFRs significantly increased parent-infant closeness. Mothers’ daily presence doubled, from about 3.5 hours in OBUs to 7 hours in SFRs. Partners showed a similar pattern, with their presence rising from 3 to 6 hours per day. Skin-to-skin care also improved—mothers increased from 2 to nearly 3 hours a day, and partners from under 2 to more than 2 hours. Lap holding saw smaller gains, mostly for mothers. These increases were consistent across all gestational age groups and started as early as the first day of life. The study highlights that while SFRs support stronger bonds, even with this improvement, parental presence fell short of WHO and GFCNI (former: EFCNI) recommendations. This suggests that room design alone is not enough—staff encouragement, flexible routines, and family-integrated care also matter.   Designing care that includes families For parents, these findings offer hope: the environment can support their presence and involvement, even in the stressful NICU setting. For hospitals and care teams, the study reinforces that investing in SFRs can enhance emotional and developmental outcomes. However, to fully support closeness, physical changes should be paired with cultural shifts that truly integrate parents into the care team. Encouraging closeness isn’t just about architecture—it’s about prioritizing family-centered care. This study adds to the growing evidence that where infants heal can shape how they connect.     Paper available at: Effect of Shifting From Open Bay to Single-Family Rooms on Closeness in a NICU – PubMed Full list of authors: Wielenga, J.M.; Pascual, A.; Ruhe, K.; Aarnoudse, C.; van Kaam, A.H. DOI: https://doi.org/10.1111/apa.70108