Healthcare professional demonstrating a quiet gesture to support communication in care settings. © Pexels / Olly Care in the neonatal intensive care unit can vary widely in how much sound, speech, and silence a preterm infant experiences. Consistent, standardised care matters because the auditory environment supports brain and behavioural development during a very sensitive period. This prospective observational study followed 64 infants born at or before 28 weeks of gestation in a Level IV NICU and measured sound exposure at four points during hospitalisation. The study showed that higher adult word exposure was linked with lower infant stress, while louder sound levels were linked with less favourable neurobehaviour near term age.   Preterm infants often spend many weeks in the NICU while the brain and auditory system are still developing. During this time, they may hear staff voices, family speech, alarms, equipment noise, music, and long periods of silence. The study highlights why standardised newborn care should include attention to the sound environment, not only medical treatment. It also shows that different sound exposures do not appear to relate to infant outcomes in the same way. The researchers aimed to examine whether language and sound exposure during NICU hospitalisation related to infant neurobehaviour near discharge. They used repeated 16-hour recordings to measure adult words, silence, electronic sounds, and sound levels. They then assessed neurobehaviour between 35 and 41 weeks postmenstrual age. This approach allowed the team to compare different types of auditory exposure across the NICU stay.   Why standardised care for sound exposure matters The main findings suggest that both too much harsh sound and too little positive sound may matter. Higher average decibel levels were associated with lower orientation scores, and higher peak decibel levels were associated with greater hypertonia. More silence was also associated with greater hypertonia. At the same time, higher adult word counts were linked with lower infant stress. The paper also reports that more electronic sound exposure was associated with less hypotonia, but the authors caution that this finding is difficult to interpret. The recording device could not distinguish between potentially helpful sounds, such as music, and potentially disruptive sounds, such as alarms. The authors therefore do not suggest that electronic noise is beneficial. Instead, they argue for careful attention to the type, timing, and intensity of auditory input in the NICU.   What this means for parents and healthcare professionals For parents, families, and healthcare professionals, the findings suggest that clearer standards around NICU sound may support more consistent, high-quality care. Care teams may need to reduce loud and unnatural noise. They also need to avoid an overly silent environment and make room for meaningful speech around the infant. The authors note that more research is needed, but this study supports practical discussion about how sound is managed in the NICU. Parents and professionals can ask how the unit supports a developmentally appropriate auditory environment. They can also use this evidence to encourage care practices that combine neuroprotection with responsive human interaction.   Paper available at: Journal of Perinatology Full list of authors: Pineda, R; Woodward, LJ; Vesoulis, ZA; Smyser, CD; Inder, TE; Mathur, AM; Schlaggar, BL DOI: 10.1038/s41372-026-02623-y

Child engaged in drawing activity, reflecting early cognitive development. © Pexels / Olly Children born preterm have an increased risk of cognitive and language difficulties. In this context, researchers identify maternal sensitivity as an important and potentially modifiable early-life factor influencing long-term development. This international individual participant data meta-analysis combined data from seven birth cohorts in five countries and included 2,560 children. Overall, the study found that higher maternal sensitivity relates to better cognitive and language outcomes. Notably, the strongest associations occurred in children born at lower gestational ages. Together, these findings inform newborn care practices and long-term follow-up for preterm children.   Children born preterm often score lower on cognitive and language tests than those born at term. Therefore, identifying modifiable protective factors remains an important goal in newborn care. Maternal sensitivity describes well-attuned and emotionally warm responses to an infant’s cues. In this study, the researchers examined how maternal sensitivity and gestational age relate to later cognitive and receptive language outcomes. To address this question, the researchers conducted a one-stage individual participant data meta-analysis using harmonised data from seven longitudinal birth cohorts in Europe and Oceania. They assessed maternal sensitivity through standardised observations. They then measured cognition and receptive language using validated tests. Finally, the analyses adjusted for relevant child and family characteristics.   Why maternal sensitivity in preterm children is important for newborn care Across cohorts, higher maternal sensitivity related to better cognitive and receptive language scores. Specifically, each standard deviation increase in maternal sensitivity corresponded to higher cognitive and language outcomes. In addition, gestational age independently predicted both outcomes. Importantly, the link between maternal sensitivity and cognition was stronger in children born at lower gestational ages. This pattern suggests a potential protective effect in those born most preterm. Moreover, the association remained after adjustment for neurodevelopmental impairment. In contrast, for receptive language, maternal sensitivity and gestational age showed additive effects. However, the analysis found no significant interaction. As expected, children born extremely or very preterm scored lower on cognitive and language measures than those born at term. Nevertheless, maternal sensitivity continued to show a positive association with cognitive outcomes. Overall, results remained consistent across cohorts despite differences in sampling and timing of assessments.   What this means for parents and health professionals Taken together, the findings show that maternal sensitivity in preterm children relates to improved cognitive and language outcomes across the full range of gestational ages. For health professionals, this supports including approaches that promote sensitive parent–infant interactions in standardised newborn care and follow-up services. Likewise, for parents and families, the results underline the importance of responsive and emotionally warm interactions in everyday care. In addition, the study provides a basis for discussions between parents and health professionals about how follow-up services support sensitive interactions. Ultimately, greater awareness of evidence-based standards may strengthen consistency in care across settings.   Paper available at: https://pubmed.ncbi.nlm.nih.gov/41655627/ Full list of authors: Jaekel, J; Wolke, D; Esser, G; Woodward, LJ; Spittle, A; Cheong, J; van Baar, AL; Verhoeven, M; Gueron-Sela, N; Atzaba-Poria, N; Anderson, PJ; Treyvaud, K DOI: 10.1016/j.jpeds.2026.115024

Specialised neonatal ambulance used for emergency newborn transfers. © Montreal Children’s Hospital Care can vary when a newborn needs urgent transfer between hospitals, and this can affect safety and access to specialist support. Therefore, a consistent approach is essential. Neonatal emergency transport services form part of a wider perinatal network, and gaps between regions can lead to unequal care. This national survey examined how transport services for newborn emergencies are organised and used across Italy. The study is relevant for parents, families, and health professionals involved in pregnancy, birth, and newborn care. Overall, the findings highlight where services are well established and where more aligned standards could improve consistency.   Neonatal transport is sometimes required even when care is planned around specialist centres. In a decentralised health system, regions organise services differently. As a result, access to standardised newborn care during transfers may vary. The study aimed to describe organisation, coverage, and activity across the country. Researchers sent a questionnaire to all identified neonatal transport teams, and all responded. The survey focused on service organisation and practice rather than medical outcomes.   Why neonatal emergency transport services require standardised newborn care Most regions provided full coverage. However, some areas offered only partial coverage, and one region had no active service despite an approved plan. All services operated 24 hours a day, 7 days a week. Nevertheless, most relied on on-call teams drawn from neonatal intensive care staff, while only a few had dedicated transport teams. Over one year, teams reported thousands of transports. Most involved primary transfers to higher-level care, whereas fewer involved back-transfers. Transport duration varied widely, with a median time just over 100 minutes. In addition, the availability of specific capabilities differed between regions, including nitric oxide, phototherapy, and active cooling. Signs of standardisation were evident. For example, many services used transport databases, written guidelines, audits, and internal training. However, activity levels differed sharply. Several teams carried out low numbers of transports each year. Although some regions used air transport, it represented only a small share of total activity.   What this means for parents and health professionals If a newborn requires transfer, parents can ask their care team whether neonatal emergency transport services are available locally and how teams staff them. In practice, health professionals can strengthen consistency by using shared guidelines, regular audits, and structured training. Where possible, planned referral pathways within regional perinatal networks can help match newborn needs to the appropriate level of care. Finally, reviewing local standards may help parents and professionals understand how neonatal emergency transport services operate in their area.   Paper available at: https://doi.org/10.3390/children12020162 Full list of authors: Bellini, C; Gente, M; Minghetti, D; on behalf of the Neonatal Transport Study Group of the Italian Society of Neonatology DOI: 10.3390/children12020162