The case for a chronobiological approach to neonatal care. (November 2018)

• Record Type: Journal Article
• Authors: McKenna, Helen; Reiss, Irwin Karl Marcel
• Is Part Of: Early human development. Volume 126(2018)
• Page Start: 1
• Page End: 5
• Publication Date: 2018-11
• Subjects: Chronobiology -- Circadian rhythms -- Intensive care, neonatal -- Infant, newborn; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2018.08.012
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Time of day is a critical factor for most biological functions, but concepts from the field of chronobiology have yet to be fully translated to clinical practice. Circadian rhythms, generated internally and synchronised to the external environment, promote function and support survival in almost every living species. Fetal circadian rhythms can be observed in utero from 30 weeks gestation, coupled to the maternal rhythm, but synchronise to the external environment only after birth. Important cues for synchronisation include the light/dark cycle, the timing of feeding, and exposure to melatonin in breast milk. Disruption to these cues may occur during admission to the neonatal intensive care unit. This can impair the development of circadian rhythms, and influence survival and function in the neonatal period, with a potential to impact health and well-being throughout adult life. Here we outline the rationale and evidence to support a chronobiological approach to neonatal care.