The Better Outcomes through Research for Newborns (BORN) Network was founded in 2010 to increase the evidence base for the care of term and late-preterm newborns through collaborative research projects.
Routine hospital care for newborns is essential for a safe and healthy transition home and plays a key role in preventing common newborn problems that may lead to hospital readmission, such as weight loss, dehydration, and hyperbilirubinemia. Most routine care in the well baby nursery is not based on strong evidence, but rather on expert opinion as well as historical and anecdotal experience.
The BORN Network was created to change that: Until now, there was no concerted effort to study newborn nursery care on a national basis. The BORN Network is recognized as a core program of the APA.
More about BORN
Mission
The BORN Network mission is to improve the health of newborns and their families by establishing an evidence base for optimal outcomes. The BORN Network is a national collaborative of pediatric clinicians and researchers who evaluate care in the birth setting and in the transition to home.
Goals
The overarching goal of the BORN Network is to conduct research to establish a firm evidence-base for the routine care of the term and late preterm infant. Our vision is that the BORN Network become internationally recognized and utilized by practitioners and educators as the primary source for evidence-based practice and health care delivery for newborns and their families.
Enroll as an Individual BORN Member, then enroll your institution and newborn nursery!
The potential of the BORN Network lies in you! The evidence for newborn care can only be developed with enrollment of a large, diverse, nationally representative sample of newborns. Your ideas, energy, and willingness to collect a small amount of data will set the national agenda, shape the practice of physicians, and ensure high quality care in newborn nurseries everywhere.
Incentives to Participate
Once you have joined the network, you will have the following opportunities to participate and contribute to furthering the evidence-base for newborn care:
- Complete surveys on your current newborn practices that will allow us to understand the current state of newborn care in the US and link specific practices to outcomes.
- Collect data on network research studies
- Be elected to either the Research or Executive Committees of BORN and formulate the future of the network
- Be elected as a managing director of BORN
- Develop a research study for the BORN network to conduct
- Be a principal investigator or co-investigator on BORN network studies
- Provide comments on proposed, planned or ongoing research projects
Submit a Proposal
Have an idea for a study and want to collaborate with BORN? Consider submitting a proposal.
Ongoing Studies
Screening for ABO incompatibility in the well-newborn unit: A BORN study
A survey to newborn nurseries to evaluate variation in blood type incompatibility screening across newborn nurseries in the United States and identify characteristics that predict screening practices. (PIs: Ladawna Gievers and Sheevaun Khaki)
Donor Milk Utilization
A survey to newborn nurseries to intended to gather information regarding human donor milk practices amongst well newborn units and nurseries across the U.S. With increasing use of donor breast milk amongst neonatal intensive care units and newborn nurseries and known regional availability, it is likely that there are disparities within its use. It is our hope that this research will better inform current practices regarding human donor milk use and identify potential regional or population disparities that can be addressed. (PIs: La'Toya James Davis & Rasheda Vareen)
Improving skills in examining the infant hip (IHIP)
This project aims to determine whether a new infant hip model and curriculum is feasible and practicable and can improve the infant hip examination skills of interns. (PI: Joe Lopreiato)
Temperature Values in Newborns and Implications for Clinical Practices Surrounding Hypothermia
A retrospective cohort study to describe the normal distribution of temperature values and compare prevalence of hypothermia in newborns by thermometer route; to identify predictors of neonatal hypothermia in term and LPI beyond the first hour of life; and to characterize interventions in response to and diagnostic outcomes of neonatal hypothermia, as defined in Table 1 below. (PI: Rebecca Dang)
Screening and Referring for Unmet Social Needs in the Nursery Setting
A survey of newborn nurseries to determine the prevalence of screening/referral for unmet social needs in the nursery setting and to examine nursery-level factors that are associated with adoption of screening/referral for unmet social needs. (PI: Arvin Garg)
Completed Studies
Knowledge, Attitudes, and Practices Related to Marijuana Use and Breastfeeding
An exploratory study to determine new mothers’ knowledge, attitudes and practices related to marijuana use and breastfeeding and to describe the variation in hospital approaches to breastfeeding among mothers with UDSs positive for cannabinoids at the time of delivery using a cross-sectional survey of newborn service directors, and postpartum mothers and infants during the newborn hospitalization. (PI: Esther Chung)
Car Seat Tolerance Screening in Newborns: Epidemiology and Outcomes
PI Skye McLaurin-Jiang and her co-investigators are working on a retrospective cohort study around CSTS Screening. The aims of the study are: 1) describe which infants undergo a pre-discharge CSTS, 2) describe the epidemiology of CSTS failure, and 3) determine the relative risk of adverse outcomes in infants who failed an initial CSTS.
Umbilical Nonseverance
The goal is to examine and describe the practice of umbilical nonseverance along with related incidences of infection. (PI: Kimberly K. Monroe)
Vaccine Preferences
Jake Lohr’s study into vaccine preferences aims to determine when first-time parents in the immediate postpartum period developed their vaccine preferences: before, after or during pregnancy. The secondary aim is to determine what co-variables (demographic and otherwise) contribute to the timing of parents’ development of vaccine preferences. Characterize the external factors (e.g, individuals, information sources) that contribute to vaccine preference development.
COVID Case Study
Collected cases of newborns with COVID-19 positive mothers across the BORN network. (PI: Jayme Congdon)
COVID Variations
A cross-sectional survey that examined variations in the evaluation, routine care and discharge planning of mothers and infants for COVID-19 in Well Newborn Units in the BORN network. (PI: Elena Aragona)
Management of Newborns with Lumbosacral Findings
This cross-sectional study of management choices made by practitioners who see newborns in a regular newborn nursury setting aims to see how much inter-observer agreement exists for management of various neonatal lumbosacral findings.
Vitamin K Refusal
As a follow-up to PI Jaspreet Loyal's, Yale University, earlier project surveying BORN nursery directors perceptions of Vitamin K refusals at their institutions, the aims of the current study are to 1) report the number of infants discharged from newborn nurseries in the BORN network who did not receive IM vitamin K and 2) describe the epidemiology of infants not receiving IM vitamin K and their mothers.
Hypoglycemia
In this BORN study, Sudha Rani Narasimhan aims to describe and analyze the practice variations related to routine maternity and newborn care, breastfeeding practices, diagnosis and treatment of hypoglycemia.
Breastfeeding Study
Laura Kair’s prospective cohort study aimed to identify hospital practices associated with any and exclusive breastfeeding at 3 months of age among infants born at 34-36 6/7 weeks’ gestation who are admitted to the well-baby nursery.
Newborn Bathing
Ann Kellam’s study surveyed variations on standardized procedures related to the bathing of newborns across multiple BORN locations.
The Utility of Transcutaneous Bilirubin Measurement
Jim Taylor, University of Washington, served as PI for the first study conducted by the BORN network. The specific aims of the study were to: 1) Describe the distribution of TcB values in term and late preterm newborns measured in diverse settings by developing a TcB nomogram based on the data collected (BORN TcB nomogram) 2) Identify test thresholds for TcB percentiles that maximize the specificity of the screening tool while maintaining sensitivity near 100% for identification of infants with significantly elevated TSB and 3) Identify systematic sources of error in TcB measurements.
BORN Delphi Study
The objective of this study led by PI Elizabeth Simpson, University of Missouri, was to develop a consensus-based, prioritized agenda for well newborn care. A two-round modified Delphi survey of BORN members was conducted. The highest rated research questions of importance to BORN clinicians were: 1) At what weight-loss percentage is it medically necessary to formula supplement a breastfeeding infant? 2) What is the optimal management of infants with neonatal abstinence syndrome? 3) How and when should we initiate a workup for sepsis, and how should these newborns be managed?
Variation in Care of Opioid-Exposed Newborns: a BORN survey
BORN member hospitals were surveyed to identify practice variations for newborns with in-utero chronic opioid exposure. Identification of variation is the first step toward establishing best practice standards to improve care for this rapidly growing population. Deb Bogen from University of Pittsburgh, was PI for this survey.
Practice Variation in Evaluation of Term Infants at Risk for Early-Onset Sepsis
PIs Sagori Mukhopadhyay and Karen Puopolo from UPenn surveyed BORN nursery directors to determine variation in the management of newborns at risk for EOS.
Publications
2023
Joshi NS, Flaherman VJ, Halpern-Felscher B, Chung EK, Congdon JL, Lee HC. Admission and Care Practices in United States Well Newborn Nurseries, Hosp Pediatr. (2023), doi: 10.1542/hpeds.2022-006882
Hadfield BR, Rowley J, Puyol F, Johnson MA, Ali M, Neuhoff BK, Lyman R, Saravia A, Svatek M, Sherburne K, Cantey JB. Quality Improvement Through Nurse-initiated Kaiser Sepsis Calculator at a County Hospital. Hosp Pediatr. 2023 Jan 1;13(1):31-38. doi: 10.1542/hpeds.2022-006554. PMID: 36537146.
2022
Yarnall JN, Seashore C, Phillipi CA, Hatch JE, King B, Hart C, Lohr JA, Vaccine Preferences Study Group. Timing of vaccine decision-making among first-time parents, Acad Pediatr. (2022), https://doi.org/10.1016/j.acap.2021.10.004
Harrison WN, Ritter VS, Flower KB, Seashore CJ, McLaurin-Jiang S. The Association Between Routine Car Seat Screening and Subsequent Health Care Utilization, Hosp Pediatr. (2022), https://doi.org/10.1542/hpeds.2021-006509
Hoffman, B, & Vining, M. Continued Challenges of the Car Seat Tolerance Screen. Hosp Pediatr. (2022), https://doi.org/10.1542/hpeds.2022-006929
2021
Pace RM, Williams JE, Jarvinen KM, Meehan CL, Martin MA, Ley SH, Barbosa-Leiker C, Andres A, Yeruva L, Belfort MB, Caffe B, Navarrete AD, Lackey KA, Pace CDW, Gogel AC, Fehrenkamp BD, Klein M, Young BE, Rosen-Carole C, Diaz N, Gaw SL, Flaherman V, McGuire MA, Mcguire MK, Seppo AE. Milk from women diagnosed with COVID-19 does not contain SARS-CoV-2 RNA but has persistent levels of SARS-CoV-2-Specific IgA antibodies. Front. Immunol. (2021). 12:801797. doi: 10.3389/fimmu.2021.801797
Aragona E, West D, Loyal J. Well-Newborn unit director experiences during the COVID-19 pandemic: A BORN study. Hospital Pediatrics. 2021 September. 11(9): e170-e181. doi: https://doi.org/10.1542/hpeds.2021-005862
Wisniewski JA, Phillipi CA, Goyal N, Smith A, Hoyt AEW, King E, West D, Golden WC, Kellams A. Variation in newborn skincare policies across United States maternity hospitals. Hospital Pediatrics. 2021 September. 11(9): 1010-1019. doi: https://doi.org/10.1542/hpeds.2021-005948
Congdon JL, Kair LR, Flaherman VJ, Wood KE, LoFrumento MA, Nwaobasi-Iwuh E, Phillipi CA; Better Outcomes through Research for Newborns (BORN) Network. Management and Early Outcomes of Neonates Born to Women with SARS-CoV-2 in 16 U.S. Hospitals. Am J Perinatol. 2021 Mar 15. doi: 10.1055/s-0041-1726036. Epub ahead of print. PMID: 33723834.
2020
Laura R. Kair, Carrie A. Phillipi, Allison M. Lloyd-McLennan, Kimberly M. Ngo, Heather L. Sipsma, Beth A. King, Valerie J. Flaherman. Supplementation Practices and Donor Milk Use in US Well-Newborn Nurseries. Hospital Pediatrics. 2020, 10 (9) 767-773.
Natalie L. Davis, Benjamin D. Hoffman, Eric C. Eichenwald. Variation in Car Seat Tolerance Screen Performance in Newborn Nurseries. Pediatrics. 2020, 146 (2): e20193593.
Janelle Aby, Juliann Kim, Lillian Lai, Valerie Flaherman, Jaspreet Loyal. Variation in Management of Cutaneous Lumbosacral Findings in Newborns. Hospital Pediatrics. 2020, 10 (6) 496-501.
Afshar Y, Gaw SL, Flaherman VJ, Chambers BD, Krakow D, Berghella V, Sharmshirsaz AA, Boatin AA, Aldrovandi G, Greiner A, Riley L, Boscardin WJ, Jamieson DJ, Jacoby VL. Clinical Presentation of Coronavirus Disease 2019 (COVID-19) in Pregnant and Recently Pregnant People. Obstetrics & Gynecology, 136(6), 1117–1125. https://doi.org/10.1097/AOG.0000000000004178.
Flaherman VJ, Afshar Y, Boscardin J, Keller RL, Mardy A, Prahl MK, Phillips C, Asiodu IV, Berghella WV, Chambers BD, Crear-Perry J, Jamieson DJ, Jacoby VL, Gaw SL. Infant Outcomes Following Maternal Infection with SARS-CoV-2: First Report from the PRIORITY Study. Clinical Infectious Diseases, Published: 18 September 2020.
2018
Jaspreet Loyal, James A. Taylor, Carrie A. Phillipi, Neera K. Goyal, Kelly E. Wood, Carl Seashore, Beth King, Eve Colson, Veronika Shabanova, Eugene D. Shapiro, on behalf of the BORN investigators. Factors Associated With Refusal of Intramuscular Vitamin K in Normal Newborns. Pediatrics. 2018, 142 (2): e20173743.
2017
Loyal J, Taylor JA, Phillipi CA, Goyal NK, Dhepyasuwan N, Shapiro ED, Colson E. Refusal of vitamin K by parents of newborns: A survey of the Better Outcomes through Research for Newborns (BORN) Network. Academic Pediatrics. 2017. 17(4): 368-373.
Bogen DL, Whalen B, Kair LR, Vining M, King BA. Wide variation found in care of opioid-exposed newborns. Academic Pediatrics. 2017. 17(4): 374-380.
2016
Taylor JA, Burgos AE, Flaherman V, Chung EK, Simpson EA, Goyal NK, Von Kohorn I, Dhepyasuwan N. Utility of decision rules for transcutaneous bilirubin measurements. Pediatrics. 2016. 137(5).
2015
Taylor JA, Burgos AE, Flaherman V, Chung EK, Simpson EA, Goyal N, Von Kohorn I, Dhepyasuwan N. Discrepancies between transcutaneous and serum bilirubin measurements. Pediatrics. 2015. 135(2):224-231.
Mukhopadhyay S, Taylor J, Von Kohorn I, Flaherman V, Burgos AE, Phillipi CA, Dhepyasuwan N, King E, Dhudasia M, Puopolo KM. Variation in sepsis evaluation across a national network of nurseries. Pediatrics. 2017. 139(3).
2014
Simpson E, Goyal N, Dhepyasuwan N, Flaherman V, Chung E, Von Kohorn I, Burgos T. E, Taylor J. Prioritizing a research agenda: a delphi study of the Better Outcomes Through Research for Newborns (BORN) network. Hospital Pediatrics. 2014. 4(4): 195-202.
Presentations
2023
James-Davis, L., Drumm, C., Krick, J., Ulrich, A., Phillipi, C., Tyrrell, H., & Vereen, R. (2023). Donor Human Milk Access and Utilization within Well Newborn Nurseries across Better Outcomes through Research for Newborn (BORN) Network sites in the United States. Poster Presentation, 2023 AAP National Conference & Exhibition, Washington, D.C.
Chung EK, Chang P, Goyal N. Marijuana Use During Pregnancy: Associated Factors and Neonatal Outcomes. Poster Presentation, 2023 Pediatric Academic Societies Meeting, Washington DC, May 1.
Joshi N, Zven S, Graziose B, Tyrrell H, Ahuja A, Loyal J, Zafar N, Lopreiato JO. Using an Innovative Model to Improve Performance of the Infant Hip Exam. Oral Abstract Presentation, 2023 Pediatric Academic Societies Meeting, Washington, DC, April 29.
Chung EK, Chang P, Goyal N. Marijuana use and breastfeeding: Knowledge, attitudes, and practices among new mothers. Poster Presentation, 2023 Pediatric Academic Societies Meeting, Washington DC, April 28.
McLaurin-Jiang S, Germana S, Goyal N, Gupta Basuray R, Gupta S, Hoyt-Austin A, Ibragimov A, Kohn M, Ritter V, Seashore C, Shaikh S, Flower K. Car seat tolerance screening implementation and outcomes: Findings from a multi-site study through the Academic Pediatric Association's BORN Network. Poster Presentation, 2023 Pediatric Academic Societies Meeting, Washington, DC, April 28.
Lopreiato J, Graziose B, Zven S, Joshi N, Tyrrell H, Ahuja A, Loyal J, Zafar N. Using an Innovative Teaching Bundle to Improve the Infant Hip Exam. Platform Presentation, 2023 APA Region IV Meeting, Charlottesville, VA, February 26.
2022
Joshi NS, Flaherman V, Halpern-Felsher B, Lee H. Admission and care practices in United States nurseries: A BORN study. Poster Presentation, 2022 Pediatric Hospital Medicine Meeting, Lake Buena Vista, FL, July 29.
Loyal J, Wood KE, Goyal N, Wexeblatt S, Congdon J, Joshi NS, Hoffman B. Controversies in well newborn care debated. Debate/Pro-Con Discussion, 2022 Pediatric Academic Societies Meeting, Denver, CO, April 25.
Joshi NS, Flaherman V, Halpern-Felsher B, Lee H. Admission and care practices in United States nurseries: A BORN study. Platform Presentation, 2022 Pediatric Academic Societies Meeting, Denver, CO, April 25.
Chang PW, Goyal N, West D, Chung EK. Marijuana use during pregnancy and lactation: National survey of hospital practices and nursery director knowledge. Poster Presentation, 2022 Pediatric Academic Societies Meeting, Denver, CO, April 24.
Recio S, Kim HY, Wood KE, Goyal N, Huang JX, Garcia EFY, Nidey N, West D, Kair LR. Anticipatory guidance in the newborn nursery: A survey of the Better Outcomes through Research for Newborns Network. Poster Presentation, 2022 Pediatric Academic Societies Meeting, Denver, CO, April 23.
2019
Lloyd-McLennan A, Phillipi CA, King BA, Sipsma HL, Flaherman VJ, and Kair LR. Personal Breastfeeding Experience and Clinical Care of Well Newborns: A Mixed-Methods Study of the BORN Research Network (Platform). Pediatric Academic Societies Annual Meeting. Baltimore, MD. April 28, 2019.
2018
Kair LR, Sipsma H, Lloyd AM, Flaherman VJ, King BA, and Phillipi CA. Provider Opinions about Hospital Practices to Promote Breastfeeding: A Mixed-Methods Study of the BORN Network (poster). Pediatric Academic Societies. Toronto, Canada. May 8, 2018.
Kair LR, Phillipi CA, Lloyd AM, King BA, Sipsma HL, and Flaherman VJ. Variation in Newborn Breastfeeding Management in US Hospitals in the BORN Network (poster). Pediatric Academic Societies. Toronto, Canada. May 8, 2018.
2016
Bogen DL, Whalen B, Vining M, Kair LR, Dhepyasuan N, and King BA. Variation in Care for NAS is Common among BORN Nurseries (Platform). Pediatric Academic Societies Annual Meeting. May 1, 2016. Baltimore, MD.
Managing Directors
Valerie Flaherman, MD, MPH
University of California, San Francisco
Laura Kair, MD, MAS
UC Davis
Steering Committee
Esther K. Chung, MD, MPH (APA Research Chair)
University of Washington/Seattle Children's Hospital
Neera Goyal, MD (BORN Chair)
Thomas Jefferson University, Nemours/AI duPont Hospital for Children
Nagma Zafar, MD
University of Louisville
Adrienne Hoyt-Austin, DO, MAS, IBCLC
UC Davis
Abieyuwa Iyare, MD
Texas
Elena Aragona, MD, MS
Yale
Neha Joshi, MD
Stanford
Jayme Congdon, MD, MS
UCSF Benioff Children's Hospital
Ian M. Paul, MD, MSc
Penn State College of Medicine
Anne-Marie Rick, MD, MPH, PhD
University of Pittsburgh
Cristina Fernandez, MD
Columbia University
