Care of the Preterm Newborn

Care of the Preterm Newborn

Risk factors of preterm and low birth weight babies:
• Feeding difficulties since the coordinated “suck and swallow” process only starts at 34 weeks gestation. Preterm babies need help to feed and are more likely to aspirate.
• Premature babies are at higher risk of dying from sepsis once they get an infection.
• Babies born below 32 weeks of gestation, are at higher risk of developing respiratory distress syndrome (RDS), although this risk can be reduced by antenatal corticosteroids given to the mother at risk of preterm labour.
• Jaundice is more common in premature babies since the immature liver cannot easily metabolise bilirubin and the preterm baby’s brain is at a higher risk since their blood-brain barrier is less developed to protect the brain.
• Brain injury in preterm babies is most commonly intraventricular haemorrhage, occurring in the first few days after birth, in about 1 in 5 babies under 2 kg and is often linked to severity of RDS and hypotension.
• Necrotizing enterocolitis is a rare condition affecting the intestinal wall of very premature babies. Formula feeding increases the risk tenfold compared to babies who are fed exclusive breastmilk.
• Retinopathy of prematurity due to abnormal proliferation of blood vessels around the retina of the eye, which is more severe if the baby is given very high levels of oxygen for long durations.
• Anaemia of prematurity, which often becomes apparent at a few weeks of age due to the delay in producing red blood cells as the bone morrow is immature.

Erythroleukemia: A Rare Case Report

Erythroleukemia: A Rare Case Report

A 4-month-old child was brought by the mother to the paediatric ward of Goa Medical College with the chief complaint of abdominal distension in the past 7 days. There was no history of fever or any drug intake. On general examination, the patient appeared pale, and there was no icterus or lymphadenopathy noted.
On systemic examination, the neurological examination was normal. The patient was conscious and alert. Abdominal examination revealed the liver was 4 centimetres below the right costal margin, firm, non-tender, and with a smooth surface. The spleen was 6 centimetres below the left costal margin, firm, extending up to umbilicus. No free fluid was noted.

Gastric Serosal Tear: A Rare Complication of Congenital Diaphragmatic Hernia

Gastric Serosal Tear: A Rare Complication of Congenital Diaphragmatic Hernia

A five-day-old male neonate with 3.2 kg weight was referred for non-bilious vomiting and refusal of feeds. He was delivered by caesarean section and no congenital anomaly had been detected antenatally or at birth.
On examination, he was lethargic, pale, tachypneic, and dehydrated, with mild icterus. There was no cyanosis. He had passed normal meconium at birth. Further physical examination revealed epigastric fullness with tenderness. His investigations showed hemoglobin of 6 grams per decilitre (gm/dL), white blood cell count of 16,000 per cubic millimetre, low serum sodium and potassium, with C-reactive protein (CRP) level of 12 milligrams per decilitre (mg/dL).
The chest X ray showed a left sided diaphragmatic hernia.

Breastfeeding

Breastfeeding

Breastfeeding is the right of every newborn child. It has many benefits for the newborn, the infant, as well as the mother. The results of breastfeeding can affect a society and its economy. Understanding the reflexes behind breastfeeding and the skills required by the mother is essential for every physician that looks after a child. Breastmilk has many stages which are responsive to the physiology and stage of the neonate. Breastfeeding is also beneficial to the mother which a physician can help explain. If the physician can encourage and stress to the mother how vital it is to breastfeed, then it can be followed by the mother in a proper manner.