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Aorto-pulmonary window (APW) is a rare congenital heart disease. The non-restrictive types of APWs present at an early age and require early surgical correction. The transcatheter device closure in young infants pose significant challenges that include hemodynamic instability during arteriovenous loop formation and due to potential encroachment of the occlusive device on vital adjacent structures, and sizing of introducer sheaths and delivery systems. We report a successful transcatheter closure of an AP window in a 1.35 Kg preterm infant with heart failure requiring mechanical ventilation. To the best of our knowledge this is the smallest and youngest baby , wherein transcatheter device closure has been attempted for a non-restrictive aorto-pulmonary window. The procedure was done through a 4 French right femoral venous access, thus avoiding an arterial access. A 0.025 Terumo wire was maneuvered through the pulmonary artery across the APW without formation of an arteriovenous loop. The APW was successfully occluded with a Konar multi-functional device delivered via a 4-French delivery system. The baby could be successfully weaned off the ventilator and could be discharge. On 1 month follow up, baby was in good health and gaining adequate weight. Thus we conclude that careful selection of patients allows successful closure of APW, even in the smallest baby.

Aorto-pulmonary window (APW) is a rare congenital heart disease. The non-restrictive types of APWs present at an early age and require early surgical correction. The transcatheter device closure in young infants pose significant challenges that include hemodynamic instability during arteriovenous loop formation and due to potential encroachment of the occlusive device on vital adjacent structures, and sizing of introducer sheaths and delivery systems. We report a successful transcatheter closure of an AP window in a 1.35 Kg preterm infant with heart failure requiring mechanical ventilation. To the best of our knowledge this is the smallest and youngest baby, wherein transcatheter device closure has been attempted for a non-restrictive aorto-pulmonary window. The procedure was done through a 4 French right femoral venous access, thus avoiding an arterial access. A 0.025 Terumo wire was maneuvered through the pulmonary artery across the APW without formation of an arteriovenous loop. The APW was successfully occluded with a Konar multi-functional device delivered via a 4-French delivery system. The baby could be successfully weaned off the ventilator and could be discharge. On 1 month follow up, baby was in good health and gaining adequate weight. Thus we conclude that careful selection of patients allows successful closure of APW, even in the smallest baby. [ABSTRACT FROM AUTHOR]

The psychomotor development of children is very important outcome concerning the proper growth and development of a child. We try to eliminate the risk factors that impair its course during intrauterine life, during childbirth, as well as during the first months/years of life, to provide children with optimal conditions for healthy development. Newborns born prematurely are at risk of impaired psychomotor development, including cognitive, neurological, and/or sensory outcomes. The following review presents risk factors that weaken the development of preterm infants, the areas of development in which this weakness may be visible, and methods of evaluation of this development.

The COVID-19 pandemic is the largest and most widely spread health emergency globally in recent years and affects all, irrespective of race or sex. This pandemic is caused by severe acute respiratory syndrome - coronavirus- 2 (SARS-CoV-2). Unlike adults, most babies and children who are infected with this virus are symptomatic. Fever is the most common symptom that has been reported in children who are positive for COVID-19. Our study reports a case of a preterm, extremely low birth weight baby who was positive for COVID- 19. He had tachypnea, hypoxia and neurological symptoms, which include episodes of high pitched cry and hypertonia. The mother was COVID-19 negative, while over sixty per cent of the staff, including doctors and nurses, were positive when he was on admission. This baby was infected probably by the staffs in the newborn unit. Babies with COVID-19 should not be assumed to have a mild form of the disease but must be admitted at least for observation

Introduction: All-in-one parenteral nutrition (AIO-PN) is essential for patients with limited venous access, e.g. premature infants. So far, there are still some conflicting data related to the stability of AIO-PN. The aim of this study is to examine the physical stability and sterility of AIO-PN as it was being stored at room and cold temperature. Materials and Methods: AIO-PN contains dextrose, amino acid, lipid, sodium chloride, magnesium sulfate, potassium chloride, calcium gluconate, and vitamin. Formulation of AIO-PN was prepared based on the guidance of nutrition for 3-day-old preterm baby weighing 1000 g. The formulation of AIO-PN then was stored at room temperature (25.43ºC ± 0.54) and cold temperature (6.2ºC ± 2.04). Results and Discussion: Based on the experiments, all formulas confidently fulfilled the sterile criteria, in which there is no microbial growth in the formula within 7 days. During those days, the droplet size of all formulas was under the range (

Objectives: Delayed or insufficient breast milk production, as well as low milk supply, is still a challenging problem to overcome, particularly in the case of preterm delivery. Herbal galactagogues might be a good way to increase milk supply, however, there is a lack of clinical studies confirming their efficacy and safety. The aim of this study was to verify the safety and effectiveness as a galactagogue of the unique galactagogue composition based on barley malt with β -glucan and lemon balm. Material and methods: The study included 117 mothers of preterm infants randomly divided into the Galactagogue Group given galactagogue and the Placebo Group. A complete data set was obtained for 80 participants, divided equally between two groups. Volume of milk expressed by mothers during the first two weeks after delivery was the primary outcome and safety of the product was the secondary outcome. Results: Volume of milk recorded on participants' last visit in the Galactagogue Group was significantly higher than in the Placebo Group (95 mL vs 62.5 mL, p = 0.049). The total expressed milk volume during the study was 4209 ± 335 mL in the Placebo Group vs 6036 ± 498 mL (p = 0.003) in the Galactagogue Group. Conclusions: Supplementation with unique Galactagogue composition was safe and increased milk output which allowed achieving target minimal volume of 500 mL per day in first week of lactation in preterm mothers. [ABSTRACT FROM AUTHOR]

Tracheoesophageal fistula is a challenging anomaly with a rare prevalence with symptoms mainly respiratory, sometimes digestive. We present a rare case of oesophageal atresia with distal Tracheoesophageal fistula in a female child whose mother presented with severe oligohydramnios on ultrasonography with intrauterine growth retardation before cesarean section. After the birth of preterm and very low birth weight neonate, we initially diagnosed as respiratory distress syndrome with a club foot. However, we diagnosed oesophageal atresia with distal Tracheoesophageal fistula on the 2nd day as nasogastric tube insertion was failed beyond 10cm and confirmed by X-ray with a rubber catheter. Right thoracotomy with ligation of the fistula with end to end anastomosis was performed successfully without complications. Breastfeeding initiated and the child discharged after she started gaining weight. Early post-operation complication (anastomotic stricture) was noticed after 2 weeks; however, corrected with endoscopic balloon dilatation. Currently, the child is healthy weighing 10kgs at 18 months of age.

Introduction: All-in-one parenteral nutrition (AIO-PN) is essential for patients with limited venous access, e.g. premature infants. So far, there are still some conflicting data related to the stability of AIO-PN. The aim of this study is to examine the physical stability and sterility of AIO-PN as it was being stored at room and cold temperature. Materials and Methods: AIO-PN contains dextrose, amino acid, lipid, sodium chloride, magnesium sulfate, potassium chloride, calcium gluconate, and vitamin. Formulation of AIO-PN was prepared based on the guidance of nutrition for 3-day-old preterm baby weighing 1000 g. The formulation of AIO-PN then was stored at room temperature (25.43°C ± 0.54) and cold temperature (6.2°C ± 2.04). Results and Discussion: Based on the experiments, all formulas confidently fulfilled the sterile criteria, in which there is no microbial growth in the formula within 7 days. During those days, the droplet size of all formulas was under the range (<500 nm) with a good range of pH. However, during the process of storing under the room temperature, AIO-PN showed the reversible creaming starting on day 2 and the discoloration starting on day 4. Meanwhile, we found that there are no such physical changes in the formula within 7 days under the cold temperature. Conclusion: This research confirmed that AIO-PN that is being stored at room temperature cannot be used starting on day 4, but the formulation storage under the cold temperature is still accepted within 7 days. [ABSTRACT FROM AUTHOR]

The psychomotor development of children is very important outcome concerning the proper growth and development of a child. We try to eliminate the risk factors that impair its course during intrauterine life, during childbirth, as well as during the first months/years of life, to provide children with optimal conditions for healthy development. Newborns born prematurely are at risk of impaired psychomotor development, including cognitive, neurological, and/or sensory outcomes. The following review presents risk factors that weaken the development of preterm infants, the areas of development in which this weakness may be visible, and methods of evaluation of this development. [ABSTRACT FROM AUTHOR]

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Amyand hernia is a rare disease seen in approximately 1% of all hernias, complications of it, like acute appendicitis, or perforated appendicitis are even more rare, about 0.1%. Its diagnosis is very difficult in the pre-operative period; it is usually an incidental finding. [ABSTRACT FROM AUTHOR]

Preterm baby suffered from metabolic stress and hypogammaglobulinemia after birth. Extrauterine growth restriction (EUGR) is a common problem and related to neurodevelopmental outcome. The Independent risk factor of EUGR is necrotizing enterocolitis (NEC). Concentration secretory IgA (sIgA) as main immunity system decreased by age. Human milk fortification may resolve EUGR and organ immaturity of preterm baby. Objective : Analyzed difference gain velocity and sIgA fecal between preterm baby received human milk and human milk fortified. Methods : Prospective analytic observational study between December 2015-July 2016 at Soetomo Hospital Surabaya. Inclusion criteria consisted of gestational age ≤ 34 weeks and birth weight 1000 till less than 2000 g. Multiple congenital anomaly and enteral nutrition avoidance as exclusion criteria. Indication human milk fortification were stable period, no suckling reflex and gain weight velocity (GWV) <10 g/kg/d. Preterm baby was recruited and followed in 14 days. Chi-square, Mann-whitney and t-test independent sample used to analyzed discrepancies GWV, gain length velocity (GLV), gain head circumference velocity (GHC) and sIgA fecal. Results : Human milk fortification (22(12,86-51,76) g/kg/day) showed significance difference to GWV than human milk (14,28(-12,86-(+32,86)) g/kg/day) group (p=0,020). GLV(p=0,257), GHC (p=0,215) and sIgA fecal (p=0,418) revealed no difference. Side effects (feeding intolerance and NEC) not found during observation. Conclusions : Human milk fortification showed higher GWV than human milk group. Follow up still needed to evaluate anthropometric parameter. [ABSTRACT FROM AUTHOR]

Introduction: Objective: this study aims to investigate the physical stability of standard formulations for parenteral nutrition, with and without lipids, in one bag for preterm babies. Method: standard formulations for first-day and for second-day parenteral nutrition of preterm babies weighing 1,000 grams were prepared in triplicate. Standard all-in-one formulas for first-day and for second-day parenteral nutrition were compared with equivalent standard lipid-free formulations. The standard formulas contain glucose, lipids, calcium gluconate, potassium chloride, sodium chloride, and vitamins. Stability was evaluated using visual inspection, particle size analysis, and pH measurement. The physical instability of the all-in one parenteral nutrition formulas was reported as creaming, coalescence, or cracking, whereas the instability of the lipid-free parenteral nutrition formulas was described as turbidity, precipitation, gas formation, or colour changes. Two independent evaluators assessed the visual changes under light and against a dark-light background, as well as using the Tyndall beam effect. Particle size was measured using a particle size analyzer. Chemical compatibility was checked using a pH-meter. Result: the result showed that the all-in-one (AIO) parenteral nutrition formulas develop reversible creaming on day three, while the lipid-free ones remain clear. As regards pH and particle size, none of the four AIO and lipid-free formulas developed significant changes (ΔpH < 0.05 and particle size < 400 nm) until after seven days. Conclusion: all four formulas are stable following examination with visual inspection, a pH-meter, and a particle size analyzer. [ABSTRACT FROM AUTHOR]

Introduction: The Mother Kangaroo Method (MKM) is a neonatal care alternative for low-weight newborn or preterm babies. It is an outpatient method based on the direct skin contact between the caregiver and the newborn baby. It includes nurturing the baby only by breastfeeding, and some essential measures to improve the baby quality of life. Objective: To determine the clinical and sociodemographic characteristics of the population included in the program Family Kangaroo at a high-complexity hospital in Medellín (Colombia) during 2015- 2016. Method: It is a retrospective descriptive study including both low-weight newborn and preterm babies treated in the program Family Kangaroo during 2015 and 2016. Patients with congenital diseases, dead mothers or mothers unable to breastfeed mothers were excluded. Results: The average mother age was 26 years and 47% of them were housewives. The most frequently found disease in the pregnancy was the preeclampsia. Most of the babies Kangaroo were males (51.1 %), with an average weight at birth of 2195 grams. Sixty percent of them were nurtured only by breastfeeding when they entered in the program and 34% received formula as a supplementary feeding. Conclusions: The population included in the program Family Kangaroo had sociodemographic characteristics similar to those reported in other researches. However they provided specific public health strategies in response to the needs in this population. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to review accompanied congenital anomalies to gastrointestinal pathologies. Materials and Methods: The medical records of patients who were admitted to neonatal intensive care unit with gastrointestinal system surgical pathologies during 2015-2018 were retrospectively evaluated for associated congenital anomalies. Results: 67 patients were identified during the study period. The most common gastrointestinal system pathology was anal atresia in 15 cases (22.4%), followed by diaphragmatic hernia in 14 cases (20.9%), esophageal atresia (n:10) and ileal atresia (n:10) (14.9%). Thirty two patients (48.8%) have had accompanied congenital anomalies to gastrointestinal system pathologies. Congenital heart disease was the most common anomaly and the most frequent one was atrial septal defect in 18 cases (26.8%). In addition, there was complex congenital heart disease in (n:13) 19.4%. In 12 patients (17.9%), accompanied extracardiac anomalies were detected. Hydronephrosis and sludge in gall bladder were detected in three patients (4.5%). Vesicoureteral reflux or ectopic kidney or polysplenia was detected as a separate anomaly in each case. In our cases, prematurity rate was found in 54%. Conclusion: Gastrointestinal system pathologies are frequently associated with multiple anomalies, especially with congenital heart diseases. In addition, these patients are likely to be preterm baby. [ABSTRACT FROM AUTHOR]

A preterm infant is a baby born with gestational age less than 37 weeks. Preterm babies tend to have problems compared to normal ones. Premature gestational age might result in immaturity of all organ systems of the body including cardiovascular organs. The aim of this study was to find out the right ventricle function by tricuspid annular plane systolic excursion (TAPSE) and left ventricle by ejection fraction and shortening fraction using echocardiography on preterm babies. The subject of this study were term and preterm babies who fulfilled the inclusion criteria: appropiate gestational age babies 3–30 days old. This was an analytic descriptive study with cross-sectional method held in Department of Child Health Dr. Hasan Sadikin Hospital Bandung during July–October 2010, and statistical analysis using t–test Spearman rank correlation test. The result of the study showed that the right ventricle function examined by TAPSE method was different on preterm compared to term babies (p=0.006). No significant difference was found in the ejection fraction between preterm and term babies (p=0.22) and so did the shortening fraction (p=0.20). It was concluded that there is a difference in the right ventricle function by TAPSE method between preterm (lower) and term babies.

Colostrum from mothers is rich in immunomodulating bio-factors such as immunoglobulins (IgA), lactoferrin, and oligosaccharides and supports gut microbial and inflammatory processes. The support in these processes may provide some relief for infants who are born pre-term. Pre-term infants are more likely to develop necrotizing enterocolitis (NEC), late-onset sepsis (LOS), and ventilator-acquired/associated pneumonia (VAP). Due to the components of colostrum, there may be incentives towards early administration for preterm infants. An extensive literature review was done using ProQuest, ScienceDirect, and PubMed. Only meta-analyses and experimental studies were used. The search included the keywords 'colostrum and preterm' and 'colostrum and necrotizing enterocolitis'. The initial search generated 13,543 articles and was narrowed to 25 articles through comprehensive inclusion and exclusion criteria. There were significantly higher levels of Lactobacillus and Bifidobacterium in pre-term infants given colostrum and a decrease in Moraxellaceae and Staphylococcaceae . Salivary secretory IgA increased following oral colostrum administration in pre-term infants along with downregulation of interleukin (IL)-1b and IL-8. It was also observed that tumor necrosis factor (TNF)-a, and interferon-gamma (IFN-g) were significantly higher in the control group. There was no significant difference in the incidence of LOS, NEC, or VAP between pre-term infants receiving colostrum and those who did not. Secondary outcomes such as time to full enteral feeding were improved in pre-term infants receiving oral colostrum in addition to reduced hospital stays. Lastly, there was no difference in mortality between pre-term infants that received colostrum compared to those who did not., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Slouha et al.)

Aim: The aim of this study was to evaluate physical growth of very low birth weight (VLBW) preterm babies at a mean age of three years and to investigate the factors which affected growth. Material and Methods: The factors including maternal problems, prenatal problems, early neonatal problems, nutrition, familial socioeconomical status and presence of chronic disease which affected catch-up growth in terms of height and weight in VLBW infants followed up in the neonatal intensive care unit (NICU) of our hospital were examined. The target height formula was used in assessment of growht in height and the contribution of genetic properties was investigated. The points of the subjects on the growth curve were plotted according to the Percentile Curve of the Turkish Children prepared by Neyziet al. The states of the subjects with and without intrauterine growth retardation (were compared. The study was intitiated after obtaining approval from the ethics committeee of our hospital (100/25.10.2005). Results: One hundred and seventeen preterm babies (57 females and 60 males) with a mean adjusted age of 35.8±2.39 80 of whom were appropriate for gestational age (AGA), 28 of whom were symmetrical (small gestational age) SGA and 9 of whom were asymmetrical SGA were included in the study. The mean gestational age (GA) was found to be 31±2.16 weeks and the mean birth weight (BW) was found to be 1271±226 g. The mean current height was found to be 92.06±4.90 cm. The mean weight was found to be 12.98±1.94 kg. The mean target height was calculated to be 163.66±8.1 cm (157.20 cm for the girls and 170.20 cm for the boys). It was found that 15 preterm babies (12.8%) could not achieve the target height (girls: 6%, boys: 6.8%). The risk factors related with failure to achieve target height were found to include ventilator treatment, presence of chronic disease, advanced stage intracranial bleeding (ICB), posthemorrhagic hydrocephalus, absence of breastfeeding, failure to sit at the table with the family and malnutrition. The maternal age, early rupture of membranes (PROM), preeclampsia, smoking, early neonatal problems, gender, being AGA and SGA, gestational age, birth weight and socioeconomical level were statistically insignificant in terms of achieving target height (p>0.05). Conclusions : If very low birth weight preterm babies have no chronic disease and condition leading to neurodevelopmental retardation and if they are breastfed early and continuously (0-24 months), they can achieve catch-up growth similar to term babies. In examination of growth in terms of height, using target height may be more appropriate to shown the genetic potential. [ABSTRACT FROM AUTHOR]

Aim: This research was conducted to determine the effect of the feeding methods of spoonfeed and feeding by bottle on the time of switching to full breastfeeding and sucking success. Material and Methods: The study was conducted between September 2013 and January 2014 at the primary level of the neonatal intensive care clinics in two hospitals found in the eastern region of Turkey in a comperative and descriptive fashion. The population was composed of preterm babies who received treatment and care in these clinics during the period when the study was conducted and who met the criteria of the investigators. Without selecting the sample group the whole of the population was studied. The study was conducted with 37 preterm babies who were spoonfed and 35 preterm babies who were fed by bottle. The data were collected with “information form introducing preterm baby”, “follow-up form for preterm baby” and “LATCH Breastfeeding Assessment Tool”. The data were evaluated using percentage distribution, mean, chi-square test, t-test in independent groups, Cronbach alpha coefficient and McNemar analysis. Ethics committee approval was obtained from Atatürk University Faculty of Health Sciences (dated 08.05.2013) and official approvals were obtained from the related hospitals to conduct the study. Results: A significant difference was found between the mean times of switching to full breastfeeding from the first breast - feeding in preterm babies in the spoonfed group and bottle fed group in favour of the spoodfed group (p<0.05). No significant difference was found between the two groups in terms of starting breastfeeding, switching to full breastfeeding, the mean weights at discharge and the mean times of discharge (p>0.05). While no significant difference was found between the groups in terms of mean LATCH scores measured initially (p>0.05), the mean scores in the spoonfed group at the second and final measurement were found to be statistically significantly higher (p<0.05). Conclusions : It was found that the preterm babies in whom spoonfeeding was used as a supportive method in addition to breast - feeding switched to full breastfeeding in a shorter time compared to the babies who were fed by bottle and their sucking success was at a better level. [ABSTRACT FROM AUTHOR]

Aim: Mechanical ventilation is an invasive method and causes to important problems in the respiratory tract and lung parenchyma. The objective of our study was to investigate if administration of early surfactant and nasal continuous positive airway pressure (nCPAP) was superior to delayed surfactant administration and mechanical ventilation. Material and Methods: The study was conducted in the Van 100th Year University, Medical Faculty Hospital, Neonatal Intensive Care Unit. One hundred and nine infants with respiratory distrss syndrome (RDS) with a gestational age of 32 weeks and/or below were included in the study. Surfactant was given to 61 infants in the delivery room or intensive care unit and subsequently nCPAP was administered. Surfactant was administered in 48 infants in the control group and mechanical ventilation was inititated subsequently. Informed consent was obtained from the relatives of all patients and ethics committee approval was also obtained (Approval number: 03.02.2011/15). Results: There was no statistically significant difference between the two groups in terms of gestational age, birth weight, gender, height and head circumference measurements (p>0.05). The mean hospitalization time in the patients in the study group was 24.4±17.8 days, whereas the mean time of nCPAP was 28.4 (4-120) hours. In the study group, intracranial hemorrhage was found with a rate of 27.85%, bronchopulmonary dysplasia was found with a rate of 4.91%, pneumothorax was found with a rate of 3.27%, necrotizing enterocolitis was found with a rate of 3.27%, patent ductus arteriosus was found with a rate of 16.39, sepsis was found with a rate of 22.95% and retinopathy of prematurity was found with a rate of 1.63%. No statistically significant difference was found between the study and control groups in terms of the rates of complications. During the follow-up period, 17 (27.86%) patients were lost. The length of stay on mechanical ventilation in the study group was found to be statistically significantly shorter compared to the control group (p<0.05). Conclusions : In our study, it was observed that administration of early surfactant and nCPAP in treatment of preterm newborns with a diagnosis of RDS markedly decreased the lenght of stay on mechanical ventilation, but had no significant impact on morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: The AIO-parenteral nutrition is essential for patient with limited venous access e.g. premature infants. Until now there is still conflicting data related to the stability of all in-one parenteral nutrition. Objectives: The aim of this study is to examine the physical stability and sterility of AIO-PN during being stored at room and cold temperature. Materials and Methods: AIO-PN contains dextrose, amino acid, lipid, sodium chloride, magnesium sulphate, potassium chloride, calcium gluconate and also vitamin. Formulation of AIO-PN is prepared based on guidance of nutrition for preterm baby with weight of 1000g and with three days of age. The formulation of AIO-PN then is stored at room temperature (25.43 °C ± 0.54) and cold temperature (6,2 °C ± 2.04). Results: Based on the experiments, all formulas confidently meet the sterile criteria, where there is no microbial growth in the formula within 7 days. During 7 days, the droplet size of all formulas were under the range (<500nm) with a good range of pH. However, during being stored under room temperature, AIO-PN showed the creaming starting at day 3 and the discoloration starting at day 5. We found that there is no such physical changes of the formula within 7 days under cold temperature. Conclusion: This research confirmed that AIO-PN being stored at room temperature cannot be used starting at the day 3, but the formulation storage under cold temperature remains accepted within 7 days. [ABSTRACT FROM AUTHOR]