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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]

Background Growth in the first year of life depends primarily on nutrition. Currently, the infant feeding practices of term babies are being extrapolated for preterms. While extrapolating, it is not clear if corrected age (CA) or chronological age should be used. In preterm infants, born ≤34 week gestation age, this difference may be more than 6 weeks. We studied the growth parameters and body composition of preterm infants born ≤34 week gestation age as compared to that of term infants at 12–13 months CA. Methods The growth of 99 term infants and 170 preterm infants born ≤34 weeks was evaluated at 12–13 months CA. The anthropometric measurements, body mass index (BMI) and skin fold thickness (SFT) at four sites (biceps, triceps, subscapular and suprailiac) were compared in the two groups. The sum of the SFT was taken as a marker of fat mass. Result At 12–13 months CA, preterm infants had significantly less weight, length and BMI as compared to term babies. The weight and BMI for age Z -scores, weight for length Z -scores and fat mass were also significantly less in preterm babies. Conclusion The anthropometry measures in preterms (<34 weeks) at 12–13 months CA were significantly lower than that of term infants. In our study population, preterms did not catch up in growth in the first year even when the CA is used for comparison. The causes could be multifactorial and need to be studied further. [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 (

Objective: This study examined the effect of breast milk on oral care practices in neonatal intensive care units. Methods: This study involved 64 preterm infants (intervention/breast milk: 32, control/distilled water: 32) and was carried out with a prospective, parallel, randomized controlled design. The "Newborn Oral Health Assessment Tool (NOHAT)" was used to assess oral care. The Mann-Whitney U test, continuity correction test, Fisher's exact test, independent-samples T test, and Wilcoxon signed ranks test were used to analyze the data. Results: Examining the oral care performed using breast milk and distilled water with NOHAT scores, it was determined that there was a significant difference in the intervention group ( p < 0.05). Conclusions: It is recommended to use breast milk for oral care.

Objective  According to the most recent metanalysis, the best way to establish safe enteral feeding in preterm babies using nasogastric or orogastric tubes is still not well understood. This study aimed to determine the effects of bolus nasal tubes versus bolus orogastric tubes on the time required to reach full enteral feeding in preterm infants, as well as to compare the incidence rates of adverse events including nonintentional removal or displacement of the feeding tube, aspiration pneumonia/pneumonitis, apnea, necrotizing enterocolitis, gastric residual, and growth parameters between the studied cohort of preterm infants. Study Design  We conducted an unblinded pilot randomized clinical trial on hemodynamically stable preterm infants (>28 weeks) recruited from level 2 neonatal intensive care unit at Mansoura University Children's Hospital from June 2015 to May 2017. Results  Our study included 98 stable preterm infants with mean gestational age (orogastric group: 33.27 ± 1.08, nasogastric group: 33.32 ± 1.57) and mean birthweight (orogastric group: 1,753.3 ± 414.51, nasogastric group: 1,859.6 ± 307.05). Preterm infants who were fed via bolus nasogastric tube achieved full enteral feeding in a significantly shorter duration compared with the infants fed via bolus orogastric tube. The incidence rates of aspiration and feeding tube displacement were significantly higher in the bolus orogastric tube group compared with the bolus nasogastric tube group. There was no difference in the incidence rates of apnea, necrotizing enterocolitis, bradycardia, oxygen desaturation, and gastric residual in both groups. Conclusion  Preterm infants without any respiratory support receiving bolus nasogastric tube feeding achieved full enteral feeding significantly sooner than those receiving bolus orogastric tube feeding. Additionally, bolus nasogastric tube feeding had a lower incidence of aspiration, tube displacement, and the infants regained birthweight more quickly than those receiving orogastric tube feeding. Key Points Preterm babies achieve full entral feeds sooner by nasogastric tubes than orogastric tubes. Incidence of nasogastric tube displacement and aspiration is less than orogastric tube. Infants on nasogastric tubes feeding regain birth weight quicker than those fed by orogastric tubes. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

The diagnostic and therapeutic advances in the Neonatology area have resulted in a significant decrease in the mortality rate of preterm newborns and, consequently, an increase in the morbidity of these babies. The concern with the evaluation of its evolution has become increasingly evident, requiring strategies to reduce the repercussion of possible compromises and to increase the quality of life of these children. This study aims to investigate about the main instrument for assessing the development and follow-up of preterm babies. A systematic search was conducted in the main databases, consulting articles and books that provide detail on studies, evaluations and instruments. It was found that developmental assessment and follow- up are performed through screening and developmental diagnosis tests that examine the most relevant aspects in the various age groups. Twenty-one evaluation instruments for preterm development and follow-up were identified, which can be divided into three categories: the comprehensive, the specifics and the neurological and neurobehavioral exams. Studies show that the Bayley Scales of Infant Development - Bayley III (BSID III) are the most widely used scales for assessing the preterm. It is a comprehensive assessment tool that points out the strengths and weaknesses as well as the baby's competencies. The scales are most indicated for early identification of risk for development, elaboration of intervention projects and to provide guidance and information to parents about the evolution of the child, whose follow-up should be continuous and systematic, carried out by an interdisciplinary team. [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]

Aims and objectives: To determine the comparative efficacy of developmental care versus standard care for reducing pain and stress in preterm infants during examinations for retinopathy of prematurity (ROP). Background: ROP examinations are routinely performed in neonatal intensive care units to detect these lesions. Pain scores recorded during and after eye examinations have revealed physiological and behavioural manifestations of pain and stress. Design: A randomised crossover trial was conducted. Methods: Fourteen preterm infants were evaluated. The modified developmental care bundle included environmental modifications, positioning and containment, oxygen supplementation, interaction and approach and cue‐based individual care, which were applied before, during and after the ROP examination. The primary outcomes were obtained from pain and stress scores using the premature infant pain profile‐revised (PIPP‐R) and a behavioural evaluation. The secondary outcomes were recovery time to the baseline of the vital signs and oxygen saturation. Results: Statistical significances were found in the care type comparison (p = 0.013), time comparison (p < 0.001) and type‐by‐time interaction (p = 0.005) in the PIPP‐R, and also in the care type comparison (p < 0.001), time comparison (p < 0.001) and type‐by‐time interaction (p = 0.001) in the behavioural evaluation scores using a generalised estimating equation (GEE) analysis. Recovery time for the developmental care (N = 13, mean = 8.6 ± 11.5 min, 95% CI = 1.68–15.57) was significantly shorter than for the standard care (N = 11, mean = 25.5 ± 20.8 min, 95% CI = 11.45–39.46), which was found to be statistically significant according to the Wilcoxon signed‐rank test (N = 11, p = 0.003). Conclusions: A bundled developmental care intervention significantly reduced pain and stress responses and the time needed for infants to recover their physiological status following the procedure. Relevance to clinical practice: Since the results show the benefits of developmental care in an ROP examination, it can be the practical evidence basis by which to develop a standard of procedure or guideline for clinical practice. [ABSTRACT FROM AUTHOR]

Background: Pregnant women are exposed to a wide range of medications, including antibiotics. Although antibiotics are many times absolutely important to prevent and treat infections as well as prevent premature labor, their overuse poses a threat to the growing fetus as well as the mother. The ill-effects of antibiotic over-use and having them without prescription can cause developmental abnormalities in the fetus, known as teratogenicity. They could also cause maternal allergic reactions, as well as long term effects on the child's immunity and growth in future. Aim: In this study we aim to study the knowledge and attitude of pregnant women toward usage of antibiotics and risk of preterm baby. Methodology: We conducted a cross-sectional study, of 2470 women who presented in king Abdulaziz University, Jeddah, Saudi Arabia from April 2017 to December. Conclusion: We noted that most mothers were aware of that they must not take antibiotics without prescription while pregnant, especially for ailments such as common cold and abdominal pain. However, the pharmacists must be regulated for unnecessary over-dispatching of antibiotics, especially without confirming the pregnancy status of the costumers. [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.)

Objective: To replace 75 % of formula feeds by donor human milk (DHM) feeds in the first three days of life in neonates admitted to the neonatal intensive care unit (NICU).Methods: It was a prospective observational study in the NICU in a resource-limited set up in India. All neonates admitted during December 2013 and August 2014, were included in the study without any exclusion. Expressed DHM was administered within 2-3 h of manual expression without refrigeration or pasteurization. It was left standing at room temperature in a covered stainless steel container prior to use. Prospective entries of 2 hourly neonatal feeds, for first 3 d of life, (36 entries) were made in the charts. Main outcome was the desired percentage replacement of formula feeds.Results: Total 168 neonates were admitted to the NICU over the study period. Their median [Interquartile range (IQR); Range] gestation and birth weight was 37 (36, 38; 24-42) wk and 2300 (2100, 2700; 500-2950) g respectively. A total of 4136/6027 (68.6 %) charted feeds were of human milk and 1891(31.4 %) were of formula milk. Thus, 68.6 % of formula feeds were replaced by DHM. Neonates weighing ≤2 kg were at a lower risk of getting >25 % formula feeds.Conclusions: A simple low cost method was effective in replacing a significant proportion of formula feeds by DHM in the first three days of life for neonates in a resource poor set up. [ABSTRACT FROM AUTHOR]

Surgery on an infant with factor VII deficiency is a risky affair, more so when the infant is premature and low birth weight. A 2-month-old infant with factor VII deficiency presented with obstructed right inguinal hernia. He had features suggestive of intestinal obstruction. The hernia was reduced, and the infant was initially managed conservatively. He was operated upon after 72 h under cover of recombinant activated factor VII concentrate to control the bleeding and was closely monitored for bleeding in the postoperative period. After confirming optimal wound healing and no recurrence on 6-month follow-up, contralateral herniotomy for a reducible inguinal hernia was performed at the age of 9 months. Even on thorough literature search, no references have been found on the management of an infant with this rare coagulation disorder undergoing herniotomy during early infancy. Hence, the case is being reported. [ABSTRACT FROM AUTHOR]