Term Baby Nutrition

The ideal feeding method for newborn babies is breastfeeding by their mother. In cases where this is not possible, giving the mother's expressed milk, donor breast milk, or the use of formulas should be applied. The World Health Organization recommends breastfeeding only for the first six months and breastfeeding with complementary foods after the sixth month until age two and beyond. The content of breast milk is regulated according to the baby's needs, and each mother produces the most suitable milk for her baby. The nutrients, protective factors, living cells, growth factors, pre and probiotics in breast milk are miraculous. With the proper breastfeeding technique, the baby suckles effectively, sufficient milk production continues, and the possibility of problems such as nipple cracking and refusing to suckle is much reduced. To prevent mothers from worrying unnecessarily and to be able to breastfeed their babies adequately, the mother should be well informed about the signs of hunger, satiety, and sufficient milk supply. Formulas are used in feeding infants in the presence of insufficient or absent breast milk or in the presence of certain metabolic diseases. Standard formulas are suitable for term infants with normal gastrointestinal system functions. It can also be given to premature babies whose gestational age is over 34 weeks and birth weight is over 2,000 g. Breastfeeding should be discontinued if the mother has human immunodeficiency virus infection or if the baby has galactosemia or a similar metabolic disease

Gestasyon haftasına göre küçük olmak prematüre bebeklerde nörogelişimsel sonuçları olumsuz etkiler

Introduction: There is insufficient data on neurodevelopmental outcomes of infants small for gestational age (SGA) with ≤30 weeks of gestation. The aim of our study was to compare the neurodevelopmental outcomes of preterm infants who are ≤30 weeks, in terms of being SGA or appropriate for gestational age (AGA). Materials and Methods: The data of infants who were born at ≤30 GW, were evaluated retrospectively. Neurological examinations and developmental assessment using Bayley Scales of Infant Development 2nd edition was performed at the corrected age of 18-24 months. Results: The data of 228 infants of whom 65 were SGA and 163 were AGA was evaluated in terms of neurodevelopment at the corrected age of 18-24 months. The mean gestational age (GA) was 28.4±1.1 in both groups (p=0.82) and the mean BW was 810±135 g in the SGA group and 1175±183 g in the AGA group (p<0.001). The SGA group had significantly lower Mental Development Index (p=0.01) and Psychomotor Development Index (p<0.001). In multivariate regression analysis, SGA was identified as an independent risk factor for neurodevelopmental delay (RR: 2.27; p=0.02). Conclusion: Being SGA is a risk factor for neurodevelopmental impairment of preterm infants (≤30 GW).Giriş: Gestasyon haftasına göre küçük (SGA) olan ≤30 hafta bebeklerin nörogelişimsel sonuçları hakkında yeterli veri bulunmamaktadır. Çalışmadaki amacımız SGA ve gestasyon haftasına göre normal (AGA) doğum ağırlığına sahip ≤30 hafta prematüre bebeklerde nörogelişimsel sonuçları karşılaştırmaktır. Gereç ve Yöntem: Düzeltilmiş 18-24. aylarda nörolojik muayeneleri ve “Bayley Bebekler için Gelişimsel Değerlendirme Ölçeği II” ile gelişimsel değerlendirmeleri yapılan ≤30 hafta prematüre bebeklerin verileri retrospektif olarak değerlendirildi. Bulgular: Düzeltilmiş 18-24. ayda SGA (n=65) ve AGA (n=163) gruplarında toplam 228 bebek nörogelişimsel açıdan değerlendirildi. SGA ve AGA grubunda ortalama gestasyon yaşı (sırasıyla 28,4±1,1 ve 28,4±1,1, p=0,82) ve doğum ağırlığı (sırasıyla 810±135 ve 1175±183 g, p<0,001) olarak tespit edildi. Nörogelişimsel değerlendirmede, SGA grubunda bilişsel ölçek puanı (p<0,01) ve hareket ölçek puanı (p<0,001) anlamlı olarak daha düşük bulundu. Çok değişkenli lojistik regresyon analizinde SGA’nın nörogelişimsel gerilik için bağımsız risk faktörü olduğu saptandı (RR: 2,27, p=0,02). Sonuç: Prematüre bebeklerin (≤30 hafta) gestasyon haftasına göre düşük doğum ağırlığı ile doğmaları, nörogelişimsel gerilik açısından risk faktörüdür

Aşırı düşük doğum ağırlıklı bebeklerde erken dönem solunum desteğinin nörogelişimsel sonuçlarla ilişkisinin incelenmesi

Objective: This study investigated relationship between early respiratory support and neurodevelopmental outcomes in extremely low birth weight infants. Methods: Our study included infants born before 32 weeks’ gestation at a birth weight of 750-1000 g that were admitted to the neonatal intensive care unit and underwent a neurodevelopmental evaluation at the corrected age of 24 months. Two hundred-twelve infants were divided into 3 groups by determining the predominant type of respiratory support required in the first 3 days of life. Infants who received supplemental oxygen therapy group 1, those who received nasal continuous positive airway pressure and/or nasal intermittent mandatory ventilation were in group 2, and intubated infants were included in group 3. Differences between the groups and relationships between neurodevelopment scores [mental development index (MDI); psychomotor development index (PDI)] were examined. Results: The patients mean birth weight was 887±73 g and mean gestational age was 27±1.9 weeks. MDI and PDI values were below 70 in the intubated patient group (68 and 66, respectively). Patients who received noninvasive ventilation or supplemental oxygen therapy for the first 3 days of life had significantly higher MDI and PDI values. In terms of morbidities of prematurity, intubated infants had higher rates of bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular hemorrhage, and retinopathy of prematurity. Conclusion: Restrictive invasive ventilation policies can be applied to preterm infants and may improve neurodevelopmental outcomes. The results of this study suggest that every additional day of invasive mechanical ventilation should be avoided if possible.Amaç: Bu çalışmanın amacı aşırı düşük doğum ağırlıklı bebeklerde erken dönem solunum desteği ile nörogelişimsel sonuçların ilişkisini araştırmaktır. Yöntem: Yenidoğan yoğun bakım ünitesinde yatmış, doğum ağırlığı 750-1000 gram arasında ve gebelik haftası 32 haftadan küçük, çalışma sırasında düzeltilmiş 24 aylık nörogelişim muayenesini 2018 Kasım ayı itibarı ile tamamlamış bebekler çalışmaya dahil edildi. İki yüz on iki bebeğin yaşamının ilk üç gününde hangi solunum desteğine ihtiyaç duyduğu belirlenerek üç ayrı grup oluşturuldu. Ağırlıklı serbest oksijen alan bebekler 1., nazal sürekli pozitif hava yolu basıncı ve/veya nazal aralıklı zorunlu ventilasyon alanlar 2., entübe izlenen bebekler ise 3. gruba alınarak gruplar karşılaştırıldı. Bu üç grup arasındaki farklar ve nörogelişim skorları [mental gelişim indeksi (MDI); psikomotor gelişim indeksi PDI)] arasındaki ilişkiler incelendi. Bulgular: Hastaların ortalama doğum ağırlığı, 887±73 gr, gebelik haftası 27±1,9 hafta idi. Mekanik ventilatörde entübe izlenen hastaların MDI ve PDI değerleri <70 idi (sırasıyla; 68, 66) idi. İlk üç günde ağırlıklı olarak non-invaziv modda veya serbest oksijen desteği ile takip edilen hastaların MDI ve PDI değerleri daha yüksek saptandı ve istatistiksel olarak anlamlı kabul edildi. Prematüre morbiditeleri açısından analiz edildiğinde ise entübe takip edilen grupta bronkopulmoner displazi, patent duktus arteriozus, intraventriküler hemoraji ve prematüre retinopatisi daha yüksek oranda bulundu. Sonuç: Erken doğmuş bebeklerde kısıtlayıcı invaziv ventilasyon politikası uygulanabilir ve nörogelişimsel sonuçları iyileştirebilir. Bu çalışmanın sonuçları göz önüne alındığında; ilave her invaziv mekanik ventilasyon günü mümkün olduğunca önlenmelidir

Effects of cord blood vitamin D levels on the risk of neonatal sepsis in premature infants

PurposeVitamin D plays a key role in immune function. Vitamin D deficiency may play a role in the pathogenesis of infections, and low levels of circulating vitamin D are strongly associated with infectious diseases. In this study, we aimed to evaluate the effects of low vitamin D levels in cord blood on neonatal sepsis in preterm infants.MethodsOne hundred seventeen premature infants with gestational age of <37 weeks were enrolled. In the present study, severe vitamin D deficiency (group 1) was defined as a 25-hydroxyvitamin D (25(OH)D) concentration <5 ng/mL; vitamin D insufficiency (group 2), 25(OH)D concentration ≥5 ng/mL and <15 ng/mL; and vitamin D sufficiency (group 3), 25(OH)D concentration ≥15 ng/mL.ResultsSixty-three percent of the infants had deficient levels of cord blood vitamin D (group 1), 24% had insufficient levels (group 2), and 13% were found to have sufficient levels (group 3). The rate of neonatal sepsis was higher in group 2 than in groups 1 and 3.ConclusionThere was no significant relationship between the cord blood vitamin D levels and the risk of neonatal sepsis in premature infants

Comparison of Mortality and Morbidities in Small and Appropriate For Gestational Age Preterm Infants

Aim:To compare morbidity and mortality in very low birth weight premature infants (VLBW) with small (SGA) and appropriate (AGA) for gestational age.Materials and Methods:The records of infants with VLBW who were followed up in our unit between 2013 and 2017 were retrospectively analyzed. SGA was defined as the birth weight being below the 10th percentile compared to the gestational week and the AGA birth weight being between the 10th and 90th percentile. A total of 96 SGA infants were identified as the study group and 204 AGA infants randomly selected and matched with the gestational week of the study group. Infants with major congenital anomalies and lack of data were excluded from the study.Results:The mean gestational age (28.3 ± 1.1–28.3 ± 1.2, p = 0.94) and birth weight (769 ± 144–1132 ± 190 g, <0.001, respectively) were in the SGA and AGA group respectively. Preeclampsia and cesarean delivery were significantly more frequent in the SGA group, whereas APGAR score was lower and CRIB score was significantly higher. The frequency of surfactant requirement, moderate-severe bronchopulmonary dysplasia, spontaneous intestinal perforation, periventricular leukomalacia, premature osteopenia, postnatal growth retardation, mortality and feeding intolerance were found to be significantly higher in SGA infants. Similarly, the duration of invasive ventilation and additional oxygen requirement and hospital stay were longer in SGA infants.Conclusion:The birth of premature babies with low birth weight according to gestational age causes premature morbidity and mortality

Turkish Neonatal Society Guideline on neonatal encephalopathy

WOS: 000484450300004PubMed ID: 31236017Neonatal encephalopathy is a major cause of neonatal mortality and morbidity. Therapeutic hypothermia is standard treatment for newborns at 35 weeks of gestation or more with intrapartum hypoxia-related neonatal encephalopathy. Term and late preterm infants with moderate-to-severe encephalopathy show improved survival and neurodevelopmental outcomes at 18 months of age after therapeutic hypothermia. Therapeutic hypothermia can increase survival without increasing major disability. Neonates with severe neonatal encephalopathy remain at risk of death or severe neurodevelopmental impairment. This guideline was prepared by the Turkish Neonatal Society to standardize the management of neonatal encephalopathy throughout the country

Turkish Neonatal Society Guideline on neonatal encephalopathy

WOS: 000484450300004PubMed ID: 31236017Neonatal encephalopathy is a major cause of neonatal mortality and morbidity. Therapeutic hypothermia is standard treatment for newborns at 35 weeks of gestation or more with intrapartum hypoxia-related neonatal encephalopathy. Term and late preterm infants with moderate-to-severe encephalopathy show improved survival and neurodevelopmental outcomes at 18 months of age after therapeutic hypothermia. Therapeutic hypothermia can increase survival without increasing major disability. Neonates with severe neonatal encephalopathy remain at risk of death or severe neurodevelopmental impairment. This guideline was prepared by the Turkish Neonatal Society to standardize the management of neonatal encephalopathy throughout the country

Comparing neonatal respiratory morbidity in neonates delivered after 34 weeks of gestation with and without antenatal corticosteroid

Objective: To investigate the effect of antenatal corticosteroid prophylaxis on neonatal respiratory morbidity between 34 and 37 weeks of gestation