Enteral Feeding in Premature Infants

Neonatology practice has seen remarkable advancements in the past three decades. This has enabled the survival of premature infants born at smaller gestational weeks. Accordingly, the relatively high premature survival rate has lead to an increase in the incidence and severity of short-medium and long term morbidities. A critical approach in preventing such morbidities in premature infants is well-planned nutritional management. Application of proper feeding models that consider current premature problems as well as personal dynamics will provide significant short and long-term advantages for the infants' progression throughout life. This article discusses practical applications such as identifying the needs of premature infants during extrauterine life, choices in feeding practice, and adaptation of necessary interventions for current problems faced by infants

Results of newborn hearing screening in tepecik education and research hospital

Objectives: This study aimed to emphasize the significance of newborn hearing screening for detecting congenital hearing loss within the first 6 months of birth. Methods: The data of 5399 infants born in the Izmir University of Health Science Tepecik Training and Research Hospital, Izmir, Turkey, and screened for hearing between January 2018 and December 2018 was presented in this study. All term, preterm, and asphytic newborn deliveries in the aforementioned hospital were included. The hearing screening was conducted using the auditory brainstem response (ABR) method. The first step involves the evaluation of the results of all infants before being discharged from the hospital and, the second step involves infants with problems in the results of their first step and subjected to advance testing. Results: This study included 5399 infants in the first and second steps. Of these infants, 5231 (96.9%) passed the first step. Consequently, 136 (2.5%) of the 168 infants evaluated in the second step passed it, while 32 (0.6%) of the infants were evaluated again in more detail in the third step. Six (0.2%) of the infants were not called for further evaluation, and 5 (0.2%) were diagnosed with advanced/very advanced bilateral sensorineural hearing loss. Conclusion: Congenital hearing loss negatively affects the child's language, speaking, communication, and cognitive skills. Newborn hearing screening has an important place in the early diagnosis of congenital hearing loss. The number of diagnosed and treated babies suffering from hearing loss is increasing as the number of hearing screening tests becomes widespread in Turkey. © Anatolian Journal of Family Medicine 2021

A Population Model of Time-Dependent Changes in Serum Creatinine in (Near)term Neonates with Hypoxic-Ischemic Encephalopathy During and After Therapeutic Hypothermia

The objective was to apply a population model to describe the time course and variability of serum creatinine (sCr) in (near)term neonates with moderate to severe encephalopathy during and after therapeutic hypothermia (TH). The data consisted of sCr observations up to 10 days of postnatal age in neonates who underwent TH during the first 3 days after birth. Available covariates were birth weight (BWT), gestational age (GA), survival, and acute kidney injury (AKI). A previously published population model of sCr kinetics in neonates served as the base model. This model predicted not only sCr but also the glomerular filtration rate normalized by its value at birth (GFR/GFR0). The model was used to compare the TH neonates with a reference full term non-asphyxiated population of neonates. The estimates of the model parameters had good precision and showed high between subject variability. AKI influenced most of the estimated parameters denoting a strong impact on sCr kinetics and GFR. BWT and GA were not significant covariates. TH transiently increased sCr in TH neonates over the first days compared to the reference group. Asphyxia impacted not only GFR, but also the sCr synthesis rate. We also observed that AKI neonates exhibit a delayed onset of postnatal GFR increase and have a higher sCr synthesis rate compared to no-AKI patients. Our findings show that the use of sCr as marker of renal function in asphyxiated neonates treated with TH to guide dose selection for renally cleared drugs is challenging, while we captured the postnatal sCr patterns in this specific population. Graphical Abstract: [Figure not available: see fulltext.].</p

A Turkish case of congenital chloride diarrhea with SLC26A3 gene (c.2025-2026insATC) mutation: Diagnostic pitfalls

Congenital chloride diarrhea is a rare autosomal recessively inherited disorder characterized by impairment of Cl-/HCO3- exchange in an otherwise normal distal ileum and colon. Infrequency of congenital chloride diarrhea makes diagnostics difficult. The typical presentation is watery Cl- rich diarrhea, hypochloremia, hypokalemia, metabolic alkalosis and failure to thrive. This is a report of a Turkish female infant who was falsely diagnosed with Bartter syndrome when she was two months old. Ibuprofen was commenced at that time. However, severe watery diarrhea, dehydration, failure to thrive, abdominal distention, and electrolyte abnormalities persisted. She was diagnosed with congenital chloride diarrhea based on high fecal Cl- level and SLC26A3 gene c.2025-2026insATC mutation at the age of eight months. Oral NaCl and KCl supplementation was started. Our patient is now 26 months old. Her growth and development are normal. Early diagnosis and treatment are essential for normal growth and development and prevention of other severe complications of congenital chloride diarrhea

Acute suppurative parotitis in early neonatal period Erken yenidoğan döneminde akut süpüratif parotit

Acute neonatal suppurative parotitis (NSP) is a rare condition, characterized by parotid swelling and other local inflammatory signs. Common predisposing conditions include dehydration, Stensen’s duct stasis, local trauma, immune suppression and prematurity. Staphylococcus aureus is the most common pathogen isolated from infants with NSP. Here, we present a case of unilateral suppurative parotitis successfully treated with ampicillin in a 7-day-old infant. In conclusion, acute NSP should be kept in mind in cases of swelling and tenderness in parotid gland during neonatal period

Effect of partially hydrolyzed synbiotic formula milk on weight gain of late preterm and term infants—a multicenter study

Introduction: Data on the effectiveness of hydrolyzed infant formula containing both pre- and probiotics (synbiotic formula) on the growth of infants is still scarce. This retrospective study was designed to evaluate the effect of a partially hydrolyzed synbiotic formula on growth parameters and the possible occurrence of major gastrointestinal adverse events or morbidities in infants born via cesarean section (C-section) delivery. Methods: C-section-delivered term and late preterm infants who received either partially hydrolyzed synbiotic formula, standard formula, or maternal milk and followed at seven different hospitals from five different regions of Turkey, during a 1-year period with a minimum follow-up duration of 3 months were evaluated retrospectively. All the included infants were evaluated for their growth patterns and any kind of morbidity such as diarrhea, constipation, vomiting, infection, or history of hospitalization. Results: A total of 198 infants (73 in the human milk group, 61 in the standard formula group, and 64 in the partially hydrolyzed synbiotic formula group) reached the final analysis. The groups were similar regarding their demographic and perinatal characteristics. No difference was observed between the three groups regarding gastrointestinal major side effects. Growth velocities of the infants in the human milk and partially hydrolyzed synbiotic formula groups during the first month of life were similar whereas the weight gain of infants in the standard formula group was significantly less than these two groups (p < 0.001). Growth velocities were similar among the three groups between 1st and 3rd months of age. Discussion: A partially hydrolyzed synbiotic formula provided better weight gain in late-preterm and term infants who were delivered via C-section delivery compared to the standard formula during the first month of life. This weight gain was similar to the infants receiving exclusively human milk. This difference was not observed in length and head circumference gain. No difference was observed in any of the parameters during the 1st–3rd months of age. Specially formulated partially hydrolyzed synbiotic formulas may reverse at least some of the negative impacts of C-section delivery on the infant and help to provide better growth, especially during the early periods of life

Epidemiologic and clinical characteristics of neonates with late-onset COVID-19: 1-year data of Turkish Neonatal Society

The literature on neonates with SARS-CoV-2 is mainly concerned with perinatal cases, and scanty data are available about environmentally infected neonates. To fill knowledge gaps on the course and prognosis of neonatal cases, we analyzed 1-year data from the Turkish Neonatal Society in this prospective cohort study of neonates with postnatal transmission. Data from 44 neonatal intensive care units (NICUs), of neonates with positive RT-PCR results at days 5-28 of life, were extracted from the online registry system and analyzed. Of 176 cases, most were term infants with normal birth weight. Fever was the most common symptom (64.2%), followed by feeding intolerance (25.6%), and cough (21.6%). The median length of hospitalization was 9 days, with approximately one quarter of infants receiving some type of ventilatory support. Myocarditis (5.7%) was the most common complication during follow-up. Among the clinical findings, cough (odds ratio [OR]: 9.52, 95% confidence interval [CI]: 4.17-21.71), tachypnea (OR: 26.5, 95% CI: 9.59-73.19), and chest retractions (OR: 27.5, 95% CI: 5.96-126.96) were associated with more severe clinical disease. Also, there were significant differences in the C-reactive protein level, prothrombin time (PT), partial thromboplastin time, international normalized ratio, and days in the NICU (p = 0.002, p = 0.012, p = 0.034, p = 0.008, and p < 0.001, respectively) between patients with mild-moderate and severe-critical presentations. A PT above 14 s was a significant predictor of severe/critical cases, with a sensitivity of 64% and specificity of 73%