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Neonatology, العنوان, Cairo (2026)

14/03/2019

Salmon patch
The naevus simplex is very common and occurs in about 40% of all newborns. They are usually small flat patches of pink or red skin with poorly defined borders. They are commonly found at the nape of the neck (stork bite, erythema nuchae), on the forehead between the eyebrows (angel's kiss) or on the eyelids. They become more intense in colour and noticeable when the child is crying

04/02/2019

pacifier use
Pacifier use has previously been discouraged in breastfed infants because studies have demonstrated
an association with less successful breastfeeding. However, pacifier use has also been shown
to be associated with a reduction in the incidence of sudden infant death syndrome (SIDS). Thus it is
now recommended that all formula-fed infants be given a pacifier at nap or at bedtime. For breastfeeding
infants the use of a pacifier is also recommended at bedtime, but its use should not begin
until breastfeeding has been well-established, which is typically 3 to 4 weeks after birth.

04/02/2019

vitamin D supplementation
Although breast milk is the best nutritive substance for infants, studies have demonstrated a high incidence
of deficient vitamin D levels in breastfed infants. Breast milk can be low in vitamin D as a result
of a lack of maternal sun exposure (particularly in the winter and in northern latitudes), increased use
of sunscreen, and dress habits that prevent skin exposure. The AAP recommends that any breastfeeding
infant be given 400 IU of vitamin D daily beginning within a few days of life. In breastfed infants
who are receiving supplemental formula, vitamin D supplementation should still be provided unless
the infant is consuming 1 liter of formula per day (the amount needed to provide 400 IU).

04/02/2019

nutritional differences between breast milk and formula
A
mother’s milk is said to “mature” over the course of the first weeks of an infant’s life, with the
composition changing to some degree during that period. Furthermore, breast milk changes
even during the course of a single feeding between what is referred to as the foremilk (the early
part of a feeding) and the hindmilk (the later part of a feeding). The gradual and progressive
transition to hindmilk during a feed results in a higher fatty content, which aids in allowing the
infant to feel satiated and initiates the termination of feeding. Over the first weeks of an infant’s
life, breast milk caloric density usually drops from approximately 20 to 25 calories per ounce on
average to approximately 15 to 17 calories per ounce. In addition, levels of sodium and calcium
decline.
Variations in the composition of breast milk among individual mothers can be quite dramatic.
Some women will have relatively modest fat content in their milk, resulting in a caloric content as
low as 9 to 10 calories per ounce. In contrast, other mothers produce rich, creamy breast milk, with a
high fat content and a caloric density that may reach 30 calories per ounce

04/02/2019

immunologic differences between breast milk and formula?
it is evident that breast milk and formula are
different in terms of their appearance and their composition. The most striking difference is the
immunoprotective aspect of breast milk, which contains white cells and antibodies that appear to
be quite valuable in preventing neonatal infections of a variety of types, especially in the respiratory
system and the gastrointestinal tract

04/02/2019

contraindications to breastfeeding
Although breastfeeding is clearly best, it is not always possible. Infants with galactosemia should not
nurse; instead, they must be fed a lactose-free formula. In the United States mothers with human
immundeficiency virus (HIV) should also not nurse or provide expressed milk because they may pass
on the virus to the infant. Mothers with active untreated tuberculosis or active herpes simplex lesions
on the breast should also not breastfeed, but they may use expressed milk because these organisms
are not transmitted through the milk. Mothers who require antimetabolites or chemotherapy should
not breastfeed as long as they are receiving those medications. Radioactive materials acquired during
the performance of a medical study are temporary contraindications to nursing. Whereas most
drugs are secreted into breast milk, they rarely form an absolute contraindication to nursing. Drug
effects, however, should be carefully checked using a reliable resource to ensure that the infant is not
unnecessarily exposed to a potentially hazardous medication

04/02/2019

eye prophylaxis in neoborn
Historically, one of the most important issues with regard to newborn infants was the possibility of
developing gonococcal ophthalmia as a result of passing through the birth canal of a mother infected
with Neisseria gonorrheae. Gonococcal ophthalmia can produce a severe purulent conjunctivitis that
may result in permanent loss of vision and generalized neonatal sepsis. The eye discharge resulting
from this infection typically begins during the first 5 days of life.
Eye prophylaxis previously consisted of treatment with silver nitrate drops to the eyes. However,
silver nitrate itself causes a significant, though temporary, chemical conjunctivitis. In the past decade
it has been replaced by the administration of antibiotic ointment, such as 1% tetracycline or 0.5%
erythromycin in single-use ampules

04/02/2019

1. About 10% of neonates will need some degree of resuscitative support at the time of birth.
2. Cold stress can adversely affect the resuscitation of a newborn infant in the delivery room.
3. With the elimination of silver nitrate eye prophylaxis at the time of delivery (causing a chemical
conjunctivitis), the presence of any red eye, or a discharge from the eye of a neonate, must be
evaluated and treated immediately.
4. Without pulse oximeter screening, congenital heart disease may be missed during the immediate
newborn period in about 50% of neonates with the condition.
5. The average caloric content of breast milk is 20 calories per ounce but can range from 8 to
30 calories per ounce, primarily depending on the fat content.
6. For the first 6 months of life, breast milk alone provides adequate nutrition for virtually any term
neonate.
7. Vaginal bleeding in newborn female infants is not uncommon and usually occurs because of
withdrawal of maternal hormones that are present during pregnancy.
8. In the first 3 to 4 months of life, a newborn infant should gain about one ounce per day on average.
9. By 4 to 5 months of age, a healthy term infant should weigh double his or her birth weight.
10. Sonographic assessments of fetal weight are associated with a significant (approximately 10% to
20%) margin of error.

02/02/2019

significance of green vomiting during the first 72 hours of life?
During the neonatal period, green vomiting should always be interpreted as a sign of potential
intestinal obstruction potentially requiring surgical intervention. In one study of 45 infants with
green vomiting, 20% had surgical conditions (e.g., malrotation, jejunal atresia, jejunal stenosis),
10% had nonsurgical obstruction (e.g., meconium plug, microcolon), and 70% had idiopathic
vomiting that self-resolved. Plain radiographs frequently can be normal, particularly for malrotation,
and thus falsely reassuring

30/01/2019

A neoborn who requires extensive resuscitation should be observed closely
for the development of hypoxic-ischemic encephalopathy.the acute
neurologic components of this syndrome are
- Persistent and prolonged hypotonia
- Depressed reflexes
- Altered level of consciousness
- Convulsions

30/01/2019

Why should ceftriaxone not be used in neonates?
Ceftriaxone can displace bilirubin from albumin and may increase the risk of kernicterus in a jaundiced
infant.

Neonatology

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