Monthly Archives: August 2020

Diagnosing seizures in the newborn: a small step forward

The use of continuous EEG has become much more frequent in the NICU in recent years. It has become clear that clinical recognition of seizures, both those with and without clinical convulsions (which I will call electrographic seizures for all … Continue reading

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Dexamethasone ENT doses

Although we have a great group of ENT surgeons at my hospital, we do have one bone of contention; at least, there is just one bone left since they have agreed that you cannot diagnose reflux by performing a laryngoscopy! … Continue reading

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Probiotics: are they cost effective?

Like almost any intervention in the NICU (even maternal breast milk requires pumps and equipment, and kangaroo care requires chairs) there is some cost associated with routine probiotic administration. A new publication attempts to calculate the cost-effectiveness relationship. (Craighead AF, … Continue reading

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Probiotics, can’t get enough…

All probiotics are not equal. I think it is clear, for example, that the probiotic fungi (Saccharomyces) studied in 2 small trials had no impact on NEC. In addition one of the largest and best trials (PiPS) from the UK … Continue reading

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Probiotics save the lives of preterm infants. Find a reliable source.

The American Gastroenterological Association has recently published its guidance about probiotics for various conditions. They found little evidence of benefit for most indications with the probable exception of preventing antibiotic-associated diarrhoea. The 8th indication that they reviewed was the prevention … Continue reading

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Lactoferrin: Does it decrease late-onset sepsis?

The first multicentre trial of bovine lactoferrin supplementation in preterm infants showed a dramatic reduction in late-onset sepsis of about 70%. I was very excited when I first saw Paolo Manzoni’s trial and rushed to set up a pilot in … Continue reading

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When should we start Parenteral Nutrition?

Following on from the previous post: This all brings me to a larger and very thorny issue, which is whether we should even be routinely starting parenteral nutrition (PN) immediately after birth at all! I hate to discuss this, as … Continue reading

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How much Intravenous lipid should we start with?

Since I started neonatology (just a little over 5 years ago…) we have given intravenous lipid emulsions starting at low doses and progressively increasing. As a reminder to everyone, when intralipid (as I will call it to refer to all … Continue reading

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How much should we feed babies?

Surely after 60 years of neonatal intensive care, we have figured out what volume of milk to give to small preterm babies? Our local feeding protocol uses a standard of 160 mL/kg/d, which we will increase to 170 mL/kg/d if … Continue reading

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Not neonatology: Julian Bream 1933-2020 RIP

Most of my readers probably don’t know that for a few years I have been struggling to learn Classical Guitar. One of my inspirations is Julian Bream, who was fundamental in the UK in the recognition of the guitar as … Continue reading

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