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Our findings suggest that early fortification from the first feeding in neonates with exclusive breast feeding did not improve growth in the first 4 weeks in preterm neonates in comparison with late fortification; so early fortification may not be cost effective.

With no disease recurrence, minimal complication rate, time off work, and acceptable aesthetic outcome, this fascio-cutaneous transposition flap technique is a safe and effective method for surgically treating pilonidal sinus.

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Objective: To study a hypothesis that keeping preterm infants' heads in midline positions reduces their risk of intraventricular hemorrhage (IVH). Methods:We conducted a pilot randomized trial to study this hypothesis by comparing the IVH risk associated with flat midline (FM) and flat lateral (FL) head positions throughout the first seven days of life. Randomization was stratified based on gender and gestational age (< 27 or 27-29.9 weeks).Results: Twenty-three infants younger than 30 weeks gestation were randomly assigned to the FM group, and 21 infants of similar age were assigned to the FL group (right-tilted: n = 9; left-tilted: n = 12). Important baseline characteristics were similar in both groups, except for multiple births which were significantly higher in the FM group. The risk of IVH was higher in the FM group than in the FL group (6 vs. 4; risk ratio (RR) 1.4; 95% confidence interval (CI): 0.4-4.2; p = 0.8). A secondary analysis showed that the risk of IVH was two times higher in the FM group than in the right-tilted FL group (6 vs. 1; RR 2.3; 95% CI: 0.3-16.9; p = 0.6) and was the same in the FM and left-tilted FL groups (6 vs. 3; RR 1.0; 95% CI: 0.3-3.5; p >0.99). Conclusions:Keeping a preterm infant´s head in the FM position throughout the first seven days of life does not decrease the risk of IVH; however, a right-tilted FL position may reduce this risk. A larger study is needed for a definitive conclusion. 1176RADIOGRAPHIC Conclusions: Preterm infants are exposed to a number of radiographs in the early weeks of life due to associated morbidities and also have diagnostic procedures that may involve X ray radiation. Repeated handling for radiographs can cause clinical instability and accumulation of a radiation dose that can have serious health consequences. Careful consideration should be given before requesting a radiograph in this vulnerable group. THE EFFECTS OF