Objectives:
Early establishment of human milk (HM) feeding significantly decreases neonatal morbidity. There are barriers in establishing and maintaining lactation in mothers of hospitalized extreme preterm and very low birth weight (VLBW) infants, particularly during the first 2 weeks of life. Infant feeding policy modification was done to improve lactation as a quality initiative project and the effect of this modification was studied.
Material and Methods:
This study was done at SRIHER by analyzing retrospective data from the period before infant feeding policy modification (April 1, 2017–June 30, 2017) and prospective data from post-policy modification (July 1, 2017–December 31, 2017). All extreme preterm babies and VLBW babies both inborn and outborn were included in the study. The policy was approved by the institutional quality control cell. Fishbone analysis and “why” question pattern were implemented to identify pitfalls in establishing and maintaining lactation in mothers of extreme preterm and VLBW mothers. Prior antenatal counseling (for inborn deliveries), immediate postnatal assessment, constant surveillance, internal audits, and regular interprofessional team meets were done to carry out the implementation of the quality control program.
Results:
Daily milk output improved after intervention from baseline value in the pre-policy modification group to nearly 3 times after policy modification. The total duration of the requirement of parenteral nutrition decreased from 11 days to 7 days and time to reach birth weight decreased from 17 days to 11 days after quality improvement initiative.
Conclusion:
A simple quality improvement initiative was able to achieve increased lactation in mothers of extreme preterm and VLBW neonates.
Hypothyroidism is most common preventable cause of Mental retardation. Most of developed countries have been adopted neonatal thyroid screening programme three decades back. In India still congenital hypothyroism is important preventable cause of mental retardation. Universal Neonatal thyroid screening looks a distant dream in Indian scenario.
Therapeutic hypothermia for infants with perinatal asphyxia has been studied in several randomised controlled trials. There is convincing evidence that moderate therapeutic hypothermia (33-34°C for 72 h), when initiated within 6 h after birth among term & near-term infants (≥35 weeks) with moderate to severe HIE reduces the risk of death or major disability & increases the rate of disability-free survival at 6-7 years of age
An 8-year-old female child presented with simultaneous symptoms of post infectious glomerulonephritis and acute rheumatic fever. The child was treated with penicillin V, Aspirin and she responded well to the treatment. However, this co presentation of acute rheumatic fever and post infectious glomerulonephritis in a child is rare and hence authors report the case. This sequela of streptococcal autoimmunity are considered to be pathogenetically distinct.
Tuberculous presenting in early infancy is rare. Most expectant mothers with TB are asymptomatic & were discovered to have tuberculosis only after the diagnosis in their infant was made. We report an infant who presented with fever, Right sided cervical mass with ipsilateral LMN type facial palsy with ear discharge whose evaluation revealed Tuberculous. This report describes probably the youngest infant to be diagnosed with cervical mass of tuberculous origin presenting with facial paralysis.
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