ABSTRACT
Preterm deaths are responsible for the highest number of neonatal mortality in Nigeria. Preterm nutrition contributes significantly to overall outcome particularly as it relates to neurodevelopment. Recently; new guidelines for enteral feedings in premature infants were issued by the American Academy of Paediatrics and European Society of Pediatric Gastroenterology; Hepatology and Nutrition Committee on Nutrition. Nevertheless; in clinical practice it is often difficult to attain suggested intakes at all times. The situation is worse in Nigeria where there are no specific national guidelines and recommendations derived from local data targeting Preterms. There is a high possibility of significant potential cumulative nutritional deficits occurring in Nigerian preterms. The inevitable suboptimal intake contributes significantly to the incidence of neonatal diseases and outcome. This review describes practical ways of optimizing nutritional intake in these vulnerable neonates with reference to Nigerian situation. Understanding the preterm gut; initiation of parenteral nutrition; need for minimal enteral feeds; ensuring adequate macro and micronutrients intake and need for follow up are discussed. There are limitations to the practice of the recommended preterm nutrition in Nigerian settings; nevertheless the interventions like early commencement of minimal enteral feeds and preference for human breast milk should be practiced optimally. Hence; all health professionals should acknowledge that preterm nutrition may be an emergency and need to improve their knowledge on when and how to achieve optimal feeds in them. There is a dare need through both clinical practice as well as research; to reduce nutritional deficits in these vulnerable infants
Subject(s)
Health Planning Guidelines , Nutritional Status , Premature BirthABSTRACT
Background and objectives: There is a huge need for blood transfusion in the newborn particularly due to the reduced marrow activity in the neonatal period. Despite widely use of blood products in the neonatal period; there is paucity of local data on the pattern; indications and reactions to blood transfusions in Nigerian newborns. This study evaluates the blood transfusion indications and patterns in special care baby unit and C12nd of University College Hospital; Ibadan; Nigeria. Methodology: A cross sectional study was carried on the recruited newborns and structured questionnaires were used to obtain bio data; medical problems; indications for blood transfusion; type of blood products transfused and clinical signs. Urinalysis was performed out before and after the transfusion. Results: A total of 100 neonates were recruited into the study with a male: female ratio of (M: F= 1:1). The age range was 2-34 days and their weight ranged between 0.8kg to 3.6 kg with a mean weight of 1.64 kg. The main indications for transfusion were anaemia from prematurity et neonatal sepsis(NNS) 46; (red cell replacement); NNS; Disseminated intravascular coagulation(DIC) et anaemia 24; (partial exchange + top up + Fresh frozen plasma); neonatal jaundice(NNJ) et anaemia 14; (whole blood); NNJ; NNS + anaemia 6(Blood transfusion + Fresh frozen plasma); NNS + anaemia 10(whole blood). Conclusion: Blood transfusion is still frequent in the study area and prematurity; neonatal sepsis and jaundice rank high in the indications. Transfusion reactions are rare in the evaluated neonates