Effect of Gastric Lavage on Meconium?Aspiration Syndrome and Feed Intolerance in Vigorous? Infants Born with Meconium Stained Amniotic Fluid – A?Randomized Control Trial

Objective: To compare the incidence of meconium aspirationsyndrome and feed intolerance in infants born through meconiumstained amniotic fluid with or without gastric lavage performed atbirth.Setting: Neonatal unit of a teaching hospital in New Delhi, India.Design: Parallel group unmasked randomized controlled trial.Participants: 700 vigorous infants of gestational age ?34 weeksfrom through meconium stained amniotic fluid.Intervention: Gastric lavage in the labor room with normal salineat 10 mL per kg body weight (n=350) or no gastric lavage (n=350).Meconiumcrit was measured and expressed as ?30% and >30%.Outcome Measures: Meconium aspiration syndrome, feedintolerance and procedure-related complications during 72 h ofobservation.Results: 5 (1.4%) infants in lavage group and 8 (2.2%) in nolavage group developed meconium aspiration syndrome (RR0.63, 95% CI 0.21, 1.89). Feed intolerance was observed in 37(10.5%) and 53 infants (15.1%) in lavage and no lavage groups,respectively (RR 0.70, 95% CI 0.47, 1.03). None of the infants ineither group developed apnea, bradycardia or cyanosis during theprocedure.Conclusion: Gastric lavage performed in the labor room does notseem to reduce either meconium aspiration syndrome or feedintolerance in vigorous infants born through meconium stainedamniotic fluid.Keywords: Neonate, Prevention, Respiratory distress, Riskfactors, Vomiting.

Effect of Simultaneous Administration of Oral Polio Vaccine on Local Reaction of BCG Vaccine in Term Infants.

Objective: To study local reaction and to ascertain timing of scar formation in infants after BCG vaccination at birth, with and without simultaneous administration of trivalent OPV. Design: Prospective observational study. Setting: Teaching hospital in Lucknow, India. Participants: 152 term neonates born in the hospital and given BCG and OPV 0-dose simultaneously before discharge, within 7 days of birth (Group I) , and 122 infants born at home or in private health facility, not given OPV-0 dose, coming for vaccination within 7 days of age (Group 2). Intervention/Observation: Follow up done at 6 week, 10 week, 14 week and 9 months. Local reaction was recorded at the site of BCG vaccination. Results: Scar formed in ≤14 wks in 51.3% and 89.3% babies in Group 1 and Group 2, respectively following BCG vaccination (P<0.001). At 9 months, scar developed in 93.9% infants in Group I and 94.3% babies in Group II. Abortive reaction and nonreactors were similar in both groups (P>0.05). Conclusions: Simultaneous administration of BCG vaccine with trivalent OPV to term infants in early neonatal period prolongs the time of scar formation but sequence of local reaction is not affected.

Complementary feeding--reasons for inappropriateness in timing, quantity and consistency.

OBJECTIVE: To assess the practice of complementary feeding (CF) in infants 6 month to 2 year, knowledge of mothers regarding CF, and reasons for inappropriate CF practices. METHODS: CF practices were assessed in children aged 6 months to 2 years using semi-structured questionnaire. Demographic profile and mother's knowledge regarding CF was recorded. Cause of inappropriate CF was ascertained by open-ended questions. RESULTS: Among the 200 children studied, 32(16%) were not started on CF at all, and only 35 (17.5%) received CF from 6 months. Of the 168 who were started CF, mean age of starting feeds was 13.37 months. Quantity was adequate in 42(25%) and consistency of food was thick in 64(38%) cases. Only 7(3.5%) mothers started CF at proper time, in adequate quantity and with proper consistency. Knowledge of proper timing was present in 46% of children, adequate quantity in 46.5% and thick consistency in 25.5%. Only 16(8%) mothers had proper knowledge of all three aspects of CF. Knowledge regarding appropriate timing and consistency varied significantly with maternal education and paternal education (Chi-square P< 0.05). On multiple logistic regression only maternal education of graduate level correlated with knowledge of timing of CF (P=0.089. OR-3.5, CI 0.826-15.2). Most common reason for inappropriate practice in 154 mothers who delayed feeds was "tried but did not eat, vomits everything" (52%). CONCLUSION: CF practices were inappropriate and knowledge inadequate in majority of the children studied.