Screening and Detection of Congenital Hypothyroidism in Newborns.

Unrecognized congenital hypothyroidism (CH) is the most common cause of preventable cognitive delay in children. Infants with CH appear normal and are usually asymptomatic at birth. Early detection is critical for prevention of intellectual disability. Standardized newborn screening can have a positive impact on cognitive development in infants with CH.

Cumulative impact of multiple evidence based strategies on postnatal growth of extremely-low-birth-weight infants.

BACKGROUND: Postnatal growth failure is common in very preterm infants and is associated with worse neurodevelopmental outcome. OBJECTIVE: To evaluate the cumulative impact of multiple evidence based strategies on the postnatal growth of extremely-low-birth-weight (ELBW) infants. METHODS: We conducted a prospective observational study. Based on current literature, changes were implemented to provide optimal parenteral and enteral nutrition. Daily intakes of calories, protein, lipids and carbohydrates were calculated. The average growth velocity (GV) was calculated using 2-point exponential model and is reported as grams/kg/day. The length and head circumference gains are reported as centimeters/week. RESULTS: The mean gestational age and birth weight for 38 ELBW survivors were 27.0 ± 2.1 weeks and 752 ± 147 g respectively. The GV was 13.2 ± 2.2 g/kg/day (range 8.8-17.4) and gains in length and head circumference were 0.88 ± 0.9 (range 0.15-1.42) and 0.71 ± 0.5 (range 0.22-0.96) centimeters/week respectively. Twenty nine (76.3%) infants were small-for-gestational-age (SGA) at discharge and 23 of these (60.5% of all infants) had weight below 3rd percentile. All 11 infants who were SGA at birth were SGA at discharge as well. Of 25 appropriate-for-gestational-age (AGA) infants at birth, 16 (64%) were SGA at discharge. The number of infants with length and head circumference below 10th percentile at birth and discharge were 11 (28.9%) and 29 (76.3%) for length and 20 (52.6%) and 27 (71.1%) for head circumference. Infants with multiple morbidities and more hospital days with no enteral feeds had lower GV. CONCLUSION: All infants born SGA at birth and majority of ELBW survivors born AGA at birth had weight, length and head circumference below 10th percentile at discharge despite aggressive nutrition supplementation.

Neonatal Nurses Book Club: A Novel Approach to Promote Nursing Resilience.

The Neonatal Critical Care Unit Book Club began with a common passion for reading and a need for socialization. There was also the hope that the club would foster a positive work culture and increase staff morale and resilience. In addition, the book club provided a mechanism for obtaining continuing education.The purpose of this article is to describe how a group of nurses participating in a book club were able to find support and encouragement during a pandemic.

The Importance of Hepatitis B Antigen Screening in Pregnancy.

In the United States, pregnant women are screened for hepatitis B antigen because of the significant risk of perinatal vertical transmission of hepatitis to the fetus. It is important that the maternal hepatitis B antigen screen is documented in the medical record to ensure appropriate prophylaxis for the neonate. The purpose of this column is to discuss the pathophysiology of hepatitis B, as well as the screening process and prophylaxis for the neonate.

Calcium Levels in the Neonate.

Calcium, the most abundant ion in the neonate, plays a role in bone formation, blood coagulation, muscle contractility, and nerve conduction. Calcium levels are regulated via a negative feedback loop by the parathyroid hormone, calcitonin, and vitamin D. Calcium levels in the neonate must be monitored carefully to avoid complications that affect the central nervous system as well as the cardiac and musculoskeletal systems.