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  1. Today
  2. Hi I got information from Twitter 5 neonatal cases from Khorasan Razavi province Iran detected on day 2.3,6 and 8 and another baby on day 35 . Separate two cases from another 2 hospitals ,is it true so many new born cases . If true how they are doing . any update from any other countries than China about neonatal cases .
  3. Check this out: https://trends.hms.harvard.edu/2020/03/31/covid-19-separating-infected-mothers-from-newborns-weighing-the-risks-and-benefits/ @neobfmd thanks for sharing this as a comment in the blog by @AllThingsNeonatal
  4. Check out this comment by @neobfmd to the blog post by @AllThingsNeonatal and read the link provided (https://trends.hms.harvard.edu/2020/03/31/covid-19-separating-infected-mothers-from-newborns-weighing-the-risks-and-benefits/)
  5. Yesterday
  6. https://trends.hms.harvard.edu/2020/03/31/covid-19-separating-infected-mothers-from-newborns-weighing-the-risks-and-benefits/ Melissa Bartick just posted this on the Harvard “trends” blog - weighing risk/benefit similarly
  7. Dear all As all of us are preparing ourselves to form potential strategies to mitigate and manage SARS CoV2 positive neonates, we come across various challenges. Our NICU has Sophie ventilators which do not have a expiratory filter. So the potentially infectious aerosols would be released in the NICU environment. We have not been able to devise a way to circumvent that yet. Though thankfully there have been no suspect cases so far in Delhi. But in order to prepare for a possible surge it is essential to look at such issues. Please suggest what is being followed in other units who are currently managing such neonates and suggest the possible solution to the issue that our unit is facing Thank you
  8. The NeoMate app is very helpful! There is an infusion calculator, where you can easily 'calculate' how much medication needs to go in the syringe, with how much glucose/saline, and at which rate the pump then needs to run. https://london-nts.nhs.uk/professionals/neomate-mobile-app/
  9. This is another hot topic out there as centers around the world struggle to determine how best to manage the mother who has contracted COVID-19 in pregnancy. There are resources out there already such as the CDC which states the following. The World Health Organization also has this to say as of yesterday. The question though is where do these recommendations come from? How strong is the evidence? Let’s begin with another Coronavirus Do you remember SARS? This was another coronavirus. Wong SF et al published Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome in 2004 in which they described the outcomes of 12 women infected with the coronavirus causing SARS. In this study they sampled Evidence of perinatal transmission of virus was assessed by SARS-associated coronavirus reverse-transcriptase polymerase chain reaction (SARS-CoV RT-PCR) and viral culture on cord blood, placenta tissue, and amniotic fluid at or after delivery. None of the tested infants were found to have infection nor were any of the tissues or fluids positive. They did not test breast milk specifically but as none of the infants developed SARS one could infer that if the other samples were negative so were the breastmilk samples. The conclusion after the SARS epidemic is that vertical transmission does not occur. Moving on to COVID-19 It may surprise you but there is very little out there on breastmilk and COVID-19. Having said that, there is very little data on pregnancy and COVID-19 so the question then is how strong is the evidence for lack of transmission in breastmilk? There is really one study by Chen H et al Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The authors looked at 9 women presenting in the third trimester and examined outcomes from pregnancy. All of the infants were delivered via c-section and in 6 of the 9 samples of breastmilk were obtained and sampled for COVID-19. The good news was that none of the samples tested positive for the virus. I suppose the result shouldn’t be that surprising as the virus causing SARS is similar and also has not been demonstrated to lead to neonatal infection. The question then is whether one should freely breastfeed their newborn if they are known to be positive for COVID-19. Getting back to the earlier recommendations from the CDC, they read as pretty firm. Looking at the sum total of evidence I think it is safe to say we don’t have a lot of data to go by. What we have though in this situation is to look at risk/benefit. To the best of our knowledge, the COVID-19 is not transmitted into the fetus and after birth does not get into breastmilk. Both of these things appear to be quite good but as the virus spreads and more pregnant women contract the virus we may see as we get a larger sample that it is possible but I suspect this is a virus that simply doesn’t transmit to breastmilk. What if we banned breastfeeding in suspect or confirmed patients? The potential loss of immunoglobulins against COVID-19 is a real risk for the infant as they continue to live in the same home as the mother. How do we know that such antibodies exist? As for as I know for COVID-19 this hasn’t been proven yet but in the SARS epidemic a case report demonstrated that antibodies against this virus were indeed in breastmilk; SARS and pregnancy: a case report. Given that the viruses are part of the same class I would imagine the same would hold true with the new coronavirus. They may not be born with the virus but if they are receiving passive immunity from the mother that needs to be considered given that we have nothing effective (at the moment) to treat anyone. An alternative is to use donor breast milk but if we go down that road, our supplies will be exhausted before long. Weighing everything and using the best data we have at the moment my bias would be continue breastfeeding albeit with the recommendations for droplet precautions and hand hygiene as the CDC suggests. Stay safe out there everyone.
  10. Last week
  11. This new paper just came onto my radar - on "State-of-the-art neonatal cerebral ultrasound: technique and reporting" in Pediatric Research. Great read! (and if those of us who cannot read, we can look at the pictures like the one below 😛 ) Open access here: https://www.nature.com/articles/s41390-020-0776-y
  12. Dear all, I want to share a website that I have created - www.perinatalcovid19.org Please share widely. It has resources to help all of us manage the covid-19 situation we are all facing. I am open to suggestions on how to make it more useful. K.S. Gautham, MD, DM, MS, FAAP Professor of Pediatrics, Baylor College of Medicine Section Head and Service Chief of Neonatology Texas Children's Hospital 6621 Fannin, Suite W6104 Houston, TX 77030
  13. I am guided by the vision that every infant should have access to evidence-based interventions. The principal idea to practice EBM in the NICU has been central for me to pursue many projects, also the initiative in 2016 that led to Neobiomics, a “neonatal startup” now under the wings of the Innovation Incubator at Karolinska Institutet in Stockholm. The vision that all infants have access to evidence-based interventions also guided Neobiomics to develop ProPrems®, a high-quality probiotics product tailor-made for preterm infants. I am particularly glad that ESPGHAN recently acknowledged the combination of strains in ProPrems® (Bb-02, Bb-12 and Th-4) and that the high-end manufacturing complies to listed safety conditions. In brief, we drew the same conclusions as ESPGHAN in our review of the literature a few years back. Due to obvious reasons during the current Covid-19 pandemic, more long-term development of neonatal care is put on hold. We have therefore decided to provide ProPrems® free of charge to NICUs with implementation plans now postponed due to time constraint and shift in focus. We aim to provide a sufficient number of ProPrems® doses for use until May 31. The same offer is given to hospitals already using ProPrems®. Please note that ProPrems® is only available in Europe. Visit this URL to fill in the request form and I will connect back within 48 hours to discuss practical aspects further: https://proprems.eu/proprems-delivery/
  14. As the world deals with the Covid-19 pandemic, clinicians caring for newborn babies are all scrambling to come up with guidelines to handle babies who are at risk of or confirmed to have Covid-19 infection. We are also trying to personally stay healthy and avoid catching the infection. By sharing our resources and ideas we can make more progress than working individually. This free repository of information is offered as a resource for you and your clinical team. Please share any useful documents you might have.
  15. www.perinatalcovid19.org
    Dear Colleagues, 
    I want to share a website, www.perinatalcovid19.org (link is also provided above) that I have created. It has resources to help all of you manage the covid-19 situation we are all facing. I am open to suggestions on how to make it more useful to you. 

    K.S. Gautham, MD, DM, MS, FAAP

    Professor of Pediatrics, Baylor College of Medicine

    Section Head and Service Chief of Neonatology

    Texas Children's Hospital

    6621 Fannin, Suite W6104

    Houston, TX 77030

    Tel: 832-826-1363

  16. Join experts in the field of neonatal neurology as they speak on clinical and research guidelines, educate on new techniques, and answer your questions! April Speakers: April 2nd: Betsy Pilon - Supporting HIE Families April 9th: Seetha Shankaran, MD - Hypothermia for HIE, Updates and Controversies April 16th: Gerda Meijler, MD - Neonatal Head Ultrasonography: How to Scan a Baby, Normal Anatomy of the Neonatal Brain April 23rd: Linda de Vries, MD - Neuroimaging in the Full Term Infant April 30th: Trainee Session RSVP below to confirm your attendance: https://is.gd/RSVP_NBS_Ed_Webinar_April_2 Contact info@newbornbrainsociety.org with any questions.
  17. These cases need enough hydration and well humidification . We can determine our success by measuring levels of electrolytes and aldosterone. Locally we should use emollients e.g. Olive oil
  18. The professional communication during the Covid-19 pandemic really shows the potential to share expertise and experience through web-based channels. Journals, societies, regular news media, social media platforms etc-etc play an important role for us to keep updated, and many web sites have also opened up their content free of charge. We will learn many things from facing and tackling this pandemic, but one major change will certainly be our communication channels. Many are discovering the web-based possibilities to learn and discuss. We will do our best to facilitate professional communication within the neonatal community. And, finally it seems that the company providing our software (IPB) will finally roll out a smartphone app. Which means that 99nicu will literally become available in your pocket through a "99nicu App". The screen shots below comes from the beta-version of the app now used by the company providing our software. And yes, there will be light-mode and dark-mode Stay tuned!
  19. New paper out today in JAMA Ped, a case series of 33 mothers and 3 newborns being positive for Covid-19 (i.e. 30 infants were tested negative) https://jamanetwork.com/journals/jamapediatrics/fullarticle/2763787
  20. This document has been drafted by Dr Riccardo Davanzo, Chair of the Technical Panel on Breastfeeding (TAS) of the Ministry of Health (MOH), and Prof. Fabio Mosca, President of the Italian Society of Neonatology (SIN), with the collaboration of Dr Guido Moro, President of AIBLUD (Human Milk Banking Association of Italy), Dr Fabrizio Sandri, Secretary of SIN and Prof. Massimo Agosti, President of the SIN Breastfeeding Commission. https://www.uenps.eu/2020/03/16/sars-cov-2-infection-sin-recommendations-endorsed-by-uenps/?utm_source=Social&utm_medium=Post&utm_campaign=UENPS_Congress_Awareness&fbclid=IwAR125OOwyNmMpZjY30YXo23GEISvYUFoTu6RMlWYBhjDcISIWRo3EoBMTUU 14marzo.SIN_UENPS0.pdf
  21. I see it frequently in otherwise healthy babies..the reassuring sign: the postductal saturation is 95-100% in those babies with very well felt femorals. It happened that most of those babies where somehow polycythaemic ( Hb around 200mg%) Also if you do echo..likely the duct will be still open ( transitional). If you check the Saturations pre and post few times a day (baby is healthy and feeding) you will see the difference decrease and likely to normalize around day3. I still have no physiological explanation.
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