Ruth

We have a Network of sorts in KwaZulu-South Africa where the 54 public health hospitals offering maternity services all use the same guidelines, records and clinical governance and audit tools (Essential Package of Care-EPOC) in their neonatal and paediatric units.

I would recommend using skin to skin care to transport them.

We use the Intergrowth charts.

Great idea to have a journal club. Currently although parental presence is encouraged it occurs very seldom in our units.

I am based in South Africa. We tried both the Neobar and Neofit. The Neofit was the better option but agree with the comments above. Having tried both we felt tape was still the better option. We use a barrier film to protect the skin (if available) then extra thin hydrocolloid strips. We then use either zinc oxide or hypofix tape (5 strips) in much the same technique as described above.

What scary experiences for you and ongoing stress working and living in such a volatile country. I pray for peace in Libya and safety for you and your family. I have also twice felt physically threatened in an NICU. The first was a mother who threatened us with a knife and wouldnt let us near her baby. We discovered she had post partum psychosis. The second occurred during a national nurses and teachers strike. Strikers gained access to the hospital and two of my colleagues were attacked in the corridors. They were told that all nurses must leave the hospital. We were informed that the strikers were going ward to ward forcing nurses out. I made a decision that I would not leave and was fearful of being physically attacked. Fortunately the strikers never came to the NICU.

In Kwa Zulu Natal South Africa we are advocating that well at risk term babies are monitored (and if necessary receive antibiotics via short line-hep locked) in skin to skin care with their mother in post natal and are only admitted to the neonatal unit if they develop problems.

Have you considered kangaroo mother care? Once the mother has been taught and understands and practices 24 HR KMC in the hospital- the mother and baby could be discharged to continue KMC at home with follow up in 3 days and then weekly until term and 2500g.

Congratulations and welcome to the family! You couldn't have chosen a better field than neonatal nursing. I encourage you to be actively involved in your local neonatal nursing association and / or to join the Council of International Nenatal Nurses( COINN) This is a wonderful way to gain and share knowledge and experience and to feel part of a larger family of passionate individuals. For a basic introduction to neonatal care the Perinatal Education Programme Newborn Manual is a useful resource: http://bettercare.co.za/books/newborn-care/

There is a physiological dip in glucose immediately after birth but this should be normal by 1 hour. So if the dextrose is low at one hour you should manage it. The practice appears to be treating hypoglycaemia earlier. Some centres are even suggesting 3.0mmol/l. If I remember correctly STABLE is teaching 2.8? Currently we still treat less than 2.5mmol/l

This is the email address for Natalie Shellack. She is a neonatal pharmacologist who has particularly studied the use of caffeine in neonates. I would suggest contacting her. nschellack@gmail.com

Hi Aymen I have many guidelines I can share with you. Please post your email address and I can send them to you.

Hi. We have developed a lot of resources that we can share with you-guidelines, records, audit tools etc There is a good online self study course developed in South Africa -The Perinatal Education Programme http://pepcourse.co.za

These are the charts being used in South Africa RP NN Jaundice assessment chart 2010 NT.ppt

We have an excellent comprehensive chart for all gestations. I can email it to you?