Stefan Johansson

The N3RO and MOBYDICK, which studied DHA supplementation in two different ways (via the mother->breastmilk, or directly to the infant, links below) showed that there was no benefit from DHA supplementation only, and seemingly associated with potential risks. But, for the record, being founder of Neobiomics, I do have a conflict-of-interest about omega-fatty acid supplementation. https://jamanetwork.com/journals/jama/fullarticle/2768134 https://www.nejm.org/doi/full/10.1056/NEJMoa1611942

@Mohan this webinar will be repeated, 12 June 4 PM CET, more info will be posted later

We do!

My ten cents to the discussion are... given a normal ventilation, the Stockholm strategy would probably be 10Hz and a 1:1 IE ratio. @Martin.Keszler and @Padkaer - what's your advice?

Many thanks @Mariana Oliveira , while I have the same vague idea about breast feeding benefits as most NICU staff (and the social determinants thereof!) I admit I was not aware about Cesar Victoria. While googling for his book, the first google hit was the Wikipedia article about his carrier (https://en.wikipedia.org/wiki/Cesar_Victora One thought that popped up… while most of know that ”breast is best”, there is a bit of learning when it comes to both basics and details about the actual data supporting that statement. Maybe we could make some educational activity ?

Thanks @Sari Ahlqvist Bjorkroth , very inspiring to read! Best of luck with the conference!

This is an illustrative example of social inequalities - how breastfeeding rates vary by socioeconomic/-demographic factors in the UK. What do you think about it? My personal thoughts - the neonatal community need to be aware and take this into account when counseling etc, but (IMHO) this boils down political strategies how to overcome societal gaps (so a difficult perspective!) And (again IMHO), this is not UK-specific results, they are probably generalizable to most context (Sweden, for sure!) ADC Fetal & Neonatal EditionAssociation between maternal sociodemographic characteris...Objective To ascertain the sociodemographic and geographical determinants of exclusive and no mother’s own milk (MOM) feeding for infants <34 weeks’ gestational age (GA) in England and Wales. Stud...

I found a long article about the Letby case on Wikipedia, very interesting read. I personally feel confused on a higher level… There are many suspicious circumstances. But legal conviction is about ”certainty beyond any uncertainty” and it seems there is indeed lack of technical evidence and that the court decision is based on reasoning around probabilities. https://en.wikipedia.org/wiki/Lucy_Letby

👋 @Kartika Darma Handayani , thanks for sharing this question. I have read and learnt a lot about the intestinal microbiome but your take is new to me :) I looked into PubMed and did not find anything - can you elaborate how you came up with this research question and what exactly you would like to study (etiology of plac accrete?)

I hereby share a legal disclaimer to everyone participating in this thread ! Yes, you are very right one needs to be careful with opinions. Being declared guilty is a black-white decision, but like medicine, it is based on probabilities (although, if someone is shot by a person 1 meter away and holding a smoking gun, the probability is almost 100%!). And to be honest, I was not much aware of the case before it showed on my various radars about "experts", so I am not into any details. Still, if someone is declared guilty based on reasoning and no technical evidence, then it is mind-shaking to think about all stakeholders in this case. Letby herself, parents of the diseased infants, staff members, everyone in public authorities engaged etc-etc. So many levels of impact. My personal mind-shake is also about that I connect to similar cases in Sweden where HCPs was judged guilty in processes not living up to standards (later found out). In one legal case here, a GP and a forensic pathologist was sentenced for cutting up the body of a dead woman with drug addiction, and it all seems this legal process was just so incorrectly managed (the "da Costa case") back in the 1980s. Some pretty basic journalism, that resulted in a recent documentary, has revealed so many strange details, and it all just seems those two are completely innocent. Since that case went up to the highest court, it seems though that their sentences cannot be re-assessed in a new legal process. The other case I connect to is the "Astrid Lindgren case", this was about an anesteiolgoist accused for killing a former extremely preterm infant admitted to the PICU after discharge from the NICU, that was like a "witch process" from the mediveal times! If there are some good public reading etc, please share some links for background etc. I tried to google but the web is so full of stuff about this, I find it hard to find good sources.

Final call for the International Survey on Probiotics use in Preterm Infants! It is still open for responders (we want to reach the goal of 200 responders). Please consider! https://forms.office.com/e/0rbYem4Bwg

I assume you may already know about the so-called Letby case, where a neonatal nurse was accused and charged for several neonatal deaths, deemed intentional by the UK courts. A panel of neonatology experts have now reviewed the (legal) evidence and found that (medical) evidence speaks for alternative and natural causes of death. I find it hard to fully grasp the whole situation, first of all, if someone being unguilty is declared guilty, that is disastrous at so many levels, from the imprisoned person to the society as a whole. Calling this "Epic fail" is not enough. I wanted to share a comment by Prof Neena Moody in London, a piece to the point. What do you think and feel around all this? https://www.theguardian.com/commentisfree/2025/feb/12/lucy-letby-case-trial-justice

Exciting times are ahead of us! We are approaching the Big Leap upgrading to our community software to a new version. This is a major upgrade, but we hope there won't be too much issues while doing it. In addition to lots of tech stuff, the look and feel will also change, especially on your mobile 😀 In case the site drops offline 🫣 we will share updates on Mastodon, BlueSky, and LinkedIn. We are yet to finalize the timeline for doing this. You will know it when you see it!

If the clinical history is typical (complicated vaginal delivery etc), we don’t do anything investigation apart from clinical assessment. We liberally refer to our physiotherapist for assessment and follow up However, if the arm is completely paralytic, then we ask neurology/neurosurgery for advice, but I have not myself been involved in a case that went for nerve suture. But I understand that could be an option.

Hi @agoz, we normally don’t do any investigation for cephal hematomas unless the clinical diagnosis is unclear (when we do ultrasound to confirm)

@PHutchings I am referring to the first neonatal check before discharge home

Interesting observation, did you measure serum levels of insulin?I have always thought that the higher risk of post.term infants to develop hypoglycemia (like doubled even in "low-risk" post-term deliveries https://fn.bmj.com/content/102/4/F286.long) was related to less good energy storages but interestingly, the MSD manual mentions that post-term infants may have higher levels of insulin (https://www.msdmanuals.com/professional/pediatrics/perinatal-problems/postterm-infants) I tried but failed to find levels on s-insulin in post-term infants on Pubmed, anyone else with input?

Fully agree, also the "easy patients" deserve an individualized strategy, similarly to the TLC that we otherwise dedicate to the tiny preterm infants.

Thanks for raising this question, I think this is a more common patient than those needing iv fluids / TPN! For a term infant we typical start with 40 ml/kg/d and a late preterm (say 34-36w) we usually go for 40-60 depending on fetal growth, clinical situation etc. We increase feeding volume w 20-30 ml/kg/d. We feed every 3 hours, so a 3 kg term would have 120 ml first 24 hours. We would probably feed some thing like 10 ml x 1-2, 15 ml x 5-6 and then 20ml per feed. it is common we do not go up to ”full feeding”which at our NICU is 170-185 ml/kg/d. If the infant is starting breastfeeding practise early (for example, term infant with TTN) we usually stop at 125~150 to promote a quicker full breastfeeding. Of course, we do take b-glucose, weight development, nutritional needs due to clinical symptoms and everything like that into account, so all infants have their own path too

I want to bump this thread, we are still collecting responses to this survey, we are half way to reach the 200 replies needed.

Hello again, as you know there are several surfactant brands around. Which surfactant do you use and why?