Mohan

Both writings are wonderful. Great to know about Brazil's efforts especially the Milk bank initiative. Could be a template for all LMIC countries. This is an area were India lags behind. Would be keen to know how much Maternity leave is given officially to working mothers in Brazil. This is another area were I have been advocating for at least 8 months instead of the traditinally 6 months presently. It is very important if we want to give exclusive breast feeds for at least 6 monthsas most pregnant women take a leave in the last month or two of pregnancy. DrP.Lall(mohan) India

Completely agree with the beautiful graphic

We use LED lights for phototherapy and found no effect on hypothermia

Because of the importance of KMC we do allow SSC after securing the umbilical canula with another tape on the abdominal skin. However we do not allow prone position in the crib routinely

Does Human milk fortifiers reduce this gap of protein in preterm infants?

Does human milk fortifier close this protein gap partially?

I work in Rourkela, a small city in Odisha, India. We have tried coconut oil (rich in natural MCT and culturally acceptable) both for massage (some direct absorption from the skin) and to mix with MOM with good results. Anybody else with a similar expierence?

Thanks to all for your responses. After conventional treatment with hydration ,Furosemide and steroids failed to completely reverse severe hypercalcemia I had to use Zoledronic Acid Injection as Pamidronate was not available. Serum ionized Calcium normalized to upper end of normal and the baby is on follow up

We also follow most of the TOBY guidelines. However in our set up many babies reach after 1 hour but before 6 hrs. What ABG criteria should we take at that time. All criteria mention criteria within one hour or Cord Blood

How common is subcutaneous fat necrosis in newborn with hypercalcemia in your practice and how do you manage it

This is indeed an interesting topic with many unanswered questions. Lot of research required. Areas of real concern if mother is on antipsychotics or anti depressants. Any take on this

My question for diagnosing Mild HIE has not been answered as yet.

It would have interesting to know the basis for diagnosing Mild HIE. Was it Sarnat and Sarnat or Thomson and any ABG criteria used

we use a mixture of glycerine and normal saline in a ratio of 1:1 when required. IT has worked well for us.

Great discussion. We are also in a low resource setting in Odisha ,India. We do not have a human milk bank. I have also had to use formula feeds even for some newborns in the wards because of documented borderline sugars. This is especially for prime gravidas and post LSCS mothers. The rationale being it is better to prevent hypoglycemia and its consequences and not be very strict about formula especially in the first 24 hrs. We always give formula after checking blood sugars. "Not enough Milk" is the most common complaint during post natal rounds. Any role of galactagogues and if so which ones in your experience. Any major difference between preterm formula and term formulas as their are cost implications No mother is allowed to buy any formula as per the IMS act. It is always hospital supply.