Mohan

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.

Great initiative! Will contribute and learn

Could anyone let us know the exact dose of MCT powder(as available here).Any role of oral Coconut oil which is rich in MCT especially in resource poor settings

How does one manage skin of an ELBW baby and till what PMA should it continue

Is there any role of DHA supplements in preterm babies especially ELBW

I missed this webinar. Any recording or way to see it

Thanks for all your inputs. Good to know that there are no strict guidelines. Do you all heparinize these lines especially for ELBW and 25 weeke rs

When an ELBW neonate is on Amino acid infusion what is the upper limit of blood Urea that must be considered before stopping or reducing the amino acid infusion

How long can a Umbilical Artery line and an Umbilical Venous Line be used in an ELBW neonate when PICC line is not available. Various centers follow different protocols. Your views please

We are frequently using this practice all over India with good results

Great job. Is this similar to the Life start trolley being used in UK?

Outcome depends on cause. Just had a a preterm baby with sclerema due to hypothermia. He has recovered with appropriate treatment

Thanks

Any insights into my questions. At least let us know the practice you all are following

Kindly attached a photograph of baby on Mira Cradle in our hospital

Just a thought. Since these solutions(3% saline and Sod Bicarb) are hyperosmolar can they increase the risk of NNEC

We talk to the Obstetrician before delivery and find out if there are no contraindication for DCC. If so we plan for 3 minutes for DCC in term babies. For a vaginal delivery after delivery the baby is placed on the mother's abdomen and covered and monitored. Sometimes the placenta is delivered before 3 minutes and presently we are cutting the cord then though this is controversial. If for some reason the cord has to be cut early then only milking is done. For LSCS we keep the baby on the OT table and follow the same procedure. All attending Pediatricians in our hospital are aware of the contraindications and follow it. In fact in our delivery notes we have made a column for DCC time and reasons for not doing DCC which they fill up. For preterms we do DCC for 1 minute and strictly no milking

I am practicing on an exclusive mother and child care hospital in a resource poor setting in Western Odisha India where we get a lot of babies with birth asphyxia. For the last 4 yrs we have been using a low cost device called Mira Cradle which uses phase change material in a a polyurethane cradle. We have found it to be very effective in maintaining the requisite temperature for 72 hrs without use of electricity. This has resulted in favorable out comes especially in babies with moderate encephalopathy

Dear Rianne, Thanks a lot for the interesting insight into DCC and the referenced article. I do agree the placental blood volume will be helpful to the neonate. But how will blood flow into the neonate after the placenta has been delivered? One study suggested that the placenta be collected in a sterile bag(if delivered before 3 minutes) and taken along with the baby. If so where will the placenta be kept? On the same matress as the baby or should it be suspended at a higher level for gravity to allow the placental blood to flow into the neonate? Any studies on this and the practical methods of doing this? Mohan

Thanks satyen for clarifying

Is there any point in delaying clamping the cord after the placenta has been delivered which sometimes happens before 3 minutes, the time recommended for term babies in the webnar Also neither AAP nor WHO or Gynecological societies mention 3 minutes as the recommended time as yet. So can there be medico legal issues

Is there any point in doing DCC after the placenta has been separated and delivered

Can we diagnose PPHN fairly confidently by this procedure to start Sidenafil