piatkat

Hi @Mariana Oliveira , I'd like to just ask for a practical clarification. I've read this case, and now I'm wondering- this mother seems to be interested in a transition to direct breastfeeding. While pumping and bottle/tube feeding we can control amounts of MOM intake, however with direct breastfeeding, especially at home, parents have much less control of the amount of consumed milk. What would be your practical advice for the mother while preparing them for a home discharge- aim to breastfeed before medication dose (as much as infant wants, without controlling the amount?), and offer formula if infant demands feeds at peak plasma concentration moments? Would you recommend that mother pumps-and-dumps in between the feeds to sustain the lactation (hoping when infant grows, the medication levels will become less problematic and she will be able to breastfeed until a desired timepoint, eg. 1 or 2 yrs of age?). I'm just thinking of this case in terms of long term planning and supporting lactation beyond NICU and immediate post-discharge.

Such an important topic! Having a dear colleague, a brilliant scientist with a PhD, who was born very preterm in the 90's as one of the triplets, where one of his siblings died in the NICU, and another one is living with a severe disability, I'm always reminded: you need to survive in good overall health to be able to tell your story. And I'm glad that, although it feels a bit like a pushback, your ethics committee is actively trying to be the voice of the ones who don't get to tell their stories.

Conference in Brazil? Packing ASAP!

Hi @ali , while waiting for more answers here, I will suggest browsing for previous posts on the topic (is nanoprem the same as micropreemie?) - How do you manage micropremies? https://99nicu.org/forums/topic/2661-how-do-you-manage-micropremies/#comment-12636, and my favorite resource coming from Japan https://plaza.umin.ac.jp/nrndata/pdf/NICUManual.pdf.

99nicu has been definitely a lifechanging journey for me too! I remember registering here as medical student (I also recall asking @Stefan Johansson for permission via email explicitly!!!). At that point I was actively searching for summer observership opportunities*. I had previously done an excellent observership via IFMSA in Sweden and wanted to visit another NICU there, but @Stefan Johansson said his unit is very quiet during the summer and suggested I ask @Francesco Cardona instead. I can confirm that Francesco's unit was NOT quiet during the summer- it turned out to be one of my best learning experiences, and I'm forever grateful! Then I remember it being a bit more quiet for a while, there was an episode of me writing a blog here but nothing regular, until I joined the 99nicu Team. Since then it has been a fun rollercoaster, full of us having insane ideas and Stefan supporting them (with a patience of a saint). Have grown so fond of everybody in the Team and appreciate so much Stefan being always there for us, despite his many many hats. It's so funny how small choices can affect our life (they call it a butterfly effect, don't they?). I don't want to say that 99nicu is the reason why I've been pursuing the neonatology path (this dream has been there even before), but it has definitely had a very supportive role throughout this process. Feeling nostalgic now!!!!!! * In 🇵🇱 it was obligatory for students to complete summer internships, and some of them could be completed abroad.

Neonatal sepsis remains one of the leading causes of death and harm in newborns worldwide, and it disproportionately affects babies in low- and middle-income settings. This week at the PAS 2026 conference, a new global initiative took its first formal step: the Newborn Sepsis Society held its founding meeting. The Society brings together clinicians, researchers, and partner organizations across disciplines and borders, with a shared mission: to improve outcomes for newborns worldwide by advancing the prevention, diagnosis, and treatment of neonatal sepsis. They explicitly prioritize representation from diverse regions, especially where the burden of neonatal sepsis is greatest. 👉 Learn more and join at https://newbornsepsissociety.org/ And as 99nicu, we are excited to see this initiative take off, and keeping our fingers crossed for the growth and good ideas to come. And being the grassroot community we are, we are always open for sepsis discussions- so bring them on! Kat from 99nicu

I’ll dare to tag our expert in Heliox from Poland, @Tomasz Szczapa - maybe you could share some insights here

Hi @Mo7 , recently I gave a talk on apnea focused respiratory monitoring in a conference, and was also surprised about many different approaches! In southern Finland (where I do my research) it's not uncommon to discharge kids home on caffeine. There's a lot of trust towards parents abilities here, so it aligns well with other practices ( eg. kotiloma, I even committed a blog post about it ages ago: https://99nicu.org/blogs/entry/330-kotiloma-means-vacation-at-home/). From what I understand, they later admit caffeine-at-home kids for an overnight observation in the ped unit (SpO2 and HR, Edi monitoring if possible) when they try to wean off the medication, and only then make a final decision. Everybody is quite chill about it (but hey, it's Finland). A small proportion of the kids in my study were on caffeine at home (7/99 included) until median age of 45 weeks PMA (data still unpublished).

Hi all, @Brar post visibility should not be a problem - I can build a dedicated box for neoIPC in the main page (currently, only neoIPC class users see it) or something similar. Let’s see what works best for this content. I was waiting with this task until I had a clearer idea of how you would like to use this space. We have plenty of options here. I have completed a launch post in consultation with @Valentina Canepa , @Stefan Johansson has also already "OK" it, so now we are waiting for your go-ahead. Have good week!

We are excited to share news that 99nicu.org has begun collaborating with NeoIPC, a European Union-funded initiative addressing hospital-acquired infections and antimicrobial resistance in neonatal units. What is NeoIPC?Nearly 1 in 10 European newborns requires NICU admission in their first days of life, which can expose them to antibiotic-resistant bacteria. NeoIPC is a European Union-funded research initiative focused on improving infection prevention and control (IPC) in NICUs. The project brings together an international network of clinicians and researchers to develop innovative, evidence-based strategies to reduce the transmission of resistant bacteria in premature newborns. It integrates clinical research, implementation science and surveillance to better understand infection patterns and improve IPC practices across neonatal care settings. Moreover, through an innovative study named NeoDeco, NeoIPC is also evaluating if the implementation of optimised kangaroo care can reduce severe neonatal infection, sepsis and resistant bacterial colonisation in high-risk newborns in the neonatal intensive care unit. NeoIPC has also developed standardised surveillance methods focused on healthcare-associated infections, multidrug-resistant organisms and antibiotic use in neonatal care. Participation in the NeoIPC Surveillance is completely free and open to neonatal care sites worldwide. The NeoIPC Surveillance Network already includes 25 partner sites across Europe and Africa, working together to improve infection prevention and surveillance in neonatal care. More about the NeoIPC surveillance Finally, NeoIPC places strong emphasis on the perspectives of families. "NICU Journeys" is a video series that captures and amplifies the voices of parents, sharing their experiences, concerns and hopes, and highlighting their essential role in the care of their premature babies. More about NICU Journeys Why This Matters to Our CommunityNeoIPC aims to connect units together in a global Clinical Practice Network, encouraging greater involvement of units in infection prevention planning and delivery. This aligns well with what we do at 99nicu.org—connecting professionals across borders to share practices, learn from each other, and improve neonatal care. Meet the NeoIPC LeadershipThe project is led by : Julia Bielicki, NeoIPC Scientific Coordinator, University Children’s Hospital Basel (UKBB), Switzerland; City St George’s, University of London, UK Tuuli Metsvaht, Chair of the NeoIPC Clinical Practice Network, Professor of pediatric and neonatal intensive care, Head of the Clinic of Paediatrics Tartu University Childern’s Hospital (Estonia) Annika Tiit-Vesingi, Deputy Chair of the NeoIPC Clinical Practice Network, Head of the Neonatology department Tartu University Children’s Hospital (Estonia) Brar Piening, NeoIPC Surveillance lead, Member of the NeoIPC Clinical Practice Network Steering Board, Deputy director of the Institute of Hygiene and Environmental Medicine at Charité – Universitätsmedizin Berlin (Germany) Chiara Minotti, Member of NeoIPC, MD, Paediatrician, PhD candidate in Clinical Research (University Children's Hospital Basel, Switzerland) You can learn more about NeoIPC in the club space they are hosting in the 99nicu NeoIPC Club. You can freely join the club to stay in touch and get notified when new content is being shared. Join us in warmly welcoming NeoIPC to 99nicu! Kat from 99nicu Julia Bielicki Professor Julia Anna Bielicki is a Professor of Paediatric Infectious Diseases at City St George’s, University of London, Professor of Paediatric Clinical Pharmacology at the University of Basel. Julia trained in Social and Political Sciences and Medicine at the University of Cambridge, where she graduated top of her year, and holds a Medical Doctorate from the University of Zurich, as well as an MPH and PhD from the London School of Hygiene and Tropical Medicine. Her research focuses on optimising antibiotic use in neonates and children and developing innovative infection prevention and control strategies across high-income and low- and middle-income country settings. She has led and co-led multiple randomised controlled trials, including cluster and platform trials, funded by organisations such as NIHR, Horizon 2020, EDCTP, IMI and the Wellcome Trust, with the aim of generating robust evidence to inform clinical practice and health policy in the context of rising antimicrobial resistance. Tuuli Metsvaht Tuuli Metsvaht is a paediatric and neonatal intensive care doctor in Tartu University Hospital, Estonia, with over 25 years of experience in the field. She is also Professor of paediatric and neonatal intensive care and pharmacotherapy in the University of Tartu, Estonia. Her interest has been in developemntal pharmacology with specific focus on PK and efficacy studies of antimicrobial therapy in neonates. She has worked in several EU-funded International projects like NeoMero, NeoVanc, ALBINO. Other fields of interest include early cardiovascular support in postnatal adaptation, excipients use in neonatal drug formulations (Era-Net funded International Project ESNEE). Currently she is involved in postnatal colonisation studies in NICU with specific focus on family centred care and development and implementation of novel infection prevention and control measures in NICU in the NeoIPC Project. Annika Tiit-Vesingi Annika Tiit-Vesingi is a paediatrician at Tartu University Hospital in Estonia with over 20 years of experience in the field of neonatology. She currently serves as the Head of the Neonatology Department at the University of Tartu, where she plays a key role in both clinical care and academic development. Her main areas of interest include neonatal feeding, family-integrated care, and advancing the concept of the “golden first hour” for all newborns to improve outcomes. In addition to her clinical and leadership work, she is actively involved in research on postnatal colonisation in neonatal intensive care units, with a special focus on promoting family-centred care practices. Brar Piening Brar Piening is a senior physician and deputy director of Charité's Institute of Hygiene and Environmental Medicine, board-certified in hygiene and environmental medicine. He is responsible for infection prevention and control at Charité's Campus Virchow-Klinikum and has worked in HAI surveillance, antimicrobial resistance, and antibiotic use for more than 20 years. He is the scientific coordinator of NEO-KISS, Germany's national surveillance system for nosocomial infections in very low birth weight infants and leads the MEASURE work package of the EU-funded NeoIPC project, where he coordinates the development and operation of a multinational HAI surveillance system for high-risk neonates. His research spans the epidemiology of healthcare-associated infections in vulnerable patient populations, with a focus on neonatal infection outcomes, antibiotic use, and the design and evaluation of surveillance systems. Chiara Minotti Chiara Minotti is an MD and a NICU‑trained, board‑certified paediatrician (University of Bologna and Padova University Hospital, Department of Women's and Children's Health, Italy). She previously worked as a neonatologist and clinical researcher at the Department of Neonatology, Modena University Hospital, Italy, and was involved in large, EU‑funded international projects (PedMERMAIDS, GBS‑PREPARE). She is currently a PhD candidate in Clinical Research at the University Children’s Hospital Basel, Switzerland. Her research focuses on innovative strategies for the prevention and management of infections in neonatal intensive care units, within the NeoIPC and NeoSep ADAPT projects.

Hi @Brar - welcome! I'm really excited to see NeoIPC members joining, this is the essence of what we want to be doing here at 99nicu- creating spaces for people to share their expertise. Make yourself at home! We're ready to post about this collaboration, but currently still awaiting some materials from your comms team. Good thing about old-fashioned forums- nothing is on fire here. Much more relaxing than Twitter! Have a good week everyone!

How long have you been a member of 99nicu? A year? Five years? Longer than some of your colleagues have been qualified? You might be surprised how far back this community goes. Our 99nicu community has more than 7,000 members from 76 countries. We have been around longer than Facebook has been in Europe, and almost as long as Twitter has existed at all — and despite being "old school", we have persevered. Many predicted that forums would disappear once social media took over. But looking at where the world is going, it feels more and more like we need spaces we can rely on — grassroots, independent, and not subject to the whims of algorithms or platform owners. And honestly? Sometimes we all just need a place that isn't endless doom scrolling. Yes, you can justify it with "but there's educational content there too" — but what is your actual retention of something you had less than three seconds to grasp before the next thing came along? We love meeting you in person — whether at 99nicu meetups or other conferences. It matters, putting faces to usernames. Over the years we have had the chance to meet many of you, whether wearing our academic, clinical, or entrepreneurial hats. Later this year we will meet some of you in France, where we are partnering with the CEPAS conference — and we are genuinely looking forward to what we have planned there. But our global village is much bigger than whoever can make it to a conference. We span continents, and not everyone can travel all the time — after all, somebody has to stay on call. So this year, we want to connect more. As part of our 20th anniversary, we want to organize a few informal online meetings. We want to hear from you — your thoughts on where 99nicu should go, projects we could take on together, and how you can get involved. The first meeting is on May 7th. Details are available in our Community Calendar. Save the date! - Kat from 99nicu

TL;DR: What's Changed and Why You might have noticed while browsing 99nicu recently: reading the full discussions now requires you to be logged in. The first post of any thread remain visible to everyone, like the news updates and feeds. But to read replies and join the conversation, you'll need to log in as a member. We know this adds a step. Here's why we're doing it, and how we're working to make it worthwhile. ________________________________________ Why This Matters?For 20 years, 99nicu is built on professional exchange by NICU staff. When you contribute here, you're part of a community where many members use their real names and affiliations when sharing their clinical experience, knowledge, and personal insights. Our members are willing to be known, and we believe the readers should be, too. ________________________________________ What You Need to KnowRegistration is free and always will be. No fees, no paywalls, no corporate gatekeeping. Just a basic account, that takes one minute to register for, and then you just need to await our manual approval of your account (usually within 24 hours). Homepage News , Blogs and Calendar remain open. Many sections remain open/public for browsing without logging in, including the Homepage, the Latest Research feed. Discussion Forum Topics are visible to everyone. You can see the first post in all Discussions, what colleagues are asking, but to read answers and expert responses, you need to log in. Posting and commenting requires login. Only members can contribute to discussions. We don't verify institutional emails. You can register with any email address. We trust you to be part of this professional community in good faith, but please remember to be thoughtful about what and how you post. Your profile information is visible to other members. Be mindful when sharing patient-related information. While clinical discussions are essential to our community, you must respect patient confidentiality and integrity. Never include information that could potentially identify a patient or family. When discussing specific cases, parental consent is recommended. You are responsible for ensuring your posts comply with your national laws and regulations regarding patient privacy. See our [privacy policy] and [registration terms] for details. Stay logged in with the 99nicu app. Available for iOS and Android, the app keeps you connected without needing to sign in every time. If you visit us with your mobile browser, you'll see a prompt: "View in the app: a better way to browse." It's a simple, browser-style app that lets you keep 99nicu on your phone homescreen — no notifications, no instant messages. Just at the reach of your tap when you want to browse and interact. ________________________________________ The Platform Grows When Your Activity Grows99nicu thrives when you participate! The value of this community isn't just in what you can read — the value is built from people sharing their questions, comments and expertise. Therefore we encourage you to ask questions and share your experiences. Remember: what seems like a "basic, normal thing" to you might be genuinely eye-opening for another clinician somewhere else in the world. We all have unique perspectives shaped by the context where we work, what we've seen, and who we've learned from. So don't hold back! ________________________________________ Help Us Get This RightWe want to make this transition as smooth as possible. So we're asking: What can we do to make logging in easier for you? Is the registration process clear? Do you have any issues recovering your password? Let us know in the comments, or send us a message- we're here for you! See you inside! Kat from the 99nicu Team

I found this case series from Boston Children's Hospital: Shumer et al. (2014). Severe hypercalcaemia due to subcutaneous fat necrosis: presentation, management and complications. Archives of Disease in Childhood. Fetal and Neonatal Edition, 99(5), F419–F421, https://pmc.ncbi.nlm.nih.gov/articles/PMC4134364/ It's a chart review of 7 infants over 13-year period, so quite rare even for a large center. They report the use of iv hydration, furosemide, glucocorticoids and low-calcium formula for most patients. One patient was treated with calcitonin, and another with pamidronate after conventional therapy failed (reaching normocalcemia within 12 hours from pamidronate). They also mention complications: fever, eosinophilia and persistent nephrocalcinosis (though without renal dysfunction over follow-up period). Does it align with your experiences?

Dear 99nicu friends, Some of you might have already noticed our 99nicu page has been going through small improvements. We keep thinking about how to make this page more friendly for you, our users. What would it take to make us a page you visit often, or maybe even your starting page? Last week I implemented an RSS feed with the newest papers in neonatal medicine. As 99nicu, we cannot guarantee you access to full texts, but at least we can show you new research being published every single day—for the betterment of neonatal care. Living in Europe and communicating in English almost everywhere, I never even considered that 99nicu might not be accessible enough for people who simply don't use English. I'm thankful to our dear @Mariana Oliveira who opened my eyes and encouraged me to find solutions to make our page more accessible for non-English speakers. So, first of all—in the bottom right corner, you will find a blue "Translate" button. This is a whole page translation powered by Google Translate that will allow you to browse the page in any language you choose. Roam around and explore our content in the language you feel most comfortable with—you're welcome. Second—underneath each post and reply to a post, you will find a button "Translate", which will give you an opportunity to choose a language. This will translate that post to your chosen language. This way, you can participate in the conversation in any language you feel comfortable with, and other users can translate your post to their language of preference. Right now the languages to choose from are limited to 12 (Spanish, French, German, Italian, Portuguese, Dutch, Polish, Russian, Japanese, Chinese, Arabic and English), but we can add as many as you like—just let us know. We're doing our best here, without an army of social media, IT and marketing experts—but honestly, it's been fun figuring out these improvements for you. I'd love to hear your feedback: what else can we do to make 99nicu work better for you? Drop your ideas in the comments or send me a message. You can help us in this mission by visiting our page, being an active part of our community, and telling us what you need. And if you like what we do, you can become a 99nicu Society Member (https://99nicu.org/subscriptions/) for 10 EUR/year to keep our servers alive. All the best, Kat

Hi @Famke, your survey has just been sent to our community via an email newsletter :) Good luck!

Hi @dratiqur , since this thread is 17 years old (! long live 99nicu!!!) I had to double check- it seems the files attached here are empty or the pages cannot be found anymore, sorry! Maybe newer resources are already available online? Our own 99nicu interactive quizzes can be found here: https://99nicu.org/quizzes/

I use https://www.e-lactancia.org/. Wasn't even aware of other resources listed here, thank you!