In the spotlight
Zika virus disease and congenital Zika virus infection are nationally reportable diseases. Between January 1, 2015 and December 7, 2016, there have been 4,575 reported cases of Zika virus infection in the United States. As of November 30, 2016 in the U.S., there were 1,172 reports of pregnant women with any laboratory evidence of possible Zika virus infection, 32 reports of liveborn infants with birth defects (affecting the brain) born to women with laboratory evidence of possible Zika infection, and 5 pregnancy losses with birth defects affecting women with laboratory evidence of possible Zika virus infection. In August 2016 the CDC published guidelines on the management of infants with possible congenital Zika virus infection.
Neonatal Resuscitation Program (NRP) New 7th Edition
The NRP 7th edition materials were published in Spring 2016 with the expectation that all institutions and learners will be utilizing the 7th edition of the NRP by January 1, 2017. Some of the changes included in the the 7th edition involve the following: Resuscitation of neonates with meconium stained fluid, cardiac monitoring during resuscitation, chest compressions from the head of the bed during resuscitation, early intubation, measurement of depth of the ET tube, and the newborn’s temperature during resuscitation.
SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment
After an initial decrease in the 1990s, the overall death rate attributable to sleep-related infant deaths has not declined in more recent years. The AAP Task Force on Sudden Infant Death Syndrome recently published updated guidelines for SIDS reduction that include new evidence for skin-to-skin care for newborn infants, use of bedside and in-bed sleepers, sleeping on couches/armchairs and in sitting devices, and use of soft bedding after 4 months of age.
in the news
Dextrose Gel For the Management of Asymptomatic Hypoglycemia in Newborns
Per guidelines published by the AAP in 2011, neonates at risk for hypoglycemia should undergo routine monitoring of their blood glucose levels in the hours following birth. At risk neonates include those who are small for gestational age, large for gestational age, late preterm, and infants of diabetic mothers. Furthermore, several publications have noted an association between neonatal hypoglycemia and impaired neurodevelopmental outcomes. A randomized, double-blinded, placebo-controlled study published by Harris, et al. in 2013 showed that the administration of a 40% dextrose gel to at risk neonates with hypoglycemia resulted in fewer NICU admissions for hypoglycemia. Termed the “Sugar Babies” study, the authors recently published 2-year follow-up data validating the safety of the dextrose gel. Some facilities are now routinely using dextrose gel for at risk newborns with hypoglycemia. A recent review by Rozance and Hay endorses the use of buccal dextrose gel as a strategy for managing newborns with asymptomatic hypoglycemia (“New approaches to management of neonatal hypoglycemia”, Rozance and Hay. Maternal Health, Neonatology, and Perinatology (2016) 2:3).
IAC: Give Birth to the End of Hepatitis B!
The Immunization Action Coalition (IAC) has created a comprehensive guide to promote the administration of the Hepatitis B vaccine to newborns prior to discharge from the hospital or birthing center. They report that nearly 1 in 3 newborns currently do not receive the recommended Hepatitis B vaccine at birth and that receiving the vaccine could prevent 800 newborns from contracting perinatal Hepatitis B.
Infant Deaths Associated with the Usage of Infant Sleep Positioners
The CDC reports that 13 infants in the past 13 years have died of suffocation as a result of Infant Sleep Positioners (ISPs). These ISPs are devices that allow an infant to sleep on his/her side, rather than the supine position recommend by the AAP. Pediatricians and other healthcare providers should remember to counsel families about “safe sleep” habits at home which include infants sleeping in their own bed, supine and without soft objects or loose bedding.
Raising Awareness: Late Preterm Birth and Non-Medically Indicated Introductions Prior to 39 Weeks
he National Child and Maternal Health Program offers an online educational module, Raising Awareness: Late Preterm Birth and Non-Medically Indicated Inductions Prior to 39 Weeks, that addresses the science behind medical recommendations to schedule elective deliveries on or after 39 weeks’ gestation.
More information »
New resources are available. This is designed to help pediatricians deliver quality care and conduct an efficient, fiscally sound practice.
what does the section on perinatal pediatrics do?
The Section on Perinatal Pediatrics committees and working groups focus on perinatal health from many viewpoints.
California Association of Neonatologists
March 2-5, 2017
San Diego, CA
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