scholarly journals Significant weight loss and hypernatremia in exclusively breast-fed neonates

2017 ◽  
Vol 5 (1) ◽  
pp. 151
Author(s):  
Daniel Jayaraj ◽  
Poornima Kumar ◽  
Peter Prasanth Kumar Kommu ◽  
Lalitha Krishnan

Background: Weight loss in the early neonatal period is a problem that often goes unrecognized. Weight loss of upto 5-7% of birth weight is normal but losses more that 10% may result in increased morbidity, especially hypernatremia. Methods: Prospective cohort study of 900, exclusive breastfed inborn babies, >34 weeks gestation and >1800g born in a tertiary care hospital in South India. Babies who were discharged before 96 hours of life, admitted to intensive care and received phototherapy for >24hrs were excluded. Maternal and neonatal variables were collected, and daily weight loss percent was calculated. Data was entered in EPI-INFO and analysed. Independent sample t test was used to compare the means of two independent normally distributed sample groups, ANOVA was used to compare means of more than 2 variables, linear logistic regression was used to find out the relationship between significant weight loss and hypernatremia Results: The mean birth weight of the cohort was 2937±438.4 g and the gestational age was 38±5weeks. The mean maximum weight loss for the entire cohort was 178.71g (±82.08 g) and the mean percent weight loss was 6.12% (2.69). The mean weight nadir of the entire cohort was 2758.32±425.67g. Mean serum sodium levels for all babies who lost >10% of their birth weight was 145.95 (±2.34) mmol/LConclusions: Early neonatal weight loss is a universal phenomenon though often unrecognized. Babies losing more than 10% of birth weight are at risk of morbidities like hypernatremia.

2010 ◽  
Vol 8 (2) ◽  
pp. 180-186 ◽  
Author(s):  
Marcia de Freitas ◽  
Ana Merzel Kernkraut ◽  
Simone Maria Amadio Guerrero ◽  
Sonia Teresa Gaidzakian Akopian ◽  
Sandra Harumi Murakami ◽  
...  

ABSTRACT Objective: To describe the activities of a multiprofessional outpatient clinic performed by neonatologist, physiatrist, physical therapist, occupational therapist, speech therapist, audiologist and psychologist, who evaluated the development of premature newborns. Methods: Twenty children born at a tertiary-care hospital (São Paulo, Brazil), between April 2006 and April 2007, with birth weight below 1250 g or less than 32 weeks of gestation, were evaluated. The multiprofessional evaluation included assessment of development using the Bayley III scale, at the corrected age of 3, 6, 9, 12, 18 and 24 months. Results: The mean gestation age at birth was 28.8 weeks; mean birth weight was 1055 g. The mean maternal age was 35 years and the mean length of stay of neonates was 46.3 days. Fifteen percent of children presented impaired sensory motor skills, 20% had hearing abnormalities and 10% motor alterations. Bayley III showed alterations in the communication area in 10% of subjects and in the motor area in 10% of individuals. The parents were oriented to stimulate the child or a specific intervention was suggested. The major development delay was observed between 6 and 18 months of age and the development was improved at 24 months of age. Conclusions: Most children evaluated had improved growth and development at 24 corrected-age months. Further studies with a larger sample are recommended, as well as the possibility to follow this population group up till the primary school.


2017 ◽  
Vol 4 (3) ◽  
pp. 979
Author(s):  
Gowri S. ◽  
Kumar G. V.

Background: Gestational age and birth weight are the two most useful parameters for assessing maturity of the newborn. Major causes of neonatal mortality are diseases associated with low birth weight babies (LBW). It has been shown that foot length measurement is particularly valuable in premature babies who are so ill that conventional anthropometric measurements cannot be carried out due to the incubator and intensive care apparatus. Methods: The cross-sectional study was conducted in the department of pediatrics Sri Siddhartha Medical College Hospital, Tumkur, India. The birth weight in grams and length of the foot were documented in centimeters. Data was collected using standard proforma.Results: A total of 600 neonates were studied of which, males were 54.67 % (328) and females were 45.33 % (272). The neonates weighing less than 2.5 kg had a mean foot length of 6.94. The mean foot length for neonates weighing between 2.5 to 3.5 was 7.68. The mean foot length for neonates weighing more than 3.5 kg was 8.2cm. The correlation coefficient of birth weight with foot length was maximum in low birth weight babies (r= 0.94).Conclusions: The foot length is an efficient screening tool in identifying low birth weight babies. Foot length is a simple, quick and reliable anthropometric measurement which can be used as a proxy measurement to birth weight especially in sick and pre-term neonates receiving intensive care. 


2019 ◽  
Vol 6 (2) ◽  
pp. 718
Author(s):  
Muhammad Hassan ◽  
Adarsh E. ◽  
Rajanish K. V.

Background: The aim of this study was to determine the clinical profile of neonates admitted with dehydration fever and ascertain the maternal and neonatal factors affecting it.Methods: A observational descriptive study was conducted at Rajarajeswari Medical College and hospital, population included neonates who were admitted in NICU with dehydration fever.Results: The study were conducted among 50 neonates admitted with dehydration fever. Majority of neonates (72%) were diagnosed with dehydration fever on day 3 of life. 84 % neonates were born to primiparous mothers. In the study there was significant difference in mean birth weight, weight at admission and percentage of weight loss between birth weight and weight at admission with respect to symptoms on presentation. Mean % of weight loss was 12.06 when dehydration fever was presented with fever, 11.29 when dehydration fever presented with decreased urine output, 18.44 when presented with both fever and decreased urine output and 12.73 when presented with jaundice these values were statistically significant.Conclusions: Dehydration fever occurs most commonly on day 3 or after, effective measures should be initiated for early diagnosis and prevention of complications like effective breast-feeding counselling, proper techniques, good latching and supplementation of artificial feeds if required and monitoring of daily weight and daily urine output.


2021 ◽  
Vol 8 (7) ◽  
pp. 1183
Author(s):  
Varun Ganjigunta ◽  
Varsha Suresh Ahirrao ◽  
Premalatha R. ◽  
Ravichander B.

Background: Iron deficiency anemia in 3-6 months-old infants is often neglected. Its presence in healthy infant of less than 6 months of age is largely debated. Neglecting IDA in this critical phase of growth can lead to serious consequences. The aim and objective of the study was to estimate the frequency of IDA in 3-6 months old infants, admitted in rural tertiary care hospital and to study its risk factors.Methods: The cross-sectional study was conducted in the pediatric department of rural tertiary care hospital. 100 infants in the age group 3-6 months were included in the study. Relevant maternal and infant factors were noted. CBC with blood indices, peripheral blood smear and reticulocyte count were studied. Anemia in them was defined as hemoglobin <9.5 g/dl. IDA was diagnosed based in history, examination, indices, and peripheral smear.Results: 22% of infants of 3-6 months had IDA. 40.9% of infants with IDA were low birth weight compared to 11.5% without IDA (p value<0.05). All pre-terms included in the study had IDA. 16% of term, normal birth weight, exclusively breast-fed infants had IDA. Underweight and stunting were seen in 31.8 % and 30.8% of IDA infants compared to 9% and 5.4% of infants without IDA.Conclusions: IDA was quite common in infants less than 6 months and also seen in healthy, term and exclusively breast-fed babies, so universal iron supplementation before 6 months need to be considered in National Iron plus Initiative in India. Preterm, LBW babies and babies with NICU stay are at higher risk of IDA. 


2017 ◽  
Vol 4 (6) ◽  
pp. 2065 ◽  
Author(s):  
Arshiya Rehman Sheikh ◽  
Sushama Subhash Thakre ◽  
Subhash Thakre ◽  
Chaitanya Rangangouda Patil ◽  
Prithvi B. Petkar

Background: In spite of the interventions being taken, low birth weight still persists as a public health problem in low and middle-income countries. World Health Organization defines low birth weight as birth weight less than 2500 gm. There is a constant search to find newer methods to detect low birth weight babies so that early methods can be instituted. This study was conducted to evaluate calf circumference as procedure to screen low birth weight babies in tertiary care hospital in Nagpur. Methods: A cross sectional study was conducted in tertiary care hospital of Nagpur, Maharashtra for a period of 4 months. The study subjects were babies delivered at the hospital. Birth weight was recorded using a digital weighing scale within 24 hours of the delivery. Length, calf circumference, head and chest circumference were measured according to standard guidelines. Results: Majority of mothers were in the age group of 20 to 24 years of age group, were educated up to primary school and belonged to Hindu religion. The mean calf circumference of low birth weight babies was 9.64±1.13 cm and was 10.96±1.01 cm in normal weight babies. The mean values of calf circumference were significantly lower in low birth weight babies (p <0.001). The sensitivity and specificity for the best cut off of calf circumference was found to be 89.97% and 42.86% respectively.Conclusions: Measuring calf circumference was found to be a good test with higher sensitivity but lower specificity. Hence, calf circumference can be used as an alternative method to screen babies born in remote areas, where the facility of weighing the baby at birth is not available.


2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Raju Kafle ◽  
Kabiraj Nibedita ◽  
Binod Kumar Gupta

Introduction: Placenta is an organ that connects the developing fetus to the uterine wall to allow nutrient uptake, provide thermo-regulation to the fetus, waste elimination, and gas exchange. The present study was undertaken to look for mean birth weight and placental weight among deliveries in a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted in a tertiary hospital of Nepal. Ethical clearance was taken from institutional review comittee of hospital. Mothers with term and preterm gestation, their infants and the placentas were the subjects for the study. The study was conducted on 158 term and preterm deliveries. Placental weight, birth weight, gestational age, neonates’ gender, weight, length and head circumference were recorded. Results: The mean of weight of total 158 placentas was 449.24±82.07 g and the mean of birth weights was 2872.84±478.88 g. Out of 158 deliveries, 138 (87.4%) babies were of term gestation and 20 (12.6%) babies were preterm. Conclusions: Mean birth weight and placental weights are similar to that found on similar studies done on other hospitals. Knowing the mean placental weight and birth weight which relates to different functional dimensions of placenta and baby growth helps for further evaluation of placenta and baby.


2018 ◽  
Vol 5 (4) ◽  
pp. 1447
Author(s):  
Sundar K. C. ◽  
Devi Meenakshi K. ◽  
Aruna B. Patil

Background: Retinopathy of prematurity (ROP) affects developing retinal vasculature in premature infants. The risk factors for ROP are prematurity, low birth weight, oxygenation, respiratory distress, infection and frequent blood transfusion. Identification of risk factors leading to ROP may help in planning preventive strategies.Methods: A retrospective analysis of records of preterm babies less than 34 weeks of gestation or birth weight less than 1750 grams and between 34 -36 weeks gestation or 1750-2000 grams birth weight associated with risk factors for ROP admitted to NICU of Kilpauk Medical college hospital from August 2015 to July 2016 were evaluated.Results: Out of a total of 166 babies who were screened for ROP, 37 babies were detected to have ROP (22.3 %). Of these 20 (54%) were female and 17 (46%) were male. The mean birth weight of babies with ROP identified in our study was 1480 grams. The mean gestational age of babies with ROP was 32 weeks. By logistic regression analysis for mode of oxygen therapy as a risk factor for ROP it was found that prongs alone showed the strong risk factor towards ROP which was statistically significant. Sepsis, transfusion and shock requiring inotropes individually and statistical significantly contributed to the risk of ROP.Conclusions: ROP was more common in babies <34 weeks. Sepsis, transfusion and shock requiring inotropes significantly contributed to the risk of ROP. Analysis of the mode of oxygen therapy showed that use of prongs significantly increased the risk of ROP.


2020 ◽  
Author(s):  
Aliya B Aziz ◽  
Syeda Kauser Ali

Abstract Background Empathy is one of the vital personality attributes for all physicians. It is essential for establishing general interpersonal relationships among doctors and patients.Unfortunately, there is evidence for the decline of physician’s empathy during the clinical training phase and is a major concern for medical educators worldwide. One of the major factors reported for the decline of this trait is an unprofessional learning environment. Objective This study examines the relationship between empathy level and perception of climate of professionalism among residents. Method The study participants included 70 residents of Obstetrics & Gynecology and Pediatrics departments of a private sector tertiary care hospital in Karachi, Pakistan. Two self-administered internet based surveys - Jefferson Scale of Physician Empathy (JSPE) and “Professionalism Climate Instrument”(PCI) - were administered to assess the level of empathy among the participants and their perception of professionalism in the learning environment. The relationship between the level of empathy and professionalism was analyzed using Spearman rank correlation. Results The overall response rate was 81.4% with mean empathy level of 103±13. The internal consistency of each scale measured by Cronbach’s coefficient α was 0.76 for JSPE and 0.65 for PCI. No significant difference was observed in the mean empathy scores between senior and junior residents of both specialties. Statistically significant difference in empathy scores existed between female and male residents (p = 0.012; 95% CI, 2.27 to 17.59). The mean PCI score was 106+8.88 with no significant difference among residents of two specialties. Professionalism score was not found to vary with either the year of residency or gender. Empathy score and professionalism climate were not found to be correlated (rs= 0.56, p = 0.64). Conclusion The findings suggested that empathy is a relatively stable trait that remains unchanged during residency training programs. Female residents had higher empathic concern than the male trainees, however, the empathy level of the participants was not found to be influenced by the climate of professionalism.


2020 ◽  
Vol 33 (2) ◽  
pp. 1-9
Author(s):  
Mst Rokeya Khatun ◽  
Nasrin Akter ◽  
Md Nowshad Ali

Objective: To describe the clinical presentation and feto-maternal outcome of preterm prelabor rupture of the membrane of patients admitted in a tertiary care hospital of Bangladesh. Methods and Material: This is a cross-sectional observational type study carried out in Rajshahi Medical College Hospital, Rajshahi, Bangladesh during the year 2019 in the Department of Obstetrics and Gynecology. Sixty pregnant women with preterm prelabor rupture of the membrane (gestational age 28 to 37 weeks) were included in this study. Results: The mean age of the women was 27.03±6.13 years. Forty (66.7%) of them were from rural area. Majority were studied up to primary school (33.30%). Sixty five percent were house wife. Thirty seven (61.7%) women were multi gravid. Mean gestational age of the patient was 34.43±2.75 weeks. Antenatal care of the women was low. Most of the women have associated one or more diseases like anemia (35%), Urinary tract infection (28.33%), Pregnancy induced hypertension (20%), Lower genital infection (13.33 %,), gestational diabetes mellitus (10%) and heart disease (3.33%). The mean time interval between membrane rupture and delivery was 29±9 hours. Thirty one patients (51.7%) were delivered by caesarian section. Twenty eight (46.7%) women did not experience any complication and other suffered from wound infection (20%), PPH (10%), puerperal sepsis (8.33%) and chorioamnionitis (11.7%). Mean birth weight of the newborns was 2.16±0.42 Kg. Thirty eight (63.33%) newborn suffered from complications like neonatal asphyxia (30%), respiratory distress syndrome (13.3%), neonatal jaundice (11.7%) and neonatal sepsis (3.3%). Neonatal death was noticed in three (5%) cases. Fetal outcome was found significantly (p< 0.001) associated with low gestational age. Conclusion: Women with low education, associated co-morbidity, long latency and neonate with low birth weight have unfavorable outcome. Antenatal care is an important tool to prevent preterm prelabor rupture of the membrane by identifying the risk factors and its management. Optimum obstetric and medical care is essential for the reduction of these devastating complications. TAJ 2020; 33(2): 1-9


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Aliya B. Aziz ◽  
Syeda Kauser Ali

Abstract Background Empathy is one of the vital personality attributes for all physicians. It is essential for establishing general interpersonal relationships among doctors and patients. Unfortunately, there is evidence for the decline of physician’s empathy during the clinical training phase and is a major concern for medical educators worldwide. One of the major factors reported for the decline of this trait is an unprofessional learning environment. Objective This study examines the relationship between empathy level and perception of climate of professionalism among residents. Method The study participants included 70 residents of Obstetrics & Gynecology and Pediatrics departments of a private sector tertiary care hospital in Karachi, Pakistan. Two self-administered internet based surveys - Jefferson Scale of Physician Empathy (JSPE) and “Professionalism Climate Instrument”(PCI) - were administered to assess the level of empathy among the participants and their perception of professionalism in the learning environment. The relationship between the level of empathy and professionalism was analyzed using Spearman rank correlation. Results The overall response rate was 81.4% with mean empathy level of 103 ± 13. The internal consistency of each scale measured by Cronbach’s coefficient α was 0.76 for JSPE and 0.65 for PCI. No significant difference was observed in the mean empathy scores between senior and junior residents of both specialties. Statistically significant difference in empathy scores existed between female and male residents (p = 0.012; 95% CI, 2.27 to 17.59). The mean PCI score was 106 + 8.88 with no significant difference among residents of two specialties. Professionalism score was not found to vary with either the year of residency or gender. Empathy score and professionalism climate were not found to be correlated (rs = 0.56, p = 0.64). Conclusion The findings suggested that empathy is a relatively stable trait that remains unchanged during residency training programs. Female residents had higher empathic concern than the male trainees, however, the empathy level of the participants was not found to be influenced by the climate of professionalism.


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