Sarah Reynolds, Owen Bendor-Samuel, Taffy Makaya, Jean Yong, Catherine Quinlan
{"title":"A guide on how to approach neonatal hypercalcemia","authors":"Sarah Reynolds, Owen Bendor-Samuel, Taffy Makaya, Jean Yong, Catherine Quinlan","doi":"10.1016/j.paed.2025.01.001","DOIUrl":"10.1016/j.paed.2025.01.001","url":null,"abstract":"<div><div>Neonatal hypercalcemia although often mild and benign has the potential to be a serious condition. There are a wide variety of causes which differ from those seen in children and adults. We present a brief overview of its presentation, common and serious ‘not to be missed’ causes and management. Our aim is to provide a guide of how to approach neonatal hypercalcemia for the paediatrician or other healthcare professional caring for newborn infants.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 2","pages":"Pages 57-64"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A pragmatic approach to paediatric postural orthostatic tachycardia syndrome (POTS)","authors":"Michael Harris","doi":"10.1016/j.paed.2024.11.002","DOIUrl":"10.1016/j.paed.2024.11.002","url":null,"abstract":"<div><div>Postural orthostatic tachycardia syndrome (POTS) is a debilitating condition. It is now quite well-known but still poorly understood. The multi-system nature of the condition and the difficulty in treating it adequately are discouraging for health professionals and patients alike. Whilst there is no known associated mortality, it has considerable morbidity. Knowledgeable history taking is essential, diagnostic tests are simple, differential diagnoses are limited. Parental interactions and expectations are key in management. POTS provides an opportunity to combine the science and art of medicine with compassion and empathy. This article outlines a pragmatic approach to understanding, diagnosing and treating this condition. The physiology of standing is discussed, as are some of the putative pathophysiological mechanisms responsible for POTS. The importance of sub-typing POTS as an aid to considered management is explained. Treatment strategies ranging from conservative measures to medications are discussed. Practical, workable tips for managing this condition are provided.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 2","pages":"Pages 47-52"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oxygen therapy in preterm infants: past, present and future","authors":"Sanoj KM Ali, Peter A Dargaville, Samir Gupta","doi":"10.1016/j.paed.2024.10.001","DOIUrl":"10.1016/j.paed.2024.10.001","url":null,"abstract":"<div><div>Oxygen is one of the most commonly used therapies in neonatology but the parameters of optimal oxygen for preterm infants have been debated for the past 50 years. The history of oxygen use in this population, as well as the results of clinical trials, have shown that liberal oxygen administration is associated with retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD) whereas restrictive use results in increased mortality and neurodisability. Oxygen saturation (SpO<sub>2</sub>) continuously measured by pulse oximetry is the bedside tool used to guide the fraction of inspired oxygen (FiO<sub>2</sub>) delivered to preterm infants. Although evidence favours targeting predetermined SpO<sub>2</sub> ranges, achieving this goal consistently in clinical practice has been challenging due to intrinsic pulmonary immaturity, the need for respiratory support therapies and factors relating to the bedside caregivers’ ability to adjust FiO<sub>2</sub>. This review article focuses on the difficulties of titrating oxygen therapy in this vulnerable group and provides recommendations for best practice based on up-to-date evidence.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to survive and thrive on night shifts","authors":"Katrina Roberts, Nicola Goodall","doi":"10.1016/j.paed.2024.10.007","DOIUrl":"10.1016/j.paed.2024.10.007","url":null,"abstract":"<div><div>Nightshifts are often unavoidable in the career paths we have chosen as paediatric doctors and whilst we can't pretend it's all fun and games', there is something very satisfying when you get through a set of nights and look back on what you have accomplished with little support in numbers. Here we explore how we, as two paediatric doctors, have developed our own ways of tackling the dark side aiming to keep patient safety a priority and maintaining some sanity. There is now more support than ever to support doctors working nightshifts and we hope to share some tips and resources to make the transition from days to nights a little easier.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 36-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Probiotics in the NICU: a personal practice","authors":"Sybil Barr","doi":"10.1016/j.paed.2024.10.006","DOIUrl":"10.1016/j.paed.2024.10.006","url":null,"abstract":"<div><div>There is increasing interest in the use of probiotics in preterm infants in NICUs to reduce intestinal dysbiosis and subsequently reduce morbidity in these vulnerable neonates. However, heterogenicity of organisms used in various trials has meant definitive evidence is still not available to make strong recommendations and probiotic use remains varied.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 34-35"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aravanan Anbu Chakkarapani, S Meghana, Umamaheswari Balakrishnan
{"title":"Unveiling the hidden risks: therapeutic creep in mild hypoxic ischemic encephalopathy","authors":"Aravanan Anbu Chakkarapani, S Meghana, Umamaheswari Balakrishnan","doi":"10.1016/j.paed.2024.10.004","DOIUrl":"10.1016/j.paed.2024.10.004","url":null,"abstract":"<div><div>Hypoxic-ischemic encephalopathy (HIE) in neonates, particularly near-term and term infants, presents significant risks to survival and neurodevelopmental outcomes. Mild HIE, comprising about 50% of HIE cases, has traditionally been seen as lower risk compared to moderate and severe HIE. However, emerging research suggests that mild HIE can lead to similar adverse outcomes to more severe cases, including brain injury and neurodevelopmental impairment. Therapeutic hypothermia (TH), a proven intervention for moderate to severe HIE, has been largely excluded for mild HIE management due to a lack of robust evidence. This gap has led to a phenomenon known as therapeutic creep, where interventions like TH are extended to milder cases without solid guidelines, raising concerns about its appropriateness and efficacy. This short article discusses the possible limitations of this approach and highlights why evidence from new research is urgently required.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 23-27"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The role of occupational therapy and physiotherapy in the neonatal unit","authors":"Lucy Robertshaw, Stacey Dobbin","doi":"10.1016/j.paed.2024.10.003","DOIUrl":"10.1016/j.paed.2024.10.003","url":null,"abstract":"<div><div>A neonatal intensive care unit (NICU) is an area within a hospital designed for newborns and infants born early (before 37 weeks gestation), infants with a low birth weight and/or with a medical condition requiring specialist doctor and nurse care. Approximately 1 in 7 infants require this specialist input. An addition to this, was the evolution of developmental services and neonatal therapists since the 1970s; this was due to the increasing awareness that infants and children may present with developmental challenges and special educational needs following prolonged neonatal intensive care stays. Therefore, developmental care on the NICU needs to be considered as important alongside medical interventions. There is a significant difference between the environment of the NICU and the uterine/womb experience. The role of the neonatal and developmental professionals, alongside the medical staff, such as an occupational therapist (OT) or physiotherapist (PT) is to help bridge this gap by considering and adapting the environment to promote optimal conditions to support brain development, including appropriate sensory and movement experiences, as well as supporting and coaching parents/carers to care for and nurture their newborns’ development from birth.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 16-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comprehensive insights into neonatal seizure: etiologies, diagnostic tools, management and future directions","authors":"Aravanan Anbu Chakkarapani, Ishita Singh, Umamaheswari Balakrishnan","doi":"10.1016/j.paed.2024.10.005","DOIUrl":"10.1016/j.paed.2024.10.005","url":null,"abstract":"<div><div>Neonatal seizures are a neurological emergency, particularly prevalent in very low birth weight (VLBW) infants, with incidences ranging from 58/1000 live births in VLBW to 1–3.5/1000 in term infants. These seizures are often linked to hypoxic–ischemic brain injury, intracranial haemorrhage, arterial ischemic stroke, or infection. The diagnosis relies heavily on electroencephalography (EEG) due to the high incidence of electrographic-only seizures. Common aetiologies such as hypoxic ischemic encephalopathy (HIE), hypoglycemia, stroke, and hypocalcemia significantly impact neurodevelopment and seizure recurrence. This short article discusses the causes, diagnosis and management strategies of neonatal seizures, offering practical advice on how to best manage symptomatic and subclinical seizures in babies of various gestation. It highlights the gaps in our knowledge and suggests what further research is essential to refine treatment protocols and improve prognoses for affected neonates.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 28-33"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moriam Mustapha, Kim Cahill, Jenifer Moffat, Kate Adele Wilson, Sybil Barr
{"title":"Nutrition of preterm and term infants in the neonatal unit","authors":"Moriam Mustapha, Kim Cahill, Jenifer Moffat, Kate Adele Wilson, Sybil Barr","doi":"10.1016/j.paed.2024.10.002","DOIUrl":"10.1016/j.paed.2024.10.002","url":null,"abstract":"<div><div>Optimum nutrition leads to improved long-term neurodevelopmental outcomes in both preterm and term infants admitted to neonatal units (NNUs). This review delineates the phases of nutritional management from full parenteral nutrition, transitioning to enteral nutrition and on to full enteral feeds. It describes the essential components and provides practical tips in the management of nutrition in these infants.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"35 1","pages":"Pages 8-15"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143162676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Children and young people with mental health issues admitted to the hospital: a toolkit for the general paediatrician","authors":"Marianne Leach, Laura Sand, Mel Wood","doi":"10.1016/j.paed.2024.09.005","DOIUrl":"10.1016/j.paed.2024.09.005","url":null,"abstract":"<div><div>As the number of children and young people (CYP) attending the emergency department (ED) with a mental health crisis is increasing, it has become evident that neither the environment nor the training for general paediatricians is adequate to meet CYPs’ mental health needs. This short article provides an essential toolkit for paediatricians and other healthcare professionals working with CYP. It provides a resource encompassing skills and knowledge to promote understanding of mental health crises and strategies to address these when CYP are in ED or admitted to the ward. It will allow general paediatricians to address the agitation and distress experienced by many CYP in EDs or on paediatric wards and use verbal de-scalation techniques rather than medications. The toolkit highlights how to take an appropriate mental health history, perform a mental state examination and if necessary medical investigations required, as well as providing an overview of the legal framework under which mental health conditions are managed in different age groups. A short section highlights the most common mental health issues and their management. Lastly, the CAMHS structure is explained to support the multi-professional collaboration needed to ensure CYP are managed appropriately between teams and have the best support and care possible in the ED and on paediatric wards.</div></div>","PeriodicalId":38589,"journal":{"name":"Paediatrics and Child Health (United Kingdom)","volume":"34 12","pages":"Pages 444-455"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}