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Neonatology is one of the subspecialties of pediatrics which deals with the medical care of newborn infants, especially the ill or premature babies. It is a hospital-based specialty, and is usually practiced in neonatal intensive care units (NICU). The neonatal period is defined as the first month of life.
- Track 1-1Neonatal Resuscitation
Nutrient demands for preterm babies are challenging to meet, and hence the growth faltering is common. The primary and most important form of nutrition for infants is breastfeeding. For the infants who cannot breastfeed; standard infant formulas should be given to support adequate nutrition and growth.
Newborns should receive their first dose of hepatitis B vaccine within the first 24 hours of birth. Newborns who for a medical or other reason did not get the vaccine at birth should get their first dose as soon as possible, and complete all 3 doses at the recommended intervals. The AAP recommends that all medically stable preterm babies with a minimum birth weight of 2000 grams should be treated like full-term babies and receive the first dose of the hepatitis B immunization according to the recommended childhood immunization schedule. If birth weight is less than 2000 g, the AAP recommends administering the hepatitis B vaccine at one month of age or at the time of discharge from the hospital – whichever comes first.â€‹
Neonatal infections are acquired during prenatal development or in the first four weeks of life. There is a higher risk of infection for preterm or low birth weight neonates. Infant respiratory distress syndrome is often a condition of preterm neonates that can have long-term negative consequences; it can also arise following an infection. Other infections include bacterial, fungal, viral, protozoan infections and blood infection; termed as neonatal sepsis.
Congenital anomalies are also known as birth defects, congenital disorders or congenital malformations. Congenital anomalies can be defined as structural or functional anomalies that occur during intrauterine life and can be identified prenatally, at birth or later in life. Examples include cleft lip or palate, certain heart defects, and neural tube defects.
There are chances that a baby is born with genetic disorders. These are the direct result of a mutation in one gene. There are three types of genetic disorders: Single-gene disorders, where a mutation affects one gene; Chromosomal disorders, where chromosomes (or parts of chromosomes) are missing or changed; Complex disorders, where there are mutations in two or more genes. Examples include Cystic fibrosis, Sickle cell disease, etc.q
Neonatal Cardiology deals with the fetal diagnosis and treatment given for pregnant women at risk of or known to be carrying babies with heart problems. Neonatal heart conditions mainly includes heart defects associated with other types of disease, such as diaphragmatic hernia, heart muscle disease (cardiomyopathy) or infection (myocarditis), Heart problems due to lung masses, etc. Neonatal Hematology deals with the hematologic problems occur in the majority of sick neonates.
Neonatal Neurology focuses on the recognition and management of neurological diseases that affect the fetus, neonates and infants. It also deals with the management of neonatal infantile epilepsies, neuromuscular disorders, genetic disorders and metabolic diseases. Some of the technical aspects for the diagnosis of neonatal neural defects include amplitude integrated EEG, conventional EEG, head ultrasound and MRI.
Neonatal Gastroenterology focuses on the newborn digestive system and its disorders. Diseases affecting the gastrointestinal tract, include the organs from mouth into anus. Some of the symptoms of Gastrointestinal Problems include vomiting, reflux, diarrhea and colic. Neonatal hepatology deals with the study of newborn’s liver, the biliary tree, the gallbladder and the pancreas.
Neonatal endocrinology deals with the problems of endocrine system and its specific secretions known as hormones. Some of the neonatal endocrine disorders include pituitary gland disorders, sexual differentiation disorders, glucose homeostasis disorders, thyroid gland disorders, calcium homeostasis disorders and hypopituitarism.
Retinopathy of prematurity is a potentially blinding complication of preterm birth. The condition starts within a few weeks of birth and can progress rapidly over the following few weeks, or regress spontaneously. The international classification describes 5 stages, 3 zones, and plus disease (tortuosity and dilation of retinal blood vessels). In 2010 the annual incidence of blindness or visual impairment from ROP was estimated to affect 32,000 infants born preterm. All regions are now affected.
Risk factors for ROP include increasing prematurity, intrauterine fetal growth restriction and a range of postnatal risk factors including hyperoxia and fluctuating hypo-/hyperoxia, sepsis, failure to gain weight, thrombocytopenia and transfusion with blood products. Infants who are unstable, and who develop necrotising enterocolitis and bronchopulmonary dyplasia are particularly at risk.
Neonatal pulmonology deals with diseases involving the respiratory tract. The main respiratory disorder in neonates is Respiratory distress syndrome (RDS). It occurs in preterm infants due to a deficiency of surfactant in the lungs. This disorder is the result of under developed lungs in infants. Other respiratory problem in neonates include Chronic lung disease, Transient tachypnoea of the newborn, Persistent pulmonary hypertension of the newborn, Meconium aspiration syndrome, Pneumothorax, Congenital pneumonia, Surgical and congenital conditions.
Neonatal Dermatology deals with the skin problems seen at birth and in the first few months of life. Some of the neonatal skin problems include Transient Vascular Phenomena, Erythema Toxicum Neonatarum, Transient Neonatal Pustular Melanosis, Acropustulosis of Infancy, Neonatal Acne, Milia, Miliaria, Diaper Dermatitis, Dimpling, Umbilical Granulomas, Collodion Baby and Neonatal Pemphigus.