Key Points The most common cause of mild to moderate, early-onset thrombocytopenia in well-appearing neonates is placental insufficiency, frequently manifesting as small-for-gestational status at birth. This thrombocytopenia resolves spontaneously, usually within 10 days, and carries good prognosis. Thrombocytopenia in sick…
Key Points Acquired or inherited coagulation disorders should be considered in any neonate that suffers significant hemorrhage. Treatment for specific coagulation disorders should be provided in consultation with pediatric hematology and based on the most current guidelines. Thromboembolism (TE) is…
Key Points Pluripotential stem cells sustain hematopoietic function throughout a person's lifetime; the fate of developing cells is influenced by the microenvironment. The site of erythropoiesis changes over development, progressing from the yolk sac to the aortogonadomesonephron, to the liver,…
Key Points Early onset (<24 hours of age) or new jaundice is never normal and should be investigated. Initial evaluation of a jaundiced infant should always include conjugated and unconjugated bilirubin levels. Infants presenting with jaundice secondary to conjugated hyperbilirubinemia…
Key Points What we have termed “necrotizing enterocolitis” (NEC) is not a discrete entity but, rather, a manifestation of different forms of intestinal injury that can lead to intestinal necrosis. To make progress in terms of prevention, a better delineation…
Key Points Gastroesophageal reflux (GER) is almost universal in neonates. It is a physiologic process secondary to frequent spontaneous transient lower esophageal sphincter relaxation, relatively large volume liquid diet, and age-specific body positioning. Preterm infants have relative immaturity of neural…
Key Points Gastroschisis is a congenital abdominal wall defect located just to the right of the umbilicus. The bowel that herniates out of the abdomen is not covered by a membrane. Fetuses and newborns with a gastroschisis have a low…
Key Points Small inclusion cysts in the oral cavity are common in newborns and almost always resolve without treatment. Suspect the diagnosis of esophageal atresia when there is feeding difficulty with an inability to pass a tube from the nose…
Key Points Early use of parenteral nutrition in the very low birth weight (VLBW) neonate minimizes nutrient store losses and improves growth outcomes. Initial support goals include glucose infusion of 4 to 8 mg/kg/min, amino acids at 2 to 3…
Key Points Early protein intake is associated with improved growth and neurodevelopmental outcomes in premature infants; achieving adequate intake requires a combined parenteral and enteral approach. Mother’s own milk (MOM) is the preferred diet for preterm infants; further research is…