Fluid and electrolyte and acid–base management are essential components in the care of neonates who are considered high risk. This is particularly true for infants with very low birth weight (VLBW) for several reasons. Premature neonates typically require parenteral fluids,…
Bilirubin is one of three biologically active end-products of heme catabolism. Its clinical significance in the neonate relates to its propensity for deposition in the skin and mucous membranes, producing easily identifiable jaundice (French jaune , yellow) or icterus (Greek…
The main problems facing the physician caring for a sick newborn infant are to know when to consider the possibility of a metabolic disorder, what to do to determine quickly and efficiently whether a child has a metabolic disease, and…
Genetic sex is determined at the time of fertilization, but carrying out the steps of sexual differentiation takes place over 14 weeks of embryonic and fetal development. An error in this process may result in a disorder of sex development…
Thyroid hormone is critical for linear growth and maturation of thyroid-dependent tissues, including the brain. Many physiologic factors influence fetal and neonatal thyroid function, including fetal–maternal relationships and the dynamic alteration of thyroid function with birth. Understanding the action of…
Approximately 98% of the calcium, 80% of the phosphorus, and 65% of the magnesium in the body are in the skeleton; these elements, often referred to as the “bone minerals,” are also constituents of the intracellular and extracellular spaces. The…
The fetus depends entirely on the mother for its nutritional needs, of which glucose is the principal energy substrate that fuels fetal growth and metabolism. At birth, when the maternal supply is discontinued, the neonate must adjust to an independent…
Summary Necrotizing enterocolitis (NEC) is a devastating disease of the gastrointestinal tract that affects mostly premature infants. It is the most significant contributor of gastrointestinal morbidity and mortality in preterm infants. NEC was first described over 60 years ago but…
Thoracic Anomalies Esophageal Atresia and Tracheoesophageal Fistula Combined anomalies of the esophagus and trachea are regular occurrences in most tertiary neonatal units caring for high-risk infants. The spectrum of recognized deformities comprises a variety of combinations involving esophageal atresia (EA)…
Chronic and prolonged diarrhea is a symptom complex with a variety of underlying etiologies. This chapter focuses on the approach to infants with protracted diarrhea and is a review of recent literature on infantile diarrheal illnesses. Intractable diarrhea is a…