Key Points The neonate and the young infant depend primarily on the innate immune system for host defense. With limited prior exposure to infectious and environmental antigens, the adaptive immune arm is still in a phase of structural and functional…
Key Points Recent multicenter randomized trials support more conservative transfusion approaches with the use of lower hemoglobin and platelet count thresholds. Two multicenter clinical trials did not show improvement in survival without neurodevelopmental impairment or other important outcomes with the…
Key Points Erythropoiesis occurs in stages or waves during embryonic development, initiating in the yolk sac, migrating to the liver, and finally to the bone marrow. The sites of erythropoietin production also transition during development from the neuronal cells to…
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…