Tip 3: Meningococcal B immunisation

In 2015 MenB vaccine was added to the UK immunisation schedule at 2 months, 4 months and 12 months of age.

MenB vaccine should be accompanied by prophylactic paracetamol (3 doses from the time of vaccination unless contra-indicated) at 2 months and 4 months due to the high incidence of pyrexia.

Reference: Public Health England. (2015). Meningococcal B (MenB) vaccination programme. Crown copyright 2015.

 

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Tip 2: ROP screening

100% neonates <32/40 or <1501g at birth need to be screened for retinopathy of prematurity (ROP).
<27/40, the first screening should be at 30-31/40 CGA.
For all other eligible babies, the first screening should be at 4-5/52 age, before discharge from hospital.

Reference: Royal College of Paediatrics and Child Health, Royal College of Ophthalmologists, British Association of Perinatal Medicine, BLISS. (2008). UK Retinopathy of Prematurity Guideline.

 

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Tip 249: hypoglycaemia 4

Ward based blood gas analysers should be used to guide the management of neonatal hypoglycaemia, as most handheld glucometers are not sufficiently accurate in the range of 0 – 2.0 mmol/l.

Reference: British Association of Perinatal Medicine. (2017). Identification and Management of Neonatal Hypoglycaemia in the Full Term Infant – A Framework for Practice. 

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Tip 1: anaemia

The haemoglobin nadir for term babies is at 8 – 12/52 age.

External link: anaemia of prematurity (eMedicine) (updated 2016)

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Feedback?

Dear followers,

So, we’ve reached the end of the tips that I (or some co-writers) have already written and I’ll begin the tips again from number one on Wednesday.

If you have any comments, feedback or requests for certain tips or topics, then please let me know in the comments box below or email me at hazel.clargo@doctors.org.uk.

All the best for a sunny day,

Hazel 🙂

Posted in Uncategorized | 2 Comments

Tip 248: osteopenia of prematurity 2

The following all increase the risk of fractures in association with osteopenia (or metabolic bone disease) of prematurity:

  • NEC
  • Taking >30 days to establish full enteral nutrition
  • Conjugated hyperbilirubinaemia
  • Chronic lung disease
  • Receiving chronic furosemide

The most common period for fractures is at 10 – 11 weeks’ of age.

References:

Bishop N. Metabolic bone disease. In Rennie J, Rennie & Roberton’s Textbook of Neonatology, 5th edition, 2012. Elsevier: London.

Bishop, N., Sprigg, A., & Dalton, A. (2007). Unexplained fractures in infancy: looking for fragile bones. Archives of disease in childhood92(3), 251-256.

Previously published: 29/06/15

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Tip 247: gestational borderline viability

The Nuffield Council on Bioethics produced a framework for clinical practice in 2006 regarding the resuscitation of premature babies <26/40.

  • <22/40 =  any intervention must be within an approved research study.
  • 22 – 22+6/40 = standard practice NOT to resuscitate.
  • 23 – 23+6/40 = preference given to wishes of parents.
  • 24 – 24+6 = normal practice is to resuscitate.

Reference: Nuffield Council on BioethicsCritical care decisions in fetal and neonatal medicine: ethical issues. London: Nuffield Council on Bioethics, 2006.

Previously published: 22/06/15

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