What Parents Need to Know About Vitamin K Administration at Birth

Morbidity and mortality outcomes in neonates who were transferred from home and hospitals to the only neonatal intensive care unit in Guinea: a descriptive report using routinely collected health data

Background

The Sustainable Development Goal (SDG) for neonatal mortality has identified its reduction as one of the main targets to be achieved by 2030. We provide a descriptive report on neonatal outcomes from the only neonatal intensive care unit (NICU) in Guinea.

Methods

Data collection took place between November 2004 and May 2005 at the NICU of the Institute of Child Health in the capital, Conakry. A descriptive summary of the neonatal, maternal and intrapartum characteristics is reported.

Results

A total of 294 neonates were admitted to the NICU incubators during the study period, transferred either from hospitals (48%) or directly from their homes (52%). The most common reasons for admission were foetal distress (37.1%) and maternal–foetal infections (35.4%). Among 270 neonates with known outcome, the overall mortality among the admitted children remained high at 20.7% (56/270),with a large proportion of the deaths (71.4%, 40/56) occurring within 7 d of their admission. The mortality rate was 23.7% (31/131) among the neonates who were admitted to our NICU after home birth and 17.9% (25/139) among those who were transferred from hospitals (OR: 1.41, 95% CI: 0.75–2.67).

Conclusion

Almost one in every five neonates who were admitted to the NICU incubator died during the study period. More hospitals equipped with NICU facilities are urgently required if Guinea is to achieve the SDG target for neonatal mortality.

Ankyloglossia and the Breastfeeding Infant: Assessment and Intervention

BACKGROUND

Our current culture defines breastfeeding and the use of human breast milk as the preferred criterion standard for infant nutrition. Medical and health professionals have a responsibility to support breastfeeding in the mother-infant dyad. This includes the recognition of anatomical barriers to breastfeeding such as a tongue-tie, ankyloglossia.

PURPOSE

The purpose of this article is to enrich and expand the clinical knowledge of health professionals about the physical assessment of ankyloglossia and its impact on breastfeeding. Techniques for assessing anterior and posterior ankyloglossia and interventions across the spectrum are discussed. We also explore maternal emotional experiences of breastfeeding an infant with ankyloglossia.

METHODS/SEARCH STRATEGY

A systematic literature search from MEDLINE, CINAHL, and Cochrane databases was performed. The search results consisted of qualitative and quantitative studies performed involving infants with anykloglossia and breastfeeding experiences. Data and findings from the search results were analyzed and reviewed.

FINDINGS

Ankyloglossia, commonly referred to as tongue-tied, can result in weight loss, painful breastfeeding, and a cessation of breastfeeding prematurely. Depending on severity, interventions to alleviate breastfeeding difficulties can range from a lactation consultation to surgical intervention. The options for treatment and intervention must be discussed thoroughly with caregivers.

IMPLICATIONS FOR PRACTICE

Thorough assessment of the breastfeeding dyad is essential to discovering ankyloglossia and its role in breastfeeding difficulties. Intervening appropriately can prevent negative outcomes associated with ankyloglossia and breastfeeding.

IMPLICATIONS FOR RESEARCH

Future studies should be focused on developing universal tools for grading ankyloglossia and the effects of ankyloglossia on speech development. There is also a gap in the knowledge regarding ankyloglossia in the preterm infant and its impact on developing breast and bottle-feeding technique in the neonatal intensive care unit.