The e-Journal of Neonatology Research

Your open access, online source for everything in neonatology

Volume 4, Issue 2, Summer 2014

without comments



The editors of the e-Journal of Neonatology Research



1. Projected Versus Actual Vitamin D Intake in Premature Infants

Dorey A. Glenn and Stephanie Schuck


2. Increased Protein Intake Decreases Weight Gain Due to Fat in Preterm Infants

Courtney B. Atchley, Patricia K. Williams, David A. Fields, and Michael P. Anderson


3. Increasing Serum Alpha-Fetoprotein Levels in a Neonate with Multiple Hepatic Lesions: A Case of Multifocal Congenital Hepatic Hemangioendotheliomas

Pratibha Ankola, Patricia Donovan, Sarah Milla, Rafael Rivera, Howard Ginsburg, M. Alba Greco, Farzana Arif and Francine Biel



1. Going too far, too fast…(The Joint Workshop and Their Own Private Iowa)

Phillip Gordon


2. Is the Old BPD Making a Come Back?

Phillip Gordon




1. Periviable birth: executive summary of a joint workshop by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists. Raju TNK, Mercer BM, Burchfield DJ, Joseph GF. J Perinatol 2014; 34: 333-342.

See editorial above

2Cognitive outcomes of preterm infants randomized to darbepoetin, erythropoietin, or placebo. Ohls RK, Kamath-Rayne BD, Christensen RD, Wiedmeier SE, Rosenberg A, Fuller J, Backstrom Lacy C, Roohi M, Lambert DK, Burnett JJ, Pruckler B, Peceny H, Cannon DC, Lowe JR. Pediatrics 2014; 133:1023-30.

3. Antenatal magnesium sulfate and spontaneous intestinal perforation in infants less than 25 weeks gestation. Rattray BN, Kraus DM, Drinker LR, Goldberg RN, Tanaka DT, Cotten CM. J Perinatol 5 June 2014; Epub ahead of print.

4. Acute drop in blood monocyte count differentiates NEC from other causes of feeding intolerance. Remon J, Kampanatkosol R, Kaul RR, Muraskas JK, Christensen RD, Maheshwari A.  J Perinatol 2014; 34: 549-54.

Finally, a potential use for all those differentials when we suspect NEC. PVG

5. Cannabis, the pregnant woman and her child: weeding out the myths. Jaques SC, Kingsbury A, Henshcke P, Chomchai C, Clews S, Falconer J, Abdel-Latif ME, Feller JM, Oei JL. J Perinatol 2014; 34:453-7.

6. Feeding preterm infants during red blood cell transfusion is associated with a decline in postprandial mesenteric oxygenation. Marin T, Josephson CD, Kosmetatos N, Higgins M, Moore JE. J Pediatr 18 June 2014; Epub ahead of print.

7. Prophylactic use of lactobacillus acidophilus/Bifidobaceterium infantis probiotics and outcome in very low birth weight infants. Hartel C, Paggel J, Rupp J, Bendiks M, Guthmann F, Rieger-Fackeldey E, Heckmann M, Franz A, Schiffmann JH, Zimmermann B, Hepping N, von der Wense A, Wieg C, Herting E, Gopel W. J Pediatr 02 June 2014; Epub ahead of print.

8. Effects of hypothermia for perinatal asphyxia on childhood outcomes. Azzopardi D, Strohm B, Marlow N, Brocklehurst P, Deierl A, Eddama O, Goodwin J, Halliday HL, Juszczak E, Kapellou O, Levene M, Linsell L, Omar O, Thoresen M, Tusor N, Whitelaw A, Edwards AD, for the TOBY Study Group N Engl J Med 2014; 371: 140-9.

9. Surgery and neurodevelopmental outcome of very low-birth-weight infants.  Morriss FH, Saha S, Bell EF, Colaizy TT, Stoll BJ, Hintz SR, Shankaran S, Vohr BR, Hamrick SEG, Pappas A, Jones PM, Carlo WA, Laptook AR, Van Meurs KP, Sanchez PJ, Hale EC, Newman NS, Das A, Higgins RD; for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. JAMA Pediatr 16 June 2014; Epub ahead of print.

10. Feeding Preterm Infants during Red Blood Cell Transfusion Is Associated with a Decline in Postprandial Mesenteric Oxygenation. Marin T, Josephson CD, Kosmetatos N, Higgins M, Moore JE. J Pediatr 2014 Jun 16. pii: S0022-3476(14)00428-4. doi: 10.1016/j.jpeds.2014.05.009. [Epub ahead of print]

This pretty much convinces me about holding feeds during high risk transfusions, and gives reasonable guidance for how long. PVG


Complications of feeding practices  and product choices that lead to acquired neonatal intestinal diseases that may or may not be true NEC

1. Late onset necrotizing enterocolitis in infants following use of a xanthan gum-containing thickening agent. Beal J, Silverman B, Bellant J, Young TE, Klontz K. J Pediatr. 2012 Aug;161(2):354-6. doi: 10.1016/j.jpeds.2012.03.054. Epub 2012 May 9.

Looks like NEC but occurs at or after discharge to home. This is not NEC as we know it.

2. Human milk fortifier: an occult cause of bowel obstruction in extremely premature neonates. Stanger J, Zwicker K, Albersheim S, Murphy JJ 3rd.J Pediatr Surg. 2014 May;49(5):724-6. doi: 10.1016/j.jpedsurg.2014.02.054. Epub 2014 Feb 22.

This seems to be on the rise with high protein fortifiers of breast milk. NEC can be a secondary complication and the shadow around the lactobezoar may look like pneumatosis.

3. Reducing necrotizing enterocolitis in very low birth weight infants using quality-improvement methods. Patel AL, Trivedi S, Bhandari NP, Ruf A, Scala CM, Witowitch G, Chen Y, Renschen C, Meier PP, Silvestri JM. J Perinatol. 2014 Jul 10. doi: 10.1038/jp.2014.123. [Epub ahead of print]

OK, this is NEC and this is not the first time we have seen QI with NG feeding practice improve NEC outcomes.

4. Cronobacter: an emerging opportunistic pathogen associated with neonatal meningitis, sepsis and necrotizing enterocolitis. Hunter CJ, Bean JF.J Perinatol. 2013 Aug;33(8):581-5. doi: 10.1038/jp.2013.26. Epub 2013 Mar 28. Review.

If the person in charge of formula and fortification does not know about Cronobacter, you could eventually have a problem.

5. Prolonged duration of initial empirical antibiotic treatment is associated with increased rates of necrotizing enterocolitis and death for extremely low birth weight infants. Cotten CM, Taylor S, Stoll B, Goldberg RN, Hansen NI, Sánchez PJ, Ambalavanan N, Benjamin DK Jr; NICHD Neonatal Research Network. Pediatrics. 2009 Jan;123(1):58-66. doi: 10.1542/peds.2007-3423.

We would be remiss if we did not remind you that inappropriate use of early antibiotics drives intestinal flora towards a higher NEC risk condition.


Recommended Neonatal Blogs and Sites by Dr Dr Keith Barrington

Public Health Blog Page at Texas Childrens by Dr Steven Abrams

Neonatology on the Web by Ray Duncan

Neoknowledge by Dr Gautham Suresh

Research Raven – Neonatal Conferences by Good Samaritan

Retrospectoscope –

Ethical dilemmas in the care of the most premature infants: the waters are murkier than ever. Lorenz JM. Curr Opin Pediatr. 2005 Apr;17(2):186-90.

In the aftermath of the workshop decision regarding aggressive resuscitation of 23 0/7 week infants, I cannot think of a more appropriate retrospectoscope than one that reviews the case of the Miller baby. (PVG)


National Association of Neonatal Nurses, Annual Educational Conference, September 10-13, Phoenix, Arizona

Perinatal Research Society, 45th Annual Meeting September 12 – 14, 2014 Monterey, California

American Academy of Pediatric National Conference, Oct 11-14. San Diego , California

2014 Newborn Screening and Genetic Testing Symposium, October 27-30, 2014 Anaheim, California

Hot Topics in Neonatology® The Omni Shoreham Hotel, Washington, DC , December 7-10, 2014



There were no rejected manuscript(s) and zero rejected letter(s) for this volume (we will NOT publish specific information about individual rejections).

We received and honored a request for the withdrawal of the manuscript entitled: “Influence of Maternal Factors on Birth Weights of Neonates”  by Anshumali Jyothishi, Rajesh K. Padhi and Soumya Mishra in Volume 3, Issue 3, Summer 2013. Because eJNR is an entirely electronic journal, the article was removed and all links severed. This missive will now serve as the only record of the original publication. The reason given for the withdrawal was a recent, post-publication finding of critical errors in the data collection and statistics, making the study invalid.

Written by Dr Phillip Gordon

July 28th, 2014 at 3:46 pm

Posted in Uncategorized