70 e-Letters

published between 2011 and 2014

  • UNICEF Baby Friendly Initiative and Vitamin D
    Ossie F Uzoigwe

    Cleminson and co-authors are to be commended for their excellent and comprehensive work, which raises awareness to an important health issue(1). Breastfeeding has undoubted benefits. However, it is important to recognise, when promoting the health benefits, of breastfeeding that breastmilk has very low levels of vitamin D (20IU or 0.5micrograms/litre)(2,3). This places infants, who are exclusively breastfed, at risk of...

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  • Authors' response: Perinatal Outcomes; Marlow et al 2014;99:F181-8
    Neil Marlow

    Dear Editor

    We are grateful to Dr Ehrhardt for his response to our recent paper.(1) It is certainly true that the populations compared are indeed very different, which generally makes any such comparison fraught with potential problems in interpretation. However, we would respectfully point out that we made some allowance for this in our analysis of place of booking and outcomes. This quite clearly shows adva...

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  • Answer to: "Physiolgical transition ?"
    Jeroen J van Vonderen

    Response to "Physiological transition ?"

    Thank you for your response to our research "Non-invasive measurements of ductus arteriosus flow directly after birth".

    We agree with Dr. Hutchon that a caesarian section can influence the respiratory transition of a newborn infant. As such, our results reflect the transition after elective caesarian section with cord clamping within 1 minute after birth, which...

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  • Reliability of NNAP's RoP screening data
    Sam J Oddie

    We are sorry to hear that colleagues at the Royal Free Hospital felt that our analysis of the data they provided did not reflect the realities of what is happening in their neonatal unit.

    We have already made significant changes to the processes for the 2013 data, which is expected to be published this October. NNAP now includes entries in either of the locations within the badger system ("daily data" or "ad h...

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  • Reliability of NNAP's RoP screening data
    Andrew J Lyon

    The letter by Neil Finer and others raises important questions around quality and completeness of data used for national benchmarking.

    The authors criticise the quality of NNAP data used in the published 2012 report. They show in one unit where there were inaccuracies due to data not being entered into the Badger system. They give examples of how the Badger system possibly contributed to the problem by not aler...

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  • An early PDA is not always a benign entity
    Martin R Kluckow

    We read with interest the article by Rolland et al regarding a retrospective natural history study of the PDA in a cohort of preterm infants in a unit which conservatively managed the presence of a PDA after 24 hours(1). We have concerns about the data analysis and the conclusions drawn. In particular we question the decision to exclude infants who died within the first 72 hrs and the subsequent exclusion of infants who d...

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  • Fresh frozen plasma use in the NICU: a prospective, observational, multicentred study
    Elaine Neary

    We read with interest the recent publication by Motta and colleagues (1). Their data pertaining to use of fresh frozen plasma (FFP) in the neonatal intensive care unit are helpful.

    The British Committee for Standards in Haematology transfusion guidelines (2) suggest that any neonates with significant coagulopathy [e.g. prothrombin time (PT)/activated partial thromboplastin time (APTT) ratio >1.5] and signif...

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  • Physiolgical transition ?
    David JR Hutchon

    Dear Sir,

    We congratulate the authors on this study of neonatal transitional circulation performed so quickly after birth. The authors state that the ductal flow ratio reported in their study reflects pulmonary and haemodynamic transition and can be used to monitor neonatal transition in healthy infants. The implication is that their study describes a physiological transition in healthy term infants, but we que...

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  • Re:Cardiac assessment using echocardiography in the sick neonate - An unmet need for a training syllabus for aspiring neonatologists
    Martin R Kluckow

    Dear Editor I would like to thank Dr's Madar and Kariholu for their interest in the recent review article on use of ultrasound to assess the haemodynamic status of the sick neonate(1,2). They raise an important point that highlights the current disconnect between the recognition of the usefulness of ultrasound in general for assessment of sick neonates and the lack of availability of suitable training courses to learn th...

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  • Cardiac assessment using echocardiography in the sick neonate - An unmet need for a training syllabus for aspiring neonatologists
    John Madar

    In the UK speciality training through the grid scheme has been in existence for about a decade with a well-defined syllabus of knowledge and skills deemed necessary for the qualified neonatologist. Although much emphasis is laid on various aspects of neonatal care and the acquisition of procedural skills including cranial ultrasound, cardiac assessment using echocardiography is still considered to be an optional skill (1)...

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