619 e-Letters

  • Herpes virus must be considered as one of the causes for late onset sepsis
    Dushyant Batra

    Dear Editor, Archives of Disease of childhood: Foetal and Neonatal edition

    We read the review article by Dong et al(1) with interest. We wanted to congratulate the authors on a very balanced and clinically relevant review; highlighting the epidemiological, therapeutic and preventative aspects of late onset sepsis caused by bacteria and fungi. We believe that the review would have been even more clinically releva...

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  • Re: Impact of the NICE early onset neonatal sepsis guideline in our neonatal unit: Length of stay and number of lumbar punctures performed are not increased.
    Arindam Mukherjee

    Mukherjee et al. were interested by the response to their paper indicating that not all units may have seen an increase in antibiotic use and length of stay following introduction of NICE guidance CG149. The important difference for our unit was the introduction of a second CRP at 18-24 hours to inform further investigations (lumbar puncture) and length of antibiotic course. It is not surprising that units that already u...

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  • Management of infantile haemangiomas of the eyelid
    Natalia V Cartledge

    In this review (Eye disorders in newborn infants (excluding retinopathy of prematurity), Wan MJ, VanderVeen DK, Arch Dis Child Fetal Neonatal Ed. 2015 May;100(3):F264-9. doi: 10.1136/archdischild-2014- 306215. Epub 2014 Nov 13, PMID:25395469) the authors describe clinical presentation, natural history and treatment of infantile haemangiomas (IH). These vascular tumors are common and if left untreated will result in visua...

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  • Re: I know you don't like our American brand of English, but......
    Alison Bedford Russell

    We thank Dr Perlin for his response which specifically refers to the prevention of early onset Group B streptococcus (GBS) infection.

    Similar declines in GBS EONS have been seen in many other countries that have introduced screening for GBS and IAP. In contrast, in the UK the RCOG recommendation for a risk based approach has not been associated with a fall in the incidence of GBS EONS. If the incidence fell by 75%,...

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  • Symptoms of breastfeeding difficulties are the main indication for lingual frenotomy
    Shaul Dollberg

    To the Editors: We have read with interest the article by Ingram et al (1) entitled "The development of a tongue assessment tool to assist with tongue-tie identification". The authors should be commended for simplifying and validating the ATLAF assessment. However, using their tool to decide upon whether or not to carry out lingual frenotomy has neither been proven nor is it justified. Unfortunately, this study, similar...

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  • I know you don't like our American brand of English, but......
    Barry M Perlin

    Dear Sir:

    I have read the most excellent review of early onset neonatal sepsis (EONS) published recently in these Archives by Dr's Bedford Russell and Kumar. We, in America, have witnessed the gradual evolution from a risk factor approach initially advocated by the American College of Obstetricians and Gynecologists, (as opposed to universal screening during gestation, as recommended by the American Academy of P...

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  • Congenital Chylothorax in the UK: Findings from a BPSU epidemiological study
    Caroline Haines

    We read with interest the publication by Bialkowski et al (1). Their paper on infants with congenital chylothorax (CCT) in Germany focused in detail on this patient group, in comparison to our recently published paper reporting on all infants and children >24 weeks gestation to <16 years who developed a chylothorax in UK (2).

    When reviewing data from infants with CCT from our epidemiological study, we hav...

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  • Impact of the NICE early onset neonatal sepsis guideline in our neonatal unit: Length of stay and number of lumbar punctures performed are not increased.
    Jennifer Mitchell

    We were interested to read the experiences of other units 1-4 sharing their findings of increased duration of antibiotics, length of stay in hospital and lumbar punctures (LP) performed following implementation of the NICE guideline on prevention of early onset neonatal infection (EONI)5. We recently changed our practice to follow these NICE recommendations advocating observation of low risk infants to reduce antibiotic...

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  • Oxygenation is not the only factor regulating heart rates at birth.
    S.B. Hooper

    The alternative explanation for the cardiovascular differences between immediate and delayed cord clamping at birth suggested in this commentary is not new and has been acknowledged for over 50 years. The basic premise is that asphyxia is the underlying cause of birth-related bradycardias and that avoiding asphyxia will avoid the bradycardia and associated cardiac instability. However, neonatologists have known for almo...

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  • Early cord clamping and stability of the circulatory transition during preterm birth
    Joseph J. Smolich

    The review by Hooper et al1 is timely and mounts a compelling case for a stable circulatory transition during preterm birth. However, advocacy of early ventilation with delayed cord clamping as the primary way forward to ensure such a transition is open to question, as the main supportive evidence for this paradigm comes from an experimental study by the same group,2 for which an alternative interpretation of observed f...

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