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Neonates are the future of the society and care of the neonates in the first few days of life is extremely
unique. The neonates who have some health problems right after birth need special care in special units
like NICU or SCUBU. To take care of these babies especially those who need help for their breathing we need
not only special unit, but special infrastructure, equipments and especially trained medical professionals that
are doctors and nurses. When there are extreme preterm then the care required is much more important. The
care required starts from antenatal period to the delivery room care and then postnatal period. There are very
good research on improving the care of these premise. Some of them have really changed the outcome to an
extent that we are able to have babies surviving at 22 week or so. The research starts from antenatal period of
giving antenatal steroids, magnesium sulfate to the mothers and managing the infections. In delivery room
temperature control, airway management, giving PEEP, sustained inflation, delayed cord clamping and to
maintain normoxia, normocarbia, perfusion, are most important interventions. Stabilization of the neonate
in delivery room and then transporting the premise maintaining the temperature and PEEP is important.
We have new ways to give surfactant to these little ones and so we use less invasive ways to deliver surfactant
to them this technique is called LISA and helps in preventing Bronchopulmonary Disease (BPD). We need
to discuss on IVH prevention strategies to have good long term neurodevelopmental outcomes. Nutrition is
another important factor which will decide on outcome of baby not only on growth but also on development.
These premise in spite of all these measures may develop BPD and so when to give steroids and if we can give
inhaled steroid to have better outcome.
Monika Kaushal is MBBS, MD Pediatrics, DM Neonatolgy, FRCPCH and has extensive experience and several publications in journals which are indexed both nationally and internationally indexed journals. She is currently undertaking MSc in Neonatology from Southampton University, UK. Dr Monika started the Fellowship program in Neonatology with affiliation to National Neonatology Forum and Indian Academy of Pediatrics India. She is honored with Fellow of Royal Collage of Pediatrics and Child Healthm, UK (FRCPCH).
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