Illness

Necrotizing enterocolitis (NEC) is one of the most serious morbidities in preterm infants (PTNB). It is an inflammatory disease of the bowel that can cause perforation of the gut and peritonitis. Its underlying cause would be multifactorial. Some theories blame intestinal mucosal injury, inflammation and the presence of abnormal gut colonization.

Feeding PTNBs with human milk (HM) seems to have a preponderant role in the reduction of NEC, even if the supply of HM is partial.

As efforts to improve the outcomes of neonatal survival are scaled up, there is an increased demand for access to safe and effective transport.

Improving the procedures related to neonatal transport and the quality of care in critical conditions requires evidence-based technical guidelines as a reference for agencies, facilities, and health professionals responsible for setting health system priorities and policies around newborn transport.

Regionalization poses the challenge of defining where to assign resources to intensive care, transport or prevention and primary care.

Neonatal transport should be seen in the context of regionalized perinatal care, which encompasses the care of the pregnant woman and her fetus, the mother-to-be and her baby.

Surveillance of congenital defects (CDs) consists of: case detection, data collection and submission, coding, classification, analysis, interpretation and dissemination of information. Developing surveillance systems allows countries to have their own data to assess the size of the problem, evaluate its impact from different perspectives and assess the effect of interventions.

Before organizing a neonatal transport system, there needs to be planning and coordination at the national and regional levels to align transport goals and objectives with those of the health system as a whole.
The planning process includes:
• Alignment of the objectives aimed to improve health system outcomes and transportation priority cases (and cases excluded).
• Estimation of the demand for care for each health problem selected and per region (met and unmet needs).

In gestations with high risk of prematurity or potentially needing admission to the Neonatal Care Unit, prenatal admission is an opportunity for communication with the pregnant women.
Evidence-based counseling about the benefits of human milk feeding is a public health intervention that improves breastfeeding rates. Repeated prenatal informational interviews are more effective than isolated interventions and should be documented in the medical record.

Neural tube defects (NTDs) are the most common defects of the central nervous system, with a strong impact on infant morbidity and mortality.
These are some of the milestones that can be highlighted about their evolution:
- 70s: advances in medical/surgical therapies lead to a significant reduction of sequelae and disability.

According to the World Health Organization (WHO), every year, about 8 million children are born with a birth defect in the world. Congenital anomalies cause 10 per cent of all newborn deaths and many of the babies who survive are at risk of carrying a lifelong disability if they do not have timely access to high-quality care.

However, the burden of death and disability differs by place of birth and is disproportionately high in low- and middle-income countries.

Banked human milk (BHM) is the alternative of choice for feeding preterm infants (PTNB) as it provides the opportunity for them to receive a diet consisting of exclusive human milk when the milk of the baby’s own mother is unavailable, scarce or contraindicated.
In terms of its benefits, BHM is somewhat inferior to the mother's own, but superior to artificial formula.

After childbirth, it is usual for some mothers to suffer from depression or anxiety. This is due to multiple causes and, in no case should the woman going through these situations be judged. It usually appears as feelings of sadness, irritability, difficulty falling asleep or extreme tiredness.
It is very important to attend to the mother's mental health and social well-being. Referral to a specialist may be advisable.
It is also important to involve the father, sexual partner or other companions, both in the care of the child and in supporting the mother.