FREQUENT QUESTIONS

Given their social and biological risk factors, premature, small, or sick newborns must meet certain criteria for safe hospital discharge.

When it is not possible to avoid preterm birth, the most beneficial interventions are those that can increase the chances of survival and improve health outcomes for premature infants.

These interventions are provided to mothers shortly before or during delivery to prevent immediate or future health-related problems in the premature newborn, such as lung immaturity, susceptibility to infection, and neurological complications.

Retinopathy of prematurity (ROP) is the leading cause of preventable blindness in childhood. Managing ROP is a priority policy to reduce its prevalence and promote eye health.

The equipment used in transport must comply with several general characteristics:

• Appropriate for the age group and for the health problems to be managed.
• Lightweight, portable, rugged and easy to clean
• It must be securely fastened in the transport vehicle for patient and equipment safety.
• Tested in transport conditions (temperature, altitude, vibration).

It is essential to have equipment that allows for:

The daily application of chlorhexidine to the umbilical cord stump in the first postnatal week is a recommendation that depends on the settings.

The only scenario that supports its use is where traditionally noxious substances (e.g., animal manure) are used on the umbilical cord. In newborns with unhygienic cord care (defined as the use of noxious substances on the cord, such as dust, clay, mud, and animal manure), chlorhexidine reduced mortality.

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.

Universal newborn hearing screening (UNHS) with otoacoustic emissions (OAE) or automated auditory brainstem evoked potentials (ABEP-A) testing is recommended for early detection of permanent bilateral hearing loss (PBHL). UNHS should be accompanied by diagnostic and treatment services for infants in whom hearing loss is detected.

Universal neonatal screening for eye anomalies is recommended. This should be accompanied by diagnostic and treatment services for infants in whom an abnormality is detected.

An estimated 1.14 million children aged 0-15 years are blind or have severe visual impairment due to eye conditions. The main causes of blindness are congenital and developmental cataracts, corneal scarring, congenital ocular anomalies, retinal dystrophies, glaucoma, and retinopathy of prematurity.