All Things Neonatal.

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All Things Neonatal.

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I am Dr. Michael Narvey a Neonatologist with over 25 years of experience and a passion for education.

This site is meant for Neonatology and specifically dissemination of interesting research.

10/28/2026

Don’t do these three things when resuscitating a baby! I am sure the provider was trying to do what he believed was right but let’s explore why these aren’t correct!

10/27/2026

This condition is preventable through but if it does happen treatment is available!

10/26/2026

A baby suddenly collapses due to something mysterious happening around their heart. not sure if this was divine intervention, but a cure mysteriously appeared!

10/26/2026

To suction or not to suction meconium after delivery...that is the question.

Multicenter retrospective study looked at two eras with the first being before routine suctioning for non-vigorous infants born through meconium and the second after this was no longer the practice.

After adjusting for s*x and site of birth the authors found that the change to no longer suction routinely led to an increase in meconium aspiration syndrome with an odds ratio of 1.37 (1.11 to 1.69) but before you jump on the bandwagon of "I knew it was a bad idea", here is what wasn't different.
🚫pneumothorax
🚫needing inhaled nitric oxide
🚫therapeutic hypothermia
🚫extended mechanical ventilation

In other words, while the diagnosis increased somewhat of MAS the implications were not that severe.

These are associations of course as it was a retrospective study but there doesn't seem to be a strong signal of harm here. While we CAN intubate well in a tertiary center the evidence doesn't say that we SHOULD.

10/25/2026

When it comes to transfusions in babies what if they didn't need adult units but could use their own blood instead.

A new feasibility study shows that this is possible by using their own saved umbilical cord blood (UCB).

This isn't just about saving adult units but rather the study which looked at < 28 weeks found that not only was it usually feasible to use their own blood but the reduction in hemoglobin F (the fetal hemoglobin which has a strong ability to deliver oxygen to tissues) is reduced when you give them their own blood.

With UCB being given the median reduction in fetal HgB-F was 2.6% vs 30.2% if adult units were used!

Previous work has suggested that use of UCB may also translate into less ROP and BPD so stay tuned!

10/25/2026

The viral moustached baby may be fake but such newborns do exist but with a lot more hair!

10/24/2026

Cellophane over the mouth & nose while sensible to protect against these things has one critical flaw.

10/23/2026

Love it when a study challenges dogma!

Do babies born at 34 weeks gestation need to be admitted to NICU (NU) or rooming in (RI) with NICU nursing support on a post partum ward could these late preterm infants room in with their parents?

In the study an NICU (NU) could care for up to 4 babies on the post-partum unit and babies were monitored (with parental education and no central monitor) for a minimum of 48 hours or up to 35 weeks gestation.

Findings are impressive!

✅Earlier skin-to-skin contact (RI: 0 h (IQR 0); NU: 1 h (IQR 14.2); p < 0.001)
✅Earlier colostrum exposure (RI: 2 h (IQR 3.2); NU: 5.5 h (IQR 8.2); p < 0.001)
✅Higher rates of exclusive breastfeeding at 15 days post-discharge (RI: 63.2%; NU: 37.5%; p = 0.005).
✅They required less nasogastric tube feeding (RI: 10.5%; NU: 76.6%; p < 0.001) ✅discharged earlier (RI: 8 days (IQR 7); NU: 19 days (IQR 14); p < 0.001)

10/23/2026

As technology improves our ability to resuscitate smaller and smaller babies improves. Should there be a weight limit?

10/22/2026

Some people are not fans of giving buccal dextrose gel for treating hypoglycemia.

Interesting alternative out of Thailand as they performed an RCT using D50W as 0.4 mL/kg rubbed into the buccal mucosa to determine if in asymptomatic newborns 34 weeks and older could avoid IV therapy for hypoglycemia.

Unfortunately, compared to placebo there was no benefit to avoiding IV therapy.

What was different though was the ability of the D50W to raise the blood glucose as the increment was statistically higher in those that received the D50W:

Median BG increment post-treatment was significantly greater in the OG group than in the placebo group (28.0 [18.0,40.0] vs. 22.5 [14.0, 35.0] mg/dL; p < 0.01).

So in the end this may not be superior to glucose gel (which previously has been shown to reduce the need for IV therapy) but if you don't have access to dextrose gel or refuse to use it in your centre might this be an alternative?

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