There is consensus that late vitamin K defi ciency bleeding (VKDB) should be prevented by vitamin K prophylaxis, One single dose of 1 mg vitamin Ki is effective if given i.m. or s.c., but not if given orally. Repeated oral doses might be as effective as the par enteral dose but the optimal dose regimen remains to be established. Different oral dose schedules are presently used in different countries. In Australia, Germany, The Netherlands and Switzerland active surveillance data on late VKDB were collected in a similar manner and failure rates compared. Identical case definitions were used. There were three basic strategies for oral and one for parenteral vitamin K prophylaxis for healthy new borns in the four countries: (1) daily supplementation of low dose vitamin K (25 pig) for breast-fed infants (The Netherlands); (2) 3 x
In our study population fluid supplements offered by bottle with or without the use of pacifiers during the first 5 days of life were not associated with a lower frequency or shorter duration of breastfeeding during the first 6 months of life.
We report the 9-year follow-up of a patient suffering from N-acetylglutamate synthetase deficiency, an urea cycle disorder leading to severe neonatal hyperammonaemia. Hitherto two patients from two families with this inborn error of metabolism had been observed. Our management consisted mainly of a protein-restricted diet and oral treatment with N-carbamylglutamate, an activator of carbamylphosphate synthetase, together with arginine or citrulline. The somatic development was normal whereas a moderate psychomotor retardation was diagnosed. The patient died after an episode of coma and prolonged generalized convulsions at the age of 9.5 years.
We report a 3-week-old boy with cholestatic hepatitis, most likely due to carbamazepine exposure during pregnancy and breastfeeding. Cholestasis resolved after cessation of nursing. Liver function test results and histological findings were compatible with a drug-induced hepatitis. Other causes were excluded. While carbamazepine-induced hepatitis is well known in children and adults, it has never been described in association with prenatal exposure and/or breast-feeding.
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