BackgroundBreast feeding by SARS-CoV-2-infected mothers has been a concern because of the possibility of excretion of virus in breast milk.ObjectiveTo detect SARS-CoV-2 in expressed breast milk (EBM) of mothers infected with SARS-CoV-2 and clinical outcome of neonates delivered and breast fed by them.DesignA single-centre, prospective observational study involving 50 SARS-CoV-2-infected mothers and their 51 neonates.SettingA tertiary care hospital in Eastern India.ParticipantsSARS-CoV-2-infected mothers and neonates delivered by them.Main outcome measuresWe investigated the presence of SARS-CoV-2 in the breast milk of mothers, who tested positive for this virus in their nasopharyngeal swab (NPS). Clinical outcome was assessed in neonates breast fed by these mothers after 1 month of the postnatal period.Results50 SARS-CoV-2-positive expectant mothers were enrolled for the study. One out of 51 neonates, who delivered through lower segment caesarean section at term gestation and tested SARS-CoV-2 negative, died due to severe birth asphyxia. One sample of EBM was collected from each of the 49 mothers within 4 days of delivery. All EBM samples tested negative for SARS-CoV-2 through real-time reverse transcriptase-PCR (RT-PCR). All the newborns were screened twice for presence of SARS-CoV-2 RNA in their NPS, by RT-PCR. 2 of 51 neonates had COVID-19 infection after 24 hours of life. Caregivers of 37 of 50 alive neonates responded to follow-up via telephone. Except for minor feed intolerance in one (1 of 37) neonate, all neonates were reported well after 1 month of their age.ConclusionAll the samples of breast milk were negative for SARS-CoV-2. Most of the neonates remained asymptomatic on breast feeding, whose mothers had SARS-CoV-2 infection before delivery.

Most of the cardiac abnormalities which pediatricians come across, require echocardiography for confirming the diagnosis. Due to the introduction of 'point of care ultrasonography' and widespread availability of ultrasonography equipment in clinical care areas, pediatricians are able to diagnose some of these cardiac abnormalities; however, they are unable to make a prompt echocardiographic diagnosis by themselves in most of these cardiac conditions due to lack of echocardiography skills. Pediatric residents and consultants, especially those who are involved in providing care in pediatric emergency, pediatric ICU, and neonatal ICU, should learn the skills of basic echocardiography for making the quicker diagnosis of such conditions and improving patient care. Subcostal view echocardiography can detect many cardiac abnormalities through a single echocardiographic window. There is a need of formulating a need-based basic Echocardiography training program to be incorporated into the Pediatric residency curriculum.

Accidental strangulation is an uncommon injury in children, however it may lead to neurological disability or death. Various modes of injuries have been reported in such accidents. Children might get strangulated while playing if they are wrapping any cord or cloth like material around their neck. Caregivers of the children should be aware of the potential sources around and mechanisms of such injuries to avoid such accidents.

Introduction: Data on COVID-19 transmission, manifestations and outcome for the neonatal population is scarce, particularly from developing country settings. Objectives:To assess the transmission risk of SARS-CoV-2 in the mother-infant dyad and to describe the clinical profile of neonates born to COVID-19 positive mothers in a tertiary care centre in Northern India.Method: An observational cohort study was conducted in the neonatal COVID-19 unit of All India Institute of Medical Sciences Patna, India. All neonates delivered by COVID-19 positive mothers at this hospital were admitted. During the pandemic, admissions were also allowed for out-born neonates positive for SARS-CoV-2. COVID-19 RT-PCR on nasopharyngeal swab of neonate at 24 and 48-72 hours was the primary outcome variable. Clinicolaboratory variables were collected during the hospital stay and follow up. An inferential analysis was done using SPSS version 22.0.Results: Fifty-one out of 145 (142 delivered at our institute and 3 at other institutes) pregnant women tested positive for COVID-19. Two in-born neonates and two out-born neonates also tested positive. They had a significantly higher respiratory rate (p=0.0006) as compared to COVID-19 negative new-borns. COVID-19 RT-PCR done on breast milk samples of twenty-five mothers, tested negative.