IntroductionNeonatal transport involves moving sick neonates in optimal conditions to ensure good outcomes. It is well organized in most developed countries but receives little attention in developing countries where the highest burden of neonatal mortality exists and a large number of newborns require referrals daily for better medical care. This study sought to evaluate the modes of transport, pre- and intra-transport care of neonates referred to the University College Hospital (UCH), Ibadan, Nigeria.MethodsThe methods of transporting 401 neonates presenting to the children’s emergency room of the hospital were evaluated as well as the care the babies received during transport. Categorical variables were compared using the Chi square test while continuous variables were compared by the student t-test.ResultsAbout a third presented in the first 12hours and 85% in the first week of life, all from within 80km radius. There were 67.1% term, 31.4% preterm and 1.5% post-term neonates, all without prior communication. The modes of transport included private vehicles (43.9%), commercial vehicles (40.6%), motorcycles (9.0%), ambulance (4.0%) and on foot (2.5%). Only 3 (0.7%) were transported in incubators and none in KMC position. Only 42.0% had referral letters and 7.0% were accompanied by medical personnel. Materials available during transport included Ambubags (3.7%), oxygen (3.5%) and some drugs (3.5%). Events during transport were apnoea, 4.7%, vomiting 1.0%, reduced activity 16.2% and seizures 13.7%. 19 (4.7%) neonates were dead on arrival. Pre-transport care included resuscitation (18.2%), intravenous fluid/feeding (24.4%) and supplemental oxygen (14.0%).ConclusionNeonatal transport practices in Ibadan, Nigeria are abysmal with associated high mortality.

The perinatal mortality rate remains unacceptably high in Nigeria. Fresh stillbirth accounted for most perinatal deaths. Interventions to improve the utilization and quality of prenatal care, in addition to the quality of intrapartum care, would considerably reduce perinatal death.

Background Transition to enteral feeding is difficult for very low‐birth‐weight (VLBW; ≤1500 g) infants, and optimal nutrition is important for clinical outcomes. Method Data on feeding practices and short‐term clinical outcomes (growth, necrotizing enterocolitis [NEC], mortality) in VLBW infants were collected from 13 neonatal intensive care units (NICUs) in 5 continents (n = 2947). Specifically, 5 NICUs in Guangdong province in China (GD), mainly using formula feeding and slow feeding advancement (n = 1366), were compared with the remaining NICUs (non‐GD, n = 1581, Oceania, Europe, United States, Taiwan, Africa) using mainly human milk with faster advancement rates. Results Across NICUs, large differences were observed for time to reach full enteral feeding (TFF; 8–33 days), weight gain (5.0–14.6 g/kg/day), ∆z‐scores (−0.54 to −1.64), incidence of NEC (1%–13%), and mortality (1%–18%). Adjusted for gestational age, GD units had longer TFF (26 vs 11 days), lower weight gain (8.7 vs 10.9 g/kg/day), and more days on antibiotics (17 vs 11 days; all P < .001) than non‐GD units, but NEC incidence and mortality were similar. Conclusion Feeding practices for VLBW infants vary markedly around the world. Use of formula and long TFF in South China was associated with more use of antibiotics and slower weight gain, but apparently not with more NEC or higher mortality. Both infant‐ and hospital‐related factors influence feeding practices for preterm infants. Multicenter, randomized controlled trials are required to identify the optimal feeding strategy during the first weeks of life.

NMR is high among hospital live births in Ibadan. There is a need for programs encouraging the use of antenatal care, improving skills on neonatal resuscitation and care of LBW infants; as well as implementation of community-based newborn survival strategies.