Background Bovine colostrum with egg powder (BC/egg) is rich in essential amino acids and immunoactive compounds. Objectives This trial tested the hypothesis that a daily supplement of BC/egg would reduce linear growth faltering and environmental enteric dysfunction (EED) in Malawian infants when compared with an isoenergetic ration of corn/soy flour used as a control. EED was defined by a lactulose permeability test. Methods This was a prospective, randomized, blinded, placebo-controlled clinical trial in which 9-mo-old infants received BC/egg or a control for 3 mo. The primary outcomes were change in length-for-age z-score (ΔLAZ) and urinary lactulose excretion (%L) at 12-mo-old. Secondary outcomes included episodes of diarrhea, stunting, EED, and the 16S configuration of the fecal microbiota. Results Of the 277 children enrolled, 267 completed the intervention phase of the study. LAZ decreased in all children from 9 to 17 mo, although ΔLAZ was less in children receiving BC/egg from 9 to 12 mo (difference = 0.12 z-scores; P = 0.0011). This difference persisted after feeding was completed, with less ΔLAZ (difference = 0.09 z-scores). A lower prevalence of stunting was seen in the intervention group (n = 47/137) than the control group (n = 62/127) at 17 mo (RR = 0.70; 95% CI: 0.52, 0.94).The median %L at 12 mo of age in the children receiving BC/egg was 0.14%, compared with 0.17% in the control group (P = 0.74). In children with %L >0.45% at enrollment (severe EED), the BC/egg group had more children with normal %L at 12 mo of age (10/20, 50%) than was seen in controls (2/15, 13%; P = 0.024). Episodes of diarrhea and β-diversity of the 16S configuration of fecal microbiota did not differ between the 2 groups. Conclusions Addition of BC/egg to complementary feeding in Malawian infants resulted in less linear growth faltering. This trial was registered at clinicaltrials.gov as NCT03801317.

Objectives This study aims to evaluate the implementation of a delayed umbilical cord clamping (DCC) protocol for neonates <32 weeks. Secondarily, to evaluate the impact of DCC on maternal outcomes and on the ability to obtain umbilical cord blood gases. Study Design Retrospective cohort study from November 2014 to March 2016 of patients delivered by 316/7 weeks. In 2014, an institutional protocol for DCC at <32 weeks was implemented. We assessed adherence to the protocol and compared adverse maternal outcomes (utilizing a hemorrhage composite). We evaluated the impact of DCC on the ability to obtain adequate umbilical cord blood gas specimens. Results Of the 185 patients included in the study, 90 underwent DCC, and 72% of potentially eligible patients appropriately received DCC. There was no significant difference in the maternal hemorrhage composite outcome between DCC and immediate cord clamping (23.3 vs. 36.8%, adjusted odds ratio = 0.64, 95% confidence interval = 0.33, 1.26). There was also no significant difference in the ability to obtain a single or paired umbilical cord blood gas result. Conclusion Implementation of a DCC protocol for preterm neonates is feasible and was successful. We did not find an increase in maternal risk or a decrease in the ability to obtain umbilical cord blood gases following DCC.

1.2 is the equivalent of HC 3% / weight 25%. Diagnosis codes were obtained from electronic medical records. RESULTS: 28,886 newborns met inclusion criteria. 3.1% had a HC< 3%tile based on Fenton standards. (Female: 3.5%; Male: 2.6%; Preterm: 3.2%; Full-term: 2.6%). However, only 40 (0.1%) had a discharge diagnosis of microcephaly. 2.8% of the total population met criteria for HCWD. Notably, 34% of those with the discharge diagnosis of microcephaly had HCWD. All HCs in this group were < 15 th percentile. Of those with the diagnosis of microcephaly, 15% had abnormal head imaging, 2.5% were diagnosed with a potential infectious etiology of microcephaly (CMV), 65% did not require neurologic follow-up, and 40% were full term newborns who were discharged with only routine follow-up. CONCLUSION: Microcephaly is an uncommon diagnosis without clear diagnostic criteria. Congenital infection is associated with a small percentage of microcephalic infants. The vast majority of infants with small HC do not have HCWD. As awareness of microcephaly increases due to discussions of Zika virus, we risk overdiagnosis of infants without clinically significant findings. Additional studies are needed to determine which features of newborns require further workup and to establish clear diagnostic criteria for microcephaly.