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Dr Ranjan Kumar Pejaver, Bengaluru 16 January 2018

Cost-effective interventions to improve outcomes in preterm newborns - Antenatal steroids for women in Antenatal corticosteroids have been found to decrease respiratory distress syndrome (RDS), need for respiratory support and NICU admission, intraventricular hemorrhage (IVH), necrotizing enterocolitis (NEC), and neonatal deaths.
Antenatal magnesium sulfate therapy given to women at risk of preterm birth has been found to decrease the risk of cerebral palsy in newborns.
Delayed cord clamping is a safe and inexpensive way to prevent infant anemia.
Use less oxygen for resuscitation. For infants born at ≥35 weeks gestation, begin with 21% oxygen (room air); infants <35 weeks gestation – resuscitation should begin with 21%-30% FiO2 to maintain appropriate target preductal oxygen saturations. Initiating resuscitation with higher than 65% FiO2 is not recommended.
Temperature control – Plastic wrap/plastic bag prevents evaporative heat loss in preterm infants.
Kangaroo mother care in LBW infants decreases mortality, hypothermia, nosocomial infection and length of hospital stay.
Use of human milk in the intensive care nursery decreases the incidence of nosocomial sepsis.
Feeding in NICU – Start feeding early; use mother’s own milk whenever possible.
Antibiotics use – Avoid empirical usage of antibiotics; develop logistics to improve and increase true culture yields; stop antibiotics as soon as possible; do not use broad spectrum antibiotics; have an antibiotic policy.

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