Dr P.K Gupta, MBBS, DCH, MNAMS, Consultant Pediatrician & Neonatologist
“The motto is to have a safe childhood”
There have been tremendous advances both in the understanding and the availability of technology for effective and rational management of development of development of healthy newborn babies. The focus has also shifted from mere survival to intact survival and the quality of life among survivors. Our aim should be to reduce the neuromotor disability and sensory neural handicaps to our society. Because the modern specialised obstetrical and neonatal care converting deaths into disability eg. Cerebral palsy, mental retardation etc.
So, proper health screening for every neonate, esp. LBW, VLBW, and extremely premature babies are must. Following is an indication for proper screenings and follow ups
All infants with a birth weight < 1800 gms
All infants with a < 35 weeks gestations
Birth asphyxia with 5 minutes APGAR score of 3 or less
Babies with assisted ventilations
Babies with metabolic disorders
Neonatal seizure due to any cause
Infants with abnormal neurological behavior
Neonatal Sepsis
Infants with malformations
Infants of HIV & Hep B+ve mother
Screening Parameters
Physical growth
Anthropometric evaluation eg. Weight, length, head circumference etc
Assessment of muscle tone
Development screening – for details assessment of neuromotor development to assess the effect of cerebral palsy
To assess the development of intelligence
Vision-especially in premature, LBW, VLBW babies
Hearing- regular assessment especially in an asphyxiated child, a child with meningitis or premature babies
Systematic Disorders
Sick babies, premature sick babies discharged from NICU may develop following systematic disorders which must be kept in mind while re-evaluating babies during Screening Programme.
Pulmonary
Bronchopulmonary dysplasia
Reactive airway disease
Recurrent respiratory infection
Blocked nose, Palatal groove
Damage to vocal cords and speech disorders
Cardiovascular
Systematic Hypertension
Carpulmonate
Pulmonary Hypertension
Renal
Nephrocalcinosis
Renal dysfunction
G.I.T
Gastroesophageal reflux
Feeding difficulties
Shut gut
Umbilical/ Inguinal hernias
Reticuloendothelial
Nutritional Anaemia
Immunodeficiency
Endocrinal
Growth Hormone
Thyroid function
Miscellaneous
Rickets
Haematological disorders
So, it is our duties to select high-risk babies & do their screening on a regular interval and if possible all babies must be screened up to 1 yr of age regularly.
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