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September 2020 NEONATOLOGY Peer Reviewed Research, News and Information TODAY in Neonatal and Perinatal Medicine Volume 15 / Issue 9 | September 2020 The Genetics Corner: Human and Donor Milk Use Post NICU Discharge DiGeorge Anomaly Associated with Diabetic Embryopathy Elaine Ellis, MD, Christine Aune, MD, Mario Fierro, MD, Cathleen Roberts, in an Infant without a Deletion on Chromosome 22q11 DO, Mary Allare, MD, Bradlee Drabant, MD, Amy S. Kelleher, MSHS, Subhadra Ramanathan MS, MSc, Robin Dawn Clark MD Christina Sanchez, Cheryl McDuffie, FNP .............................................................................................................Page 95 .............................................................................................................Page 3 2020 Infant Health Policy Summit Agenda Fellow Column: An Unbalanced Translocation Involving Mitchell Goldstein, M,D., Susan Hepworth Partial Duplication of Chromosome 6 and Partial Deletion of .............................................................................................................Page 100 Chromosome 10 in a Premature Infant with Tetralogy of Fallot Clinical Pearl: Kevin Mo, Teagan Tran, Arjina Boodaghian, John Wear, John Ho, MD, The COVID-19 Vaccine and Viral Variants Robin Clark MD, Mitchell Goldstein MD Joseph R. Hageman, MD .............................................................................................................Page 20 .............................................................................................................Page 108 The Vaccine Rate Decline and Addressing Vaccine Interpreting Umbilical Cord Blood Gases: Hesitancy Around Sudden Infant Death Syndrome Cord Occlusion with Terminal Fetal Bradycardia: Part 1 Barb Himes, IBCLC Jeffrey Pomerance, MD, MPH .............................................................................................................Page 27 .............................................................................................................Page 111 Balancing the Needs of the Patient and the Needs of the System Error as a Faulty Failure Signal Rob Graham, R.R.T./N.R.C.P. Daved van Stralen, MD, FAAP, William Gambino, MA, MMAS .............................................................................................................Page 32 .............................................................................................................Page 114 A Price Tag of $38.50 Saved My Son 99nicu webinar 2020-10-14 Tiffany Moore, RN, PhD Stefan Johansson, MD, PhD and Francesco Cardona, MD, MSc .............................................................................................................Page 36 .............................................................................................................Page 119 Precluding Pregnant Women from COVID-19 Vaccine Trials is Cause for Letters to the Editor: Concern Mitchell Goldstein, MD, Editor in Chief replies to Michelle Winokur, DrPH, and the AfPA Governmental Affairs Team Daved van Stralen, MD, Poi Lysouvakon, MD, Joseph R. Hageman, and ...................................................................................................................Page 44 Jaclyn Eisenberg, MD Williams-Beuren Syndrome Presenting as Pulmonary Edema with .............................................................................................................Page 121 Pleural Effusion: Neonatology Today Readies the Beta Test of its Digital Web Site A New Pulmonary Manifestation of Elastin Vasculopathy Fu-Sheng Chou, MD, PhD, Mitchell Goldstein, MD Fadi Al Khazzam, Ashraf Gad, Muhammad Dilawar .............................................................................................................Page 124 .............................................................................................................Page 48 Erratum Neonatology Today – Reflection on the Past and Future .............................................................................................................Page 125 Mikko Hallman, MD, PhD Academic True Open Model (ATOM) ...................................................................................................................Page 56 .............................................................................................................Page 126 Coping With COVID-19: An Online Educational Course Upcoming Meetings Sue Hall, MD .............................................................................................................Page 128 ...................................................................................................................Page 59 Subscriptions and Contact Information Health Equity Column: .............................................................................................................Page 128 More Than A Moment: The Alliance for Black NICU Families Editorial Board Jenné Johns, MPH .............................................................................................................Page 131 ...................................................................................................................Page 62 Neonatology Today: Policy on Animal and Human Research Perinatal/Neonatal Medico-Legal Forum: Valpractice .............................................................................................................Page 131 Gilbert Martin, MD Neonatology Today: Instructions for Manuscript Submission ...................................................................................................................Page 72 .............................................................................................................Page 131 Neonatology Solutions NICU Directory: Neonatology and the Arts Updated Content Herbert Vasquez, MD Scott Snyder, MD .............................................................................................................Page 133 ...................................................................................................................Page 75 Cactus - Paula Whiteman, MD Medical News, Products & Information .............................................................................................................Page 134 Compiled and Reviewed by Mitchell Goldstein, MD Editor in Chief Growth of the Pink Flamingo Colony - Larry Tinsley, MD ...................................................................................................................Page 80 .............................................................................................................Page 135 NEONATOLOGY TODAY Loma Linda Publishing Company © 2006-2020 by Neonatology Today A Delaware “not for profit” 501(c) 3 Corporation. Published monthly. All rights reserved. c/o Mitchell Goldstein, MD ISSN: 1932-7137 (Online), 1932-7129 (Print) 11175 Campus Street, Suite #11121 All editions of the Journal and associated Loma Linda, CA 92354 manuscripts are available on-line: Tel: +1 (302) 313-9984 www.NeonatologyToday.net LomaLindaPublishingCompany@gmail.com www.Twitter.com/NeoToday NT Peer Reviewed Human and Donor Milk Use Post NICU Discharge Elaine Ellis, MD, Christine Aune, MD, Mario Fierro, MD, Cathleen Introduction Roberts, DO, Mary Allare, MD, Bradlee Drabant, MD, Amy S. Kelleher, MSHS, Christina Sanchez, Cheryl McDuffie, FNP Feeding of human milk in the NICU and after discharge is associ- ated with improved outcomes, but rates of human milk provision Abstract: after infants are discharged from the NICU remain low(1) despite the fact that the American Academy of Pediatrics endorses exclu- Background: The health benefits of feeding all infants human milk sive breastfeeding for the first 6 months with the recommendation are well established but the use of human milk after infants are dis- that, ideally, breastfeeding continues for the first year of life. (2) charged from the Neonatal Intensive Care Unit (NICU) remains low. The World Health Organization and UNICEF recommend initiation of breastfeeding within the first hour after birth, exclusive breast- Aims: Our aim was to investigate which infants were receiving feeding for the first six months, and continued breastfeeding for human milk at discharge from the NICU and at varying times after two years or more, together with safe, nutritionally adequate, age- discharge and to explore factors that foster or inhibit increasing appropriate, responsive complementary feeding starting in the human milk use in NICU graduates. sixth month. (https://www.who.int/elena/titles/early_breastfeed- ing/en/). Benefits to low birth weight infants have been demon- Methods: We conducted a prospective, observational study and strated to include fewer re-hospitalizations, higher Bayley scores collected data on the use of human milk at hospital discharge and and better emotional regulation at 30 months. (3-5) Even though during follow-up visits in five developmental follow-up programs. there are established benefits for providing human milk to infants These follow up programs were in 5 different large cities in 3 dif- requiring admission for intensive care, mothers face real challeng- ferent states in the United States. es to accomplish this goal. (6;7) Results: The overall rate of use of any human milk decreased NICUs have implemented programs to increase the use of human from 841/1160 (72. 5%) at discharge to 233/791 (29.5%) in par- milk, and in some units, as many as 80 percent or more of infants ticipants who were followed for >4 and ≤7 months after birth and receive at least some human
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