Patient Safety Alert: Risk of severe harm and death from infusing total parenteral nutrition too rapidly in babies

NHS Improvement, Patient Safety Alert, NHS/PSA/W/2017/005 

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From incident reporting, three main types of error were identified: lipids infused at the rate intended for the aqueous solution, incorrect infusion rate, and miscalculation of volumes. NHS organisations should consider if immediate action is needed to be taken locally.

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Faltering growth- recognition and management of faltering growth in children

Faltering growth- recognition and management of faltering growth in children – guidance (NG75) – National Institute for Health and Care Excellence

This new guideline includes a definition of growth thresholds for concern and identifying the risk factors for, and possible causes of, faltering growth. It also covers interventions, when to refer, service design, and information and support.

Intensive lifestyle interventions can help obese young people lose weight

O’Connor EA, Evans CV, Burda BU, et al. Screening for Obesity and Intervention for Weight Management in Children and Adolescents: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2017;317(23):2427-44.

BikeObese children and adolescents can lose up to seven pounds over six to 12 months when they engage in at least 52 hours of behaviour-based lifestyle interventions. Minimal benefit was seen with shorter contact time, with less than 25 hours ineffective. The control group gained weight.

Rising obesity in the young is a global concern, which may lead to high rates of obesity-related diseases in adulthood. This review identified trials covering various weight management strategies. Lifestyle-based-interventions with sufficient contact time – as recommended by UK guidelines – showed clear benefits with no evidence of harms.

Investing in effective strategies to manage child obesity will ultimately save healthcare costs. Behaviour-based support should now be assessed for long-term weight loss and maintenance.

The evidence is still lacking whether universal child screening for obesity should be performed in the UK.

National Neonatal Audit 2016

National Neonatal Audit Programme (NNAP) 2017 annual report on 2016 data | The Royal College of Paediatrics and Child Health (RCPCH)  

This report highlights key findings and recommendations form the NNAP analysis of neonatal care data for over 95,000 babies during 2016.  The report is accompanied by case studies and a guide to the audit for parents and carers.

See also: Your Baby’s Care’ – A guide for parents and carers to the NNAP 2017 Annual Report on 2016 data

Additional link: RCPCH press release

Group B streptococcal disease guideline

Group B Streptococcal Disease, Early-onset (Green-top Guideline No 36) | The Royal College of Obstetricians and Gynaecologists. 

Group B Streptococcal Disease (GBS) is recognised as the most frequent cause of severe early-onset infection in newborn infants. GBS is present in the bowel flora of 20–40% of adults (colonisation) and those who are colonised are called ‘carriers’. This includes pregnant women. There is variation in practice across the UK regarding the best strategies to prevent EOGBS disease.

In 2015, the incidence of EOGBS in the UK and Ireland was 0.57/1000 births (517 cases), a significant increase from the previous surveillance undertaken in 2000 where an incidence of 0.48/1000 was recorded.

The purpose of this guideline is to provide guidance for obstetricians, midwives and neonatologists on the prevention of early-onset (less than 7 days of age) neonatal group B streptococcal (EOGBS) disease and the information to be provided to women, their partners and families.

Group B Streptococcal Disease, Early-onset (Green-top Guideline No 36)

Breastfeeding and vitamin D

The UK Royal College of Paediatrics  and Child Health guidance on breastfeeding has been warmly welcomed in both the medical and lay spheres | Archives of Disease in Childhood

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Breastfeeding has undoubted benefits and should be singularly promoted and encouraged. However, in their position statement, the college omits to mention the importance of vitamin D supplementation for breastfed children and lactating women in the UK. This is an important measure to support women and children and ensure their health during this period. Hypovitaminosis D is exceedingly common in the UK with rates as high as 20% for adults and 8%–24% for children depending on gender and age

Full reference: Uzoigwe, C.E. & Ali, O. (2017) Breastfeeding and vitamin D. Archives of Disease in Childhood Published Online First: 14 September 2017.