Neonatology for Primary Care

1344 Pages·2020·13.373 MB·English

by  Deborah E. Campbell

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for Primary Care n
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2nd Edition for Primary Care
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Editor: Deborah E. Campbell, MD, FAAP
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The revised and updated second edition covers practical approaches to caring for healthy and
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high-risk newborns and infants. Topics covered include maternal and fetal health, care of the
newborn after delivery, breastfeeding, follow-up care, common congenital anomalies, the newborn 2nd Edition
with a heart murmur or cyanosis, neurologic findings, primary care issues relating to newborns l
and infants requiring intensive care, and health and developmental outcomes. o
The content covers the continuum of care from delivery through hospitalization and discharge
for the healthy term and late preterm newborn and infant, as well as the newborn who requires
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specialized neonatal intensive care.
More than 40 chapters cover step-by-step recommendations on what to do, when to admit, and
when to refer. Detailed references and links to relevant American Academy of Pediatrics policies y
are noted within each chapter.
New in the second edition
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8 new chapters, including o
• Prenatal Diagnosis • Balancing Safe Sleep and Other r
• Fetal Interventions Recommendations for Newborns
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• Optimizing Nutrition for the Preterm, • Vascular Anomalies
Very Low-Birth-Weight Infant After • Endocrine Disorders Manifesting in the r
Discharge From Neonatal Intensive Care Newborn Period im
• Newborn Immunizations and Immune • Shared Decision Making Around Home
Prophylaxis Technologies
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Comprehensive coverage includes r
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• Perinatal preventive care • Caring for the high-risk infant

• Routine care issues • Neonatal outcomes C
• Assessment and physical examination • Medicolegal considerations
of the newborn • Support for families during perinatal a
• Neonatal medical conditions illness and death
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Neonatology for Primary Care, 2nd Edition, is an ideal resource for pediatricians, family physicians,
medical students, residents, residency program directors, physician assistants, pediatric nurse
practitioners, and nurses.
For other neonatal and pediatric resources, visit the American Academy of Pediatrics
Editor: Deborah E. Campbell, MD, FAAP
at shop.aap.org.
AAP
Neonatolog y
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for rimary are
2nd Edition
Editor
Deborah E. Campbell, MD, FAAP
Professor of Pediatrics
Associate Professor of Obstetrics & Gynecology and Women’s Health
Albert Einstein College of Medicine
Chief, Division of Neonatology
Children’s Hospital at Montefiore
Bronx, NY
American Academy of Pediatrics Publishing Staff
Mary Lou White, Chief Product and Services Officer/SVP, Membership, Marketing, and
Publishing
Mark Grimes, Vice President, Publishing
Chris Wiberg, Senior Editor, Professional/Clinical Publishing
Theresa Wiener, Production Manager, Clinical and Professional Publications
Mary Louise Carr, MBA, Marketing Manager, Clinical Publications
Published by the American Academy of Pediatrics
345 Park Blvd
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Telephone: [phone]
Facsimile: 847/434-8000
www.aap.org
The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians,
pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health,
safety, and well-being of infants, children, adolescents, and young adults.
The recommendations in this publication do not indicate an exclusive course of treatment or
serve as a standard of medical care. Variations, taking into account individual circumstances,
may be appropriate.
Any websites, brand names, products, or manufacturers are mentioned for informational and
identification purposes only and do not imply an endorsement by the American Academy of
Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information
was current at the time of publication.
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If they have inadvertently overlooked any, they will be pleased to make the necessary
arrangements at the first opportunity.
This publication has been developed by the American Academy of Pediatrics. The authors,
editors, and contributors are expert authorities in the field of pediatrics. No commercial
involvement of any kind has been solicited or accepted in the development of the content
of this publication. Disclosures: Dr Derrick (Ch 32) disclosed a family member’s consulting
relationship with Colgate. Dr Drzewiecki (Ch 32) disclosed a consulting relationship with
Astellas Pharma. Dr Kim (Ch 10) disclosed a consulting relationship with Medela and with
Astarte Medical, a shareholder relationship with Nicolette, and a principal investigator
relationship with Mallinckrodt. Dr Munjal (Ch 11) disclosed an employee and stockholder
relationship with Pfizer, Inc. Dr Schanler (Ch 9) disclosed a medical advisory board
relationship with Medela.
Every effort has been made to ensure that the drug selection and dosages set forth in this text
are in accordance with the current recommendations and practice at the time of publication.
It is the responsibility of the health care professional to check the package insert of each drug
for any change in indications and dosages and for added warnings and precautions.
Every effort is made to keep Neonatology for Primary Care consistent with the most recent
advice and information available from the American Academy of Pediatrics.
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© 2020 American Academy of Pediatrics
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at 847/434-8780 or email [email protected]). First edition published 2015; fourth, 2020.
Printed in the United States of America
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MA0884
ISBN: 978-1-61002-224-8
eBook: 978-1-61002-225-5
Cover and publication design by Peg Mulcahy
Library of Congress Control Number: 2018932591
Contributors
Mohamed Farooq Ahamed, MD, Albert Einstein College of
FAAP Medicine
Assistant Professor of Pediatrics Bronx, NY
Division of Neonatology 11. Newborn Immunizations and
Southern Illinois University- Immune Prophylaxis
School of Medicine
Springfield, IL Ada E. Aponte, MD, FAAP
34. Surgical Emergencies of the Assistant Professor, Albert
Chest and Abdomen in the Einstein College of Medicine
Newborn Newborn Nursery Hospitalist
The Children’s Hospital at
Neil Joseph B. Alviedo, MD Montefiore - Weiler Division
Assistant Professor Bronx, NY
Division of Neonatal-Perinatal 18. Physical Examination of the
Medicine Newborn
University of Florida
Jacksonville, FL Felix De Paz Bañadera, MD
29. Prenatal Drug Use: Neonatal Assistant Professor of Pediatrics
Effects and the Neonatal Neonatologist
Withdrawal Syndrome Division of Neonatology
University of Florida
Wyatt Andrasik, MD Jacksonville, FL
Resident, Dermatology 29. Prenatal Drug Use: Neonatal
Cleveland Clinic Foundation Effects and the Neonatal
Cleveland, OH Withdrawal Syndrome
20. Vascular Anomalies
Judy C. Bernbaum, MD, FAAP
Robert Angert, MD, FAAP Professor of Pediatrics
Attending Neonatologist The University of Pennsylvania
Assistant Professor of Pediatrics School of Medicine
Children’s Hospital at Montefiore Senior Attending Physician
iii
CONTRIBUTORS
iv
Director, Neonatal Follow Up Chief, Division of Neonatology
Program Children’s Hospital at Montefiore
The Children’s Hospital of Bronx, NY
Philadelphia 7. Prenatal Pediatric Visit
Philadelphia, PA 38. Continuing Care of the Infant
40. Follow-up Care of the After Transfer From Neonatal
Graduate From Neonatal Intensive Care
Intensive Care 39. Discharge Planning for the
High-Risk Newborn Requiring
Diane E. Bloomfield, MD, FAAP Intensive Care
Assistant Professor 41. Health and Developmental
Division of Academic General Outcomes of Very Preterm and
Pediatrics Very Low-Birth-Weight Infants
The Children’s Hospital at 42. Health and Developmental
Montefiore Outcomes of Selected Medically
Albert Einstein College of Complex Neonates
Medicine 44. Support for Families Whose
Bronx, NY Infant Is Sick or Dying
8. Care of the Newborn After
Delivery Amy Y-Y. Chen, MD, FAAD
Assistant Professor of Dermatology
Luc P. Brion, MD, FAAP Department of Dermatology
Professor of Pediatrics University of Connecticut School
University of Texas Southwestern of Medicine
Medical Center Farmington, CT
Dallas, TX 19. Neonatal Skin
24. Neonatal Jaundice 20. Vascular Anomalies
Christie J. Bruno, DO, FAAP Charlie Tan Cheng, MD
Attending Neonatologist Research Assistant
Yale-New Haven Children’s Department of Pediatrics
Hospital Wayne State University
Assistant Professor of Pediatrics Detroit, MI
Yale School of Medicine 29. Prenatal Drug Use: Neonatal
New Haven, CT Effects and the Neonatal
2. Assisted Reproductive Withdrawal Syndrome
Technologies, Multiple Births,
and Pregnancy Outcomes Josef Cortez, MD, FAAP
Medical Director, Neonatal
Deborah E. Campbell, MD, Intensive Care Unit
FAAP Assistant Professor of Pediatrics
Professor of Pediatrics Division of Neonatology
Associate Professor of Obstetrics University of Florida College of
& Gynecology and Women’s Medicine - Jacksonville
Health Associate Neonatologist
Albert Einstein College of Wolfson Children’s Hospital
Medicine Jacksonville, FL
CONTRIBUTORS
v
29. Prenatal Drug Use: Neonatal M. Catherine Driscoll, MD
Effects and the Neonatal Professor of Clinical Pediatrics
Withdrawal Syndrome Division of Pediatric
Hematology-Oncology
Lilia C. De Jesus, MD, FAAP Albert Einstein College of
Neonatologist Medicine
Benioff Children’s Hospital Bronx, NY
Oakland 28. The Newborn With
University of California San Hematologic Abnormalities
Francisco
San Francisco, CA Beth A. Drzewiecki, MD
29. Prenatal Drug Use: Neonatal Assistant Professor of Urology
Effects and the Neonatal Division of Pediatric Urology
Withdrawal Syndrome Children’s Hospital of Montefiore/
Albert Einstein College of
Sonia Dela Cruz-Rivera, MD
Medicine
Assistant Professor of Pediatrics Bronx, NY
Division of Pediatrics 32. Endocrine Disorders
Montefiore Medical Center Manifesting in the Newborn
Bronx, NY Period
15. Hospital Discharge of the
Healthy Term and Late Preterm
Marian F. Earls, MD, MTS, FAAP
Infant
Clinical Professor of Pediatrics
University of North Carolina
Kristina M. Derrick, MD, ScM
School of Medicine
Assistant Professor of Pediatrics
Chapel Hill, NC
Division of Pediatric
Director of Pediatric Programs
Endocrinology
Community Care of North
Children’s Hospital at
Carolina
Montefiore/Albert Einstein
Raleigh, NC
College of Medicine
5. Maternal Depression
Bronx, NY
32. Endocrine Disorders
Jonathan M. Fanaroff, MD, JD,
Manifesting in the Newborn
FAAP
Period
Professor of Pediatrics
Elaine A. Dinolfo MD, MS, Case Western Reserve University
FAAP School of Medicine
Director, Rainbow Center for
Harlem Hospital Center
Pediatric Ethics
Department of Pediatrics
Co-Medical Director, Neonatal
Assistant Clinical Professor of
Intensive Care Unit
Pediatrics
Rainbow Babies & Children’s
Columbia University College of
Hospital
Physicians and Surgeons
Cleveland, OH
New York, NY
8. Care of the Newborn After 6. Medicolegal Considerations in
the Care of Newborns
Delivery
CONTRIBUTORS
vi
John M. Fiascone, MD, FAAP Anna C. Ganster, MD
NICU Medical Director, South Clinical Assistant Professor of
Shore Hospital Pediatrics (Clinician Educator)
Lecturer in Pediatrics, Part time Fetal and Neonatal Institute,
Harvard Medical School Division of Neonatology
South Weymouth, MA Children’s Hospital Los Angeles,
30. Transient Metabolic Department of Pediatrics
Disturbances in the Newborn Keck School of Medicine,
University of Southern
Katie R. Forman, DO, FAAP California
Co-Director Neonatal Palliative Los Angeles, CA
Care Program 34. Surgical Emergencies of the
Assistant Professor of Pediatrics Chest and Abdomen in the
Albert Einstein College of Newborn
Medicine
The Children’s Hospital at Gina M. Geis, MD, FAAP
Montefiore Attending Neonatologist, Albany
Bronx, NY Medical Center
44. Support for Families Whose Associate Professor of Pediatrics
Infant Is Sick or Dying Associate Professor, Center for
Bioethics, Education and
Andrew L. Freedman, MD Research
Walter and Shirley Wang Chair in Chair, Hospital Ethics Committee,
Pediatric Surgery Albany Medical Center
Vice Chair for Pediatric Surgical Albany Medical College
Services Albany, NY
Director of Pediatric Urology 37. Care of the Sick or Preterm
Professor of Surgery Newborn Before Transport
Department of Surgery
Cedars-Sinai Medical Center Sarah Chambers Gurson, MD
Los Angeles, CA Pediatric Cardiology Associates, a
13. The Circumcision Decision MEDNAX affiliate
Fairfax, VA
Mamta Fuloria, MD, FAAP 42. Health and Developmental
Associate Professor, Pediatrics Outcomes of Selected Medically
Albert Einstein College of Complex Neonates
Medicine
Director, Neonatal-Perinatal Kendria C. Hall, MD, FAAP
Medicine Fellowship Training Assistant Professor of Pediatrics
Program Division of Neonatology
The Children’s Hospital at Albert Einstein College of
Montefiore Medicine
Bronx, NY Children’s Hospital at Montefiore
34. Surgical Emergencies of the Bronx, NY
Chest and Abdomen in the 17. Maternal Medical History
Newborn
CONTRIBUTORS
vii
Nancy M. Hurst, RN, PhD, University of California San Diego
IBCLC San Diego, CA
Director, Women’s Support 24. Neonatal Jaundice
Services
Texas Children’s Hospital Pavilion Tamara Kalhan, MD
for Women Assistant Professor of
Assistant Professor of Pediatrics Pediatrics
Baylor College of Medicine Division of Neonatology
Houston, TX Children’s Hospital at Montefiore
10. Optimizing Nutrition for the Bronx, NY
Preterm, Very Low-Birth-Weight 11. Newborn Immunizations and
Infant After Discharge From Immune Prophylaxis
Neonatal Intensive Care
Harpreet Kaur, MD
Sonia O. Imaizumi, MD, FAAP Assistant Professor of Pediatrics
Medical Director, Independence Rutgers New Jersey Medical
Blue Cross School
Philadelphia, PA Newark, NJ
41. Health and Developmental 17. Maternal Medical History
Outcomes of Very Preterm and 18. Physical Examination of the
Very Low-Birth-Weight Infants Newborn
Abieyuwa Iyare, MD, FAAP Ann L. Kellams, MD, IBCLC,
Assistant Professor of Pediatrics FAAP, FABM
Division of Neonatology Associate Professor, Department
Albert Einstein College of Medicine of Pediatrics
Children’s Hospital of Montefiore Medical Director, Well Newborn
Bronx, NY and Breastfeeding Medicine
22. Postnatal Assessment of Services
Common Prenatal Sonographic University of Virginia
Findings Charlottesville, VA
12. Balancing Safe Sleep and
Yong-Hui Jiang, MD, PhD Other Recommendations for
Professor and Chief of Medical Newborns
Genetics
Department of Genetics Jae H. Kim, MD, PhD, FAAP
Yale University School of Professor of Pediatrics
Medicine Director, Division of Neonatology,
New Haven, CT Perinatal Institute
21. Common Congenital Cincinnati Children’s Hospital
Anomalies Medical Center
Cincinnati, OH
Kathryn A. Johnson, MD, FAAP 10. Optimizing Nutrition for
Associate Professor of Pediatrics the Preterm, Very Low-
Division of Academic General Birth-Weight Infant After
Pediatrics, Child Development, Discharge From Neonatal
and Community Health Intensive Care
CONTRIBUTORS
viii
Tsoline Kojaoghlanian, MD, 21. Common Congenital
FAAP Anomalies
Director, Pediatric Infectious
Diseases Grace L. Lee, MD, FAAD
SBH Health System Assistant Professor of
Albert Einstein College of Medicine Dermatology and Pediatrics
Bronx, NY Texas Children’s Hospital
27. The Newborn at Risk of Baylor College of Medicine
Infection Houston, TX
20. Vascular Anomalies
Faye Kokotos, MD, FAAP
Assistant Professor of Pediatrics Bridget Leone, MD
Division of Academic General Montefiore Medical Center
Pediatrics Albert Einstein College of
Children’s Hospital at Montefiore Medicine
Albert Einstein College of Bronx, NY
Medicine 33. The Newborn With Neurologic
Bronx, NY Findings
8. Care of the Newborn After
Delivery George A. Little, MD, FAAP
Active Emeritus Professor of
Zuzanna Kubicka, MD Pediatrics
Boston Children’s Hospital Geisel School of Medicine
Boston, MA Dartmouth College
30. Transient Metabolic Hanover, NH
Disturbances in the Newborn 1. Perinatal Preventive Care: Fetal
Assessment
Leslie Lam, MD
Assistant Profess of Pediatrics Christina M. Long, DO
Interim Chief, Division of Associate Professor of Pediatrics
Pediatric Endocrine and Division of Neonatology
Diabetes University of Washington, Seattle
Children’s Hospital of Montefiore Children’s Hospital
Bronx, NY Seattle, WA
32. Endocrine Disorders 25. Respiratory Distress and
Manifesting in the Newborn Breathing Disorders in the
Period Newborn
39. Discharge Planning for the
M. Susan LaTuga, MD, MSPH, High-Risk Newborn Requiring
FAAP Intensive Care
Assistant Professor of Pediatrics
Division of Neonatology Deepa Manwani, MD
Albert Einstein College of Director, Pediatric Hematology
Medicine Program
The Children’s Hospital at Children’s Hospital at Montefiore
Montefiore Albert Einstein College of Medicine
Bronx, NY Bronx, NY
CONTRIBUTORS
ix
28. The Newborn With Iona Munjal, MD
Hematologic Abnormalities Assistant Professor of Pediatrics
Montefiore Medical Center
Britni B. Maple, MD Bronx, NY
Fellow, Neonatal-Perinatal 11. Newborn Immunizations and
Medicine Immune Prophylaxis
University of Texas Southwestern
Medical Center Upender K. Munshi, MBBS,
Dallas, TX MD, FAAP
24. Neonatal Jaundice Professor of Pediatrics,
Neonatology Division
Nelly Maseda, MD, FAAP Albany Medical Center
Assistant Professor of Pediatrics Albany, NY
Albert Einstein School of Medicine 36. Identifying the Newborn Who
Pediatrician Requires Specialized Care
Children’s Hospital at Montefiore
Bronx, NY Suhas M. Nafday, MD, MRCP
7. Prenatal Pediatric Visit (Ire), DCH, FAAP
Associate Professor of Pediatrics
Teri Jo Mauch, MD, PhD, Albert Einstein College of
FAAP, FASN Medicine
Professor and Chief, Pediatric Director, Weiler Newborn
Nephrology Services, Neonatology
University of Nebraska Medical Chair, Neonatal Performance
Center and Omaha Children’s Improvement and Patient
Hospital Safety
Omaha, NE Children’s Hospital at Montefiore
22. Postnatal Assessment of Bronx, NY
Common Prenatal Sonographic 23. Abnormalities of Fetal Growth
Findings 25. Respiratory Distress and
Breathing Disorders in the
Rochelle R. Maxwell, MD Newborn
Instructor in Clinical
Investigation Sheri L. Nemerofsky, MD,
The Rockefeller University FAAP
New York, NY Associate Professor of Pediatrics
28. The Newborn With Division of Neonatology
Hematologic Abnormalities Albert Einstein College of
Medicine
Marie McDonald, MD Montefiore Medical Center
Division of Medical Genetics Bronx, NY
Department of Pediatrics 14. Care of the Late Preterm and
Duke University Early Term Infant
Durham, NC 22. Postnatal Assessment of
21. Common Congenital Common Prenatal Sonographic
Anomalies Findings