He L, Harold SF, Frydrysiak–Brzozowska A. It's time: Let's Erase Racism. Newborn 2025; 4(2):iv-x. DOI: 10.5005/newborn-4-2-iv.

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Harold SF, Discenza D, Blueford L, Carlo WA, Maheshwari A. A Bill of Rights for Children Born into Historically-marginalized Communities. Newborn 2025; 4(2):59-68. DOI: 10.5005/jp-journals-11002-0124.

 

Abstract: This article presents a bill of rights for children born into historically-marginalized communities, aiming to safeguard the dignity, equity, and healing during the fetal, perinatal, and neonatal periods, and in early childhood. This declaration responds to the pervasive and persistent disparities that disproportionately affect Black, Indigenous, Latinx, immigrant, and economically-disenfranchised populations. Drawing from the principles of cultural humility, trauma-informed care, and structural justice, this article reviews the limitations of procedural compliance and advocates for a paradigm of ethical presence and relational accountability. Through 10 explicit rights, the framework outlines the need for humane care that is operational, not merely aspirational. There is a blueprint for clinical practice reform, institutional reflection, and policy reimagination; the goal is to position lived experience, cultural insight, and emotional integrity to promote healing and delivery of care. Finally, this bill of rights challenges systems to move beyond symbolic inclusion toward a structural transformation, to prioritize safety, voice, and wholeness for these individuals and their families, especially those left historically at the margins.

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​Key scientific associations: Newborn, neonate, Black, Blueprint, Cultural insight, Economically-disenfranchised, Emotional integrity, Immigrant, Indigenous, Infant, Latinx, Reform. 

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Michie C, Hoyos A, Pomar EG, Lui K, Ebrahimpour M, Kumar A, Maheshwari A. Medicine is not the Sole Determinant of Healthcare Outcomes: Lessons to Learn from Neonatal Tetanus. Newborn 2025; 4(2):69-72. DOI: 10.5005/jp-journals-11002-0127.

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Abstract: Improved survival of newborn infants has been a great global achievement of the last century. However, medical problems, such as neonatal tetanus, continue to be important healthcare concerns. One challenge has been in quantifying the case burden; actuarial measures of these disorders are not accurate. But increasingly, we are also realizing that medicine is not the sole determinant of healthcare outcomes. There is a need to study how differences of neonatal practice that could increase infant deaths may have persisted, despite access to affordable, effective, and efficient interventions. Free exchange of information could have changed history. We need to standardize and focus our practices afresh and then develop/apply diverse skill-sets to engage parents and other practitioners. Newer methods using geo-temporal mapping applications can help quantify the number of individuals in a target population who are reachable by existing immunization locations

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​​Key scientific associations: Newborn, NICU, infection, neonate, Clostridium tetani, Eighth-day disease, Four−six wind, Ginklofi, Hippocratic aphorism, Maternal and neonatal tetanus elimination, Neonate, Pasmo, Quechohuara, Toxemia.

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The LAYA* Group of the Global Newborn Society. The Growth Care Bundle: A Comprehensive Set of Evidence-based Practices to Minimize Extra-uterine Growth Restriction in Newborn Infants. Newborn 2025;4(2):73–87. DOI: 10.5005/jp-journals-11002-013. *Looking At Your practices in Application.

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Abstract: Advances in neonatology have significantly improved the survival of premature and very low birth weight (VLBW) infants, but concerns remain about optimal growth for these infants. Extra-uterine growth restriction (EUGR), defined as a discharge weight below the 10th percentile (z-score: −1.28), poses significant morbidity risks for both premature and VLBW infants. Approximately half of all VLBW infants face this preventable condition, which is indirectly linked to an increased risk of necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), and long-term neurodevelopmental challenges. There are potentially-modifiable factors such as inadequate nutrition, lack of standard feeding guidelines, frequent stoppage of feeds, and cold stress; and many non-modifiable conditions such as chronic maternal illnesses, placental abnormalities, genetic conditions, intrauterine growth restriction, and extreme prematurity that can impact an infant’s growth in the immediate extrauterine period. There is a need for identification, standardization, implementation, evaluation, and continual monitoring of growth-restricted infants after birth. In this article, we focused on a 5-pronged care bundle comprised of steps to optimize enteral feeding, parenteral nutrition, growth monitoring, metabolic rates, and post-discharge follow-up. We will follow these guidelines and evaluate the impact on the rates of EUGR in 3 years.

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​​Key scientific associations: neonate, preterm infant, Adjusted risk ratio, Assessment, Body mass index, Development, European Society for Pediatric Gastroenterology, Evaluation, Familycentered care, Golden hour management, Grades of recommendation, Hepatology, Institute for healthcare improvement, Intergrowth-21, Intrauterine growth restriction, Kangaroo mother care, Light-emitting diode, Neonate, Newborn, Nutrition, Reference growth charts, Relative risk, Secretory IGA, Secretory IGM, Somatometric, Speed of increasing milk feed trial, Standard growth charts, Trans-epidermal heat and water loss, z-scores.

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Sahota R, Sahota N, Gahtori B, Joshi V, Bedi V, Mahindre A. Initiation of Breastfeeding within the Golden 1st Hour after Birth Led to Sustained Lactation during Infancy: Results from a Single-center Quality Improvement Project. Newborn 2025;4(2):88–92. DOI: 10.5005/jp-journals-11002-0123. 

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Abstract: Background: At our center in Northern India, we have had low breastfeeding rates despite repeated efforts focused on recruitment of experienced staff and providing information about the benefits of human milk (HM) to mothers and families. 

Methodology: A QI project was conducted in infants born at ≥35 weeks’ gestation over 1 year, with an aim to increase breastfeeding rates. A multidisciplinary team focused on the early initiation of breastfeeding (EIBF), in addition to other ongoing measures such as skin-to-skin contact, staff training, and maternal education. 

Results: We studied 756 mother–infant dyads over a 1-year period. Early initiation of breastfeeding increased the number of HM-fed infants from 8 to 88% within 3 months. A minor, statistically insignificant drop in breastfeeding rates to 82% was seen at 6 months, but reinforced educational efforts restored this success back to 87% within a month. These rates were then maintained throughout the rest of the year. 

Conclusion: In our center, initiation of breastfeeds in the golden 1st hour after birth has helped not only in initiation but also in maintaining high rates of maternal feeding throughout infancy. Focused education of staff and families can promote a sustained increase in breastfeeding rates.

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​Key scientific associations: infant, Breastfeeding support, Delayed cord clamping, Early initiation of breastfeeding, Maternal education, Neonatal care, Quality improvement, Skin-to-skin contact, Staff training.

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Mohammadabadi T, Kumar G, Maheshwari A. Lactoferrin: A Multifaceted Glycoprotein in Milk. Newborn 2025; 4(2):93-104. DOI: 10.5005/jp-journals-11002-0125. 

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Abstract: Lactoferrin, a multifaceted glycoprotein, is a key milk-borne carrier for iron and other trace metals important for infant nutrition. It also plays an important role in innate immunity with antibacterial and antiviral properties, as an anti-inflammatory agent, and an antioxidant. Lactoferrin is present in high concentrations in mammalian milk; it is often the most abundant protein in milk after casein. The highest concentrations are seen in colostrum at nearly 5 gm/L and then at 2−3 gm/L in mature milk. The current review highlights our understanding of lactoferrin’s structure, properties, and possible clinical applications, offering insights for future research and the development of functional products. There are also possible uses in food, pharmaceuticals, and biotechnology industries. There is a need for serious, focused work.

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Key scientific associations: newborn, neonate, iron, infant nutrition, innate immunity, antibacterial, antiviral, anti-inflammatory, antioxidant, mammalian milk, casein, transferrin, apo-lactoferrin, holo-lactoferrin, lactoferrin-binding protein, camelid, bacteriostatic, PFKFB3, hyperferritinemia.

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Arora G, Mehta P, Gupta K. Cryptophthalmos. Newborn 2025;4(2):105–107. DOI: 10.5005/jp-journals-11002-0118.

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Abstract: Cryptophthalmos is a rare congenital disorder characterized by incomplete/total separation of eyelids and hence, a continuous layer of skin covering the globe. It can present as an isolated defect or as part of Fraser syndrome. Here, we describe a premature infant with bilateral cryptophthalmos. The lids were completely fused on the right; the left side showed partial fusion, but there were no responses to light. The infant was born in a nonconsanguineous marriage with no family history of the condition and no known exposure to drugs, radiation, and/or toxins. Sonographic examination showed an altered shape, aphakia, and cryptopthalmos in the right globe. The left side showed a microblepharon with an otherwise preserved anatomy. Echocardiography was suggestive of a mild peripheral pulmonary stenosis, and a cortical cyst was seen in both kidneys. Genetic studies showed known compound heterozygous variants with autosomal recessive inheritance, p.Arg2167Trp, in the gene Fraser syndrome 1-related extracellular matrix protein 2 (FREM2). In this article, we have summarized the clinical presentation, diagnostic approach, and management strategies that are available for these infants.

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Key scientific associations: neonate, newborn, infant, Abortive cryptophthalmos, Ambiguous genitalia, Aphakia, Case report, Conjunctival fornix, Fraser syndrome, Fraser syndrome 1-related extracellular matrix protein 2, Microblepharon, Microphthalmos, Rudimentary eyelids, Syndactyly.

 

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Nair S, Raghavendra PR, Goyal M, Haribalakrishna A. Non-surgical Expectant Management led to a Complete, Timely Recovery from Traumatic Subdural Hemorrhage and Related Status Epilepticus in a Neonate: A Case Report. Newborn 2025;4(2):108-109. DOI: 10.5005/jp-journals-11002-0129.

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Abstract: ​Objective: The authors report their recent experience with a 10-day-old neonate who was admitted with continuous seizures following an accidental fall from a hammock. Computerized tomography of the head revealed an extradural hemorrhage (EDH) along the left parietal region with a mass effect causing a midline shift of 3 mm. Considering the high severity of illness, they counseled the family very cautiously and managed the neonate conservatively in the intensive care unit without surgical intervention. Interestingly, the infant recovered from the status epilepticus as the hemorrhages resolved over the next 48–72 hours. The infant was discharged home in a fully functional status with normal feeding and no detectable abnormalities in sensorium or neuromotor status. This case suggests that all subdural hematomas, even if associated with midline shift, might not need surgical intervention. We may need to re-evaluate our currently accepted indications for surgery in these patients.

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Key scientific associations: neonate, infant, Baby, Brain injury, Case report, Infant, Neonate, Newborn, Status epilepticus, Subdural hemorrhage, Traumatic brain injury.

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Pratasevich TS, Zhemoytiak VA, Denisik NI, et al. Some Neonates with Congenital Adrenal Hyperplasia may Need Disproportionately High Doses of Mineralocorticoids. Newborn 2025;4(2):110-113. DOI: 10.5005/jp-journals-11002-0128.

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Abstract: Introduction: Infants with congenital adrenal hyperplasia need hormone replacement beginning in early infancy to avoid abnormal metabolic effects and progression of masculinization. In this article, we describe a patient who showed a need for rapid escalation in the doses of mineralocorticoids in the first 3 postnatal weeks. These patients need to be closely observed in the neonatal period to avoid the risks of adrenal insufficiency. 

Methods: Serum electrolytes and 17-hydroxyprogesterone levels were measured, and sonographic evaluation of adrenal and pelvic structures was done. Molecular genetic diagnostics and karyotype were tested. Serum electrolyte levels have been closely monitored for titration of hormone replacement therapy. 

Results: Venous blood showed low sodium and higher potassium levels from postnatal day 7. The diagnosis was established in the early neonatal period, and hormone replacement (gluco- and mineralocorticoid) was started to prevent life-threatening complications. The infant showed increasing needs for fludrocortisone, from an initial 50 µg/day to 300 µg/day during the neonatal period. 

Conclusions: Congenital adrenal hyperplasia, particularly the salt-wasting form, often require disproportionately higher doses of mineralocorticoids than would be needed in adults who have lost adrenal function. The underlying reasons remain unclear and likely reflect multiple mechanisms. There is a need to closely monitor these patients during the early weeks to avoid inadequate treatment and potentially life-threatening adrenal crises during this period.

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Key scientific associations: Neonate, Baby, 11-deoxycortisol, 17-hydroxyprogesterone, Adrenal crisis, Case report, Clitoral hypertrophy, Congenital adrenal hyperplasia, CYP21A2, Ehlers-Danlos Syndromes, Fludrocortisone, GDF3, GDF6, Growth Differentiation Factor-6, Heterozygous mutations, Klippel-Feil syndrome, Masculinization, MEOX1, Mesenchyme Homeobox 1, Mineralocorticoids, Myosin-XVIIIb, MYO18B, Newborn, RIPPLY2, Ripply transcriptional represso 2, Scrotal labia majora, Tenascin XB, Urogenital sinus, Virilization.