Acta paediatrica
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Despite widespread use, effects of volume boluses and dopamine in hypotensive newborn infants remain controversial. We aimed to elucidate if hypovolemia alone impairs cerebral autoregulation (CA) and if dopamine affects cerebral vasculature. ⋯ Our findings do not support that hypovolemia alone impairs CA. Furthermore, dopamine seems to increase cerebral perfusion but not oxygenation.
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A greater emphasis on exclusive breastfeeding in recent years has re-ignited the historical debate over the role of ankyloglossia (tongue-tie) in infants with breastfeeding difficulties. Several prospective cohort studies and randomized control trials have been published in this area in the last 10-15 years. We critically evaluated recent evidence and attempted to answer two important clinical queries in this area, that is, (i) whether ankyloglossia is associated with breastfeeding difficulties and (ii) whether frenotomy helps mother-baby dyad in such setting? ⋯ Neonates with tongue-tie are at increased risk for breastfeeding difficulties. An early recognition of this association by primary care provider and prompt referral to a lactation consultant is important. In cases with clearly documented breastfeeding difficulties, frenotomy often results in rapid improvement in symptoms.