NICU

Today I saw the tiniest babies ever -- some weighing only ~600 grams. I spent the entire day in the NICU and realized how much I have to learn about nutrition during this rotation. These little babies have such individualized needs, and the importance of encouraging nippling early in the patient's care is a central nutrition focus. If the mothers are able and willing, breast feeding is encouraged once the infants are able to pass food orally. Many of the NICU babies were on TPN and even more fed enterally (with the smallest feeding tubes ever).

I saw an extremely interesting case today. Baptist, being the largest hospital in the area and having more advanced care than most medical centers nearby, seems to receive the challenging cases and/or the infants with a number of anomalies. Today, I saw a baby with lamellar ichthyosis. This form of ichthyosis is (and I quote from eMedicine) "an autosomal recessive disorder that is apparent at birth and is present throughout life. The newborn is born encased in a collodion membrane that sheds within 10-14 days. The shedding of the membrane reveals generalized scaling with variable redness of the skin. The scaling may be fine or plate-like, resembling fish skin. Although the disorder is not life threatening, it is quite disfiguring and causes considerable psychological stress to affected patients." The prevalence is 1 in 300,000. The infant I saw was a few days old and had a covering of what appeared to be wet saran wrap around her entire body. The dietitian said she did some research regarding the nutrition needs of these babies and said there are no specific needs for them (at this time). She said she is just monitoring the baby like others in the NICU and making sure all of the nutrient needs are met as well as weight gain goals.

More to come. Hope all is well,
Rachael