Ugur Dilmen

METOCLOPRAMIDE FOR BREAST MILK PRODUCTION

Abstract The efficacy of a dopamine antagonist-metoclopramide to recommend for healthy mothers with lactational insufficiency was evaluated in healthy mothers with lactational insufficiency. Thirty-two mothers with babies 10 days to 120 days of age who had inadequate lactation confirmed by failure to gain weight of their babies and two consecutive measurements of breast milk by pump that proved to be less than the daily requirements of the baby. The drug was started to the mothers with lactational insufficiency only after a brief educational period to make sure the proper technique for breast feeding being used and a second measurement one week later that was still less than the requirements of the baby. Mothers were given 300–500μgr/kg of metoclopramide (10 mg×3) in 3 divided doses orally. A control group of 32 mothers with adequate lactation was also included in the study. A ‘true control group of women with lactational failure that placebo should be given was not approved by the ethical committee. The therapy group and control group were comparable in parity, socioeconomic status, age of the mothers and the age of the babies. About half of the babies were premature in each group. The amount, (twice in the initial measurement) and the osmolality of breast milk, the blood pressure, prolactin and aldosterone levels of the mothers, and maternal blood counts, ferritin and serum iron and iron binding capacity were determined. The laboratory analyses were repeated after 15 days both in the drug therapy and control groups. Daily milk production increased by 28.5%. (from 378±28(SD) ml to 690±37ml) which was statistically significant (P

Salbutamol in the Treatment of Neonatal Hyperkalemia

Salbutamol is a beta-2 selective adrenoceptor agonist and is used extensively in the treatment of reversible obstructive airway disease of children [1]. The hypokalemic effect of salbutamol was investigated in adults with asthma and chronic renal failure [2-4]. We would like to draw attention to the successful treatment of hyperkalemia in 2 newborn infants

Intussusception Following Ingestion of Broken Glass

was refreshing to see that the gold standard of treatment for otitis media (OM) is still a viable option. My pediatric patients in Utah County, Utah, were having frequent failures on t.i.d. amoxicillin. I was leaning’toward discontinuing its use altogether for OM. After reading the article, I began using amoxicillin 40 mg/kg once-aday. Patients were asked to keep track of side effects and return in 10 days. After 10 days, a reminder call or letter was sent to patients who had missed their recheck. My results are listed in Table 1.

Pilomatrixoma: Patient Report of a Common Childhood Tumor

Pilomatrixomas are common skin appendage tumors of hair matrix cell origin that usually present as a slowly growing dermal or subcutaneous mass.1 The lesion is well known to dermatologists and pathologists but has received infrequent attention in the pediatric lit erature in spite of the fact that it has a distinct age distribution, occurring most commonly in children and adolescents.2 This report presents a case in which the preliminary clinical diagnosis was atypical mycobacterial cervical adenitis, with review of the literature to demonstrate the diagnostic dilemma that can occur.

Early Erythropoietin for Preventing Red Blood Cell Transfusion in Preterm and/or Low Birth Weight Infants

Early administration of EPO reduces the use of RBC transfusions and the volume of RBCs transfused. These small reductions are of limited clinical importance. Donor exposure is probably not avoided since most studies included infants who had received RBC transfusions prior to trial entry. There was a significant increase in the rate of ROP (stage 3 or greater). Early EPO does not significantly decrease or increase any of the other important adverse outcomes. Ongoing research should deal with the issue of ROP and evaluate the current clinical practice that will limit donor exposure. Due to the limited benefits and the increased risk of ROP, early administration of EPO is not recommended. Evidence is lacking for the possible neuroprotective role of EPO in preterm infants.