Ranitidine in the newborn.

An infusion of ranitidine 0.2 mg/kg/hour abruptly halted a life threatening gastrointestinal haemorrhage in an anuric infant of 30 weeks'' gestation.     

Breast development in the newborn.

Breast size and milk secretion was studied in term and preterm infants. Breast nodules were palpable in most of the mature infants, both boys and girls. In 6 term infants without palpable breast tissue there was a high incidence of complications during late pregnancy or delivery. In light-for-gestational age infants the breast diameter was generally appropriate for gestation. None of the infants under 31 weeks'' gestation had palpable breast tissue at birth, but some in the first weeks of life developed breast tissue and secreted milk. Milk had been secreted by most of the mature infants by age 7 days, and the onset was earlier in light-for-dates infants. The breast does not regress rapidly after birth. The nodules persist into the second half of the first year by which time sex differences have emerged. Clearly the growth and activity of the neonatal breast cannot be explained solely in terms of the influence of maternal hormones towards the end of gestation. Further studies on early breast tissue development may indicate the other endocrine factors concerned.     

Congenital syphilis in the newborn.

We studied 53 newborn babies with congenital syphilis. The common clinical features seen were low birth weight, hepatosplenomegaly, anaemia, jaundice, and symmetrical superficial desquamation of the skin affecting palms and soles. The presence of these clinical signs is highly suggestive of early congenital syphilis. Hydrops fetalis without rhesus or ABO isoimmunisation should always arouse the suspicion of congenital syphilis.     

Coliform meningitis in the newborn.

Thirty-six patients with coliform meningitis in the 15-year period 1960-1974 are reported. Only 9 patients survived unscathed though the other 5 survivors were not seriously affected. During the septicaemic phase of the illness the cerebrospinal fluid (CSF), though positive on culture, may be otherwise normal. Meningitis can ensue even when the patient is receiving antibiotics to which the organism is sensitive and the possible disadvantages of using a nondiffusible antibiotic must be appreciated. The CSF in Esch. coli meningitis can be persistently haemorrhagic which may cause difficulties in the initial diagnosis. It must be emphasized that infective illness in the newborn is often nonspecific in its presentation and that repeated bacteriological investigations are essential in neonates who are unwell.