An extreme preterm infant born of spontaneous preterm labour with minimal antenatal care was noted on admission to have areas of linear skin scarring and breakage. The infant was initially thought to have very fragile preterm skin. Due to these lesions being out of keeping with the purported gestational age and coupled with a petechial rash, viral infection investigations were sent and yielded a positive result for Herpes simplex
type 1.

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This article outlines the provision of less invasive surfactant administration (LISA) at Midland Metropolitan University Hospital’s (MMUH) local neonatal unit. The procedure is associated with a reduction in bronchopulmonary dysplasia and the number of days that an infant is mechanically ventilated, compared to the previous conventional way of administrating surfactant while infants were ventilated or via the INSURE technique.¹ The hospital’s LISA guidelines have been revised for a local edition, where pre-medication (sedation) has been replaced by non-pharmacological techniques such as cuddle and wrap, as well as sucrose. Fentanyl might cause respiratory depression and chest wall rigidity, ending with a requirement for positive pressure ventilation and intubation.² Only approximately 30% of neonatal units in the UK use sedation such as fentanyl or other opioids.³ After the guidelines were approved,⁴ staff were trained through simulation and the LISA procedure has now become routine.

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In this review of the management of bronchopulmonary dysplasia (BPD) in neonatal graduates as they transition to home and community care, we describe our experience over a five-year period, including the use of the Paediatric Pan London Oxygen Group guidelines alongside the Hillingdon Bundle of Care, including our home oxygen video, BPD clinic, community and dietetic input.

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Peters anomaly is a rare congenital condition characterised by central corneal opacification. When there are associated systemic abnormalities, including abnormal ears, cleft lip, cleft palate, short stature and intellectual disability, this is known as Peters plus syndrome. We present a case of Peters plus syndrome diagnosed in infancy after corneal clouding was noted, along with other dysmorphic features, on first newborn examination. We consider the differential diagnosis of similar presentations with corneal clouding, as well as reviewing the potential treatments and prognosis.

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