Infant Journal
for neonatal and paediatric healthcare professionals

When should a neonatal death be referred to the coroner? Initiation of a guideline to aid decision making

Despite improved survival, particularly for extremely preterm infants, sadly some neonates die. When this happens, it may be appropriate to refer the death to the coroner, however, there is huge variation in practice between settings regarding the coroner referral process. After a particular case concerning several hospitals, we reviewed available evidence and produced a guideline to aid this process, involving both neonatologists and our coroner’s office, and including parental concerns. This has enabled a systematic, transparent approach that is equal for all infants.

Narendra Aladangady
Consultant Neonatologist and Honorary Clinical Professor in Child Health, Neonatal Unit, Homerton University Hospital NHS Foundation Trust, London, and Queen Mary University of London

Philippa Chisholm
Consultant Neonatologist, Neonatal Unit, Homerton University Hospital NHS Foundation Trust, London

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stoma; nutrition; growth; necrotising enterocolitis; spontaneous intestinal perforation
Key points
  1. Optimal timing of stoma closure in preterm infants is unknown.
  2. Complications following stoma formation are common and associated with significant morbidity.
  3. Complications can be related to poor growth, vascular access or the stoma itself.

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Optimising the delivery of parenteral nutrition in newborn care
Parenteral nutrition (PN) is a key component of newborn care, especially for preterm and growth restricted infants. Inadequate nutrition is associated with growth failure and suboptimal development. The 2016 British Association of Perinatal Medicine (BAPM) Framework for Practice provided the first UK standards for delivering PN. This articles describes a quality improvement initiative in a neonatal intensive care unit that successfully optimised PN feeding regimens resulting in higher protein and lipid intakes over the first five days of feeding, in line with BAPM recommendations.