Infant Journal
for neonatal and paediatric healthcare professionals

A floppy baby with elevated right hemidiaphragm and large stomach bubble on chest radiograph: what’s the diagnosis?

A preterm neonate of 36 weeks’ gestation was born via emergency lower segment caesarean section, requiring respiratory support soon after birth. She was hypotonic from birth and was found to have a large gastric bubble and a raised right hemidiaphragm on X-ray. She reached full feeds through a nasogastric tube on day 3 of life but later developed severe gastro-oesophageal reflux with pulmonary aspiration. What is the likely diagnosis?

Fatimah Aliyu
ST6 Paediatric Trainee, York Teaching Hospital, NHS Foundation Trust,

Udoka Asoh
ST7 Paediatric Trainee, Neonatal Unit, Hull University Teaching Hospitals NHS Trust,

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neonatal; hypoxia; diabetes insipidus; familial; neurohypophyseal; hypernatraemia; sodium valproate
Key points
  1. This case of DI presented a dilemma: was it DI secondary to hypoxic ischaemic encephalopathy or familial DI?
  2. Neonatologists should consider the possible effect of sodium valproate in increasing ADH secretions when used to treat seizures in a neonate with DI.

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A case series of vitamin D deficiency in mothers affecting their infants
Vitamin D plays an essential role in calcium homeostasis, prevention of rickets and the development and maintenance of the skeleton. We present three cases representing the spectrum of maternal vitamin D deficiency affecting the infants of deficient mothers. We would like to highlight the importance of antenatal screening of vitamin D in high-risk populations and the treatment of infants and mothers at risk following detection of deficiency.