(1) Background: Every year, 2.5 million neonates die, mostly in low- and middle-income countries (LMIC), in total disregard of their fundamental human rights. Many of these deaths are preventable. For decades, the leading causes of neonatal mortality (prematurity, perinatal hypoxia, and infection) have been known, so why does neonatal mortality fail to diminish effectively? A bottom-up understanding of neonatal morbi-mortality and neonatal rights is essential to achieve adequate progress, and so is increased visibility. (2) Methods: We performed an overview on the leading causes of neonatal morbi-mortality and analyzed the key interventions to reduce it with a bottom-up approach: from the clinician in the field to the policy maker. (3) Results and Conclusions: Overall, more than half of neonatal deaths in LMIC are avoidable through established and well-known cost-effective interventions, good quality antenatal and intrapartum care, neonatal resuscitation, thermal care, nasal CPAP, infection control and prevention, and antibiotic stewardship. Implementing these requires education and training, particularly at the bottom of the healthcare pyramid, and advocacy at the highest levels of government for health policies supporting better newborn care. Moreover, to plan and follow interventions, better-quality data are paramount. For healthcare developments and improvement, neonates must be acknowledged as humans entitled to rights and freedoms, as stipulated by international law. Most importantly, they deserve more respectful care.

Background Neonatal sepsis (NS) is a global health issue, particularly in Sub-Saharan Africa, where it accounts for a substantial portion of neonatal morbimortality. This multicountry survey aimed to elucidate current practices, challenges and case definitions in managing NS among clinicians in Sub-Saharan Africa. Methods The survey targeted physicians and medical practitioners working in neonatal care who participated in a Self-Administered Web Questionnaire. The main objective was to understand NS and infection case definitions and management from the clinician’s point of view and to identify challenges and opportunities in sepsis management. Participants were queried on demographics, definitions and diagnostic criteria, treatment approaches, and infection prevention and control (IPC) measures. A total of 136 participants from 86 healthcare structures responded, providing valuable insights into NS management practices. Results From May to July 2022 across 25 Sub-Saharan African countries, 136 neonatal clinicians with an average from 86 structures with on average 10-year experience took the survey. NS ranked highest among prevalent neonatal conditions. Diagnostic case definitions between sepsis and infection were attributed to clinical signs, anamnesis, C reactive protein, white blood cll count and blood cultures with no statistically significant differences. Early-onset sepsis was defined within 72 hours by 48%, while late-onset varied. Antibiotics were likely on admission (86.4%) and during the stay (82.2%). Treatment abandonment was reported unlikely. The preferred antibiotic regimen for early-onset sepsis was intravenous amoxicillin (or ampicillin), gentamycin and cefotaxime. Blood culture availability and IPC protocols were reported as limited, particularly concerning patient environment, pharmacy protocols and clean–dirty circuits. Conclusions This NS survey emphasises clinicians’ challenges due to limited access to diagnostic tools and raises concerns about antimicrobial overexposure. IPC also seem limited, according to participants. Addressing these challenges can enhance diagnostic practices, antibiotic stewardship and infection control in the region.

Aim: This study aimed to investigate the safety of transfusing red blood cell concentrates (RBCCs) through small [24 gauge (24G)] and extra-small [28 gauge [28G)] peripherally inserted central catheters (PICCs), according to guidelines of transfusion practice in Switzerland.Methods: We performed a non-inferiority in vitro study to assess the safety of transfusing RBCC for 4 h at a 4 ml/h speed through 24G silicone and 28G polyurethane PICC lines, compared with a peripheral 24G short catheter. The primary endpoint was hemolysis percentage. Secondary endpoints were catheter occlusion, inline pressure, and potassium and lactate values.Results: For the primary outcome, hemolysis values were not statistically different among catheter groups (0.06% variation, p = 0.95) or over time (2.75% variation, p = 0.72). The highest hemolysis values in both 24G and 28G PICCs were below the non-inferiority predefined margin. We did not observe catheter occlusion. Inline pressure varied between catheters but followed the same pattern of rapid increase followed by stabilization. Potassium and lactate measurements were not statistically different among tested catheters (0.139% variation, p = 0.98 for potassium and 0.062%, p = 0.96 for lactates).Conclusions: This study shows that RBCC transfusion performed in vitro through 24G silicone and 28G polyurethane PICC lines is feasible without detectable hemolysis or pressure concerns. Also, it adds that, concerning hemolysis, transfusion of RBCC in small and extra-small PICC lines is non-inferior to peripheral short 24G catheters. Clinical prospective assessment in preterm infants is needed to confirm these data further.

Infantile hemangioma (IH) is the most common vascular tumor in infancy, and its physiopathology is not fully understood. Nevertheless, a hypoxic insult may be an essential element for the formation of an IH. Herein, we describe a case of a 25-week premature newborn who developed an IH after a post-burn scar and its evolution.

Introduction: Ophthalmia neonatorum (ON) is a serious neonatal eye infection, primarily caused by Chlamydia trachomatis (CT) or Neisseria gonorrhoeae (NG). Although the World Health Organization (WHO) recommends universal antibiotic prophylaxis at birth, many high-resource countries have suspended this procedure. European data on incidence of ON and prophylaxis use are limited. Aims: The aims of this study were to evaluate the routine implementation of prophylaxis across a selected sample of European birth centres, assess adherence to WHO recommendations, and estimate the incidence of conjunctivitis caused by CT and NG among newborns, comparing centres with and without prophylaxis. Methods: An electronic questionnaire was distributed to 94 birth centres in 21 European countries, focusing on those with significant birth volumes and university or referral hospital status. Data collection occurred over 2 days, November 20–21, 2024, with cases of CT/NG conjunctivitis reported for 2023. Results: Among 94 responding centres, 54 (57.5%) routinely implemented prophylaxis, but 74% of them did not adhere to WHO guidelines. Of 1,636 newborns observed, 598 (36.6%) received prophylaxis at birth. Seventeen cases of CT/NG conjunctivitis were reported in 2023, with similar incidence rates in centres with and without prophylaxis (6.2 vs. 5.8 per 100,000 live births; p = 0.89). Conclusions: Variations in ocular prophylaxis across involved centres, coupled with low rates of NG and CT conjunctivitis and no significant differences between centres using or not using prophylaxis, suggest that this practice could inform antibiotic stewardship in newborns. A unified, evidence-based European protocol is essential to enhance safety and reduce early antibiotic use.

Review question / Objective: What is the prevalence of drug-resistant pathogens associated with neonatal Early Onset Sepsis (NEOS) in the African continent and their likelihood of resistance to commonly used antibiotics in the NEOS, and what is the trend through time? Condition being studied: There is no consensus on the definition of neonatal sepsis. Two main categories of neonatal sepsis are widely accepted: early-onset sepsis (EOS) defined as occurring in the first 72 hours of life, hence representing perinatal vertical infection; and late-onset sepsis (LOS), which occurs between 72 hours to 28 days and can be hospital or community-acquired. Information sources: Pubmed, EMBASE, Web of Science. All authors from papers with missing information were contacted before article exclusion.