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i

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Oxford Handbook of
Neonatology
ii

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iii

Oxford Handbook of
Neonatology
Second Edition

Dr Grenville Fox
Consultant Neonatologist,
Evelina London Children’s Hospital,
Guy’s & St Thomas’ NHS Foundation Trust,
London, UK

Dr Nicholas Hoque
Consultant Neonatologist,
Queen Charlotte’s and St Mary’s Hospitals,
Imperial College Healthcare NHS Trust, UK

and

Dr Timothy Watts
Consultant Neonatologist,
Evelina London Children’s Hospital,
Guy’s & St Thomas’ NHS Foundation Trust,
London, UK

1
iv

1
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v

Preface

The original idea for this handbook arose from files of clinical guidelines
from our own neonatal unit. Our ethos in developing these guidelines was
that they should avoid dogma and provide practical guidance rather than
rigid rules and regulations. These have been rewritten to provide much of
the practical advice given in this handbook, with succinct background notes
added to each topic. We hope this will provide enough detail to inform
medical and nursing staff at all levels and act as an aide-memoire to those
with more experience in the specialty. Practical guidance and a suggested
approach to different clinical situations have been written using the best
available evidence, but we have relied on consensus of opinion where evi-
dence is lacking.
This second edition has a revised chapter order and a new chapter on
neonatal endocrinology, with updates to all other sections reflecting recent
changes and evidence in the specialty.
Grenville Fox
Nicholas Hoque
Timothy Watts
vi
vii

vii

Acknowledgements

We are grateful to our consultant colleagues, trainees, senior nursing staff,

and subspecialty teams at the Evelina London Children’s Hospital Neonatal
Unit at St.Thomas’ Hospital, who have contributed to the guidelines which
formed the original idea for this handbook. We are particularly grateful to
Michael Champion from the Evelina London Children’s Hospital for his con-
tribution to the metabolic section; and to Julia Phillips from King’s College
Hospital, and Tony Hulse from the Evelina London Children’s Hospital for
the new endocrinology chapter. We are also grateful to Victoria Barr for
rendering of selected illustrations.
viii
ix

ix

Contents

Symbols and abbreviations xi

1 Antenatal care, obstetrics, and fetal medicine    1

2 Management at birth and routine postnatal care   19
3 Problems on the postnatal ward   31
4 Admission, discharge, and outcome   51
5 Fluids and electrolytes   71
6 Nutrition   87
7 Respiratory problems 105
8 Respiratory support 149
9 Cardiovascular problems 169
10 Gastrointestinal problems 235
11 Neurological problems 275
12 Infection 323
13 Metabolic problems and jaundice 371
14 Haematological problems 393
15 Nephrological and urological problems 423
16 Endocrinology 439
17 Iatrogenic problems 457
18 Neonatal transport 465
19 Family support, consent, and end of life care 483
20 Practical procedures 493
21 Normal values, therapeutic drug levels,
and useful formulae 531

Index 543
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