Easy NEONATAL feeding/ fluid concepts you need to understand!!
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- เผยแพร่เมื่อ 5 ก.ค. 2024
- First video in a series. Learn NINE fundamental facts about a newborn's fluid /energy status. Once you get these, understanding their fluid and feeding requirements will be easy!
Please be sure to give us a like, comment about future topics, and subscribe to this channel to stay up to date on all things NICU! Also, click the notification bell after you subscribe to gain your weekly NICU knowledge as soon as it's loaded!
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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*TIMESTAMPS*
01:08 Expected weight loss within the first week of life
02:08 Energy and Fluid reserves of a term infant
03:08 The importance of glycogen
04:18 Surface area to volume ratio
08:08 Not all infants are born with the ability to consume full daily calories
09:27 The importance of the infant's growth
12:08 Provide infants with the nutrition they would receive in utero
13:42 Energy demands of a growing infant
14:45 Calories in breastmilk and formula
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Music: www.bensound.com (royalty free with credit)
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*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.
I’ve been a NICU nurse almost 2 years now and your videos are the best! They make so much sense and I learn something new every single time!
Thank you so much Brandie!!! Literally can't tell you how motivating comments like yours are. Really keep us going! We hope you enjoy your job as much as we all do! Thanks again :)
I'm a neonatologist in Vietnam. I've been working in this area for almost 3 years but I just found your channel recently by accident and it really attracts me to watch all of your videos. Most of things I'm familiar with but I can not explain it thoroughly like the way you present in each video. Keep up this great work and I really hope to watch videos about Inotropes and application of NO inhalation in treatment some neonatal disorders.
Yay! So happy you're watching all the way from Vietnam. We'd love to visit a unit there some day! We definitely need to do a video on inotropes (although I feel like the ones people use seem to be very unit dependent!). We made a video on pulmonary hypertension and we touch on inhaled NO in that one. We try to avoid using iNO in preemies (although I will say, every now and again we have a premature infant who responds to it). Do you use iNO in premature infants? Thank you so much for taking the time to comment!
@@TalaTalksNICU really sorry for replying late cause I've not checked notifications recently. Actually, I changed my workplace from children hospital in which is equipped with full machinery, devices and specified doctors (like ped-cardiologist - radiologist - neurologist...) are always available of all time to a hospital mainly specified for obstetrics and gynecology, my department includes neonatologist only. As a result, our NICU department faces with lots of difficulties in treating extremely premature babies and even premature, term babies accompanied with comorbidities. iNO is still on a process of trial in my department and we just use it in selective cases (pulmonary hypertension on term babies due to meconium aspiration, pneumonia). I wanted to know more about using experiences on inotropes since I don't understand it fully and very few materials I could find mentioning about it clearly in neonate.
Really admire your work and your hospitality.
Love all your videos! You made it so easy to understand. Thank you very much Dr. Tala!
Thank you so much for watching and for taking the time to send us a note :)
Hi , I am a paediatric consultant in srilanka.I really enjoyed your you tube channel.It is very informative and very helpful for doctors who manage neonates.Thank you and keep it up!!!
Thank you so much! What a lovely compliment - were so happy this channel is at all helpful even for established pediatricians! Thank you!
studying for my final midwifery exam and these videos have been so helpful in understanding my SCN content. thank you so much for this!!
Oh wow- so glad they're helpful! Makes us so happy to hear! Good luck on your exam!!!
Love your videos! Can you make a video on common neonatal electrolyte disturbances - patho, causes, effects, & management?
We are very thankful that you are giving such a beautiful and helpful information thank you once again
Thank You again Nadar for your continued compliments. we are so happy you are still here and watching :)
Thx for all the sharing. As a physio working in NICU, I learn a lot from ur video. The premie’s energy expenditures I did spend lots of time on, but still find that a bit harsh to make them clear. With ur videos, all the obstacles are solved! Looking forward to ur next video. Gd day!
Hello Henry! I completely agree- it is tricky- because it's such a grey area! I hope this was clear enough- although EVERY single time a video comes out I think of something else I put in it! ha! Thank you so much for your support- we really really appreciate your comments :)
Thank you so much for your amazing videos, keep up the great work. Really helps me understand these fluids stuff.
We're so glad Nina! Thanks so much for subscribing and for taking the time to comment!
Thank you Dr. Tala!!!! 😊
Thank you so much for continuing to watch and comment :)
Thank you for valuable lessons!!! I used to read these concepts from different books...now I can hear them sublimated in short, clear sessions... Thank you, dr Tala
Oh so happy that you find these helpful! Thanks so much for being here :)
Great. Very great
May I add to your marvelous lecture the value of feeding test for such babies, and the danger of hyperosmolar feeding in NEC.
Yes! Those are great points- it was hard picking a few to be succinct!
Great video as always!! Just here to leave a couple of ideas to talk about so that you never run out of possible content :)
- Congestive heart failure and drugs to treat it
- Jaundice in the first 24h of life
- The very first moments of the management of a newborn that need help transitioning. What is being done first? In what order?
We love your comments Christoph!!!
When you say congestive heart failure- do you mean any heart failure- like from a PDA or VSD, or more specifically with like a myocarditis or from a CHD. We use the word heart failure to describe lots of situations in babies, most of which are very different from adults in heart failure. But we could talk about drugs we use to make the heart pump better? Is that what you mean?
We covered a series on jaundice - so maybe take a look there. Let us know if there is something else about jaundice you think we should cover.
And YES! The GOLDEN HOUR is such an important topic for a video!!! We need to do that soon! Thanks so much- and keep the suggestions coming :)
Thank you, keep the great work, love from Peru
Thank you so much Jaquelin- so happy you're watching from Peru- I have always wanted to go there!!! XX
Me: “I need to supplement some studying I’m doing on fluid and electrolytes. I wonder if Tala has a video on it…”
Tala (eleven days ago, reading my mind): 😁
You amaze me! Thank you for your clear, concise videos. They help me to be a better NICU nurse.
HAHAHA Alison! We're in your head! Thank you SOO much for taking the time to write your lovely lovely comments, for subscribing, and for being the type of NICU nurse who is always looking to do even better!
Wonerfull presentation Dr.Tala.I am following all your presentation .Good continue with new topics eagerly waiting to hear from you.
Please talk about pneumothorax in infants.Thank You.
Hello Reena! Thanks so much for all your LOVELY comments. We have pneumothorax on the list- we're just trying to figure out how we can simulate a needle thoracocentsis as well as chest tube placement-without using an actual baby! We promise we'll get there! Thanks!!!
thanks for your video lectures
Thank you for watching, and for taking the time to comment :)
Thanks Tala
Thank you again so much Themby! Hope you are doing well :)
Would love a video on blood results, specifically U&E’s, LFTs, FBC and what these results mean 😌
Hello Lauren! It's funny- every hospital calls their blood tests by something else. LFTs I get- and we're thinking of doing a quick nugget on those soon. But what is U and E? Urine analysis? FBC is blood count I guess! ha! (Our first videos were on different aspects of the CBC- platelets, WBCS and anemia- so maybe check those out). We're about to put out videos on TPN- so we think we'll follow that with electrolyte videos too. Thanks so much for subscribing and for writing to us :)
Excellent as usual. Thank you! Can you also review how to interpret xrays- ABCD. Thank you!!!
Hello Nicole! We're having a really big problem with showing X-rays because everything is copyrighted and we have privacy issues using X-rays of patients we are taking care of.So we'd love to do this if we could get our hands on films!!!!
Thank you Tala vey helpful videos. Please make a video on PVL
Thank you for commenting. We’ve been meaning to cover PVL for ages- I promise we’ll get to it!!!
Hi Tala, LOVE your videos! My suggestions are PVL, BPD, CHARGE Syndrome, & Hydrops.
Hi Jaxson! THANKS SO much!!! Those are excellent suggestions- the BPD will be the soonest- but definitely planning on hydrous and PVL too. We didn't have CHARGE syndrome down at all- so that's a really good one (and more common than we'd think!) Thank you again :)
@@TalaTalksNICU do you think you guys would be able to include the difference between Intralipids, SMOF, & Omegaven in this fluid series? I was recently learning for the CCRN that intralipids can contribute to hyperglycemia due to free fatty acids and glycerol, which increase the rate of gluconeogenesis. What I didn’t find out is if hyperglycemia would be an indication to switch to a different lipid infusion with a different class of FFAs. I also don’t know why we use one over the other, other than to say that smoff and omegaven are easier on the liver for long term use… I just don’t know why they are easier or what the pathophysiology is…
Please do a video on thermoregulation! I would love a video on care of a baby in an isolette/radiant warmer
This is an excellent idea- and also probably the most important thing in the tiny babies- look for this soon!
Awesome 👌
Thanks so much for watching!
Many thanks
Thank you for watching!
Very informative maam tx u so mch being a NICU nurse its helps me to gain knowledge
This comment makes us so happy! Exactly why we started channel! Thanks so much for being here!
Thank you Dr Tala💫 Please can you cover cardiac murmurs 🙏
Yes! Shanice, thanks for watching and for your suggestion. That is an excellent idea!
Just Brilliant. 💖
What threshold weight do you consider when deciding 24 kcal or 20 kcal feeding formulas. Thanks
Thank you so much. The calories really depends on the age as well as the weight of the infant. All premature infants , 32-33 weeks will likely need at least 24kcal/oz. From 34- term (37 weeks), they'd probably need 22kcal/oz. Generally term babies are on 20kcal/oz formula. This is a rough guide! Lots of variability in sizes of babies, glucose levels etc etc
hello, i am a nicu nurse from the netherlands. suggestions include NIRS, HeRo, total bodycooling, cadiotonics, neonate seizures, PVL, and sepsis.I look forward to your explanation. The videos are very clear.Thank you very much.
Hello Manuela! So happy you're watching from Netherlands! I LOVE your suggestions- we didn't have NIRS down at all- but that is a great topic (something that people will understand immediately with a tiny bit of explanation!). We'll try to get to that one soon. I have read about HeRo- changes in HR variability is used a lot in the adult worlds, but I have never used it, so I wouldn't feel comfortable covering that. Do you use HeRo monitoring in the NICU? Studies have shown how excellent NICU nurses are at identifying early onset sepsis (the times when we're told "this baby is just off.") So basically those are the HeRoes we use!!!!! We did a video on cooling (prt 2 of HIE)- so maybe check that out. And we'll definitely get to the other ones!!! Hope you're well and enjoying your role :)
You are miracle
Definitely not! But thank you for the ego boost! Ha!
thank you
Thank you so much for watching and for taking the time to comment!
Thanks alot ma'am,love from Pakistan
Thank you so much! Also love that you're watching from Pakistan- love knowing where everyone is- and that the whole world is working in the same direction to make babies better :)
Suggestions: pulmonary hypertension with BPD
Ohhh that's a good one. We've just started on the BPD video- so that's great you suggested that now, so we can discuss that in the video itself. Thanks so much!!!
can u plz do video on how to do correction of hypernatremia in neonates..
That's so funny- we just got asked for exactly that video. We'll get around to it try soon! thanks so much!!
Hi doctor..can u make a video about how to check precordium for newborns
Hello Bindu! Thanks for watching! Do you mean to listen to heart sounds? or literally how to feel the chest to evaluate whether there is a very active precordium?
Thank you ma, your videos are always very explanatory and easy to understand. I am a medical student currently in paediatric postings. Pls can you do a playlist on nephrology: nephrotic syndrome, nephritic syndrome..AkI, CKD. Thank you ma
Hello! Thats so great that as a medical student you're looking for alternate ways to add to your studying- so impressive. We really need to start a kidney course- we haven't covered any of those!! Thanks so much for being here!
@@TalaTalksNICU thank you ma
Dear Dr Tala and team, ❤❤❤, pls discuss neonatal hypertension, is stat furosemide recommended, thanks 🌹
Yes- that is an important topic. Honestly HTN is pretty rare in the NICU- and so when we have it- the most important thing is to figure out what caused it- and then treat appropriately. Is it a coarct? a clot in the aorta? Steroids? CLD? Renal issues? ETC Well get there though!!!!
@@TalaTalksNICU thank you 🙏
Thank you, ABG's would be helpful
Hello Elaine! We did a whole series on blood gases if you want to check them out? Go to playlist on home page- hopefully they’ll be helpful?
@@TalaTalksNICU thank you, I will look for them.
can u pls make video on hypernatremic dehydration management in neonates
Yes! This is a great idea for a video!! Thanks so much!
Please go over basic lab values for NICU. For example, CBC w diff, BMP, etc
Hello! We went over CBC in a couple of videos we filmed a couple of years ago. And we’ll get to the BMP!!! Thank you for taking the time to comment :)
@@TalaTalksNICU thank you guys so much for your videos! Truly honing in on my RNC-NIC and CCRN studies with these videos
Hi Dr Tala. I request for presentation about Human Milk fortification .thanx
That is a great suggestion/ we’ll add to the list and get to it soon. We’ll try to get a nutritionist involved too!
Please make a video on GIR and calories calculation in neonates Doc🙏🙏
We did! Check out the video on the homepage on GIR- and then there are another couple of feeding ones :) let us know if information still missing!!
I m pediatrician from Pakistan, like to watch ur videos..
Thank you so much for letting us know Dr. Punhal- that makes us so happy :)
So what is the average weight gain per week for preemie baby?
Shooting for about 15-20g/kg per day after first 7-14 days of life or so.
Neonatal seizures please, like examples of neonatal seizure signs and symptoms
Hello Beverly! Good to hear from you again! Arianna and I have been going back and forth as to how we can best film a neonatal seizure video without an infant having seizures. Part of the problem, as you know is the privacy problems. I could discuss it and 'act' out the seizures, but I'm not sure that would be too helpful??
Videos on inotropes plss
Coming up relatively soon- thanks so much for watching and for offering a suggestion :)
Transport incubator with ventilator and portable ventilator please 🙏
Hello Mohammed! Thanks for your comment and suggestion. While this is a great topic- most institutions have completely different equipment- and so I'm not sure exactly what you'd like us to discuss? Which ones do you use? Or would you like us to go over generalities? Thanks for being here!
plz make video on vomiting in neonates...
Oh that's such a great idea! We're planning a series on symptoms and what to do about it.... (after heart diseases though!)- so we'll add this to the list!
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THANKS!
Dr Tala, plz vid on birth asphyxia is needed(hyper detailed...lol)
Hello!!! I’m not sure if you looked but we made two videos on HIE ( if you go to home page you’ll be able to find them?). Maybe check those out and if there’s information we missed or you’d like- then let us know!!
@@TalaTalksNICU thank you!
Rester beni!
Why does a baby who is large for gestational age have less energy reserves?
Not so much less energy reserve but needs more to satisfy metabolic requirements- so harder to keep up!
@@TalaTalksNICU Thank you tala!! Your channel is sooo helpful and ill be sure to pay this forward one day!
some preterm do not tolerate the 24 cal formula
You're absolutely right- sometimes it takes time for babies to build the enzymes or the tolerance to higher calories. Sometimes it's something in the fortifier they don't like- and we have to try other ones. The fact that we know that babies do better developmentally when they follow their growth curves, keeps us trying though! Thanks for your important point!
Please, courses on pdf if possible, thanks
Hi! We are planning on doing this- it all takes so much time!
ECMO
YES! We definitely need to cover that! My (Tala) mother- who is not in medicine- is asking for this too- so we better do it on the sooner side!!! Thanks!!!