Intranasal breast milk for severe intraventricular hemorrhage in a preterm neonate: A case report
Keywords:
Preterm, Intraventricular haemorrhage, Intranasal breast milk, Resolution of intraventricular haemorrhage, Positive neurological outcomesAbstract
Introduction: Intraventricular haemorrhage is a serious complication predominantly affecting preterm neonates, particularly those with very low birth weight. Severe intraventricular haemorrhage is associated with high mortality and long-term neuro developmental impairment. While preventive measures such as antenatal steroids and delayed cord clamping exist, their application is often limited by the unpredictability of preterm birth. Emerging therapies such as intranasal breast milk administration offer promising neuroprotective potential in these infants
Case Presentation: We report a preterm male infant born at 25 weeks gestation age who required positive pressure ventilation at birth, surfactant and continuous positive airway pressure after birth for respiratory distress syndrome and antibiotics for presumed sepsis. The infant was found to have grade 1 intraventricular haemorrhage on day 2 of life that worsened to grades 2 and 3 by day 13 of life. Freshly expressed breast milk was given intranasal using syringe for 8 weeks. Subsequent cranial scan revealed complete resolution of intraventricular haemorrhage and normal neurodevelopmental assessment at 20 weeks corrected age
Conclusion: The resolution of intraventricular haemorrhage could have been multifactorial but intranasal administration of breast milk may have played a role in positive neuro-developmental outcomes in the infant following its complete resolution. Further studies of a controlled nature are warranted to confirm the therapeutic role of intranasal breast milk for intraventricular haemorrhage. This intervention could provide a safe, low cost and readily accessible therapeutic treatment option for preterm infants with intraventricular haemorrhage
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