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Edited by Patti J Thureen and William W Hay. Published by Cambridge University Press, New York, 2006, £165.00 (US$300.00), pp 692. Hardback. ISBN 0-5218-2455-9.
In an age when babies are surviving at earlier gestations, it is vital that we have an accurate and up‐to‐date understanding of their extrauterine metabolic and nutritional requirements. We now know that optimum fetal and neonatal nutrition is reflected in long‐term health, therefore all the information and advice that we gather can only be beneficial. This book has it all.
Reference books are becoming less fashionable as the internet has come to the forefront. However, I think this is a book which should be part of the reference library of all neonatal units. But it is not for the faint hearted. It is a large and weighty volume, packed full of text, with few charts, graphs and tables, and no photographs or pictures. It certainly is not a book to be read from cover to cover even by the most studious of neonatologists.
As I opened the book and perused the first few pages, I was immediately struck by the huge number of contributors. Over 60 are listed, from the USA, Canada, Italy, the Netherlands and the UK; an impressive gathering of knowledge. But it is this mix of knowledge that can create a book with the most recent advances in a specialist area of which little has been previously known. As the editor quite rightly states, being provided with such expert up‐to‐date knowledge gives the reader “stimulation to persue new research to resolve the problems that still exist”.
Neonatal Nutrition and Metabolism has 46 chapters, some of which are fairly general, such as “Fetal nutrition” and “Postnatal growth in preterm infants”. These chapters cover the nutritional requirements of “normal” premature babies and preterm babies with specific pathologies, such as congenital heart disease and bronchopulmonary dysplasia. Thus the book is not just for tertiary neonatal units. Much of the text is applicable to babies of later gestations with the common neonatal complications. I found the chapter on gastro‐oesophageal reflux particularly useful. A table comparing the physiological “happy spitter” refluxers with the pathological “scrawny screamers” simplifies the evaluation. A detailed description of the pathophysiology is followed by sections on investigation and treatment options.
One chapter I found intriguing and especially stimulating was Chapter 40, “Nutritional assessment of the neonate”. It has a review of the nutritional assessment tools that are currently available, with a chart mapping all the factors which should be considered during the assessment. The following text is divided into “Medical record review”, “Nutritional intake”, “Laboratory assessment” and finally “Anthropometrics” (body measurements). A fascinating diagram annotates the changes in body composition from the second trimester through to the first year of life. This is a very useful chapter as it gives practical advice to the clinician faced with assessing the nutritional status of a neonate.
Although initially daunting due to its size and lack of visual aids, this book contains a wealth of knowledge in a very specialised area. Parts of it can be applied to every baby on a neonatal unit. Optimal nutrition is critical in weeks 22–40 of postconceptional age for the best possible long‐term neurodevelopmental and neurocognitive outcome. This book will certainly aid our clinical acumen in optimising nutrition in preterm infants.infants.