Assessment of thyroid function in the preterm and/or very low birth weight newborn.

The screening program or early detection of congenital hypothyroidism is one of the greatest advances achieved in Pediatrics. Thyroid hormones are essential for brain development and maturation, which continue into the neonatal stage. Alterations in thyroid function in premature and underweight children in the first months of life causes irreversible damage to the central nervous system and is one of the most frequent and avoidable causes of mental retardation. Diagnosis in the neonatal period is difficult, so it requires an analytical study to be able to carry out the appropriate treatment. The relevance of this problem justifies its communication to all areas of pediatrics. The main objective is to avoid brain damage in these patients. Other aspects to optimize the adequate development of these children with all the necessary periodic controls and to achieve the inclusion of the diagnosis of thyroid alterations during the stay in neonatal units and in the first months of life, need to implement the resources of the health centers and continue advancing according to current knowledge. In this document, we will focus on the screening of preterm newborns VLBW (<32 weeks of gestation) and/or very low weight for gestational age (1500-1000 g VLBW or <1000 g) and the function evaluation protocol thyroid in premature babies. We update the diagnostic procedures, the essential and complementary tests required, the etiology and the differential diagnoses in this pathology.

Is iodine nutrition in the Spanish pediatric population adequate? Historical review and current situation. / ¿Es suficiente la nutrición de yodo en la población infantil española? Revisión histórica y situación actual.

Iodine is an essential component of thyroid hormones, and iodine deficit is the leading cause of preventable mental retardation worldwide. Spain was considered iodine-deficient until 2003. Although iodine urinary levels have been in the optimal range in Spain since 2004, the WHO recognizes that our country does not meet the necessary requirements to ensure that the whole population is not at risk of an iodine deficiency disorder. The aim of this article is to review the current iodine status in Spain. Data from several studies emphasize the low consumption of iodized salt at home. Despite the progress made in recent decades, Spanish children are not exempt from suffering an iodine deficiency disorder. Policies that allow for controlling iodine nutrition and promote universal consumption of iodized salt should therefore be implemented.

La importancia de la nutrición materna durante la lactancia, ¿necesitan las madres lactantes suplementos nutricionales? / The importance of maternal nutrition during breastfeeding: Do breastfeeding mothers need nutritional supplements?

La leche materna es el mejor alimento para los recién nacidos y lactantes. Las reservas nutricionales de una mujer lactante pueden estar más o menos agotadas como resultado del embarazo y la pérdida de sangre durante el parto. La lactancia plantea necesidades nutricionales especiales, principalmente debido a la pérdida de nutrientes a través de la leche materna. El volumen de leche materna varía ampliamente. Los nutrientes presentes en la leche proceden de la dieta de la madre o de sus reservas de nutrientes. Para conseguir un buen estado nutricional durante la lactancia, la mujer tiene que aumentar la ingesta de nutrientes. La leche materna tiene una composición bastante constante y la dieta de la madre solo afecta a algunos nutrientes. El contenido de grasa de la leche materna varía con la dieta. El contenido de hidratos de carbono, proteína, calcio y hierro no cambia mucho incluso si la madre ingiere poca cantidad de estos en su dieta. Sin embargo, si la dieta de una madre es deficiente en vitaminas hidrosolubles y vitaminas A y D, su leche contiene menos cantidades de estos nutrientes. En cada visita posnatal tanto la madre como el niño deben ser examinados, y se debe proporcionar asesoramiento sobre la alimentación saludable. Durante la lactancia se debe evitar una dieta que aporte menos de 1.800cal al día

Breastmilk is the best food for newborns and infants. The nutritional stores of a lactating woman may be more or less depleted as a result of the pregnancy and the loss of blood during childbirth. Lactation raises nutrient needs, mainly because of the loss of nutrients, first through colostrum and then through breastmilk. Breastmilk volume varies widely. The nutrients present in this milk come from the diet of the mother or from her nutrient reserves. The conversion of nutrients in food to nutrients in breastmilk is not complete. To have good nutritional status the breastfeeding woman has to increase nutrient intake. Human breastmilk has a fairly constant composition, and is only selectively affected by the diet of the mother. The fat content of breastmilk varies somewhat. The carbohydrate, protein, fat, calcium and iron contents do not change much, even if the mother is short of these in her diet. A mother whose diet is deficient in thiamine and vitamins A and D, however, produces less of these in her milk. The mother should be given advice on consuming a mixed diet. At each postnatal visit, both the mother and the baby should be examined, and advice on the diets of both mother and infant should be provided. A satisfactory gain in the infant's weight is the best way to judge the adequacy of the diet of the infant. Mothers should not receive less than 1800 calories per day

[The importance of maternal nutrition during breastfeeding: Do breastfeeding mothers need nutritional supplements?]. / La importancia de la nutrición materna durante la lactancia, ¿necesitan las madres lactantes suplementos nutricionales?

Breastmilk is the best food for newborns and infants. The nutritional stores of a lactating woman may be more or less depleted as a result of the pregnancy and the loss of blood during childbirth. Lactation raises nutrient needs, mainly because of the loss of nutrients, first through colostrum and then through breastmilk. Breastmilk volume varies widely. The nutrients present in this milk come from the diet of the mother or from her nutrient reserves. The conversion of nutrients in food to nutrients in breastmilk is not complete. To have good nutritional status the breastfeeding woman has to increase nutrient intake. Human breastmilk has a fairly constant composition, and is only selectively affected by the diet of the mother. The fat content of breastmilk varies somewhat. The carbohydrate, protein, fat, calcium and iron contents do not change much, even if the mother is short of these in her diet. A mother whose diet is deficient in thiamine and vitamins A and D, however, produces less of these in her milk. The mother should be given advice on consuming a mixed diet. At each postnatal visit, both the mother and the baby should be examined, and advice on the diets of both mother and infant should be provided. A satisfactory gain in the infant's weight is the best way to judge the adequacy of the diet of the infant. Mothers should not receive less than 1800 calories per day.