The time of passage of the first stool and first urine by the newborn infant

Biologically, human breast milk is the best nutrition for the infant, whether born preterm or at full-term. There are also important immunologic, metabolic, and other multisystem biologic benefits for both the baby and her/his mother. Unfortunately, in the clinical setting, we frequently see biologic, psychological, social, and economic impediments in successful establishment of maternal feedings. In this chapter, we describe the importance, preparation of the mother both in biologic and psychological terms, expression of milk and its safe storage, nutritional components, biologic importance, and various ongoing social efforts to promote breastfeeding.

Myenteric plexus (MP) is well recognized as an important regulator of peristaltic activity. Knowledge regarding prenatal and postnatal normal morphological changes is important when interpreting histopathologic findings in motility disorders of childhood. The aim of this study was to determine the neuronal density and morphology of the myenteric plexus (MP) of the porcine bowel from fetal life to adulthood.

Small and large bowel whole-mount preparations of the MP were stained using NADPH diaphorase histochemistry in animals from 6 different age groups (60 and 90 days of gestation, newborn, 4-week and 12-week-old, and adult pigs). Using light microscopy, above parameters was quantified, and cell/nucleus sizes were measured. Results were analyzed using 1-way analysis of variance test.

There were significant regional and age-related differences in cell numbers per ganglia noted in MP throughout the lifetime of a pig. There was an abrupt increase in cell numbers per ganglia from the newborn to 4-week-old animals, which then stabilized in most parts of the bowel, except in the distal large bowel, where it continued to increase. Ganglion density and ganglia cell density both decreased steadily with advancing age. Cell size increased with age, mostly secondary to increase in the cytoplasm.

Our results show that significant changes occur in the MP in relation to age and the region of the bowel. These changes are most evident in the immediate period after birth but continue throughout life. Such age-related changes must be taken into account during morphological evaluation of biopsy specimens taken from infants who had constipation.

A 6-day-old boy was admitted to the hospital because of vomiting, diarrhea, and abdominal distention, which had begun earlier that day and worsened. On admission, he showed signs of sepsis. Imaging showed narrowing of the rectosigmoid colon.

Presentation of Case

Dr. Rebecca C. Bell (Pediatrics): A 6-day-old boy was admitted to this hospital because of vomiting, diarrhea, and abdominal distention.

The patient was born at another hospital to a teenaged primigravida by vaginal delivery after a full-term, uncomplicated gestation. The mother had received prenatal care; she had no history of sexually transmitted infections, and prenatal screening tests were negative. Meconium was present at delivery. The patient's birth weight was 4.3 kg (95th percentile), and the 1-minute and 5-minute Apgar scores were 7 and 9, respectively. Breast-feeding was initiated. The newborn passed two stools on the second day . . .