Less is more for transient tachypnoea of the newborn

The edition in brief

The edition closes on a quality-improvement project in two US neonatal units: a guideline, case audits and an order set for babies of 35 weeks or more with transient tachypnoea of the newborn cut NICU stay from 90 to 51 hours, with earlier feeds, less respiratory support, fewer drips and cannulas, less hyponatraemia and more babies going home with their parent, without more readmissions or hypoglycaemia. A JAMA Pediatrics analysis of 106,581 bacterial isolates from children in 82 countries found resistance rising everywhere from 2004 to 2022, fastest in resource-limited settings and intensive care, with Watch-group resistance in ICU isolates doubling to 33%. Carbapenem resistance in Klebsiella is projected to reach 35% by 2035, with the steepest rises in South-East Asia. In 5119 children with suspected sepsis across 11 Australian and New Zealand emergency departments, 10% received corticosteroids within 24 hours, mostly dexamethasone, and largely outside refractory shock. A US cohort of 2771 boys found no association between neonatal circumcision and autism (OR 0.83, 95% CI 0.59 to 1.17). The pearl covers supportive care in bronchiolitis.