Maria Teresa Montes

Neurological disorders acquired during the perinatal period are a leading cause of long-term childhood disability and constitute a significant portion of the global disease burden. Despite progress in reducing neonatal mortality, neurological morbidity remains a major challenge. Neonatal neurology, a relatively new subspecialty, aims to improve outcomes for affected infants through advances in understanding neurological injury mechanisms, developing assessment tools, and implementing preventive and therapeutic strategies. In Spain, neonatal neurology has significantly progressed over the past three decades, largely due to the contributions of Dr. Alfredo García-Alix. Recognized as a pioneer in the field, he played a crucial role in establishing neonatal neurological care services and fostering education and research. After training at Washington University in St. Louis, he introduced comprehensive neonatal neurology programs in Spain and co-founded the NeNe Foundation to advance education in the field. He also led the creation of the ‘Spanish Neonatal Brain Group’ and contributed extensively to neonatal neurology research. Dr. García-Alix was an advocate for holistic, multidisciplinary neonatal care, emphasizing early intervention, neuroprotective strategies, and parental involvement. His work significantly influenced neonatal care models in Spain and Latin America, and his legacy continues to shape the field through his teachings, research, and clinical contributions.

Fortified human milk is the first choice for preterm infants. Although individualized fortification is recommended, the optimal method for this population remains uncertain. We conducted a comparative study assessing the growth effects of adjusted (AF) and targeted fortification (TF) in extremely low birth weight (ELBW) infants. This single-center, randomized, controlled clinical trial was conducted at a tertiary neonatal unit in Spain. Eligible participants were premature infants with a birthweight of p = 0.001). No differences were found in the lipid, carbohydrate, and energy intake; in the weight z score change between the different time points; nor in the length and head circumference growth. Both AF and TF are comparable methods of fortification and provide the appropriate growth rate in ELBW infants.

Fortified human milk is the first choice for preterm infants. Although individualized fortification is recommended, the optimal method for this population remains uncertain. We conducted a comparative study assessing the growth effects of adjusted (AF) and targeted fortification (TF) in extremely low birth weight (ELBW) infants. This single-center, randomized, controlled clinical trial was conducted at a tertiary neonatal unit in Spain. Eligible participants were premature infants with a birthweight <1000g exclusively fed with human milk. A total of 38 patients were enrolled, 15 of them randomised to AF group and 23 to TF group. AF was based on BUN concentration and TF on human milk analysis. The primary outcome was weight gain velocity (g/kg/day).No significant differences were found in weight gain velocity at 28 days, at 36 weeks of postmenstrual age, at discharge nor during intervention. Protein intake was significantly higher in AF group (5.02 g/kg/day vs 4.48 g/kg/day, p= 0.001). No differences were found in lipids, carbohydrates and energy intake; neither in weight z score change between the different time points; nor in length and head circumference growth. Both AF and TF are comparable methods of fortification and provide appropriate growth rate in ELBW infants.

Dear Editor:We have carefully read the article about healthcare-associated infections, which are very frequent in Neonatal Intensive Care Units(NICU)1. This makes us reflect on how neonatal teaching, training and outcomes have been widely uneven in Spanishspeaking countries2 with poor and variable indicators. The figures indicate that 3100 newborn children (NB) need care in Neonatal Intensive Care Units daily in Latin America;15 NB die every hour and 60 % of deaths occur in the first 28 days of postnatal age2.Aware of these problems, the IberoAmerican Society of Neonatology (SIBEN) was founded in 2004. SIBEN is an international, non-profit, educational and academic organization founded by a group of pediatricians, neonatologists, nurses and interdisciplinary professionals and includes parents. Its legal status is registered in the United States.