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Background: An umbilical cord that remains attached beyond a week is usually a matter of concern to mothers in developing countries. Furthermore, delayed cord separation may increase the risk of bacterial infection. Objectives: To determine the average time of umbilical cord separation and evaluate the relationship between this time and gender, birth weight, gestational age, parity of the mother, mode of feeding and common cord care practices among Nigerian neonates. Methods: Questionnaires were administered to mothers of healthy newborns seen at the Infants' Welfare Clinic of the Institute of Child Health, College of Medicine, University College Hospital (UCH), Ibadan, and the Adeoyo Hospital and Maternity, Yemetu, Ibadan. Mother's parity, place of antenatal care and birth, gestational age, time and nature of amniotic fluid, duration of labour, birth weight, time of umbilical cord separation after birth, mode of feeding and mode of cord care were recorded. Results: Complete data were available in respect of 536 newborns. The mean cord separation time was 8.7 days (SD 3.7; range 2-21 days). Cord separation time was significantly shorter among male babies, infants fed with only breast milk, those whose mothers did not book for antenatal care and those delivered per vaginam (p

Background: Neonatal mortality is a pointer to the effectiveness of the obstetric and neonatal services in any particular community and a regular auditing should help in improving the delivery of such services. Objective: This study was carried out in order to obtain an update on the pattern of mortality among newborn babies admitted to the Special Care Baby Unit (SCBU) of the University College Hospital, Ibadan, over a ten-year period. Methods: The case records of all neonates admitted to the SCBU from January 1991 to December 2000 were examined for the total number of admissions and all deaths that occurred in the unit. The data extracted included age at admission (hours), the gender, gestational age (weeks), birth weight (kg), mode of delivery, indication for admission, temperature on admission, cause of death and the age at death (days). Results: The yearly mortality rate ranged between 24.6 percent and 39.2 percent with a mean annual rate of 30.8 percent. The leading causes of death were low birth weight, birth asphyxia and sepsis. A higher rate of mortality occurred among babies with admission temperatures of less than 35.5°C than in those whose temperatures were above 35.5°C (p

Objectives: To measure the horizontal corneal diameters in infants at birth and compare with values reported in other studies., Design: A cross-sectional hospital based study., Subjects: All the healthy infants born within the period of one month in these hospitals were eligible for enrolment into the study. Horizontal corneal diameter measurements were performed with indirect caliper in both eyes of each of the 342 healthy full term infants and 25 preterm healthy infants born in these two hospitals. These results were evaluated according to the age of the infants, Results: The corneal diameter in term infants was found to range from 9.00 mm to 12.50 mm during the first week of life with a mean of 10.26 mm (SD +/-0.59 mm, n = 64). This is higher than what was reported for Caucasian infants (P < 0.01). Mean horizontal corneal diameter in all male infants aged 1-238 days was 11.06 mm (SD 0.75 mm, n = 187), slightly higher than 10.93 mm (SD 0.22 mm, n = 154) in all females, though this difference was not statistically significant. Horizontal corneal diameter increased progressively with age, from a mean value (SD) of 10.26 mm (0.72) to a mean value (SD) of 12.0 mm at 34 weeks of age. There was no significant difference in the mean corneal diameter of the right and left cornea. A few infants had corneal diameters of 12.50 mm and had no congenital glaucoma. Mean corneal diameter in preterm infants less than 37 weeks of gestation was 8.90 mm at birth (SD 1.25 mm, n = 25)., Conclusion: The horizontal diameter increased with age from birth to the 34 weeks of age. Changes after this period were not studied. The values obtained in these African infants were slightly higher than those reported from other populations.

Hydranencephaly, a relatively rare malformation of the brain, is characterised by absence of the cerebral hemispheres and their replacement by sacs filled with cerebrospinal fluid. It is one of the recognised forms of intracranial malformations associated with intrauterine fetal demise of one of twins in monochorionic twin gestation. This report illustrates the development of hydranencephaly in a surviving twin sequel to intrauterine fetal demise of the co-twin.

Screening of 104 mother-baby pairs for P. falciparum malaria revealed that 29% of mothers from low socio-economic group and 11% of their babies had malaria parasitaemia. The corresponding figures for middle and high socio-economic groups were 15% and 7%, respectively. The parasite densities in the babies were not proportional to maternal load and were generally low, although higher in the low socio-economic group. Maternal pyrimethamine prophylaxis did not appear to protect babies from parasitisation and there was no demonstrable beneficial effect on the babies' birtth-weights.

Fontanelle sizes were studied in 200 term and appropriate-for-gestational age neonates delivered at the University College Hospital, Ibadan, Nigeria with the aim of determining their normal range of variation. The anterior and posterior fontanelle sizes were described using the range, mean, standard deviation and selected (3rd, 25th, 50th, 75th and 97th) percentiles. The anterior fontanelle size ranged from 1.0 to 6.4 cm with a mean of 4.0 (SD 1.0) cm. The posterior fontanelle size ranged from 0.0 to 5.5 cm with a mean of 1.4 (SD 1.7) cm. The posterior fontanelle was not palpable in 99 (49.5%) of the neonates and there was no association between the sex of the neonate and posterior fontanelle closure (X2 = 0.97, p = 0.325). The findings of the study are consistent with those of other workers who have documented larger anterior fontanelle sizes in the Negro neonate compared to his caucasian counterpart. However, the anterior fontanelle size in this study was larger than previously reported Nigerian figures, a fact which may be due to the exclusion of neonates who still had overriding cranial bones (from excessive moulding) at the time the measurements were taken. It is suggested that local values derived from well-defined populations be used as reference in the evaluation of the child with dysmorphic features in order to avoid errors of classification due to racial differences in the normal range of variation. Further studies of this nature are needed in order to delineate such differences where they exist.

A study of selected facial and ear dimensions in 200 term and appropriate-for-gestational age neonates delivered at the University College Hospital, Ibadan, Nigeria, was carried out with the aim of describing their normal range of variation and providing reference values for clinical use. The features studied included inner canthal distance, outer canthal distance, palpebral fissure length, nasolabial distance, oral intercommissural length, total ear length and ear length above the eyeline. The inner canthal distance ranged from 1.6 to 2.5 cm with a mean of 2.1 (SD 0.2) cm while the outer canthal distance ranged from 5.2 to 7.2 cm with a mean of 6.1 (SD 0.4) cm. The oral intercommissural length ranged from 2.5 to 4.0 cm with a mean of 3.1 (0.3) cm and the total ear length ranged from 2.4 to 4.0 cm with a mean of 3.2 (SD 0.3) cm. Three per cent of the neonates had the whole ear located completely below the eye line. No significant sex differences in the mean values of any of the dimensions studied were found. The findings of the study are consistent with those of other workers who have documented shorter ears in the Negro neonate compared to his Caucasian counterpart. It is suggested that local values derived from well-defined populations be used as reference in the evaluation of the child with dysmorphic features in order to avoid errors of classification due to racial variations in the range of normal.