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I am pleased to present the seventh edition of Neonatology, the 25th anniversary silver edition. The first edition was published in 1988 and was started during my neonatology fellowship at University of Kentucky Medical Center in Lexington. The origins of the manual were fairly simple and started as a series of handouts designed to help students and residents get through their NICU rotation. Because of a complicated twin pregnancy during my fellowship, I had to delay my training and finish my required neonatology fellowship at Johns Hopkins University. Therefore, the roots of this manual began at University of Kentucky while I was a fellow with Dr. Doug Cunningham’s program, but it was ultimately completed while I was finishing my fellowship at Johns Hopkins University and working at the Bayview campus under Dr. Fabien Eyal. This has made the book somewhat unique since it was originally written from the perspective of two programs. Over the years this fact, along with the addition of other authors from around the United States and the world, helps to diversify our contributors and provide a more varied overview of the field.

In this seventh edition we reformatted the table of contents to make it more user friendly and hopefully more logical. Section I includes “Fetal Assessment,” “Obstetric Anesthesia and the Neonate,” “Resuscitation of the Newborn,” and “Infant Transport.” Section II encompasses basic assessment and management of a newborn. Section III includes advanced management such as the evolving areas of complementary and alternative medical therapies and bioethics in neonatology. Section IV includes all the basic and advanced procedures commonly used in neonatology, and new chapters include “Transillumination,” “Therapeutic Hypothermia,” “Laryngeal Mask Airway,” “Peripheral IV Extravasation and Infiltration: Initial Management,” and “Transpyloric Intubation” was added to the “Gastric Intubation” chapter. One of the most popular sections of the book, the On-Call Problems section, now includes a total of 34 common neonatal problems. “Hematuria” was added as a new on-call problem. Section VI, Diseases and Disorders, covers all the common and a few not so common, but clinically important, diseases of the neonate. We have added new chapters on coagulation disorders, transient neonatal myasthenia gravis, pertussis, and tuberculosis. The section on neonatal pharmacology includes significant updates of medications for neonates. We believe it to be the most comprehensive list of medications found in a manual such as ours. The “Effects of Drugs and Substances on Lactation and Infants” chapter has been revised to include the most common medications that might be used by a breast-feeding mother. The appendices include other useful reference tables and information. A hallmark of our book has been noting areas that are controversial, and this edition continues that tradition.

In addition to completely updating each chapter we have added several new clinically important areas such as pain management in the neonate. Several years ago, the concept of neonatal pain was occasionally mentioned, but definitive treatment plans did not exist. Since the American Academy of Pediatrics (AAP) has produced pain management guidelines for certain procedures, we have also added pain management in each procedure where appropriate. This addition provides AAP recommendations and also covers some recommendations from other countries. We have also added a chapter on “Pain in the Neonate” in Section III. The chapter “Sedation and Analgesia” goes over pain and sedation issues when on call. Also new to this edition are 21 color plates of common and not so common pictures of neonatal rashes and disorders. This corresponds to our chapter, “Rash and Dermatologic Problems.”

Another exciting ongoing aspect of this manual is its global reach. As we have a growing number of readers all over the world, we have added an international editorial board of physicians. They are from Poland, the Netherlands, the Philippines, Finland, Japan, India, Canada, and Australia. These physicians, along with our many international contributors, help to make the manual a useful reference worldwide. The manual has been translated into 12 different languages over the last 25 years. These translations include Russian, Spanish, Portuguese, Polish, Chinese (short and long form), Turkish, Greek, Yugoslavian (now Serbian), Italian, Hungarian, and Korean.

I would like to thank Drs. Doug Cunningham and Fabien Eyal, my valued mentors and associate editors; Dr. Deborah Tuttle, my consulting editor; Dr. Barbara McKinney, who put together an excellent pharmacology and breast-feeding section; and all the contributors to this and previous editions of the book. In addition to their long-term commitment to this manual, the associate editors have brought together outstanding authors from all over the United States and the international community. Dr. Deborah Tuttle’s extensive clinical experience brings unique perspectives from a different neonatal unit. I also express appreciation to Louise Bierig, Alyssa Fried, Harriet Lebowitz, and the editorial and production staff at McGraw-Hill and their colleagues abroad (especially Arushi Chawla) for their extensive assistance during the 2-year journey to complete this new edition. A special thanks to my husband, Lenny, who helped me extensively concerning matters of editorial content, and my awesome children, Leonard, Patrick, Andrew, and Michael, who helped troubleshoot computer issues and tolerated many sacrifices while I worked on the book. Michael often served as our “house chef” for many nights when the book required work into late hours. Andrew provided a level of expertise concerning graphics, imaging, and IT issues. Patrick provided advice from a medical student perspective. Leonard provided moral support by Skype from China.

Please visit our web site,, for additional information on this book and for links to enhanced online content for images in this edition, indicated by the symbol image. Any suggestions and comments about this manual are always welcome.

Tricia Lacy Gomella, MD

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