Just like every other organ in the body, the hematological and immune systems in the newborn are in a state of maturational flux. Exposed to a continuous barrage of environmental antigens at birth, the neonatal immune system has to protect the host from potentially harmful pathogens while developing tolerance to commensal microbes and dietary macromolecules. Although many components of the innate immune system are reasonably mature at full-term birth, the neonate remains highly susceptible to specific pathogens because of developmental constraints in the adaptive branch of immunity. Not surprisingly, despite major strides in neonatal care, neonatal sepsis Temains the leading cause of death at any point of time in human life.A\In the second edition of this volume of the series "Neonatology Questions and Controversies," our original goals remain unchanged: we seek to update physicians, nurse practitioners, nurses, residents, and students on (1) developmental physiology of the immune response in the human fetus and neonate that are not typically highlighted, (2) cellular or cytokine replacement therapies for treatment of hematological deficiencies or infectious disease, and (3) controversies in immune modulation that may play a role in preventing allergic disorders in the developing infant. Each chapter provides an overview of how the neonate must utilize cells of the hematological and immune systems to thwart the onslaught of micTobial challenges and a roadmap for the clinician to quickly diagnose and intervene to augment neonatal hematological or immunological defenses. We further provide information about how distortions in the immune response can result in allergy or autoimmunity in the neonate. In this extensively revised edition, we have also added several new chapters on infectious diseases specific to the perinatal/neonatal period.A\We wish to thank Judith Fletcher, global content development director at Else-vier; Lisa Barnes, content development specialist at Elsevier; and Dr. Richard Polin, chairman of the Department of Pediatrics at Morgan Stanley Children's Hospital of New York Presbyterian, for their encouragement to write this volume. We, of course, are indebted and grateful to the authors of each chapter whose contributions from around the world will be fully appreciated by the readers and to our families (Daniel, Erin, and Fiona and Ritu, Jayant, and Vikram) for then enduring support. Finally, we would like to acknowledge Dr. Robert Christensen for his ongoing inspiration, enthusiasm, and generosity and for being the best mentor and role model we could ever ask for. Robin K. Ohls, MD Akhil Maheshwari, MD

CHAPTER 1 Updated Information on Stem Cells for the Neonatologist 1

CHAPTER 2 Current Issues in the Pathogenesis, Diagnosis, and Treatment of Neonatal Thrombocytopenia 15

CHAPTER 3 The Role of Recombinant Leukocyte Colony-Stimulating Factors in the Neonatal Intensive Care Unit 37 CHAPTER 4 Nonhematopoietic Effects of Erythropoietin 49

CHAPTER 5 Why, When, and How Should We Provide Red Cell Transfusions and Erythropoiesis-Stimulating Agents to Support Red Cell Mass in Neonates? 57

CHAPTER 6 Diagnosis and Treatment of Immune-Mediated and Non-Immune-Mediated Hemolytic Disease of the Newborn 75

CHAPTER 7 Hematology and Immunology: Coagulation Disorders 89

CHAPTER 8 A Practical Approach to the Neutropenic Neonate 97

CHAPTER 9 What Evidence Supports Dietary Interventions to Prevent Infant Food Hypersensitivity and Allergy? 111

CHAPTER 10 Maternally Mediated Neonatal Autoimmunity 129

CHAPTER 11 CMV: Diagnosis, Treatment, and Considerations on Vaccine-Mediated Prevention 171

CHAPTER 12 Neonatal T Cell Immunity and Its Regulation by Innate Immunity and Dendritic Cells 189

CHAPTER 13 Breast Milk and Viral Infection 219

CHAPTER 14 Probiotics for the Prevention of Necrotizing Enterocolitis in Preterm Neonates 237

CHAPTER 15 The Ureaplasma Conundrum: Should We Look or Ignore? 253

CHAPTER 16 Control of Antibiotic-Resistant Bacteria in the Neonatal Intensive Care Unit 269

CHAPTER 17 Neonatal Fungal Infections 287

CHAPTER 18 The Use of Biomarkers for Detection of Early- and Late-Onset Neonatal Sepsis 303

CHAPTER 19 Chorioamnionitis and Its Effects on the Fetus/Neonate: Emerging Issues and Controversies 317

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