The current practice of neonatology in Malaysia.

More than 95% of Malaysian infants are born in hospitals where the healthy majority are discharged home within 24 to 48 hours. Postnatal home visits are then carried out by the maternal and child health nurses provided that the latter are informed of the birth. In most small towns and rural areas, the newborns receive good care from maternal and child health staffwho visit their homes every alternate day for the first 10 day of life. However, in big cities such as Kuala Lumpur, such home visits are often much fewer in number or none althogether. Although we have one of the best maternal and child health services among developing countries, the recent rapid and massive urban migration of our population has caused concern among doctors working in big cities and towns, where more neonatal problems are seen with the fewer postnatal home visits by health staff. Thus, despite the fact that routine screening of cord blood for glucose-6-phosphate dehydrogenase (G6PD) deficiency has been in practice for more than' a decade, severe jaundice in G6PD deficient neonates requiring readmission and exchange blood transfusion is still a common problem in big towns and cities. Furthermore, although efforts have been intensified to promote breast feeding, the rate of successful breast feeding is still not high among Malaysian mothers. For the sick neonates admitted to hospitals, roomingservices are often insufficient to accomodate all the mothers to help them continue breast feeding their babies. In the big towns, the lack of family support for small nuclear families and the fewer maternal and child health visits are some of the common factors which contribute to the low success rate of breast feeding.