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2.
Viruses ; 14(10)2022 10 14.
Article in English | MEDLINE | ID: covidwho-2071836

ABSTRACT

Compared to adults, severe or fatal COVID-19 disease is much less common in children. However, a higher risk for progression has been reported in infants. Different pediatric COVID-19 severity scores are reported in the literature. METHODS: Subjects under 90 days of age admitted to 35 Italian institutions for COVID-19 were included. The severity of COVID-19 was scored as mild/moderate or severe/critical following the classification reported in the literature by Venturini, Dong, Kanburoglu, and Gale. To assess the diagnostic accuracy of each classification system, we stratified all enrolled patients developing a posteriori severity score based on clinical presentation and outcomes and then compared all different scores analyzed. RESULTS: We included 216 infants below 90 days of age. The most common symptom was fever, followed by coryza, poor feeding, cough, and gastrointestinal manifestations. According to Venturini, Dong, Kanburoglu, and Gale's severity scores, 18%, 6%, 4.2%, and 29.6% of infants presented with severe/critical disease, respectively. A correlation analysis between these four scores and the a posteriori severity score assigned to all enrolled subjects was performed, and a crescent strength of correlation from Gale (R = 0.355, p < 0.001) to Venturini (R = 0.425, p < 0.001), Dong (R = 0.734, p < 0.001), and Kanburoglu (R = 0.859, p < 0.001) was observed. CONCLUSIONS: The percentage of infants with severe COVID-19 varies widely according to the score systems. A unique clinical score should be designed for neonates and infants with COVID-19.


Subject(s)
COVID-19 , Infant , Adult , Infant, Newborn , Humans , Child , COVID-19/diagnosis , SARS-CoV-2 , Fever , Cough
3.
J Pediatr ; 2022 Oct 14.
Article in English | MEDLINE | ID: covidwho-2069385

ABSTRACT

OBJECTIVE: To Assessthe clinical effectiveness of the BNT162b2 vaccine during pregnancy in preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) hospitalizations of infants. STUDY DESIGN: A retrospective, multicenter, 1:3 case-control (test-negative) study. Symptomatic hospitalized infants <6 months, with positive SARS-CoV-2 polymerase chain reaction (PCR) test between 1/3/2021-31/11/2021 were matched by age and time to negative controls, hospitalized with symptoms compatible with SARS-CoV-2 infection. Mothers were defined as fully vaccinated; received 2 doses of BNT162b2 with the second given 2 weeks to 6 months before delivery, or partially vaccinated; received only one dose or 2 doses with the second given >6 months or <2 weeks before delivery. Severe SARS-CoV-2 was defined as need for assisted ventilation. RESULTS: 116 SARS-CoV-2 positive infants were matched to 348 negative controls with symptoms compatible with SARS-CoV-2 infection. The effectiveness of fully vaccinated mothers was 61.6% (CI: 31.9-78.4) and the effectiveness of partially vaccinated mothers was not significant. Effectiveness was higher in infants 0-2 vs. 3-6 months of age. The effectiveness (57.1%, CI: 22.8-76.4) was similar when excluding mothers who were infected with SARS-CoV-2 during pregnancy. OR of severe infection in infants born to unvaccinated versus fully vaccinated mothers was 5.8. CONCLUSIONS: At least 2 doses of BNT162b2 vaccine administered during the second or third trimester of pregnancy had an effectiveness of 61.6% in reduction of hospitalization for SARS-CoV-2 infection in infants <6 months.

4.
J Obstet Gynaecol Res ; 2022 Oct 09.
Article in English | MEDLINE | ID: covidwho-2063833

ABSTRACT

AIMS: To evaluate the coronavirus disease 2019 pandemic's impact on pregnancy outcomes in a Japanese rural area. METHODS: This retrospective study focused on the periods between March 1, 2020, and February 28, 2021 (during the coronavirus disease 2019 pandemic), and January 1, 2017, and December 31, 2019. Singleton pregnancies delivered at or after 22 gestational weeks were included. Preterm delivery, low-birth-weight, and small-for-gestational-age infant rates during the pandemic were compared to those in the preceding 3 years. RESULTS: In the pandemic and control groups, 1650 and 5762 pregnant women were included, respectively. Two pregnant women with coronavirus disease 2019 were identified (0.1%). There were no significant intergroup differences in preterm delivery rates (control, 4% vs. pandemic, 3.3%; difference: -0.7% [95% confidence interval: -1.7%-0.3%], p = 0.22). The low-birth-weight rate tended to decrease; however, the difference was insignificant (7.9% vs. 6.5%; difference: -1.4% [95% confidence interval: -2.8-0%], p = 0.06). The small-for-gestational-age infant rate was significantly lower in the pandemic than in the control group (7.3% vs. 5.2%; difference: -2.1% [95% confidence interval: -3.3-0.8%], p < 0.01). However, the interrupted time series analysis showed no significant trend. CONCLUSIONS: There were no significant changes in the rates of preterm delivery, low-birth-weight infants, and small-for-gestational-age infants during the pandemic's first year compared to those in the preceding 3 years. Behavioral changes, such as "stay-at-home" measures, may not improve pregnancy outcomes in Japan.

5.
Annali dell'Istituto Superiore di Sanita ; 56(3):378-389, 2020.
Article in English | GIM | ID: covidwho-2055978

ABSTRACT

Introduction: The study was implemented to provide guidance to decision-makers and clinicians by describing hospital care offered to women who gave birth with confirmed SARS-CoV-2 infection. Materials and methods: National population-based prospective cohort study involving all women with confirmed SARS-CoV-2 infection who gave birth between February 25 and April 22, 2020 in any Italian hospital.

6.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; 83(11-B):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-2045433

ABSTRACT

Experiences of homelessness and housing instability have implications for child and family well-being across the life course. In this three-paper dissertation, I explore a variety of housing experiences for families within additionally stressful contexts. First, I review the existing literature regarding infants' and toddlers' experiences of homelessness, a consequential developmental time period, and a critical gap in homelessness scholarship. Second, using qualitative analyses, I investigate families' descriptions of their experiences of housing instability and homelessness in addition to experiencing the incarceration of a parent, addressing family-identified challenges and supports. Lastly, I address relations between parents' well-being and children's stress within families living doubled-up during the COVID-19 pandemic, comparing across doubled-up status for parent mental health symptoms, emotions, behaviors, and employment, and child stress and adaptive behaviors. Following the three papers, I discuss implications for future research, policy, and practice within the field of family homelessness and housing instability. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

7.
Proceedings of the Nutrition Society ; 81(OCE1):E1-E58, 2022.
Article in English | CAB Abstracts | ID: covidwho-2044707

ABSTRACT

This journal issue includes 48 articles that discuss development and validation of a novel quality assessment tool to measure the quality of nutrition information online;longitudinal association between takeaway food environment and secondary school adolescents BMI and body fat percentage;dietary practices, beliefs, and behaviours among adults with inflammatory bowel disease;postpartum depression in Irish mothers and associations with infant feeding practices;the impact of dietary saturated fat replacement with unsaturated fat on the plasma lipidome and cardiometabolic disease risk;ole of brain serotonin in age-related decline in physical activity in mice;ey stakeholder perceptions of food allergies within the airline industry;sleep quality of higher education students during COVID-19 and its association with diet quality and lifestyle behaviours.

8.
Pathogens ; 11(10)2022 Sep 23.
Article in English | MEDLINE | ID: covidwho-2043893

ABSTRACT

(1) Background: Massive social efforts to prevent the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have affected the epidemiological features of respiratory infections. (2) Methods: The study aims to describe the trend of hospitalizations for bronchiolitis among newborns and infants up to three months of life in Rome (Italy), in the pre-COVID-19 era and during the pandemic. (3) Results: We observed a marked decrease in the number of neonates and infants with bronchiolitis after national lockdowns in 2020 and the first months of 2021 and a similar trend in the number of bronchiolitis caused by respiratory syncytial virus (RSV). RSV was the leading pathogen responsible for bronchiolitis before the national lockdown in March 2020 (70.0% of cases), while Rhinovirus was the leading pathogen responsible for bronchiolitis (62.5%) during the pandemic while strict restrictions were ongoing. As Italy approached the COVID-19 vaccination target, the national government lifted some COVID-19-related restrictions. A surprising rebound of bronchiolitis (particularly cases caused by RSV) was observed in October 2021. (4) Conclusions: In this study, we describe for the first time the fluctuations over time of RSV bronchiolitis among newborns and young infants in Italy in relation to the restrictive measures containing the spread of the COVID-19 pandemic. Our results are in line with other countries' reports.

9.
BMC Pediatr ; 22(1): 166, 2022 03 31.
Article in English | MEDLINE | ID: covidwho-2038686

ABSTRACT

BACKGROUND: Respiratory virus infection is common in early childhood, and children may be symptomatic or symptom-free. Little is known regarding the association between symptomatic/asymptomatic infection and particular clinical factors such as breastfeeding as well as the consequences of such infection. METHOD: We followed an unselected cohort of term neonates to two years of age (220 infants at recruitment, 159 who remained in the study to 24 months), taking oral swabs at birth and oropharyngeal swabs at intervals subsequently (at 1.5, 6, 9, 12, 18 and 24 months and in a subset at 3 and 4.5 months) while recording extensive metadata including the presence of respiratory symptoms and breastfeeding status. After 2 years medical notes from the general practitioner were inspected to ascertain whether doctor-diagnosed wheeze had occurred by this timepoint. Multiplex PCR was used to detect a range of respiratory viruses: influenza (A&B), parainfluenza (1-4), bocavirus, human metapneumovirus, rhinovirus, coronavirus (OC43, 229E, NL63, HKU1), adenovirus, respiratory syncytial virus (RSV), and polyomavirus (KI, WU). Logistic regression and generalised estimating equations were used to identify associations between clinical factors and virus detection. RESULTS: Overall respiratory viral incidence increased with age. Rhinovirus was the virus most frequently detected. The detection of a respiratory virus was positively associated with respiratory symptoms, male sex, season, childcare and living with another child. We did not observe breastfeeding (whether assessed as the number of completed months of breastfeeding or current feed status) to be associated with the detection of a respiratory virus. There was no association between early viral infection and doctor-diagnosed wheeze by age 2 years. CONCLUSION: Asymptomatic and symptomatic viral infection is common in the first 2 years of life with rhinovirus infection being the most common. Whilst there was no association between early respiratory viral infection and doctor-diagnosed wheeze, we have not ruled out an association of early viral infections with later asthma, and long-term follow-up of the cohort continues.


Subject(s)
Coronavirus , Respiratory Tract Infections , Virus Diseases , Child , Child, Preschool , Cohort Studies , Humans , Infant , Infant, Newborn , Life Style , Male , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/epidemiology , Virus Diseases/diagnosis
10.
Indian Pediatrics ; 59(5):424-425, 2022.
Article in English | CAB Abstracts | ID: covidwho-2035429

ABSTRACT

Lactating mothers (n=126) residing in Pune, Maharashtra were interviewed to assess the prevalence of stress, rate of exclusive breastfeeding (EBF), and its association with different demographic factors. 75.4% mothers were found to be moderately stressed. Rate of EBF was 62.7%. Moderate stress and testing positive for COVID-19 were significantly negatively associated with EBF (P < 0.001).

11.
Revista Ra Ximhai ; 18(1):103-119, 2022.
Article in Spanish | Web of Science | ID: covidwho-2033591

ABSTRACT

The solidity of social-emotional skills has become a useful tool related to success in the lives of individuals. Some statements claim that a high level of IQ does not ensure assertiveness when acting or making good decisions, but that there must be a balance between it and socio-emotional intelligence. What concerns social-emotional education cannot be simplified as a look inside, but represents a greater complexity, although it leads the subject to self-centeredness;individual concreteness, to discover their inner strength, promote personal growth and the construction of their own identity, its purpose is not individualism, but it is a collective consciousness, where competences such as self-knowledge, self-regulation, autonomy, empathy and collaboration come into play. The present research was carried out in the pandemic situation caused by the COVID-19 virus, it pursues the objectives of a more clearly understanding of socio-emotionalskills development process, in addition to identify the factors that prevent their acquisition, as well as explaining the benefits that individuals can achieve by promoting these abilities. This is channeled by an interpretative paradigm to analyze the phenomena in which the participating subjects are involved;how certain factors interfere with the development of social-emotional skills. This is linked to a qualitative approach, thus focusing on the experiences of the sample in question. The process takes the methodology of the case study due to the small number of students who manifest socioemotional limitations. Data collection was carried out through interviews, observation guides, file research and anecdotal recording. These techniques and instruments made it possible to systematize the information obtained and then schematize them. It was found that there are different factors that influence the development of the emotional intelligence, such as parents, parenting style, teaching intervention, psychological, psychiatric or neurological issues, as well as the disposition and motivation of students. It is concluded that socio-emotional skills are not innate, but it is necessary to activate them, they are influenced, limited or propitiated, by the particular life experience, in the same way they are not acquired at the same pace. Another relevant point is the teaching preparation necessary to achieve a socioemotional solidity, in order to lead students to emerge the best version of themselves.

12.
J Clin Virol Plus ; 2(4): 100110, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-2031437

ABSTRACT

Background: Very limited information is available on SARS-CoV-2 seroprevalence in infants in sub-Saharan countries. Objective: In this study, we aimed to determine the rate and the temporal evolution of SARS CoV-2 seropositivity in breastfed Malawian infants. Study design: Blood samples (n = 250) from 158 infants, born to HIV-negative women and women living with HIV, collected from February 2020 to May 2021, were first tested using an Anti-IgG/A/M SARS CoV 2 ELISA assay against trimeric spike protein, and then, if positive, confirmed using a second ELISA assay detecting IgG against Receptor Binding Domain. Results: The confirmed prevalence of anti-SARS CoV-2 antibodies was 31.0% (95% CI: 23.7%-38.3%) with no significant difference between HIV-exposed and HIV-unexposed infants (29.3% and 37.1% respectively, P = 0.410). The presence of anti-SARS-CoV-2 IgG was not associated with maternal socioeconomic or demographic indices. Conclusions: Our data underline the wide spread of the SARS-CoV-2 infection in the pediatric population in sub-Saharan Africa. Design of more specific serological tests for African samples and improvements in serosurveillance programs are needed for more rigorous monitoring of the dynamics of SARS-CoV-2 infection in Africa.

13.
PLoS Global Public Health ; 2(7), 2022.
Article in English | CAB Abstracts | ID: covidwho-2021497

ABSTRACT

Access to safe and effective contraception for postpartum women is an important priority in India, where the unmet need for postpartum contraception is high. In this paper, we estimate the potential market size in India for the progesterone vaginal ring (PVR), a novel user-controlled contraceptive method that offers additional contraceptive choice for lactating women. We integrated results of a one-year phase-3 multicenter clinical trial for the PVR conducted in India with an analysis of the National Family Health Survey (2015-16) and 2019 United Nations Population Division data to generate three estimates of potential market size for the PVR among postpartum breastfeeding women in India. We estimate the potential market size for the PVR ranges from a low estimate of 543,262 women to a high estimate of 1.3 million women, with a separate intermediate estimate of 737,460 women. Our analysis indicates the PVR could play an important role in decreasing unmet need among postpartum women in India, thereby reducing risks to mothers and children associated with short birth intervals, helping to prevent unintended pregnancies, and helping to address access-related issues heightened by the COVID-19 pandemic.

14.
PLoS Global Public Health ; 2(7), 2022.
Article in English | CAB Abstracts | ID: covidwho-2021491

ABSTRACT

Transmission of respiratory pathogens, such as Mycobacterium tuberculosis and severe acute respiratory syndrome coronavirus 2, is more likely during close, prolonged contact and when sharing a poorly ventilated space. Reducing overcrowding of health facilities is a recognised infection prevention and control (IPC) strategy;reliable estimates of waiting times and 'patient flow' would help guide implementation. As part of the Umoya omuhle study, we aimed to estimate clinic visit duration, time spent indoors versus outdoors, and occupancy density of waiting rooms in clinics in KwaZulu-Natal (KZN) and Western Cape (WC), South Africa. We used unique barcodes to track attendees' movements in 11 clinics, multiple imputation to estimate missing arrival and departure times, and mixed-effects linear regression to examine associations with visit duration. 2,903 attendees were included. Median visit duration was 2 hours 36 minutes (interquartile range [IQR] 01:36-3:43). Longer mean visit times were associated with being female (13.5 minutes longer than males;p<0.001) and attending with a baby (18.8 minutes longer than those without;p<0.01), and shorter mean times with later arrival (14.9 minutes shorter per hour after 0700;p<0.001). Overall, attendees spent more of their time indoors (median 95.6% [IQR 46-100]) than outdoors (2.5% [IQR 0-35]). Attendees at clinics with outdoor waiting areas spent a greater proportion (median 13.7% [IQR 1-75]) of their time outdoors. In two clinics in KZN (no appointment system), occupancy densities of ~2.0 persons/m2 were observed in smaller waiting rooms during busy periods. In one clinic in WC (appointment system, larger waiting areas), occupancy density did not exceed 1.0 persons/m2 despite higher overall attendance. In this study, longer waiting times were associated with early arrival, being female, and attending with a young child. Occupancy of waiting rooms varied substantially between rooms and over the clinic day. Light-touch estimation of occupancy density may help guide interventions to improve patient flow.

15.
Archives of Disease in Childhood ; 107(Suppl 2):A488-A489, 2022.
Article in English | ProQuest Central | ID: covidwho-2019936

ABSTRACT

1350 Figure 1[Figure omitted. See PDF] 1350 Figure 2[Figure omitted. See PDF]ConclusionThe quality improvement team successfully met its goals. We plan to extend this initiative to further increase the rate of exclusive breastfeeding and reduce the expenditure on formula feeds. During the Covid-19 pandemic-mandated lockdown, the number of home deliveries in the city grew. We also envision studying the safety and implementation of home-based or domiciliary KMC.

16.
Archives of Disease in Childhood ; 107(Suppl 2):A335-A336, 2022.
Article in English | ProQuest Central | ID: covidwho-2019895

ABSTRACT

1347 Figure 1Deaths by SARS in Brazil between January 2019 and March 2021[Figure omitted. See PDF] 1347 Figure 2Percentages of the hospitalizations of infants due to severe acute respiratory syndrome (SARS), in Brazil, between 2019-2021[Figure omitted. See PDF]ConclusionContrary to popular belief, infants are not unable to contract COVID nor develop only mild symptoNonetheless, even though there was a SARS wave in 2019, its cause was probably not SARS-COV-2. However, it is necessary to study these waves more profoundly, not only after the pandemic started, but also before it, so that we can have a better understanding on the effects of SARS in infants and the COVID particularities in this group.

17.
Archives of Disease in Childhood ; 107(Suppl 2):A333, 2022.
Article in English | ProQuest Central | ID: covidwho-2019893

ABSTRACT

AimsTo assess the feasibility and acceptability of using trained peer mothers to deliver breastfeeding support to mothers of low-birth-weight (LBW, <2500g) infants in healthcare facilities in rural, western Kenya.MethodsThe study was conducted in Homa Bay County. Seventeen peer mothers attended a 4-day training programme that focussed on communication skills, breastfeeding support, Kangaroo Mother Care, hygiene and identification of danger signs. Competency-based scenarios were used to select the 10 (59%) peer mothers, who delivered the interventions to the mother-LBW infant pairs (<28 post-delivery) across 8 healthcare facilities in Homa Bay County. A mixed methods approach was employed using structured observations and post-intervention semi-structured interviews with mothers, healthcare providers and peer mothers. Descriptive statistics were used to analyse the quantitative data. A thematic framework was used to analyse the qualitative data.ResultsFrom September-November 2021, 23 mother-LBW infant pairs (3 sets of twins so 26 infants) were recruited and received the intervention. The median maternal age was 25 years (Interquartile range, IQR 22, 29) and all infants were born in hospital. The median age of the infants was 1 day (IQR 1,3), median birth weight 2100g (IQR 1900, 2260) and median gestation was 34 weeks (IQR 34,36). Although all the mothers who received the intervention looked well, worryingly 4 (17%) showed no signs for bonding with the infant. Peer mothers consistently explored mothers’ wellbeing (25, 100%), positioning on the breast (21, 87%) and supported mothers with expressing breast milk but were less consistent with supporting and observing infant breast attachment (15, 63%) and suckling (13, 54%) during feeds. Only one infant was noted to be too weak to suckle and was referred to the health care providers. Key themes from the interviews were the promotion of resilience in infant feeding decision making among mothers, against community misconceptions of practices such as expressing breast milk;and the enhancement of positive interactions between mothers, peer mothers and health care providers in the context of healthcare facility restrictions on visitors due to COVID-19 and staff shortages. Insufficient breastmilk was a recurrent theme sometimes attributed to poor maternal diet.ConclusionFacility-based breastfeeding peer support for mothers of LBW infants has the potential to improve uptake of appropriate infant feeding practices and their post-discharge survival and growth outcomes in rural communities in Kenya. These preliminary data, including the observed implementation challenges will be used to inform the design of a future trial to rigorously evaluate this potentially sustainable approach to addressing adverse post discharge outcomes of these vulnerable infants.

18.
Archives of Disease in Childhood ; 107(Suppl 2):A293, 2022.
Article in English | ProQuest Central | ID: covidwho-2019884

ABSTRACT

988 Table 1ConclusionThere were less medicals carried out in 2020, likely a reflection of the reduction in face to face contact with health professionals. The pandemic heightened risk factors for abuse which our data appear to reflect. 26% of infants with concerns for NAI following JPFME had head injuries on imaging and 20% had occult fractures on skeletal survey. This is higher than the average yield expected for this age group described in the literature. These audit findings at a local level, support findings published by a large centre for Paediatric abusive head trauma in the UK in 2020.This audit further provides evidence to consider the risk of occult injuries and support the existence of policies and protocols with a low threshold for information sharing and investigation. This also highlights the importance of training those working with families with young babies to support parents with keeping their babies safe and reducing the risk of non-accidental head injuries in the form of standardised training packages for example.

19.
Archives of Disease in Childhood ; 107(Suppl 2):A239, 2022.
Article in English | ProQuest Central | ID: covidwho-2019874

ABSTRACT

776 Figure 1Bronchiolitis management[Figure omitted. See PDF] 776 Figure 2Length of Stay[Figure omitted. See PDF]ConclusionThis study shows a dramatic decrease in overall admissions for bronchiolitis during ‘lockdown’ at the start of the Covid-19 pandemic, then a subsequent summer spike in 2021;but no overall difference in severity. The length of stay was in fact marginally shorter during the pandemic. We conclude that there is no indication that the Covid-19 pandemic led to delays in presentation causing more severe disease in these patients, which may be useful for future service planning.

20.
Archives of Disease in Childhood ; 107(Suppl 2):A195, 2022.
Article in English | ProQuest Central | ID: covidwho-2019866

ABSTRACT

AimsBackgroundHeart murmurs in a new born are common due to transition from fetal circulation to neonatal circulation. Majority of these heart murmurs disappear in few days, but they can also be a sign of underlying congenital heart disease. In UK the practice in majority of neonatal units is, heart murmur in an asymptomatic new born with normal examination and passing pulseOx, is reviewed again by middle grade after 24 hours. If the murmur is innocent (Grade 1-2/6, no signs or symptoms) then baby is brought back to neonatal clinic in 4 -6 weeks for follow-up. Due to the Covid pandemic in March 2020 our unit policy changed for all innocent murmurs to be followed up by the GP at 6 – 8 weeks.ObjectiveTo assess the outcome of change in policy of heart murmur follow-up during the pandemic.MethodsA retrospective study from March 2020 – June 2021 (15 months). Data collected of infants who had a heart murmur on routine newborn examination, using NIPE Smart data, admission notes, Badger and postnatal notes. Infants discharged for GP follow up as per revised guideline were identified, and parents of these infants were contacted to enquire about GP follow up and the outcome.ResultsDuring the audit period, 101 infants were found to have a heart murmur on routine neonatal examination.Of these 101:• 72 had resolved on middle grade review after 24 hours• 11 received inpatient ECHO before discharge.• 18 were discharged for GP review at 6-8 weeks.17 of 18 parents of these infants were contacted, with one baby excluded due to incorrect data. 16 were aware of the heart murmur at the time of discharge.17/17 (100%) patients contacted had a GP review at 6-8 weeks as planned.At this review, the murmur persisted in 4/17 (24%) infants. One of these infants was re-reviewed by the GP and subsequently resolved, and a further two infants were referred to paediatrics for ECHO. The final infant was not referred or re-reviewed, but has remained clinically well.ConclusionAll infants discharged for GP follow up were reviewed, and all have remained clinically well since discharge. Murmur had resolved in the majority of infants. Where the murmur persisted, the infant was appropriately referred or re-reviewed in the majority of cases. Asymptomatic infants with low grade (likely innocent) murmurs, we can continue to discharge home with GP follow-up.

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