Hypertensive disorders of pregnancy, neonatal outcomes and offspring developmental delay in Japan: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

INTRODUCTION: Developmental delay at an early age indicates the probability of continued problems after school age. Hypertensive disorders of pregnancy (HDP) are associated with developmental delays in offspring, with inconsistent outcomes. Neonatal outcomes vary according to HDP exposure and are relevant to development in later years. Here we aimed to clarify the relationship between HDP and developmental delay in offspring and whether neonatal outcomes mediate this association. MATERIAL AND METHODS: We used data from 5934 mother-child pairs from the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study, a prospective cohort study conducted in Japan between July 2013 and March 2017. The Ages and Stages Questionnaires, third edition, at 24 and 42 months of age, measured developmental delay in five areas. We performed multivariate quasi-Poisson regression and causal mediation analysis by neonatal outcomes. RESULTS: At 24 months of age, compared to offspring born from normotensive mothers, offspring born from HDP-affected mothers were more likely to experience developmental delay (risk ratio [RR] 1.29, 95% confidence interval [CI]: 1.09-1.52) in the areas of communication (RR 1.21, 95% CI: 1.00-1.45) and personal-social (RR 1.15, 95% CI: 1.03-1.28). This association was mediated by neonatal outcomes: preterm birth, neonatal asphyxia, NICU admission, and neonatal small head circumference. No association was observed between HDP and developmental delay at 42 months of age. CONCLUSIONS: Exposure to HDP during fetal life is associated with offspring developmental delay. This association is partly mediated by neonatal outcomes.

Maternal Mental Health in Pregnancy and Its Impact on Children's Cognitive Development at 18 Months, during the COVID-19 Pandemic (CONCEPTION Study).

BACKGROUND: The COVID-19 pandemic has significantly affected the mental health of pregnant persons. OBJECTIVE: We aimed to evaluate the impact of maternal mental health and antidepressant use on children's cognitive development. METHODS: We followed a cohort of children born during the COVID-19 pandemic. Maternal mental health was self-reported during pregnancy (Edinburgh Postnatal Depression Scale, General Anxiety Disorder-7, stress levels, and antidepressant use). The child's cognitive development was measured using the third edition of the Ages & Stages Questionnaires® (ASQ-3) at 18 months. Multivariate multinomial logistic regression models were built to assess the association between in utero exposure to maternal mental health and ASQ-3 domains: communication, gross motor, fine motor, problem-solving, and personal-social. RESULTS: Overall, 472 children were included in our analyses. After adjusting for potential confounders, a need for further assessment in communication (adjusted odds ratio (aOR) 12.2, 95% confidence interval (CI) (1.60;92.4)), and for improvement in gross motricity (aOR 6.33, 95%CI (2.06;19.4)) were associated with in utero anxiety. The need for improvement in fine motricity (aOR 4.11, 95%CI (1.00; 16.90)) was associated with antidepressant exposure. In utero depression was associated with a decrease in the need for improvement in problem solving (aOR 0.48, 95%CI (0.24; 0.98)). CONCLUSIONS: During the COVID-19 pandemic, maternal mental health appears to be associated with some aspects of children's cognitive development.

Increasing the uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) through seasonal malaria chemoprevention channel delivery: protocol of a multicenter cluster randomized implementation trial in Mali and Burkina Faso.

BACKGROUND: The uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) remains unacceptably low, with more than two-thirds of pregnant women in sub-Saharan Africa still not accessing the three or more doses recommended by the World Health Organisation (WHO). In contrast, the coverage of Seasonal Malaria Chemoprevention (SMC), a more recent strategy recommended by the WHO for malaria prevention in children under five years living in Sahelian countries with seasonal transmission, including Mali and Burkina-Faso, is high (up to 90%). We hypothesized that IPTp-SP delivery to pregnant women through SMC alongside antenatal care (ANC) will increase IPTp-SP coverage, boost ANC attendance, and increase public health impact. This protocol describes the approach to assess acceptability, feasibility, effectiveness, and cost-effectiveness of the integrated strategy. METHODS AND ANALYSIS: This is a multicentre, cluster-randomized, implementation trial of IPTp-SP delivery through ANC + SMC vs ANC alone in 40 health facilities and their catchment populations (20 clusters per arm). The intervention will consist of monthly administration of IPTp-SP through four monthly rounds of SMC during the malaria transmission season (July to October), for two consecutive years. Effectiveness of the strategy to increase coverage of three or more doses of IPTp-SP (IPTp3 +) will be assessed using household surveys and ANC exit interviews. Statistical analysis of IPT3 + and four or more ANC uptake will use a generalized linear mixed model. Feasibility and acceptability will be assessed through in-depth interviews and focus group discussions with health workers, pregnant women, and women with a child < 12 months. DISCUSSION: This multicentre cluster randomized implementation trial powered to detect a 45% and 22% increase in IPTp-SP3 + uptake in Mali and Burkina-Faso, respectively, will generate evidence on the feasibility, acceptability, effectiveness, and cost-effectiveness of IPTp-SP delivered through the ANC + SMC channel. The intervention is designed to facilitate scalability and translation into policy by leveraging existing resources, while strengthening local capacities in research, health, and community institutions. Findings will inform the local national malaria control policies. TRIAL REGISTRATION: Retrospectively registered on August 11th, 2022; registration # PACTR202208844472053. Protocol v4.0 dated September 04, 2023. Trail sponsor: University of Sciences Techniques and Technologies of Bamako (USTTB), Mali.

Formula Feeding Practice and Associated Factors Among Mothers Who Visited Health Facilities for Their Infants Aged Below 6 Months in Bahir Dar City, Northwest Ethiopia, 2020.

Background: Even though breastfeeding for infants and young children provides the ideal food for healthy growth and development, nowadays the use of infant formula feeding has increased worldwide. In developing countries, 1.3 million to 1.45 million childhood deaths are attributed to suboptimal breastfeeding practices. Objective: This study aimed to assess infant formula feeding practice and associated factors among mothers who visited health facilities for their infants aged less than 6 months in Bahir Dar city in 2020. Methods: An institution-based cross-sectional study was conducted in March-May 2020. Data were collected from 593 randomly selected mothers with infants less than 6 months of age. A multivariable logistic regression analysis was performed to identify associated factors of formula feeding practice with an a p-value of less than 0.05 and an adjusted odds ratio of 95% confidence interval. Results: The prevalence of infant formula feeding practices was 25%. Maternal age group of 25-34 years [AOR = 2.388; 95% CI: 1.295, 4.406], mother's occupation of private employee [AOR = 6.726; 95% CI: 2.756, 16.413], government employee [AOR = 4.726; 95% CI: 1.895, 8.700] and merchant [AOR = 2.798; 95% CI: 1.066, 7.345], positive attitude to infant formula [AOR = 2.10; CI: 1.09, 4.06], delayed breast milk initiation after delivery [AOR = 3.73; 95% CI: 1.504, 9.252], mothers who had 3 antenatal care [AOR = 2.294; 95% CI: 1.317, 3.997] and source of formula milk information from supermarket/pharmacy [AOR = 6.57; 95% CI: 1.48, 29.16] and from families/friends [AOR = 2.24; 95% CI: 1.24, 4.03] were independent predictors of infant formula feeding practice. Conclusion: This study's findings revealed that one-fourth of mothers fed infant formula before the age of 6 months. Therefore, we recommended promoting behavior change communication, focusing on attitude change in formula feeding practice and its health consequences, promoting exclusive breastfeeding practice, and strengthening ANC service provision.

Prevalence of white spot lesions in children up to 71 months of age in Gujarat state.

Introduction: The earliest sign of a new carious lesion is the appearance of chalky white spots on the surface of the tooth, indicating an area of demineralization of enamel. At this stage, the demineralization process can be reversed or arrested. This study aimed to determine the prevalence of white spot lesions (WSLs) among children up to 71 months in Gujarat state and to increase awareness among parents about its various preventive measures. Materials and Methods: Oral examination was done using the mouth mirror and tongue depressor. The prevalence of WSL was recorded using the International Caries Detection and Assessment System II coding and WSL index by Gorelick. Results: The overall prevalence of WSL was 31.8% (n = 2025) in Gujarat state. The parents of the participating children explained the various preventive measures to prevent decay followed by diet counseling and toothbrushing techniques. Conclusion: Knowledge of the actual prevalence of WSL will help in the implementation of appropriate and timely preventive measures required to decrease the incidence of early childhood caries in that region.

Problems in the Development of the Sleep-Wake Rhythm Influence Neurodevelopmental Disorders in Children.

Development of the sleep-wake rhythm has a significant effect on the physical and mental development of children. The sleep-wake rhythm is controlled by aminergic neurons in the brainstem's ascending reticular activating system, which is associated with synaptogenesis and the promotion of brain development. The sleep-wake rhythm develops rapidly within the first year after birth. At 3-4 months of age, the framework of the circadian rhythm is established. The objective of the present review is to assess a hypothesis concerning problems in the development of the sleep-wake rhythm and their effect on neurodevelopmental disorders. Autism spectrum disorder is characterised by a delay in the development of sleep rhythms at 3-4 months of age and also insomnia and night-time awakenings, as supported by several reports. Melatonin may shorten the sleep latency in ASD. Rett syndrome sufferers kept awake during the daytime were analysed by the Sleep-wake Rhythm Investigation Support System (SWRISS) (IAC, Inc., (Tokyo, Japan)), and the cause was found to be the dysfunction of aminergic neurons. Children and adolescents with attention deficit hyperactivity disorder show sleep problems such as resistance to bedtime, difficulty falling asleep, sleep apnoea, and restless legs syndrome. Sleep deprivation syndrome in schoolchildren is deeply influenced by Internet use, games, and smartphones, and this syndrome affects emotion, learning, concentration, and executive functioning. Sleep disorders in adults are strongly considered to affect not only the physiological/autonomic nervous system but also neurocognitive/psychiatric symptoms. Even adults cannot avoid serious problems, much less children, and the impact of sleep problems is considerably greater in adults. Paediatricians and nurses should be aware of the significance, from birth, of sleep development and sleep hygiene education for carers and parents. This research was reviewed and approved by the ethical committee of the Segawa Memorial Neurological Clinic for Children (No. SMNCC23-02).

Powered Intracapsular Tonsillotomy and Adenoidectomy in Infants ≤36 Months Compared to Older Children: A Retrospective Analysis.

OBJECTIVES: To evaluate the safety and outcomes of powered intracapsular tonsillotomy and adenoidectomy (PITA) for the treatment of sleep disordered breathing in infants up to 36 months of age compared to older children. METHODS: This retrospective analysis included children who underwent PITA from 2013 to 2019 at a single tertiary care medical center. The patients were divided into 2 groups: up to 36 months, and 36 to 72 months. The data were collected from electronic medical records and from a telephone survey based on a modified version of the OSA-18 questionnaire. Post-operative complications, and short- and long-term outcomes were compared. RESULTS: A total of 48 patients met the inclusion criteria for the main study group (up to 36 months of age). They were compared to 59 children 36 to 72 months of age. There were no differences in subjective outcomes between age groups (P = .65). There were no differences in the frequency of post-operative complications between age groups (P = .8) or in the number of hospitalization days (P = .91). CONCLUSION: The short- and long-term outcomes and safety of PITA for the treatment of sleep disordered breathing in infants up to 36 months of age are similar to those of older children.

Optimal complementary feeding practices and associated factors among mothers having children 6 to 23 months, south WOLLO zone, Dessie ZURIA, Ethiopia.

INTRODUCTION: Optimal complementary feeding practice is a child feeding practice that fulfills the minimum dietary diversity, the minimum meal frequency, continuing breastfeeding with complementary feeding, and initiation of complementary feeding from 6 to 8 months. METHOD: A community-based comparative cross-sectional study was conducted on a total of 732 randomly selected mothers having children 6 to 23 months of age from March 10 to April 21 /2021.Data were collected using a pre-tested interviewer-administered questionnaire. Data entry was performed by using Epi data version 3.1 and was exported to Stata version 14.1. Descriptive statistics were done. Multivariable Logistic regression was used to predict the role of independent variables on optimal complementary feeding. Findings with a p-value <0.05 at a 95% confidence interval (CI) were considered statistically significant in the final model. RESULT: The overall proportion of mothers with optimal complementary feeding practice was 18.1% (95% C I 15.3% - 21.0). Only 90 (25.1%, 95% CI = 20.6-29.7) of mothers were found to have optimal complementary feeding practice in NGO supported kebeles but only 37 (10.8%, 95% CI = 7.5-14.1) practiced optimal complementary feeding is not NGO-supported kebeles. Mothers from Kebeles with no NGO support were 46% (AOR = 0.54, 95% CI 0.31, 0.96) less likely to practice optimal complementary feeding. On the other hand, mothers of children aged20-23 months were four times (AOR = 4.47, 95% CI 2.02-9.91) more likely to practice optimal complementary feeding than mothers having children 6-8 months of age. PRACTICE IMPLICATIONS: Different interventions have been implemented by governmental and non-governmental organizations to improve this condition in Dessie Zuria District. But, there is limited data on the extent to which intervention by governmental and non-governmental organizations reduces this improving condition. The aim of this study was to assess the Optimal Complementary Feeding Practice and Associated Factors among Mothers Having Children Aged 6-23 Months, Ethiopia 2021. CONCLUSION: Optimal complementary feeding practices among mothers in NGO-supported kebeles were higher than not supported kebeles. Therefore, strengthening and scaling up the program to not-supported kebeles is recommended to improve the optimal complementary feeding practiced.

Predictors of the amount of intake of Ready-To-Use-Therapeutic foods among children in outpatient therapeutic programs in Nairobi, Kenya.

Ready-to-use Therapeutic Food (RUTF) therapy is a standard protocol for treating children with severe acute malnutrition (SAM) admitted in Out-Patient Therapeutic Programmes (OTP). The amount of RUTF to be consumed by a child is based on weight (200 kcal/kg body weight/day) as stipulated in the Kenya Integrated Management of Acute Malnutrition (IMAM) protocol for timely weight gain. There is limited information on the determinants of consumption of the correct amount of RUTF. This study sought to fill this gap by establishing the associations between the caregivers' and the child's characteristics and the amount of RUTF the child ate within a 24-h recall period. We used a cross-sectional study design and interviewed 200 caregivers of children 6-23 months of age admitted in four OTP centers in Nairobi Kenya. We used a researcher-administered questionnaire to collect information from the caregivers. Seventy-three percent of the children ate the recommended amount of RUTF. A smaller proportion (54.4%) of younger children (6-11 months of age) ate the recommended amount of RUTF compared to older children (12-17 months old and 18-23 months old at 89.1% and 82.8%, respectively). The predictors of consumption of the correct amount of RUTF were child's birth order-firstborn (AOR 29.92; 95% CI: 5.67-157.93) and children's age; 12-17 months old (AOR 5.19; 95% CI: 2.18-12.36) and 18-23 months (AOR 6.19 95% CI: 2.62), indicating that firstborn and older children were more likely to consume the correct amounts of RUTF. Caregivers' knowledge and correct practices in feeding a child with RUTF also predicted the consumption of the correct amount of RUTF. In conclusion, maternal and child characteristics are determinants of the consumption of the correct amount of RUTF by children in OTP.

Which Bayley-III cut-off values should be used in different developmental levels?

Background/aim: Latest version of Bayley Scales (Bayley-III) and its predecessor (BSID-II) are the most widely used standardized developmental tools in infancy and early childhood. Recent studies showed that Bayley-III scores were higher than BSID-II in 18­24 month-old and mostly premature infants. We aimed to evaluate the generalization of inflated scores of Bayley-III to children aged 6­42 months with different disease groups, and to find out which cut-off points should be used in Bayley-III to detect mild, moderate, and severe developmental delay according to BSID-II standard cut-off points. Materials and methods: Two hundred and fifty-five children aged 6­42 months with different diseases and developmental levels were administered both the Bayley-III and BSID-II in the same session between 15 November 2017 and 15 April 2018. Results: The mean Bayley-III Cognitive Composite (CC) and Cognitive Language Composite (CLC) scores were respectively 13.1 ± 9.1 and 8.6 ± 8 points higher than BSID-II Mental Development Index (MDI) scores (P < 0.001). The mean Bayley-III Motor Composite (MC) scores were 14.4 ± 10.5 points higher than BSID-II Psychomotor Developmental Index (PDI) scores (P < 0.001). Cognitive delay was found in 126 (49.4%) and 59 (23.1%) children according to BSID-II MDI and Bayley-III CC scores, respectively. Motor delay was found in 174 (69.3%) and 86 (34.3%) children according to the BSID-II PDI and Bayley-III MC scores, respectively. Children had less cognitive (48.6%) and motor delay (54.5%) according to Bayley-III scores. Bayley-III scores were significantly higher than BSID-II scores for all ages (P < 0.001). According to ROC analysis the cut-off scores for mild, moderate, and severe delay were 92.5, 83.2, and 71.2 for Bayley-III CLC; and 98.5, 86.5, and 74.5 for Bayley-III MC, respectively. Conclusion: Bayley-III scores should be interpreted carefully for all age ranges and different diagnosis. The risk for underestimation of developmental delays by Bayley-III should be kept in mind. Different Bayley-III cut-off scores should be used to define developmental delay levels.

The impact of "Child Care" intervention in rural Primary Health Care Program on prevalence of diarrhea among children less than 36 months of age in rural western China.

BACKGROUND: It was unclear how and to what extent the "Child Care" intervention (CCI) in rural Primary Health Care Program affected the prevalence of childhood diarrhea in rural western China. METHODS: The available data of 10,829 and 10,682 households was collected from shared 34 counties of 9 provinces of western China in 2001 and 2005 respectively. A log-binomial regression model was used to predict the effect of CCI on prevalence of childhood diarrhea. RESULTS: In 2001, the prevalence rate of diarrhea among children less than 36 months of age was 17.01% in intervention group and 17.72% in control group, and in 2005 this crude rate declined to 4.85% in the former and 6.84% in the latter. Log-binomial regression analysis showed that CCI decreased the overall prevalence of childhood diarrhea by 27% (adjusted relative prevalence ratio (rPR) = 0.73 95% CI 0.59, 0.89). The stratification regression by social-economic status (SES) of the households showed that this effect varied with SES of the households. In the medium or rich households, this intervention was effective significantly (the medium: adjusted rPR = 0.63,95%CI 0.41,0.95; the rich: adjusted rPR = 0.72,95%CI 0.54,0.97), but in poor households it seemed to be less effective (adjusted rPR = 0.86,95%CI 0.55,1.36). CONCLUSION: In rural Primary Health Care Program, CCI was effective in improving childhood diarrhea but this effect was inequitable among SES of the households. So, attention should be paid to the inequality when CCI was adopted to reduce childhood diarrhea in rural China.

[Effects of scalp acupuncture on brain injury in premature infants with different months of age].

OBJECTIVE: To explore the clinical efficacy differences of scalp acupuncture on brain injury in premature infants with different months of age. METHODS: According to the corrected months of age, 90 cases of premature infants with brain injury were divided into a group A (3 through 6 corrected months of age), a group B (7 through 9 corrected months of age) and group C (10 through 12 corrected months of age), 30 patients in each one. Based on the conventional early intervention, the infants in the group A were treated with scalp acupuncture at Zhiqizhen, motor area; the infants in the group B were treated with scalp acupuncture at Zhiqizhen, motor area and foot motor sensory area; the infants in the group C were treated with scalp acupuncture at Zhiqizhen, motor area, foot motor sensory area and balance area. All the treatment was given once every other day, and totally 30 treatments were given. The Alberta infant motor scale (AIMS), development quotient (DQ) of each function indexes in Gesell developmental scale (GDS) were observed before and after treatment; the clinical efficacy of each group was compared and the correlation between clinical efficacy and months of age was analyzed. RESULTS: Compared before treatment, the total score of AIMS and DQ of each function indexes of GDS were all improved in the three groups after treatment (all P<0.01). After treatment, the differences of total score of AIMS and DQ of each function indexes of GDS among the three groups were significant (P<0.05, P<0.01), and the results in the group A were higher than those in the group B and the group C (P<0.05, P<0.01). The total effective rate was 96.3% (26/27) in the group A, which was higher than 89.7% (26/29) in the group B and 83.3% (25/30) in the group C. The correlation analysis indicated less months of age was significantly corelated with better efficacy (P<0.05). CONCLUSION: Scalp acupuncture has superior improvement on the recovery of brain damage in premature infants, especially for those with 6 months of age or less.

Probiotics and the development of very low birthweight infants: follow-up study of a randomised trial.

OBJECTIVE: To investigate the effect of Bifidobacterium bifidum OLB6378 on the development of very low birthweight (VLBW) infants at 18 months of corrected age. DESIGN: Long-term follow-up study of a cluster-randomised, placebo-controlled trial. PATIENTS: VLBW infants (birth weight <1500 g) born between January 2010 and March 2011 and managed at 19 neonatal intensive care unit facilities assigned to two groups to account for the effect of probiotic cross-contamination within facilities. INTERVENTIONS: For VLBW infants, administration of OLB6378 as a probiotic was started within 48 hours of birth and continued until the body weight reached 2000 g. MAIN OUTCOME MEASURES: At 18 months of corrected age, physical status and developmental quotient (DQ18) were assessed. The distribution of DQ18 scores was categorised into four levels of development: <70, significant developmental delay; 70-84, moderate developmental delay; 85-99, without developmental delay; ≥100, average development or better. RESULTS: Among 153 infants assigned to the OLB6378 administration group and 130 assigned to the placebo administration group, 102 and 105 infants, respectively, underwent the 18-month medical examination. The distribution of developmental levels (DQ18 scores <70, 70-84, 85-99 and ≥100) was significantly more favourable for OLB6378 administration (12, 12, 25 and 40 infants, respectively) than for placebo administration (15, 17, 23 and 24 infants, respectively) (ordered logistic regression analysis: partial correlation coefficient, 0.589; P value, 0.038). CONCLUSIONS: Although limited by assessment rates, result suggests that OLB6378 may have a beneficial effect on the psychological development in VLBW infants. CLINICAL TRIAL REGISTRATION: UMIN000002543.

Prevalence of initiation of complementary feeding at 6 months of age and associated factors among mothers of children aged 6 to 24 months in Addis Ababa, Ethiopia.

BACKGROUND: Inappropriate complementary feeding practices are a major contributor to poor nutritional status of children under 2 years old in Ethiopia. The Ethiopian Ministry of Health recommends that continued breast feeding beyond 6 months should be accompanied by consumption of nutritionally adequate, safe and appropriate complementary foods. The aim of this study was to determine the prevalence of initiation of complementary feeding at 6 months of age and its associated factors among mothers of children aged 6 to 24 months in Addis Ababa, Ethiopia. METHODS: A cross-sectional study was conducted during January and February of 2017 among 600 mothers with children aged 6 to 24 months in Addis Ababa City. The study participants were selected using systematic random sampling technique through a multistage sampling technique. Data were collected using a pre-tested and structured questionnaire by trained data collectors. Data were entered and analyzed using EpiInfo 7 and SPSS version 21, respectively. We used multivariable binary logistic regression to model the associations of selected independent variables with initiation of complementary feeding at 6 months of age. RESULTS: Approximately 83% of mothers initiated feeding of complementary foods to their child at 6 months of age. This practice was associated with maternal education (primary education v. no education) Adjusted Odds Ratio (AOR) (95%CI): 2.26(1.19, 4.43)), and home delivery of the child (AOR (95%CI): 0.32 (0.12, 0.82)). CONCLUSION: Most mothers in the study initiated feeding of complementary foods to their children at 6 months of age. To further improve complementary feeding practices, mothers should be educated on the benefits of introducing complementary feeding at 6 months of age and the consequences of early or late initiation of complementary feeding on child health.

Effects of scalp acupuncture on brain injury in premature infants with different months of age / 中国针灸

<p><b>OBJECTIVE</b>To explore the clinical efficacy differences of scalp acupuncture on brain injury in premature infants with different months of age.</p><p><b>METHODS</b>According to the corrected months of age, 90 cases of premature infants with brain injury were divided into a group A (3 through 6 corrected months of age), a group B (7 through 9 corrected months of age) and group C (10 through 12 corrected months of age), 30 patients in each one. Based on the conventional early intervention, the infants in the group A were treated with scalp acupuncture at , motor area; the infants in the group B were treated with scalp acupuncture at , motor area and foot motor sensory area; the infants in the group C were treated with scalp acupuncture at , motor area, foot motor sensory area and balance area. All the treatment was given once every other day, and totally 30 treatments were given. The Alberta infant motor scale (AIMS), development quotient (DQ) of each function indexes in Gesell developmental scale (GDS) were observed before and after treatment; the clinical efficacy of each group was compared and the correlation between clinical efficacy and months of age was analyzed.</p><p><b>RESULTS</b>Compared before treatment, the total score of AIMS and DQ of each function indexes of GDS were all improved in the three groups after treatment (all <0.01). After treatment, the differences of total score of AIMS and DQ of each function indexes of GDS among the three groups were significant (<0.05, <0.01), and the results in the group A were higher than those in the group B and the group C (<0.05, <0.01). The total effective rate was 96.3% (26/27) in the group A, which was higher than 89.7% (26/29) in the group B and 83.3% (25/30) in the group C. The correlation analysis indicated less months of age was significantly corelated with better efficacy (<0.05).</p><p><b>CONCLUSION</b>Scalp acupuncture has superior improvement on the recovery of brain damage in premature infants, especially for those with 6 months of age or less.</p>

Determinants of exclusive breastfeeding in infants less than six months of age in Hawassa, an urban setting, Ethiopia.

BACKGROUND: The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for the first six months of life. However, the proportion of EBF in Ethiopia is 58%. The EBF practice and factors affecting it have not been studied in Hawassa, Southern Ethiopia. The aim of this study was to assess the prevalence and determinants of EBF practice among infants less than six months age in Hawassa city, Ethiopia. METHODS: A total of 529 mothers with infants aged 0-6 months were involved in this study between November 2015 and January 2016. Trained interviewers collected data from the mothers of the infants. Exclusive breastfeeding was assessed based on infant feeding practice in the prior 24 h. Multivariable logistic regression analysis was conducted. RESULTS: Infants aged 0-5.9 months were studied with comparable gender composition (51.4% females). The exclusive breastfeeding prevalence was 60.9% (95% CI 56.6, 65.1). Mothers with infants aged 0-1.9 months and 2-3.9 months practiced EBF more likely than mothers with infants aged 4-6 months (Adjusted odds ratio [AOR] 3.59; 95% CI 2.07, 6.2) and (AOR 2.08; 95% CI 1.23, 3.5), respectively. Married mothers practiced EBF more likely than singles (AOR 2.04; 95% CI 1.03, 4.06). Housewives practiced EBF more likely than employed mothers (AOR 2.57; 95% CI 1.34, 4.9). Mothers who had a vaginal birth were more likely to practice EBF than mothers who gave birth via Cesarean section (AOR 2.8; 95% CI 1.7, 4.6). Mothers who gave birth at a healthcare facility were more likely to practice EBF than mothers who gave birth at home (AOR 8.8; 95% CI 5.04, 15.4). Mothers without a breast complication practiced exclusive breastfeeding more than mothers with breast complications (AOR 2.05; 95% CI 1.5, 4.1). CONCLUSIONS: This study showed a low prevalence of exclusive breastfeeding. Younger infants, babies born to married women, who are housewives, having a vaginal birth in a health facility, and whose mother's breasts were healthy, were predictors for EBF. The promotion of an institutional delivery, optimal breastfeeding practices, and designing strategies to better support employed mothers are recommended.

Adenovirus species C detection in children under four years of age with acute bronchiolitis or recurrent wheezing.

BACKGROUND: Lower respiratory tract viral infection is an important cause of morbidity and mortality in children worldwide. Among viral etiological agents the human Adenovirus (AdV) has been associated to mild or severe respiratory tract infection. OBJECTIVE: To detect the presence of human Adenovirus (AdV) in children with acute bronchiolitis or recurrent wheezing, describing their clinical features and determining Adenovirus species and AdV association to Respiratory Syncytial Virus (RSV), Human Metapneumovirus (MPV) and Parainfluenza virus (PIV). STUDY DESIGN: A total of 155 children bellow 48 months of age with acute bronchiolitis or recurrent wheezing were investigated for the presence of AdV, RSV, MPV and PIV in nasopharyngeal aspirate, by real-time PCR method. RESULTS: AdV, predominantly of species C, has been detected as the unique pathogen (AdVi) or in association to other pathogens (AdVa.), in 39/155 samples. Crackles were more frequent in children with AdV. RSVi was detected predominantly in children with acute bronchiolitis while AdVi and AdVa were detected more frequently in patients with recurrent wheezing. CONCLUSION: A small outbreak of AdV species C was observed in 2012 and 2013. AdV was detected more frequently in children with recurrent wheezing while RSVi was more frequent in infants with acute bronchiolitis.

Lactation Consultant Support from Late Pregnancy with an Educational Intervention at 4 Months of Age Delays the Introduction of Complementary Foods in a Randomized Controlled Trial.

BACKGROUND: Although the WHO recommends that complementary feeding in infants should begin at 6 mo of age, it often begins before this in developed countries. OBJECTIVE: Our objective was to determine whether lactation consultant (LC) support, with educational resources given at 4-mo postpartum, can delay the introduction of complementary foods until around 6 mo of age. METHODS: A total of 802 mother-infant pairs were recruited from the single maternity hospital serving Dunedin, New Zealand (59% response rate) and randomly assigned to the following: 1) usual care (control group); 2) infant sleep education intervention (Sleep); 3) food, activity, and breastfeeding intervention (FAB); or 4) combination (both) intervention (Combo). Certified LCs delivered 3 intervention sessions (late pregnancy and 1-wk and 4-mo postpartum). The 4-mo contact used educational resources focused on developmental readiness for complementary foods. Age when complementary foods were introduced was obtained from repeated interviews (monthly from 3- to 27-wk postpartum). RESULTS: A total of 49.5% and 87.2% of infants received complementary foods before 5 and 6 mo of age, respectively. There was evidence of group differences in the number of infants introduced to complementary foods before 5 mo (P = 0.006), with those receiving support and resources (FAB and Combo groups combined; 55.6%) more likely to wait until at least 5 mo compared with controls (control and Sleep groups combined; 43.3%) (OR: 1.52; 95% CI: 1.08, 2.16). However, there was no evidence they were more likely to wait until 6 mo of age (P = 0.52). Higher maternal age, higher parity, and a less positive attitude toward breastfeeding were positively associated, and drinking alcohol during pregnancy was negatively associated, with later age of introduction of complementary foods. CONCLUSIONS: Providing an LC and educational resources at 4-mo postpartum to predominantly well-educated, mainly European, women can delay the introduction of complementary foods until 5 mo of age, but not until the WHO recommendation of 6 mo. This trial was registered at clinicaltrials.gov as NCT00892983.

Low-Dose Chemoreduction for Infants Diagnosed with Retinoblastoma before 6 Months of Age.

AIM: The purpose of this study was to evaluate the outcomes of infants diagnosed with retinoblastoma before 6 months of age, including the need for chemoreduction (CRD). In this age group, dosage of CRD was reduced due to its potential for toxicity. METHODS: This is a retrospective review from 2000 to 2009 that includes 126 eyes of 72 infants (18 unilateral, 54 bilateral). Systemic CRD was administered when local modalities failed or were considered inadequate. Primary outcome measures were the need for CRD and globe salvage. RESULTS: Of the 72 infants diagnosed before 6 months of age, 48 (67%) ultimately required CRD for globe salvage, 40 (56%) patients before 6 months of age. Globe salvage was achieved in 62% (78/126) of eyes overall and in 93% (68/73) of eyes with Group A-C disease. No patient was hospitalized for CRD-related illness; survival was 100%. The mean follow-up was 52.9 months (range 1-148 months). CONCLUSION: Utilizing a combination of focal modalities and reduced-dose CRD, children diagnosed with retinoblastoma before 6 months of age attain globe salvage rates comparable to those of older age groups. Two thirds of the infants ultimately required CRD for globe salvage. Bilateral disease as well as Group D and E classification in at least one eye at presentation increased the chance of requiring CRD (p < 0.0001 and p < 0.016, respectively).