A Belgian consensus-statement on growing-up milks for children 12-36 months old.

UNLABELLED: Growing-up milks (GUM) are milk-based drinks with low protein and added minerals and vitamins intended for children 12-36 months. Since the advantages of GUM are heavily debated, we reviewed the literature. A literature search was done using the classic databases (Pubmed, Embase, Cochrane) on the use of GUM in 12- to 36-month-old young children. Only limited data are available. GUM have a highly variable composition as their marketing is not regulated. Nevertheless, all papers conclude that GUM help to cover nutritional requirements of 12- to 36-month-old infants. CONCLUSION: Appropriate intakes of macro- and micronutrients in 1- to 3-year-old children have long-term health benefits. Present diets offered to toddlers do in general not meet the requirements. Supplemented foods are therefore helpful, of which GUM is a possibility.

[Management of fever in children younger then 3 years]. / La fiévre chez les enfants de moins de 3 ans.

Fever represents a normal physiological response as a result of the introduction of an infectious agent producing exogenous and endogenous pyrogenes influencing the central set point of body temperature. This response is an important immunological defence. Fever can be defined as any elevation of body temperature above 38 degrees C. Infancy body temperature should be measured rectal. Fever is mostly caused by a benign viral infection, but it can be an indicator of a major illness such as meningitis, septicaemia, pneumonia. The risk for severe evolution depends on the clinical context and the age of the infant. Most predictive for major illness are situations in which infants are younger than 3 months with body temperature > or = 38 degrees C, infants between 3 and 6 months with body temperature > or = 39 degrees C, and children of any ages with critical clinical signs. Those patients should be seen by a medical doctor as soon as possible. Height and duration of fever are no predictive parameters for major illnesses. Repeated observation of the feverish child is very important in order to follow any evolution. Uncomplicated fever is harmless and should not be treated. If necessary, we prefer acetaminophen (paracetamol), given orally except in cases of vomiting. Antipyretics will not affect the cause of fever, sometimes they might make the diagnosis of the underlying cause difficult, but they may have an effect on discomfort for the child. If antipyretics have been given, repeated observations stay important. Postvaccineal fever should not be treated in a different way. Febrile convulsion is a common outcome of childhood febrile illness. Adverse effects are rare. The use of antipyretics cannot prevent initial or recurrent febrile convulsions and they should not be used for this purpose.