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Volume IV
Issue 10

              Weekly Updates in Pediatrics         March 6, 2013

EDITOR:  Jack Wolfsdorf, MD, FAAP                   

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Milk oral immunotherapy (OIT) for cows milk allergy (CMA) 

Milk allergy is an immune response to one or more constituents of milk, most frequently the alpha S1-casein, a protein in cow's milk

 

A small study of 28 school-aged children (6-14 years of age) with documented CMA by oral challenge, were given increasing weekly amounts of cow's milk protein (0.06mg to 6400mg) over a 23 week period (and compared to a matched placebo given group) and followed up for 3 years.

 

OIT treatment appears effective and of sustained benefit (3 yrs.) in desensitizing school children with CMA.

 

High Frequency Oscillation (HFOV) vs conventional ventilation for treating acute lung disease in preterm infants 

One in 5 very low birth weight infants receives HFOV during their NICU stay.

 

An extensive Cochrane review comparing HFOV to conventional ventilation to treat preterm infants with acute pulmonary dysfunction and/or prevent chronic lung disease, does not support at this time, the use of HFOV as the treatment approach to the ventilator management of the preterm infant with acute lung disease.

 

Source:

Neonatology 2013;103:7-9

DOI: 10.1159/000338553

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Lesbian, Gay, Bisexual, & Transgender youth in Middle school  

 

A Youth Risk Behavior Survey given to a random sample of 2,730 children grades 6-8, in 22 public middle schools indicates that 3.8% of middle school students identify themselves as lesbian, gay or bisexual and 1.3% as transgender. Too little is known, or being addressed, concerning their needs.

 

Source:  Journal of Adolescent Health 

Does "light drinking" during pregnancy affect the long term mental development of the child

 

A prospective population-based study of 6,587, 11 year old children assessed by parent and teacher rated Strength and Difficulties Questionnaire and whose mother had consumed alcohol during the first trimester of pregnancy indicated that light drinking (< 1 glass per week) does not appear to be associated with any clinically important adverse effect on either mental development or academic achievement.

 

Source:  Archives of Disease in Childhood 

Video Feature
Does Light Drinking During Pregnancy Hurt Babies? 
Does Light Drinking During Pregnancy Hurt Babies?
via YouTube

Infantile Colic?  Help at last!

 

Infantile colic is a condition that occurs, usually within the first month of life, in which healthy mostly breast fed babies repetitively cry intensively, moan, or show other signs of distress, for more than 3 hours/day and more than 3 days per week. It usually lasts for up to approximately 3 - 4 months of age, though it may continue for as long as one year. Frequently these babies grunt/pass gas/cry after eating, though 85-90% of colicky babies have no evidence of significant gastrointestinal abnormality, and colic is unrelated to the babies' diet. 10% of colicky babies however may respond to changing the mother diet or to feeding the infant a hypoallergenic formula.

 

While there are multiple causes postulated for infantile colic, no consensus opinion on etiology or treatment exists. The use of commercial lactase enzyme drops added to babies' feeds is now the preferred method of treating infantile colic in the UK, while the use of probiotics (particularly L. reuteri DSM 17938) appears to significantly reduce median crying time.  All other treatments frequently suggested do not appear to have any consistent beneficial effect.                                 

 

Source:  The Journal of Pediatrics     Click HERE to see related video. 

Chorioamnionitis- a risk factor for necrotizing enterocolitis (NEC)

 

Antenatal maternal inflammation appears to be among the many risk factors (prematurity, plus many infants factors, low Apgar score, enteral feeding, maternal hypertension during pregnancy, use of packed red cell transfusions, umbilical catheterization, etc.) associated with the development of NEC in the newborn.

 

A systematic search of the literature reveals that clinical Chorioamnionitis and histological Chorioamnionitis with fetal involvement, are both strongly associated with the subsequent development of neonatal NEC. 

 

Source: The Journal of Pediatrics 

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