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December 18, 2013   Vol. IV, Issue 51
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MCH's 49th Annual Pediatric Postgraduate Course


February 27- March 2



Register today! 


Physical activity in children attending preschool -modifiable factors.

A study was undertaken to document moderate/vigorous physical activity (MVPA) in 5-6 year old preschool children and to identify factors that influence such activity. 426 randomly selected healthy boys and girls were selected from a variety of preschools, and time-spent in MVPA ( utilizing ActiGraph accelerometers ) measured over 4.3 preschool days during Spring.


9 significant correlates (out of a total of 37 potential domains) with MVPA can be identified. Preterm birth, vegetation on the playground and rainy days negatively correlate with MVPA, while gender (boys), child motor coordination, location of the preschool building on the playground, percentage afternoon hours, and size of indoor area per child are positively associated with MVPA.



Late preterm (LP) infants: Risks.  

LP infants are defined as those born at 34-0/7 to 36-6/7 weeks gestation (previously called "near term" infants).


An excellent "State-of-the-Art" review article explores the reason for the change in terminology, the evidence of the last 6 weeks of gestation being a "critical period of growth and development" for both the lungs and brain, the higher morbidity rate and the 3 fold increase in mortality. It explores the possible prenatal, natal, development and environmental causes and addresses the practical implication of all of these on newborn care.

A "must read article" (Ed.).



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Risk factors for cessation of breast feeding.


870 pregnant women who anticipated having full term infants and breast feeding, voluntarily provided weekly data of feeding and sleeping practices for 26 weeks post-partum. 94% started breast feeding of which 66% breast fed exclusively and 47% continued to 26 weeks post-partum (<1% exclusively).


Breast feeding exclusively for at least 4 weeks, and bed-sharing is significantly associated with longer breast feeding continuation.


Journal of Human Lactation 

E-cigarette use in youths.  


Between 2011 and 2012, students in grades 6 to 12 who had ever smoked an e-cigarette increased from 3.3% to 6.8% (nearly 2 million middle and high school youths), and current smokers from 1.1% to 2.1%. 76.3% of current users also smoked conventional cigarettes. Whether smoking e-cigarettes is benign remains unknown.WTVG - E-cig usage among youth has lawmakers worried




via YouTube>> 

Video Feature  
Are E-Cigs Safer?
Are E-Cigs Safer?
via YouTube
Palivizumab (Pmab) (Synagis) in preterm infants to prevent subsequent recurrent wheezing.


Palivizumab is a humanized monoclonal antibody produced by recombinant DNA technology directed at an antigenic site on the respiratory syncytial virus (RSV), given by intramuscular injection.


A prospective observational multicenter case-control study of preterm infants (gestational age 33-35 weeks) given intramuscular Pmab prophylaxis during their first RSV season and followed for 3 years documenting physician diagnosed recurrent wheezing, indicates that Pmab prophylaxis significantly reduces the incidence of recurrent wheezing during the first 3 years of life.



Hypospadias & residential proximity to pesticide applications during early pregnancy.


690 male infants (with matched controls) born with hypospadias between 1991 and 2004 living in 8 California counties were identified, and maternal exposure to pesticide applications during early pregnancy ( within a 500-m radius of mother's residential address) assessed.


While 41% of children with hypospadias and controls were found to have chemical exposure (57 chemical groups and 292 chemicals), most pesticides were not associated with an elevated hypospadias risk. As experimental evidence suggests a link between pesticide association and hypospadias, this study requires replication.



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