February 18, 2015   Vol. VI, Issue 7
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Explaining the increase in the prevalence of Autism Spectrum Disorders (ASD) 

A population-based birth cohort study (677,915 children) that included information on all individuals in Denmark, followed from birth until diagnosis of ASD, death, immigration or until the end of the follow-up period (20 years later) analyzed the effect that a change in diagnostic criteria and reporting which occurred during this period, had on the prevalence of ASD diagnosis.

Changes in reporting practices appear to account for 60% of the increase in the observed prevalence of ASD diagnosed in children seen over a 20 year period.


JAMA Pediatrics 

Domperidone as a galactagogue? 

Domperidone is a specific blocker of dopamine receptors; relieves nausea and vomiting, is a prokinetic increasing gastrointestinal peristalsis and enhances breast milk production (by enhancing prolactin release). It is not approved for use in the USA but is used in various European countries and off label in Australia as a galactagogue.


Domperidone usage in adults may result in drug-induced long QT syndrome and death. There appears to be no benefit to its off label use to enhance breast milk production in mothers.


Journal of Human Lactation 

Accuracy of infrared tympanic thermometry (IRTT) used in the diagnosis of fever in children.

A systematic review and meta-analysis of 31 studies assessing the accuracy of IRTT indicates that this is a good method to diagnose fever and encourages its widespread use.


Clinical Pediatrics 

Early Childhood Neurodevelopment after intrauterine growth retardation (IUGR).

A systematic review of neurological outcomes six months - three years after IUGR birth, suggests that motor, cognitive, language, attention, social development and adaptive behavior abnormalities result in poorer neurodevelopmental outcomes (the multiplicity of confounding variables however limit the strength of the conclusions).





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A prospective examination of whether childhood sexual abuse predicts subsequent sexual offending


Childhood sexual abuse has been assumed to increase the risk of sexual offending, despite the less than perfect research on which this claim has been based.


A prospective cohort study and archival records check investigated children with documented physical and sexual abuse and neglect (aged 0 - 11 years) and compared them to a matched group of children without such histories. All were followed into adulthood (mean age: 51 years).


A large cohort study of non-abused children and those physically and sexually abused which followed them to 51 years of age, indicates that physically abused and neglected boys are at increased risk for subsequent sexual offenses. Childhood sexual abuse does not appear to be a risk factor for subsequent sexual offenses.


JAMA Pediatrics 

Video Feature 

(via YouTube)
A View From the Shadows: Exposing the Mind of Child Sex Offenders
Estimating impacts of a Breakfast in the Classroom (BIC) program on school outcomes


"Short-term impacts of breakfast consumption on diet quality and cognitive functioning have been reported".


A large quasi-experimental study involving 446 public elementary schools predominantly serving low-income, racial/ethnic minority students examined the ability of a BIC program to improve breakfast participation, school attendance from kindergarten to sixth grade and academic achievement at second through sixth grades.


A BIC program enhances breakfast participation, improves school attendance rates and data suggests that academic achievement may improve (though larger studies are required).


JAMA Pediatrics

Nissen Fundoplication


Gastro esophageal reflux (GE) "is the physiological passage of gastric contents into the esophagus, with or without

Nissen Fundoplication
Nissen Fundoplication

regurgitation and vomiting".


Gastro esophageal reflux disease (GERD) is the reflux of gastric contents which results in symptoms or complications.


Management of GERD includes lifestyle changes, and optimal pharmacological management - to surgical correction. Surgery is indicated for children who are non adherent to therapy, when optimal drug therapy has failed, when severe GERD-associated complications (failure to thrive, severe esophagitis, esophageal stricture and apnea) exist, or when the cause of the GERD is a large hiatal hernia. 


Nissen fundoplication (a 360� fundal wrap around the lower esophageal sphincter- LES) strengthens the LES and reduces transient LES relaxation. It is one of the most common surgeries performed by pediatric surgeons in the USA (potential complications associated with this procedure are fully discussed in this well worth reading article: Ed).


Clinical Pediatrics 

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