January 22, 2014   Vol. V, Issue 4
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Age & the risk of fever & seizures associated with measles-containing vaccine administration.

"The first dose of live attenuated measles-containing vaccines is associated with an increased risk of febrile seizures 7-10 days later Child Immunization among 12-23 month old children." Combination vaccines appear to have a greater (two fold) risk for subsequent febrile seizures compared to separately given vaccines.


A studying investigating effect of age and risk of fever and seizures following measles-containing vaccines, indicates higher risk among older children. 12-15 months of age appears to be the optimum time to administer measles-containing vaccines.


JAMA Pediatrics 

Probiotics to prevent/treat "excessive crying"/"infantile colic."

A systematic search of a number of data bases examined the effects of oral probiotics on randomized infants (< 3 months of age) diagnosed with "excessive crying"/"infantile colic."

While L reuteri may be of value in treating breast-fed infants with excessive crying"/"infantile colic," to date no evidence appears to exist to support their use to prevent or treat this problem in formula-fed infants.


JAMA Pediatrics 

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Potential asphyxia & brainstem abnormalities in Sudden Unexpected death (SIDS) in infants.  


Sudden Unexpected Death in Infants (SIDS), the etiology of which remains controversial, is thought to include asphyxia during sleep.


A study involving infants who died under potentially asphyxial conditions, or not, investigated brainstem neurochemical status to assess whether perhaps infants with borderline or intermediate neurochemical brainstem deficiencies were more likely to die with minimal asphyxial stress that may occur during sleep.


Brainstem neurochemical abnormalities are found in potentially asphyxiated babies and those who died under non-asphyxial conditions. The cause/s of SIDS remains under discussion.



Video Feature  
Bringing Awareness to: Sudden Infant Death Syndrome (SIDS)
Bringing Awareness to: Sudden Infant Death Syndrome (SIDS)
via YouTube

 A longitudinal study of breast development onset.


Cross-sectional studies and surveys on the onset of secondary sexual characteristics in girls have observed pubertal maturation occurring at earlier ages.


A prospective, longitudinal study (3 geographic USA sites) of more than 1,200 girls starting at age 6-8 years involved regularly (every 6-12 months) assessing onset of breast development (Thelarche) (using Tanner staging) over a 4.3 year (mean) period and correlating this information with race, ethnicity, BMI at baseline and site.


Median age at onset of breast stage 2 development is 8.8 (African American), 9.3 (Hispanic), 9.7 (non-Hispanic white and Asian girls), years respectively. Girls with a greater BMI reach Stage 2 development earlier. Thelarche appears to be occurring at younger ages than previously documented. (It does not appear that younger age at menarche raises the risk of earlier first sexual intercourse).




Abbreviated bed rest protocol in the management of blunt abdominal spleen & liver injury (BSLI) in children.

Blunt trauma occurs in 90% of pediatric trauma victims; blunt abdominal trauma causing most abdominal injuries, with the spleen, liver and kidney respectively most frequently damaged.


A large study of an abbreviated protocol for BSLI where bed rest was restricted to 1 night for Grade I and II injuries and 2 nights for Grade > III injuries (vs. APSA guidelines of Grade + 1 night) indicates that this approach can be safely utilized and decreases hospitalization time significantly.



Blood eosinophil count during Bronchiolitis & subsequent development of bronchial hyperactivity/lung function in early adolescence.


Inflammatory markers (blood and urine) were measured during hospitalization of 105 children < 1 year of age diagnosed with bronchiolitis. 90% of these children were available for follow-up at 11 years of age.


A higher blood eosinophil count in infants with bronchiolitis is associated with greater bronchial-hyper responsiveness (asthma) and poorer lung function at 11 years of age.


Acta Paediatrica