Updates in Pediatrics from Miami Children's Hospital: Nov 21 Issue

Weekly Updates in Pediatrics November 21, 2012

EDITOR: Jack Wolfsdorf, MD, FAAP

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Behavioral sleep interventions-a 5yr follow-up

Behavioral sleep problems in infants include bedtime refusal or resistance, delayed sleep onset and prolonged night awakenings, without the presence of any adverse medical condition. i.e. pain. Randomized trials have demonstrated the effectiveness of behavioral sleep interventions.
Concerns however continue that they may harm the child's emotional development and subsequent mental health.

A 5 year follow-up of 326 old children who underwent behavioral techniques at 8-10 months, vs. usual care, indicates no differences between intervention and control family for children's emotional and conduct behavioral scores, sleep problems, sleep habits, psychosocial function, chronic stress, child-parent closeness, etc.

Behavioral sleep techniques have no marked long lasting deleterious effects on infants or family relationships.

Source: Pediatrics

EEG for predicting neurodevelopment in preterm infants

780 EEG records of 333 preterm infants born < 34 weeks gestation undertaken during 3 time periods (at least once each within 1-6 days of birth, 7-19 days, and 20-36 days respectively) were utilized to categorize the relationship between early EEG measurements and neurodevelopment. Neurodevelopment outcomes were assessed at 12-18 months of age.

EEG abnormalities in preterm infants during the first month of life significantly predict adverse neurodevelopment at 12-18 months.

Source: Pediatrics

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Trampoline safety in children

Council on Sports Medicine of the American Academy of Pediatrics (AAP) has recently reissued an updated policy statement on recreational trampoline usage at home. Current implementations of safety measures have not appeared to mitigate the risk of injury.

In spite of previous recommendations from the AAP discouraging home use of trampolines, the activity continues with resultant trampoline-related injuries. Most injuries appear to occur with multiple simultaneous users and falls off or attempts at flips or somersaults.

Home use of trampolines is strongly discouraged.

Source: Pediatrics

Video Feature

Trampoline Safety | St. Louis Children's Hospital
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Postnatal fish oil supplementation to prevent pediatric allergy

Relative deficiency in the dietary intake of omega 3 polyunsaturated fatty acids (n-3PUSA) has been suggested as a reason for the rising prevalence of allergy in Westernized countries.

A double-blind randomized control study of 420 infants at high risk for developing atopy examined the preventive effects of a daily supplement, given from birth to 6 months of age, of fish oil against olive oil, given to a control group.

Postnatal fish oil supplementation increased n-3PUSA levels but had no beneficial effect on the prevention of eczema, food allergy, asthma, and sensitization measured at 1 year of age.

Source: Pediatrics

Hypertension screening in primary care

Hypertension occurs in 2-5% of children in the USA and its prevalence is increasingly associated with an obesity epidemic. Overall 2/3 of ambulatory pediatric patient (3 - 18 years) are not screened for hypertension. Providers have much room for improvement!

Source: Pediatrics

Bottle feeding and the risk of Pyloric Stenosis (PS)

A large population-based cohort study was utilized to examine the relationship during the first 4 months of life, between feeding practices and PS.

Bottle-fed infants are 4.6 fold more likely to develop PS, compared to those who are not bottle fed, adding to the benefits of exclusive breast feeding for the first few moths of life.

Source: Pediatrics

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