Miami, FL
April 24, 2019
Volume X | Issue No. 17
Oral sweet solution to prevent pain during neonatal hip examination
From a randomized controlled study of 100 healthy newborns undergoing routine hip physical examination (half of whom received 50ml oral 30% glucose, the other half oral sterile water) before the examination, that crying time (total and during examination) is significantly reduced in infants receiving the oral glucose solution.
Acta Paediatrica
Pilot study of cardiovascular (CV) function in young children with obstructive AOA disease 
A study of 41 non-cooperating children (mean age: 4.13 years) with chronic cough and wheezing (and 18 matched healthy children with obstructive chest disease) had indirect airway resistance (using the "open interrupter technique - RINT) and cardiac function assessed to determine CV impartment associated with obstructive respiratory airway disease.
Right ventricular diastolic dysfunction occurs early in children with chronic cough and wheezing. Repeated follow-up with echocardiography and RINT airway assessment is required in these children.
Acta Paediatrica
Nasal swab bacteriology by polymerase chain reaction (PCR) during the first 24 months of life
A prospective epidemiological study of community-based infants (158 - and 8,100 high-quality nasal swabs collected weekly) (followed from birth to 2 years of age) evaluated nasal swab specimens for bacteria and related results of illness burden.
Streptococcus pneumonia, Moraxella catarrhalis and Haemophilus influenzae are detected in 49.2%, 38.9% and 14.8% of nasal swabs respectively. Concomitant bacteria and PCR of nasal swabs by parents appears a feasible mechanism to study major respiratory bacterial colonization in infants.
Childhood Obesity Facts 
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Pediatric Eosinophilic Esophagitis (EoE) 
"EoE is a chronic immune/antigen mediated inflammatory disease associated with esophageal dysfunction and severe eosinophilic predominant inflammation." Recommendations for diagnosing and treating are evolving. A retrospective review from 26 European pediatric gastroenterology centers in 13 countries reveals (from 410 patients between December 1999 and June 2016) the following information regarding "real world clinical practice" of children with EoE:
  1. 76.3% are boys.
  2. Time from symptoms to diagnosis: 12 months.
  3. Age at diagnosis: 8.9 years.
  4. Indications for endoscopy include: dysphagia (38%), gastrointestinal reflux (31.2%), bolus impaction (24.4%), failure to thrive (10.5%).
  5. Foods found to be causative by elimination and re-challenge: milk (42%), eggs (21.5%), wheat/gluten (10.9%), and peanuts (9.9%).
  6. Treatments:
  • 70.3% fail proton pump inhibitors.
  • Elimination diets use: exclusively (37.5%), topical steroids without elimination diets (12.6%), both diet and steroids (44.6%), systemic steroids (5.3%) and esophageal dilatation (1.7%).
See related video HERE
Infants who die in shared sleeping situations and sudden infant death syndrome (SIDS) 
Awareness of factors which increase the likelihood of SIDS (like a prone sleeping position, maternal smoking and the use of soft bedding) has led to a decrease in the number of infants who die from SIDS (though this still remains a leading cause of death in infants <1 year of age).
46% of parent-infant (<8 months of age) dyads in the USA apparently bed-share for all or part of the night often, "usually". Vigorous debate continues as to the possible cause/s and mechanism/s involved in infants who die in shared sleeping arrangements (bed, sofa or armchair) as about 15% of apparent SIDS die in this scenario.  
It appears from a recent literary review of a number of databases examining data associated with SIDS and co-sleeping that sex ratios are different, brain histology and chemistry are different and co-sleeping infants who die have higher numbers of nucleated red blood in their peripheral blood.
It appears that the mechanism of infant death occurring during co-sleeping is different from SIDS and may involve a single episode of suffocation, and a more rapid death as expected from overlaying.
Acta Paediatrica 
See related video HERE
Video Feature
Newborns and Lip Tie (labial frenulum, frenum) and breastfeeding
Newborns and Lip Tie (labial frenulum, frenum) and breastfeeding
Upper lip tie (ULT) and breast feeding
Lip tie is a condition where the thin membrane attached from the upper gum line to the upper lip is thickened and stiff making movement of the upper lip difficult.  
A Medline search to retrieve all articles published on ULT (or labial frenum) (from 1948 to 2018) examined any relationship to breast feeding.
No randomized clinical trial and no good reliable study is available to allow for predicting ULT and difficulty of breast feeding.
Hip developmental dysplasia (DDH) in babies - summary of three articles 
Hip dysplasia is a condition where the pelvis socket for the femoral head is smaller than normal resulting in a hip joint easily dislocated. It has been assumed that following a normal clinical examination and selective ultrasound screening for high risk babies (breech position, oligohydramnios etc.) between birth and 3 months of age, that babies' hips would continue to be normal. Late dysplasia may however be recognized in 18% of babies with normal initial screening (breech babies as high as 29%).
A study to identify the rate of late dysplasia after normal screening in 90 breech babies indicates that 7.4% have radiographic dysplasia at 13 months of age. Prophylactic hip abduction does not appear to be beneficial to prevent this.
A retrospective study of 46 patients with (bilateral DDH) investigated whether attempted closed reduction (CR) and/or open reduction was more beneficial. While CR may be successful (with acceptable rates of secondary surgery) more severe dislocations risk osteonecrosis and require early surgery (which may require supplementary surgery later). Improved screening would be beneficial.
See related video HERE
Children's Health Chats
What does genetic testing entail?
What does genetic testing entail?
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