March 1, 2017
Volume VIII |  Issue No. 9

The microbiome and risk of obesity and diabetes 
While it has long been known that gut bacteria synthesize essential vitamins, amino acids and assist in degrading toxins, it has lately become clearer that by the time adulthood is attained, gut colonization by microbes (microbiota) outnumber the roughly 13 trillion human cells and collectively probably have 250 to 800 times more genes (the microbiome) than do human cells. Many of these genes generate proteins, including hormones, neurotransmitters and molecules of inflammation that on entering the blood stream may affect health, and in fact may play as great or greater role in human health than human genes do.

This very interesting article explores the relationship between the microbiome and obesity and diabetes and should be read by all. (Ed.)

Bed sharing and oral health related feeding behaviors in young infants 
A comparison between mother-infants dyads who bed shared (or not) indicates that bed sharing appears to occur more often with healthy offspring and with non-white and single mothers who breast feed through the night.

Bed sharing places infants at greater risk for caries.

Protective prevention effects on the association of poverty with brain development
It appears from a 667 participant program in rural SE United States that a parenting-focused intervention program enhancing supportive parenting for children aged 11 years, brought up in poverty, can effectively ameliorate the long-effects of a diminished left dentate gyrus, hippocampal subfields and left amygdalar volume. "These findings are consistent with a possible role for supportive parenting and brain development and suggest a strategy for narrowing social disparities".

JAMA Pediatrics

Poverty & brain development
Poverty & brain development
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Parent perception, and fundoplication 

A Nissen fundoplication is a surgical anti-reflux procedure to correct gastrointestinal reflux disease (GERD), which occurs frequently (but by no means exclusively) in children neurologically impaired. Symptoms include vomiting, esophagitis, gastroesophageal stricture, recurrent pneumonia, aspiration with respiratory distress and inadequate growth.

A study in which 34 post-fundoplication (median follow-up time: 7.3 years) children (median age 6.5 years) parents were interviewed to assess postoperative symposiums and parental satisfaction, indicates that vomiting and reflux-associated pain appear to be treated most effectively (60%); with overall improvement occurring in 37%. While re-do fundoplication is common (20% of patients) most parents appear satisfied with post-operative outcomes.

Video Feature
Enterome: the gut microbiome and its impact on our health
Enterome: the gut microbiome and its impact on our health
Video Feature
Parents' perception of their and their preterm infants' sleep during and after neonatal intensive care unit (NICU) discharge

86 mothers and 84 fathers of preterm infants in NICU's answered questionnaires on infant's sleep patterns during the infant's hospital stay and in infants' corrected age of 2, 6, and 12 months. Parents' own sleep was explored with Insomnia Severity Index.

Mothers report more severe insomnia than fathers during their infant's NICU stay and this perception is associated with more severe infant sleep problems at discharge and later, with high rates of bed-sharing to 1 year of age. Parents need support to enhance optimal sleep! (Ed.)

Cerebral sinovenous thrombosis and hypothermia for asphyxiated infants

There is strong evidence that moderate (reducing body temperature 2-3 C), early (within six hours) total body cooling of full or near full-term infants following asphyxiation results in long-term neuroprotection. Many deleterious effects have been noted with its use. While cerebral sinovenous thrombosis has been described, reliable data on its occurrences is lacking.

A study of 37 asphyxiated infants who underwent hypothermic treatment and who had cerebral magnetic resonance venography (MRV) after warming, indicates that 27% have a sinovenous thrombosis (primarily sagittal sinus) which occurs more frequently in those with higher (>32 C) blanket temperatures.

Three interesting discussions on infant feeding 
1.    From a retrospective chart review of 457 Adolescent mothers it appears that pre-delivery 66% plan to breast feed. However parental (mothers) or care-giving involvement in decision making is associated with more bottle fed babies!

2.    Infant feeding practices in sequential birth is strongly recurrent; successful breast feeding for first-time mothers leads to subsequent baby breast-feeding (being young, single, smoking during pregnancy and poor are all strongly associated with formula-only feeding).

3.    Women with post-partum anxiety (PPA) are less likely to breast feed, to breast feed exclusively and more likely to terminate breast feeding earlier. PPA reduces self-efficacy, enhances breast feeding difficulties and may even affect breast milk composition.

Did you know?
52nd Annual Pediatric Postgraduate Course - Perspectives in Pediatrics - Thurs., March 16, 2017 - Sun., March 19, 2017 at the InterContinental Hotel in Miami, FL
52nd Annual Pediatric Postgraduate Course - Perspectives in Pediatrics
Thurs., March 16, 2017 - Sun., March 19, 2017
 The InterContinental Hotel, Miami
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