Miami, Florida
Nov. 8, 2017
Volume VIII |  Issue No. 44

Sleep positioners and the risk of suffocation in infants
The US Food and Drug Administration (FDA) has recently issued an update on infant (<6 months of age) sleep positioners ("nests" or "anti-roll" products); the two most common types feature raised supports/pillows (called bolsters) or a wedge to raise the babies' heads. The FDA has received reports of both apparently being associated with an increased risk of infant suffocation.

The "ABC" of a safe environment for a young infant to sleep in includes: Alone - on the Back - in a bare Crib. "Positioners" should not be used.

Neurodevelopment with fetal growth restrictions (FGR)
A study which evaluated 889 very preterm (<28 weeks gestation) infants non-growth restricted and compared them to FGR babies indicates that at 10 years of age being growth restricted increases the likelihood of cognitive and behavioral problems, impaired social awareness, social and psychosocial function, phobias, obsessions and compulsions, autistic mannerisms, autistic spectrum disorders and problems with semantic and speech coherence.

Lactobacillus reuteri DSM 17938 (L. reuteri) vs. a placebo in the management of functional abdominal pain (FAP) in children
L. reuteri is a gram-positive bacterium normally found in the gut of humans. Some studies have found it of use in the treatment of irritable bowel syndrome. Probiotics (defined as live microorganisms that confer benefits on a host when given in adequate amounts) of which L. reuteri is one, have been tried in the management of other gastrointestinal pathologies with mixed results.
A study of 54 children (mean age 9.1 years) diagnosed with FAP and randomly assigned to receive either L. reuteri or a placebo for 4 weeks, examined frequency and intensity of abdominal pain at 4 and 8 weeks.
Either L. reuteri or a placebo are equally effective in decreasing abdominal pain in children with FAP.
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Management following measles exposure
A study 3,409 non-immune contacts <19 years of age exposed to measles, examined the benefits of post-exposure prophylaxis administration with measles, mumps and rubella vaccine (MMR) or immune globulin.

Following exposure to measles, administration of any post-exposure prophylaxis (MMR or immune globulin) decreases the chance of contracting measles by 92.9%.

Video Feature
Video Feature
Dietary intake and relapse rate in early pediatric multiple sclerosis (MS)
MS is an autoimmune disease that attacks the central nervous system that is increasingly being identified in children appearing to account for 3-10% of all patient with MS. Environmental exposure to ultraviolet radiation, vitamin D levels, EB infection, passive smoking and obesity have all been identified as risk factors in genetically predisposed children (mostly the histocompatibility complex on chromosome 6). Epigenetic factors probably link the two.
Children with MS have a higher relapse rate compared to adults.
A multicenter study of 219 children with MS examined the effect of diet on relapse rate.
High energy intake from fat (especially saturated fat) appears to increase the chances of relapse while vegetable intake provides protection.
Maternal tetanus, diphtheria and acellular pertussis vaccination in preventing pertussis in infants <2 months of age
In the USA and in spite of the impact of vaccines, pertussis remains endemic placing infants at greatest risk for pertussis-related complications and mortality during the first months of life (infant vaccination against pertussis with DTaP begins at 2 months of age).

A case control study among pertussis cases <2 months of age examined (against hospital matched controls) maternal immunization status (mothers were considered immune if Tdap was administered >14 days prior to delivery) and vaccine effectiveness.

On multivariable analysis it appears that when a mother is vaccinated during pregnancy with Tdap it significantly reduces the likelihood of her young infant presenting with pertussis.

Abstinence-Only-Until-Marriage (AOUM); an update review of its impact
While AOUM may be a healthy choice, it appears that in actual practice intentions to abstain from sexual activity until marriage often fail. As marriage takes place at an older age than previously, withholding information regarding sexual intercourse and sexually risky behaviors seems counterproductive, and scientifically and ethically suspect. This update on current US government policies suggests that it withholds information about sexuality and threatens fundamental human rights to health, information and life, and prevents Youth accessing accurate and comprehensive sexual health information.
An interesting and provocative article argues that AOUM policies and programs are not effective, violate adolescents' rights and reinforce harmful gender stereotypes.
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