Nov. 11, 2015
Volume VI, Issue No. 45

Advanced maternal age - effects on breast milk
A comparative study was undertaken of macronutrients (fat, lactose and protein) from matched mothers' (>35 years and <35 years of age) breast milk, during their infants' first two weeks of life.

Fat content in colostrum and carbohydrate content in mature mothers are significantly higher, with carbohydrate content correlating with maternal age.

Long-term effects of abdominal pain (Functional gastrointestinal disorders - FGID)
FGID's are a common group of conditions (25% of children miss school with this diagnosis) characterized by a combination of gastrointestinal symptoms that appear to arise from multiple biological, psychological and social factors.

A study of 951 children (mean age 6.2 years) involved parents completing a questionnaire which identified FGID (Rome III criteria), and incontinence plus 14 items from the anxious/depressed scale of the Child Behavior Check List (CBCL).

10% of children with abdominal pain have symptoms of anxiety and depression (more so if diagnosis is FGID; particularly with incontinence).

Clinical applications of real-time tele-ultrasonography (US) in diagnosing pediatric acute appendicitis (AC) in the Emergency Department (ED)
A prospective observational study of 115 pediatric cases with suspected AC examined the effectiveness of tele-mentored US between ED residents and a remote expert in diagnosing acute appendicitis.

Tele-mentoring US between an ED resident and an experienced mentor to diagnose acute pediatric appendicitis in the ED is effective.



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Long-term adherence to daily asthma medication

It appears that non-adherence to daily medication is common, with 30%-70% of patients with chronic illnesses poorly complying with medication prescription. A 1-year perspective follow-up study of 104 asthmatic children (mean age 4.8 years) in a comprehensive asthma program investigated constancy of inhaled corticosteroid use and related it to scheduled follow-up visits.

85% of children followed in a comprehensive asthma clinic adhere to their medication regimen of inhaled steroids. This is unchanged prior to, or following a clinic visit. Comprehensive management programs of chronic illnesses enhances patient compliance.
Video Feature
Ketogenic diet & seizures
Ketogenic diet & seizures
Efficacy of the Ketogenic diet for the treatment of refractory childhood epilepsy

The ketogenic diet, usually recommended for children whose seizures have not responded to multiple different seizure medications (or for specific types of seizure activity) is one that provides a high-fat, low carbohydrate diet (3-4 grams fat for every 1 gram carbohydrate and protein). It is one of the oldest treatments (1920's) for epilepsy. The mechanisms of the diet remain unclear.

A study of 60- children with refractory epilepsy (83% focal epilepsy), 40% of whom had cerebral spinal fluid (CSF) neurotransmitters, pterins and amino acids analyzed indicates:

1.    Six months after initiation of the diet 32% of children have a >50% decrease in seizure frequency.

2.    While some CSF's amino acids differ on a ketogenic diet, no relationship exists between CSF pterins (cofactors in enzyme catalysis), biogenic amines (from breakdown of amino acids) and epilepsy.

Is rapid growth in early life associated with an increased risk of being overweight at 16-18 years of age?

From a Swedish study of 3,537 chil dren whose w eight and height
How can protein intake in early infancy affect later life ?
How can protein intake in
early infancy affect later life?
were collected from birth to 18 years of age, it appears that body weight at 1 year of age is associated with being overweight at both 16 and 18 years of age, with weight gains between 18 months and 4 years of age being the strongest factor for being overweight in late adolescence (in both sexes). Early intervention appears wise.  

Head injury (HI) from falls in children younger than 6 years of age
From a cross-sectional study of HI's from 1,775 children
admitted to a hospital in the UK following falls, most (87%) are alert with Glasgow Coma Scores (GCS) of 15, 32% have abnormal brain CT scans; 17% isolated skull fractures with or without raised intracranial pressure (ICP) (12% of alert children with a GCS of 15 have raised ICP).

Most head injuries from a fall in children admitted to a hospital are minor; however it appears that infants dropped from a carer's arms, falls from infants' products and windows/wall or attic falls impose a greater risk for skull fracture and/or raised ICP.

Archives of Diseases in Children
Take the Quiz !    
Exposure to acid suppression is associated with what GI disorder?
What is the average age of a patient suffering from childhood osteomyelitis?
Can you define
selective eating disorder?

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