March 16, 2016
Volume VII | Issue No. 11

Influenza-like illness (ILI) in households with children of preschool age
ILIs are a leading cause of health-care consumption and productivity loss in households with children younger than 4 years of age. A study of 8,768 child-parent pairs in the Netherlands were invited to report their symptoms and related medical history, productivity loss and risk exposure for one parent and one child.
 
ILI incidence appears to be 2.51 episodes/child/year and 1.72 episodes/parent /year. 35.7 % of children and 17.7% of parents utilize a form of healthcare with 2 parental work days (median) lost/year and 22.8% of children being absent from day-care. Chronic respiratory conditions, developmental disabilities, parental occupation in health-child care and/or having a sibling attending day-care increases ILI risk. Breast feeding infants and those attending day-care >24 months decreases ILI risk.
 
Association of type of toy used during play and quantity and quality of parent-infant communication
Early language environment of young infants (10-16 months of age) influences child language outcomes. A study investigating (in a controlled experiment in a natural environment) the number of adult words used, child vocalizations, conversations between parent and child in 26 parent-infants dyads evaluated whether the type of toy used in play is associated with language interaction between child and parent.

It appears during play with electronic toys that fewer adult words, conversational terms, parental responses and the use of content-specific words are used than during play with traditional toys or books. To enhance early language development in young children the use of electronic toys should be discouraged.
Relationship of maternal stress with milk immune components
48-72 hours post-delivery of a term baby, mothers collected breast milk (days 3, 9 and 14), plus saliva (day 9) and completed on each day a "Perceived Stress Scale Questionnaire", and a survey of pregnancy stress experiences to assess the relationships between maternal stresses and milk immune components (MIC) levels (10 measured).

It appears that maternal stress results in at least one statistically significant decrease in 9 of 10 MIC's on days 3 and 9 which could potentially impact the health of term (and preterm) infants.
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Epilepsy after febrile seizures - genetic influence

"A history of complex febrile seizures can increase the risk of epilepsy but the role of genetic factors in unclear".

A questionnaire study using information on seizure history, genetic epidemiology (with febrile seizures being defined as; simple, complex or febrile status epilepticus) from 900 pairs of twins to evaluate genetic associations of different febrile seizure subtypes/relationship between febrile seizure and epilepsy, indicates that 61% of febrile seizures are simple, 12% complex and 7% febrile status epilepticus.

A twin with febrile status epilepticus is at highest risk for developing epilepsy, but simple febrile seizures gives the highest risk for the unaffected twin to develop seizures or other neurological issues. It appears not possible as yet to accurately identify which individual child with a febrile seizure will develop subsequent seizures or which form it might take.

Video Feature   
Epilepsy Mystery Uncovered
Epilepsy Mystery Uncovered
Genetic Causes of Epilepsy
Endocrine effects of inhaled corticosteroids (ICS) in children
 
In spite of wide spread use of inhaled ICS for various chronic respiratory diseases in children, and while advances in devices and formulations have decreased local side-effects, it is important to remember that systemic absorption (usually associated with highest doses) may occur with adverse effects (adrenal insufficiency, increase in serum glucose levels and decreased linear growth, etc.).
Inhaled Steroids
Inhaled Steroids

An excellent review by the pediatric Endocrine Society Drugs and Therapeutics Committee on ICS side effects and their recommendations regarding testing and referral is well worth reading.

Behavioral management of sleep
problems in infants under six months - what works!

Bedtime problems and frequent night waking are common in infants, toddlers and preschoolers. Evidence suggests these may be potentially deleterious to both infant/toddler and parent. Non-medicinal behavioral sleep investigations support the following three recommendations:
  1. Behavioral interventions are effective.
  2. Unmodified extinction (letting the infant cry); extinction with parental presence and preventive parent education are equally valuable.
  3. Graduated extinction (bedtime "fading" techniques) is effective but with less certainty.
An electronic search of the literature to identify a behavioral intervention technique (extinction) aimed at improving sleep in under 6 month old infants indicates that a simple parent educational program regarding this technique is effective, and long-term follow-up studies do not show any adverse physical or psychological effects.

Nasal irrigation with saline, and oxygenation in infants with bronchiolitis

A single-blind, multicenter, randomized control trial of 133 infants ( <1 year of age) admitted to an Emergency Department with a diagnosis of bronchiolitis and oxygen saturations 88%-94%, given nasal irrigation treatment using either 0.9%, hypertonic 3% sodium chloride or standard care indicates that at 5, 15, 20 & 50 minutes post-treatment, oxygen saturations in the isotonic nasally irrigated group are significantly higher than with either of the other two treatments.

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