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Updates in Pediatrics
Editor: Jack Wolfsdorf, MD, FAAP
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February 23, 2022 | Volume 13 | Issue 8 |
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Association of child masking with COVID-19 related closures in US childcare programs |
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“Face masks reduce SARS-CoV-2 respiratory droplet transmission in the community and high-risk environments”. Many studies suggest that masks are part of successful mitigation bundles in children from kindergarten to 12th grade and facilitate a safe return to in-person education. The effect of child masking in childcare facilities has not been previously studied.
A 1-year, prospective, longitudinal survey study (between May 22, 2020, to June 8 - “baseline” and May 26, 2021, to June 23, 2021) of childcare professionals (6,654) examined the association between child masking and the closure of childcare programs (in 50 US states).
It appears from this study that child masking reduces childcare program closures from SARS-CoV-2 infection (Supporting masking recommendations for young children provided by the Centers for Disease Control and Prevention – CDC).
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Read the full article at JAMA Network Open
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Effect of an open-label placebo on children and adolescents with Functional Abdominal Pain/Irritable Bowel Syndrome (IBS) |
“Recurrent abdominal pain is one of the most common health complaints in children and adults”. For most children no defined pathological gastrointestinal abnormality can be found. Despite 50 years of scientific effort, the management remains a time-consuming and frustrating challenge. Treatment strategies suggested include both non-pharmacological and pharmacologic options, with non-pharmacologic treatments usually being well accepted by children and their parents.
“Although it is widely believed that concealment or deception is required to elicit a placebo response, recent studies with adults suggest that honestly prescribed placebos (open-label placebos) may be of great value”. No studies have been performed on children.
From a multicenter crossover randomized clinal trial which evaluated the efficacy of an open-label placebo (given for 3 weeks) vs. a control period among children and adolescents (30 children: 8-18 years of age) with Functional abdominal pain/IBS which evaluated mean daily pain scores, it appears that children take nearly twice as many hyoscyamine pills during the control, compared to that of the open-label placebo, period.
“Open-label placebos may be an effective treatment for children/adolescents with Functional abdominal pain or Irritable Bowel Syndrome”.
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Grandmothers’ endocrine disruption during pregnancy, low birth weight and preterm birth in third generation |
Diethylstilbestrol (DES) is a nonsteroidal estrogen endocrine-disrupting pharmaceutical product widely prescribed in the past (1940’s to 1970’s) to pregnant women to prevent pregnancy complications like recurrent miscarriages.
Information from the Participants in Nurses’ health Study (NHS) II (born 1946-64: G1) who reported on their mothers (G0) use of DES while pregnant (54,334 G0-G1 pairs) was utilized to assess the risk of low birth weight (LBW) and preterm birth (PTB) among the grandchildren of grandmothers exposed to DES during pregnancy.
Grandmother use of DES during pregnancy appears to be associated with a 3.09-fold increased risk of LBW, (predominantly through an increased risk of preterm birth) in their grandchildren.
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Analysis of early life growth, and age at pubertal onset in US children |
“During the past few decades substantial concern has been raised about children entering puberty at younger ages in the US and other countries”. Children with early pubertal onset may not only be at increased risk for long-term chronic diseases but may also experience acute physical, emotional and psychological difficulties and dysmetabolism. How growth in the first 5 years of life affects pubertal onset remains unstudied.
A cohort study using data from 7,495 children (50.3% girls) in the Environmental Influence on Child Health Outcomes program assessed whether changes in weight, length or height and body mass index (BMI) during the first 5 years of life is associated with early pubertal onset.
In both boys and girls faster gains in BMI, length and height in early/late infancy and early childhood is associated with younger onset of puberty (after adjusting for multiple confounders). Children who grow fast during early childhood should be monitored closely for the early onset of puberty and referred as needed to supporting services.
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Global prevalence of depression and anxiety symptoms in children and adolescents during COVID-19 |
A metanalysis of a multi-database review of 3094 abstracts and 136 full text articles, (plus some unpublished studies) of 8,879 youth <18 years of age globally, (from January 2020 to February 16, 2021) which examined the global prevalence of child and adolescent anxiety and depression symptoms during COVID-19, indicates that depression has significantly increased by 25.2% and anxiety by 20.5% compared to pre-pandemic estimates.
Pooled estimates obtained in the first year of the COVID-19 pandemic suggest that 1 in 4 youth are showing an increase in depressive symptoms and 1 in 5 are presenting clinically with elevated anxiety symptoms (double pre-pandemic estimates).
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Effectiveness of e-cigarettes as aids for smoking cessation |
Though e-cigarette use has increased significantly (particularly among adolescents) there continues to be controversy as to whether they enhance cigarette smoking cessation. With the introduction of “high nicotine” (>4%) pods for e-cigarette use (which allows for blood nicotine levels similar to that of cigarette smoking) it might be anticipated that this would enhance the effectiveness of e-cigarettes in people trying to quit smoking.
From a 12-year follow-up study of 3,578 previous years smokers who recently attempted to quit, and 1,323 recent former smokers who reported on “high nicotine” e-cigarette or other product used to stop cigarette smoking, it appears that “high nicotine” e-cigarette use does not improve successful cigarette smoking cessation or prevent relapse.
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Prevalence of common infectious diseases after COVID-19 vaccination and the easing of pandemic restrictions |
“Social restrictions intended to limit the transmission of CoV-2 may have also been associated with decreased rates of other communicable diseases”.
A cross sectional study from 2017-2021 using records of all patients diagnosed with respiratory and gastrointestinal infectious diseases from 209 community clinics (in Israel) examined (during the 3 months after the easing of COVID-19 related “social restrictions”- masking) whether social restriction/masking is associated with changes in the spread of other infectious diseases in children.
Following the easing of restrictions (masking) for COVID-19, respiratory infections increase across all ages of children with children 0-3 years having significantly elevated rates of respiratory and gastrointestinal infections.
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