Infants

Exposure assessment of lead (Pb) and Arsenic (As) from food, water, and house dust intake were assessed among pregnant women, their children and fetuses in Pakistan and Japan, as well as their body burden of the metals in their blood.Fifty families which included a pregnant woman, a fetus and the 1–3-year-old siblings were recruited in Karachi and Khairpur in Pakistan, and Shimotsuke and Asahikawa in Japan, respectively. Their dietary exposure to Pb and As was measured in 3-day food duplicates and drinking water by ICP-MP. Pb in house dust and respirable dust was evaluated with an energy dispersive X-ray fluorescence spectrometry. Non-radioactive isotope Pb profiles of blood specimens will be compared with those of the exposure origins, such as food duplicates, respirable house dust, the soils nearby, and gasoline.Judging from the data collected and analyzed so far, contribution from dietary intake is highly correlated to higher body burden of Pb among Pakistani mothers. Additional ...

Background: Parents play a vital role in the assessment and management of pain. There is limited knowledge about parental viewpoint or their participation in the pain management of the neonates admitted to the intensive care units. The present study aimed to assess the viewpoints of mothers about the pain management of neonates/ infants admitted to Tabriz hospitals.

The study on beneficial effects of maternal vitamin A supplementation on some infants’ malaria-related morbidity in rural communities in Ebonyi State, Southeastern Nigeria was carried out between August 2010 and November, 2011. One hundred and fifty two (152) malaria parasitaemic pregnant women whose pregnancies had matured up to the 6th months were randomized into supplemented and placebo groups,
with each group consisting of 76 women. Ten thousand international units (iu) of vitamin A was administered to the supplemented group three times per week while the placebo group received the vitamin A soft gels drained off its active ingredients thrice weekly. The two groups
were followed up until they delivered their babies. On delivery of the babies, 200, 000 iu of vitamin A was administered within 8 weeks to the supplemented group. This regimen was cautiously repeated after every three month until the end of the study. The placebo group also
received placebo at equal frequencies until the study was over. The study lasted until the infants of the women of the two groups were 12 months old. Quarterly, from the third month postpartum, venous blood specimens were collected from the infants of both groups and used for
malaria parasite examinations, using standard parasitological techniques. Incidence of malaria-related morbidity among the infants was assessed with strict adherence to standard diagnostic methods and procedures. Data collected were analysed at p<0.05 level of significance, using analysis of variance ((ANOVA) and Fisher’s least significance difference (FLSD) for mean separation. T-test was used to compare the supplemented group with the placebo group and statistical significance was also determined at p<0.05. Maternal vitamin A supplementation was found to be beneficial in reducing the mean incidence of malaria-related morbidity among the infants irrespective of the fact that some
non-significant beneficial effects were observed in some cases. Its beneficial effect was most significantly recorded in the control of fever episodes. Pre-partum and post-partum vitamin A supplementation are therefore recommended for general infant health especially as it affects malaria morbidity.

This work gives growth reference values at birth to 24 months of age for Pakistan based on upper middle class infants. Growth rate reference values are also included and they are given for various interval lengths. The growth was differently affected in infants living in three poorer areas; the stunting incidence at 24 months of age was 63% in periurban slum, 54% in the village and 26% in the urban slum. Less differences could be seen between the areas in weight for length. There was an age dependency in the incidence of reduced growth; a normal length gain was seen at birth to about six months of age, but they were highly reduced at 6 to 18 months of age. The weight gain was to some degree reduced during the first 12 months of life, followed by a catch-up growth period. The seasonal influence was also age dependent; weight was highly affected during the summer at birth to 24 months of age, but not in the winter. The seasonal effect in length was marginal at birth to 6 months, little at 6 to 12 months (although, constant below the normal) and large at 12 to 24 months of age. We did not see any seasonality of growth in the reference group. The incidence of reduced growth reflects the socio-economic differences in one restricted geographic area, i.e., in the city of Lahore, Pakistan.

When does a human being acquire legal personality? I would like to stand on the shoulders of giants in order to address the rights of the tiniest human beings, for what is at issue is nothing less than the very notion of human rights. Human embryos and fetuses, however small and vulnerable, are unquestionably living human beings of the species Homo sapiens. If we possess any human rights, it is purely and simply because we are human. I was once a living human embryo and am still a living human being, last I checked. If I have human rights, I had them when I began to be a living human being. Perhaps Dr. Seuss’s Horton the Elephant, throwing his massive weight around, said it most succinctly, “A person’s a person, no matter how small.” But in a law school setting, I do not suppose that qualifies as legal authority. Too bad. How about William Blackstone, then? And for this, I must acknowledge the magisterial work of a University of St. Thomas School of Law professor, Michael Stokes Pau...

Children of teenage mothers are at high risk for developmental delays, intellectual and learning disabilities, behavior  disorders  and  school  related  problems [1].  Early  identification and referral into prevention or early intervention programs may ameliorate that risk. Children of teen mothers who are in family childcare may not have access to routine developmental  and  behavioral  screenings  that  would  lead  to  early  identification and referral. Members of an early childhood  advisory  board  collaborated  to  conduct  a  screening  event  using  the  ASQ-3®  and  the  ASQ:SE®  at  a  local children’s  museum for 26 children  of teen  mothers who had  no previous access to developmental screenings.  Parents completed the questionnaires while playing with their children at the museum. Nine of the children scored well within the range  of  typical  development  and  17  scored  at  or  beyond  the  cut-off  scores  on  the  ASQ-3  and/or  the  ASQ:SE.  Each child who scored  at  or  beyond  the  cut-off  received  referrals  for  evaluation,  parent  and  child  programming  and/or  family support  services.  When  there  were  concerns,  families  also  received  care  coordination  while  all  families  received activities  and  a  child’s  book.  The  implications  for  this  study  suggest  that  collaborative  efforts  are  effective  in  providing access  to  developmental  screenings  and  referral  into  subsequent  services  for  at-risk  young  children  who  are  in  family childcare settings

This study aims to evaluate household and individual level drivers of stunting among Filipino children aged 0-23 months in the 2003 National Nutrition Survey (NNS) and identified which factors pushed these same children to or out of stunting in middle childhood (8-9 years old) in 2011 Updating National Nutrition Survey (UNNS). All children aged 0-23 months in 2003 NNS were tracked if they're still in 2011 UNNS by matching identifiers: region, province, municipality/city, name, and birthdate. There are 290 children included in both surveys. Children were categorized as: stunted in 2003 but not in 2011 (catch-up); stunted in 2003 & 2011 (persistently stunted); stunted in 2011 but not in 2003 (stunted later). The prevalence of stunting increased from 17.2% in 2003 to 35.2% in 2011. About 22.1% became stunted later; persistently stunted (13.1%); catch-up (4.1%). The individual-level factors that contributed towards persistent stunting are older age onset of stunting, underweight, and a <2 years birth interval; while the household level factors are those with ≥ 5 dependents, and a higher number of under-fives in the family. Households usage of water-sealed toilets and availability of electricity decrease the odds of persistent stunting and stunting later. No significant factors were found on what moves a child out of stunting. Living in shanties (Huts) pushed a normal child to be stunted in 2011. This study reflects the strong influence of both individual and household factors on stunting. These results could be useful in crafting area and problem-specific interventions.

Challenging multi-assisted families with economical constrains have less resources, are exposed to several stress agents over time. They experience interdependent problems across life family life cycle. Are considered as being disengaged, disorganized, conflicted with inconsistent or neglecting parenting. With difficulty in setting rules and boundaries, authoritarian and permissive parenting styles may alternate in child rearing, and to an unstable insecure environment. Nonetheless, parenting concerns maybe common to other no troubled families. Boden and Dekovic, (2016) pinpoint seven factors that enhance family vulnerability and family risk 1) child and 2) parents' characteristics and problems 3) child-rearing 4) family functioning 5) and other contextual factors 6) social network 7) mental health care problems. This cross-sectional mixed methods study explores domains 1, 2,3,4 with a purpose sample of 32 low-income participants - families from a daycare social project with children aged under than 3 years old. Most of the children lived with both parents (n = 13), 9 with a single parent and the 12 in blended families. Semi-structure clinical interviews to access families' clinical background were conducted and Family Adaptability and Cohesion Evaluation Scales (FACES IV), Parental Authority Questionnaire - Parents version (PAQ) were applied. Lexical analysis of interviews revealed domains considered as high risk (Harsh life experiences and traumas, complex family structures, economic constrains, dependency of social support) as well as common daily life hassles and parenting concerns. Quantitative measures revealed opposite perspectives about family functioning and parenting. Participants are satisfied with their families and consider having a good enough communication, flexible and cohesive. Parents consider themselves as more authoritative with a good sense of parenting efficacy, though with authoritarian scores above expected average. Only authoritarian parenting is correlated to family cohesion. Quantitative measures do not validate qualitative results. With low income multi-stressed families, we recommend the use of the qualitative data collection analyzed in mixed methodology to mitigate social desirability and bias. Families are often evaluated in by social services for child custody legal decisions that often result in government child custody. Along with naturalistic observation, clinical in-depth interview is indispensable to collect data and evaluating family psycho-social risk and parent's capabilities with this type of population.

Aims: To determine the rate of admissions of infant and children from the mother older than 35 years, to determine the main pathology sources of hospitalization, to determine the place of birth defects, and to identify their risks factors. Patient and Methods: A cross sectional study comparing infants and children born to the mother (≤ 35 years old = group 2) and those born to the mother older than 35 years (group1) which was conducted from March 2013 to March 2014 in pediatric ward. Results: One hundred and seventeen infants and children born to the older mothers were registered, which is 4% of hospitalization. No predominance of sex was noted (sex ratio = 1). The mean age of infants and children was 11.6 ± 7.9 months old (range, 1 to 30 months).The mean age of older mother was 40 ± 2.6 years (range, 36 to 45years). The main pathology sources of hospitalization were acute gastroenteritis followed by upper respiratory infections. Twenty three(18.8%) had birth defects. The main one was Down syndrome followed by congenital heart defects. The mother's age didn't influence the occurrence of main conditions source of hospitalization in both groups. Lower socioeconomic level impacted the occurrence of congenital defects (P < 0.025) and so was the advanced maternal age (AMA) (p ˂ 5%). Primiparity and the first order birth were the predisposing factors for birth defects (p ≤ 0.01). Conclusions: The infants and children of the older mother are less frequently admitted. Under nutrition and birth defects especially down syndrome, are common. There is a close relationship between the lower socioeconomic level, the advanced maternal age and the happening of birth defects.

Over the first year, infants tune into the signals of their native language and begin to link them to meaning. Here, we ask whether infants, like adults, can also infer the communicative function of otherwise arbitrary signals (here, tone sequences) and link these to meaning as well. We examined 6-month-olds’ object categorization in the context of sine-wave tones, a signal that fails to support categorization at any point during their first year. However, before the categorization task, we exposed infants to tones in one of two vignettes. In one, the tones were produced by an actor in a rich communicative exchange; in the other, infants heard the very same tones, but these were uncoupled from the actors’ activity. Infants exposed to the communicative vignette successfully formed object categories in the subsequent test; those exposed to the non-communicative vignette failed, performing identically to infants with no prior exposure to this novel signal. This reveals in 6-month-old infants a remarkable flexibility in identifying which signals in the ambient environment are communicative and in linking these signals to core cognitive capacities including categorization.

Purpose – The purpose of the paper is to analyze what notions of infants parents are visually met through addressed direct marketing. Questions discussed are: How are infants visually constructed as a category? and How are they argued to be in need of consumption? Design/methodology/approach – Unsolicited direct marketing sent to three Swedish first-time parents during their child’s first year has been collected and analyzed. Using critical visual discourse analysis, attention is paid to recurring visual patterns and contradictions in how infants are visualized and described at the intersection of materiality, image and text. Findings – The analysis shows three dominant visual commercial discourses of infants, here called “the angel”, “the adventurer” and “the transformer”. These discourses are articulated in such a way and with such a strong claim to truth that it appears as if it is not the marketer that is arguing for consumption, but that it is the infant’s character that demand...

BACKGROUND AND OBJECTIVE: Mothers with premature infants often experience a lot of anxiety, and since music has positive effects on anxiety, the present study was conducted to investigate the effect of music on the anxiety of mothers of infants admitted to the neonatal intensive care unit.
METHODS: This clinical trial was performed on 120 mothers with infants admitted to the neonatal intensive care unit of Rouhani Hospital in Babol and Bu-Ali Sina Hospital in Sari. Samples were randomly divided into two groups of experimental and control each consisting of 60 patients. In the experimental group, relaxing music was played daily through mobile phones and headphones for each mother individually for 10 minutes in 10 sessions. No intervention was performed for the control group. Both groups of mothers completed the Spielberger State-Trait Anxiety Inventory (STAI) before the start of the study and on the tenth day and were compared.
FINDINGS: The mean age of mothers was 27.8±5.71 years and the mean age of infants was 3.92±3.88 days. In this study, anxiety was relatively severe or severe in 60% of mothers before the intervention. Levels of overt anxiety and covert anxiety in mothers of music groups before the intervention (59.48±13.66), (55.62±12.26) showed a significant decrease compared to after the intervention (31.27±6.57), (33.08±8.66), respectively (p<0.0001).
CONCLUSION: The results of the study showed that music is effective in reducing the anxiety of mothers with infants admitted to the neonatal intensive care unit.

Objectives: Infant-Toddler Meaningful Auditory Integration Scale (IT-MAIS) is a useful tool for the quantitative evaluation of auditory behaviors in different situations. The present study aimed to develop the Persian version of IT-MAIS. Methods: There was 4 main steps in the translation and validation of the scale, as follows: forward translation, synthesis, backward translation, and expert committee discussion. Then, the final Persian version of the scale was analyzed in terms of reliability and validity. The scale was studied on the parents of 17 hearing impaired and 17 normal hearing children. Results: There was a significant difference in the mean score of scale between hearing impaired and normal hearing children (P≤0.001). The internal consistency of the items was satisfactory. The Cronbach's alpha for the overall score was 0.93.

Inguinal hernia is a common diagnosis in children. A real scrotal hernia is less common and underreported in medical textbooks. In this case a tiny Libyan boy was admitted with a big swelling of the left groin and hemiscrotum. His clinical findings have been mistaken for a longer time, until the definitive diagnosis has been made. During surgery a giant real scrotal hernia has been dissected and successfully repaired. All specific findings in this special case of infant scrotal hernia are discussed in front of a literature review.

Background: The use of antiretroviral therapy (ART) in HIV-infected women is crucial to restore and maintain the immune system and prevent HIV transmission during pregnancy, labor, delivery and breastfeeding. Furthermore, ART reduce the risk of Mother-to-child transmission (MTCT). Therefore, ART has been associated
with mitochondrial defections that could induce preeclampsia, preterm birth, low birthweight, intrauterine growth restriction (IUGR), stillbirth and sudden infant death.
Objective: To evaluate the effect of antiretroviral therapy on mitochondrial defections in HIV-infected pregnant women. Methods: We searched eligible studies in MEDLINE, Scorpus and WHO Global Index Medicus. Included studies were assessing the effects of antiretroviral therapy on genetic mitochondrial diseases in HIV infected
pregnant women and HIV exposed infants. JTL searched eligible studies in different databases and both JLT and JLT critically appraised included studies. Results: We found five observational studies with low risk of bias. All studies illustrated that ART increased the mean of mitochondrial defections. The results were statistically significant in all studies with P<0.05. Conclusion: Mitochondrial lesions were very common in HIV infected pregnant women and HIV exposed infants. However, further investigations are needful to strengthen this evidence.

Having a preterm infant is a life-altering event for parents. The use of interventions intended to support the parents is recommended. In this study, we investigated how parents&#39; perceptions of physiotherapy in primary health care influenced their adaptation to caring for a preterm child. We conducted 17 interviews involving parents of seven infants, at infants&#39; corrected age (CA) 3, 6, and 12 months. The analysis was a systematic text condensation, connecting to theory of participatory sense-making. The parents described a progression toward a new normalcy in the setting of persistent uncertainty. Physiotherapists can ameliorate this uncertainty and support the parents&#39; progression toward normalization, by providing knowledge and acknowledging both the child as subject and the parent-child relationship. Via embodied interaction and the exploration of their child&#39;s capacity, the parents learn about their children&#39;s individuality and gain the confidence necessary ...

Exposure assessment of lead (Pb) and Arsenic (As) from food, water, and house dust intake were assessed among pregnant women, their children and fetuses in Pakistan and Japan, as well as their body burden of the metals in their blood.Fifty families which included a pregnant woman, a fetus and the 1–3-year-old siblings were recruited in Karachi and Khairpur in Pakistan, and Shimotsuke and Asahikawa in Japan, respectively. Their dietary exposure to Pb and As was measured in 3-day food duplicates and drinking water by ICP-MP. Pb in house dust and respirable dust was evaluated with an energy dispersive X-ray fluorescence spectrometry. Non-radioactive isotope Pb profiles of blood specimens will be compared with those of the exposure origins, such as food duplicates, respirable house dust, the soils nearby, and gasoline.Judging from the data collected and analyzed so far, contribution from dietary intake is highly correlated to higher body burden of Pb among Pakistani mothers. Additional ...

The American Academy of Pediatrics (AAP) has recommended that children younger than 24 months of age not be exposed to television. Nevertheless, television programs and home videos are increasingly produced for very young children. This article reviews the extant research concerning television and very young children with respect to the AAP recommendation. More very young children are currently watching television than in the recent past; they pay substantial attention to TV programs and videos made for them. When learning from videos is assessed in comparison to equivalent live presentations, there is usually substantially less learning from videos. Although one study finds positive associations of language learning with exposure to some children’s TV programs, other studies find negative associations of viewing with language, cognitive, and attentional development. Background TV is also a disruptive influence. Evidence thus far indicates that the AAP recommendation is well taken, ...

Congenital Diaphragmatic Hernia (CDH) is a rare birth defect in which the diaphragm fails to close during prenatal development, which causes the intestinal contents to herniate into the chest from the abdominal cavity causing lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for infants having CDH on whom the conventional ventilation strategies fail. Our systematic review aimed to evaluate the outcomes of Extracorporeal Membrane Oxygenation (ECMO) use on infants with Congenital Diaphragmatic Hernia (CDH). We used PubMed, Embase, Web of Science and Google Scholars databases for our data collection, and articles from 2010-2021 were analyzed and included as part of this research. We included studies in the English language conducted on human infants. We excluded studies conducted before 2010, studies on animals, languages other than English, or studies conducted on the adult population from our research. We identified a total of 3650 studies from the databases. After removing duplicates, screening titles, applying inclusion-exclusion criteria, and assessing the papers' quality, we were left with nine articles. Six out of these nine articles were retrospective cohort studies, and three were literature reviews. We extracted data manually from these studies. ECMO's role in managing CDH in infants is controversial as some studies show improvements in infants' survival rate. In contrast, other studies mention that the risks involved in ECMO use outweigh the benefits, and we should only use it in those infants who are severely affected. Due to inadequate data, we require additional research to determine whether the use of ECMO is favorable or should it be discouraged.

Pediatric obesity is a declared epidemic with enormous consequences.1,2 There are
many risk factors for being overweight, including frequent consumption of fast food. Fast food
is cheap, calorie-dense, and easily accessible. Infant formulas closely resemble some of these
characteristics and thus may contribute to expansion of pediatric obesity epidemic.

In the present review, we focus on evidence-based data for the use of inhaled corticosteroids (ICS), leukotriene receptor antagonist (LTRA), long-acting beta2-agonits (LABA) and oral corticosteroids (OCS), with a special emphasis on well-performed randomized clinical trials (RCTs) and meta-analyses of such trials for the chronic management of asthma/wheeze in infants and preschoolers.
RESULTS:
Seven meta-analyses and 14 RCTs were reviewed. Daily ICS should be the preferred drug for infants/preschoolers with recurrent wheezing, especially in asthmatics. For those with moderate or severe episodes of EVW, the use of high intermittent ICS doses significantly reduce the use of OCS. There is no evidence of effect of intermittent ICS at low-moderate dose in preschoolers with mild EVW episodes. In preschoolers with asthma, there were no significant differences between daily vs. intermittent ICS in terms of asthma exacerbations with insufficient power to conclude to equivalence; however, for other asthma control outcomes, daily ICS works significantly better than intermittent ICS for older children. Daily ICS is superior to daily or intermittent LRTA for reducing symptoms, preventing exacerbations, and improving lung function. No RCTs testing combination therapy with ICS and LABA (or LTRA) were published in infant/preschoolers. Parent-initiation of OCS at the first sign of symptoms is not effective in children with recurrent wheezing episode. In terms of ICS safety, growth suppression is dose and molecule-dependent but it's effect is not cumulative beyond the first year of therapy and may be associated with some catch-up growth while on or off therapy. Linear growth must be monitored as individual susceptibility to ICS drugs may vary considerably.

Purpose — to study of concentration of zinc, copper, iron and magnesium in children with acute obstructive bronchitis and thymomegaly during the acute phase of the disease and during recovery period.
Patients and methods. The children were divided into 2 groups according to the presence of thymomegaly: I group — patients with acute obstructive bronchitis without thymomegaly (28 children); Group II — patients with acute obstructive bronchitis with thymomegaly (28 children). Results. It was observed the increase of concentration of copper and low levels of zinc, iron and magnesium in all children with thymomegaly in the first days of illness. After a standard treatment the copper levels decreased, but it was still higher than in the control group. The content of zinc and iron was tended to increase in recovery period, but it did not reach the level of healthy children. Conclusions. When comparing the content of macro- and microelements in both groups, it was found that children with thymomegaly in acute zinc levels significantly lower than those of children with acute obstructive bronchitis without thymomegaly, while copper concentration remained significantly higher.

Introduction: Diarrhoea is the 10 th most common cause of infant morbidity and mortality in the developing countries, though it is regarded as a minor illness in developed countries. The burden of diarrhoea in the developing world has been estimated by the world health organisation (WHO) to be about 1.7x10 9 episodes of diarrhoea with 4.4 million children per year. This accounts for 15 to 30% of total outpatient visits in many paediatrics clinics. Aim: To determine the prevalence of diarrhoea disease among infants and compare the risk factors for diarrhoea in infants in the two Local Government Areas (LGAs). Methodology: This was a comparative cross-sectional study. An interviewer-administered, pre-tested, semi-structured questionnaire was utilized. Data was analysed using SPSS Version 20. Frequencies and percentages were presented in tables. Chi square test of independence was used to determine association between qualitative variables. Level of statistical significance was set at p < 0.05. Result: Two hundred and ninety one respondents participated in this study. There were 143 respondents in the urban LGA and 148 respondents in the rural LGA. In the urban LGA, Out of the 143 infants, 73 (51.0%) were males while 70 (49.0%) were females. Also in the rural LGA there were more males (50.7%). This difference was not statistically significant. Out of 143 respondents in the urban LGA 65 (45.5%) has had diarrhoea but in the rural LGA, out of 148 respondents, 95 (64.2%) have had diarrhoea. This difference was statistically significant. In the urban LGA 46.2% of the mothers whose infants have had diarrhoea practiced exclusive breast feeding, while in the rural LGA only 26.3% of the mothers whose infants have had diarrhoea practiced exclusive breast feeding. This difference was not statistically significant. Among the mothers of the urban infants that have had diarrhoea, 93.8% reported that they practice hand washing after handling child's faeces, but in the rural LGA, only 80.0% reported that they practice hand washing. This difference was statistically significant. Among the urban mothers whose infants had diarrhoea, 92.3% wash their hands before meals, but among the rural mothers, only 89% wash their hands before meals. This difference was statistically significant. Conclusion: Diarrhoea prevalence was higher among infants in the rural LGA. Exclusive breastfeeding was practiced more in the urban than in the rural LGA. We recommended that health education should be intensified in the rural areas.