The microbiome is a complex ecosystem comprising microbes, their genomes, and the surrounding environment. The microbiome plays a critical role in early human development, including maturation of the host immune system and gastrointestinal tract. Multiple factors, including diet, antibiotic use, and other environmental exposures, influence the establishment of the microbiome during infancy. Numerous studies have identified associations between the microbiome... |
Though positive-pressure ventilation (PPV) has traditionally been performed using a face mask in neonatal resuscitation, face mask ventilation has a high failure rate in delivering PPV due to mask leaks, airway obstruction, or gastric inflation. Further, face mask ventilation is compromised during chest compressions. Endotracheal intubation in neonates requires a high skill level, with a first-attempt success rate of <50%.... |
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Question: What are the current palliative care protocols, palliative course, and implementable palliative care programs for hospitalized pediatric patients with neurological diseases in Italy? Finding: We studied 34 newborns with nervous system diseases, all of whom had a poor prognosis. Meaning: Despite current legislation in Italy, no palliative care network has been implemented. Given the vast number of patients with neurological conditions, standardized palliative care guidelines and protocols are required. |
Although advances in neonatology have reduced the mortality rate of high-risk infants, sick newborns or premature infants have been exposed to more intensive monitoring and painful procedures, and lengthy hospitalization leading to prolonged separation from their parents. Over recent decades, the importance of parent-infant closeness early in an infant’s life has become more apparent, especially for preterm infants who are... |
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· Question: What level of parenting stress is experienced by parents of children with developmental delays (DDs) without autism spectrum disorder, and what factors contribute to it? · Findings: Parents of children with DDs experienced high parenting stress that were significantly mediated by their children’s low interactive behaviors. · Meaning: The interactive behaviors of children with DDs mediate parenting stress. |
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· Congenital hearing loss is common, with an approximate incidence of 1.5 per 1,000 newborns and affecting 1.2%–11% of preterm and 1.6%–13.7% of neonatal intensive care unit neonates. · Etiologies vary, and up to 80% of cases are genetic. · Newborn hearing screenings follow the 1-3-6 rule, and babies at high risk of hearing loss should be referred to otolaryngology for early detection and timely intervention. |
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· Among survivors, 60.9% of infants born at 22 weeks’ gestation had moderate to severe impairments, whereas 50.3% born at 23 weeks’ and 42.2% at 24 weeks’ gestation had moderate to severe impairments. · Moderate and late preterm infants reportedly have less severe disease than very preterm infants, but they still experience adverse neurodevelopmental outcomes. · The careful follow-up and early detection of developmental problems in these patients are required. |
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Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants? Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants. Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties. |
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Question: Do probiotics added to maternal nutrition affect infantile colic symptoms and intestinal microbiota? Finding: Infants whose mothers ingested probiotics demonstrated decreased crying frequency and intensity and significantly increased bacterial diversity in the stools. The bacterial variety was substantially affected by the added probiotic product. Meaning: The addition of probiotics to maternal nutrition in early infancy could play an important role in preventing infantile colic. |
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Some neonates, especially those who are premature, may experience hypertension while in the neonatal intensive care unit (NICU). The most common causes are prematurity-related and the hypertension usually resolves over the first 1–2 years of life. Unfortunately, the increasing population of NICU graduates is at risk for later cardiovascular and kidney disease in childhood and adulthood. This population requires careful attention to blood pressure and weight throughout their life course. |
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Question: Plastic feeding bottles are used commonly to feed infants who cannot be breastfeed. Does plastic bottle feeding produce biochemical changes in infants? Finding: The plastic bottles leach out endocrine disruptors and affects bodily functions in terms of biochemical alterations like increased blood urea, raised creatine-kinase–MB levels, and altered lipid profile in infants exposed to bottle feeding. Meaning: Plastic bottles feeding alters bodily functions in infants. |
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Nutrients are important in the developing immune system. Human milk supplies diverse bioactives to prevent acute infection or chronic inflammation. Immunoglobulins, lactoferrin, and glutamine in human milk decrease gastrointestinal and respiratory infection. Human milk oligosaccharides promote the growth of intestinal microbiota, the gut barrier, and antimicrobial or antiviral activity. Micronutrients act as anti-inflammatory immunonutrients, too. However, the toxicity of some nutrients from an overdose should be considered. |
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∙ Microbial colonization primarily occurs after birth but there may be some colonization in utero, although this remains highly controversial. ∙ Maternal factors during pregnancy affect the infant microbiota: diet, weight, gestational weight gain, and antibiotic usage. ∙ Microbes are passed from mother-to-infant during and after birth. Delivery mode, breastfeeding, early life antibiotic, and proton pump inhibitor treatment have the largest effects on microbial composition in early life. ∙ The early life gut microbiome plays an important role in the development of the immune system and metabolism. |
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∙ Exclusively breastfed infants are at risk of developing vitamin D deficiency associated with hypocalcemia, rickets, and various health outcomes. ∙ The prevalence of vitamin D deficiency in breastfed infants differs vastly between studies and nations at 0.6%–91.1%. ∙ The vitamin D content of breast milk does not meet the requirements of exclusively breastfed infants. ∙ Most international guidelines recommend that breastfed infants be supplemented with 400 IU/day of vitamin D during the first year of life. ∙ Vitamin D intake (milk+supplements) of 800 IU/day can be considered in preterm infants along with biochemical monitoring. |
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Question: When is the best screening timing and what is the risk factor for developmental dysplasia of the hip (DDH) in preterm infants? Finding: Ultrasonography performed earlier than 38 weeks of postmenstrual age caused unnecessary subsequent ultrasonography. DDH did not occur predominantly on the left side or in breech infants. Meaning: The screening timing, etiology, and risk factors for DDH in preterm infants are somewhat different from those in term infants. |
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· Thrombocytosis, common in newborns and infants (<2 years) (3%–13%), is caused by elevated thrombopoietin (TPO) concentrations. · Serum TPO levels are significantly higher immediately to 1 month postnatal and decrease with age. · Platelet counts are positively correlated with gestational age at birth and postnatal age. · Thrombocytosis is more common in preterm than in term infants. · Thrombocytosis in newborns is reactive and resolves spontaneously without complications. |
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Question: Are the short-term outcomes of minimally invasive surfactant therapy (MIST) relatively superior to those of INtubation, SURfactant administration, and Extubation (INSURE) in preterm infants with respiratory distress syndrome (RDS)? Finding: MIST could be an appropriate substitution for INSURE in preterm infants with RDS since it reduced hospitalization time and number of side effects. Meaning: MIST is recommended for surfactant administration for its proven advantages over the INSURE technique. |
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∙ The growth of preterm infants is a main focus of neonatology. ∙ Preterm infants in Korea, especially those with a very low birth weight, achieve retarded growth. ∙ Careful growth monitoring and early intervention will contribute to better development outcomes and quality of life for preterm infants and improve public health. |
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∙ Diphtheria and tetanus toxoids and acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b-hepatitis B (DTaP-IPV-Hib-HepB) was licensed in Korea in April 2020. ∙ DTaP-IPV-Hib-HepB is indicated as a 3-dose primary series for infants aged 2, 4, and 6 months who received the standalone HepB vaccine at birth. ∙ Infants born to HepB surface antigen-positive mothers are currently recommended to be immunized with HepB immunoglobulin at birth and then monovalent HepB vaccine at 0, 1, and 6 months. |
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Question: Do probiotics reduce colic symptoms? Finding: Probiotics reduced colic symptoms in colicky infants probably due to the anti-inflammatory properties. Meaning: Probiotics may be an effective and less noxious way to manage infantile colic. |
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This national cohort study included all Korean children born in 2008 and 2009 observed over a period of more than 10 years. Our findings demonstrate that it is possible to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors by integrating National Health Insurance System data with national health screening data. |
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· Very low birth weight infants remain at high risk of developing neurodevelopmental impairments in early childhood. · It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants. · All possible strategies should be employed to maintain good compliance after neonatal intensive care unit discharge. |
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Paroxysmal nonepileptic events (PNE) comprise of a variety of nonepileptic behaviors and are divided into various types. A more accurate diagnosis is possible by examining the video clip provided by the caregiver. In infants, physiologic PNE accounts for the majority of the PNE. It is important to exclude epilepsy, for which blood tests, electroencephalography, and imaging tests can facilitate differential... |
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Question: Does a tethered maxillary frenulum in the newborn result in breastfeeding difficulty or other oral symptomatology? Finding: The analysis of subjects with a tethered maxillary frenulum surveyed beyond a mean 5-year follow-up did not reveal an increase in oral issues versus those of a random agematched control group. Meaning: These data demonstrate no need to intervene upon the diagnosis of a tethered maxillary frenulum. |
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Question: What is the most important factor that increases mortality in infants with hypoxic-ischemic encephalopathy (HIE) who receive selective head cooling? Finding: All cases of neonatal mortality were severe HIE (stage 3), and a severely abnormal amplitude-integrated electroencephalography and mortality were increased with the need for advanced neonatal resuscitation upon delivery. Meaning: Advanced neonatal resuscitation affects HIE outcomes, and medical personnel should be prepared to provide the best intervention. |
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This review summarized the accumulated epidemiologic evidence with emphasis on studies conducted in Korea and heterogeneity in the literature. Based on systematic reviews and meta-analyses, there is consistent evidence on the association between exposure to ambient air pollution and children’s health, especially respiratory health and adverse birth outcomes, and growing evidence on neurodevelopmental outcomes. |
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· Mortality is decreased significantly in meta-analysis of studies in different regimen of fluconazole prophylaxis. · Significant decrease was seen in incidence of invasive candidiasis-associated mortality in extremely low birth weight infants in same schedules of prophylaxis. · More studies required to relief the concerns. |
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Question: Can the Korean Developmental Screening Test for Infants and Children (K-DST) be a useful screening tool for infants and children in Korea? Finding: The K-DST has high reliability (internal consistency of 0.73–0.93, test-retest reliability of 0.77–0.88) and a high discriminatory ability with a sensitivity of 0.833 and specificity of 0.979. Meaning: The K-DST is an effective and reliable screening tool for infants and children with neurodevelopmental disorders in Korea. |
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Coronavirus disease-2019 (COVID-19), which started in Wuhan, China, in December 2019 and declared a worldwide pandemic on March 11, 2020, is a novel infectious disease that causes respiratory illness and death. Pediatric COVID-19 accounts for a small percentage of patients and is often milder than that in adults; however, it can progress to severe disease in some cases. Even neonates... |
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Human breast milk (HBM) is essential for the infant’s growth and development right after birth and is an irreplaceable source of nutrition for early human survival. Various infant formulas have many similarities to HBM in many components, but there is no perfect substitute for HBM. Recently, various breast milk components and their roles have been studied according to the development... |