Latest & greatest articles for infants

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Top results for infants

141. Adverse effects of small for gestational age differ by gestational week among very preterm infants

Adverse effects of small for gestational age differ by gestational week among very preterm infants To characterise the excess risk for death, grade 3-4 intraventricular haemorrhage (IVH), bronchopulmonary dysplasia (BPD) and stage 3-5 retinopathy of prematurity independently associated with birth small for gestational age (SGA) among very preterm infants, stratified by completed weeks of gestation.Retrospective cohort study using the Optum Neonatal Database. Study infants were born <32 weeks (...) gestation without severe congenital anomalies. SGA was defined as a birth weight <10th percentile. The excess outcome risk independently associated with SGA birth among SGA babies was assessed using adjusted risk differences (aRDs).Of 6708 infants sampled from 717 US hospitals, 743 (11.1%) were SGA. SGA compared with non-SGA infants experienced higher unadjusted rates of each study outcome except grade 3-4 IVH among survivors. The excess risk independently associated with SGA birth varied by outcome

2018 EvidenceUpdates

142. Effect of Higher vs Standard Dosage of Vitamin D3 Supplementation on Bone Strength and Infection in Healthy Infants: A Randomized Clinical Trial

Effect of Higher vs Standard Dosage of Vitamin D3 Supplementation on Bone Strength and Infection in Healthy Infants: A Randomized Clinical Trial Although guidelines for vitamin D supplementation in infants have been widely implemented, they are mostly based on studies focusing on prevention of rickets. The optimal dose for bone strength and infection prevention in healthy infants remains unclear.To determine whether daily supplementation with 1200 IU of vitamin D3 increases bone strength (...) or decreases incidence of infections in the first 2 years of life compared with a dosage of 400 IU/d.A randomized clinical trial involving a random sample of 975 healthy term infants at a maternity hospital in Helsinki, Finland. Study recruitment occurred between January 14, 2013, and June 9, 2014, and the last follow-up was May 30, 2016. Data analysis was by the intention-to-treat principle.Randomization of 489 infants to daily oral vitamin D3 supplementation of 400 IU and 486 infants to 1200 IU from age

2018 EvidenceUpdates

143. HIV and infant feeding in emergencies: operational guidance

HIV and infant feeding in emergencies: operational guidance The duration of breastfeeding and support from health services to improve feeding practices among mothers living with HIV HIV AND INFANT FEEDING IN EMERGENCIES: OPERATIONAL GUIDANCEHIV and infant feeding in emergencies: operational guidance© World Health Organization 2018 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https (...) . HIV and infant feeding in emergencies: operational guidance. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. Third-party materials. If you wish to reuse material from this work

2018 World Health Organisation Guidelines

144. Early planned removal versus expectant management of peripherally inserted central catheters to prevent infection in newborn infants. (PubMed)

Early planned removal versus expectant management of peripherally inserted central catheters to prevent infection in newborn infants. Duration of use may be a modifiable risk factor for central venous catheter-associated bloodstream infection in newborn infants. Early planned removal of peripherally inserted central catheters (PICCs) is recommended as a strategy to reduce the incidence of infection and its associated morbidity and mortality.To determine the effectiveness of early planned (...) removal of PICCs (up to two weeks after insertion) compared to an expectant approach or a longer fixed duration in preventing bloodstream infection and other complications in newborn infants.We searched of the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 4), Ovid MEDLINE, Embase, Maternity & Infant Care Database, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (until April 2018), and conference proceedings and previous reviews.Randomised and quasi

2018 Cochrane

145. Protein supplementation of human milk for promoting growth in preterm infants. (PubMed)

Protein supplementation of human milk for promoting growth in preterm infants. Preterm infants require high protein intake to achieve adequate growth and development. Although breast milk feeding has many benefits for this population, the protein content is highly variable, and inadequate to support rapid infant growth. This is a 2018 update of a Cochrane Review first published in 1999.To determine whether protein-supplemented human milk compared with unsupplemented human milk, fed to preterm (...) infants, improves growth, body composition, cardio-metabolic, and neurodevelopmental outcomes, without significant adverse effects.We used the standard search strategy of Cochrane Neonatal to search CENTRAL, MEDLINE via PubMed, Embase, and CINAHL (February 2018). We also searched clinical trials databases, conference proceedings and the reference lists of retrieved articles for randomised controlled trials (RCT) and quasi-randomised trials.Published and unpublished RCTs were eligible if they used

2018 Cochrane

146. Formula versus donor breast milk for feeding preterm or low birth weight infants. (PubMed)

Formula versus donor breast milk for feeding preterm or low birth weight infants. When sufficient maternal breast milk is not available, alternative forms of enteral nutrition for preterm or low birth weight (LBW) infants are donor breast milk or artificial formula. Donor breast milk may retain some of the non-nutritive benefits of maternal breast milk for preterm or LBW infants. However, feeding with artificial formula may ensure more consistent delivery of greater amounts of nutrients (...) ) for continuous data, with respective 95% confidence intervals (CIs). We used a fixed-effect model in meta-analyses and explored potential causes of heterogeneity in subgroup analyses. We assessed the quality of evidence for the main comparison at the outcome level using "Grading of Recommendations Assessment, Development and Evaluation" (GRADE) methods.Eleven trials, in which 1809 infants participated in total, fulfilled the inclusion criteria. Four trials compared standard term formula versus donor breast

2018 Cochrane

147. Fat supplementation of human milk for promoting growth in preterm infants. (PubMed)

Fat supplementation of human milk for promoting growth in preterm infants. As preterm infants do not experience the nutrient accretion and rapid growth phase of the third trimester of pregnancy, they are vulnerable to postnatal nutritional deficits, including of fat. Consequently, they require higher fat intakes compared to their full term counterparts to achieve adequate growth and development. Human milk fat provides the major energy needs of the preterm infant and also contributes to several (...) metabolic and physiological functions. Although human milk has many benefits for this population, its fat content is highly variable and may be inadequate for their optimum growth and development. This is a 2018 update of a Cochrane Review last published in 2000.To determine whether supplementation of human milk with fat compared with unsupplemented human milk fed to preterm infants improves growth, body composition, cardio-metabolic, and neurodevelopmental outcomes without significant adverse

2018 Cochrane

148. The best of intentions: Prenatal breastfeeding intentions and infant health (PubMed)

The best of intentions: Prenatal breastfeeding intentions and infant health Health organizations recommend that mothers exclusively breastfeed infants for the first six months of life. The current study contributes to a growing body of research that examines whether the purported benefits of breastfeeding are causal. We systematically evaluated the role of an expectant mother's prenatal breastfeeding intentions, which reflect not only demographic characteristics, but also knowledge, attitudes (...) , and social norms about infant feeding, and therefore serve as a proxy for positive maternal selection into breastfeeding. We used the Infant Feeding Practices Study (IFPS) II (n = 1008) to examine a heretofore overlooked group of mothers-those who intended to breastfeed but did not actually breastfeed. Results suggest that mothers who intended to breastfeed had infants with fewer ear infections and respiratory syncytial viruses, and used fewer antibiotics in the first year of life compared to infants

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2018 SSM - population health

149. Spontaneous reversion of a lineage switch following an initial blinatumomab-induced ALL-to-AML switch in MLL-rearranged infant ALL (PubMed)

Spontaneous reversion of a lineage switch following an initial blinatumomab-induced ALL-to-AML switch in MLL-rearranged infant ALL 29898879 2019 03 15 2473-9537 2 12 2018 06 26 Blood advances Blood Adv Spontaneous reversion of a lineage switch following an initial blinatumomab-induced ALL-to-AML switch in MLL -rearranged infant ALL. 1382-1385 10.1182/bloodadvances.2018018093 Wölfl Matthias M Pediatric Hematology, Oncology and Stem Cell Transplantation, Children's Hospital, University

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2018 Blood advances

150. Association Between Oxygen Saturation Targeting and Death or Disability in Extremely Preterm Infants in the Neonatal Oxygenation Prospective Meta-analysis Collaboration. (PubMed)

Association Between Oxygen Saturation Targeting and Death or Disability in Extremely Preterm Infants in the Neonatal Oxygenation Prospective Meta-analysis Collaboration. There are potential benefits and harms of hyperoxemia and hypoxemia for extremely preterm infants receiving more vs less supplemental oxygen.To compare the effects of different target ranges for oxygen saturation as measured by pulse oximetry (Spo2) on death or major morbidity.Prospectively planned meta-analysis of individual (...) participant data from 5 randomized clinical trials (conducted from 2005-2014) enrolling infants born before 28 weeks' gestation.Spo2 target range that was lower (85%-89%) vs higher (91%-95%).The primary outcome was a composite of death or major disability (bilateral blindness, deafness, cerebral palsy diagnosed as ≥2 level on the Gross Motor Function Classification System, or Bayley-III cognitive or language score <85) at a corrected age of 18 to 24 months. There were 16 secondary outcomes including

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2018 JAMA

151. Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease

Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease Circulation. 2018;137:e691–e782. DOI: 10.1161/CIR.0000000000000524 May 29, 2018 e691 ABSTRACT: Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high- quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during (...) Chitra Ravishankar, MD Ricardo A. Samson, MD Ravi R. Thiagarajan, MBBS, MPH Rune Toms, MD James Tweddell, MD, FAHA Peter C. Laussen, MBBS, Co-Chair On behalf of the American Heart Association Congenital Cardiac Defects Committee of the Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Cardio- vascular Surgery and Anesthe- sia; and Emergency Cardiovas- cular Care Committee Cardiopulmonary Resuscitation in Infants

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2018 American Heart Association

152. Optimal Target Range of Closed-Loop Inspired Oxygen Support in Preterm Infants: A Randomized Cross-Over Study

Optimal Target Range of Closed-Loop Inspired Oxygen Support in Preterm Infants: A Randomized Cross-Over Study To investigate the effect of different pulse oximetry (SpO2) target range settings during automated fraction of inspired oxygen control (A-FiO2) on time spent within a clinically set SpO2 alarm range in oxygen-dependent infants on noninvasive respiratory support.Forty-one preterm infants (gestational age [median] 26 weeks, age [median] 21 days) on FiO2 >0.21 receiving noninvasive

2018 EvidenceUpdates

153. Pulmonary Vein Stenosis in Infants: A Systematic Review, Meta-Analysis, and Meta-Regression

Pulmonary Vein Stenosis in Infants: A Systematic Review, Meta-Analysis, and Meta-Regression To quantify outcomes of infants (<1 year of age) diagnosed with pulmonary vein stenosis (PVS).MEDLINE (PubMed), Scopus, and Web of Science were searched through February 1, 2017, with no language restrictions. Publications including infants diagnosed with primary PVS, defined as the absence of preceding intervention(s), were considered. The study was performed according to Meta-analysis of Observational (...) Studies in Epidemiology guidelines, the Systematic Reviews, and Meta-Analysis checklist, and registered prospectively. The quality of selected reports was critically examined. Data extraction was independently performed by multiple observers with outcomes agreed upon a priori. Data were pooled using an inverse variance heterogeneity model with incidence of mortality the primary outcome of interest.Forty-eight studies of 185 infants were included. Studies were highly diverse with regards

2018 EvidenceUpdates

154. Efficacy and safety of pulmonary application of corticosteroids in preterm infants with respiratory distress syndrome: a systematic review and meta-analysis

Efficacy and safety of pulmonary application of corticosteroids in preterm infants with respiratory distress syndrome: a systematic review and meta-analysis Systemic corticosteroids as the frontline treatment of respiratory distress syndrome (RDS) in preterm infants are associated with adverse effects on growth and neurodevelopmental outcome, but the pulmonary administration of steroids may help prevent the development of bronchopulmonary dysplasia (BPD) without these side effects.To evaluate (...) the efficacy and safety of pulmonary application of corticosteroids in preterm infants with RDS.MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, the WHO's International Clinical Trials Registry and grey literature were searched with no restriction on date and language of publication from inception to May 2016. Using a random-effect model, we pooled data from randomised controlled trials (RCTs) comparing inhaled or endotracheal corticosteroids with the standard of care

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2018 EvidenceUpdates

155. Usefulness of an Online Risk Estimator for Bronchopulmonary Dysplasia in Predicting Corticosteroid Treatment in Infants Born Preterm

Usefulness of an Online Risk Estimator for Bronchopulmonary Dysplasia in Predicting Corticosteroid Treatment in Infants Born Preterm To assess the usefulness of a bronchopulmonary dysplasia (BPD) outcome estimator developed by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) in identifying high-risk preterm infants treated with steroids.This was a single-center retrospective study of infants born ≤30 weeks of gestational age. The NICHD BPD outcome (...) estimator was used to retrospectively calculate BPD risk at various postnatal ages. The best combination of risk estimates for identifying steroid treatment was identified using stepwise model selection. A cut-off value with the best combination of sensitivity and specificity was identified using receiver operating characteristic analysis.A total of 165 infants born preterm (mean gestational age 26 ± 1.6 weeks, mean birth weight 837 ± 171 g) were included. Of these, 61 were treated with steroids for BPD

2018 EvidenceUpdates

156. Evaluation of a Booster Dose of Pentavalent Rotavirus Vaccine Co-Administered with Measles, Yellow Fever and Meningitis A Vaccines in 9-month-old Malian Infants

Evaluation of a Booster Dose of Pentavalent Rotavirus Vaccine Co-Administered with Measles, Yellow Fever and Meningitis A Vaccines in 9-month-old Malian Infants Rotavirus vaccines given to infants are safe and efficacious. A booster dose of rotavirus vaccine could extend protection into the second year of life in low-resource countries.We conducted an open-label, individual-randomized trial in Bamako, Mali. We assigned 600 infants aged 9-11 months to receive measles vaccine (MV), yellow fever (...) vaccine (YFV), and meningococcal A conjugate vaccine (MenAV) with or without pentavalent rotavirus vaccine (PRV). We assessed the noninferiority (defined as a difference of ≤10%) of seroconversion and seroresponse rates to MV, YFV, and MenAV. We compared the seroresponse to PRV.Seroconversion to MV occurred in 255 of 261 PRV recipients (97.7%) and 246 of 252 control infants (97.6%; difference, 0.1% [95% confidence interval {CI}, -4.0%-4.2%]). Seroresponse to YFV occurred in 48.1% of PRV recipients

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2018 EvidenceUpdates

157. Early Caffeine and Weaning from Mechanical Ventilation in Preterm Infants: A Randomized, Placebo-Controlled Trial

Early Caffeine and Weaning from Mechanical Ventilation in Preterm Infants: A Randomized, Placebo-Controlled Trial To evaluate in a randomized, double-blind, placebo-controlled trial the effect of early caffeine on the age of first successful extubation in preterm infants.Preterm infants born at 23-30 weeks of gestation requiring mechanical ventilation in the first 5 postnatal days were randomized to receive a 20 mg/kg loading dose followed by 5 mg/kg/day of caffeine or placebo until considered (...) the trial. Unblinded analysis revealed mortality did not differ significantly between the early caffeine (9 [22%]) and control groups (5 [12%]; P = .22).Early initiation of caffeine in this group of premature infants did not reduce the age of first successful extubation. A nonsignificant trend toward higher mortality in the early caffeine group led to a cautious decision to stop the trial. These findings suggest caution with early use of caffeine in mechanically ventilated preterm infants until more

2018 EvidenceUpdates

158. Repetitive versus standard tactile stimulation of preterm infants at birth - A randomized controlled trial

Repetitive versus standard tactile stimulation of preterm infants at birth - A randomized controlled trial To evaluate the direct effect of repetitive tactile stimulation on breathing effort of preterm infants at birth.This randomized controlled trial compared the effect of repetitive stimulation on respiratory effort during the first 4 min after birth with standard stimulation based on clinical indication in preterm infants with a gestational age of 27-32 weeks. All details of the stimulation

2018 EvidenceUpdates

159. Preprocedural Ultrasound for Infant Lumbar Puncture: A Randomized Clinical Trial

Preprocedural Ultrasound for Infant Lumbar Puncture: A Randomized Clinical Trial Our purpose was to determine the potential effect of preprocedural ultrasound (US) to increase lumbar puncture (LP) success compared with standard palpation method. Further, we assessed feasibility of and clinician satisfaction with a standardized US protocol.This prospective, two-arm, parallel-group randomized trial was conducted in a single-center pediatric emergency department. We compared preprocedural US (...) versus palpation method on success with infant LPs. Infants less than 3 months of age requiring LP were enrolled. Sixteen pediatric emergency medicine physicians with varied US experience were trained to conduct the USs to mark interspace locations. Primary outcome was successful LP, defined as obtaining a cerebrospinal fluid (CSF) sample on first attempt with < 1,000 red blood cells per high-powered field (clear CSF). Secondary outcomes included clear CSF on any attempt, any CSF on the first attempt

2018 EvidenceUpdates

160. Effect of non-nutritive sucking and sucrose alone and in combination for repeated procedural pain in preterm infants: A randomized controlled trial

Effect of non-nutritive sucking and sucrose alone and in combination for repeated procedural pain in preterm infants: A randomized controlled trial Sucrose combined with non-nutritive sucking provided better pain relief than sucrose or non-nutritive sucking alone in a single painful procedure. However, whether the combination of non-nutritive sucking with sucrose could obtain a significant difference in analgesic effect of the repeated procedural pain than any single intervention has not been (...) established.To compare the effect of non-nutritive sucking and sucrose alone and in combination of repeated procedural pain in preterm infants.Randomized controlled trial.A level III neonatal intensive care unit of a university hospital in China.Preterm infants born before 37 weeks of gestation were randomly assigned to four groups: routine care group (routine comfort through gentle touch when infants cried; n = 21), non-nutritive sucking group (n = 22), sucrose group (0.2 ml/kg of 20%; n = 21), sucrose

2018 EvidenceUpdates