Latest & greatest articles for infants

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Top results for infants

161. Cost-Effectiveness Analysis of Nasal Continuous Positive Airway Pressure Versus Nasal High Flow Therapy as Primary Support for Infants Born Preterm

Cost-Effectiveness Analysis of Nasal Continuous Positive Airway Pressure Versus Nasal High Flow Therapy as Primary Support for Infants Born Preterm To compare the cost-effectiveness of 2 common "noninvasive" modes of respiratory support for infants born preterm.An economic evaluation was conducted as a component of a multicenter, randomized control trial from 2013 to 2015 enrolling infants born preterm at ≥28 weeks of gestation with respiratory distress, <24 hours old, who had not previously (...) intubation and mechanical ventilation during admission.Hospital inpatient cost records for 435 infants enrolled in all Australian centers were obtained. With "rescue" CPAP backup, an incremental cost-effectiveness ratio was estimated of A$179 000 (US$123 000) per ventilation avoided if CPAP was used compared with high flow. Without rescue CPAP backup, cost per ventilation avoided was A$7000 (US$4800) if CPAP was used compared with high flow.As sole primary support, CPAP is highly likely to be cost

2018 EvidenceUpdates

162. Effects of a home-based participatory play intervention on infant and young child nutrition: a randomised evaluation among low-income households in El Alto, Bolivia (PubMed)

Effects of a home-based participatory play intervention on infant and young child nutrition: a randomised evaluation among low-income households in El Alto, Bolivia Stunting affects child survival and is a key indicator of child well-being. Therefore, reducing stunting is a global goal. Improving infant and young child feeding (IYCF) practices is a recommended approach to reduce the risk of mortality and ameliorate nutritional status. Behavioural change interventions have the potential

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2018 BMJ global health

163. Effect of Vitamin D Supplementation on Recurrent Wheezing in Black Infants Who Were Born Preterm: The D-Wheeze Randomized Clinical Trial. (PubMed)

Effect of Vitamin D Supplementation on Recurrent Wheezing in Black Infants Who Were Born Preterm: The D-Wheeze Randomized Clinical Trial. Black infants born preterm face high rates of recurrent wheezing throughout infancy. Vitamin D supplementation has the potential to positively or negatively affect wheezing through modulation of the pulmonary and immune systems.To assess the effectiveness of 2 vitamin D dosing strategies in preventing recurrent wheezing.A randomized clinical trial enrolled (...) 300 black infants born at 28 to 36 weeks' gestation between January 2013 and January 2016 at 4 sites in the United States, and followed them up through March 2017. Randomization was stratified by site and maternal milk exposure.Patients were enrolled prior to discharge from the neonatal intensive care unit or newborn nursery and received open-label multivitamin until they were consuming 200 IU/d of cholecalciferol from formula or fortifier added to human milk, after which they received either 400

2018 JAMA

164. Glucocorticosteroids for infants with biliary atresia following Kasai portoenterostomy. (PubMed)

Glucocorticosteroids for infants with biliary atresia following Kasai portoenterostomy. Biliary atresia is a life-threatening disease characterised by progressive destruction of both intra- and extra-hepatic biliary ducts. The mainstay of treatment is Kasai portoenterostomy, as soon as the disease has been confirmed. Glucocorticosteroids are steroid hormones which act on the glucocorticoid receptor and have a range of metabolic and immunomodulatory effects. Glucocorticosteroids are used (...) to improve the postoperative outcomes in infants who have undergone Kasai portoenterostomy.To assess the beneficial and harmful effects of glucocorticosteroid administration versus placebo or no intervention following Kasai portoenterostomy in infants with biliary atresia.We searched the Cochrane Hepato-Biliary Group Controlled Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE Ovid, Embase Ovid, Science Citation Index Expanded (Web of Science

2018 Cochrane

165. Playing it cool: Characterizing social play, bout termination, and candidate play signals of juvenile and infant Tibetan macaques (Macaca thibetana) (PubMed)

Playing it cool: Characterizing social play, bout termination, and candidate play signals of juvenile and infant Tibetan macaques (Macaca thibetana) Play behaviors and signals during playful interactions with juvenile conspecifics are important for both the social and cognitive development of young animals. The social organization of a species can also influence juvenile social play. We examined the relationships among play behaviors, candidate play signals, and play bout termination in Tibetan (...) macaques (Macaca thibetana) during juvenile and infant social play to characterize the species play style. As Tibetan macaques are despotic and live in groups with strict linear dominance hierarchies and infrequent reconciliation, we predicted that play would be at risk of misinterpretation by both the individuals engaged in the play bout and by those watching, possibly leading to injury of the players. Animals living in such societies might need to frequently and clearly signal playful intent to play

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2018 Zoological research

166. Mind the gap: Temporal trends in inequalities in infant and child mortality in India (1992–2016) (PubMed)

Mind the gap: Temporal trends in inequalities in infant and child mortality in India (1992–2016) •Temporal trends in inequalities in infant and child mortality over two and half decades in India.•Relative change in inequalities in child mortality over survey periods.•Scatter plots to identify states with largest inequalities among wealth index groups.•Concentration Index by various background characteristics and decomposition analysis to identify factors contributing in inequality in infant

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2018 SSM - population health

167. Lower versus higher oxygen concentrations titrated to target oxygen saturations during resuscitation of preterm infants at birth. (PubMed)

Lower versus higher oxygen concentrations titrated to target oxygen saturations during resuscitation of preterm infants at birth. Initial resuscitation with air is well tolerated by most infants born at term. However, the optimal fractional inspired oxygen concentration (FiO2 - proportion of the breathed air that is oxygen) targeted to oxygen saturation (SpO2 - an estimate of the amount of oxygen in the blood) for infants born preterm is unclear.To determine whether lower or higher initial (...) oxygen concentrations, when titrated according to oxygen saturation targets during the resuscitation of preterm infants at birth, lead to improved short- and long-term mortality and morbidity.We conducted electronic searches of the Cochrane Central Register of Controlled Trials (13 October 2017), Ovid MEDLINE (1946 to 13 October 2017), Embase (1974 to 13 October 2017) and CINAHL (1982 to 13 October 2017); we also searched previous reviews (including cross-references), contacted expert informants

2018 Cochrane

168. Managing infants born to mothers who have used opioids during pregnancy

Managing infants born to mothers who have used opioids during pregnancy The incidence of infant opioid withdrawal has grown rapidly in many countries, including Canada, in the last decade, presenting significant health and early brain development concerns. Increased prenatal exposure to opioids reflects rising prescription opioid use as well as the presence of both illegal opiates and opioid-substitution therapies. Infants are at high risk for experiencing symptoms of abstinence or withdrawal (...) that may require assessment and treatment. This practice point focuses specifically on the effect(s) of opioid withdrawal and current management strategies in the care of infants born to mothers with opioid dependency. Keywords: Discharge planning; Management; NAS; NPI; Treatment strategies

2018 Canadian Paediatric Society

169. Use of high-flow nasal cannula oxygen therapy in infants and children

Use of high-flow nasal cannula oxygen therapy in infants and children Heated, humidified high-flow nasal cannula (HHHFNC) therapy provides warmed, humidified oxygen to infants and children in respiratory distress at flow rates that deliver higher oxygen concentrations and some positive airway pressure compared with standard low-flow therapy. Increased use and experience is informing practice and establishing the benefits of HHHFNC use in a variety of clinical conditions. 

2018 Canadian Paediatric Society

170. Predictors of extubation readiness in preterm infants: a systematic review and meta-analysis

Predictors of extubation readiness in preterm infants: a systematic review and meta-analysis A variety of extubation readiness tests have already been incorporated into clinical practice in preterm infants.To identify predictor tests of successful extubation and determine their accuracy compared with clinical judgement alone.MEDLINE, Embase, PubMed, Cochrane Library and Web of Science were searched between 1984 and June 2016. Studies evaluating predictors of extubation success during a period (...) free of mechanical inflations in infants less than 37 weeks' gestation were included. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. After identifying and describing all predictor tests, pooled sensitivity and specificity estimates for the different test categories were generated using a bivariate random-effects model.Thirty-five studies were included, showing wide heterogeneities in population characteristics, methodologies and definitions

2018 EvidenceUpdates

171. Integration of postpartum healthcare services for HIV-infected women and their infants in South Africa: A randomised controlled trial (PubMed)

Integration of postpartum healthcare services for HIV-infected women and their infants in South Africa: A randomised controlled trial As the number of HIV-infected women initiating lifelong antiretroviral therapy (ART) during pregnancy increases globally, concerns have emerged regarding low levels of retention in HIV services and suboptimal adherence to ART during the postpartum period. We examined the impact of integrating postpartum ART for HIV+ mothers alongside infant follow-up within (...) maternal and child health (MCH) services in Cape Town, South Africa.We conducted a randomised trial among HIV+ postpartum women aged ≥18 years who initiated ART during pregnancy in the local antenatal care clinic and were breastfeeding when screened before 6 weeks postpartum. We compared an integrated postnatal service among mothers and their infants (the MCH-ART intervention) to the local standard of care (control)-immediate postnatal referral of HIV+ women on ART to general adult ART services

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2018 EvidenceUpdates

172. Corticosteroids for the prevention of bronchopulmonary dysplasia in preterm infants: a network meta-analysis

Corticosteroids for the prevention of bronchopulmonary dysplasia in preterm infants: a network meta-analysis To determine the comparative efficacy and safety of corticosteroids in the prevention of bronchopulmonary dysplasia (BPD) in preterm infants.We systematically searched PubMed, EMBASE and the Cochrane Library. Two reviewers independently selected randomised controlled trials (RCTs) of postnatal corticosteroids in preterm infants. A Bayesian network meta-analysis and subgroup analyses were (...) ). There were no statistically significant differences in the risk of cerebral palsy (CP) between different corticosteroids. However, high-dose and long-term dexamethasone ranked lower than placebo and other regimens in terms of CP. Subgroup analyses indicated budesonide was associated with a decreased risk of BPD in extremely preterm and extremely low birthweight infants (OR 0.60, 95% CrI 0.36 to 0.93).Dexamethasone can reduce the risk of BPD in preterm infants. Of the different dexamethasone regimens

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2018 EvidenceUpdates

173. Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta-analysis

Domperidone for increasing breast milk volume in mothers expressing breast milk for their preterm infants: a systematic review and meta-analysis Mothers of preterm infants often struggle to produce enough breast milk to meet the nutritional needs of their infant. Galactagogues such as domperidone are often prescribed to increase breast milk supply but evidence supporting their role in clinical practice is uncertain.To evaluate the efficacy and safety of domperidone for increasing breast milk (...) volume in mothers expressing breast milk for their preterm infants.MEDLINE, Embase and Web of Science were searched without language restrictions from first publication until January 2017. Bibliographies of articles and reviews were hand-searched for additional reports.Randomised controlled trials that compared domperidone with placebo in mothers of preterm infants (<37 weeks' gestation) experiencing insufficient milk supply.Two review authors independently assessed studies for inclusion, extracted

2018 EvidenceUpdates

174. Cost-Effectiveness of Supplemental Donor Milk Versus Formula for Very Low Birth Weight Infants

Cost-Effectiveness of Supplemental Donor Milk Versus Formula for Very Low Birth Weight Infants To determine the cost-effectiveness of supplemental donor human milk (DHM) versus preterm formula (PTF) for very low birth weight (VLBW, <1500 g) infants from a societal perspective to 18 months' corrected age.This prospective cost-effectiveness analysis of 363 VLBW infants was conducted for a randomized control trial. Infants recruited from October 2010 to December 2012 were fed DHM or PTF whenever (...) mother's milk was unavailable. Formal health care costs for initial hospitalization and readmissions were obtained from standardized cost-accounting systems and physician fees. Informal and nonhealth care sector costs (eg, caregiver transportation, labor market earnings) were calculated from parent reports.Mean infant birth weight was 996 (SD, 272) grams. Incidence of necrotizing enterocolitis (NEC) differed between groups (all stages 3.9% DHM, 11.0% PTF; P = .01). Costs to 18 months did not differ

2018 EvidenceUpdates

175. Infant Hospitalizations and Mortality After Maternal Vaccination

Infant Hospitalizations and Mortality After Maternal Vaccination The Advisory Committee on Immunization Practices currently recommends pregnant women receive influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines. There are limited studies of the long-term safety in infants for vaccines administered during pregnancy. We evaluate whether maternal receipt of influenza and Tdap vaccines increases the risk of infant hospitalization or death in the first 6 (...) months of life.We included singleton, live birth pregnancies in the Vaccine Safety Datalink between 2004 and 2014. Outcomes were infant hospitalizations and mortality in the first 6 months of life. We performed a case-control study matching case patients and controls 1:1 and used conditional logistic regression to estimate odds ratios for maternal exposure to influenza and/or Tdap vaccines in pregnancy.There were 413 034 live births in our population. Of these, 25 222 infants had hospitalizations

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2018 EvidenceUpdates

176. Characteristics distinguishing abusive head trauma from accidental head trauma in infants with traumatic intracranial hemorrhage in Japan (PubMed)

Characteristics distinguishing abusive head trauma from accidental head trauma in infants with traumatic intracranial hemorrhage in Japan To identify markers for detecting abusive head trauma (AHT) and its characteristics in the Japanese population.We retrospectively reviewed the clinical records of 166 infants with traumatic intracranial hemorrhage between 2002 and 2013 in three tertiary institutions in Japan. The infants were classified into AHT (57), suspected AHT (24), and accidental (85 (...) ) group based on the defined criteria. We compared clinical presentations and computed tomography findings among these three groups and also compared age distribution of infants with AHT in our study to those in the USA.Age distribution of AHT cases is significantly higher in our study than in the USA (P < 0.001). The rates of male sex, bruising, retinal hemorrhage, subdural hematoma, cerebral edema, and neurological sequelae were significantly higher, and those of skull fracture and scalp finding

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2018 Acute medicine & surgery

177. Hydrolyzed Formula Compared With Standard Formula for Preterm Infants. (PubMed)

Hydrolyzed Formula Compared With Standard Formula for Preterm Infants. For preterm infants, is hydrolyzed formula associated with lower rates of feeding intolerance, lower rates of necrotizing enterocolitis, and faster rates of growth compared with standard cow's milk formula?Compared with standard formula, feeding preterm infants hydrolyzed formula is not associated with a lower rate of feeding intolerance, a lower rate of necrotizing enterocolitis, or with faster growth.

2018 JAMA

178. You can have your breastmilk and safe sleep too: a preliminary analysis of infant safe sleep data in a Midwestern home visiting program (PubMed)

You can have your breastmilk and safe sleep too: a preliminary analysis of infant safe sleep data in a Midwestern home visiting program Sudden unexpected infant death (SUID) accounted for approximately 3700 infant deaths in the US in 2015. SUID risk factors include prone sleeping, bed-sharing, soft bedding use, and maternal smoking. Infant safe sleep data in at-risk communities are difficult to obtain and home visiting programs can add to what we know. This study's purpose is to determine how (...) often caregivers enrolled in home visiting programs provide safe sleep environments for their infants in relation to breastfeeding status and tobacco use.Female caregivers in at-risk communities were prospectively enrolled in Midwestern home visiting programs. Those that had infants < 365 days old and completed a safe sleep survey between October 1, 2016 and May 18, 2017 were included. Caregivers' responses (always, sometimes, or never) to three safe sleep questions were compared by breastfeeding

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2018 Injury epidemiology

179. Paternal perception of infant sleep risks and safety (PubMed)

Paternal perception of infant sleep risks and safety Sudden Unexpected Infant Death (SUID) results in 3400 sleep-related deaths yearly in the United States, yet caregivers' compliance with safe sleep recommendations remains less than optimal. Paternal caregiver's attitudes toward infant safe sleep messages are largely unaddressed, despite established differences between female and male caregiver perceptions. This study aimed to explore the determinants of safe sleep practices among male (...) caregivers.Focus groups were conducted in Arkansas with male caregivers of infants ages 2-12 months to discuss infant sleep routines, parental roles, sources for safe sleep information, and messaging suggestions for safe sleep promotion. The Health Belief Model of behavior change framed a moderator guide. Transcript-based analysis was used, and data were managed using HyperRESEARCH (version 2.8.3). The transcribed data were coded to identify significant themes.Ten focus groups were conducted with 46

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2018 Injury epidemiology

180. Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants. (PubMed)

Paracetamol (acetaminophen) for patent ductus arteriosus in preterm or low birth weight infants. In preterm newborns, the ductus arteriosus frequently fails to close and the infants require medical or surgical closure of the patent ductus arteriosus (PDA). A PDA can be treated surgically; or medically with one of two prostaglandin inhibitors, indomethacin or ibuprofen. Case reports suggest that paracetamol may be an alternative for the closure of a PDA. An association between prenatal (...) and mode of administration in preterm (≤ 34 weeks' postmenstrual age) infants. We both reviewed the search results and made a final selection of potentially eligible articles by discussion. We included studies of both prophylactic and therapeutic use of paracetamol.We performed data collection and analyses in accordance with the methods of the Cochrane Neonatal Review Group. We used the GRADE approach to assess the quality of evidence for the following outcomes when data were available: failure

2018 Cochrane