Latest & greatest articles for infants

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Top results for infants

1. Iodine supplementation for the prevention of mortality and adverse neurodevelopmental outcomes in preterm infants. (PubMed)

Iodine supplementation for the prevention of mortality and adverse neurodevelopmental outcomes in preterm infants. Parenteral nutrition solutions, artificial formulas, and human breast milk contain insufficient iodine to meet recommended intakes for preterm infants. Iodine deficiency may exacerbate transient hypothyroxinaemia in preterm infants and this may be associated with adverse neonatal and longer-term outcomes.To assess the evidence from randomised controlled trials that dietary (...) supplementation with iodine reduces mortality and morbidity in preterm infants.We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 1), Ovid MEDLINE, Ovid Embase, Ovid Maternity & Infant Care Database, and CINAHL to February 2018. We searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.Randomised or quasi

2019 Cochrane

2. Positive end-expiratory pressure for preterm infants requiring conventional mechanical ventilation for respiratory distress syndrome or bronchopulmonary dysplasia. (PubMed)

Positive end-expiratory pressure for preterm infants requiring conventional mechanical ventilation for respiratory distress syndrome or bronchopulmonary dysplasia. Conventional mechanical ventilation (CMV) is a common therapy for neonatal respiratory failure. While CMV facilitates gas exchange, it may simultaneously injure the lungs. Positive end-expiratory pressure (PEEP) has received less attention than other ventilation parameters when considering this benefit-risk balance. While (...) an appropriate PEEP level may result in clinical benefits, both inappropriately low or high levels may cause harm. An appropriate PEEP level may also be best achieved by an individualized approach.1. To compare the effects of PEEP levels in preterm infants requiring CMV for respiratory distress syndrome (RDS). We compare both: zero end-expiratory pressure (ZEEP) (0 cm H2O) versus any PEEP and low (< 5 cm H2O) vs high (≥ 5 cm H2O) PEEP.2. To compare the effects of PEEP levels in preterm infants requiring CMV

2019 Cochrane

3. Education of family members to support weaning to solids and nutrition in infants born preterm. (PubMed)

Education of family members to support weaning to solids and nutrition in infants born preterm. Weaning refers to the period of introduction of solid food to complement breast milk or formula milk. Preterm infants are known to acquire extrauterine growth restriction by the time of discharge from neonatal units. Hence, the postdischarge and weaning period are crucial for optimal growth. Optimisation of nutrition during weaning may have long-term impacts on outcomes in preterm infants. Family (...) members of preterm infants may require nutrition education to promote ideal nutrition practices surrounding weaning in preterm infants who are at high risk of nutritional deficit.To investigate the role of nutrition education of family members in supporting weaning in preterm infants with respect to their growth and neurodevelopment compared with conventional management.We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018

2019 Cochrane

4. Late erythropoiesis-stimulating agents to prevent red blood cell transfusion in preterm or low birth weight infants. (PubMed)

Late erythropoiesis-stimulating agents to prevent red blood cell transfusion in preterm or low birth weight infants. Preterm infants have low plasma levels of erythropoietin (EPO), providing a rationale for the use of erythropoiesis-stimulating agents (ESAs) to prevent or treat anaemia. Darbepoetin (Darbe) and EPO are currently available ESAs.To assess the effectiveness and safety of late initiation of ESAs, between eight and 28 days after birth, in reducing the use of red blood cell (RBC (...) controlled trials of late initiation of EPO treatment (started at ≥ eight days of age) versus placebo or no intervention in preterm (< 37 weeks) or low birth weight (< 2500 grams) neonates.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 the evidence.We include 31 studies (32 comparisons) randomising 1651 preterm infants. Literature searches in 2018 identified one new study for inclusion

2019 Cochrane

5. Efficacy and Safety of EMLA Cream for Pain Control Due to Venipuncture in Infants: A Meta-analysis

Efficacy and Safety of EMLA Cream for Pain Control Due to Venipuncture in Infants: A Meta-analysis : media-1vid110.1542/5852339542001PEDS-VA_2018-1173Video Abstract CONTEXT: The eutectic mixture of lidocaine (EMLA) cream has been used to reduce the pain during venipuncture in infants.To determine the efficacy and safety of EMLA in infants <3 months of age requiring venipuncture in comparison with nonpharmacological interventions in terms of pain reduction, change in physiologic variables (...) trials (907 infants) were included. EMLA revealed little or no effect in reduction of pain (standardized mean difference: 0.14; 95% confidence interval [CI]: -0.17 to 0.45; 6 trials, n = 742; moderate-quality evidence) when EMLA was compared with sucrose, breastfeeding, or placebo. In comparison with placebo, EMLA revealed a small-to-moderate effect on increasing methemoglobin levels (mean difference: 0.35; 95% CI: 0.04 to 0.66; 2 trials, n = 134; low-quality evidence). There was an increased risk

2019 EvidenceUpdates

6. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV

Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV UPDATED RECOMMENDATIONS ON FIRST-LINE AND SECOND-LINE ANTIRETROVIRAL REGIMENS AND POST-EXPOSURE PROPHYLAXIS AND RECOMMENDATIONS ON EARLY INFANT DIAGNOSIS OF HIV SUPPLEMENT TO THE 2016 CONSOLIDATED GUIDELINES ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION DECEMBER 2018 INTERIM GUIDELINES HIV TREATMENTUPDATED (...) RECOMMENDATIONS ON FIRST-LINE AND SECOND-LINE ANTIRETROVIRAL REGIMENS AND POST-EXPOSURE PROPHYLAXIS AND RECOMMENDATIONS ON EARLY INFANT DIAGNOSIS OF HIV: INTERIM GUIDELINES SUPPLEMENT TO THE 2016 CONSOLIDATED GUIDELINES ON THE USE OF ANTIRETROVIRAL DRUGS FOR TREATING AND PREVENTING HIV INFECTION DECEMBER 2018WHO/CDS/HIV/18.51 © 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

2019 World Health Organisation HIV Guidelines

7. External validation and clinical usefulness of first-trimester prediction models for small- and large-for-gestational-age infants: a prospective cohort study

External validation and clinical usefulness of first-trimester prediction models for small- and large-for-gestational-age infants: a prospective cohort study To assess the external validity of all published first-trimester prediction models based on routinely collected maternal predictors for the risk of small- and large-for-gestational-age (SGA and LGA) infants. Furthermore, the clinical potential of the best-performing models was evaluated.Multicentre prospective cohort.Thirty-six midwifery (...) after recalibration.The clinical relevance of the models is limited because of their moderate predictive performance, and because the definitions of SGA and LGA do not exclude constitutionally small or large infants. As most clinically relevant fetal growth deviations are related to 'vascular' or 'metabolic' factors, models predicting hypertensive disorders and gestational diabetes are likely to be more specific.The clinical relevance of prediction models for the risk of small- and large

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2019 EvidenceUpdates

8. The Association of Hydrocortisone Dosage on Mortality in Infants Born Extremely Premature

The Association of Hydrocortisone Dosage on Mortality in Infants Born Extremely Premature To characterize common dosing strategies and to investigate the association between hydrocortisone dosage and in-hospital mortality in infants born extremely premature.We performed a retrospective review of a cohort of infants born ≤30 weeks' gestational age from 2010 to 2016 from the Pediatrix Clinical Data Warehouse who received hydrocortisone in the first 14 postnatal days. Infants were divided (...) by initial hydrocortisone dosage (high: >2 mg/kg/d vs low: ≤2 mg/kg/d). Baseline characteristics and medication coexposures were compared and mortality was evaluated in a multivariable analysis.A total of 1427 infants were included, 733 with high dosage (51%) and 694 with low dosage (49%). The groups were similar with regard to baseline characteristics. Infants in the high-dosage group had significantly more exposure to any vasopressors (89% vs 84%, P < .001) and greater mortality (50% vs 23%, P < .001

2019 EvidenceUpdates

9. Timing of introduction of allergenic solids for infants at high risk

Timing of introduction of allergenic solids for infants at high risk Food allergy affects an estimated 2% to 10% of the population, with evidence of increasing prevalence over time. Preventing food allergy has become an important public health goal. Health Canada currently recommends breastfeeding infants exclusively until they are 6 months old, while acknowledging that in individual practice, signs of infant readiness may guide the introduction of complementary foods a few weeks earlier (...) . There is emerging evidence that early food introduction, between 4 to 6 months of age, may have a role in preventing food allergy, particularly for egg and peanut, in high-risk infants. For infants at high risk for allergic disease, it is now recommended that commonly allergenic solids be introduced at around 6 months of age, but not before 4 months of age, and guided by the infant’s developmental readiness for food. Continued breastfeeding should be encouraged and supported because of its

2019 Canadian Paediatric Society

10. Mupirocin for Staphylococcus aureus Decolonization of Infants in Neonatal Intensive Care Units

Mupirocin for Staphylococcus aureus Decolonization of Infants in Neonatal Intensive Care Units : media-1vid110.1542/5849573989001PEDS-VA_2018-1565Video Abstract BACKGROUND AND OBJECTIVES: Staphylococcus aureus (SA) is the second leading cause of late-onset sepsis among infants in the NICU. Because colonization of nasal mucosa and/or skin frequently precedes invasive infection, decolonization strategies, such as mupirocin application, have been attempted to prevent clinical infection, but data (...) supporting this approach in infants are limited. We conducted a phase 2 multicenter, open-label, randomized trial to assess the safety and efficacy of intranasal plus topical mupirocin in eradicating SA colonization in critically ill infants.Between April 2014 and May 2016, infants <24 months old in the NICU at 8 study centers underwent serial screening for nasal SA. Colonized infants who met eligibility criteria were randomly assigned to receive 5 days of mupirocin versus no mupirocin to the intranasal

2019 EvidenceUpdates

11. Smaller facemasks for positive pressure ventilation in preterm infants: A randomised trial

Smaller facemasks for positive pressure ventilation in preterm infants: A randomised trial Facial measurements of preterm infants indicate that standard diameter facemasks used during positive pressure ventilation are too large, which may lead to mask leak and compromise resuscitation. We aimed to determine whether the use of a facemask that better complies with the dimensions of preterm faces, compared with a standard facemask, reduces facemask leak.Parallel group, randomised controlled trial (...) . Preterm infants ≤32 weeks' gestation receiving facemask ventilation prior to intubation in the neonatal intensive care unit, and those 28-32+6 weeks' receiving facemask ventilation in the delivery room were eligible. Infants were randomised to receive ventilation via a standard (50mm) (control), or a smaller (35mm or 42mm) diameter facemask (intervention), stratified by gestation (≤26 weeks'; 35mm, 27-32+6; 42mm). The primary outcome was leak between the mask and the infants face.Of 298 eligible

2019 EvidenceUpdates

12. Effect of Hydrocortisone Therapy Initiated 7 to 14 Days After Birth on Mortality or Bronchopulmonary Dysplasia Among Very Preterm Infants Receiving Mechanical Ventilation: A Randomized Clinical Trial. (PubMed)

Effect of Hydrocortisone Therapy Initiated 7 to 14 Days After Birth on Mortality or Bronchopulmonary Dysplasia Among Very Preterm Infants Receiving Mechanical Ventilation: A Randomized Clinical Trial. Dexamethasone initiated after the first week of life reduces the rate of death or bronchopulmonary dysplasia (BPD) but may cause long-term adverse effects in very preterm infants. Hydrocortisone is increasingly used as an alternative, but evidence supporting its efficacy and safety is lacking.To (...) assess the effect of hydrocortisone initiated between 7 and 14 days after birth on death or BPD in very preterm infants.Double-blind, placebo-controlled randomized trial conducted in 19 neonatal intensive care units in the Netherlands and Belgium from November 15, 2011, to December 23, 2016, among preterm infants with a gestational age of less than 30 weeks and/or birth weight of less than 1250 g who were ventilator dependent between 7 and 14 days of life, with follow-up to hospital discharge ending

2019 JAMA

13. Delayed umbilical cord clamping reduces hospital mortality for preterm infants

Delayed umbilical cord clamping reduces hospital mortality for preterm infants Delayed umbilical cord clamping reduces hospital mortality for preterm infants Discover Portal Discover Portal Delayed umbilical cord clamping reduces hospital mortality for preterm infants Published on 6 February 2018 doi: Delays to clamping the umbilical cord of about a minute can reduce hospital mortality for preterm infants by around 32%. Delayed clamping also reduced the proportion of infants needing a blood (...) transfusion by 10%. This review adds more precise data on survival from new trials including a large Australian trial (over 1,600 babies) to a previous Cochrane 2012 review of trails including 738 infants and provides new more precise data on the survival benefit. These findings are consistent with current guidelines which recommend delayed clamping in preterm infants. Share your views on the research. Why was this study needed? The optimal timing of umbilical cord clamping has been debated. Globally

2019 NIHR Dissemination Centre

14. Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events

Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events Discover Portal Discover Portal Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events Published on 11 July 2017 doi: Adverse breathing events are about three times more common when using endotracheal tubes than laryngeal mask airways for infants under 12 months (...) receiving non-urgent surgery. Airway problems are common during anaesthesia in children, accounting for three quarters of critical incidents and a third of cardiac arrests. They are more frequent in younger children, especially infants under 12 months, who have smaller airways and rapidly use up their oxygen reserves. Laryngeal mask airways have been used in adults and older children for over 35 years for minor and intermediate surgery. Many studies have shown them to have fewer airway-related

2019 NIHR Dissemination Centre

15. Infant diets that include egg or peanut products appear to reduce food allergies

Infant diets that include egg or peanut products appear to reduce food allergies Infant diets that include egg or peanut products appear to reduce food allergies Discover Portal Discover Portal Infant diets that include egg or peanut products appear to reduce food allergies Published on 29 November 2016 doi: Certain allergenic foods introduced to an infant’s diet while weaning appear to reduce the chance of developing food allergies. This high quality review, including studies published (...) this year, suggests that historical recommendations to delay the introduction of peanut and other allergenic foods to infant child’s diet in the first year of life may have been mistaken. The methodological limitations in some studies included in this review, reduce our certainty in the degree of benefit, but as more high quality studies are undertaken the benefits and practicalities of how to introduce these foods are likely to become clearer. The causes of food allergies are not fully understood

2019 NIHR Dissemination Centre

16. High-flow oxygen therapy may have a role in treating infants with more severe bronchiolitis

High-flow oxygen therapy may have a role in treating infants with more severe bronchiolitis High-flow oxygen therapy may have a role in treating infants with more severe bronchiolitis Discover Portal Discover Portal High-flow oxygen therapy may have a role in treating infants with more severe bronchiolitis Published on 18 September 2018 doi: A randomised controlled trial of 1,472 infants with bronchiolitis found that more children improved when started on high-flow oxygen therapy than (...) with standard oxygen therapy. Those who failed to improve on standard therapy were switched to high flow oxygen. Most then improved - overall, similar numbers were transferred to intensive care. There was also no difference between the groups in the proportion of infants needing intubation, length of time on oxygen therapy or days spent in hospital. The place in the pathway for high-flow oxygen remains to be clarified. For example, it isn’t clear from this study whether high flow oxygen is best used

2019 NIHR Dissemination Centre

17. Inducing labour at or after 41 weeks reduces risks to infants

Inducing labour at or after 41 weeks reduces risks to infants Inducing labour at or after 41 weeks reduces risks to infants Discover Portal Discover Portal Inducing labour at or after 41 weeks reduces risks to infants Published on 11 September 2018 doi: Inducing labour after the due date slightly lowers the risk of stillbirth or infant death soon after birth compared with watchful waiting. But the overall risk is very low. Induced deliveries may reduce admissions to the neonatal intensive care (...) unit. Pregnant women having induced labour are less likely to have a caesarean section than those who wait for labour to begin naturally. They may have a slightly higher chance of needing an assisted vaginal birth (for example, using forceps or vacuum extraction). Many pregnancies continue for longer than the average 40 weeks. Because of the risks to infants, women are often offered the option of induced labour at between 41 and 42 weeks. However, induction also carries risks to mother and baby

2019 NIHR Dissemination Centre

18. Plastic wraps or bags keep pre-term infants warm immediately after birth

Plastic wraps or bags keep pre-term infants warm immediately after birth Plastic wraps or bags keep pre-term infants warm immediately after birth Discover Portal Discover Portal Plastic wraps or bags keep pre-term infants warm immediately after birth Published on 22 May 2018 doi: Cheap and simple plastic wrapping used in the first 10 minutes after birth helps pre-term and low birth weight infants avoid hypothermia. Infants treated in this way are likely to be warmer when admitted to neonatal (...) intensive care than those treated according to standard care. Pre-term infants are most likely to benefit. Routine infant care usually involves ensuring the delivery room is warm, drying the infant immediately after birth, wrapping the infant in pre-warmed dry blankets and pre-warming surfaces. Despite this, about a quarter of babies born eight weeks early have temperatures that are too low and additional measures to warm pre-term and low birth weight infants are needed. Although babies were warmer

2019 NIHR Dissemination Centre

19. C-reactive protein for diagnosing late-onset infection in newborn infants. (PubMed)

C-reactive protein for diagnosing late-onset infection in newborn infants. Late-onset infection is the most common serious complication associated with hospital care for newborn infants. Because confirming the diagnosis by microbiological culture typically takes 24 to 48 hours, the serum level of the inflammatory marker C-reactive protein (CRP) measured as part of the initial investigation is used as an adjunctive rapid test to guide management in infants with suspected late-onset infection.To (...) review authors independently assessed eligibility for inclusion, evaluated the methodological quality of included studies, and extracted data to estimate diagnostic accuracy using hierarchical summary receiver operating characteristic (SROC) models. We assessed heterogeneity by examining variability of study estimates and overlap of the 95% confidence interval (CI) in forest plots of sensitivity and specificity.The search identified 20 studies (1615 infants). Most were small, single-centre

2019 Cochrane

20. Enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial. (PubMed)

Enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial. Infections acquired in hospital are an important cause of morbidity and mortality in very preterm infants. Several small trials have suggested that supplementing the enteral diet of very preterm infants with lactoferrin, an antimicrobial protein processed from cow's milk, prevents infections and associated complications. The aim of this large randomised controlled trial was to collect data (...) to enhance the validity and applicability of the evidence from previous trials to inform practice.In this randomised placebo-controlled trial, we recruited very preterm infants born before 32 weeks' gestation in 37 UK hospitals and younger than 72 h at randomisation. Exclusion criteria were presence of a severe congenital anomaly, anticipated enteral fasting for longer than 14 days, or no realistic prospect of survival. Eligible infants were randomly assigned (1:1) to receive either enteral bovine

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2019 Lancet