Latest & greatest articles for infants

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Top results for infants

1. Enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial.

Enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial. BACKGROUND: 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. METHODS: 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

Lancet2019

2. 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 Dissemination Centre Discover Portal NIHR DC Discover Plastic wraps or bags keep pre-term infants warm immediately after birth Published on 22 May 2018 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

NIHR Dissemination Centre2018

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

Delayed umbilical cord clamping reduces hospital mortality for preterm infants Signal - Delayed umbilical cord clamping reduces hospital mortality for preterm infants Dissemination Centre Discover Portal NIHR DC Discover Delayed umbilical cord clamping reduces hospital mortality for preterm infants Published on 6 February 2018 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

NIHR Dissemination Centre2018

4. 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 Signal - Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events Dissemination Centre Discover Portal NIHR DC Discover Infants anaesthetised without placing a tube in the trachea have fewer adverse breathing events Published on 11 July 2017 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

NIHR Dissemination Centre2018

5. 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 Signal - Infant diets that include egg or peanut products appear to reduce food allergies Dissemination Centre Discover Portal NIHR DC Discover Infant diets that include egg or peanut products appear to reduce food allergies Published on 29 November 2016 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

NIHR Dissemination Centre2018

6. 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 Dissemination Centre Discover Portal NIHR DC Discover 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 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

NIHR Dissemination Centre2018

7. 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 Dissemination Centre Discover Portal NIHR DC Discover 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

NIHR Dissemination Centre2018

8. Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants.

Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants. BACKGROUND: Inflammation may contribute to preterm birth and to morbidity of preterm infants. Preterm infants are at risk for alterations in the normal protective microbiome. Oral probiotics administered directly to preterm infants have been shown to decrease the risk for severe necrotizing enterocolitis (NEC) as well as the risk of death, but there are safety concerns about administration (...) of probiotics directly to preterm infants. Through decreasing maternal inflammation, probiotics may play a role in preventing preterm birth and/or decreasing the inflammatory milieu surrounding delivery of preterm infants, and may alter the microbiome of the preterm infant when given to mothers during pregnancy. Probiotics given to mothers after birth of preterm infants may effect infant bacterial colonization, which could potentially reduce the incidence of NEC. OBJECTIVES: 1. To compare the efficacy

Cochrane2018

9. Facilitating discharge from hospital of the healthy term infant

Facilitating discharge from hospital of the healthy term infant This statement provides guidance for health care providers to ensure the safe discharge of healthy term infants who are born in hospital and who are ≥37 weeks’ gestational age. Hospital care for mothers and infants should be family-centred, with healthy mothers and infants remaining together and going home at the same time. The specific length of stay for newborn infants depends on the health of their mother, infant health (...) and stability, the mother’s ability to care for her infant, support at home, and access to follow-up care. Many mother–infant dyads are ready to go home 24 h after birth. Parent or guardian education and assessment of discharge readiness are important components of discharge planning. Each infant must have an appropriate discharge plan, including identification of the infant’s primary health care provider and assessment by a health care provider 24 h to 72 h after discharge. Keywords

Canadian Paediatric Society2018

10. Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial

Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial 30337189 2018 10 19 1097-6833 2018 Oct 15 The Journal of pediatrics J. Pediatr. Weaning of Moderately Preterm Infants from the Incubator to the Crib: A Randomized Clinical Trial. S0022-3476(18)31253-8 10.1016/j.jpeds.2018.08.079 To assess whether length of hospital stay is decreased among moderately preterm infants weaned from incubator to crib at a lower vs higher weight. This trial was conducted (...) in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Infants with gestational ages 29-33 weeks, birthweight <1600 g, and in an incubator were randomly assigned to a weaning weight of 1600 or 1800 g. Within 60 to 100 g of weaning weight, the incubator temperature was decreased by 1.0°C to 1.5°C every 24 hours until 28.0°C. The infants were weaned to the crib following stable temperature at 36.5°C to 37.4°C for 8 to 12 hours. Clothing

EvidenceUpdates2018

11. Prolonged slow expiration technique improves recovery from acute bronchiolitis in infants: FIBARRIX randomized controlled trial

Prolonged slow expiration technique improves recovery from acute bronchiolitis in infants: FIBARRIX randomized controlled trial 30442030 2018 11 16 1477-0873 2018 Nov 16 Clinical rehabilitation Clin Rehabil Prolonged slow expiration technique improves recovery from acute bronchiolitis in infants: FIBARRIX randomized controlled trial. 269215518809815 10.1177/0269215518809815 To examine the effect of prolonged slow expiration respiratory physiotherapy treatment on the acute bronchiolitis severity (...) scale and O 2 saturation at short-time and at medical discharge in infants and the hospital stay. Randomized controlled trial. Infants' unit of university hospital. Infants with acute bronchiolitis ( N = 80). Infants were randomized into respiratory treatment (RT) with prolonged slow expiration or treatment as usual (control) for one-week period. The primary outcomes were Acute Bronchiolitis Severity Scale score and O 2 saturation, recorded shortly after each intervention during the stay

EvidenceUpdates2018

12. Analgesic efficacy and safety of morphine in the Procedural Pain in Premature Infants (Poppi) study: randomised placebo-controlled trial.

Analgesic efficacy and safety of morphine in the Procedural Pain in Premature Infants (Poppi) study: randomised placebo-controlled trial. BACKGROUND: Infant pain has immediate and long-term effects but is undertreated because of a paucity of evidence-based analgesics. Although morphine is often used to sedate ventilated infants, its analgesic efficacy is unclear. We aimed to establish whether oral morphine could provide effective and safe analgesia in non-ventilated premature infants for acute (...) procedural pain. METHODS: In this single-centre masked trial, 31 infants at the John Radcliffe Hospital, Oxford, UK, were randomly allocated using a web-based facility with a minimisation algorithm to either 100 μg/kg oral morphine sulphate or placebo 1 h before a clinically required heel lance and retinopathy of prematurity screening examination, on the same occasion. Eligible infants were born prematurely at less than 32 weeks' gestation or with a birthweight lower than 1501 g and had a gestational age

Lancet2018

13. Exploring the intergenerational effects of undernutrition: association of maternal height with neonatal, infant and under-five mortality in Bangladesh

Exploring the intergenerational effects of undernutrition: association of maternal height with neonatal, infant and under-five mortality in Bangladesh 30498585 2018 12 03 2059-7908 3 6 2018 BMJ global health BMJ Glob Health Exploring the intergenerational effects of undernutrition: association of maternal height with neonatal, infant and under-five mortality in Bangladesh. e000881 10.1136/bmjgh-2018-000881 Global or regional evidence showed maternal height as a strong predictor of child (...) survival. However, there is limited information that confirms the intergenerational effect of short maternal height on the risk of offspring mortality in Bangladesh. Therefore, this study aimed to examine the association of maternal height with neonatal, infant and under-five mortality in Bangladesh. It was a pooled analysis of data from four rounds of Bangladesh Demographic and Health Surveys 2004, 2007, 2011 and 2014. We included singleton children aged 0-59 months born to mothers aged 15-49 years (n

BMJ global health2018 Full Text: Link to full Text with Trip Pro

14. Sudden infant death syndrome

Sudden infant death syndrome Sudden infant death syndrome - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Sudden infant death syndrome Last reviewed: October 2018 Last updated: November 2018 Summary Leading cause of infant death beyond the neonatal period. Incidence roughly 1 in 2000 infants. Peak incidence between 1 and 3 months of age, although events may occur up to 12 months of age. Risk factors include exposure (...) , and breastfeeding. Careful evaluation of death by trained forensics teams is necessary to rule out other causes of death, including suffocation, asphyxia, entrapment, infection, ingestions, metabolic diseases, arrhythmia-associated cardiac channelopathies, and trauma (accidental or non-accidental). Definition The term 'sudden infant death syndrome' (SIDS) was first used, and an early definition described, at the 2nd International Conference on the Causes of Sudden Death in Infants in 1969. Beckwith JB

BMJ Best Practice2018

15. Impact of Steroid Therapy on Early Growth in Infants with Biliary Atresia: The Multicenter Steroids in Biliary Atresia Randomized Trial

Impact of Steroid Therapy on Early Growth in Infants with Biliary Atresia: The Multicenter Steroids in Biliary Atresia Randomized Trial 30244988 2018 10 26 1097-6833 202 2018 Nov The Journal of pediatrics J. Pediatr. Impact of Steroid Therapy on Early Growth in Infants with Biliary Atresia: The Multicenter Steroids in Biliary Atresia Randomized Trial. 179-185.e4 S0022-3476(18)30895-3 10.1016/j.jpeds.2018.07.002 To investigate the impact of corticosteroid therapy on the growth of participants (...) in the Steroids in Biliary Atresia Randomized Trial (START) conducted through the Childhood Liver Disease Research Network. The primary analysis in START indicated that steroids did not have a beneficial effect on drainage in a cohort of infants with biliary atresia. We hypothesized that steroids would have a detrimental effect on growth in these infants. A total of 140 infants were enrolled in START, with 70 randomized to each treatment arm: steroid and placebo. Length, weight, and head circumference were

EvidenceUpdates2018

16. Preterm Infant Outcomes after Randomization to Initial Resuscitation with FiO2 0.21 or 1.0

Preterm Infant Outcomes after Randomization to Initial Resuscitation with FiO2 0.21 or 1.0 30251639 2018 09 25 1097-6833 201 2018 Oct The Journal of pediatrics J. Pediatr. Preterm Infant Outcomes after Randomization to Initial Resuscitation with FiO 2 0.21 or 1.0. 55-61.e1 S0022-3476(18)30766-2 10.1016/j.jpeds.2018.05.053 To determine rates of death or neurodevelopmental impairment (NDI) at 2 years corrected age (primary outcome) in children <32 weeks' gestation randomized to initial (...) resuscitation with a fraction of inspired oxygen (FiO 2 ) value of 0.21 or 1.0. Blinded assessments were conducted at 2-3 years corrected age with the Bayley Scales of Infant and Toddler Development, Third Edition or the Ages and Stages Questionnaire by intention to treat. Of the 290 children enrolled, 40 could not be contacted and 10 failed to attend appointments. Among the 240 children for whom outcomes at age 2 years were available, 1 child had a lethal congenital anomaly, 1 child had consent for follow

EvidenceUpdates2018

17. Direct infant UV light exposure is associated with eczema and immune development

Direct infant UV light exposure is associated with eczema and immune development 30366577 2018 10 27 1097-6825 2018 Oct 15 The Journal of allergy and clinical immunology J. Allergy Clin. Immunol. Direct infant UV light exposure is associated with eczema and immune development. S0091-6749(18)31289-2 10.1016/j.jaci.2018.08.037 Suboptimal vitamin D levels during critical periods of immune development have emerged as an explanation for higher rates of allergic diseases associated (...) with industrialization and residing at higher latitudes. We sought to determine the effects of early postnatal vitamin D supplementation on infant eczema and immune development. By using a double-blind randomized controlled trial, newborn infants were randomized to receive vitamin D supplementation (400 IU/d) or a placebo until 6 months of age. Some infants also wore personal UV dosimeters to measure direct UV light (290-380 nm) exposure. Infant vitamin D levels were measured at 3 and 6 months of age. Eczema, wheeze

EvidenceUpdates2018

18. The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year

The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year 30172426 2018 10 26 1097-6833 2018 Aug 29 The Journal of pediatrics J. Pediatr. The Impact of Pulmonary Hypertension in Preterm Infants with Severe Bronchopulmonary Dysplasia through 1 Year. S0022-3476(18)30940-5 10.1016/j.jpeds.2018.07.035 To assess the effect of pulmonary hypertension on neonatal intensive care unit mortality and hospital readmission through 1 year of corrected age (...) in a large multicenter cohort of infants with severe bronchopulmonary dysplasia. This was a multicenter, retrospective cohort study of 1677 infants born <32 weeks of gestation with severe bronchopulmonary dysplasia enrolled in the Children's Hospital Neonatal Consortium with records linked to the Pediatric Health Information System. Pulmonary hypertension occurred in 370 out of 1677 (22%) infants. During the neonatal admission, pulmonary hypertension was associated with mortality (OR 3.15, 95% CI 2.10

EvidenceUpdates2018

19. Improved Outcomes in Preterm Infants Fed a Nonacidified Liquid Human Milk Fortifier: A Prospective Randomized Clinical Trial

Improved Outcomes in Preterm Infants Fed a Nonacidified Liquid Human Milk Fortifier: A Prospective Randomized Clinical Trial 30195561 2018 10 26 1097-6833 202 2018 Nov The Journal of pediatrics J. Pediatr. Improved Outcomes in Preterm Infants Fed a Nonacidified Liquid Human Milk Fortifier: A Prospective Randomized Clinical Trial. 31-37.e2 S0022-3476(18)30898-9 10.1016/j.jpeds.2018.07.005 To compare growth, feeding tolerance, and clinical and biochemical evaluations in human milk-fed preterm (...) infants randomized to receive either an acidified or a nonacidified liquid human milk fortifier. This prospective, controlled, parallel, multicenter growth and tolerance study included 164 preterm infants (≤32 weeks of gestation, birth weight 700-1500 g) who were randomized to acidified or nonacidified liquid human milk fortifier from study day 1, the first day of fortification, through study day 29 or until hospital discharge. There was no difference in the primary outcome of weight gain from study

EvidenceUpdates2018

20. Effects of a new device for automated closed loop control of inspired oxygen concentration on fluctuations of arterial and different regional organ tissue oxygen saturations in preterm infants

Effects of a new device for automated closed loop control of inspired oxygen concentration on fluctuations of arterial and different regional organ tissue oxygen saturations in preterm infants 30154236 2018 08 29 1468-2052 2018 Aug 28 Archives of disease in childhood. Fetal and neonatal edition Arch. Dis. Child. Fetal Neonatal Ed. Effects of a new device for automated closed loop control of inspired oxygen concentration on fluctuations of arterial and different regional organ tissue oxygen (...) saturations in preterm infants. fetalneonatal-2018-314769 10.1136/archdischild-2018-314769 To assess the efficacy of a newly developed system for closed loop control of the fraction of inspired oxygen (FiO 2 ) on variation of arterial (SpO 2 ) and on regional tissue oxygen saturation (StO 2 ) in preterm infants with fluctuations in SpO 2 . Randomised crossover trial comparing automated (auto) to manual FiO 2 adjustment (manual) during two consecutive 24 hours periods using a Sophie infant ventilator (SPO

EvidenceUpdates2018