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Latest & greatest articles for infants
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Early planned removal versus expectant management of peripherally inserted central catheters to prevent infection in newborn infants. BACKGROUND: 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. OBJECTIVES: 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. SEARCH METHODS: 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
Protein supplementation of human milk for promoting growth in preterm infants. BACKGROUND: 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. OBJECTIVES: 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. SEARCH METHODS: 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. SELECTION CRITERIA
Formula versus donor breast milk for feeding preterm or low birth weight infants. BACKGROUND: 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. Uncertainty exists about the balance of risks and benefits of feeding formula versus donor breast milk for preterm or LBW infants. OBJECTIVES: To determine the effect of feeding with formula compared with donor breast milk on growth and development in preterm or low birth weight (LBW) infants. SEARCH METHODS: We used the Cochrane Neonatal search strategy, including electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 6), Ovid MEDLINE, Embase
Fat supplementation of human milk for promoting growth in preterm infants. BACKGROUND: 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. OBJECTIVES: 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
The best of intentions: Prenatal breastfeeding intentions and infant health 30094314 2018 11 14 2352-8273 5 2018 Aug SSM - population health SSM Popul Health The best of intentions: Prenatal breastfeeding intentions and infant health. 86-100 10.1016/j.ssmph.2018.05.002 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
Spontaneous reversion of a lineage switch following an initial blinatumomab-induced ALL-to-AML switch in MLL-rearranged infant ALL 29898879 2018 11 14 2473-9537 2 12 2018 Jun 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
Association Between Oxygen Saturation Targeting and Death or Disability in Extremely Preterm Infants in the Neonatal Oxygenation Prospective Meta-analysis Collaboration. Importance: There are potential benefits and harms of hyperoxemia and hypoxemia for extremely preterm infants receiving more vs less supplemental oxygen. Objective: To compare the effects of different target ranges for oxygen saturation as measured by pulse oximetry (Spo2) on death or major morbidity. Design, Setting (...) , and Participants: Prospectively planned meta-analysis of individual participant data from 5 randomized clinical trials (conducted from 2005-2014) enrolling infants born before 28 weeks' gestation. Exposures: Spo2 target range that was lower (85%-89%) vs higher (91%-95%). Main Outcomes and Measures: 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
Optimal Target Range of Closed-Loop Inspired Oxygen Support in Preterm Infants: A Randomized Cross-Over Study 29571932 2018 05 26 1097-6833 197 2018 Jun The Journal of pediatrics J. Pediatr. Optimal Target Range of Closed-Loop Inspired Oxygen Support in Preterm Infants: A Randomized Cross-Over Study. 36-41 S0022-3476(18)30169-0 10.1016/j.jpeds.2018.01.077 To investigate the effect of different pulse oximetry (SpO 2 ) target range settings during automated fraction of inspired oxygen control (...) (A-FiO 2 ) on time spent within a clinically set SpO 2 alarm range in oxygen-dependent infants on noninvasive respiratory support. Forty-one preterm infants (gestational age [median] 26 weeks, age [median] 21 days) on FiO 2 >0.21 receiving noninvasive respiratory support were subjected to A-FiO 2 using 3 SpO 2 target ranges (86%-94%, 88%-92%, or 89%-91%) in random order for 24 hours each. Before switching to the next target range, SpO 2 was manually controlled for 24 hours (washout period
Repetitive versus standard tactile stimulation of preterm infants at birth - A randomized controlled trial 29580959 2018 06 04 1873-1570 127 2018 Jun Resuscitation Resuscitation Repetitive versus standard tactile stimulation of preterm infants at birth - A randomized controlled trial. 37-43 S0300-9572(18)30140-0 10.1016/j.resuscitation.2018.03.030 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 performed were noted. The main study parameter measured was respiratory minute volume, other study parameters assessed measures of respiratory effort; tidal volumes, rate of rise to maximum tidal volumes, percentage of recruitment breaths, and oxygenation
Preprocedural Ultrasound for Infant Lumbar Puncture: A Randomized Clinical Trial 29645365 2018 05 16 1553-2712 2018 Apr 12 Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Acad Emerg Med Preprocedural Ultrasound for Infant Lumbar Puncture: A Randomized Clinical Trial. 10.1111/acem.13429 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
Effect of non-nutritive sucking and sucrose alone and in combination for repeated procedural pain in preterm infants: A randomized controlled trial 29684832 2018 06 01 1873-491X 83 2018 Jul International journal of nursing studies Int J Nurs Stud Effect of non-nutritive sucking and sucrose alone and in combination for repeated procedural pain in preterm infants: A randomized controlled trial. 25-33 S0020-7489(18)30085-3 10.1016/j.ijnurstu.2018.04.006 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
Pulmonary Vein Stenosis in Infants: A Systematic Review, Meta-Analysis, and Meta-Regression 29650415 2018 04 13 1097-6833 2018 Apr 09 The Journal of pediatrics J. Pediatr. Pulmonary Vein Stenosis in Infants: A Systematic Review, Meta-Analysis, and Meta-Regression. S0022-3476(18)30218-X 10.1016/j.jpeds.2018.02.030 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
Efficacy and safety of pulmonary application of corticosteroids in preterm infants with respiratory distress syndrome: a systematic review and meta-analysis 29666203 2018 04 18 1468-2052 2018 Apr 17 Archives of disease in childhood. Fetal and neonatal edition Arch. Dis. Child. Fetal Neonatal Ed. Efficacy and safety of pulmonary application of corticosteroids in preterm infants with respiratory distress syndrome: a systematic review and meta-analysis. fetalneonatal-2017-314046 10.1136 (...) /archdischild-2017-314046 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
Cost-Effectiveness Analysis of Nasal Continuous Positive Airway Pressure Versus Nasal High Flow Therapy as Primary Support for Infants Born Preterm 29550238 2018 04 28 1097-6833 196 2018 May The Journal of pediatrics J. Pediatr. Cost-Effectiveness Analysis of Nasal Continuous Positive Airway Pressure Versus Nasal High Flow Therapy as Primary Support for Infants Born Preterm. 58-64.e2 S0022-3476(17)31769-9 10.1016/j.jpeds.2017.12.072 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 received endotracheal intubation and mechanical ventilation or surfactant. The economic evaluation was conducted from a healthcare sector perspective and the time horizon was from birth until death or first
Usefulness of an Online Risk Estimator for Bronchopulmonary Dysplasia in Predicting Corticosteroid Treatment in Infants Born Preterm 29551313 2018 05 26 1097-6833 197 2018 Jun The Journal of pediatrics J. Pediatr. Usefulness of an Online Risk Estimator for Bronchopulmonary Dysplasia in Predicting Corticosteroid Treatment in Infants Born Preterm. 23-28.e2 S0022-3476(18)30143-4 10.1016/j.jpeds.2018.01.065 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
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 29659924 2018 04 20 1537-6613 2018 Apr 12 The Journal of infectious diseases J. Infect. Dis. 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. 10.1093/infdis/jiy215 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 9- to 11-month old infants to measles (MV), yellow fever (YFV), and meningococcal A conjugate vaccines with or without pentavalent rotavirus vaccine (PRV). We assessed non-inferiority of seroconversion and seroresponse rates (<10% difference) to MV, YFV and MenAV. We compared the seroresponse to PRV
Early Caffeine and Weaning from Mechanical Ventilation in Preterm Infants: A Randomized, Placebo-Controlled Trial 29519541 2018 04 28 1097-6833 196 2018 May The Journal of pediatrics J. Pediatr. Early Caffeine and Weaning from Mechanical Ventilation in Preterm Infants: A Randomized, Placebo-Controlled Trial. 52-57 S0022-3476(18)30010-6 10.1016/j.jpeds.2018.01.010 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 ready for extubation. The placebo group received a blinded loading dose of caffeine before extubation. Infants were randomized to receive caffeine (n = 41) or placebo (n = 42). Age at first successful extubation did not differ between early caffeine
Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease | Circulation Search for this keyword Search Search for this keyword Search Header Publisher Menu AHA Scientific Statement Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease A Scientific Statement From the American Heart Association Bradley S. Marino , Sarah Tabbutt , Graeme MacLaren , Mary Fran Hazinski , Ian Adatia (...) outcomes with postresuscitation care. The American Heart Association (AHA) has published guidelines for pediatric basic life support since 1980 and for pediatric advanced life support (PALS) since 1986. These guidelines have been based on research involving both animals and infants, children, and adult human subjects and provide recommendations for resuscitation of infants and children with structurally normal hearts. The most recent guidelines update, published in 2015, , focused on the quality
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 29868243 2018 11 14 2059-7908 3 3 2018 BMJ global health BMJ Glob Health 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. e000687 10.1136/bmjgh-2017-000687 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 to improve IYCF practices. We evaluated the effectiveness of an innovative behavioural change strategy on caregiver's knowledge, IYCF practices and nutritional status of children from low-income households in El Alto, Bolivia. Home
Effect of Vitamin D Supplementation on Recurrent Wheezing in Black Infants Who Were Born Preterm: The D-Wheeze Randomized Clinical Trial. Importance: 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. Objective: To assess the effectiveness of 2 vitamin D dosing strategies in preventing recurrent wheezing. Design (...) , Setting, and Participants: 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. Interventions: 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