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Pediatrics

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Child Health and Learning

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Selected child topics from InfoMedSearch InfoMedLinks and a new topic: Health-Environment and Learning.

  • Subtopics include: Bullying, Classroom Environment, General Information, Guidelines, Internet Sites, Healthy Childhood, Online-Electronic Environment, and Teaching Methods

Breastfeeding

NIH – Breastfeeding (Medical Encyclopedia) “Recommendations: Choosing how and what to feed your baby is a personal decision that deserves careful and thorough consideration. Breast milk is the natural nutritional source for infants less than one year of age. Most health care professionals (including the American Academy of Pediatricians and the National Association of Pediatric Nurse Associates and Practitioners) recommend breastfeeding for your baby's first year. Breast milk is the best source of nutrition for the first 6 months of life. It contains appropriate amounts of carbohydrate, protein, and fat, and provides digestive enzymes, minerals, vitamins, and hormones that infants require. Breast milk also contains antibodies from the mother that can help the baby resist infections. Experts agree that breastfeeding your baby for any length of time, regardless of how short, is of benefit to you and your baby. You can provide your baby with breast milk directly by breastfeeding or by feeding your baby breast milk from a bottle. ... ADVANTAGES OF BREASTFEEDING Research shows that breastfed babies may have less frequent: • Ear infections • Stomach or intestinal infections • Low iron levels in the blood (iron-deficiency anemia) • Skin diseases (infantile eczema) • Infant allergies Breastfed babies may have less risk of developing: • Digestive problems such as constipation or diarrhea • Obesity or becoming overweight • High blood pressure • Diabetes • Tooth decay”

NIH – Breastfeeding “What are the benefits of breastfeeding? Breastfeeding offers many benefits to the baby: Breast milk provides the right balance of nutrients to help an infant grow into a strong and healthy toddler. Breastfed infants, and those who are fed expressed breast milk, have fewer deaths during the first year and experience fewer illnesses than babies fed formula. Some of the nutrients in breast milk also help protect an infant against some common childhood illnesses and infections, such as diarrhea, middle ear infections, and certain lung infections. Some recent NICHD-supported research also suggests that breast milk contains important fatty acids (building blocks) that help an infant's brain develop. Two specific fatty acids, known as DHA and AA, may help increase infants’ cognitive skills. Many types of infant formulas available in the United States are fortified with DHA and AA, and all formula available for preterm infants is fortified with these fatty acids.”

NHS - Breast-feeding (Video)

Highlighted Articles

Breastfeeding and Child Cognitive Development (Arch Gen Psychiatry. 2008) “Conclusion These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development.”

Advances in our understanding of the biology of human milk and its effects on the offspring. (J Nutr. 2007) "The most important short-term immunological benefit of breast-feeding is the protection against infectious diseases. There is also some evidence of lower prevalence of inflammatory bowel diseases, childhood cancers, and type I diabetes in breast-fed infants, suggesting that breast-feeding influences the development of the infant's own immune system. One of the most consistent findings of breast-feeding is a positive effect on later intelligence tests with a few test points advantage for breast-fed infants."

Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations? (Am J Clin Nutr. 2007) "That review concluded that infants exclusively breastfed for 6 mo experienced less morbidity from gastrointestinal infection and showed no deficits in growth but that large randomized trials are required to rule out small adverse effects on growth and the development of iron deficiency in susceptible infants. Others have raised concerns that the evidence is insufficient to confidently recommend exclusive breastfeeding for 6 mo for infants in developed countries, that breast milk may not meet the full energy requirements of the average infant at 6 mo of age, and that estimates of the proportion of exclusively breastfed infants at risk of specific nutritional deficiencies are not available. Additionally, virtually no data are available to form evidence-based recommendations for the introduction of solids in formula-fed infants. Given increasing evidence that early nutrition and growth have effects on both short- and longer-term health, it is vital that this issue be investigated in high-quality randomized studies."

Immunization

NIH - Immunizations - general overview (Medical Encyclopedia) “IMMUNIZING CHILDREN: Babies get so many shots these days! Many parents are concerned that the sheer number of vaccines might overwhelm, weaken, or use up a baby's immature immune system. But a baby's immune system is built to make antibodies to as many as 10,000 foreign proteins. If a baby were to receive all 11 available vaccines at once, this would engage only a tiny fraction of the immune system. … IMMUNIZATION SCHEDULE The recommended immunization schedule is updated at least every 12 months by organizations such as the American Academy of Pediatrics. Consult your primary care provider about specific immunizations for you or your child. The current recommendations are available on the Centers for Disease Control and Prevention (CDC) website at www.cdc.gov/vaccines. At every doctor visit, ask about the next recommended immunizations.”

NIH - Childhood Immunization “Vaccines help make you immune to serious diseases without getting sick first. Without a vaccine, you must actually get a disease in order to become immune to the germ that causes it. Vaccines work best when they are given at certain ages. For example, children don't receive measles vaccine until they are at least one year old. If it is given earlier it might not work as well.”

CDC - Recommended Immunization Schedules for Persons Aged 0--18 Years --- United States, 2008

CDC - Immunization Schedules (USA)

Childhood Vaccines: What They Are and Why Your Child Needs Them “Are there any reasons my child should not be vaccinated? In some special situations, children shouldn't be vaccinated. For example, some vaccines shouldn't be given to children who have certain types of cancer or certain diseases, or who are taking drugs that lower the body's ability to resist infection. The MMR vaccine shouldn't be given to children who have a serious allergy to eggs. If your child has had a serious reaction to the first shot in a series of shots, your family doctor will probably talk with you about the pros and cons of giving him or her the rest of the shots in the series. Talk to your doctor if you have any questions about whether your child should receive a vaccine.”

CDC - Common Questions Parents Ask about Infant Immunizations

NHS – Childhood immunisations (UK) “Childhood immunisation prevents a large variety of diseases. These include: Tetanus. An infection found in the soil that causes severe muscle contractions and breathing difficulties. Polio (short for poliomyelitis). A virus that first attacks the gut (bowel) but then travels to the nervous system. Polio can cause paralysis (when you can't move your limbs) in one or more parts of your body. Pneumococcal infections. These can affect anyone, but young children are at an increased risk of developing serious complications such as meningitis. Diphtheria. A highly contagious disease caused by a bacterium called Corynebacterium diphtheriae. It causes a serious throat and chest infection. Meningitis C. Caused by the meningococcus group c bacterium. In rare cases it can lead to blood poisoning and serious types of meningitis. Hib (full name is haemophilus influenzae type b). A bacterium that can cause pneumonia and meningitis. Whooping cough (pertussis) - causes prolonged coughing that can be very distressing. In children, complications can include brain damage. Measles. Caused by the measles virus and can result in a serious fever and rash. In severe cases, measles can be fatal. Mumps. Caused by the mumps virus. Mumps usually leads to inflammation and swelling of the salivary glands (the glands located just below the ears). In severe cases this can cause deafness. Rubella (also know as German measles). Caused by the rubella virus and can lead to a mild illness and rash. In later life rubella can be serious to an unborn child as it can potentially lead to several birth defects. Other immunisations Some children may require additional immunisations that are not part of the childhood immunisation programme. Your GP will be able to advise you if your child requires any further immunisations. These may include immunisations if your child has a chronic condition.”

Highlighted Article

Thimerosal exposure in infants and neurodevelopmental disorders: An assessment of computerized medical records in the Vaccine Safety Datalink. (J Neurol Sci. 2008) “Routine childhood vaccination should be continued to help reduce the morbidity and mortality associated with infectious diseases, but efforts should be undertaken to remove Hg from vaccines.”

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Pediatrics

Diagnosis, Imaging, and Screening

NEWS:

Bipolar Disorder Amongst Children And Adolescents Receive Late Diagnosis “Both diagnostic delay and error with paediatric bipolar disorder are related, according to Escamilla, with the distinct presentation of the disorder in children and adults. Amongst children, the most common mood change is irritability, while in adults a typical manifestation is euphoria and expansiveness. In fact, a symptom like euphoria, related to bipolar disorder, appears in at least half of the paediatric patients. In this vein the specialist points to the fact that the key lies in evaluating the type of irritability, a manifestation that also appears in depression disorders. In paediatric bipolar disorder, the characteristic irritability is explosive and severe. On occasions significant violence happens in short or sporadic outbursts, and often this is not reactive to anything or the trigger is minimum. It can be confused with a tantrum, but is much more disproportionate. Likewise, she added, unlike the progress of the illness amongst adults, the episodes in children are not clearly defined: very frequent changes in mood and these fluctuating rapidly. Rarely does a sufferer have a period of at least two months without symptoms. This form of instability means that the illness is highly disabling. Also, symptoms such as euphoria and expansiveness appear in child patients, but with less frequency than in adults and with other characteristics: expansiveness in a child may manifest itself at school, where it is deemed by the patient that he or she has more authority than the teacher, who is thus defied, and is then interpreted as a behaviour problem. Also observed is social non-inhibition amongst these children. For example, making derogatory or rude comments in a loud voice about other persons in public or even of sexual content inappropriate for his or her age, remarked the specialist.”

Swine Flu and Kids: Heed Warning Signs, MDs Say “Flu viruses can damage cilia, the hair-like fibers lining the respiratory tract that move bacteria and mucous "where we can cough them out" of the lungs, he explained. That can make people susceptible to pneumonia and other bacterial infections -- a scenario blamed for many flu deaths in otherwise healthy children and adults, he said. In these cases, flu patients often appear to get better, but then fever and a cough return. Authorities urge parents to seek immediate help if emergency warning signs develop. In children, these are: - Fast or troubled breathing. - Bluish skin color. - Lack of thirst. - Failure to wake up easily or interact. - Irritability so that the child does not want to be held. - Improvement of symptoms, then a return to fever and worse cough. - Fever with a rash. Parents should also seek medical help if flu symptoms develop in children most vulnerable to flu complications: those younger than 5 or with high-risk conditions, including asthma and other lung problems; cerebral palsy, epilepsy and other neurological diseases; heart, kidney or liver problems; and diabetes. A recent report from the CDC found that one-third of pediatric deaths from the new H1N1 virus were in children like Max, with no known underlying condition that would put them at risk. “

USPSTF Recommends Screening Teens for Major Depressive Disorder

When Should A Head-Injured Child Have A CT Scan?

ARTICLES:

JOURNAL ARTICLES:

[Early development of childhood-onset schizophrenia] (Fortschr Neurol Psychiatr. 2009) “Childhood-onset schizophrenia (COS, age of onset between 7 and 14 years) is a rare and severe form of the disorder. The prevalence is about 1 / 50 of the rate of adult-onset schizophrenia. In COS-children emotional, cognitive and behavioural abnormalities are often seen years before illness onset. Premorbid symptoms including social withdrawal, isolation, introversion, peculiar behaviour, unmotivated temper tantrums, auto- and heteroaggressive acts, suicidal thoughts, anxiousness, paranoid ideas, represent early warning symptoms and are associated with an unfavourable outcome. About 60 % of 67 patients with COS examined by us (44 long-term-, 23 short-term-follow-up examinations) demonstrated premorbid abnormalities prior to the onset of their psychosis.”

Imaging of Back Pain in Children (American Journal of Neuroradiology 2009)

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