Yearly influenza immunization is recommended in patients with inflammatory bowel disease (IBD). However, concern regarding vaccine-related adverse events may limit uptake, and case reports in the literature detail disease flares after immunization.

Influenza immunization rates in children with IBD are low but immunization did not result in increased outpatient visits, hospitalizations or emergency visits. Immunization was associated with fewer IBD-related visits in the post-vaccine period, which may indicate protection against IBD symptoms. (Read the full article)

Cognitive behavioral therapy is an effective and safe treatment of chronic fatigue syndrome in children and adolescents. After 6 months, Internet-based cognitive behavioral therapy in the form of FITNET led to an 8 times higher chance of recovery compared with usual care.

The positive effects of FITNET were maintained at long-term follow-up (>2.5 years).Patients following usual-care treatment achieve similar recovery rates at long-term follow-up. (Read the full article)

Pharmacologic treatment with sapropterin dihydrochloride (6R-tetrahydrobiopterin; BH4) has been an effective option for some phenylketonuria patients since its approval by the US Food and Drug Administration in 2007 and the European Medicines Agency in 2008.

This retrospective multicenter study revealed the long-term effects of sapropterin on metabolic control, dietary tolerance, and the outcome of BH4-responsive phenylketonuria patients harboring specific phenotypes and genotypes. It also confirmed that the minor adverse events disappeared by lowering the dose. (Read the full article)

Cross-sectional studies in children and adults have reported a significant positive association between attention-deficit/hyperactivity disorder (ADHD) and obesity.

This controlled, prospective, follow-up study of boys with ADHD found significantly higher BMI and obesity rates in adulthood, compared with men without childhood ADHD, regardless of socioeconomic status and other lifetime mental disorders. (Read the full article)

Physicians have little knowledge of health care costs and charges. Studies suggest that education and awareness of hospital finances can decrease unnecessary utilization of resources. Little is known about pediatricians’ awareness of the economics of health care delivery in the inpatient setting.

Both general pediatric attending physicians and trainees acknowledged a limited understanding of hospital finances, and they demonstrated a lack of awareness of costs, charges, and reimbursements for inpatient care. (Read the full article)

Preterm neonates in resource-poor settings frequently develop hypothermia. Plastic bags or wraps are a low-cost intervention for the prevention of hypothermia in infants in developed countries.

For preterm infants born in a resource-poor health facility, placement in a plastic bag at birth can reduce the incidence of hypothermia at 1 hour after birth. (Read the full article)

Infants born late-preterm and early-term are at higher risk of morbidity and mortality compared with term infants. Home care practices recommended for all infants include supine sleep position, no smoke exposure, and breastfeeding to optimize health outcomes.

Our study provides new findings on the timing of hospital discharge, outpatient follow-up, and home care of late-preterm and early-term infants compared with term infants in the United States. (Read the full article)

Significant variation in the mortality of preterm infants has been observed among NICUs. Factors explaining this variation have been difficult to identify.

Sizable center differences in mortality exist, even among similarly sized NICUs in academic centers. Patient characteristics and center treatment rates explain some of the center effect, especially for the youngest infants, but a significant portion of these differences remains unexplained. (Read the full article)

Health care professionals face problems managing obesity and often fail to follow guidelines for its management in practice. Only a few single-country reports are available describing delivery of primary care to children with obesity.

Nearly all primary pediatric care providers from 4 European countries recognize the importance of obesity in pediatric practice, but only half use BMI clinically, and many lack the confidence and the infrastructure needed for providing care to patients with obesity. (Read the full article)

Feeding difficulties often emerge during the neonatal period and affect neonatal growth. Growth throughout the first years of life is associated with children’s IQ scores and risk of behavioral problems.

Among infants born full term (≥37 weeks’ gestation) with birth weight ≥2500 g, gain in weight and head circumference during the neonatal period is associated with higher IQ, but not with behavior at 6.5 years of age. (Read the full article)

Studies have highlighted a lack of patient awareness of potential increased cancer risks associated with computed tomography (CT) scans in adult patients and in nonurgent settings. However, little is known about parental awareness of these risks in an emergency setting.

Approximately half of parents were aware of the potential cancer risks from CT scans in an emergency setting. Although risk disclosure moderately reduced willingness to proceed with recommended testing, almost all parents preferred an informed discussion before CT imaging. (Read the full article)

Obstacles to vaccine delivery, including poverty, reduced access to medical care, and incomplete understanding of vaccine safety and importance, result in suboptimal coverage rates in some populations, allowing for disease outbreaks. Multicomponent interventions are successful in increasing immunization coverage rates.

We show that collaboration with local resources, including the county health department and a large community-based organization, effectively increases immunization coverage rates in low-income, resource-poor children. (Read the full article)

The natural history of asthma during adolescence is dynamic because both remission and relapse are common. Remission has consistently been associated with mild asthma and the absence of sensitization.

One in 5 children with asthma remitted from age 7 to 19. Remission was defined as no wheezing and no medication for ≥3 years and was inversely related to female gender, sensitization to furred animals, and asthma severity at baseline. (Read the full article)

Data available before the 1990s in addition to small studies with clinical populations have shown that ocular growth and development differ between extremely preterm and term-born children.

Contemporary data on long-term visual outcomes indicate that adolescents born extremely low birth weight and/or extremely preterm exhibit more visual sensory and perceptual morbidity than adolescents born at term. (Read the full article)

Preterm and low birth weight infants are at increased risk of hospitalization due to rotavirus gastroenteritis, and rotavirus vaccine is immunogenic and well tolerated among these infants when provided at or after discharge from the NICU.

Many preterm infants with a birth weight of ≤1500 g are not eligible to receive rotavirus vaccination because they remain in the NICU beyond the upper age limit recommended for immunization. New strategies are needed. (Read the full article)

Persons with sickle cell anemia are known to have increased medical expenses, but little is known about the effects of hydroxyurea treatment on costs. In adults with severe sickle cell anemia, hydroxyurea has been reported to reduce expenses from hospitalization.

In this randomized placebo-controlled prospective multicenter trial of hydroxyurea in very young children with sickle cell anemia, not selected for severity, hydroxyurea was associated with significant medical cost savings due to a reduction in hospitalization expenses. (Read the full article)

Surviving infants with hypoxic ischemic encephalopathy (HIE) treated with hypothermia have decreased rates of CP in childhood. CP is associated with increased risk of slow growth.

Term children with HIE who develop moderate/severe CP are at high risk of progressive impaired growth, high rates of cognitive impairment, and rehospitalizations from infancy to school age. Gastrostomy tube placement to facilitate feeds is protective of slow growth. (Read the full article)

The etiology of childhood cancers is largely unknown. However, excessive fetal growth has been associated with some childhood cancers. One of the most consistent findings is that high birth weight is associated with an increased risk of childhood leukemia.

Examining large, population-based birth and cancer registry data from 4 Nordic countries, high birth weight was the most strongly associated with risk of many childhood cancers among several measures of fetal growth that have not previously been extensively assessed. (Read the full article)

Recent guidelines for the management of childhood pneumonia recommend narrow-spectrum antimicrobial agents (eg, ampicillin) for most children; however, few studies have directly compared the effectiveness of narrow-spectrum agents to the broader spectrum third-generation cephalosporins commonly used among children hospitalized with pneumonia.

By using data from 43 children’s hospitals in the United States, we demonstrate equivalent outcomes and costs for children hospitalized with pneumonia and treated empirically with either narrow- (ampicillin/penicillin) or broad-spectrum (ceftriaxone/cefotaxime) antimicrobial therapy. (Read the full article)

Several studies have suggested that very low birth weight young adults have increased risks of physical and health problems, educational underachievement, and poorer social functioning than their peers, but there are limited population-based and longitudinal data.

Former VLBW young adults in this national cohort scored as well as term controls on many measures of health and social functioning, including quality-of-life scores, with some differences largely confined to those with disability at age 7 to 8 years. (Read the full article)

One study examined the incidence of obesity among low-income children aged <5 years who participated in federally funded child health and nutrition programs during 1985–1990. The study examined the variations by baseline age but not by gender or race/ethnicity.

This study provides most recent data on incidence and reversing of obesity and variations across gender, baseline age, and racial/ethnic subgroups among young low-income children. We conducted multivariable analyses to examine the relative risk of obesity in population subgroups. (Read the full article)

Better postnatal growth, especially head growth, associates with better cognitive development in preterm infants. Suboptimal postnatal growth is more common in infants with poor antenatal growth than in infants with normal growth.

Good weight gain and head circumference growth until 2 years was associated with better 5-year cognitive outcome in non–small for gestational age infants. Good head circumference growth around term age benefits the cognitive outcome of small for gestational age infants. (Read the full article)

Screening for autism spectrum disorders (ASDs) using the Modified Checklist for Autism in Toddlers (M-CHAT) improves early detection and long-term prognosis of ASD. Reducing the false-positive rate may increase implementation of screening for ASDs.

The Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT-R/F), simplifies wording of the original M-CHAT. The current validation study indicates that the M-CHAT-R/F improves the ability to detect autism spectrum disorders in toddlers screened during well-child care visits. (Read the full article)

Bacille Calmette-Guerin (BCG) vaccination may provide benefits beyond protecting against pediatric tuberculosis. Evidence suggests links between cell-mediated immunity from tuberculosis and bacterial/viral-related pneumonia but the impact of BCG on acute lower respiratory infection is not fully known.

BCG-vaccinated children had a lower risk of suspected acute lower respiratory infection. Protection was amplified when children were vaccinated against diphtheria-tetanus-pertussis (DTP). Number of DTP doses did not modify this effect, but order in which vaccines were received did. (Read the full article)

Preterm infants dependent on parenteral nutrition are vulnerable to deficits in early postnatal nutritional intake. This coincides with a period of suboptimal head growth. Observational studies indicate that poor nutritional intake is associated with suboptimal head growth and neurodevelopmental outcome.

This study provides randomized controlled trial evidence that head growth failure in the first 4 weeks of life can be ameliorated with early nutritional intervention. Early macronutrient intake can be enhanced by optimizing a standardized, concentrated neonatal parenteral nutrition regimen. (Read the full article)

Fetal growth restriction, particularly in preterm children, is associated with delayed development and poor growth. Knowledge about the consequences of fetal growth restriction if classified by symmetry is lacking, especially in preterm children.

In preterm children, symmetric and asymmetric growth restriction at birth results in poorer growth later in life. Both groups are at considerable risk of developmental delay because their long-term development is independent of their head circumference at birth. (Read the full article)

Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss and neurodevelopmental impairment in full-term infants. The incidence of congenital CMV infection in preterm infants and the possible associations with developmental outcomes are unknown.

This study defines the incidence of congenital CMV infection in very low birth weight infants and identifies strong associations of congenital CMV infection with hearing loss and adverse neurodevelopmental outcomes in this population. (Read the full article)

In children with congenital toxoplasmosis, ocular lesions can be detected and may relapse after birth despite pre- and postnatal treatment. Long-term ocular outcome beyond puberty and associated prognostic factors are unknown due to limited follow-up.

Our study in 477 patients with treated congenital toxoplasmosis who were followed up to 22 years indicated that new ocular lesions can be detected well into adolescence (with a cumulative probability at 18 years of almost 50%), but they rarely cause severe visual impairment. (Read the full article)

There is conflicting evidence about the relationship between dental caries in primary teeth and children’s height and weight.

Findings reveal an inverse linear association between caries levels and children’s height and weight. The findings take the argument beyond the presence or absence of an association and provide a better understanding of the pattern of this association. (Read the full article)

Preterm (PT) birth is negatively associated with growth. Particularly small for gestational age PT infants are at risk for delays in growth, whereas knowledge about the consequences regarding growth of large for gestational age PT birth is lacking.

During infancy, growth in height, weight, and head circumference of large for gestational age PT infants was well balanced and sufficient. Subsequently, however, weight gain accelerated and resulted in high BMIs compared with the World Health Organization Multicentre Growth Reference Study population. (Read the full article)

Prenatal lipid-based nutrient supplementation has been demonstrated to increase birth length. However, the impact of this intervention on infant growth and morbidity is unknown.

Infants from mothers who were given prenatal lipid-based nutrient supplements showed decelerated linear growth. The gain in length at birth related to prenatal lipid-based nutrient supplementation was not sustained during infancy. (Read the full article)

Rapid and reliable tools for the diagnosis of neonatal sepsis are still unavailable. No single biomarker studied has yielded conclusive results. Genome-wide expression profiles (GWEPs) have been successfully determined for the diagnosis of sepsis in pediatric and adult populations.

GWEPs are described for the first time in very low birth weight infants with proven bacterial sepsis. Our results suggest that GWEPs could be used for early discrimination of septic newborn versus nonseptic infants. (Read the full article)

In parts of sub-Saharan Africa, sexual assault incidence among adolescents is as high as 24%, resulting in serious physical and mental health problems. In the United States, empowerment and self-defense training have been shown to decrease incidence of sexual assault.

This study evaluated an empowerment and self-defense training intervention for adolescent girls in the African context. This intervention proved highly effective at preventing sexual assault and should be replicable in other countries in sub-Saharan Africa and around the world. (Read the full article)

Down syndrome is an independent risk factor for severe respiratory syncytial virus infection and subsequent hospitalization.

This observational study suggests that immunoprophylaxis may reduce respiratory syncytial virus-related hospitalization by 3.6-fold (95% confidence interval, 1.5–8.7) in children with Down syndrome overall. (Read the full article)

Several experimental and observational studies reveal an association between exposure to alcohol consumption in movies and youth drinking, but little is known about the effect of such exposure on drinking onset among low-risk adolescents.

In a longitudinal study, exposure to alcohol consumption in movies was associated with drinking initiation in a sample of adolescents from 6 European countries who had never drunk alcohol and were attitudinally nonsusceptible to future use at the time of exposure. (Read the full article)

Inadequate nutrient intake can compromise a child’s nutritional status, which may affect immune function. Improving dietary intake via a follow-up formula may support appropriate immune responses and improve a child’s ability to resist infection.

Children who consumed an experimental follow-up formula had fewer episodes and shorter duration of acute respiratory infections, as well as less antibiotic treatment, and fewer days missed of day care due to illness. (Read the full article)

Adverse childhood experiences have been shown to have long-term impacts on health and well-being. However, little work has been done to incorporate the voices of youth in understanding the range of adverse experiences that low-income urban children face.

Study participants cited a broad range of adverse experiences beyond those listed in the initial adverse childhood experience studies. Domains of adverse experiences included family relationships, community stressors, personal victimization, economic hardship, peer relationships, discrimination, school, health, and child welfare/juvenile justice systems. (Read the full article)

Mixed results exist regarding the efficacy of caregiver-mediated interventions for children who have ASD. To date, randomized controlled studies have rarely compared 2 active interventions; none have focused on targeting families who are low-resourced in the community.

Significant improvements were found in social communication of children who have autism when caregivers received a hands-on caregiver training intervention in the home. These are the first data from a low-intensity, short-term intervention with low-resourced families. (Read the full article)

Compared with their peers, pediatric residents who report exposure to community settings anticipate greater future community involvement at the end of training. The impact of community pediatrics training on actual future community involvement is not known.

Pediatricians exposed to enhanced community pediatrics training during residency report greater participation in community activities and greater related skills than their peers nationally. (Read the full article)

Available bowel preparation solutions for colonoscopy continue to represent a challenge for children and their families due to poor taste, high volume, and dietary restrictions with subsequent poor compliance and need to place nasogastric tube for administration.

Low-volume polyethylene glycol (PEG) preparations and sodium picosulphate plus magnesium oxide and citric acid (NaPico+MgCit) are noninferior to PEG 4000 with simethicon for bowel preparation before colonoscopy in children. Given its higher tolerability and acceptability profile, NaPico+MgCit should be preferred in children. (Read the full article)

As the number of chronically ill children grows in the United States, end-of-life discussions and advance directives (AD) will become increasingly important. Although pediatric palliative care is gaining interest, little is known about parental preferences regarding ADs for chronically ill children.

Knowledge about ADs is limited among caregivers of children who have chronic illness. However, interest in creating ADs is high, suggesting an unmet need and opportunity for health care providers to improve the care of children who have chronic illness. (Read the full article)

Delaying cord clamping beyond 30 to 60 seconds after birth seems beneficial for all infants due to blood transfusion from placenta. Experimental data have demonstrated that ventilation implemented before cord clamping improved cardiovascular stability by increasing pulmonary blood flow.

Healthy self-breathing neonates in a low-resource setting are more likely to die if cord clamping occurs before or immediately after onset of spontaneous respirations. The risk of death/admission decreases by 20% for every 10-second delay in clamping after breathing. (Read the full article)

Graduating from high school is associated with better health and health behaviors. However, no rigorous studies have tested whether exposure to a high-performing school improves health or health behaviors, thus the causal relationship is unknown.

Exposure to successful schools can reduce very risky health behaviors among low-income adolescents. The primary mechanism is mostly due to better school retention and also due to better academic achievement. (Read the full article)

Supplemented mother’s own milk is the preferred nutrition for very low birth weight infants.

Through targeted encouragement and guidance, most mothers are able to provide milk to their very low birth weight infants, both for early and prolonged feeding, in an open-bay NICU. (Read the full article)

Growth failure has been frequently reported in children who have obstructive sleep apnea syndrome (OSAS) owing to adenotonsillar hypertrophy. Adenotonsillectomy (AT) has been reported to accelerate weight gain in children who have OSAS in nonrandomized uncontrolled studies.

This randomized controlled trial of AT for pediatric OSAS demonstrated significantly greater weight increases 7 months after AT in all weight categories. AT normalizes weight in children who have failure to thrive, but increases risk for obesity in overweight children. (Read the full article)

Term MRI can assist in identifying the nature and extent of brain injury in preterm infants. However, brain injury detected by MRI does not fully account for neurodevelopmental impairments, particularly cognitive and behavioral impairments, common in preterm survivors.

In addition to brain injury, an assessment of brain growth by using one-dimensional measurements on MRI is helpful for predicting neurodevelopment. Two different patterns of impaired brain growth are observed that relate independently to early cognitive development in preterm infants. (Read the full article)

A previous study suggested that spine and pelvis views may be omitted from the follow-up skeletal survey protocol for suspected child abuse, when these views are normal on the initial skeletal survey, without limiting the sensitivity of the study.

This multicenter study provides estimates of the risk of missing occult fractures in the evaluation of suspected child abuse with omission of spine and pelvis views from the follow-up skeletal survey protocol. Results may be used to update practice recommendations. (Read the full article)

Lower respiratory tract infections (LRTIs), including pneumonia, are in the top 10 causes of death among children in the United States. In high-income countries, 3% to 14% of LRTI hospitalizations have been reported to require admission to an ICU.

During 2007–2011, approximately 31 289 hospitalizations for severe LRTI occurred in children each year in the United States. Children <1 year of age had the highest rates of severe LRTI and accounted for 30% of severe LRTI hospitalizations. (Read the full article)

Adolescent males from low-income communities are a group at increased risk of obesity and related health concerns. Obesity prevention interventions targeting adolescents have so far had mixed success. Targeted interventions, tailored for specific groups, may be more appealing and efficacious.

A multicomponent school-based intervention using smartphone technology can improve muscular fitness, movement skills, and key weight-related behaviors among low-income adolescent boys. (Read the full article)

Growth impairment in sickle disease has been a consistent finding in published reports. Hydroxyurea (HU) decreases vasoocclusive events and increases hemoglobin levels, which may improve growth. However, HU may adversely affect growth in young children by its effect on DNA synthesis.

Height, weight, and head circumference were normal in HU-treated children in the study as compared with the World Health Organization standards. Height, weight, and BMI z scores were similar in placebo and treatment groups. There were no harmful effects of HU on growth. (Read the full article)