Highlights in this issue

Abstract

The prevalence of smoking among pregnant women is decreasing but there seems to be a tendency of increased alcohol consumption during pregnancy. While the fetal alcohol syndrome (FAS) is rare, fetal alcohol spectrum disorders (FASD) were found to occur at a rate of 3.5% in an Italian affluent community. See commentary by Ulf Eriksson and the article by Taisto Sarkola and collaborators, who report about child maltreatment in connection to parental alcohol abuse in Finland (Page 1571). The incidence of respiratory distress increases in neonates according to a population study from Switzerland. A doubling of the incidence of respiratory distress occurred from 1974–2004. This was not only due to an increase of surviving preterm infants but also seen among full-term infants. The increase of caesarean sections from 5 to 30% may explain this finding. It is well-established that elective caesarean-section causes a deficient lung liquid absorption due to the lack of the stress of being born naturally. (Page 1577) Probiotics are hype. However, there are few studies showing that the addition of probiotics is of clinical value. In Australia, Colin Binns et al have demonstrated that by giving children milk containing probiotics and prebiotics the incidence of diarrhoea is significantly reduced. (Page 1646). Lilach Singer et al have estimated the use of complementary and alternative medicine by parents of asthmatic children. Surprisingly, they found that the more educated the parents, the more often they seek a rabbi's advice. (Page 1693). Finally, Johanna Edner and collaborators describe an extremely preterm infant, who developed hemophagocytic lymphohistiocytosis and was treated successfully. Although, this is a remarkable medical achievement, some colleagues have expressed concerns about the ethics. The girl is completely blind, probably autistic, and her teeth are black. However, she seems to be happy. My personal view is that an infant, who has started to become conscious, and bonding between the parents and the child has been established, should receive optimal care. This is not the same as with brain damaged neonates, who have never appeared to be conscious. (Page 1703). See my previous editorial (Acta Paediatr 2007;96:327–8).