Course Of Infants Research Articles

Commercial milk formula marketing entry points: setting the course of infant and young child feeding trajectories

BackgroundThere is a limited understanding of the dynamic influences that shape infant and young child feeding (IYCF) decisions over time. We conducted an innovative qualitative study to reconstruct IYCF trajectories across early life course phases, in the context of the socioecological model (SEM) and the commercial determinants of IYCF.MethodsWomen of different socioeconomic status were interviewed in two large metropolitan areas in Mexico. Our specific goal was to allow us to better understand if and how the commercial milk formula (CMF) marketing influenced breastfeeding decisions in a complex dynamic way involving the individual, relational, community and societal levels.ResultsHospitals, health professionals, and interactions with social media were key category entry points throughout the prenatal, perinatal, early infancy period and beyond. The CMF industry interfered by engaging a wide array of actors across the different layers of the SEM, most prominently the health care system and the workplace. Through its marketing strategies the CMF operates subconsciously and its messages are most effective when health institutions, health care providers, workplace spaces and social norms are weak in their support for breastfeeding.ConclusionsThe cases in our study highlight how, together with a weak breastfeeding counseling system, and health professionals who lack training in breastfeeding and normal infant behavior, lead to the opportunity for CMF marketing to shape infant feeding, and ultimately to the decision to feed formulas that some mothers were not planning to use and cannot afford.

Clinical and laboratory features of COVID-19 in newborns. Analysis of a severe clinical case

Background. Since the onset of the coronavirus disease 2019 (COVID-19) epidemic until January 1, 2024, more than 5.5 million confirmed cases of COVID-19 have been detected in Ukraine according to official data, approximately 6 % of them among children under 18 years old. Aim: to improve the management of newborns based on studies of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection with different course. Materials and methods. Eleven newborns (7 boys and 4 girls) diagnosed with SARS-CoV-2 confirmed by polymerase chain reaction were observed. Disease progression, results of laboratory and instrumental studies were analyzed. Results. An analysis of clinical data and the results of laboratory and instrumental investigations are presented, as well as treatment outcomes in newborns with confirmed COVID-19. It was found that in all cases, children were infected from mothers with SARS-CoV-2. The frequency of clinical symptoms is provided, revealing discrepancies between respiratory symptoms and changes identified on lung ultrasound. Most children exhibited anemia, elevated D-dimer levels in the blood, yet experienced a mild course of the disease. The average duration of illness prior to hospitalization was 3.70 ± 1.48 days, with a hospital stay of 4.01 ± 1.22 days. An exception was in case of patient N., characterized by a severe condition necessitating prolonged oxygen therapy, mechanical ventilation, and administration of remdesivir. This particular case is detailed in the article. Conclusions. In most infants under one month of age observed in this study, the course of ­COVID-19 caused by SARS-CoV-2 was characterized by symptoms such as lethargy, hyperthermia, nasal congestion, diarrhea, and changes detected only through laboratory and instrumental stu­dies: anemia, abnormalities in the coagulation system, and increased lung parenchymal density. Ho­wever, the disease course in infants of this age can also be very severe, with lung parenchymal involvement, pneumonia, COVID-19-associated coagulopathy, complicated by generalized bacterial infection, as presented in the clinical case.

Natural course of perianal abscess in infants: a real-world study

Natural course of perianal abscess (PA) in infancy remains obscure. This study aimed to investigate the natural course of infants with PA after conservative treatment. A retrospective cohort study was conducted in infants with PA who were treated conservatively (due to the parents’ refusal of surgery), for more than 2 months between 2014 and 2020 at a single tertiary center. 153 patients (149 boys and 4 girls) were identified. The median follow-up was 5.3 years (range 3–8.2 years). Initially, 119 patients (77.8%) were completely cured by conservative treatment, and 34 (22.2%) failed. Among the 34 patients, 23 continued conservative treatment (20 cure, 3 fistula formation) and 11 underwent surgery. After conservative treatment, the rate of fistula formation, abscess recurrence, and new-onset abscess were 15.0%, 4.6%, and 6.5%, respectively. Overall, 139 patients (90.8%) were cured conservatively without surgery, and 11 (7.2%) underwent surgical management. In addition, 3 (2.0%) patients developed fistula-in-ano (under observation). PA in infants may be a time-limited and self-limited condition. Conservative management should be the first choice of treatment in most cases. Longer periods of conservative treatment may achieve better clinical outcomes in selected cases. There will be a percentage of patients (about 10%) that would require surgical treatment.

Perioperative and Long-Term Outcomes in Infants Undergoing a Tracheostomy from a Neonatal Intensive Care Unit.

The purpose of this study was to identify risk factors for perioperative complications and long-term morbidity in infants from the neonatal intensive care unit (NICU) presenting for a tracheostomy. This single-center retrospective cohort study included infants in the NICU presenting for a tracheostomy from August 2011 to December 2019. Primary outcomes were categorized as either a perioperative complication or long-term morbidity. A severe perioperative complication was defined as having either (1) an intraoperative cardiopulmonary arrest, (2) an intraoperative death, (3) a postoperative cardiopulmonary arrest within 30 days of the procedure, or (4) a postoperative death within 30 days of the procedure. Long-term morbidities included (1) the need for gastrostomy tube placement within the tracheostomy hospitalization and (2) the need for diuretic therapy, pulmonary hypertensive therapy, oxygen, or mechanical ventilation at 12 and 24 months following the tracheostomy. One-hundred eighty-three children underwent a tracheostomy. The mean age at tracheostomy was 16.9 weeks while the mean post-conceptual age at tracheostomy was 49.7 weeks. The incidence of severe perioperative complications was 4.4% (n = 8) with the number of pulmonary hypertension medication classes preoperatively (OR: 3.64, 95% CI: (1.44-8.94), p = 0.005) as a significant risk factor. Approximately 81% of children additionally had a gastrostomy tube placed at the time of the tracheostomy, and 62% were ventilator-dependent 2 years following their tracheostomy. Our study provides critical perioperative complications and long-term morbidity data to neonatologists, pediatricians, surgeons, anesthesiologists, and families in the expected course of infants from the NICU presenting for a tracheostomy. 3 Laryngoscope, 134:1945-1954, 2024.

Information based similarity analysis of oxygen saturation recordings to detect Pulmonary hypertension in preterm infants

Pulmonary hypertension (PH) is a complex cardiovascular condition associated with multiple morbidities and mortality risk in preterm infants. PH often complicates the clinical course of infants who have bronchopulmonary dysplasia (BPD), a more common lung disease in these neonates, causing respiratory deterioration and an even higher risk of mortality. While risk factors and prevalence of PH are not yet well defined, early screening and management of PH in infants with BPD are recommended by consensus guidelines from the American Heart Association. In this study, we propose a screening method for PH by applying a signal analysis technique to oxygen saturation in infants. Oxygen saturation data from infant groups with BPD (41 with and 60 without PH), recorded prior to their clinical PH diagnosis were analyzed in this study. An information-based similarity approach was applied to quantify the regularity of SpO2 fluctuations represented as binary words between adjacent five-minute segments. Similarity indices (SI) were observed to be lower in subjects with PH compared to those with BPD alone (p < 0.001). These measures were also assessed for performance in screening for PH. SI of 7-bit words, exhibited 80 % detection accuracy, 76 % sensitivity and specificity of 83 %. This index also exhibited a cross-validated mean (SD) F1-score of 0.80 (0.08) ensuring that sensitivity and recall of the screening were balanced. Similarity analysis of oxygen saturation patterns is a novel technique that can be potentially developed into a signal based early PH detection method to support clinical decision and care in this vulnerable population.

Neural signatures to prosocial and antisocial interactions in young infants.

Preverbal infants appear to be more attracted by prosocial characters and events, as typically assessed using preferential looking times and manual choice. However, infants' neural correlates of observed prosocial and antisocial interactions are still scarce. Here, we familiarized 5-month-old (N = 24) infants with a prosocial and antisocial scene (i.e., a character either helping or hindering) and infants' Event-Related Potentials (ERP) were recorded in response to the presentation of short video clips of the prosocial and antisocial interaction. On a neural level, results revealed that infants could discriminate between helping and hindering events at an early stage of processing, as shown by a larger N290 response to the former compared to the latter. Further, while the Nc - typically indexing attentional processes - was larger for antisocial over prosocial events, the LPP, indexing cognitive evaluation of the stimuli, was larger for prosocial over antisocial actions. Finally, infants' higher scores on the effortful control temperamental subscale were related to infants' increased N290 neural sensitivity to antisocial scenes. Together, these findings provide new evidence of the time course of infants' ERP responses during the observation of helping and hindering interactions, which involves both attentional and socially relevant processes.

Elevated Urinary Hepcidin Level and Hypoferremia in Infants with Febrile Urinary Tract Infection: A Prospective Cohort Study.

To evaluate the kinetics of serum and urinary hepcidin levels along with anemia-related parameters during the infection course of infants with febrile urinary tract infection (UTI), we enrolled febrile infants aged one to four months in this prospective study. Febrile patients with UTI were allocated into Escherichia coli (E. coli) or non-E. coli groups according to urine culture results. Septic workup, blood hepcidin, iron profile, urinalysis, and urinary hepcidin-creatinine ratio were collected upon admission and 3 days after antibiotic treatment. In total, 118 infants were included. On admission, the febrile UTI group showed a significant reduction in serum iron level and a significant elevation of urinary hepcidin-creatinine ratio compared to the febrile control counterpart. Moreover, urinary hepcidin-creatinine ratio had the highest odds ratio, 2.01, in logistics regression analysis. After 3 days of antibiotic treatment, hemoglobin and the urinary hepcidin-creatinine ratio were significantly decreased. Patients with an E. coli UTI had a significantly decreased urinary hepcidin-creatinine ratio after 3 days of antibiotics treatment, whereas the non-E. coli group showed insignificant changes. Our study suggested that the urinary hepcidin-creatinine ratio elevated during acute febrile urinary tract infection and significantly decreased after 3 days of antibiotics treatment, especially in E. coli UTI.

The natural course of otitis media with effusion in infants who failed universal newborn hearing screening: a retrospective cohort study.

To analyse the natural course of infants with otitis media with effusion who failed universal newborn hearing screening and to explore the appropriate observation period. This retrospective cohort analysis included infants with otitis media with effusion who failed universal newborn hearing screening every 3 months for 12 months. The average recovery time of the 155 infants was 7.08 ± 0.32 months after diagnosis. Multivariate Cox regression analysis confirmed that frequent reflux, maxillofacial deformities and initial hearing status were independent factors affecting recovery. Moreover, the cumulative recovery of most infants with mild hearing loss and infants with moderate hearing loss accompanied by frequent reflux was significantly higher at six months after diagnosis than at three months. For most infants with mild hearing loss, as well as those with moderate hearing loss accompanied by frequent reflux, the observation period can be extended to six months after diagnosis.

Clinical case of long-term persistence of SARS-CoV-2 in infant with congenital acute myeloid leukemia

According to the available data, children are less susceptible for developing a severe course of COVID-19 and commonly have mild or asymptomatic course of infection. It is reported about an increased risk of having more severe course in infants, at the same time, according to the literature data, the course in children receiving antineoplastic and immunosuppressive therapy is milder in comparison with other concomitant pathologies. This article presents the unique clinical case and the literature review of combined COVID-19-pneumonia and extremely rare congenital myeloid leukemia in the infant with the description of long-term infection persistence, changes in clinical data in dynamics, bone marrow test results and the experience of using donor plasma with antibodies to SARS-CoV-2.

Networks of cortical activity in infants with epilepsy.

Epilepsy in infancy links to a significant risk of neurodevelopmental delay, calling for a better understanding of its underlying mechanisms. Here, we studied cortical activity networks in infants with early-onset epilepsy to identify network properties that could pre-empt infants' neurodevelopmental course. We studied high-density (64 channel) electroencephalogram during non-rapid eye movement (N2) sleep in n = 49 infants at 1 year of age after being diagnosed with epilepsy during their first year of life. We computed frequency-specific networks in the cortical source space for two intrinsic brain modes: amplitude-amplitude and phase-phase correlations. Cortical activity networks of all frequency bands and connectivity modes were compared between the syndrome groups as well as between the three categories of neurocognitive development. The group differences were studied at three spatial levels: global, regional, and individual connections. Cortical mechanisms related to infant epilepsy were further compared with physiological networks using an automatic spindle detection algorithm. Our results show that global connectivity does not significantly differ between epilepsy syndromes; however, it co-varies with neurocognitive development. The largest network differences were observed at the lowest (<1 Hz) and mid-range (10-15 Hz) frequency bands. An algorithmic removal of sleep spindles from the data partially reduced the mid-range frequency network's strength. The centrocentral and frontocentral networks at the spindle frequencies were found to be strongest in infants with a persistent age-typical neurocognitive performance, while their low-frequency (< 1 Hz) networks were weaker for both amplitude-amplitude [P = 0.008, effect size = 0.61] and phase-phase correlations (P = 0.02, effect size = 0.54) at low (< 1 Hz). However, subjects with persistent mild neurocognitive delay from 1 to 2 years of age had higher amplitude-amplitude (P = 0.02, effect size = 0.73) and phase-phase (P = 0.06, effect size = 0.59) at low frequencies than those that deteriorated from mild to severely delayed from 1 to 2 years of age. Our findings suggest that cortical activity networks reflect the underlying clinical course of infants' epilepsy, and measures of spectrally and spatially resolved networks might become useful in better understanding infantile epilepsy as a network disease.

Intrapulmonary percussive ventilation for children with bronchiolitis on non-Invasive Ventilation support

Objective: Pediatric Intensive Care (PICU) admission of children with bronchiolitis as well as the use of Non-Invasive Ventilation (NIV) are increasing. The current treatment for bronchiolitis is supportive, and there are no specific studies addressing this group of severe bronchiolitis patients supported with NIV. Intrapulmonary Percussive Ventilation (IPV) is a lung recruitment physical therapy technique used in our PICU to augment lung aeration and improve gas exchange. We hypothesized that IPV treatment can be used to improve the clinical course of infants on NIV support suffering from bronchiolitis. Design: A prospective, open, randomized study. Setting: Single-center Pediatric ICU Patients: Children less than 2 years old admitted to our PICU between November 2016 and April 2018 with a diagnosis of bronchiolitis who were prescribed noninvasive positive pressure ventilation as their sole respiratory treatment modality Interventions: Patients were randomly assigned to two intervention groups: IPV vs. control (standard treatment). Measurements and main results: Thirty-eight infants with bronchiolitis treated with NIV support were randomized into two groups. The probability of a superior outcome (less chance of invasive mechanical ventilation and fewer PICU days) was 62.7% (95% CI, 45%-77%, p = 0.18) in the IPV group compared to the control group. Among the IPV group, there were no failures that required intubation in comparison to three intubations (13.6%) among the control group (p = 0.24). For the IPV group, the PICU length of stay (LOS) was 4.13 ± 2.45 days, compared to 6.18 ± 4.72 for the inhalation group. This difference was not statistically significant. Conclusions: In this single-center study, the use of IPV had no adverse reactions. The study failed to show a statistically significant effect of IPV treatment on the course of hospitalization of patients with bronchiolitis on NIV support in the PICU. Trial registration: Clinical Trials.gov NCT03037801.

Whole Exome Sequencing in a Population With Severe Congenital Anomalies of Kidney and Urinary Tract.

Fetal and neonatal interventions (e.g., amnioinfusions, amniotic shunting, and infant dialysis) have increased survival of infants with severe Congenital Anomalies of the Kidney and Urinary Tract (CAKUT), however, outcomes vary dramatically. Our aim was to perform Whole Exome Sequencing (WES) in a unique severe CAKUT population with the goal to identify new variants that will enhance prediction of postnatal outcomes. We performed trio WES on five infants with severe CAKUT (undergoing fetal interventions and/or those who initiated renal replacement therapy (RRT) within 1 month of life) and their parents as well as three singletons. We identified three potential candidate gene variants (NSUN7, MTMR3, CEP162) and validated two variants in known CAKUT genes (GATA3 and FRAS1) showing strong enrichment in this severe phenotype population. Based on our small pilot study of a unique severe CAKUT population, WES appears to be a potential tool to help predict the course of infants with severe CAKUT prenatally.

Spinal anesthesia in infants undergoing urologic surgery duration greater than 60 minutes

Spinal anesthesia (SA) has been safely utilized in infants. There are limited data regarding the safety and efficacy of SA in pediatric urologic surgery lasting ≥60min. We outlined the perioperative course for infants undergoing single-injection 0.5% plain bupivacaine SA-only for urologic procedures lasting ≥60min. To characterize the safety and efficacy of SA for urologic surgery in infants lasting ≥60min. We reviewed our prospectively maintained database of infants undergoing SA for urologic procedures lasting ≥60min from May 2018 to March 2021. Patients received preoperative intranasal dexmedetomidine, some received intranasal fentanyl, and all patients received lidocaine cream applied preoperatively over the lumbar spine. Oral sucrose on a pacifier was provided as needed, and the patient's arms were swaddled for the procedure. Success was defined as no conversion to general anesthesia. Time points for start/end of spinal injection, procedure duration, wheels in/out of operating room (OR), and discharge were collected. Of 245 cases conducted with SA during the study period, 76 (31%) infants underwent surgery lasting ≥60min. Of these, 73 (96%) were successfully completed with SA alone. In the 3 cases converted to general anesthesia, 2 (67%) required mask anesthesia after 96 and 169min (for the last <10min of surgery), and one was converted to intubation before start of surgery. Median patient age was 6 (IQR 5-7) months, and median procedure length was 95 (IQR 75-120) minutes. Following initial preoperative intranasal dexmedetomidine±fentanyl, at least one additional dose of IV sedative was given in 27 (36%) cases at a median time of 90 (IQR 60-120) minutes into surgery. Following closure, patients exited the OR after a median 10 (IQR 8-12) minutes and subsequently discharged after spending a median of 73 (IQR 61-96) minutes in recovery. We describe pediatric urologic surgical cases lasting ≥60min that employed single-injection intrathecal bupivacaine alone without adjunct intrathecal agents. In this report, SA was safely utilized in infants undergoing urologic procedures lasting at least 60min, with about 40% of patients receiving additional IV dexmedetomidine and fentanyl. Non-medication measures (swaddling, oral sucrose) were important for maximizing patient comfort. Communication between surgeon and anesthesia as cases progress is key to maintaining adequate anesthesia. A single-injection bupivacaine-only spinal anesthesia approach for urologic surgery lasting over an hour and up to 3h is safe and effective in infants. Selecting appropriate candidates for SA should be a joint decision between the surgeon and the anesthesiologist.

Severity of respiratory disease is correlated with time of first oral feeding and need for a gastrostomy tube at discharge in premature infants born at &lt;30 weeks of gestation

Premature infants who cannot achieve full oral feeds may need a gastrostomy tube (GT) to be discharged from the neonatal intensive care unit (NICU). We previously developed a model to predict which infants born <30 weeks (w) gestational age (GA) will require a GT before discharge. Here we report the detailed respiratory variable data to describe the general respiratory course for infants in the NICU < 30 w GA at birth and the association between different levels of respiratory support with postmenstrual age (PMA) at the time of first oral feeding attempt (PMAff), including later need for GT for discharge. Retrospective chart review of 391 NICU admissions comprising test (2015-2016) and validation (2017-2018) cohorts. Data, including respiratory support, were collected on 204 infants, 41 GT and 163 non-GT, in the test cohort, and 187 infants, 37 GT, and 150 non-GT, in the validation cohort. Respiratory data were significantly different between GT and non-GT infants. Infants who required GT for discharge were on significantly higher respiratory support at 30 days of age, 32 w PMA, and 36 w PMA. Respiratory parameters were highly correlated with PMAff. Respiratory status predicts PMAff, which was the variable in our previously described model that was most predictive of failure to achieve full oral feeding. These data provide a catalyst to develop strategies for improving oral feeding outcome for infants requiring prolonged respiratory support in the NICU.

Abnormal Orientation of the Superior Mesenteric Vessels Detected in Asymptomatic Infants: What Is Its Destiny?

Background: Ultrasonography (USG) has been described as an alternative diagnostic tool for malrotation that evaluates the orientation of the superior mesenteric vessels. However, literature concerning the management of patients who do not have abdominal symptoms is limited. We aimed to review the clinical course of infants showing abnormal orientation of the superior mesenteric vessels on USG who were asymptomatic at the time of diagnosis.Methods: Seventy asymptomatic infants with abnormal orientation of the superior mesenteric vessels in a single center between 2014 and 2018 were retrospectively analyzed.Results: The 70 patients, 21 underwent upper gastrointestinal series (UGIS) and 11 underwent abdominal surgery for other surgical conditions. Among the 32 (45.7%) patients who underwent UGIS or abdominal surgery, 11 were proven to have malrotation. Of the 38 (54.3%) patients who did not undergo UGIS or abdominal surgery, six patients were too unstable to undergo UGIS, five died due to cardiac complications, and the remaining patient developed midgut volvulus and died 3 days after emergency surgery. The remaining 32 patients who did not undergo UGIS or abdominal surgery were discharged without additional tests, and all were asymptomatic until their last follow-up. In the multivariate analysis, history of heart surgery and the presence of more than three anomalies were significantly associated with malrotation.Conclusion: A significant number of malrotation were diagnosed in asymptomatic infants with abnormal orientation of the superior mesenteric vessels on USG. Infants with major cardiac or multiple anomalies need special attention and should undergo UGIS in a promptly manner to confirm malrotation.

Can EEG accurately predict 2-year neurodevelopmental outcome for preterm infants?

ObjectiveEstablish if serial, multichannel video electroencephalography (EEG) in preterm infants can accurately predict 2-year neurodevelopmental outcome.Design and patientsEEGs were recorded at three time points over the neonatal course for infants...

Anemia after Pediatric Congenital Heart Surgery.

The postoperative course of infants following congenital heart surgery is associated with significant blood loss and anemia. Optimal transfusion thresholds for cardiac surgery patients while in pediatric intensive care unit (PICU) remain a subject of debate. The goal of this study is to describe the epidemiology of anemia and the transfusion practices during the PICU stay of infants undergoing congenital heart surgery. A retrospective cohort study was performed in a PICU of a tertiary university-affiliated center. Infants undergoing surgery for congenital heart disease (CDH) before 6 weeks of age between February 2013 and June 2019 and who were subsequently admitted to the PICU were included. We identified 119 eligible patients. Mean age at surgery was 11 ± 7 days. Most common cardiac diagnoses were d-Transposition of the Great Arteries (55%), coarctation of the aorta (12.6%), and tetralogy of Fallot (11.8%). Mean hemoglobin level was 14.3 g/dL prior to surgery versus 12.1 g/dL at the PICU admission. Hemoglobin prior to surgery was systematically higher than hemoglobin at the PICU entry, except in infants with Hypoplastic Left Heart Syndrome. The average hemoglobin at PICU discharge was 11.7 ± 1.9 g/dL. Thirty-three (27.7%) patients were anemic at PICU discharge. Fifty-eight percent of patients received at least one red blood cell (RBC) transfusion during PICU stay. This study is the first to describe the epidemiology of anemia at PICU discharge in infants following cardiac surgery. Blood management of this distinctive and vulnerable population requires further investigation as anemia is a known risk factor for adverse neurodevelopment delays in otherwise healthy young children.

Clinical Course for Patients With Trisomy 13 and 18 Pursuing Life-Prolonging Therapies Versus Comfort-Directed Care.

Care for infants with Trisomy 13 and 18 is evolving with more children being offered medical and surgical interventions. Parents and clinicians of children diagnosed with trisomy 13 and 18 would benefit from understanding how parental goals of care correlate with the subsequent clinical course of children with these conditions. To describe and compare parental goals of care (GOC) and clinical course in infants with trisomy 13 and 18. Single center, retrospective (2013-19) analysis of electronic health record repository at a birthing center and a tertiary care hospital. ICD-9/10 codes were used to identify patients with trisomy 13 or 18 born between 2013-2019. Their records were abstracted for their diagnosis, hospitalization days, interventions, GOC, death location and length of life. Twenty-eight total patients were identified; trisomy 13, mosaic trisomy 13 and trisomy 18 were diagnosed in 9, 2 and 17 patients respectively. Among the 26 patients with complete trisomy 13 or 18, 8 had life-prolonging and 18 had comfort care goals at birth/diagnosis. Life-prolonging goals were not associated with longer life (p = 0.36) but were associated with more mean hospital days (70 vs. 12, p = 0.01), ICU days (66 vs. 9, p = 0.009), intubation (7/8 vs 7/18, p = 0.04), and death in ICU (7/7 vs. 10/17, p = 0.02). Zero patients underwent cardiac surgery. Parental GOC did not affect length of life in children with complete trisomy, but did alter treatment intensity. This may inform decision making for patients with trisomy 13 or 18.

Neural time course of pain observation in infancy.

Perception of pain in others is of great evolutionary significance for the development of human empathy. However, infants' sensitivity to others' painful experiences has not been investigated so far. Here, we explored the neural time course of infants' processing of others' pain by measuring event-related brain potentials (ERPs) while 6-month-old infants observed a painful tactile stimulation directed towards the eye and a neutral tactile stimulation on the eyebrow. We analyzed both the Negative Central (Nc) and the later Late Positive Potential (LPP) ERP components, indexing respectively attention allocation and cognitive evaluation of perceptual stimuli. Results showed that observing painful touch elicits a mid-latency Nc (300-500ms) over the right fronto-central site, which is greater in amplitude as compared to neutral touch. A divergent activity was also visible in the centro-parietal early (550-750ms) and late (800-1000ms) LPP, showing increased amplitudes in response to neutral compared to painful touch. The cognitive evaluation of painful stimuli, reflected by the LPP, might thus not be fully developed at 6months of age, as adults typically show a larger LPP in response to painful as compared to neutral stimuli. Overall, infants show early attentional attuning to others' pain. This early sensitivity to others' painful tactile experiences might form a prerequisite for the development of human empathy.

After the First Wave of COVID-19: Reflections From Italy.

After the First Wave of COVID-19: Reflections From Italy.