School performance following invasive Group B Streptococcus disease in early infancy in Denmark.

BackgroundMitochondrial DNA depletion syndrome 13 (MTDPS13) is an autosomal recessive disorder presenting in early infancy with encephalopathy, hypotonia, lactic acidosis, and severe global developmental delay. Patient‐derived cells typically exhibit impaired mitochondrial oxidative phosphorylation and a marked reduction in mitochondrial DNA (mtDNA) copy number.Case ReportWe report the case of a male preterm neonate born at 31 + 3 weeks of gestation following a pregnancy marked by severe polyhydramnios. At birth, his weight was 1400 g. Physical examination revealed dysmorphic features, redundant and lax skin, and generalized muscular hypotonia. Laboratory investigations showed marked lactic acidosis associated with lactic aciduria, ketonuria, and urinary biomarkers indicating activation of preoxidative phosphorylation biochemical pathways to sustain ATP production. Echocardiography demonstrated mild, early‐onset hypertrophic cardiomyopathy.The Exome Analysis Clinical and Biochemical Markers: The exome analysis, performed within the first week of life, highlighted a pathogenic variant in homozygous state of FBXL4 gene (c.1648_1649delGA), which led to the diagnosis of MTDPS13. In this clinical contest, a ketogenic diet (KD) was started with a daily caloric intake of 120 kcal/kg and an initial ketogenic ratio of 1:1. These intakes were administered both with a parenteral nutrition and continuous nasogastric tube feeding and were gradually increased and adapted on a day‐by‐day basis according to lactic acidosis, growth increase, and common metabolic parameters such as glucose, electrolytes, creatinine, and blood urea nitrogen. After 3 days of this treatment approach, a significant reduction in lactate levels and improvement in acid–base balance and growth trend were observed along with clinical and cardiovascular parameters. At discharge from neonatal intensive care unit, the KD was continued at home and during follow‐up. The infant showed stability in the clinical and biochemical markers.ConclusionsThis is the first documented report of the use of a KD in a preterm neonate with this mitochondrial disorder during the early days of life. Prompt genetic confirmation and early initiation of KD may enable a more targeted and effective management of MTDPS within the neonatal intensive care setting.

The safety of plant-based family diets, particularly vegan diets, during pregnancy and infancy is debated. Large population data on infant growth are scarce. To examine whether family dietary patterns (vegan, vegetarian, and omnivorous) are associated with growth trajectories, weight, and length among infants. This retrospective cohort study used data collected from January 1, 2014, through December 31, 2023, from a national network of public family care centers in Israel providing health and developmental surveillance for infants. Singleton births of infants gestational age 32 weeks or later without congenital malformations or birth weight less than 1500 g were followed up for 24 months. The data were analyzed between November 17, 2024, and December 6, 2025. The family diet as recorded at least 6 months after delivery. The primary outcome was infant length. Secondary outcomes included weight, head circumference, stunting (length-for-age z score less than -2), underweight (weight-for-length z score less than -2), and overweight (weight-for-length z score >2). Growth trajectories were analyzed using linear mixed-effects models, and nutritional status at birth, early infancy (ie, first 60 days of life), and 24 months were analyzed using logistic regression. Among 1 198 818 infants (mean [SD] gestational age, 39.2 [1.5] weeks; 53.2% male), 98.5% were from omnivorous households; 0.3% from vegan households, and 1.2% from vegetarian households. Differences in early-infancy length and length-for-age z scores among dietary groups were small (World Health Organization z score ≤0.3), and stunting prevalence was similar across groups (from 7.0% in the vegan and vegetarian groups to 7.1% in the omnivorous group), while underweight was more common in infants in the vegan vs omnivorous groups (adjusted odds ratio, 1.37 [95% CI, 1.15-1.63]). By age 24 months, stunting prevalence declined to 3.1%, 3.4%, and 3.9% in omnivore, vegetarian, and vegan groups, respectively, with no significant differences among the groups. Underweight and overweight were also low, with no differences by dietary group at age 24 months. Mean differences for weight, length, and head circumference were clinically minor (World Health Organization z score <0.2) and diminished further in adjusted longitudinal models. In this cohort study, infants from vegan households had growth patterns similar to those from omnivorous households, with a higher odds of early underweight that decreased by age 24 months. In the context of developed countries, these findings seem reassuring. Further research should examine vegan diet quality and the impact of nutritional counseling during pregnancy and infancy in supporting optimal infant development.

Feeding practice and its association with nutritional status of infants aged 0-6 months in Endumeni sub-district, South Africa.

The oral microbiome profile of Pakistani infants characterized by 16S rRNA amplicon sequencing.

Sleep Health Profile In Early Infancy Is Associated With Emerging Executive Function Development

To summarize current evidence on the etiology, diagnostic approach, management strategies, and outcomes of micropenis in children and adolescents. A narrative review was performed using PubMed/MEDLINE (October 2025) with the search terms(Micropenis OR Microphallus OR "Small Penis") AND (Children OR Youth OR Adolescents). From 707 records screened, 36 studies were selected based on methodological quality and relevance to clinical practice. Micropenis is a clinical sign frequently associated with underlying endocrinopathies, particularly Congenital Hypogonadotropic Hypogonadism (CHH). Accurate diagnosis relies on standardized Stretched Penile Length (SPL) assessment, recently optimized by the Stretched Penile Length INdicator Technique (SPLINT). Use of population-specific SPL nomograms is critical for diagnostic reliability. Testosterone therapy remains the primary treatment modality and demonstrates greatest efficacy in early infancy, promoting significant penile growth and generally favorable functional outcomes. Spontaneous catch-up growth during puberty has been reported in select cases. Current evidence supporting surgical interventions in children and adolescents is limited, heterogeneous, and associated with inconsistent long-term results; thus, surgery should not be considered first-line therapy. High-quality long-term outcome data and randomized placebo-controlled trials are lacking. Standardized SPL measurement and appropriate nomogram use are essential for accurate diagnosis. Early hormonal therapy, especially in CHH-associated micropenis, appears to yield optimal functional and psychosocial outcomes. Expectant management may be appropriate in selected clinical scenarios. Surgical techniques remain controversial, with insufficient evidence to recommend routine use. Further well-designed prospective studies, including randomized placebo-controlled trials, are needed to define long-term outcomes and guide clinical decision-making.

Critical CHD often requires surgical intervention or results in infant mortality. We aimed to determine the association between critical CHD categories and exposure levels to pollutants. A retrospective study of n = 1484 infants who underwent complex cardiac surgery in early infancy from 1996 to 2021. The association between critical CHD categories (compared to a reference category with chromosomal abnormality) and exposure levels during early pregnancy to nitrogen dioxide, ozone, fine particulate matter (<2.5 micrometers diameter), and air quality from smoke was determined. Spatial heterogeneity was accounted for using geographically weighted multinomial logistic regression. For fine particulate matter exposure, 0.34% of locations displayed statistically significant negative associations with critical CHD categories, clustered in Saskatchewan and Manitoba. These regions exhibited small spatial extents. For ozone exposure, 15.1% of locations exhibited statistically significant negative associations with critical CHD categories, with the majority originating from Alberta and a smaller fraction in Saskatchewan. Differences in significant associations with locations were observed before and after spatial adjustment. Air quality from smoke and nitrogen dioxide exposure demonstrated no statistically significant associations with critical CHD categories. Differences before and after geographic spatial adjustment underscored the importance of accounting for spatial heterogeneity to uncover patterns of association between environmental pollutants and critical CHD categories. The negative associations likely reflected pollution acting as a second hit to markedly increase the risk for critical CHD in those with genetic predisposition.

The infant gut microbiome is a dynamic ecosystem, and it is key to early development, immune maturation, and overall health. Recent insights reveal that the gut microbiota undergoes changes across the 24-h day, raising the possibility that it may act as a "zeitgeber," supporting the host's sleep-wake organization. Despite its importance, timing factors influencing microbiome composition are poorly understood, limiting its use as a health indicator. This study investigates the relationship between stool dynamics (defecation interval, time of sampling), sleep pressure (interval since last sleep), meal timing, and gut microbial composition. Stool samples from 198 healthy infants, aged 3 to 31 months, were analyzed to assess microbial diversity, richness evenness, and abundance. Our findings reveal that longer intervals between bowel movements are associated with increased microbial diversity, evenness, and richness. Stool timing is associated with shifts in microbial composition, especially in younger infants, indicating diurnal microbial fluctuations to become more stable as infants mature. Longer periods of wakefulness were associated with increased microbial diversity in early infancy, although this effect appeared to diminish with age. Feeding schedules had limited effects on the gut microbiome. Longer fasting before sampling showed no significant associations with most microbial parameters, except for a positive association with microbial richness. At the phylum level, results indicate that infant gut microbial composition is influenced by behavior and physiology. Longer intervals between bowel movements were associated with shifts in bacterial abundance, with Proteobacteria decreasing and Actinobacteria increasing. In addition, later stool sampling times revealed higher Actinobacteria levels, and longer fasting was associated with reduced Bacteroidetes. Sleep pressure showed a trend effect with Firmicutes displaying a slight decrease in infants who had been awake longer. Our findings underscore the importance of time-based factors on infant gut microbiome composition.

Background: Neonatal sepsis has been a major cause of infant mortality and morbidity in sub-Saharan Africa. Normally, the infection sets in within the first 72 hours after birth (early onset), while infections above 72 hours after birth (late onset) also affect these children. There are a number of causes associated with sepsis: prematurity, poor hygienic conditions during delivery, limited access to quality neonatal care, infections during pregnancy and poor feeding methods during early infancy. The purpose of this scoping review is to identify the prevalence and point out the various associated factors that will help make new policies to improve general practices in the health sector to improve the health of the neonates and infants. Objective of the study: Determining the patterns of prevalence rates and risk factors associated with neonatal sepsis will help the health care sector and the Ministry of Health in general to develop different approaches to improve care delivery among neonates. Methods: Most of the data was obtained from global databases, which were lastly updated on 25th March 2025. These databases include: PubMed, PLO journals, the Neonatal Institute of Health, South Sudan medical journals, ScienceDirect.com, Google Scholar, and BMC Pregnancy and Childbirth. PRISMA (Preferred Reporting Items to Systematic Reviews and Meta-Analyses extension to Scoping Reviews) framework was used to present data; a systematic search was conducted from 21st October 2025 to 20th November 2025. Results: This review included 50 studies with 3,347neonates. High prevalences of neonatal sepsis were found in sub-Saharan Africa, up to 40%. History of urinary tract infections and sexually transmitted infections, infections from poor cord care after birth, premature rupture of membranes, preterm babies, low birth weight below 2300grams, poor Apgar score and late initiation of breastfeeding were among the leading causes. Conclusion: The continent of Africa is the leading region in cases of neonatal sepsis globally. Attention needs to be given to various issues to improve the overall well-being of neonates and babies below 5 years. Screening during antenatal clinics to identify and treat infections. Timely interventions during labour and delivery to avoid complications of birth, to reduce the number of babies with poor Apgar scores and improve birth outcomes. Careful monitoring of the labour process during delivery to avoid cases of foetal distress, hence reducing neonatal complications after birth. Midwives and caregivers should ensure mothers breastfeed their neonates within the first hour of birth

This study aimed to investigate the eating behaviors of preschool children who had been exposed to a restricted diet due to an oral food challenge-confirmed diagnosis of cow's milk protein allergy (CMPA) during early infancy. This prospective cohort study compared the eating behaviors of Brazilian children previously diagnosed with CMPA to those of a nonallergic control group. Baseline data on infant feeding, clinical history, and sociodemographic characteristics were collected and later analyzed in association with the Children's eating behavior questionnaire (CEBQ) at 4 years of age. Linear regression models were used to assess associations between CMPA and CEBQ scores, with both crude and adjusted analyses performed. A total of 74 children, with a mean age of 3.2 months at recruitment, were enrolled (30 with CMPA and 44 controls). Cesarean section delivery, rural geographic location, early introduction of substitute infant formula, and a family history of atopy were associated with higher food fussiness scores. After adjusting for early predictors of eating behaviors, the CMPA group scored significantly higher on the "desire to drink" scale (B adjusted: 2.61; p = 0.031) and on the "food fussiness" scale (B adjusted: 4.07; p = 0.017). Adherence to a CME diet during infancy, following an OFC-confirmed CMPA diagnosis, was found to have a long-term impact on eating behavior, as evidenced by higher scores on food fussiness and desire to drink scales, which are linked to feeding difficulties.

Early relational health during the first 24 months of life is a key determinant of child development and wellbeing. During this postnatal period, the parent-infant relationship plays a central role in emotional regulation, bonding, and developmental trajectories. Although the broader early relational health framework encompasses the first 1,000 days of life, this scoping review focuses specifically on the postnatal phase, where parent-infant interactions are directly observable and measurable. However, existing assessment instruments vary widely in their conceptual focus, scope, and characteristics, and no comprehensive review has systematically mapped tools used to assess the parent-infant relationship during early infancy. In response to this gap, a transdisciplinary working group within the COST Action CA22114 - TREASURE collaboratively developed a scoping review protocol to systematically map instruments assessing the parent-infant relationship from birth to 24 months of age. This Brief Report describes the collaborative methodological process underpinning the protocol's development. The process followed an iterative, consensus-driven approach involving multidisciplinary experts from multiple COST member countries. Through structured online meetings, the group clarified core constructs and established the age range using the Population-Concept-Context (PCC) framework. The JBI methodology for scoping reviews was adopted and aligned with PRISMA-ScR standards to ensure transparency and reproducibility. Progressive drafting, internal peer review, and iterative refinement led to the final protocol, which was registered on the Open Science Framework (DOI: 10.17605/OSF.IO/HRVX9).The resulting protocol provides a replicable methodological framework for mapping instruments that assess the parent-infant relationship in the first two years of life. This Brief Report presents a framework for collaborative protocol development in international research networks, promoting shared knowledge generation in early relational health research and offering potential applicability to other COST initiatives.

Management of 21-hydroxylase deficiency (21-OHD) congenital adrenal hyperplasia (CAH) in early infancy is challenging, with extent of variation in management unclear. Using the I-CAH Registry, we retrospectively reviewed management over the first 90 days of life of 154 infants with 21-OHD born in 2018-2023, across 33 centers in 18 countries. Of 154 infants (92 female, 62 male), 136 were diagnosed postnatally, with median (10th centile, 90th centile) presentation age of Day 4 (0, 20.8). At initial hospital discharge, median doses of hydrocortisone (HC), fludrocortisone (FC), and salt were 17 (11.4, 39.6) mg/m2/day, 100 (50, 200) mcg/day and 3.5 (1.6, 8.7) mmol/kg/day, and at Day 90 (D90) 14.5 (8.7, 24.1) mg/m2/day, 100 (50, 200) mcg/day, and 2.1 (1.0, 5.2) mmol/kg/day, respectively. Hyponatremia, hyperkalemia, and hypoglycemia were reported in 70.0%, 71.9%, and 13.0% of infants, respectively. At D90, hyponatremia and hyperkalemia were reported in 7.4% and 28.6%, respectively. At D90, BP measurements were recorded in 30.5%, amongst whom 31.9% had hypertension reported. Median total hospitalization duration over 90 days was 9 days (2, 24). Adrenal crises were associated with 40. 6% of hospitalization episodes. Percentages (males:females) of cases seen by a pediatric endocrinologist, psychologist, pediatric endocrine nurse specialist, and surgeon by D90 were 95.9% (58:84), 33.3% (9:35), 42.1% (20:36), and 23.8% (0:35), respectively. Contemporary management of CAH in early infancy varies considerably. Hypertension and hyperkalemia are frequently reported. Our data may help inform development of quality indicators for benchmarking CAH care in infancy.

Abstract Objectives To characterise early postnatal microbial development across maternal gut, breast milk, and infant gut compartments, and explore potential modulation by maternal stress in a cohort of Chinese mothers practising traditional postpartum confinement. Methods This secondary analysis draws on a randomised controlled trial of a maternal relaxation intervention in late preterm and early‐term dyads. Vaginally delivered mothers (34 + 0 to 37 + 6 weeks) and their exclusively breastfed infants were followed from 1 to 8 weeks postpartum. Maternal stool, breast milk, and infant stool samples were collected at both time points and analysed via 16S rRNA gene amplicon sequencing. Changes in gut microbiome diversity and composition (alpha andbeta diversity metrics) and the relative abundance of dominant genera were assessed overall and by intervention group. Results Microbiome diversity (alpha diversity metrics) remained stable across all sample types. However, we observed a compositional temporal shift in breast milk microbiota ( p = 0.039), driven primarily by changes in the control group. Infant gut microbiota showed increased Bifidobacterium and decreased Staphylococcus and Enterobacteriaceae with time. A significant reduction in Staphylococcus was observed in breast milk of the intervention group only. Maternal gut microbiota remained stable. Conclusions Microbial composition in breast milk and infant gut shifted over the first 8 weeks postpartum, while maternal gut remained stable. Findings suggest maternal stress‐reduction interventions may influence breast milk microbiota. Further research is warranted to confirm these effects and investigate mechanisms.

IntroductionCongenital cataract (CC), defined as lens opacity present at birth or in early infancy, is a major cause of reversible childhood blindness and shows marked genetic heterogeneity. This study aimed to investigate the genetic basis of CC in a multigenerational Chinese family.MethodsA four-generation family with CC was clinically characterized. Whole-exome sequencing was performed in the proband, followed by stepwise variant filtering based on minor allele frequency, predicted functional impact, known CC-associated genes, and an autosomal dominant inheritance model. Candidate variants were annotated and classified according to ACMG guidelines. Sanger sequencing was used to validate variants in two additional affected relatives.ResultsTwo heterozygous missense variants were identified in known CC-associated genes: GJA3 c.776C > A (p.Ser259Tyr) and CRYBA1 c.346A > T (p.Ile116Phe). Both were extremely rare or absent in population databases and predicted to be damaging by multiple in silico tools. Sanger sequencing confirmed that the two variants co-occurred in all three affected family members tested, and no other rare, protein-altering variants meeting the filtering criteria were found in established cataract genes.DiscussionAccording to ACMG guidelines, both variants remain classified as variants of uncertain significance, but their rarity, predicted functional impact and consistent co-occurrence in affected individuals support them as strong candidate variants that may jointly contribute to CC in this family and expand the spectrum of GJA3- and CRYBA1-associated changes.

Background: General Movement Assessment is a strong early predictor of adverse neurodevelopmental outcomes but remains qualitative and examiner-dependent. Quantitative, video-based kinematic analysis may complement General Movement Assessment by providing objective, scalable metrics. Methods: In this pilot study, a computer-vision-based pipeline was used to extract trunk center-of-mass kinematics from video recordings of spontaneous General Movements in infants under three months corrected age during the Writhing and Fidgety stage. Two measures were derived: trunk quantity of motion and movement duration. Group differences were examined using t-tests and effect sizes, and associations with corrected age and sex were explored with correlation analyses. Results: Writhing Movements were substantially longer than Fidgety Movements, with a large effect size, whereas trunk quantity of motion did not differ meaningfully between movement types. Correlations between corrected age and both the quantity of motion and duration were small and imprecise. Sex did not moderate duration changes, but trunk motion showed a significant age-sex interaction effect. Conclusions: Video-based extraction of trunk kinematics is feasible in early infancy and reveals robust differences in GMs type duration between Writhing and Fidgety Movements. Larger longitudinal studies are needed to clarify the value of these measures as early quantitative markers of postural control and neuromotor development.

Hemimyelomeningocele (HMM) is a rare split cord malformation where only one hemicord forms a myelomeningocele-like sac, and the opposite hemicord undergoes normal neurulation. We aimed to compile all published HMM cases to concisely summarize embryology, presentation, imaging, associated anomalies, management, and outcomes of the disorder. Following PRISMA 2020, we searched PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar (1968-Feb 2025) for studies with confirmed human HMM, extracting clinical, radiological, surgical, and follow-up data. Of 688 records screened, 25 articles met inclusion criteria, encompassing 67 patients. Most publications were single-patient case reports. Presentation occurred predominantly in newborns or early infancy. The dysraphic sac was lumbosacral in most cases, and type I split cord malformation with a bony spur outnumbered type II. Hemivertebrae and congenital scoliosis were the common vertebrae anomalies. Nearly all patients underwent surgery combining sac excision, detethering, and bony spur removal. Postoperative neurological outcomes were favorable: the majority improved, and the other ones remained stable; no surgery-related mortality was reported. HMM can be recognized as a distinct clinic radiological entity within the split-cord spectrum. Early, ideally prenatal diagnosis, timely microsurgical repair, and coordinated multidisciplinary care yield favorable functional outcomes in most patients. This first systematic review compiles the available evidence and provides a practical basis for future diagnostic and treatment decisions.

Prematurity may place young children at increased risk for severe respiratory syncytial virus (RSV) disease because of differences in lung development. We describe characteristics of children aged less than 2years hospitalized with RSV by prematurity and bronchopulmonary dysplasia (BPD) status and examine both as risk factors for severe in-hospital outcomes. During 2016-2023, population-based surveillance was conducted at 7 medical centers for hospitalizations with RSV-associated acute respiratory illness in children. Poisson regression with robust variance was used to estimate adjusted relative risks (aRRs) of prolonged hospitalization (≥3days), intensive care unit (ICU) admission, and assisted ventilation by age in children with prematurity without and with BPD compared with term children after adjustment for surveillance site and palivizumab receipt. Among 5844 children, 4626 (79.2%) were term and 1218 (20.8%) were premature, including 1138 (93.4%) without BPD and 80 (6.6%) with BPD. Compared with term children, all premature children had greater risks for prolonged hospitalization (aRR = 1.3; 95% CI, 1.2-1.5), ICU admission (aRR = 1.4; 95% CI, 1.2-1.6), and assisted ventilation (aRR = 2.0; 95% CI, 1.4-2.8) at chronological age less than 6months. Premature children with BPD also had greater risk for prolonged hospitalization at all ages through 23months. Premature children accounted for 1 in 5 hospitalizations among children aged less than 2years hospitalized with RSV. Compared with term children, all premature children had increased risk for severe in-hospital outcomes in early infancy, and those with BPD remained at increased risk of prolonged hospitalization through age 23months.

Chronic granulomatous disease (CGD) is a primary immunodeficiency caused by defective phagocyte oxidative burst and may present in early life with severe or recurrent infections. We report a female infant born at 38 weeks’ gestation (birth weight 2700 g) who developed fever and presumed sepsis at 5 days of life, followed by multiple recurrent hospitalizations for febrile illness with suspected meningitis, diarrhea, dehydration, and failure to thrive. Cerebrospinal fluid (CSF) evaluations across episodes demonstrated pleocytosis with elevated protein and normal‐to‐low glucose, while Gram stain and CSF cultures were repeatedly negative, consistent with recurrent culture‐negative meningitis. Laboratory assessment showed intermittent anemia, thrombocytosis, and episodes of significant neutropenia. Complement and immunoglobulin levels were within reference ranges, and flow cytometry demonstrated preserved T‐ and B‐lymphocyte compartments. A flow cytometric dihydrorhodamine (DHR) oxidative burst assay was markedly abnormal (phorbol 12‐myristate 13‐acetate stimulation index 13%; Escherichia coli stimulation index 22.3%), supporting the diagnosis of CGD. At ~4.5 months of age, a sterile catheter urine culture grew multidrug‐resistant Klebsiella pneumoniae at ≥100,000 CFU/mL with susceptibility limited to aminoglycosides; the patient was treated with amikacin 15 mg/kg/dose intravenously once daily for 10 days, with defervescence within 48 h, clinical recovery, and a repeat urine culture showing no growth. Genetic testing was not performed due to financial and social constraints, and longer‐term outcomes beyond early infancy were unavailable in the record extract. This case underscores that recurrent culture‐negative meningitis in early infancy should prompt evaluation for primary immunodeficiency and that early DHR testing can expedite CGD diagnosis and guide timely preventive management and specialist referral.

BackgroundNeonatal hyperbilirubinemia is a common condition that may impair neurodevelopment, yet its impact on peripheral neuromuscular function remains underexplored.ObjectiveThis study aimed to assess the effects of hyperbilirubinemia on muscle fiber conduction velocity (MFCV) in neonates using surface electromyography (sEMG).MethodsMFCV was estimated from tibialis anterior sEMG recordings during passive and isometric contractions in neonates with and without hyperbilirubinemia. Global and local time-delay strategies were applied. Z-score analysis and repeated-measures ANOVA were used to compare groups, while regression analysis examined MFCV temporal trends.ResultsThe hyperbilirubinemia group exhibited significantly lower MFCV and Z-score values than controls (p < 0.001). Control infants showed characteristic spatial and temporal MFCV patterns, including arch-shaped conduction profiles and time-dependent declines, which were absent in the hyperbilirubinemia group. Disorganized innervation zone (IZ) distributions and reduced conduction variability further indicated impaired neuromuscular development.ConclusionsNeonatal hyperbilirubinemia may alter peripheral neuromuscular maturation. sEMG-based MFCV estimation may serve as a potential sensitive and noninvasive electrophysiological biomarker for detecting bilirubin-related neuromuscular impairment in early infancy.