Children's Reactions Research Articles

Sex education for adolescents: Indonesian nurse educators’ experience as parents

Abstract Objectives Sex education toward adolescent remains the most controversial subject due to the various thoughts and ideas of different values present in society. Nurse educators as parents must exemplify sex education to their children. The aim of this present study was to explore parents’ experience, with nurse educators background to be exact, on how they convey sex education to their children. Methods This study is a descriptive qualitative study, and the sample is recruited by using the purposive sampling technique. The qualified participants filled in the informed consent, provided demographic data, and were interviewed. Saturation data were obtained at the 6th interview in this study. The interview is transcribed to find themes and subthemes using conventional content analysis. Results We derived 3 main themes: parents’ approach, sex education topic, and children's reaction. Parents’ approach contained 4 subthemes, namely, gender match, parent–child closeness, media, and attitude. Sex education topic included 5 subthemes of bodily autonomy, health and safety, reproductive anatomy, puberty-related changes, and how to maintain healthiness. Children's reaction experiences also included 4 subthemes of uncomfortable, questioning, acknowledging, and laughing. Conclusions As a matter of fact, some parents in eastern countries, such as Indonesia, conveyed sex education to their children. Children might have various reactions to that topic, but it is important to keep them safe, especially in reproductive health, regardless of the culture or tradition. Based on nurse educators as exemplifiers, nurses and nursing students might acquire the picture in conveying sex education to adolescents.

AN OBSERVATION ON DISASTER MANAGEMENT BY PRE-SCHOOL STUDENTS: A CASE OF PRIMARY SCHOOL IN IĞDIR

Afet yönetimi ve bilincinin gelişmesi, doğal felaketlerden korunma açısından oldukça önemlidir. Bu noktada koruyucu nitelikte girişimler eğitim ve farkındalık çalışmaların gerçekleşmesi ile mümkün olur. Eğitim ve öğretim faaliyetlerinin çocukluk döneminde başlaması eğitimin kalıcılığı açısından oldukça mühimdir. Çocukluk dönemi ve özellikle okul öncesi dönem, çocukların okuma yazma bilmediği; öğrenme sürecini görmek ve taklit etmek suretiyle gerçekleştirdiği bilinmektedir. Günümüzde medya ve internet içerikleri çocukların bilgi edinme açısından rehberi konumundadır. Bu ilkeden hareketle okul öncesi dönem çocukların afet bilincine dair yapılan çalışmamızda görseller kullanılarak afetlere dair bilgi düzeyi ölçülmesi amaçlanmıştır. Bu amacı gerçekleştirmek için Iğdır’da bir ilkokulda 20 okul öncesi çocuğa doğal felaketler ile ilgili resimler gösterilip, afeti tanıyıp tanımadıkları, olması durumunda nasıl tepki verecekleri gözlenmiştir. Çocukların gördükleri karşısında tepkileri ve tutumları gözlenmiştir. Doğrudan görüşme olmadığı için etik kurul belgesine gerek duyulmamıştır. İncelenen afetlere bakıldığında yangın, çığ, sel, deprem ve heyelan çocukların en çok bildiği afetler olarak çalışma kapsamında incelenmiştir. En bilinen afet deprem olmakla birlikte çocukların, afetlerin nasıl oluştuklarını ve oluştuğunda ne yapmaları gerektiğini yeterince bilmedikleri ortaya çıkmıştır.

Firstborn Children's Reactions to Mother-Doll Interaction Do Not Predict Their Jealousy of a Newborn Sibling: A Longitudinal Pilot Study.

Mothers are concerned about their firstborn children's acceptance of a baby sibling. Observing children's reactions to mothers interacting with an infant doll simulator has been offered as one means of seeing how children will react to the baby sibling. A longitudinal pilot study with 30 pregnant mothers and their firstborn children was conducted comparing children's behaviors to mother-doll interaction in the laboratory before birth with behaviors during home observations of mother-sibling interaction 1 month after birth. Children responded to mother-doll and mother-sibling interaction differently, with no significant associations across children's behaviors in mother-doll and mother-sibling interactions. The use of an infant doll simulator before birth did not reliably predict children's behavioral adjustment after the birth of a baby sibling.

Young children's traumatic stress reactions to the COVID-19 pandemic: The long reach of mothers' adverse childhood experiences

BackgroundThe COVID-19 pandemic has negatively impacted parental and child mental health; however, it is critical to examine this impact in the context of parental histories of adversity. We hypothesized that maternal adverse childhood experiences (ACEs) and pandemic-related negative life events would predict child traumatic stress symptoms (TSS) and tested potential mediating pathways through maternal pandemic-related TSS and/or poorer maternal sensitivity during the pandemic. MethodsData were collected from a longitudinal sample of low-income, racially/ethnically diverse mothers and their children. Between May and November 2020, mothers (n = 111) of young children (M age = 7.42 years, SD = 0.45) completed questionnaires to assess their own and their child's pandemic-related TSS, exposure to pandemic-related negative events, and parent-child relationship quality. Maternal ACEs, maternal depression, parent-child relationship quality, and child internalizing symptoms had been assessed approximately 1–3 years prior. ResultsStructural equation analyses revealed that pandemic negative life events were indirectly associated with child TSS via greater maternal TSS. For mothers, recent pandemic-related negative events were associated with their own TSS, whereas maternal ACEs were not. Maternal ACEs directly predicted greater child TSS, with no evidence of mediation by either maternal TSS or maternal sensitivity. LimitationsAll measures were parent report, and pandemic-related measures were collected at the same time point. ConclusionsFindings underscore the long reach of mothers' own adverse childhood experiences, highlighting the negative consequences of these prior traumatic exposures alongside current pandemic-related maternal trauma symptoms for children's adjustment during the pandemic.

Hearing about a story character's negative emotional reaction to having been dishonest causes young children to cheat less.

There is extensive research on the development of cheating in early childhood but research on how to reduce it is rare. The present preregistered study examined whether telling young children about a story character's emotional reactions towards cheating could significantly reduce their tendency to cheat (N =400; 199 boys; Age: 3-6 years). Results showed that telling older kindergarten children about the story character's negative emotional reaction towards rule violation significantly reduced cheating, but telling them about the positive emotional reaction towards rule adherence did not. These results show that children as young as age 5 are able to use information about another child's emotional reaction to guide their own moral behavior. In particular, highlighting another child's negative emotional reaction towards a moral transgression may be an effective way to reduce cheating in early childhood. This finding, along with earlier cheating reduction findings, suggests that although cheating is common in early childhood, simple methods can reduce its occurrence.

Les effets du port du masque sanitaire sur les jeunes enfants en lieux d’accueil collectif

IntroductionMandatory for professionals working in collective care facilities with children aged 3 months to 3 years, the wearing of a mask modifies information that is crucial for verbal and non-verbal communication, which is essential for social development. ObjectiveAn exploratory survey aims to collect the perception of these professionals of the children's reactions to the wearing and removal of the mask. MethodIn mid-December 2020, 586 people recorded 895 observed reactions to the wearing of masks and 793 to their removal in a questionnaire posted on a site dedicated to early childhood professionals. ResultsThe content analysis of the discursive corpus indicates that 75% of the observations on the wearing of the mask mainly concern problems in interactional experiences and difficulties in language activities, with 25% indicating no notable reaction in the children. When the mask is removed, more than half of the observations refer to positive effects: improved relational exchanges, better involvement in activities, particularly language activities, positive emotional reactions, etc. The testimonies also evoke an ostensible attentional activity to the (re)discovery of the adult's whole face, negative emotional reactions and sometimes a non identification of the adult. ConclusionThe majority of professionals perceive difficulties in the areas of language communication and social-emotional interaction. The overall data, although not conclusive due to the inherent limitations of the method used, are consistent with the results of other studies on the effects of wearing a mask on speech and social perception.

Children's anxiety, academic self-efficacy, and intergenerational transmission of worries regarding the transition to middle school.

Worries about school transition were related to poor academic adjustment during middle school. However, limited studies simultaneously investigated individual and contextual factors that may shape the children's reaction related to transition. The first aim of this present study was to assess how children's anxiety and academic self-efficacy, including the parents' worries about school transition, are related to children's worries regarding the transition from primary to middle school. Our second aim was to explore the moderating role of children's academic self-efficacy in the relation to children's anxiety symptoms and children's worries. A sample of 292 fourth-grade children (Mage =10.43; 53.4% girls) completed scales assessing their anxiety, academic self-efficacy and worries about the transition to middle school. Parents also filled out a scale assessing the worries regarding their children's transition from primary to middle school. The results show that children's anxiety is positively related to their worries about the transition to middle school, whereas children's academic self-efficacy is negatively related to their worries. Parents' worries regarding their children's school transition are positively related to their children's worries regarding the transition. Furthermore, academic self-efficacy moderates the relation between children's anxiety and their worries about school transition. Children with lower levels of anxiety reported lower worries for the transition when their academic self-efficacy was higher, whereas children with higher anxiety reported higher worries for school transition at every level of self-efficacy. Theoretical and practical implications of these findings for successful school transition are discussed.

Eating behaviors in children with Down syndrome: Results of a home-use test.

Children with Down syndrome (DS) display a disproportionate number of health challenges, including feeding and swallowing difficulties and food texture sensitivities. To start addressing food texture challenges early in life, the aim of this research was to understand mealtime behaviors and identify preferred food textures of children with DS. Children (aged 11 to 58 months) with DS (n= 111) and without (typically developing, TD; n= 107) participated in a home use test evaluating snack products of varying textures. Parents recorded their children's reactions to each food product; a panel of trained coders coded videos for mealtime behaviors. Children were also identified as food texture sensitive (TS) or non-texture sensitive (NTS). Results showed that age, TS, the presence of a DS diagnosis and the TS*DS interaction influenced the child's behaviors to the food products. Children with DS were more likely to increase distance from the food, mouth/suck on the food, and less likely to chew/much on the food compared to children TD. Children with DS also ate significantly less than typically developing children. Similar mealtime behaviors were observed between the children with TD/<30 months of age and children with DS regardless of age (p< .05). While children with DS/TS had a higher disposition for the dissolvable texture, along with products that were salty and cheesy, children with DS/NTS had a greater tolerance for more textures in general, including crunchy and grainy. Overall, this research identified mealtime behaviors in children with DS, determined overall disposition of children with DS to foods of differences sensory properties, and demonstrated the influence of TS on a child's disposition to a food. This research will be extended to develop acceptable and innovative food products for children with DS/TS.

How to support parenting in patients with cancer and co-parents? From research to practice.

When a parent is diagnosed with cancer, the entire family is impacted. Patients with cancer and co-parents may no longer feel able to fulfill their parenting roles. The aims of this article are to describe interventions designed to support parenting in the oncological context and to make suggestions for the development and assessment of such interventions. Ten parenting support interventions published in the last 10 years in oncology were identified, among which four randomized controlled trials (RCTs). The therapeutic aims, techniques, and modalities of these interventions were heterogeneous. Five main therapeutic aims were addressed to: increase parents' knowledge, promote parents' emotion regulation, enhance parents' self-efficacy related to parenting, promote parents' support of their children's reactions and coping strategies, and promote open and appropriate parent-child communication. Few studies have combined informational resources with experiential techniques. Very few studies examining the efficacy of parenting support interventions have been published. There is still a need to develop, test, and compare interventions that meet the many needs of parents and their children. Suggestions are made about the contents and formats of parenting support interventions in oncology.

Whether and when disclosing the trauma to one’s children in a migratory context? A pilot mixed methods investigation

BackgroundDisclosing traumatic events experienced by parents to their children is a central issue in the intergenerational trauma transmission. However, little is known about this question among migrant population. The main objective of this study was to examine the choice to disclose the traumatic experiences of migrant women in France to their children.MethodsThis pilot study examined fourteen mother–child dyads in which migrant mothers (M = 30 years; range = 19–42 years) were exposed to traumatic events. A sequential mixed method design was used. In addition to the completion of the Impact Event Scale-Revised, qualitative data were collected through semi-structured interviews. These data were analyzed using thematic and cross-cultural methods. The survey took place from May 2019 to July 2020.ResultsOur study revealed three profiles of mothers with regard to the choice to disclose the traumatic story to the child: one group of mothers opted for silence (n = 4), the other for disclosure (n = 7) and the last group who were hesitant (n = 3). The modalities of choice were statistically associated with the severity of the post-traumatic stress symptoms, F (2, 11) = 4,62, p < .05. Specifically, women who made the choice of silence (M = 72.75, SD = 4.99) and those hesitated on the choice to disclosure (M = 71.33, SD = 7.51) reported higher scores on IES-R than those who made the choice to disclosure (M = 59.86, SD = 12.44). Six main themes emerged from the thematic and cross-cultural analysis of participants’ narratives: (1) the personalization of the traumatic experience, (2) the child seen as a weapon against collapse, (3) the fear of the child's personal reactions, (4) the possible partial disclosure, (5) the trauma narrative according to the child's age, and (6) the trap of the in-between two cultures.ConclusionOur results suggest that the recovery of these mothers from their trauma, through culturally appropriate therapeutic care, can effectively contribute to the choice to disclose their traumatic experiences to their children. This treatment can support them in developing open and healthy communication strategies to prevent the transmission of traumatic effects to their children.

Brief Report: Alexithymia Trait Severity, Not Autistic Trait Severity, Relates to Caregiver Reactions to Autistic Children's Negative Emotions.

Alexithymia impacts an individual's ability to recognize and understand emotions and frequently co-occurs with autism. This study investigated the relationship between children's alexithymia, autistic traits, and caregiver reactions to their child's negative emotions. Caregivers of 54 autistic and 51 non-autistic children between the ages of 7 and 12 years rated their child's alexithymia and autistic trait severity and their reactions to their child's negative emotions. Caregivers of autistic children reported greater supportive reactions and fewer restrictive/controlling reactions to their child's negative emotions when their child had more alexithymia traits. This study extends previous research by demonstrating that caregivers of autistic children with co-occurring alexithymia traits represent a specific subgroup of caregivers that respond more positively to their child's negative emotions.

Symbolic distancing in sharing situations restrains children's economic behavior and potentially also their inequity aversion

We examined whether representing a resource non-symbolically (i.e., as stickers) or symbolically (i.e., as tokens that could be exchanged for stickers) affected kindergartner's decisions in an Ultimatum/Inequity Game (N = 93). The game involved distribution offers, made by a fictitious child, that were either fair (i.e., same quantity for each child, i.e., 3:3) or disadvantageously unfair (i.e., less for the target child than for the fictitious child, i.e., 2:4 or 1:5). Children had to decide whether to accept or reject the offers. In the latter case, none of the children would get anything of the resource. Children rejected unfair offers more frequently than fair offers, and they rejected the offers involving the symbolic resource more frequently than offers involving the non-symbolic resource, which applied to a similar degree to fair and unfair offers. However, exploratory follow-up analyses of children's reactions to unfair offers revealed that children rejected the more unfair offer (i.e., 1:5) more frequently than the less unfair offer (i.e., 2:4) when the resource was represented non-symbolically instead of symbolically. The results suggest that the symbolic representation of a resource evokes economically less rational behavior in children and diminished their potential gain. Moreover, symbolic representations might level out children's differentiation of differently unfair offers. These findings are discussed in light of the subjective value approach and the Construal Level Theory.

Parents in couple therapy: An intervention targeting marital and coparenting relationships.

This article describes the treatment framework and core therapeutic principles of the integrative brief systemic intervention (IBSI), a manualized six‐session intervention intended for parents seeking couple therapy. IBSI aims to work on the couple's presenting problem, considering its specific impact in the marital and coparenting domains. The basic premise of IBSI is to consider that, when working with couples who have children, therapeutic work on their coparenting alliance may be used as a lever, as both parents may be particularly motivated to improve their relationship for their children's benefit. Increasing the coparenting alliance may then facilitate work on deeper conflicts within the marital relationship. The core therapeutic principles of IBSI are: (1) joining with the couple as romantic partners and a coparenting team from the start of the therapeutic process; (2) supporting the parents in increasing their awareness regarding their children's behavior and emotional experiences when facing their parents’ conflicts; and (3) working on the spill‐ and cross‐over effects between marital and coparenting relationships (i.e., exploring how conflict or positivity spills over from one relationship to the other or crosses over from one partner to the other). Therapeutic work following these main therapeutic principles is expected to improve the quality of both relationships. A clinical case is provided to illustrate the core therapeutic principles of IBSI.

Efficacy of Azithromycin plus Glucocorticoid Adjuvant Therapy on Serum Inflammatory Factor Levels and Incidence of Adverse Reactions in Children with Mycoplasma Pneumonia.

Objective This study was designed to explore the efficacy of azithromycin plus glucocorticoid adjuvant therapy on the levels of serum inflammatory factors and the incidence of adverse reactions in children with mycoplasma pneumonia. Method A total of 90 eligible children with mycoplasma pneumonia in our hospital from January 2019 to January 2020 were recruited. They were assigned to receive either azithromycin (control group) or azithromycin plus glucocorticoid (experimental group) according to the order of admission. Outcome measures included clinical efficacy, serum inflammatory factor indicators, lung function, clinical symptom mitigation, length of hospital stay, immune function, incidence of adverse reactions, and psychological status of the eligible children. Results Azithromycin plus glucocorticoid was associated with a significantly higher total clinical efficacy compared with azithromycin (P < 0.05). No significant differences were found in the serum inflammatory factor indices between the two groups (P > 0.05). The children given azithromycin plus glucocorticoid showed lower levels of serum inflammatory factors versus those given azithromycin alone (P < 0.001). Azithromycin plus glucocorticoid outperformed the monotherapy of azithromycin in terms of lung function (P < 0.001). Children after azithromycin plus glucocorticoid therapy had a faster clinical symptom disappearance and shorter length of hospital stay compared with after azithromycin alone (P < 0.001). Azithromycin plus glucocorticoid resulted in higher levels of immune function indices compared with azithromycin alone (P < 0.001). Azithromycin plus glucocorticoid was associated with a lower incidence of adverse reactions compared with azithromycin (P < 0.05). Lower Children's Depression Inventory (CDI) scores were witnessed in children given azithromycin plus glucocorticoid compared with monotherapy of azithromycin (P < 0.001). Conclusion Azithromycin plus glucocorticoid in children with mycoplasma pneumonia can effectively improve the clinical indicators of the children with promising efficacy and high safety, which is worthy of promotion and application.

Life under lockdown for children with autism spectrum disorder: Insights from families in South Africa.

Children with Autism Spectrum Disorder (ASD) remain vulnerable during the Covid-19 outbreak due to significant changes to their daily routines, social interactions and diets. In addition, these challenges may be exacerbated for children living in low- and middle-income countries (LMIC) such as South Africa where there are already barriers such as poverty, access to resources and availability of support. Understanding the impact of the Covid-19 outbreak on children with ASD is imperative in order to create awareness as well as provide equitable services and support to both children with ASD and their families. The study aimed to explore family-reported changes for children with ASD and their reactions and responses to the Covid-19 restrictions in South Africa. A qualitative research design was employed. Twelve families consisting of different family compositions with a total of 21 family members (mothers, fathers and grandmothers) participated in the current study using semistructured interviews. Data were transcribed and analysed using a framework method for thematic analysis. Findings indicated that children with ASD present with unique challenges related to Covid-19. Negative themes such as children's obstructive reactions due to the immediate changes to their routines, increases in emotional dysregulation as well as loss of previously acquired skills as a result of lack of access to services during lockdown were reported. However, families also reported on positive changes such as improved social interactions as children became more accustomed to their new lockdown routines. The Covid-19 response has had a negative impact on children with disabilities, specifically around access to services and support for both children with ASD and their families. While the future of the virus and impending lockdown measures is unknown, clinicians, providers and educators need to ensure that provisions are made for children's current adjustments as well as further adjustments to their current routines both during and after the pandemic.

Listening in: An Alternative Method for Measuring the Family Emotional Environment.

The family emotional environment influences children's development of emotion regulation in various ways. Children's difficulties with effectively regulating emotions, in turn, can contribute to the development of psychopathology. However, the pathways that explain how environmental emotion-including overheard emotion among family members-influences children's development of healthy or problematic emotion regulation are unclear. In this article, we briefly discuss the most common methods (e.g., questionnaires, laboratory observations) used to assess emotion in the family. We consider the benefits and limitations of these methods and discuss the need for objective measurement of the family emotional environment. We include a description of the Electronically Activated Recorder (EAR), which provides unobtrusive, extended sampling of the emotional tone of family interaction in the home. We present preliminary evidence of its use with 7- and 8-year-old and their families during one day at home. The method reveals that objectively assessed parent-to-parent interactions that are negatively toned, but not parental self-report of conflict or expressivity, are associated with children's self-reported emotional reactions to hearing independently recorded clips of their mothers' voices during simulated angry interactions. The finding suggests unique contributions of objective, unobtrusive, extended measurement of the family emotional environment to understanding aspects of children's emotional development that may not be captured with other commonly used methods. We discuss future directions that explore how EAR may be used to further our knowledge of the pathways between environmental emotion as a risk factor that influences children's emotional functioning and their psychological well-being.

Children Socio-emotional Development and Qualities of Sibling Relationship During COVID-19: Parents’ Perspective

Mobility restriction affected mesosystem social unit, including children's relationship with parents and surroundings. Declining outdoor activities and attention shifting might expose children to envy and jealousy stimuli. The current study proposed to explore the understanding, experience, and support that parents need to reinforce children's socio-emotional development. A qualitative study was conducted to analyze theoretical assumptions systematically. The method of the study was an interview, along with purposive sampling and snowball sampling. MAXQDA was used to analyze the data, underpinned with several processes, including intercoder agreement, code-recode, and validation of related sides. Thematic analysis showed 3 primary clusters and 2 secondary clusters, which indicated children and parents' responses. Nurturing emotional intelligence, warmth relationship, and playing are being the crucial frequency codes. The qualities of relationships worked dynamically in two ways simultaneously. The study reached a conclusion that the learning between children and parents can be supported by parental treatment of children's reactions and disputes, parental involvement, early contact in sibling relationships, childhood habits, and emotional intelligence teaching strategy.

Serious Adverse Drug Reactions in Children and Adolescents Treated On- and Off-Label with Antidepressants and Antipsychotics in Clinical Practice.

Introduction Despite the growing evidence base for psychotropic drug treatment in pediatric patients, knowledge about the benefit-risk ratio in clinical practice remains limited. The ‘Therapeutic Drug Monitoring (TDM)-VIGIL’ study aimed to evaluate serious adverse drug reactions (ADRs) in children and adolescents treated with antidepressants and/or antipsychotics in approved (‘on-label’), and off-label use in clinical practice. Methods Psychiatric pediatric patients aged 6-18 years treated with antidepressants and/or antipsychotics either on-label or off-label were prospectively followed between October 2014 and December 2018 within a multicenter trial. Follow-up included standardized assessments of response, serious ADRs and therapeutic drug monitoring. Results 710 youth (age=14.6±2.2 years, female=66.6%) were observed for 5.5 months on average; 76.3% received antidepressants, 47.5% antipsychotics, and 25.2% both. Altogether, 55.2% of the treatment episodes with antidepressants and 80.7% with antipsychotics were off-label. Serious ADRs occurred in 8.3% (95%CI=6.4–10.6%) of patients, mainly being psychiatric adverse reactions (77.4%), predominantly suicidal ideation and behavior. The risk of serious ADRs was not significantly different between patients using psychotropics off-label and on-label (antidepressants: 8.1% vs. 11.3%, p=0.16; antipsychotics: 8.7% vs 7.5%, p=0.67). Serious ADRs occurred in 16.6% of patients who were suicidal at enrollment versus 5.6% of patients who were not suicidal (relative risk 3.0, 95%CI=1.9-4.9). Conclusion Off-label use of antidepressants and antipsychotics in youth was not a risk factor for the occurrence of serious ADRs in a closely monitored clinical setting. Results from large naturalistic trials like ours can contribute to bridging the gap between knowledge from randomized controlled trials and real-world clinical settings.

Hyperacusis in Children: A Thematic Analysis of Discussions in Online Forums.

Hyperacusis is commonly defined as reduced tolerance to everyday sounds leading to avoidance behavior and disrupting normal functioning. Hyperacusis is prevalent in children. However, the literature on the manifestation and impact of hyperacusis on children is scant. This qualitative study examined online discussion forums to understand the lived experiences of hyperacusis in children from a parent or carer perspective. Posts from publicly available online discussion forums were thematically analyzed. Online searching identified 219 potentially relevant conversation threads across 18 forums and involving 1,436 forum users. A total number of 170 eligible conversation threads, containing 1,834 messages, were used in the analysis. Thematic analysis of the data generated six themes: personal and health information about the child, onset and prognosis, bothersome sounds and characteristics, reactions, coping strategies, and impact. Hyperacusis onset was associated with loud noise, physical trauma, or stress. Bothersome sounds were categorized in terms of appliances, vehicles, public places, nature, and very loud sounds. Children's reactions included panic, shaking, and screaming. Strategies to manage hyperacusis included ear defenders, building up tolerance, and school adaptations. Hyperacusis had an impact on various aspects of the child's life including academic performance and social development. This is the first study to account for the lived experiences of children experiencing hyperacusis from a parent/carer perspective using online forum data. These findings expand on existing research on the manifestation of hyperacusis in children and provide a basis for further work improving clinical assessment and management.

Food Proteins in Human Breast Milk and Probability of IgE-Mediated Allergic Reaction in Children During Breastfeeding: A Systematic Review

Previous reports suggested that food proteins present in human milk (HM) may trigger symptoms in allergic children during breastfeeding, but existing evidence has never been reviewed systematically. To assess the probability of food proteins in HM to trigger allergic reactions in infants with IgE-mediated food allergy. Electronic bibliographic databases (MEDLINE, EMBASE) were systematically searched from inception to November 3, 2021. The data regarding the levels of food proteins detected in HM were extracted and compared with data from the Voluntary Incidental Trace Allergen Labelling (VITAL 3.0) guide to assess the probability of food-allergic individuals to experience immediate type allergic reactions on ingesting HM. A total of 32 studies were identified. Fourteen studies assessed excretion of cow's milk proteins into HM, 9 egg, 4 peanut, and 2 wheat; 3 measured levels of cow's milk and egg proteins simultaneously. We found that levels of all food proteins across the studies were much lower than the eliciting dose for 1% of allergic individuals (ED01) in most of the samples. The probability of an IgE-mediated allergic reaction in a food-allergic infant breastfed by a woman consuming the relevant food can be estimated as ≤1:1000 for cow's milk, egg, peanut, and wheat. To our knowledge, this is the first systematic review that assesses and summarizes evidence on food proteins in HM and potential for IgE-mediated allergic reactions. Our data suggest that the probability of IgE-mediated allergic reactions to food proteins in HM is low.