Second Week Of Life Research Articles

Clinical Pharmacology of Fluconazole in Neonates: Effects and Pharmacokinetics

Fluconazole is commonly used both to prevent and to treat invasive neonatal Candida albicans infection. This drug is a potent, selective, triazole inhibitor of the fungal enzymes involved in ergosterol synthesis. It is largely excreted unchanged in the urine. In infants with a birth weight <1,500 grams, fungal infection is approximately 3% to 4%. Up to 30% of infants with invasive candidiasis die. Penetration into the cerebral spinal is good. While high-dose systemic exposure of 400 mg/day in the first trimester of pregnancy can produce serious fetal abnormalities a single dose of 150 mg of fluconazole does not produce fetal abnormalities. The fluconazole exposure target AUC of ≥400 µg.h/ml should be reached and a dosage of 12 mg/kg/day is recommended. However, to reach the desired fluconazole concentration a loading dose of 25 mg/kg of fluconazole is used in patients with candidiasis on the first day of therapy. The half-life of fluconazole ranges from 25.5 to 88.6 hours while adults it is 32 hours. In prematures, the half-life of fluconazole is 88.6, 67.5 and 55.2 hours, in the first day, in the first week and in the second week of life, respectively. The clearance of fluconazole ranges from 0.27 to 0.52 ml/min/kg and the adults it is 0.27 ml/min/kg. The distribution volume of fluconazole ranges from 1.1 to 2.4 l/kg and in adults it is 0.60 l/kg. The aim of this study is to review the effects and pharmacokinetics of fluconazole in neonates.

A CHALLENGING CASE OF SEVERE INFANTILE CHOLESTASIS IN ALPHA-1 ANTITRYPSIN DEFICIENCY

Jaundice in the newborn period can be physiologic and is often due to benign causes. Jaundice due to conjugated hyperbilirubinemia extending beyond the second week of life may be an early sign of several cholestatic or metabolic liver diseases, and it requires logical and timely analysis so that specific treatments can be initiated. A1AT deficiency is the most common genetic cause of pediatric liver disease and transplantation, and it must be considered when evaluating cholestatic infants. Here, we present an unusual case of A1AT deficiency with severe infantile cholestasis and rapid decompensation in the first 4 months of life, where in-depth but timely diagnosis was crucial for the appropriate intervention to take place.

Feasibility and efficacy of gentamicin for treating neonatal sepsis in community-based settings: a systematic review.

Neonatal sepsis is a leading cause of neonatal deaths in developing countries. The current recommended in-hospital treatment is parenteral ampicillin (or penicillin) and gentamicin in young infants for 10- 14 days; however, very few could access and afford. The current review is to evaluate the feasibility of gentamicin in community based settings. Both observational and randomized controlled trials were included. Medline, Embase, Cochrane Central Register of Controlled Trials and Central Trial Register of India were searched until September 2013. We assessed the risk of bias by Cochrane Collaboration's "risk of bias" tool. Two observational studies indicated feasibility ensuring coverage of population, decrease in case fatality rate in the group treated by community health workers. In an RCT, no significant difference was observed in the treatment failure rates [odds ratio (OR)=0.88], and the mortality in the first and second week (OR=1.53; OR=2.24) between gentamicin and ceftriaxone groups. Within the gentamicin group, the combination of penicillin and gentamicin showed a lower rate of treatment failure (OR=0.44) and mortality at second week of life (OR=0.17) as compared to the combination of gentamicin and oral cotrimoxazole. Gentamicin for the treatment of neonatal sepsis is both feasible and effective in community-based settings and can be used as an alternative to the hospitalbased care in resource compromised settings. But there was less evidence in the management of neonatal sepsis in hospitals as was seen in this review in which we included only one RCT and three observational studies.

Pseudohypoaldosteronism type 1 due to novel variants of SCNN1B gene.

SummaryAutosomal recessive pseudohypoaldosteronism type 1 (PHA1) is a rare disorder characterized by sodium wasting, failure to thrive, hyperkalemia, hypovolemia and metabolic acidosis. It is due to mutations in the amiloride-sensitive epithelial sodium channel (ENaC) and is characterized by diminished response to aldosterone. Patients may present with life-threatening hyperkalemia, which must be recognized and appropriately treated. A 32-year-old female was referred to the National Institutes of Health (NIH) for evaluation of hyperkalemia and muscle pain. Her condition started in the second week of life, when she was brought to an outside hospital lethargic and unresponsive. At that time, she was hypovolemic, hyperkalemic and acidotic, and was eventually treated with sodium bicarbonate and potassium chelation. At the time of the presentation to the NIH, her laboratory evaluation revealed serum potassium 5.1 mmol/l (reference range: 3.4–5.1 mmol/l), aldosterone 2800 ng/dl (reference range: ≤21 ng/dl) and plasma renin activity 90 ng/ml/h (reference range: 0.6–4.3 ng/ml per h). Diagnosis of PHA1 was suspected. Sequencing of the SCNN1B gene, which codes for ENaC, revealed that the patient is a compound heterozygote for two novel variants (c.1288delC and c.1466+1 G>A), confirming the suspected diagnosis of PHA1. In conclusion, we report a patient with novel variants of the SCNN1B gene causing PHA1 with persistent, symptomatic hyperkalemia.Learning points PHA1 is a rare genetic condition, causing functional abnormalities of the amiloride-sensitive ENaC.PHA1 was caused by previously unreported SCNN1B gene mutations (c.1288delC and c.1466+1 G>A).Early recognition of this condition and adherence to symptomatic therapy is important, as the electrolyte abnormalities found may lead to severe dehydration, cardiac arrhythmias and even death.High doses of sodium polystyrene sulfonate, sodium chloride and sodium bicarbonate are required for symptomatic treatment.

Single stage surgical treatment of amniotic band syndrome: Case report

Amniotic band syndrome is a rare congenital disorder with clinical presentation of constricting bands in different parts of extremities or whole extremities. Conservative or surgical treatment is provided depending on the type and severity of the anomaly. The paper presents the case of a neonate patient with constriction bands localized on the left leg. During the second week of life, a surgery was indicated, and a single-stage multiple Z-plasty was performed to correct the anomalies on the left lower leg. Postoperative edema in the distal part of the lower leg was easily managed by incisions and drainage. Two months later, the correction of the stricture of the left thigh was managed using the same procedure. The postoperative course was uneventful and the outcome was satisfactory after a two-year follow-up. Evaluation of a patient with amniotic band syndrome, as well as diagnosis, monitoring, treatment and postoperative care, should always be multidisciplinary. A single-stage correction approach provided satisfactory both functional and aesthetic results. Given many morphological variations of the syndrome, a decision on the strategy of treatment should be made individually for each patient.

Multicolor mapping of the cardiomyocyte proliferation dynamics that construct the atrium.

The orchestrated division of cardiomyocytes assembles heart chambers of distinct morphology. To understand the structural divergence of the cardiac chambers, we determined the contributions of individual embryonic cardiomyocytes to the atrium in zebrafish by multicolor fate-mapping and we compare our analysis to the established proliferation dynamics of ventricular cardiomyocytes. We find that most atrial cardiomyocytes become rod-shaped in the second week of life, generating a single-muscle-cell-thick myocardial wall with a striking webbed morphology. Inner pectinate myofibers form mainly by direct branching, unlike delamination events that create ventricular trabeculae. Thus, muscle clones assembling the atrial chamber can extend from wall to lumen. As zebrafish mature, atrial wall cardiomyocytes proliferate laterally to generate cohesive patches of diverse shapes and sizes, frequently with dominant clones that comprise 20-30% of the wall area. A subpopulation of cardiomyocytes that transiently express atrial myosin heavy chain (amhc) contributes substantially to specific regions of the ventricle, suggesting an unappreciated level of plasticity during chamber formation. Our findings reveal proliferation dynamics and fate decisions of cardiomyocytes that produce the distinct architecture of the atrium.

Plastibell circumcision of 2,276 male infants: a multi-centre study.

IntroductionThe World Health Organization's manual on male circumcision listed Plastibell technique as a well-proven paediatric method with respect to the results and complications. Although, literatures abound on its wide acceptability, there are few multi-centered reports from this environment. The objective was to evaluate the cases of infant circumcision by Plastibell device from two medical institutions.MethodsAll consecutive infants who had Classical Plastibell Circumcision (PC) at the Federal Staff Medical Centre, Abuja and the Lagos State University Teaching Hospital, Ikeja between February 2011 and June 2015 were included in this cross-sectional study. The procedures were performed by surgical registrars and medical officers after ninety minutes of topical anesthesia to the penis. Data harvested from the standard proforma were analysed using Statistical Package for Social Science 20.0 for window.ResultsA total of 2,276 infants had classical PC within the study period. Their ages at circumcision ranged from 4 days to 3 months with a mean age of 17 days. Majority of the boys were circumcised at second week of life (n=1,394,61.2%). All the cases were performed for religious (53%) and cultural (47%)reasons. The most common Plastibell size deployed was 1.3cm (n=1,040, 45.7%) while 1.6cm was the least commonly used ring (n=10, 0.4%). The mean time for device to fall-off was 6 days (range 4-12 days). There was no correlation between the age at circumcision and Plastibell size. We recorded an overall complication rate of 1.1% with postoperative bleeding leading the pack (n=12, 48%). No case of urethrocutaneous fistula was seen. We detected 17 cases (0.7%) of distal hypospadias in whom circumcisions were postponed till the time of hypospadias repairs.ConclusionThe main indication for infant circumcision in our environment was religious. The PC has good safety profile with few easily correctable early complications. Detailed attention to placement of ligature, selection of appropriate Plastibell size and adequate parental education are key to preventing post-procedure mishaps.

Newborn Screening Programmes in Europe, Arguments and Efforts Regarding Harmonisation: Focus on Organic Acidurias.

The state of newborn screening (NBS) programmes for organic acidurias in Europe was assessed by a web-based questionnaire in the EU programme of Community Action in Public Health 2010/2011 among the - at that time - 27 EU member states, candidate countries, potential candidates and three EFTA countries. Thirty-seven data sets from 39 target countries were analysed. Newborn screening for glutaric aciduria type I (GA-I) was performed in ten, for isovaleric aciduria (IVA) in nine and for methylmalonic aciduria including cblA, cblB, cblC and cblD (MMACBL) as well as for propionic aciduria (PA) in seven countries. Samples were obtained at a median age of 2.5 days and laboratory analysis began at median age of 4.5 days. Positive screening results were mostly confirmed in specialised centres by analysis of organic acids in urine. Confirmation of a positive screening result usually did not start before the second week of life (median ages: 9.5 days [IVA], 9 days [GA-I], 8.5 days [PA, MMACBL]) and was completed early in the third week of life (median ages: 15 days [IVA, PA, MMA], 14.5 days [GA-I]). Treatment was initiated in GA-I and IVA at a median age of 14 days and in MMACBL and PA at a median age of 15 days. NBS for organic acidurias in Europe is variable and less often established than for amino acid disorders. While for GA-I its benefit has already been demonstrated, there is room for debate of NBS for IVA and especially PA and MMACBL.

A postnatal peak in microglial development in the mouse hippocampus is correlated with heightened sensitivity to seizure triggers.

Explosive synaptogenesis and synaptic pruning occur in the hippocampus during the first two weeks of postnatal life, coincident with a heightened susceptibility to seizures in rodents. To determine the temporal correlation between microglial development and age-dependent susceptibility and response to seizures, we quantified developmental changes in basal microglia levels and seizure-induced microglial activation in the hippocampus of Cx3Cr1(GFP /+) transgenic mice. Basal levels of microglia were quantified in the hippocampi of Cx3Cr1(GFP /+) mice at P0, P5, P10, P15, P20, P25, P30, P40, and P60. Seizure susceptibility and seizure-induced microglial activation were assessed in response to febrile seizures (lipopolysaccharide followed by hyperthermia) and kainic acid-induced status epilepticus. The density of microglia within the hippocampus increased rapidly after birth, reaching a peak during the second week of life - the age at which the animals became most vulnerable to seizure triggers. In addition, this peak of microglial development and seizure vulnerability during the second postnatal week represented the time of maximal seizure-induced microglia activation. Overreactive innate immunity mediated by activated microglia may exacerbate acute injury to neuronal synapses and contribute to the long-term epileptogenic effects of early-life seizures. Anti-inflammatory therapy targeting excessive production of inflammatory mediators by activated microglia, therefore, may be an effective age-specific therapeutic strategy to minimize neuronal dysfunction and prevent increases in susceptibility to subsequent seizures in developing animals.

Lethal Cardiomyopathy in Mice Lacking Transferrin Receptor in the Heart.

Both iron overload and iron deficiency have been associated with cardiomyopathy and heart failure, but cardiac iron utilization is incompletely understood. We hypothesized that the transferrin receptor(Tfr1) might play a role in cardiac iron uptake andused gene targeting to examine the role of Tfr1 invivo. Surprisingly, we found that decreased iron, due to inactivation of Tfr1, was associated with severe cardiac consequences. Mice lacking Tfr1 in the heart died in the second week of life and had cardiomegaly, poor cardiac function, failure of mitochondrial respiration, and ineffective mitophagy. The phenotype could only be rescued by aggressive iron therapy, but it was ameliorated by administration of nicotinamide riboside, an NAD precursor. Our findings underscore the importance of both Tfr1 and iron in the heart, and may inform therapy for patients with heart failure.

Spanish Society for Pediatric Infectious Diseases guidelines on tuberculosis in pregnant women and neonates (I): Epidemiology and diagnosis. Congenital tuberculosis

Tuberculosis (TB) screening in pregnancy using tuberculin skin test (TST) is recommended in case of symptoms of TB disease, close contact with a patient with infectious TB, or high risk of developing active disease. The new interferon gamma release assay (IGRA) tests are recommended in BCG-vaccinated pregnant women with positive TST and no known risk factors for TB, and in those immunocompromised, with clinical suspicion of TB but negative TST. TB diagnosis is difficult due to the non-specific symptoms, the increased frequency of extrapulmonary disease, the delay in radiological examinations, and the high rate of tuberculin anergy. Neonatal TB can be acquired in utero (congenital TB), or through airborne transmission after delivery (postnatal TB). Congenital TB is extremely rare and does not cause fetal malformations. It may be evident at birth, although it usually presents after the second week of life. In newborns with no family history of TB, the disease should be considered in cases of miliary pneumonia, hepatosplenomegaly with focal lesions, or lymphocytic meningitis with hypoglycorrhachia, especially in those born to immigrants from high TB-burden countries. TST is usually negative, and IGRAs have lower sensitivity than in older children. However, the yield of acid-fast smear and culture is higher, mostly in congenital TB. Molecular diagnosis techniques enable early diagnosis and detection of drug resistance mutations. There is a substantial risk of disseminated disease and death.

Body composition of term healthy Indian newborns.

Previous anthropometry-based studies have suggested that in Indian newborns fat mass is conserved at the expense of lean tissue. This study was undertaken to assess the body composition of Indian newborns and to evaluate its relation with parents' anthropometry, birth weight and early postnatal weight gain. Body composition of healthy term singleton newborns was assessed by the deuterium dilution method in the second week of life. Anthropometry was carried out at birth and on the day of study. Data from 127 babies were analyzed. Birth weight was 2969±383 g. Body composition was assessed at a mean age of 12.7±3.1 days. Fat and fat-free mass were 354±246 and 2764±402 g, respectively, and fat mass percentage (FM%) was 11.3±7.3%. Birth weight and fat-free mass were higher among boys, but no gender difference was noted in FM%. Birth weight was positively correlated with fat as well as fat-free mass but not FM%. FM% showed positive correlation with gain in weight from birth to the day of assessment. This is the first study from India to report body composition in newborns using deuterium dilution. FM% was comparable to that reported for Western populations for babies of similar age. Our results suggest that the percentage of fat and fat-free mass is relatively constant over the range of birth weights included in this study, and greater weight gain during early postnatal period results in greater increase in FM%.

Intraluminal esophageal teratoma in a neonate

Abstract Teratomas are germ cell tumors containing one or more of the three embryonic layers (endoderm, mesoderm, and ectoderm). In neonates, the sacrococcygeal region is the most frequent site of origin, followed by the gonads and mediastinum. While most mediastinal teratomas are anterior, approximately 3–8% are found within the posterior mediastinum. Here we report the case of an infant who presented in the second week of life with frequent emesis followed by choking, dyspnea, and perioral cyanosis. An esophagram demonstrated a large pedunculated polypoid mass within the lumen of the esophagus. CT confirmed a 5 × 1.8 cm intraluminal mass with a stalk originating from the posterior wall of the esophagus at C6. Endoscopic retrieval was not possible due to its large size. The mass was operatively resected via a right-sided, 2 cm transverse cervical incision. An oblique esophagotomy was made; the polypoid mass was grasped and eviscerated using serial traction sutures. The mass was excised along with a rim of normal esophageal mucosa. Final pathology demonstrated a mature and solitary esophageal teratoma. To our knowledge, this is the first reported case of an intraluminal cervical esophageal teratoma, and the youngest patient in which a pedunculated esophageal polyp has been described.

Face recognition in newly hatched chicks at the onset of vision.

How does face recognition emerge in the newborn brain? To address this question, we used an automated controlled-rearing method with a newborn animal model: the domestic chick (Gallus gallus). This automated method allowed us to examine chicks' face recognition abilities at the onset of both face experience and object experience. In the first week of life, newly hatched chicks were raised in controlled-rearing chambers that contained no objects other than a single virtual human face. In the second week of life, we used an automated forced-choice testing procedure to examine whether chicks could distinguish that familiar face from a variety of unfamiliar faces. Chicks successfully distinguished the familiar face from most of the unfamiliar faces-for example, chicks were sensitive to changes in the face's age, gender, and orientation (upright vs. inverted). Thus, chicks can build an accurate representation of the first face they see in their life. These results show that the initial state of face recognition is surprisingly powerful: Newborn visual systems can begin encoding and recognizing faces at the onset of vision.

Guía de la Sociedad Española de Infectología Pediátrica sobre tuberculosis en la embarazada y el recién nacido (I): epidemiología y diagnóstico. Tuberculosis congénita

Tuberculosis (TB) screening in pregnancy using tuberculin skin test (TST) is recommended in case of symptoms of TB disease, close contact with a patient with infectious TB, or high risk of developing active disease. The new interferon gamma release assay (IGRA) tests are recommended in BCG-vaccinated pregnant women with positive TST and no known risk factors for TB, and in those immunocompromised, with clinical suspicion of TB but negative TST. TB diagnosis is difficult due to the non-specific symptoms, the increased frequency of extrapulmonary disease, the delay in radiological examinations, and the high rate of tuberculin anergy. Neonatal TB can be acquired in utero (congenital TB), or through airborne transmission after delivery (postnatal TB). Congenital TB is extremely rare and does not cause fetal malformations. It may be evident at birth, although it usually presents after the second week of life. In newborns with no family history of TB, the disease should be considered in cases of miliary pneumonia, hepatosplenomegaly with focal lesions, or lymphocytic meningitis with hypoglycorrhachia, especially in those born to immigrants from high TB-burden countries. TST is usually negative, and IGRAs have lower sensitivity than in older children. However, the yield of acid-fast smear and culture is higher, mostly in congenital TB. Molecular diagnosis techniques enable early diagnosis and detection of drug resistance mutations. There is a substantial risk of disseminated disease and death.

Feeding milk replacer instead of whole milk affects blood plasma proteome and lipid profile in preruminant calves.

The study was undertaken to determine the effect of feeding milk or milk-replacer on the blood plasma proteome and lipid profile in calves during the second week of life. Feeding milk-replacer significantly decreased the expression of plasma apoA-I. Age of calves affected apoA-I expression, which was higher on the 8th than on the 11th and 14th day of life. A significant effect of interaction between diet and age was also observed. The expression of apoA-IV, was significantly affected by diet and was lower in calves fed milk replacer. Expression of this protein was significantly lower at the 8th day of life and was up-regulated in the calves fed milk-replacer at the second week of life. Calves fed milk-replacer had greater expression of haptoglobin, which differed significantly between days of blood sampling, being higher on the 8th than on the 11th and 14th day. The interactive effect of diet and age affected haptoglobin expression, which was successively down-regulated in calves fed milk re- placer. Diet had a significant effect on the plasma lipid profile. Animals fed milk had a greater concentration of TC, HDLC and LDLC. The composition of milk-replacer, especially fat source, is probably the main factor that affects expression of proteins involved in cholesterol metabolism and level of components of lipid profile in calves fed formula. We claim that the initially increased level of haptoglobin, followed by its decrease during the second week of life in calves fed milk-replacer may indicate the presence of short-term stress induced by changes in the feeding system.

An automated controlled-rearing method for studying the origins of movement recognition in newly hatched chicks.

Movement recognition is central to visual perception and cognition, yet its origins are poorly understood. Can newborn animals encode and recognize movements at the onset of vision, or does this ability have a protracted developmental trajectory? To address this question, we used an automated controlled-rearing method with a newborn animal model: the domestic chick (Gallus gallus). This automated method made it possible to collect over 150 test trials from each subject. In their first week of life, chicks were raised in controlled-rearing chambers that contained a single virtual agent who repeatedly performed three movements. In their second week of life, we tested whether chicks could recognize the agent's movements. Chicks successfully recognized both individual movements and sequences of movements. Further, chicks successfully encoded the order that movements occurred within a sequence. These results indicate that newborn visual systems can encode and recognize movements at the onset of vision and argue for an increased focus on automated controlled-rearing methods for studying the emergence of perceptual and cognitive abilities.

Modelagem Fuzzy aplicada na avaliação do desempenho de frangos de corte

Com o objetivo de analisar o efeito da idade e a temperatura do ar nas respostas produtivas de frangos de corte, conduziu-se um experimento com animais criados de 1 a 21 dias de idade em túneis de vento climatizados cujos resultados observados foram utilizados no desenvolvimento e teste de um modelo matemático Fuzzy capaz de quantificar esta relação. O modelo desenvolvido tem, como variáveis de entrada: temperatura da primeira semana de vida (ºC), temperatura da segunda semana de vida (ºC) e a idade das aves (semanas), sendo que as variáveis de saída consideradas foram consumo de ração (CR, g), ganho de peso (GP, g) e conversão alimentar (CA, g g-1). O método de inferência de Mandani foi utilizado para elaboração de 36 regras e na defuzificação foi aplicado o método do centro de gravidade. Com base nos resultados e ao se comparar os dados medidos com os obtidos pela simulação com o modelo Fuzzy proposto, coeficientes de determinação (R2) da ordem de 0,9989; 0,9960 e 0,9801 foram verificados para CR, GP e CA, respectivamente.

Cardiac regeneration: harnessing the power within.

The ability of the heart to regenerate to a meaningful extent after injury has been demonstrated in animal models, such as zebrafish1; however, higher organisms seem to have lost this advantageous capacity, leading to cell loss and subsequent heart failure after insult. Recent studies found a narrow window of regenerative opportunity during the first 7 days after birth in mice, but this capacity fades away by the second week of life.2 In this study, Aguirre et al hypothesize that molecular mechanisms underlying cardiomyocyte regeneration in lower organisms are present, although dormant, in mammals creating a powerful prospect for regenerative interventions.3 The authors concentrate on the study of miRNAs as regulators of multiple simultaneous processes potentially involved in regeneration. Leveraging the established zebrafish model of cardiac regeneration after amputation of the ventricular apex, they identify changes in miRNA expression during regeneration, focusing on entities evolutionary conserved across vertebrates. Predictive algorithms are used to pinpoint downstream targets of miRNAs of interest, which are validated through luciferase reporter assays before subsequent experiments. Levels of candidate miRNAs, as well as their targets of interest, are assessed in zebrafish during heart development and regeneration using quantitative RT-PCR and immunofluorescence. With these readouts, direct functional correlation between miRNAs and target proteins is tested by modulation of miRNA/target levels using mimics, antago miRs, morpholinos, as well as rescue mRNAs. Additionally, bromodeoxyuridine incorporation is also monitored to identify cell proliferation. Levels of miR-99/100 and Let-7a/c together with target genes FNTβ (beta subunit of farnesyl-transferase) and SMARCA5 (SWI/SNF-related matrix–associated actin-dependent regulator of chromatin subfamily a, member 5) are also examined in various samples representative of human and murine cardiomyocyte differentiation and heart development, including …

Intensive rearing of male calves during the first three weeks of life has long-term effects on number of islets of Langerhans and insulin stained area in the pancreas.

Permanent effects of early postnatal nutrition on the development and function of tissues and organs have been previously demonstrated primarily in humans and rodents. The objective of this study in calves was to analyze the impact of rearing conditions during the first 3 wk of life on morphology of insulin-producing pancreatic β-cells. Forty-two male Holstein calves were raised during the first 3 wk of life either intensively (intensively reared [INT]; ad libitum milk feeding and individual hutches; = 21) or according to an established restrictive rearing protocol (4 L milk/d) during wk 1 in hutches and 720 g/d milk replacer (MR) from d 8 to 21 in group pens (restrictively reared [CON]; = 21). Thereafter, all calves were housed and fed under comparable conditions. Birth weight and weekly BW up to wk 10 were recorded. Plasma glucose, insulin, IGF-1, and GH levels were assessed in wk 1, 2, 3, and 10 of life. Slaughtering took place after 8 mo and pancreatic tissue from the medium body (corpus pancreatic) was removed. The number of islets of Langerhans and the insulin stained area were examined histologically. Total milk intake of INT calves was nearly double the intake in CON calves in the first 3 wk of life ( < 0.01). Daily starter intake during wk 4 to 10 of life did not differ between groups ( = 0.24). During the first 3 wk, the ADG were up to 9 times higher in INT calves compared to CON calves ( < 0.01), yet BW at time of slaughter did not differ ( = 0.18). Intensive rearing led to increased plasma glucose, insulin, and IGF-1 concentrations after 3 wk of life compared with rearing to the established standard protocol (all < 0.05), whereas GH was lower in INT calves during the second week of life. At time of slaughter, the mean number of islets of Langerhans was higher in INT calves compared to CON calves (9.1 ± 0.3 vs. 7.8 ± 0.3; < 0.01). Also, the total insulin stained area per photograph was higher in INT calves compared to CON calves (107,180 ± 4,987 vs. 84,249 ± 4,962 μm; < 0.01). Number of islets of Langerhans was negatively associated with birth weight but positively correlated with insulin and in trend with IGF-1 plasma levels during the second week of life. Insulin stained area tended to be linked with IGF-1 concentration during the third week of life. In conclusion, differences in the morphology of pancreatic islets of Langerhans indicate that calves can be programmed metabolically by an altered postnatal rearing intensity.