Toddler Age Research Articles

Maternal Self-Health on Toddler Diarrhea associated with Environmental Sanitation in Deli Tua Health Center Area

Morbidity surveys conducted by the Sub-directorate of Disease Control Prevention and Environmental Health (P2PL) of the Health Office from 2000 to 2010, there was an increase in the incidence of diarrhea. Many factors contribute to the increasing incidence of diarrhea, especially among children under five years of age, including maternal personal hygiene and environmental sanitation. In 2014 there were six diarrhea outbreaks that were widely spread in five provinces and six districts or cities, the number of patients increased to 2,549 people with twenty-nine deaths (CFR 1.14%) and North Sumatra was one of the five provinces with the most cases. This study was conducted in Deli Tua Subdistrict, Deli Serdang Regency, North Sumatra, for approximately 8 months from April to December 2016 is an observational analytic study with a cross sectional approach. The sample of this study were 50 mothers who brought their toddlers to the Deli Tua Health Center. The statistical analysis used was chi square test. The results showed there was a relationship between the mother's hand washing behavior (p = 0.05), the use of water sources (p = 0.04) and the age of toddlers (p = 0.00) with the incidence of diarrhea in toddlers in the Deli Tua Health Center working area.

Prenatal tobacco and tobacco-Cannabis co-exposure and unpredictability in maternal anger/hostility: Implications for toddler reactivity

Tobacco and cannabis are frequently used together during pregnancy. However, relatively little is known about how co-use and related maternal risk factors impact toddler reactivity. One understudied risk factor is maternal experience of anger/hostility, despite evidence suggesting that individuals who use substances experience more anger/hostility. In addition, mood unpredictability in anger/hostility (MUA), a relatively novel construct, may be particularly important for mothers who use substances as they attempt to cut down or quit during pregnancy and may also impact toddler reactivity. Importantly, prenatal exposures may also impact toddler outcomes via continued postnatal exposure and infant reactivity. We examined a conceptual model linking prenatal tobacco and tobacco-cannabis co-use, maternal anger/hostility, and unpredictability in anger/hostility with toddler reactivity in a sample (N = 247 at recruitment, 190 at toddler age; N = 247 for model testing) of dyads recruited during the first trimester of pregnancy into a tobacco group (use of combustible cigarettes; including sub-group of women who also used cannabis) and a non-substance use group. Results indicated a direct effect of prenatal co-exposure on blunted toddler reactivity for males only. Mothers who used substances prenatally had the highest levels of anger/hostility and MUA. Prenatal anger/hostility and MUA were associated with higher reactivity at infancy which in turn, was associated with higher toddler reactivity. Prenatal co-exposure and higher prenatal maternal anger/hostility was associated with continued postnatal exposure to cannabis which in turn, was associated with higher reactivity at toddlerhood. Results highlight the importance of examining prenatal co-exposure and continued postnatal cannabis exposure as well as associated maternal risk factors such as anger/hostility and MUA for toddler developmental outcomes.

Routine third-trimester ultrasonography and child neurodevelopmental outcomes: a follow-up of a pragmatic cluster-randomised controlled trial

ABSTRACT Aims/Background Routine third-trimester ultrasonography is increasingly conducted to screen for foetal growth restriction (FGR) and reduce adverse perinatal and child neurodevelopmental outcomes using timely obstetric management. While it did not reduce adverse perinatal outcomes in previous trials, evidence regarding its association with child neurodevelopmental outcome is absent. We examined whether routine third-trimester ultrasonography is positively associated with child developmental and behavioural/emotional outcomes compared to usual care. Design/Methods Dutch mothers with a low-risk pregnancy participating in a subsample (n = 1070) of a nationwide cluster-randomised trial reported infant (age 6 months) and toddler (age 28 months) developmental milestones (Ages and Stages Questionnaire) and toddlers’ internalising and externalising problems (Child Behavior Checklist). Usual care (n = 380) comprised selective ultrasonography. The intervention strategy (n = 690) included two routine third-trimester ultrasounds next to usual care. Both strategies applied the same interdisciplinary protocol for FGR detection and management. Results Adjusted linear mixed-level regressions revealed that routine third-trimester ultrasonography was positively but modestly related to z-standardised infant developmental milestones at 6-month follow-up, B = 0.20, 95%CI [0.07; 0.32], p = 0.003, compared to usual care. At 28-month follow-up, these strategies did not differ in child developmental outcome and internalising and externalising problems. Conclusion Routine third-trimester ultrasonography was positively but modestly associated with infant development. In toddlerhood, routine ultrasonography was not related to child developmental and behavioural/emotional outcomes. Overall, these findings do not support the implementation of routine third-trimester ultrasonography for low-risk pregnant women for reasons concerning children’s early neurodevelopmental outcomes.

Etiologic and demographic characteristics of syncope in children and adolescents: a nationwide population-based study in Korea.

Syncope is common among children and adolescents. Although it is most commonly caused by vasovagal syncope, it can also be due to undiagnosed, potentially serious, or even life-threatening conditions. We aimed to investigate the distribution of subsequent sinister diagnoses, such as heart disease (HD) and epilepsy, and analyze their demographic characteristics in children presenting with syncope. This nationwide, population-based study was conducted using the Korean Health Insurance Review and Assessment Service database. Patients aged <19 years at the time of their first visit between January 2010 and December 2014, who had primary, secondary, or additional diagnostic codes for syncope, were selected and followed up for a minimum of 5 years from the index date to investigate subsequent diagnoses of HD or epilepsy. Patient demographics, diagnostic codes, and prescriptions were retrieved from the database. A total of 75,839 patients with new-onset syncope were identified, of which 239 (0.3%) and 2,516 (3.3%) were subsequently diagnosed with HD and epilepsy, respectively. In the infant, toddler, and preschool age groups, the proportions of patients with subsequent diagnoses of HD and epilepsy were relatively lower (5/5,353, 0.1%) and higher (206/5,353, 3.8%), respectively, than the proportions in the other age groups. A male preponderance was noted for patients with syncope who were later diagnosed with HD or epilepsy (P<0.001). The proportion of patients experiencing syncope with a subsequent diagnosis of HD was relatively high in the summer. The subsequent diagnosis of potentially life-threatening diseases in pediatric syncope, including HD and epilepsy, is relatively low in all age groups. In addition to comprehensive history taking and physical examination, demographic data such as age and sex, and season of occurrence, can aid in diagnosing the underlying cause of pediatric syncope by helping to identify patients who may require further investigations.

Analysis of Factors Associated with the Incidence of Injury in Children Under Five Years in Cakung East Jakarta

Children of toddler age (pre-school) very often experience injuries, both minor and major. Therefore, the role of parents is important in monitoring, protecting, and providing knowledge to children about what to do and what not to do. The study aims to determine the relationship between attitude, level of knowledge, and behavior with the incidence of injury in children under five years of age in Cakung, East Jakarta. This research plan uses an analytical descriptive design with a Cross-Sectional approach. The sample in this study was 134 people, and the sampling method was non-probability sampling. In collecting data, a questionnaire sheet for parents regarding attitudes, knowledge levels, and behavior was used. The results showed that the injury cases of children under five years of age were choking (47.0%), which was dominated by boys (52.2%). Then, parents with parental attitudes were dominated by moderate attitudes (48.5%), the level of parental knowledge was less (38.1%), and parental knowledge was less (41.8%). Analysis showed a significant relationship between parental attitude (p=0.028), knowledge level (p=0.004), and behavior (p=0.017) in Cakung, East Jakarta. Therefore, it is necessary to increase parents' knowledge and awareness of the need for parental supervision in order to prevent injuries to children.

Determinants of Stunting in The Under-five in West Nusa Tenggara Province with Multilevel Binary Logistic Regression

Stunting is a form of malnutrition in children that is still a health problem in Indonesia, especially in NTB Province. Based on the results of the SSGI, the prevalence of stunting in children under five years of age in NTB Province was 32.7 percent, up 1.3 percent compared to the previous year. This value has not reached the threshold of 20 percent and the national target of 18.4 percent. This puts NTB Province in the fourth highest position in Indonesia. In 2022, NTB Province recorded the highest percentage in Indonesia for children under six months who received exclusive breastfeeding, which was 79.69 percent. However, the prevalence of stunting in toddlers in NTB Province is still very high. Between districts/cities in NTB Province, there is a fairly high disparity in the prevalence of stunting in children under five years of age. This shows the influence of regions or households so that there is a disparity in the prevalence of stunting in children under five years of age. This study aims to describe the incidence of stunting in toddlers in general and analyze the variables that influence it and its tendencies in NTB Province in 2022 using a multilevel binary regression model. The results of the study showed that the variables of toddler gender, toddler age, history of toddler pneumonia, maternal education level, access to clean drinking water sources, access to proper sanitation, and GRDP per capita had a significant effect

Screen Time and its Determinants in Infants and Toddlers: Results from a Metropolitan Area of Istanbul

Objective: This cross sectional study aimed to assess screen time and associated factors in infants and toddlers under the age of 3 years in a metropolitan area. Method: Data were collected from 269 mothers registered in a family health center using a questionnaire. The questionnaire examines the demographic characteristics of families, the time spent by infants and toddlers with screen devices, and factors that may affect screen time, such as income status, education level and resources. Results: Three-quarters of infants and toddlers in this sample used screen devices (n=202, 75.1%). Total screen time ranged from 20 to 270 min/day, with a mean of 101.8±56.2 min/day. Infants and toddlers spent an average of 71.9 min/day watching television, 63.1 min/day using tablets, and 36.85 min/day using mobile phones. Total daily screen time exceeded World Health Organization (WHO) recommendations in 36.3% of infants aged 0-12 months, 84.3% of toddlers aged 13-24 months, and 49.4% of toddlers aged 25-36 months. Age of infant and toddler, maternal education level, and family income were identified as factors associated with risky screen exposure. Conclusion: Families can be educated about the potential consequences of screen time and strategies to reduce screen use. In trainings, families in the risk group should be given priority in terms of factors affecting screen time such as income status, education level and age.

The Influence of Diet and Intake of Macro and Micro Zinc Nutrients on the Incident of Stunting in Toddlers Ages 12-36 Months in Usitasae Village

Short Toddlers (Stunting) is a nutritional status based on the Body Length according to Age (PB/U) index or Body Height according to Age (TB/U) where in the anthropometric standard for assessing children’s nutritional status, the results of these measurements are at the threshold (Z- Score) -3 SD to &lt;-2 SD (short /stunted) and &lt;-3 SD (very short/ severely stunted). The formulation of the problem is how Stunting occurs in toddlers aged 12-36 months and whether there is an influence of the type of food, amount of food, food schedule, carbohydrates, protein, fat, and zinc on the incidence of stunting in toddlers aged 12-36 months. This research aims to analyze the influence of diet and intake of macro and micronutrient zinc on the incidence of stunting in toddlers aged 12-36 months. This type of observational research uses a cross-sectional design. This research was carried out in Usitasae Village. The sample in this study consisted of 54 toddlers using cluster random sampling techniques with bivariate analysis using the chi-square test and multivariate analysis using the multinominal logistic regression test. The results of data analysis on the prevalence of stunting in toddlers aged 12-36 months were 64.8%. The relationship between nutritional intake and the incidence of stunting in toddlers is the type of food (P value = 0.005 ≤ α = 0.05), the amount of food (P value = 0.018 ≤ α = 0.05), the food schedule (P value = 0.022 ≤ α = 0.05), carbohydrates (P value = 0.010 ≤ α = 0.05), protein (P value = 0.000 ≤ α = 0.05), fat (P value = 0.008 ≤ α = 0.05), zinc (P value = 0.006 ≤ α = 0.05). There is a relationship between the type of food, amount of food, food schedule, carbohydrates, protein, fat, and zinc on the incidence of stunting in toddlers aged 12-36 months. There is a need for further study regarding the intake of macro and micronutrients zinc in toddlers aged 12-36 months.

Sex differences in physical activity of US children at age 13 months: child and Mother Physical Activity Study (CAMPAS)

BackgroundLower physical activity (PA) has been observed in females compared to males among preschool-aged and older children. However, the timing of when the sex gap emerges is unclear. The purpose of this study was to investigate whether females have lower PA levels than males in the early toddler age and to explore whether gross motor competency and PA parenting practices might explain a sex difference in PA.MethodsThe study design was cross-sectional. Participants were a community-based sample of 137 children aged 10–16 months residing in US Midwest urban/suburban area. Participants’ mothers completed a survey that contained a demographic questionnaire, the Ages and Stages Questionnaire gross motor competency subscale, and a PA parenting practices questionnaire. Participating children wore an ActiGraph accelerometer on their hip for 7 days. Accelerometer-measured time spent in moderate- and vigorous intensity PA (MVPA; minutes/day) and in total PA (minutes/day) were calculated. Multivariable linear regression analysis was conducted to predict MVPA and total PA by sex, gross motor competency, PA parenting practices, and socioeconomic status.ResultsAmong 137 participants (54.0% female), average age was 13.6 months (SD = 1.7). MVPA was 72 ± 25 and 79 ± 26 min/day for females and males, respectively (p = 0.14). Total PA was 221 ± 48 and 238 ± 47 min/day for females and males, respectively (p = 0.04). Both gross motor competency and PA-encouraging parenting practices were positively associated MVPA (p = 0.01 and p = 0.02, respectively) and total PA (p = 0.02 and p = 0.01, respectively); however, these relationships did not differ by sex (p = 0.11 and p = 0.89, respectively). After accounting for gross motor competency and PA parenting practices, total PA was 15 min/day lower among females than males (p = 0.04).ConclusionsThis cross-sectional study of US children observed a sex gap in total PA at 10–16 months of age. Gross motor development and PA parenting practices did not differ by child sex nor explain the sex difference in PA. A longitudinal investigation should follow to further narrow down when sex differences in PA emerge and to determine the factors that lead to this difference.

Perpetrator characteristics and firearm use in pediatric homicides: Supplementary Homicide Reports - United States, 1976 to 2020

BackgroundDescribe trends in perpetrator characteristics and firearm use in pediatric homicides across the United States.MethodsMultiply-imputed data from the Federal Bureau of Investigation’s 1976–2020 Supplementary Homicide Reports were used to estimate perpetrator characteristics (sex, age, and relationship to victim) and firearm use in pediatric homicides. Descriptive analyses were stratified by victim age group, sex, race, and five-year time periods.ResultsFamily members were the most common perpetrator of infant and toddler (ages 0–4) and child (ages 5–12) homicides, whereas acquaintances accounted for the majority of adolescent (ages 13–19) homicides. Perpetrator characteristics vary across victim sex and race, particularly among adolescents. Despite overall stability, there were changes in perpetrator characteristics from 1976 to 2020. There was a sustained increase in the proportion of homicides committed with a firearm. In 2016–2020, the proportion of firearm-involved homicides was an all-time high for infant and toddler (14.8%), child (53.1%), and adolescent victims (88.5%).ConclusionsPolicy interventions that improve family stability and well-being may be most effective at preventing infant, toddler, and child homicides, whereas programs that target peer and community relationships, as well as policies that focus on firearm access, may be more crucial for preventing adolescent homicides.

Measuring Dietary Quality Among Toddlers in the Feeding Infants and Toddlers Study, 2016, Using the New Healthy Eating Index-Toddlers-2020

BackgroundChild diet can influence risk for obesity and other related noncommunicable diseases. Few studies have used the Healthy Eating Index (HEI)-Toddlers-2020 to assess diet quality among toddlers (children aged 12 to 23.9 months). ObjectiveThe aim of this study was to examine diet quality among toddlers participating in the Feeding Infants and Toddlers Study, 2016, and determine differences by sociodemographic characteristics. Caregiver perception of how their toddler’s diet aligns with HEI-Toddlers-2020 diet quality scores was also assessed. DesignThis cross-sectional study used 24-hour dietary records collected in 2016. Participants and settingData were collected on toddlers ages 12 to 23.9 months (N = 1133) participating in the Feeding Infants and Toddlers Study, 2016. Main outcome measuresDiet quality was assessed using the HEI-Toddlers-2020. Statistical analyses performedThe population ratio method was used for all analyses using weighted data to estimate HEI-Toddlers-2020 scores overall and within subgroups. To determine significant differences of the HEI-Toddlers-2020 score between subgroups, pairwise t tests were used. Statistical significance at P < .05 was used as a cutoff for all 2-sided P values. ResultsAverage HEI-Toddlers-2020 score among toddlers ages 12 to 23.9 months participating in the Feeding Infants and Toddlers Study, 2016, was 71.2 out of a possible 100. Total scores (mean, standard error) varied by race and ethnicity with Hispanic toddlers having higher scores compared with non-Hispanic White toddlers (76.4 ± 2.5 vs 69.0 ± 1.2; P = .03) and by federal poverty level with those >200% of the poverty level having higher scores compared with those <100% of the poverty level (74.7 ± 1.5 vs 67.0 ± 2.6; P = .01). ConclusionsOpportunities for improvement in dietary intake were identified using the new HEI-Toddlers-2020 to assess diet quality among children ages 12 to 23.9 months. Scores were indicative of toddlers consuming excess added sugars and lower-than-recommended amounts of seafood and plant proteins, greens and beans, whole grains, and vegetables. Interventions to improve diet quality in toddlers may benefit from focusing on foods children should eat more of along with foods to consume in moderation.

Characteristics of Children and Youth Referred for Language Assessment at Different Ages.

Early detection of language delays is essential, as language is key for academic outcomes, well-being, and societal participation. Previous studies have focused on undetected delays in young children. Much less is known about referrals at older ages. In this study, we aimed to (a) establish how many children are referred at toddler age (2-3 years) and how many at lower elementary (4-7 years), upper elementary (8-12 years), and high school (13-16 years) age; (b) evaluate characteristics of the referred children and adolescents across age groups; and (c) assess whether the ensuing classification (no language disorder [LD], developmental LD, LD + additional problems) differed across age groups. We used the 2010-2014 database of the Dutch federation of speech and hearing centers, containing 18,894 cases with target ages. We established the number of referrals in each age group (Q1) and assessed the composition of the age groups in terms of speech, language, behavioral, and cognitive outcomes (Q2), as well as in terms of classification (Q3). To answer Q2 and Q3, we conducted chi-squared analyses with the toddler group as reference group. Late-identified LDs exist: There were new referrals in all age groups. Compared to older age groups, the toddler group contained fewer girls and multilingual children. The toddler group also contained fewer children without an LD and more children with LD + additional problems. Reassuringly, children with multiple language problems are referred earliest. However, late-identified LDs exist, even at high school age. Girls and multilingual children tend to be missed at younger ages. More work on awareness and identification of language delays is needed, requiring awareness, knowledge, and tools for educational professionals.

The Effect of Giving Moringa Leaf Cookies on Weight Increasing Toddler Age 1-5 Years

Berdasarkan data elektronik Pencatatan dan Pelaporan Gizi Berbasis Masyarakat November 2022 prevalensi balita stunting di Posyandu tersebut sebesar 36,8%, gizi kurang 18% dan balita tidak naik BB sebesar 52%. Balita merupakan masa kritis yang harus diperhatikan nutrisinya untuk dapat tumbuh kembang secara optimal. Hal ini dapat dibantu dengan optimalisasi pemanfaatan bahan alam yang mudah didapat, salah satunya dengan pemanfaatan daun kelor sebagai inovasi makanan pada balita. Tujuan penelitian ini adalah menganalisa pengaruh pemberian cookies dengan penambahan bubuk kelor terhadap peningkatan berat badan balita usia 1-5 tahun. Metode penelitian menggunakan Quasy Experiment dengan pendekatan pretest and posttest with control grup design. Subjek penelitian balita usia 1-5 tahun yang memenuhi kriteria. Sampel menggunakan purposive sampling sejumlah 36 responden. Analisis data menggunakan analisis univariat dan untuk menguji pengaruh antar dua variabel menggunakan uji Man Whitney Test. Dengan menggunakan uji Man Whitney didapatkan hasil nilai p-value 0,003&lt;0,05 artinya ada perbedaan pemberian cookies daun kelor terhadap peningkatan berat badan balita usia 1-5 tahun. Simpulan penelitian ini ada pengaruh pemberian cookies daun kelor terhadap peningkatan berat badan balita usia 1-5 tahun, hal ini dikarenakan kandungan kelor yang sangat lengkap dan dapat membantu meningkatkan berat badan balita.

Sex Differences in Physical Activity of US children at age 13 months: Child and Mother Physical Activity Study (CAMPAS).

Lower physical activity (PA) has been observed in females compared to males among preschool-aged and older children. However, the timing of when the sex gap emerges is unclear. The purpose of this study was to investigate whether females have lower PA levels than males in the early toddler age and to explore whether gross motor competency and PA parenting practices might explain a sex difference in PA. The study design was cross-sectional. Participants were a community-based sample of 137 children aged 10-16 months residing in US Midwest urban/suburban area. Participants' mothers completed a survey that contained a demographic questionnaire, the Ages and Stages Questionnaire gross motor competency subscale, and a PA parenting practices questionnaire. Participating children wore an ActiGraph accelerometer on their hip for 7 days. Accelerometer-measured time spent in moderate- and vigorous intensity PA (MVPA; minutes/day) and in total PA (minutes/day) were calculated. Multivariable linear regression analysis was conducted to predict MVPA and total PA by sex, gross motor competency, PA parenting practices, and socioeconomic status. Among 137 participants (54.0% female), average age was 13.6 months (SD = 1.7). MVPA was 72 ± 25 and 79 ± 26 minutes/day for females and males, respectively (p = 0.14). Total PA was 221 ± 48 and 238 ± 47 minutes/day for females and males, respectively (p = 0.04). Both gross motor competency and PA-encouraging parenting practices were positively associated MVPA (p = 0.01 and p = 0.02, respectively) and total PA (p = 0.02 and p = 0.01, respectively); however, these relationships did not differ by sex (p = 0.11 and p = 0.89, respectively). After accounting for gross motor competency and PA parenting practices, total PA was 15 minutes/day lower among females than males (p = 0.04). This cross-sectional study of US children observed a sex gap in total PA at 10-16 months of age. Gross motor development and PA parenting practices did not differ by child sex nor explain the sex difference in PA. A longitudinal investigation should follow to further narrow down when sex differences in PA emerge and to determine the factors that lead to this difference.

Adolescent-onset cannabis use and parenting young children: an investigation of differential effectiveness of a digital parenting intervention

IntroductionThere is scant empirical work on associations between current and past cannabis use and parenting skills in parents of young children. As recreational cannabis use is now legal in nearly half of states in the U.S., cannabis use is becoming more ubiquitous.MethodsIn the current study, parents of toddler and pre-school age children were randomly assigned to participate in an app-based parenting skills program that included telehealth coaching (Family Check-Up Online; FCU-O), with a focus on parenting in the context of substance use. We aimed to test associations between adolescent-onset and current cannabis use and parent mental health and parenting skills, as well as whether effects of the FCU-O on parent mental health outcomes varied as a function of past cannabis use. Participants were 356 parents of children ages 1.5–5 participating in a randomized controlled trial of the FCU-O. Parents screened into the study if they reported current or past substance misuse or current depressive symptoms. After completing a baseline assessment, parents were randomly assigned to the FCU-O or control group and completed a follow-up assessment 3 months later. Parents retrospectively reported on the age when they initially used substances, as well as their current use.ResultsAfter accounting for current cannabis use, adolescent-onset cannabis use was significantly associated with higher symptoms of anxiety and depression, but not with parenting skills. Adolescent-onset cannabis use was found to significantly moderate the effect of the FCU-O on parents' anxiety symptoms. Specifically, the FCU-O was particularly effective in reducing anxiety symptoms for parents with adolescent-onset regular cannabis use, after accounting for current cannabis use.DiscussionAdolescent-onset regular cannabis use may be a risk factor for later mental health challenges in parents of children under 5. An app-based parenting intervention may be particularly helpful in reducing symptoms of anxiety for parents who used cannabis regularly as adolescents. The findings have significant implications for the prevention of multigenerational risk for substance use and mental health challenges.

High protein intake on later outcomes in preterm children: a systematic review and meta-analysis

Abstract Background Appropriate protein intake is crucial for growth and development in children born preterm. We assessed the effects of high (HP) versus low protein (LP) intake on neurodevelopment, growth, and biochemical anomalies in these children. Methods Randomised and quasi-randomised trials providing protein to children born preterm (&lt;37 completed weeks of gestation) were searched following PRISMA guideline in three databases and four registers (PROSPERO registration CRD42022325659). Random-effects model was used for assessing the effects of HP (≥3.5 g/kg/d) vs. LP (&lt;3.5 g/kg/d). Results Data from forty-four studies (n = 5338) showed HP might slightly reduce the chance of survival without neurodisability at ≥12 months (four studies, 1109 children, relative risk [RR] 0.95 [95% CI 0.90, 1.01]; P = 0.13; low certainty evidence) and might increase risk of cognitive impairment at toddler age (two studies; 436 children; RR 1.36 [0.89, 2.09]; P = 0.16; low certainty evidence). At discharge or 36 weeks, HP intake might result in higher weight and greater head circumference z-scores. HP intake probably increased the risk of hypophosphatemia, hypercalcemia, refeeding syndrome and high blood urea, but reduced risk of hyperglycaemia. Conclusions HP intake for children born preterm may be harmful for neonatal metabolism and later neurodisability and has few short-term benefits for growth. Impact statement Planned high protein intake after birth for infants born preterm might be harmful for survival, neurodisability and metabolism during infancy and did not improve growth after the neonatal period. Protein intake ≥3.5 g/kg/d should not be recommended for children born preterm.

Gastrointestinal Panel Performance for the Diagnosis of Acute Gastroenteritis in Pediatric Patients.

Various methods are used to identify the causative organisms of acute gastroenteritis (AGE) in children. The gastrointestinal (GI) panel has the potential to detect up to 22 pathogens rapidly through the multiplex real-time PCR test. We studied the impact of the GI panel on clinical management in the pediatric population. A retrospective study was conducted to collect data on GI panel results and clinical details of inpatient children presenting with AGE at King Hamad University Hospital, Kingdom of Bahrain, over the course of one year. One hundred nine samples were collected. The GI panel was positive in 96 samples (88.1%), with the majority detected in the toddler age group. Forty-one (42.7%) samples were positive for at least one organism. Salmonella was the most frequently encountered bacteria as a single isolate, 10/55 (18.2%), while enteropathogenic Escherichia coli was the most common co-infected organism, 16/41 (39%). Norovirus was the most common virus among the viruses. Bacterial detection peaked from July to October, while viral detection plateaued throughout the year. The GI panel and stool culture were positive for the same organism in 17 samples, versus one sample with a different organism. Sixty-two (56.9%) samples had a positive GI panel but negative stool cultures and stool analysis, and half of those detected viruses. The GI panel was positive in 86.2% of severely ill patients; the majority were bacteria. Bacterial detection was associated with a higher CRP compared to viruses. The GI panel is an informative tool for detecting the causative pathogen of AGE in children. However, it can detect multiple organisms, indicating a possible carrier status, which points toward future studies.

The Influence Factors Of Stunting Incidents In Toddler Ages 24-59 Months At Posyandu Melati 02

Background: Data from the Indonesian Nutrition Status Survey (SSGI) in 2022 from the Ministry of Health of the Republic of Indonesia, the national stunting rate reached 21.6% from 24.45% in 2021 and fell to 2.8%. The stunting rate in Banten Province in 2021 will decrease from 4.5% to 20% from the previous 24.5%. According to the Tenger City Health Service (DinKes), the prevalence rate of stunting in the Tangerang city area is 15.3% in 2021. The aim is to determine the factors that influence the incidence of stunting in toddlers aged 24 - 59 months at Posyandu Melati 02.Research Methods: Sampling was carried out using quantitative analytical methods with a cross sectional study design.Research Result: Analysis of the relationship between the level of maternal knowledge and the incidence of stunting as much as 69.4% and good maternal knowledge as much as 30.6%. The relationship between maternal education level and the incidence of stunting was 18.2% and higher education level was 81.8%. The relationship between economic status and the incidence of stunting is 42.9% and high economic status is 57.1%. The relationship between giving exclusive breastfeeding and the incidence of stunting is 17.6% and not giving exclusive breast milk is 82.4%.Conclusion: Maternal knowledge, maternal education level, economic status and exclusive breastfeeding greatly influence the incidence of stunting.

Traumatic brain injury unmasking Vitamin B12 deficiency in an infant with long-term follow-up

Falls are very common in infancy and toddler age group. We are presenting a case of insignificant fall from the cot causing severe neurological problems in an infant due to previous underlying relatively asymptomatic vitamin B12 deficiency. A six-month-old female infant presented with a fall from a cot followed by altered sensorium, vomiting, right focal seizures, and right sided weakness. On examination, a low Glasgow coma scale (8/15), right sided weakness (MRC power of 3/5 in the right upper and lower limbs), with anaemia were noted. Investigations revealed left frontal contusion with haemorrhage, megaloblastic anaemia, and thrombocytopenia with low vitamin B12 level. The child improved with symptomatic management of raised intracranial pressure and injectable vitamin B12 supplements. Prompt intervention and appropriate treatment led to favourable outcomes in the infant, highlighting the importance of recognizing and addressing concomitant deficiencies in infants with TBI.

Development and Evaluation of Modified Criteria for Infant and Toddler Anaphylaxis

Current clinical criteria for identifying anaphylaxis do not account for unique aspects of infant anaphylaxis presentation and have not been validated in patients younger than 2 years of age. This may contribute to under recognition and is thus an unmet need. To demonstrate age-specific signs and symptoms that more accurately identify anaphylaxis in young children and to develop and compare modified criteria for "likely anaphylaxis" against the widely used 2006 National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network (NIAID/FAAN) criteria. Retrospective chart review of 337 clinical encounters presenting with suspected allergic or anaphylactic reactions to a pediatric emergency department. Modified criteria for likely anaphylaxis were developed and evaluated against the NIAID/FAAN criteria. The study population included 33% infants (age <12mo), 39% toddlers (age 12 mo to < 36 mo), and 29% children (age ≥ 36 mo). The NIAID/FAAN criteria captured 85% of all patient encounters in the study and the modified criteria captured 98% (P < .001). Compared with NIAID/FAAN criteria, modified criteria had 22.8% improved performance among infants (p < .001) and 10.3% improved performance among toddlers (P= .04). We developed modified anaphylaxis clinical criteria that incorporated symptoms specific to infants and young children. The modified criteria increased identification of anaphylaxis in infants and potentially toddlers. Future research is needed to validate our findings on a larger cohort.