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Aim: The emotional connection between mothers and infants born preterm has been associated with positive behaviour. The aim of this study was to examine the longitudinal association between emotional connection at six months of age and behavioural problems at three years.Methods: This study was carried out by the University of North Texas, USA and comprised 49 mothers and infants from a longitudinal investigation of family interaction and infant development conducted in 1994-1997. Face-to-face interaction and toy-based play were videotaped and coded at six months of age using the Welch Emotional Connection Screen (WECS), a brief screening tool for relational health. When the children were three years of age, the mothers reported on child behavioural problems.Results: The children from dyads that were rated as emotionally connected at six months of age had fewer externalising and internalising behavioural problems at the age of three. No links were found between emotional connection during toy-based play at six months and later child behavioural problems.Conclusion: We showed that when the WECS was used at six months of age it was a promising and valid relational screening tool for infants at risk of adverse behavioural outcomes at the age of three. [ABSTRACT FROM AUTHOR]

Aim: Infants hospitalised for bronchiolitis undergo examinations and treatments not supported by current research evidence and we investigated practice variations with regard to Finnish children under the age of two.Methods: This prospective, multicentre cohort study was conducted in paediatric units in three university hospitals in Finland from 2008 to 2010. Hospital medical records were reviewed to collect data on clinical course, testing and treatment. Data were analysed separately for children meeting our strict definition of bronchiolitis, aged under 12 months without a history of wheezing, and a loose definition, aged 12-23 months or with a history of wheezing.Results: The median age of the 408 children was 8.1 months. Clinical management varied between the three hospitals when stratified by strict and loose bronchiolitis subgroup definitions: complete blood counts ranged from 15-95% vs 16-94%, respectively, and the other measures were chest x-ray (16-91% vs 14-72%), intravenous fluids (2-47% vs 2-41%), use of nebulised epinephrine (10-84% vs 7-50%), use of salbutamol (18-21% vs 13-84%) and use of corticosteroids (6-23% vs 60-76%).Conclusion: The clinical management of bronchiolitis varied considerably with regard to the three hospitals and the two definitions of bronchiolitis. A stronger commitment to evidence-based bronchiolitis guidelines is needed in Finland. [ABSTRACT FROM AUTHOR]

Aim There is limited evidence about the diagnostic value of urine dipsticks in young febrile infants. The aim of this study was to determine whether urine dipsticks would identify positive urine cultures in febrile infants of less than 90 days of age. Methods This study was a subanalysis of a prospective multicentre study developed in 19 Spanish paediatric emergency departments belonging to the Spanish Paediatric Emergency Research Network. It focused on febrile infants of less than 90 days of age admitted between October 2011 and September 2013. A positive urine culture was defined as the growth of ≥ 50 000 cfu/mL of a single pathogen collected by a sterile method. Results We included 3401 patients, and 176 (12.8%) female patients and 473 (23.3%) males had a positive urine culture. The leucocyte esterase test showed a mean sensitivity of 82.1% and a mean specificity of 92.4%, with a greater mean negative predictive value for females than males (97.8 versus 94.1%) and a greater mean positive predictive value for males than females (79.4% versus 58%). Conclusion The leucocyte esterase test showed the same accuracy in young febrile infants as previously reported findings for older children. It predicted positive urine cultures and also revealed important gender differences. [ABSTRACT FROM AUTHOR]

Aim: To assess the association between weight gain at different time periods during childhood and measures of adiposity in late adolescence.Methods: A population-based birth cohort carried out in Pelotas, a 320 000-inhabitant city in a relatively developed area in Southern Brazil. All newborns in the city's hospitals were enrolled in 1982. Weight gain from 0-1, 1-2, 2-4 and 4-15 years were expressed as changes in weight-for-age Z-scores relative to the NCHS/WHO reference. In 2000, 79% (2250) of all males were located when enrolling at the national Army. Weight and height were assessed. Body composition indicators (fat mass/height(2), lean mass/height(2), fat mass/lean mass(2.3)) were estimated through bioimpedance. Analyses were adjusted for maternal and social factors, as well as for gestational age.Results: In the adjusted analyses, birthweight and weight gain in the first year of life were positively associated with attained height at age 18 years. Except for the fat mass/lean mass(2.3) ratio, all weight-related outcomes were positively associated with weight gain in different periods of life. Children who gained weight rapidly in more than one time period became fatter at age 18 years, independently of when fast growth took place.Conclusions: Height was primarily determined by fetal and infant growth. Weight-related indices, including the fat/lean mass ratio, were more strongly influenced by later growth. No clear critical windows of growth during which absolute tissue masses are programmed could be identified. [ABSTRACT FROM AUTHOR]

Aim: To describe Swedish children's growth (i.e. height, weight and body mass index) from birth to age 19 y. Methods: Every infant born on the 15th of any month in 1981 and living in Sweden as of 31 December 1989 was sampled. Longitudinal data were collected from childhood and school health records, and analysis by piecewise linear regression gave statistical descriptions of height, weight and body mass index for every age group. Results: The data include measurements of 3107 of 3158 sampled children; 1.6% of individuals are missing, so non-response bias is minimal. Thus, statistical descriptions and comparisons with similar data sets can be based on data with unusually high national representativeness. Selected subgroups (i.e. individuals born outside Sweden, suffering from chronic disease causing major growth impairment, or with birthweight Conclusion: This study represents, without selection bias, the current growth situation among children and adolescents in Sweden, enabling both epidemiological comparisons over time and comparisons with other national surveys. [ABSTRACT FROM AUTHOR]

Aim: To examine socio-economic factors, smoking, coffee consumption and exclusive breastfeeding duration.Methods: This study was part of a prospective cohort study of children born between 1 October 1997 and 1 October 1999 (the All Babies in Southeast Sweden (ABIS) study). Eleven socio-economic characteristics (parental employment, civil status, whether parents were born in Sweden, parental education, residence at birth and during child's first year, crowded living), maternal smoking, coffee consumption, infant sex, siblings, parental age, and maternal alcohol consumption during pregnancy were analysed using logistic regression and Cox's proportional hazards method. All data were obtained through questionnaires distributed at infant birth and at 1 y of age. Exclusive breastfeeding duration<4 mo and actual breastfeeding duration were our main outcome measures.Results: Out of 10205 infants, 2206 (21.6%) were exclusively breastfed for less than 4 mo ("short exclusive breastfeeding"; SEBF). Backward stepwise regression analysis identified the following risk factors for SEBF: maternal smoking (95% confidence interval for adjusted odds ratio, 95% CI AOR 2.00-2.82), low maternal education (95% CI AOR 1.45-2.19), maternal employment less than 3 mo during pregnancy (95% CI AOR 1.17-1.54), paternal ageConclusion: This study indicates that socio-economic factors and smoking may be of importance to the risk of breastfeeding exclusively for less than 4 mo, while coffee consumption is not. [ABSTRACT FROM AUTHOR]

Aim: To produce a modification of the British 1990 weight reference reflecting the growth of long-term breastfed infants.Methods: 120 infants from the Cambridge Infant Growth Study fed breast milk (with no formula) for at least 24 wk, with solids introduced at a mean age of 15 wk, were weighed every 4 wk from birth to 52 wk. Weights were converted to standard deviation scores (SDS) for gender and age post-term based on the revised British 1990 reference, averaged and smoothed across age, and then converted back to weights to provide modified median weight curves by gender. Other centile curves were constructed assuming the same variability and skewness by age as for the British reference.Results: Long-term breastfed infants were slightly heavier than the reference at birth and crossed centiles upwards to reach +0.3 SDS at 2 mo, but subsequently crossed centiles downwards to -0.2 SDS by 12 mo.Conclusion: The British 1990 reference, although better than previous growth standards, reflects the growth of long-term breastfed infants only imperfectly, with mean weight falling by 0.5 SDS from 2 to 12 mo. The provision of breastfeeding-specific centiles, either as a transparent overlay or as an alternative chart, should be useful for professionals and parents to monitor the weight of long-term breastfed infants. [ABSTRACT FROM AUTHOR]

Unlabelled: The objective of this study was to investigate the effect of body position on sidestream, end-tidal carbon dioxide (EtCO2) wave measurements in maturing infants. Sidestream EtCO2 wave patterns were analysed longitudinally in 20 preterm infants (born at > or = 32 wk) at 32-37 wk gestation, and in 39 full-term controls. Capnography measurements included maximal EtCO2, inspired CO2 and frequency of apnoea events (>3 s) in the supine, supine with inclination, side and prone positions. Apnoea frequency decreased during maturation, and was less prevalent in the prone than in the supine and side positions in preterm as well as in term infants (p < 0.05). No clinically significant apnoea episodes were found in our cohort. EtCO2 in term infants was lower than that in preterm infants (p < 0.05) and was not affected by sleep position in the most premature (<33 wk) and in term infants (>36 wk). EtCO2 was higher in the prone position than in supine or side positions in infants between 33 and 35 wk gestation (p < 0.01).Conclusion: Short apnoeic episodes decrease during maturation, and are less prevalent in the prone position in maturing infants (32-37 wk). Only modest changes in EtCO2 were recorded in the different positions during maturation. [ABSTRACT FROM AUTHOR]