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Background Admission to hospital with bronchiolitis may adversely affect breastfeeding. Correct advice and support have been pointed out as a determining factor. Objectives We conducted a telephone survey to evaluate a set of actions to promote breastfeeding during hospitalization for acute bronchiolitis. Methods Population: All patients 6 months of age or younger hospitalized with acute bronchiolitis and receiving at least partial breastfeeding were eligible for the study. Patients discharged home whose parents accepted to be contacted by phone were also included. Intervention We established a set of actions to promote breastfeeding (posters, flyers, staff training, and equipment) in all pediatric wards attending to these patients. Comparison This was a cross-sectional study conducted during two epidemic seasons of bronchiolitis in a tertiary care hospital. Data on continued breastfeeding at 3 months (0.5–6; median, range) postdischarge were collected by telephone and compared with the same set of data collected from patients with bronchiolitis in the same setting the year before the intervention. Outcome We conducted a telephone survey to evaluate whether some actions regarding breastfeeding might diminish the risk of unwanted weaning during hospitalization for bronchiolitis. The primary outcome was the proportion of stopped or reduced breastfeeding at discharge. Secondary objectives were to evaluate whether there were factors associated with breastfeeding modification. Results The results of the evaluation before intervention (phase 1) are published by Heilbronner et al. In Phase 1 of our study, 84 patients were included and 43 mothers (51%) reported that breastfeeding was modified by hospitalization of their child: 20.4% stopped, 14% switched to partial breastfeeding, and 16.6% reduced breastfeeding. These mothers stated that causes of breastfeeding disturbances were lack of support and advice (63%), followed by severity of the child's respiratory disease (32%), logistical hospital difficulties (30%), and personal organizational issues (9.3%). The intervention took place in September. After the intervention, 50 patients could be included in the study between October 1and December 31, 2016. Among them, 40 (80%) mothers kept breastfeeding as before, four (8%) stopped, four (8%) switched to partial breastfeeding, and two (4%) reduced breastfeeding without stopping. Bronchiolitis was more severe among patients with altered breastfeeding in terms of ventilatory support. Conclusion Bronchiolitis is a high-risk event for breastfeeding disruption but interventions to promote breastfeeding might help to prevent the risk of unwanted weaning. More severe bronchiolitis probably poses the highest risk of weaning and the need for supplementary nutrition.

Playing video games has been associated with several negative effects in children. However, serious games, which are video games designed for a primary purpose other than pure entertainment, should not be neglected by pediatricians. In the field of public health, some serious games are a means to decrease drug consumption and improve sexual health behavior in adolescents. In schools, serious games can be used to change students' perception of the disease of one of their classmates, or to train students on basic life support. Serious games are also used with patients: they can distract them from a painful procedure, increase their compliance to treatments, or participate in their rehabilitation. Finally, serious games allow healthcare professionals to train on the management of various medical situations without risk. For every field of application, this review presents the rationale of the use of video games, followed by concrete examples of video games and the results of their scientific evaluation.

Resume Le poumon est la cible de complications aigues et chroniques dans la drepanocytose. L’hypoxie chronique est frequente, elle joue un role dans certaines de ces complications et peut etre deletere a long terme. Sa prise en charge repose davantage sur le programme transfusionnel que l’oxygenotherapie. Le syndrome thoracique aigu (STA) peut etre d’installation tres rapide et demeure la principale cause de deces premature. Principalement secondaire a une infection ou une crise vaso-occlusive (CVO), sa prevention et son traitement sont essentiels et ont fait l’objet de nouvelles recommandations. L’asthme n’est pas plus frequent chez les enfants drepanocytaires mais pourrait etre associe a la survenue de CVO, de STA, voire de deces precoces. Sa prise en charge n’est pas specifique mais l’utilisation des corticoides systemiques doit etre prudente car elle n’est pas denuee de risques. L’hypertension pulmonaire chez l’enfant drepanocytaire est probablement source de comorbidite mais pas de mortalite contrairement a ce qui est constate chez l’adulte. Son depistage est systematique mais sa prise en charge n’est pas etablie. Concernant les fonctions respiratoires, si la prevalence du syndrome obstructif est faible, celle du syndrome restrictif augmente avec l’âge, temoignant d’un declin rapide et precoce des volumes pulmonaires. L’endurance des enfants drepanocytaires est plus faible mais ne contre-indique pas la pratique mesuree du sport. Les troubles du sommeil, dont le syndrome d’apnee obstructive du sommeil, sont plus frequents. Ils necessitent un depistage regulier car ils peuvent etre source de troubles neurologiques significativement diminues par leur prise en charge. Cette importante morbi-mortalite justifie une surveillance respiratoire attentive chez ces enfants.

Objectifs Determiner si une prophylaxie par palivizumab permettait de reduire le taux d’hospitalisation pour bronchiolite a virus respiratoire syncitial (VRS) chez les enfants de moins de 2 ans traites par corticotherapie systemique dans le cadre d’une pneumopathie interstitielle severe. Materiels et methodes Etude retrospective nationale a partir de la base de donnees Respirare , chez les enfants nes entre le 1/1/2007 et le 1/1/2014. Les donnees etaient collectees a partir des dossiers medicaux et des carnets de sante. Resultats principaux Vingt-quatre enfants ont ete inclus et evalues sur 2 saisons epidemiques, representant 36 enfants–saisons. Le taux d’hospitalisation pour bronchiolite a VRS, 305 pour 1000 enfants–saisons, etait tres superieur a celui de la population generale. Il n’existait pas de difference quant aux taux d’hospitalisation pour bronchiolite a VRS entre les enfants traites par palivizumab et les enfants non traites (respectivement 7/18 versus 4/18, p 0,47). Conclusions Les enfants suivis pour pneumopathie interstitielle et traites par corticotherapie systemique sont sujets a des bronchiolites a VRS plus frequentes et plus graves, dont la prevention par le palivizumab reste a demontrer.