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Maternal milk represents the best food for the newborn, providing specific physiologic advantages over the other sources of nutrition. It also contains many hundreds to thousands of bioactive molecules that protect against infection (i.e. IgA), inflammation (i.e. 5-methylthioadenosine) and contribute to eliciting strong immune responses in breastfed children (i.e. allergens or viral antigens). Quality and quantity of breast milk components may influence the development of infant body composition in the first years of life; in particular, it has been shown that a different composition of human oligosaccharides (HMOs) in overweight/obese women's human milk can be correlated with her offspring's growth. This could be associated with human milk's probiotic role, since probiotics support the assembly of a healthy gut microbiome, by stimulating the growth of beneficial microbes. Therefore, the aim of this review is to outline the bioactive role of human milk and its potential beneficial effect on a child's long-term health. [ABSTRACT FROM AUTHOR]

Human growth and development, starting from conception, are characterized by a progressive increase in body and organ dimensions, as well as specific functional maturity, under the influence of genetic as well as environmental and epigenetic determinants. Beyond a possible normal familial trait, increased fetal growth resulting in a large for gestational age newborn, isolated macrosomia or that associated with congenital malformation, can be attributable to both maternal metabolic and genetic pathology. Overgrowth syndromes are a heterogeneous group of diseases characterized by excessive tissue development often concomitant to neurodevelopmental involvement. Recently, an increased risk of fetal overgrowth with Assisted Reproductive Technology has been reported. Thus, in pediatric practice, it is fundamental to monitor any patient who presents with increased growth parameters, variable malformations, neurodevelopmental delay, and distinctive features from birth, aiming to ensure as adequate a medical management as possible, and for some of the disorders, strict tumor monitoring is also necessary. [ABSTRACT FROM AUTHOR]

The impact of genetic diseases on the pediatric population in clinical practice is remarkable and their prevalence has rapidly increased in the last 50 years. A wide diffusion of modern diagnostic techniques has implemented early diagnosis and consequently the precocious start of effective support therapies which have determined an increased survival rate and quality of life. The percentage of genetics anomalies in children hospitalized is really high and amounts to at least 50% of hospital pediatric admissions. Over 5% of stillborn babies, without other known causes, have genetic disorders, and it goes up to 50% in the case of visible malformations. [ABSTRACT FROM AUTHOR]

Fetal growth restriction (FGR) or intrauterine growth restriction (IUGR) are the terms used for a fetus which has not attained its full growth potential for gestational age. FGR is a multifactorial syndrome responsible for increased fetal and neonatal morbidity and mortality as well as long term adverse outcomes involving auxological, metabolic, organic and functional domains. Clinicians distinguish early and late onset FGR, in relation to specific fetal anthropometric parameters related to the possible primary etiology and to different patterns of placental and maternal cardiovascular pathologies. Delivery of an early onset FGR or growth impaired newborn with congenital pathology should be in tertiary care center, given the high perinatal morbidity. At hospital discharge the FGR infant should be enrolled, in a multidimensional individualized developmental follow-up. Subjects who have suffered from FGR should adopt a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Purpose: Aim of this study was to analyze pediatric invasive pneumococcal disease rates several years after the implementation of infant pneumococcal vaccination. Methods: The study was carried out in Sicily and involved about 30,000 children, aged 1- 59 months, actively monitored by 100 family pediatricians during 2010 and 2011. All children who met the inclusion criteria were considered eligible, recorded using a standardized case report form and investigated for the presence of S. pneumoniae in specimens from sterile sites. Results: None of the 40 eligible children was confirmed as a case of invasive pneumococcal disease. The incidence rate of invasive pneumococcal disease cases was 0.0/100,000 in both years. Regional childhood pneumococcal vaccination coverage rates were 90.7% in 2010 and 92.0% in 2011. Conclusions: Our results show that during the study period invasive pneumococcal disease cases were rare in Sicilian children, suggesting a very effective control of the disease in a region with very high vaccination coverage against S. pneumoniae. [ABSTRACT FROM AUTHOR]

Advances in DNA sequencing technologies through Next Generation Sequencing (NGS) approaches have enabled genome-wide discovery of chromosomal copy-number variants and single-nucleotide changes. NGS technologies are rapidly expanding our ability to identify and better define disease-causing mutations and genotype-phenotype correlation. Pediatric patients may particularly benefit from the introduction of these new technologies. Pediatricians must keep up with all these new skills, both in their residency programs as well as in their continuing medical education programs. [ABSTRACT FROM AUTHOR]