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Objectif Renseigner les fournisseurs de soins de premiere ligne qui dispensent des soins de medecine preventive durant l’enfance quant aux donnees ayant servi de fondement aux recommandations de l’edition 2020 du Releve postnatal Rourke (RBR). Qualite des donnees Une recherche a effectuee parmi les publications sur les soins preventifs en pediatrie entre les mois de juin 2016 et mai 2019, les principales etudes de recherche ont ete revues et rigoureusement evaluees a l’aide de la methode GRADE (Grading of Recommendations Assessment, Development and Evaluation) et les recommandations ont ete actualisees la ou les publications etayaient des changements. Message principal Les changements notables de l’edition 2020 du RBR sont les recommandations de limiter ou d’eviter les aliments tres transformes et riches en sodium alimentaire, de veiller au sommeil securitaire (les nourrissons en bonne sante doivent dormir sur le dos et sur une surface rigide a tous les dodos, et ils doivent dormir dans un moise, un berceau ou une couchette dans la chambre des parents pendant les 6 premiers mois de vie), de ne pas emmailloter les nourrissons apres qu’ils aient tente de se retourner, de s’informer de l’insecurite alimentaire, d’encourager les parents a lire et a chanter aux nourrissons et aux enfants, de limiter le temps que les enfants de moins de 2 ans passent devant un ecran (bien que ce soit accepte pour les appels video), de renseigner les parents sur les risques et les torts associes aux cigarettes electroniques et au cannabis, d’eviter les pesticides, de laver tous les fruits et legumes ne pouvant etre peles, de connaitre l’existence du nouvel Outil national d’evaluation du risque de caries, de noter les nouveaux symptomes alarmants de paralysie cerebrale et de problemes neurodeveloppementaux et de porter attention aux nouveaux groupes a risque eleve pour le depistage du plomb et de l’anemie. Conclusion Le RBR s’efforce de guider les cliniciens pour leur permettre de dispenser des soins de premiere ligne factuels aux enfants canadiens. Les revisions sont rigoureusement etudiees, et sont basees sur l’evaluation d’une base de donnees probantes croissante, quoique toujours limitee, sur les soins preventifs en pediatrie.

Objective To evaluate the relationship between the timing of infant cereal introduction between 4 and 6 months of age and growth and dietary intake in later childhood. Study design A longitudinal cohort study was conducted among healthy children 0-10 years of age participating in The Applied Research Group for Kids cohort study between June 2008 and August 2019 in Toronto, Canada. Results Of 8943 children included, the mean (SD) age of infant cereal introduction was 5.7 (2.1) months. In the primary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.17 greater body mass index z score (95% CI 0.06-0.28; P = .002) and greater odds of obesity (OR 1.82; 95% CI 1.18-2.80; P = .006) at 10 years of age. In the secondary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.09 greater height-for-age z score (95% CI 0.04-0.15; P = .002) at 1 year of age, an association that was not observed at 5 or 10 years of age. Children who were introduced to infant cereal at 4 vs 6 months had greater nutrition risk which was primarily determined by a less-favorable eating behavior score at 18 months to 5 years of age (0.18 units higher; 95% CI 0.07-0.29; P = .001). Conclusions Introduction of infant cereal at 4 vs 6 months was associated with greater body mass index z score, greater odds of obesity, similar height-for-age z score, and less favorable eating behavior. These findings support recommendations for introducing solid food around 6 months of age.

The Rourke Baby Record (RBR) is a health supervision guide for providing care and anticipatory guidance to children aged 0 to 5 years in Canada. First developed in 1979, it has been revised regularly to ensure that it remains current and evidence-informed. The RBR has a longstanding relationship with the Canadian Paediatric Society (CPS), and relies on this organization for its expertise to inform the RBR guide’s content. The 2020 edition of the RBR includes many recommendations based on evidence provided in current CPS position statements. The RBR Working Group is planning to develop app-based resources and an adapted RBR for clinical care provision in this challenging pandemic time to ensure that Canadian infants and children continue to receive high-quality care.

Objective To prevent iron deficiency, 2014 Canadian recommendations for healthy term infants from 6 to 24 months recommend iron-rich complementary foods such as meat and meat alternatives 2 or more times a day. The purpose of our study was to evaluate the association between meat and meat-alternative consumption and iron status in young children and the association between red meat consumption and iron status among children meeting recommendations. Methods Healthy children aged 12 to 36 months were recruited. A cross-sectional study was conducted. Meat and meat-alternative consumption was measured using the NutriSTEP questionnaire. Adjusted multivariable regression analyses were used to evaluate an association between meat consumption and serum ferritin, and iron deficiency (serum ferritin Results A total of 1043 children were included. Seventy-three percent of children met the recommended daily intake of meat and meat alternatives, and 66% ate red meat in the past 3 days. Eating meat and meat alternatives was not associated with serum ferritin (0.13 μg/L, 95% confidence interval −0.05, 0.31, P = .16), but it was associated with a decreased odds of iron deficiency (odds ratio 0.97, 95% confidence interval 0.94, 0.99, P = .03). Associations between red meat consumption and iron status were not statistically significant. Statistically significant covariates associated with increased odds of iron deficiency included longer breast-feeding duration, daily cow's milk intake of >2 cups, and a higher body mass index z score. Conclusions Daily cow's milk intake of >2 cups, longer breast-feeding duration, and a higher body mass index z score were modifiable risk factors associated with iron deficiency. Eating meat according to recommendations may be a promising additional target for the prevention of iron deficiency in early childhood.

The barrier function of the human mammary gland collapses if challenged with cationic drugs, causing their accumulation in milk. However, underlying molecular mechanisms are not well understood. To gain insight into the mechanism, we characterized transport of organic cations in the MCF12A human mammary gland epithelial cells, using carnitine and tetraethylammonium (TEA) as representative nutrient and xenobiotics probes, respectively. Our results show that the mammary gland cells express mRNA and proteins of human (h) novel organic cation transporters (OCTN) 1 and hOCTN2 (a Na+-dependent carnitine carrier with Na+-independent xenobiotics transport function), which belong to the solute carrier superfamily (SLC) of transporters. Other SLC OCTs such as hOCT1 and extraneuronal monoamine transporter (EMT)/hOCT3 are also expressed at mRNA levels, but hOCT2 was undetectable. We further showed mRNA expression of ATB0+ (an amino acid transporter with a Na+/Cl−-dependent carnitine transport activity), and Fly-like putative transporter 2/OCT6 (a splice variant of carnitine transporter 2: a testis-specific Na+-dependent carnitine transporter). TEA uptake was pH dependent. Carnitine uptake was dependent on Na+, and partly on Cl−, compatible with hOCTN2 and ATB0+ function. Modeling analyses predicted multiplicity of the uptake mechanisms with the high-affinity systems characterized by Km of 5.1 μM for carnitine and 1.6 mM for TEA, apparently similar to the reported hOCTN2 parameter for carnitine, and that of EMT/hOCT3 for TEA. Verapamil, cimetidine, carbamazepine, quinidine, and desipramine inhibited the carnitine uptake but required supratherapeutic concentrations, suggesting robustness of the carnitine uptake systems against xenobiotic challenge. Our findings suggest functional roles of a network of multiple SLC organic cation/nutrient transporters in human mammary gland drug transfer.