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Background: Handgrip strength (HGS) indicates current and future health. Although preterm infants have an increased risk of poor grip strength in later life, its determinants and relationship with neurodevelopment are not well understood., Aims: To determine HGS in children born preterm and explore the relationship of HGS with demography, anthropometry, nutritional factors, and neurodevelopmental outcomes., Study Design: A prospective cohort study of moderate-late preterm babies enrolled in a randomised trial of nutritional support strategies, the DIAMOND trial., Subjects: A total of 116 children born between 32 and 35 weeks' gestation, whose HGS was measured at 2 years' corrected age., Outcome Measures: HGS was measured using a dynamometer, and neurodevelopment was assessed using the Bayley Scales of Infant Development-III. Anthropometry and body composition were assessed at birth, discharge, and at 4 months' and 2 years' corrected age. Information on demographics and breastfeeding practices, including type of milk at discharge and duration of exclusive breastfeeding, was collected using questionnaires., Results: The mean (standard deviation) HGS was 2.26 (1.07) kg. The Bayley scores were < 85 (-1 standard deviation) in 6 %, 20 %, and 1 % for the cognitive, language, and motor scales, respectively. Multiple regression analysis revealed that HGS was positively associated with language and motor scores (p < .05) after adjusting for confounding factors. HGS was not associated with sex, anthropometry, body composition, or breastfeeding practices. Maternal education was independently associated with HGS (p < .01)., Conclusions: HGS at age 2 years in children born moderate-late preterm is associated with language and motor development and maternal education level., Competing Interests: Declaration of competing interest No conflicts to declare., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Poor hygiene might be a risk factor for early childhood development (ECD). This study investigated the associations of three hygiene practices ('wash hands before a meal,' 'wash hands after going to the toilet,' and 'brush teeth'), separately and combined, with ECD. Six thousand six hundred ninety-seven children (4 [0.8] years) from the East Asia-Pacific Early Child Development Scales validation study were included in this cross-sectional analysis. The hygiene variables were recoded to have comparable values as 'always,' 'sometimes,' and 'never.' These variables were then grouped to create combined categories. The binary outcome variables, poor ECD, were defined as a score < age-specific 25th centile. Modified Poisson regression models were used to analyse the associations. Data collection was performed between 2012 and 2014, and the analyses were conducted in April 2022. Compared with children who 'always' washed their hands before a meal, those who did it 'sometimes' (Prevalence Ratio [PR]: 1.30 [95% CI: 1.16-1.46]) or 'never' (PR: 1.35 [1.18-1.55]) had a higher likelihood of poorer overall development. Comparable results were identified for the other two hygiene practices and the other four domain-specific outcomes ( p < 0.05). Compared with children who always followed the three hygiene practices, the likelihood of poor overall ECD increased as the combined hygiene practice decreased among children with poor hygiene practices (PR never : 1.67 [1.40-2.00]; PR rarely : 1.49 [1.30-1.71]; PR sometimes : 1.30 [1.14-1.49]). Children who did not always follow good hygiene practices had a higher likelihood of poor ECD independently of sociodemographic factors. Considering these findings, future hygiene practice interventions and trials should consider including ECD outcomes.

The present study examined gender differences in health, physical activity, physical fitness, real and perceived motor competence, and executive function indicators in three time points, and analyzed the dynamic and non-linear association between health, biological, behavioral, and cognitive variables in children followed over time. A total of 67 children (aged between six and 10 years) were followed during two years and split into two cohorts (six to eight years old: C1; eight to 10 years old: C2). Data regarding health, physical activity, real and perceived motor competence, physical fitness, and executive function indicators were obtained according to their respective protocols. Comparison tests and network analysis were estimated. Significant gender differences were found in both cohorts. The emerged networks indicated different topologies in both cohorts. No clusters were observed between the variables in C1, and there was a greater number of interactions at eight years of age. Sparse networks were observed in children aged eight and 10 years in C2, and greater connectivity was observed at nine years of age between health, physical fitness, motor competence, and physical activity indicators. This study showed that there are non-linear dynamic relationships between health, biological, behavioral, and cognitive variables over time during child development.

The early years of a child's life are the foundation for their future capability development. Poor health, hunger, poverty, low parental education, lack of parental interaction, high screen time, and poor housing environment hamper their development. There is little evidence of a link between early child development (ECD) and sociodemographic factors in Thailand. In response to monitoring the achievement of SDG target 4.2.1 (the proportion of young children who are developmentally on track in health, learning and psychosocial well-being) as required by all UN Member States, this study analyses the prevalence of appropriate levels of ECD and its correlates of Thai children aged 3 to 4 years. A cross-sectional study of the 6th Multiple Indicator Cluster Survey (MICS) data in 2019 conducted by the National Statistical Office was employed. Face-to-face interviews with mothers and/or legal guardians were conducted. A total of 5787 children aged 3 to 4 were enrolled in this study. The majority of participants, approximately 92.3%, had achieved an appropriate level of ECD index, defined as children who were developmentally on track in at least three out of these four domains: cognitive, physical, social, and learning. Multivariate logistic regression showed that girls had a higher appropriate development index than boys (Adjusted Odds Ratio [AOR] = 1.56, 95% Confidence Interval [95% CI] 1.28-1.90; children living in the 5th wealth quintile had a higher appropriate index than those in a less well-off family the first wealth quintile (AOR = 2.92, 95% CI: 1.86-4.58. Univariate logistic regression showed children living with parents achieving post-secondary education had a significantly greater appropriate index than children living with parents completing secondary education or below (Crude OR = 1.95, 95% CI 1.47-2.58); children who had appropriate parental interactions of more than four out of six interactions, had a significantly higher chance of having an appropriate index than less than four interactions (Crude OR = 1.52, 95% CI 1.14-2.04). Multi-sectoral policies to support child development in low socio-economic households should be strengthened. In addition, family and community should promote parental interactions through reading and playing with young children. Future studies which directly measure ECD in conjunction with regular monitoring through MICS are recommended.

Background: Macrosomia, as an infant with birth weight over 4 kg, can have several perinatal, and neonatal complications. This study aimed to estimate the incidence of macrosomia in Korea and to identify the growth and developmental outcomes and other neonatal complications., Methods: In total, 397,203 infants who were born in 2013 with birth weight ≥ 2.5 kg and who underwent infant health check-up between their 1 st and 7 th visit were included from the National Health Insurance Service database. The information was obtained by the International Classification of Diseases-10 codes or self-reported questionnaires in the National Health Screening Program., Results: The distribution of infants by birth weight was as follows: 384,181 (97%) infants in the 2.5-3.99 kg (reference) group, 12,016 (3%) infants in the 4.0-4.49 kg group, 772 (0.2%) infants in the 4.5-4.99 kg group, and 78 (0.02%) infants in the ≥ 5 kg group. Macrosomia showed significantly higher incidence of sepsis, male sex, and mothers with GDM and birth injury. There was a significant difference in weight, height, and head circumference according to age, birth weight group, and combination of age and birth weight, respectively ( P < 0.001). The number of infants with the weight above the 90 th percentile in macrosomia at each health check-up showed higher incidence than in reference group. The mean body mass index significantly differed among the groups, as 50.6 in infants with 2.5-3.99 kg of birth weight, 63.5 with 4.0-4.49 kg, 71.0 with 4.5-4.99 kg, and 73.1 with ≥ 5 kg. There was a significant difference in the incidence of poor developmental results between infants with macrosomia and the reference group at 24, 36 and 48 month of age., Conclusion: Macrosomia was significantly associated with the risk of sepsis, birth injury, obesity and developmental problem especially in a boy born from mothers with gestational diabetes mellitus. Careful monitoring and proper strategies for monitoring growth and development are needed., Competing Interests: The authors have no potential conflicts of interest to disclose., (© 2021 The Korean Academy of Medical Sciences.)

Objectives: Biological mortality bias is the idea that individuals who perish (non-survivors) are biologically distinct from those who survive (survivors). If biological mortality bias is large enough, bioarchaeological studies of nonsurvivors (skeletal samples) cannot accurately represent the experiences of the survivors of that population. This effect is particularly problematic for the study of juvenile individuals, as growth is particularly sensitive to environmental insults. In this study, we test whether biological mortality bias exists in one dimension of growth, namely dental development., Materials and Methods: Postmortem computed tomography scans of 206 children aged 12 years and younger at death were collected from two institutions in the United States and Australia. The sample was separated into children dying from natural causes as proxies for non-survivors and from accidental causes as proxies for survivors. Differences in the timing of dental development were assessed using sequential logistic regressions between dental formation stages and residual analysis of dental minus chronological age., Results: No consistent delay in age of attainment of dental stages was documented between survivors and non-survivors. Delays between survivors and non-survivors in dental relative to chronological age were greatest for infants, and were greater for females than for males., Discussion: Lack of biological mortality bias in dental development reinforces confidence in juvenile age estimates and therefore in skeletal growth profiles and growth studies. As dental development is known to be less environmentally sensitive than skeletal growth and development, further studies should examine biological mortality bias in long bone length., (© 2021 Wiley Periodicals LLC.)

Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Objective: To verify the relationship between sleep characteristics and motor development in low-birth-weight preterm infants during infancy and preschool years., Method: Forty-one healthy preterm infants (<37 weeks' gestation) with low birth weight (≤1500 g) were assessed longitudinally at three different time points: at 6 months of corrected age, at 12 months of corrected age, and at 4-5 years of chronological age. At 6 and 12 months, motor development was assessed using the Denver Developmental Screening Test II and Alberta Infant Motor Scale, while sleep-related habits and disturbances were assessed using the Brief Infant Sleep Questionnaire. At 4-5 years, motor development was reassessed using the Pediatric Evaluation of Disability Inventory and sleep was reassessed using the Sleep Disturbance Scale for Children. Correlations were performed using sleep quality as the predictor variable and motor development as the outcome variable., Results: Most infants had suspected delay/atypical development at 6 and 12 months, with no difference between the scales (p = 1.000). Suspected delay/atypical development were associated with lateral sleep position (p = 0.004), greater number of nighttime awakenings (p = 0.008), and longer awake periods (p = 0.014) only at 6 months. At 4-5 years, the suspected delay/atypical development observed at 6 and 12 months disappeared., Conclusions: Sleep quality correlated with delayed/atypical motor development in healthy preterm infants with low birth weight only at 6 months of corrected age, which did not appear to affect later development of motor skills., (Copyright © 2020 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)

Objectives: To determine the relationship between socioeconomic development (SD) of local administrative units (LAU) and the height and body mass index (BMI) of second- and third-grade children in Croatia., Methods: We analyzed average height-for-age and BMI-for-age z-scores of 99 LAUs, based on the measurement of 5662 children participating in the Childhood Obesity Surveillance Initiative Croatia. SD was defined according to the governmental Development index. Pearson's correlations between average height and BMI z-scores and SD were calculated. We used ANOVA to test differences in average height and BMI z-scores among LAUs from different SD quartiles and multiple linear regression to investigate the association between average height-for-age z-scores and SD., Results: Height-for-age was significantly correlated with SD. We found a difference in average height-for-age between the least and more developed LAUs. A multiple linear regression model showed significant association between Development index and the average height-for-age z-score (F = 13.085, p < 0.001, R 2  = 0.119)., Conclusions: This finding is important for creators of policies worldwide as socioeconomic inequalities in children's height may exist in other countries that, like Croatia, have recently gone through the transition process.

We aimed to identify if maternal and infant factors were associated with neutral human milk oligosaccharides (HMOs) variability and examined the associations between HMOs concentration and infant growth and disease status in healthy Chinese mothers over a 6-month lactation period. We recruited mothers and their full-term infants as our subjects. At 1-5 days, 8-14 days, 4 weeks, and 6 months postpartum, all participants were interviewed to collect breast milk samples, obtain follow-up data and measure infant length and weight at their local hospital. A total of 23 neutral HMOs were analyzed by high performance liquid chromatography (HPLC)- mass spectrometer (MS). Secretor and Lewis phenotype were determined by the concentration of 2'-fucosyllactose (2'-FL) and Lacto-N-fucopentaose (LNFP)-II. The associations between maternal and infant factors with HMOs concentrations were investigated. A total of 464 human breast milk samples were collected from 116 mothers at four different time points. In total, 76.7% mothers were found to be Secretor and Lewis positive phenotype (Se+Le+), 17.2% were Se-Le+, 4.3% were Se+Le-, and 1.7% were Se-Le-. Several individual HMOs, including 2'-FL, Lactodifucotetraose (LDFT), LNFP-I were determined by Secretor phenotype. Most individual HMOs decreased at the later stage of lactation, except 3'-FL. We suggest that Secretor phenotype and lactation stage could influence most of the neutral HMOs. Concentrations of specific HMOs may be associated with maternal age, allergic history, pre-pregnancy body mass index (BMI), parity, delivery mode, infant gestational age and gender.

Adrenarche, the post-natal rise of DHEA and DHEAS, is unique to humans and the African Apes. Recent findings have linked DHEA in humans to the development of the left dorsolateral prefrontal cortex (LDPFC) between the ages of 4-8 years and the right temporoparietal junction (rTPJ) from 7 to 12 years of age. Given the association of the LDLPFC with the 5-to-8 transition and the rTPJ with mentalizing during middle childhood DHEA may have played an important role in the evolution of the human brain. I argue that increasing protein in the diet over the course of human evolution not only increased levels of DHEAS, but linked meat consumption with brain development during the important 5- to-8 transition. Consumption of animal protein has been associated with IGF-1, implicated in the development of the adrenal zona reticularis (ZR), the site of DHEAS production. In humans and chimps, the zona reticularis emerges at 3-4 years, along with the onset of DHEA/S production. For chimps this coincides with weaning and peak synaptogenesis. Among humans, weaning is completed around 2 ½ years, while synaptogenesis peaks around 5 years. Thus, in chimpanzees, early cortical maturation is tied to the mother; in humans it may be associated with post-weaning provisioning by others. I call for further research on adrenarche among the African apes as a critical comparison to humans. I also suggest research in subsistence populations to establish the role of nutrition and energetics in the timing of adrenarche and the onset of middle childhood., (Copyright © 2020 Campbell.)

Background: Helicobacter pylori infection is known to alter growth-related hormones and affect growth in young children. However, it is still unknown whether maternal H. pylori infection has an impact on the levels of cord blood growth-related hormones and whether this can predict intrauterine growth restriction and poor physical and neurodevelopmental outcomes in children. This study aimed to examine associations between maternal H. pylori infection and pregnancy-related adverse events, fetal growth and early childhood development., Methods: In this prospective cohort study, we recruited singleton pregnant women without major medical illnesses from January 2014 to January 2015. Seropositivity for H. pylori was defined as > 12 U/ml of anti-H. pylori IgG in maternal serum. Demographic data and pregnancy-related medical issues of the cohort were documented. Cord blood levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), insulin, and ghrelin were determined using ELISA. The growth of the included neonates was monitored annually for up to 3 years, and cognitive development was assessed using the comprehensive developmental inventory for infants and toddlers (CDIIT) test 3 years after birth., Results: Of the 106 enrolled women, 25 (23.6%) were H. pylori-seropositive. Maternal H. pylori seropositivity was correlated with a higher risk of developing gestational hypertension (GH) (12% vs. 1.2%, p = 0.04) and lower cord blood levels of IGF-1 (< 35 ng/ml, 70.0% vs. 40.7%, p = 0.02) and IGFBP-3 (< 1120 ng/ml, 100.0% vs. 76.3%, p = 0.02) compared with the seronegative women. No significant impacts on birth weight, childhood growth and cognitive development were found to be correlated with maternal H. pylori seropositivity during pregnancy., Conclusions: Maternal H. pylori infection during pregnancy was more likely to lead to the development of GH, but was not correlated with fetal and childhood growth and development. In addition to close monitoring of hypertension, H. pylori eradication can be considered for mothers with H. pylori infection.

Brain development is most rapid during the fetal period and the first years of life. This process can be affected by many in utero factors, such as chemical exposures and maternal health characteristics. The goal of this review is twofold: to review the most recent findings on the effects of these prenatal factors on the developing brain and to qualitatively assess how those factors were generally reported in studies on infants up to 2 years of age. To capture the latest findings in the field, we searched articles from PubMed 2012 onward with search terms referring to magnetic resonance imaging (MRI), brain development, and infancy. We identified 19 MRI studies focusing on the effects of prenatal environment and summarized them to highlight the recent advances in the field. We assessed population descriptions in a representative sample of 67 studies and conclude that prenatal factors that have been shown to affect brain metrics are not generally reported comprehensively. Based on our findings, we propose some improvements for population descriptions to account for plausible confounders and in time enable reliable meta-analyses to be performed. This could help the pediatric neuroimaging field move toward more reliable identification of biomarkers for developmental outcomes and to better decipher the nuances of normal and abnormal brain development., (© 2018 Wiley Periodicals, Inc.)

Background The objective of this study was to evaluate the physical growth and development characteristics of children with Williams syndrome (WS) aged 0-24 months, and provide help for early diagnosis of WS. Methods A total of 32 cases of children (17 males and 15 females) aged 0-24 months who were diagnosed with WS were enrolled between 2008 and 2017. These children were divided into four different groups: 1-6 months (six cases), 7-12 months (eight cases), 12-18 months (nine cases) and 19-24 months (nine cases). Meanwhile, a total of 32 healthy children (17 males and 15 females) were enrolled in the study from the Department of Health Care for physical examination in our hospital as the control group and matched with each divided group. Weight and height were measured, and meanwhile birth weight and height were also asked and recorded. Results There was no statistically significant difference in birth height between the two groups (p>0.05), and birth weight and the height and weight of the children with WS in the four groups were significantly lower than those of the children in the normal control (NC) group (p>0.05). When the corresponding age of WS children was compared to the Nine City Growth Curve Standards in China, 97% of cases were lagging behind in physical growth and development. Conclusions WS children often have the features of early slow physical growth, which provides certain help for the early diagnosis of WS. Therefore, for younger children, facial features combined with an accurate and objective physical growth assessment and ultrasonic cardiogram can greatly improve the screening rate.

Objective: To analyze the current situation of gross motor development of infants in nine cities of China and their relationship with physical growth. Methods: Healthy full-term infants aged 1-24 months were investigated by cross-sectional survey, which was carried out in nine cities (Beijing, Harbin, Xi'an in northern, Shanghai, Nanjing, Wuhan in central, and Guangzhou, Fuzhou, Kunming in southern regions of China) from June to October in 2015. Subjects were grouped into 12 age groups (1 - <2, 2 - <3, 3 - <4, 4 - <5, 5 - <6, 6 - <8, 8 - <10, 10 - <12, 12 - <15, 15 - <18, 18 - <21, 21 - <24 months). Gross motor development of infants was examined by fieldworkers and the information on parental education, family income and birth status were obtained by questionnaire. Weight, length and head circumference was measured by fieldworkers according to standard methods in the fields and their Z scores were calculated by using WHO growth standard. Z scores of weight (WZ), length (LZ) and head circumference (HCZ) <-2 s was considered as lower group, -2 s- <-1 s as medium-lower group, -1 s- 1 s as medium group, 1 s- <2 s as medium-higher group and ≥2 s as higher group. The age of gross motor development was calculated by Probit regression analysis and χ(2) test was used for comparison of categorical data. Results: (1) The number of infants whose gross motor development was examined were 88 968 in the nine cities. The proportion of achievement of motor development became larger with the chronological age, i.e. it was 11.1% (800/7 236) at 5-<6 months, 65.2% (4 921/7 545) at 6-<8 months and 98.5% (7 417/7 531) at 8-<10 months for sitting alone without support. There was no gender difference in the proportion of achievement of sitting alone without support, hand-knee crawl, stand alone and walk alone (χ(2)=2.873, 0.275, 0.250, 0.576, all P> 0.05). (2) The median age of achievement of sitting alone without support, hand-knee crawl, stand alone, walk alone was respectively 5.9, 7.8, 10.8, 13.0 months, and their ranges from 1(st) to 99(th) percentile were respectively 4.2 - 8.3 months, 4.9 - 12.6 months, 7.6 - 15.4 months, 9.8 - 17.4 months. The gender difference of median age of gross motor development was 0.0-0.1 months and their regional difference was 0.0 - 0.7 months. (3) In the lower weight group, their median age of sitting alone without support and walk alone were 0.2 - 0.6 months later than the medium weight group, while their median age of hand-knee crawl and stand alone were similar to those of the medium weight group. In higher weight group, the median age of sitting alone without support and stand alone were similar to that of the medium weight group, while their median age of hand-knee crawl was 0.3 later months and their median age of walk alone was 0.3 months earlier than that of the medium weight group. There was no significant relationship between length and the age of sitting alone or standing alone (the difference was 0.0 - 0.2 months in each group). The median age of hand-knee crawl and walk alone was 0.4 - 0.7 months later in lower length group than in other length groups. The median age of gross motor development was similar among different head circumference groups (0.0 - 0.2 months). The relationship between weight/length and motor development was similar to that between weight and motor development. Conclusions: There were no gender difference and slightly regional difference in the age of achievement of gross motor skills. The percentile age of gross motor skills helps to understand the population variation in healthy infants. The gross motor development is related with weight, length and body proportion.

World Health Organization recommends exclusive breastfeeding for infants for the first 6 months of life, followed by introduction of nutritious complementary foods alongside breastfeeding. Breast milk remains a significant source of nourishment in the second half of infancy and beyond; however, it is not clear whether more breast milk is always better. The present study was designed to determine the association between amount of breast milk intake at 9-10 months of age and infant growth and development by 12-18 months of age. The study was nested in a randomized controlled trial conducted in Malawi. Regression analysis was used to determine associations between breast milk intake and growth and development. Mean (SD) breast milk intake at 9-10 months of age was 752 (244) g/day. Mean (SD) length-for-age z-score at 12 months and change in length-for-age z-score between 12 and 18 months were -1.69 (1.0) and -0.17 (0.6), respectively. At 18 months, mean (SD) expressive vocabulary score was 32 (24) words and median (interquartile range) skills successfully performed for fine, gross, and overall motor skills were 21 (19-22), 18 (16-19), and 38 (26-40), respectively. Breast milk intake (g/day) was not associated with either growth or development. Proportion of total energy intake from breast milk was negatively associated with fine motor (β = -0.18, p = .015) but not other developmental scores in models adjusted for potential confounders. Among Malawian infants, neither breast milk intake nor percent of total energy intake from breast milk at 9-10 months was positively associated with subsequent growth between 12 and 18 months, or development at 18 months., (© 2018 John Wiley & Sons Ltd.)

Objective: To investigate the effects of docosahexenoic acid (DHA) supplementation on infant's growth and BMI during pregnancy. Methods: A total of 1 516 healthy pregnant women delivered their babies in two maternal and child health care hospitals in Beijing and were chosen as the subjects in this cohort study from May to October 2015. Self-developed questionnaires were used to gather general information of the subjects, including age, height, weight, weight gain during pregnancy, delivery mode, DHA supplementation etc ., before giving birth. Information on body length, weight, head circumference and BMI at birth and 6 months postnatal, of the infants were recorded. Breast milk was collected to test the fatty acid profiles by using the gas chromatography (GC) method at one to three months postnatally. Results: The overall rate of DHA supplementation was 47.76% among the pregnant women, in which introduction of DHA from the early and second stage of the pregnancy accounted for 49.31% and 39.64% respectively. When DHA supplementation began from the early pregnant stage, the DHA concentration showed an increase in the milk ( P <0.05), whereas the supplementation began from the second and third stages did not affect the milk DHA concentration ( P >0.05). Higher height and lower BMI were seen in the infants at birth and 6 months in the supplementation group when comparing to the non-supplementary group ( P <0.05), with the greatest effects noticed in the earliest supplementation group. Specifically, the head circumference appeared larger from the early pregnant stage in the DHA supplementary group, than that in the non-supplement group ( P =0.001). The increment of head circumference was larger than that in the other groups when the infants were 6-month old ( P <0.01). Results from the partial regression analysis showed that during pregnancy, there were positive correlations between DHA supplementation and height ( r =0.324, r =0.216), head circumference ( r =0.221, r =0.302) as well as the increment of head circumference ( r =0.276) at birth and 6 months ( P <0.05). Whereas, a negative correlation was shown between DHA and the infants' BMI ( r =-0.310, r =-0.371) ( P <0.05) when supplementation was given during maternal pregnancy. Conclusions: When DHA supplementation program was carried out during maternal pregnancy, it could increase the height and head circumference and inhibit the rapid increase of BMI in the infants BMI. Our findings seemed helpful in promoting brain development and preventing the childhood obesity.

Objectives: Population-specific growth references are important in understanding local growth variation, especially in developing countries where child growth is poor and the need for effective health interventions is high. In this article, we use mixed longitudinal data to calculate the first growth curves for rural East Timorese children to identify where, during development, deviation from the international standards occurs., Materials and Methods: Over an eight-year period, 1,245 children from two ecologically distinct rural areas of Timor-Leste were measured a total of 4,904 times. We compared growth to the World Health Organization (WHO) standards using z-scores, and modeled height and weight velocity using the SuperImposition by Translation And Rotation (SITAR) method. Using the Generalized Additive Model for Location, Scale and Shape (GAMLSS) method, we created the first growth curves for rural Timorese children for height, weight and body mass index (BMI)., Results: Relative to the WHO standards, children show early-life growth faltering, and stunting throughout childhood and adolescence. The median height and weight for this population tracks below the WHO fifth centile. Males have poorer growth than females in both z-BMI (p = .001) and z-height-for-age (p = .018) and, unlike females, continue to grow into adulthood., Discussion: This is the most comprehensive investigation to date of rural Timorese children's growth, and the growth curves created may potentially be used to identify future secular trends in growth as the country develops. We show significant deviation from the international standard that becomes most pronounced at adolescence, similar to the growth of other Asian populations. Males and females show different growth responses to challenging conditions in this population., (© 2017 Wiley Periodicals, Inc.)

Background: Postnatal growth restriction is very common among preterm infants. Growth restriction might be associated with neurodevelopment impairment. The definition of postnatal growth restriction varies among studies. It has often been based on statistical parameters, but we lack biological data to support this definition., Objectives: The aim here was to study the association between neurodevelopment and postnatal growth restriction defined applying 2 different strategies., Methods: Bayley Scales of Infant Development-II was performed at 2 years corrected age in 168 preterm infants. Postnatal growth restriction was defined as a weight z-score at 36 weeks <-1.5 or treated as a continuous variable (fall in weight z-scores from birth to 36 weeks postmenstrual age)., Results: Weight z-scores fell in almost all patients (98.8%), and 44.1% had z-scores <-1.5 at 36 weeks. After adjusting for gestational age and small for gestational age at birth, every 1-point fall in weight z-score was associated with a 5.6 point (95% CI 1.7 to 9.4) decrease in the Mental Developmental Index. A weight z-score <-1.5 at 36 weeks was not associated with a worse mental or psychomotor result., Conclusion: A fall in the weight z-score from birth to 36 weeks is a more rational definition of postnatal growth restriction, and it could predict neurodevelopment., (© 2018 S. Karger AG, Basel.)

Background and Objective: Understanding the associations between childhood asthma and growth in early adolescence by accounting for the heterogeneity of growth during puberty has been largely unexplored. The objective was to identify sex-specific classes of growth trajectories during early adolescence, using a method which takes the heterogeneity of growth into account and to evaluate the association between childhood asthma and different classes of growth trajectories in adolescence., Methods: Our longitudinal study included participants with a family history of asthma born during 1997-1999 in Sydney, Australia. Hence, all participants were at high risk for asthma. Asthma status was ascertained at 8 years of age using data from questionnaires and lung function tests. Growth trajectories between 11 and 14 years of age were classified using a latent basis growth mixture model. Multinomial regression analyses were used to evaluate the association between asthma and the categorized classes of growth trajectories., Results: In total, 316 participants (51.6% boys), representing 51.3% of the entire cohort, were included. Sex-specific classes of growth trajectories were defined. Among boys, asthma was not associated with the classes of growth trajectories. Girls with asthma were more likely than girls without asthma to belong to a class with later growth (OR: 3.79, 95% CI: 1.33, 10.84). Excluding participants using inhaled corticosteroids or adjusting for confounders did not significantly change the results for either sex., Conclusion: We identified sex-specific heterogeneous classes of growth using growth mixture modelling. Associations between childhood asthma and different classes of growth trajectories were found for girls only., (© 2016 Asian Pacific Society of Respirology.)

This prospective, longitudinal cohort study examined longitudinal patterns of early development in Canadian children born late preterm. A convenience sample of 82 mothers and their healthy, singleton, late preterm children participated. Mothers completed the Ages and Stages Questionnaires at 4, 8, and 18 months corrected age. Concerns were most commonly reported in the communication and gross motor domains, especially early in development. The proportion of children scoring below the referral cut-off in at least one domain at 4, 8, and 18 months was, respectively, 25.6, 25.6, and 14.6%. Only two children (2.4%) scored below referral cut-off in at least one domain at all three time points. At ages four and eight months, the late preterm sample had significantly lower communication and gross motor scores than the Ages and Stages Questionnaires normative sample. At age four months, there was also a significant difference on the fine motor domain. There were no significant differences at age 18 months. Healthy late preterm children appear to catch up to population norms by age 18 months corrected age. Longer term studies are needed to further clarify early indicators of delay in late preterm children and identity those who require close developmental monitoring.

Early childhood development (ECD) is the basis of countries' economic and social development and their ability to meet the Sustainable Development Goals (SDGs). Gestation and the first three years of life are critical for children to have adequate physical, psychosocial, emotional and cognitive development for the rest of their lives. Nurturing care and protection of children during gestation and early childhood are necessary for the development of trillions of neurons and trillions of synapses necessary for development. ECD requires access to good nutrition and health services from gestation, responsive caregiving according to the child's developmental stage, social protection and child welfare, and early stimulation and learning opportunities. Six actions are recommended to improve national ECD programs: expand political will and funding; create a supportive, evidence-based policy environment; build capacity through inter-sectoral coordination; ensure fair and transparent governance of programs and services; increase support for multidisciplinary research; and promote the development of leaders. Mexico has made significant progress under the leadership of the Health Ministry, but still faces significant challenges. The recent creation of a national inter-sectoral framework to enable ECD with support of international organizations and the participation of civil society organizations can help overcome these challenges., (Copyright © 2017 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.)

Background: Infant developmental delays have been associated with several risk factors, such as familial environmental, individual and demographic characteristics. The goal of this study was to longitudinally investigate the effects of maternal knowledge and practices, home environment and biological factors on infant motor and cognitive outcomes., Methods: This was a prospective cohort study with a sample of 49 infants from Southern Brazil. The infants were assessed three times over 4 months using the Alberta Infant Motor Scale and the Bayley Scale of Infant Development (Mental Development Scale). Parents completed the Daily Activities Scale of Infants, the Affordances in The Home Environment for Motor Development - Infant Scale, the Knowledge of Infant Development Inventory and a demographic questionnaire. Generalized estimating equation with Bonferroni method as the follow-up test and Spearman correlation and multivariate linear backward regression were used., Results: Cognitive and motor scores were strongly associated longitudinally and increased over time. Associations between the home affordances, parental practices and knowledge, and motor and cognitive development over time were observed. This relationship explained more variability in motor and cognitive scores compared with biological factors., Conclusions: Variability in motor and cognitive development is better explained by environment and parental knowledge and practice. The investigation of factors associated with infant development allows the identification of infants at risk and the implementation of educational programs and parental training to minimize the effects of developmental delay., (© 2016 Japan Pediatric Society.)

Unlabelled: The synthesizing evidence on the effectiveness of using oil massage to promote the growth of infants is still lacking. This paper aims to determine whether oil massage can promote the physical and neurobehavioral growth of infants according to variables and to evaluate whether oil massage is safe for infant skin., Eligibility Criteria: The randomized controlled trials, clinical controlled trials and quasi-experimentally designed trials published prior to or in 2014 were searched according to predetermined inclusion criteria and exclusion criteria in Medline, PubMed, Ovid, the Cochran Library, and Chinese databases, including the China National Knowledge Infrastructure, Wan Fang database and VIP journal integration platform. Besides, the grey lectures were searched as well through Open Grey, GrayLIT Network and Clinical Trials.gov., Sample: Eight studies out of 625 retrieved articles were eligible for inclusion., Results: Oil massage increased the infant weights, lengths and head circumferences. However, it did not promote a significant advantage in neurobehavioral scores or cause a significant risk of adverse skin reactions., Implications: The core mechanisms and standard procedures of oil massage as well as the preferred oil type should be the focus of future nursing practice and research., Conclusions: Oil massage may effectively improve the physical growth of infants, and it presents a limited risk of adverse skin reactions. However, the relationship between neurodevelopment and oil massage requires further study., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Introduction: It is necessary to use health indicators describing the conditions of all individuals in a population, not just of those who have a disease or die., Objectives: To introduce a method to collect population indicators of psychomotor development in children younger than 6 years old and show its results., Population and Methods: Data were obtained from a cross-sectional assessment regarding compliance with 13 developmental milestones (selected from the national reference) conducted in 5465 children using five surveys administered by the Matanza-Riachuelo River Basin Authority in areas of this basin where a high proportion of families with unmet basic needs live. For each survey, a logistic regression analysis was used to estimate the median age at attainment of the 13 developmental milestones. A linear regression model between the estimated age at attainment of the 13 milestones was adjusted for each survey based on the corresponding age at attainment of the national reference. Based on this model, three indicators were defined: overall developmental quotient, developmental quotient at 4 years old, and developmental trend., Results: Results from the five surveys ranged between 0.74 and 0.85, 0.88 and 0.81, and -0.15 and -0.26 for the overall developmental quotient, developmental quotient at 4 years old, and developmental trend, respectively. A distinct developmental delay and an increasing trend in delay with age were observed., Conclusions: Indicators are easily interpreted and related to social indicators (unmet basic needs, etc.). Collecting the information necessary to make estimations takes little time and can be applied to population groups, but not on an individual level., (Sociedad Argentina de Pediatría.)

Food intake patterns begin to be shaped at the earliest points in life. Early exposures and experiences are critical for the acceptance of some foods, particularly healthful foods such as vegetables, which often have a bitter component in their flavor profiles. In addition to repeated exposure to these foods, the quality and emotional tone of parent-child interactions are important in facilitating children's acceptance of vegetables. During early childhood, parents are challenged by children's developmental characteristics related to eating, such as the emergence of child neophobia, and by individual characteristics of the child that are more biologically based, including genetic predispositions to bitter taste and sensory sensitivities. Experimental studies consistently show that repeated exposure to novel and rejected familiar foods is the most powerful method to improve acceptance. However, the manner and persistence with which these exposures are performed are critical. Research investigating influences on children's vegetable acceptance and ingestion has focused on associations among availability, parent intakes, child neophobia, and the parental feeding response to children's reluctance to try and consume vegetables. Because young children's dietary intakes are low and below dietary recommendations, investigations have focused more on factors that impede children's vegetable acceptance, such as controlling feeding practices, than on positive influences. Research that addresses the multifaceted nature of these interactions among different levels of social-ecological environment, individual traits, parental feeding styles and practices, and socioeconomic influences and that uses longitudinal designs and complex statistical approaches is called for to ascertain more effective methods to improve children's vegetable acceptance., (© 2016 American Society for Nutrition.)

Objective: To assess the use of a health monitoring tool in Brazilian children, with emphasis on the variables related to growth and development, which are crucial aspects of child health care., Data Source: A systematic review of the literature was carried out in studies performed in Brazil, using the Cochrane Brazil, Lilacs, SciELO and Medline databases. The descriptors and keywords used were "growth and development", "child development", "child health record", "child health handbook", "health record and child" and "child handbook", as well as the equivalent terms in Portuguese. Studies were screened by title and summary and those considered eligible were read in full., Data Synthesis: Sixty-eight articles were identified and eight articles were included in the review, as they carried out a quantitative analysis of the filling out of information. Five studies assessed the completion of the Child's Health Record and three of the Child's Health Handbook. All articles concluded that the information was not properly recorded. Growth monitoring charts were rarely filled out, reaching 96.3% in the case of weight for age. The use of the BMI chart was not reported, despite the growing rates of childhood obesity. Only two studies reported the completion of development milestones and, in these, the milestones were recorded in approximately 20% of the verified tools., Conclusions: The results of the assessed articles disclosed underutilization of the tool and reflect low awareness by health professionals regarding the recording of information in the child's health monitoring document., (Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.)

Need and Purpose of Review: Though cases of 'growing pains' are quite common in pediatric practice, very little attention has been given to it, even in the standard text books. The resultant confusion among practitioners regarding diagnosis and management of this condition needs to be addressed., Methods Used for Locating, Selecting, Extracting and Synthesizing Data: PubMed search was performed using "growing pains "[All Fields] AND (("child"[MeSH Terms] OR "child"[All Fields] OR "children"[All Fields]) AND ("pediatrics"[MeSH Terms] OR "pediatrics"[All Fields] OR "pediatric"[All Fields])). Types of articles included are Review articles, Systemic Reviews, Randomized Controlled Trials, Practice guidelines and Observational studies. Google Scholar was also searched using the term "Growing pains in children". Relevant articles not included in the PubMed results were selected. Reference lists of selected studies were also screened to identify additional studies., Main Conclusions: A fairly accurate diagnosis of growing pains can be made clinically, if the widely accepted diagnostic criteria are followed . A systematic approach, with due consideration of both inclusion as well as exclusion criteria, can avoid unnecessary (sometimes potentially harmful) investigations and medications. Reassurance remains the main stay in the management of 'growing pains'.

Context: Infancy is the fastest growth period in a child's development after birth, but little is known about hormonal regulation mechanism for the growth and development of this period., Objective: The objective of this study is to analyze the trend of serum IGF-1 levels in healthy infants and the relationship of IGF-1 to the growth velocity and feeding method of infants., Design: Population-based birth cohort study., Setting: The study was conducted in the Third Hospital of Peking University., Participants: Study participants were 484 healthy infants, all of whom were full-term and appropriate for gestational age (238 boys and 246 girls)., Interventions: Interventions were anthropometrical measurements, feeding methods recorded every 1 to 2 months and serum samples (2, 4, 6, 8, 10,12 months)., Main Outcome Measures: Height, weight, feeding methods and serum IGF-1 were the main outcome measures., Results: Serum IGF-1 levels decreased in the following 2 months in boys but in females levels remained relatively high between 2 to 3 months after birth and then started to decrease. It reached the lowest point at Months 7-8, and was on a slow rise in both male infants and female infants thereafter. Serum IGF-1 levels were significantly higher in female infants [112.65 ng/ml (CI 91.82, 133.89)] than in male infants [74.38 ng/ml (CI 53.14, 95.61)] at early infancy. Infants fed with human milk had lower serum IGF-1 levels than infants fed with formula milk or human milk plus formula milk (66.94 ± 45.85 ng/ml, 72.56 ± 36.55 ng/ml, 79.89 ± 51.79 ng/ml, respectively; P = 0.019). IGF-1 levels were positively correlated to the growth velocity of body length (P<0.01)., Conclusion: This study provides the trend for IGF-1 levels at infancy. It is highly possible that IGF-1 plays an important role in the regulation and control of length increases in infants, and feeding method influences serum IGF-1 levels., (© 2013. Published by Elsevier Ltd. All rights reserved.)

Antenatal urine of 497 pregnant women was collected in the Department of Gynecology and Obstetrics of a county hospital in Jiaozuo, Henan. The content of the main metabolites of synthetic pyrethroid pesticides in urine were determined. After 1 year, physical development indices of 1-year old infants, such as height, weight, and head and chest circumference, were measured. The neural and mental development of the infants was assessed by the Development Screen Test (DST) scale. We observed that the level of synthetic pyrethroid pesticide exposure was negatively related to the neural and mental development of infants (β = -0.1527, P < 0.05). Therefore, direct or indirect exposure to synthetic pyrethroid pesticides should be avoided during pregnancy.

The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) South American site was Pelotas, Brazil. The sample for the longitudinal component was drawn from three hospitals that account for approximately 90% of the city's deliveries. The cross-sectional sample was drawn from a community survey based on households that participated in the longitudinal sample. One of the criteria for site selection was the availability of a large, community based sample of children whose growth was unconstrained by socioeconomic conditions. Local work done in 1993 demonstrated that children of families with incomes at least six times the minimum wage had a stunting rate of 2.5%. Special public relations and implementation activities were designed to promote the acceptance of the study by the community and its successful completion. Among the major challenges of the site were serving as the MGRS pilot site, low baseline breastfeeding initiation and maintenance rates, and reluctance among pediatricians to acknowledge the relevance of current infant feeding recommendations to higher socioeconomic groups.

The rationale for developing a new international growth reference derived principally from a Working Group on infant growth established by the World Health Organization (WHO) in 1990. It recommended an approach that described how children should grow rather than describing how children grow; that an international sampling frame be used to highlight the similarity in early childhood growth among diverse ethnic groups; that modern analytical methods be exploited; and that links among anthropometric assessments and functional outcomes be included to the fullest possible extent. Upgrading international growth references to resemble standards more closely will assist in monitoring and attaining a wide variety of international goals related to health and other aspects of social equity. In addition to providing scientifically robust tools, a new reference based on a global sample of children whose health needs are met will provide a useful advocacy tool to health-care providers and others with interests in promoting child health.

The World Health Organization (WHO) Multicentre Growth Study (MGRS) Middle East site was Muscat, Oman. A survey in Muscat found that children in households with monthly incomes of at least 800 Omani Rials and at least four years of maternal education experienced unconstrained growth. The longitudinal study sample was recruited from two hospitals that account for over 90% of the city's births; the cross-sectional sample was drawn from the national Child Health Register. Residents of all districts in Muscat within the catchment area of the two hospitals were included except Quriyat, a remote district of the governorate. Among the particular challenges of the site were relatively high refusal rates, difficulty in securing adherence to the protocol's feeding recommendations, locating children selected for the cross-sectional component of the study, and securing the cooperation of the children's fathers. These and other challenges were overcome through specific team building and public relations activities that permitted the successful implementation of the MGRS protocol.

The World Health Organization (WHO) Multicentre Growth Reference Study (MRGS) European site was Oslo, Norway. Oslo has a high breastfeeding rate. Ninety-nine percent of mothers initiate breastfeeding soon after delivery, and 80% continue for at least six months. There is no evidence that socioeconomic conditions constrain growth. As in other sites, the study had two components, longitudinal and cross-sectional. Recruitment for the longitudinal component was conducted in three hospitals that account for most births in Oslo. Approximately 850 subjects were screened in one year by using a systematic allocation scheme to recruit a sample of about 300. Recruitment for the cross-sectional component was based on a systematic interval sampling scheme prepared by the National Registry. More than 4,000 subjects were screened to achieve the required sample size. One of the major challenges of the study was to achieve an acceptable participation rate; great efforts were made to motivate pregnant women via the health care system and the media.

The World Health Organization (WHO) Multicentre Growth Reference Study (MRGS) North American site was Davis, California. For the longitudinal cohort (0-24 months), 208 infants were enrolled between January and December 1999 from five area hospitals at which nearly all Davis women give birth. The target sample size was lower in the United States than in the other sites, because recruitment in the United States was restricted to mothers who were willing to exclusively breastfeed for at least 4 months and continue breastfeeding for at least 12 months. For the cross-sectional component, a mixed-longitudinal design was used, which required approximately 500 subjects. The subjects were recruited by going door-to-door, with the sampling scheme based on the distribution of the subjects of the longitudinal study within the city. The cross-sectional sample was recruited between January and July 2001. Major challenges during implementation were maintaining daily communication with hospital personnel and scheduling home visits.

Thorough training, continuous standardization, and close monitoring of the adherence to measurement procedures during data collection are essential for minimizing random error and bias in multicenter studies. Rigorous anthropometry and data collection protocols were used in the WHO Multicentre Growth Reference Study to ensure high data quality. After the initial training and standardization, study teams participated in standardization sessions every two months for a continuous assessment of the precision and accuracy of their measurements. Once a year the teams were restandardized against the WHO lead anthropometrist, who observed their measurement techniques and retrained any deviating observers. Robust and precise equipment was selected and adapted for field use. The anthropometrists worked in pairs, taking measurements independently, and repeating measurements that exceeded preset maximum allowable differences. Ongoing central and local monitoring identified anthropometrists deviating from standard procedures, and immediate corrective action was taken. The procedures described in this paper are a model for research settings.

The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) Asian site was New Delhi, India. Its sample was drawn from 58 affluent neighborhoods in South Delhi. This community was selected to facilitate the recruitment of children who had at least one parent with 17 or more years of education, a key factor associated with unconstrained child growth in this setting. A door-to-door survey was conducted to identify pregnant women whose newborns were subsequently screened for eligibility for the longitudinal study, and children aged 18 to 71 months for the cross-sectional component of the study. A total of 111,084 households were visited over an 18-month period. Newborns were screened at birth at 73 sites. The large number of birthing facilities used by this community, the geographically extensive study area, and difficulties in securing support of pediatricians and obstetricians for the feeding recommendations of the study were among the unique challenges faced by the implementation of the MGRS protocol at this site.

The World Health Organization (WHO) Multicentre Growth Reference (MGRS) data management protocol was designed to create and manage a large data bank of information collected from multiple sites over a period of several years. Data collection and processing instruments were prepared centrally and used in a standardized fashion across sites. The data management system contained internal validation features for timely detection of data errors, and its standard operating procedures stipulated a method of master file updating and correction that maintained a clear trail for data auditing purposes. Each site was responsible for collecting, entering, verifying, and validating data, and for creating site-level master files. Data from the sites were sent to the MGRS Coordinating Centre every month for master file consolidation and more extensive quality control checking. All errors identified at the Coordinating Centre were communicated to the site for correction at source. The protocol imposed transparency on the sites' data management activities but also ensured access to technical help with operation and maintenance of the system. Through the rigorous implementation of what has been a highly demanding protocol, the MGRS has accumulated a large body of very high-quality data.

The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) African site was Accra, Ghana. Its sample was drawn from 10 affluent residential areas where earlier research had demonstrated the presence of a child subpopulation with unconstrained growth. This subpopulation could be identified on the basis of the father's education and household income. The subjects for the longitudinal study were enrolled from 25 hospitals and delivery facilities that accounted for 80% of the study area's births. The cross-sectional sample was recruited at 117 day-care centers used by more than 80% of the targeted subpopulation. Public relations efforts were mounted to promote the study in the community. The large number of facilities involved in the longitudinal and cross-sectional components, the relatively large geographic area covered by the study, and the difficulties of working in a densely populated urban area presented special challenges. Conversely, the high rates of breastfeeding and general support for this practice greatly facilitated the implementation of the MGRS protocol.

The World Health Organization (WHO) Multicentre Growth Reference Study (MGRS) is a community-based, multicountry project to develop new growth references for infants and young children. The design combines a longitudinal study from birth to 24 months with a cross-sectional study of children aged 18 to 71 months. The pooled sample from the six participating countries (Brazil, Ghana, India, Norway, Oman, and the United States) consists of about 8,500 children. The study subpopulations had socioeconomic conditions favorable to growth, and low mobility, with at least 20% of mothers following feeding recommendations and having access to breastfeeding support. The individual inclusion criteria were absence of health or environmental constraints on growth, adherence to MGRS feeding recommendations, absence of maternal smoking, single term birth, and absence of significant morbidity. In the longitudinal study, mothers and newborns were screened and enrolled at birth and visited at home 21 times: at weeks 1, 2, 4, and 6; monthly from 2 to 12 months; and every 2 months in their second year. In addition to the data collected on anthropometry and motor development, information was gathered on socioeconomic, demographic, and environmental characteristics, perinatal factors, morbidity, and feeding practices. The prescriptive approach taken is expected to provide a single international reference that represents the best description of physiological growth for all children under five years of age and to establish the breastfed infant as the normative model for growth and development.