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Research on stress physiology in infancy has assumed increasing importance due to its lifelong implications. In this review, we focus on measurement of hypothalamic-pituitary-adrenal (HPA) function, in particular, and on complementary autonomic processes. We suggest that the measure of HPA function has been overly exclusive, focusing on individual reactivity to single, pragmatically selected laboratory challenges. We advocate use of multiple, strategically chosen challenges and within-subject designs. By administering one challenge that typically does not provoke reactivity and another that does, it is possible to represent allostatic load in terms of "flexibility," the capacity to titrate response to challenge. We also recommend assessing infant reactivity in the context of the primary caregiver's physiological function. Infant-mother "attunement" is central to developmental psychology, permeating diverse developmental domains with varied consequences. A review of adrenocortical attunement suggests that attunement is a reliable process, manifest across varied populations. However, attunement appears stronger in the context of more highly stressful circumstances, such that administration of multiple, selected challenges may help evaluate the degree to which individuals titrate attunement to challenge and determine the correlates of this differential attunement. Finally, we advocate studying the "coordination" of HPA function with other aspects of stress physiology and variation in the degree of this coordination. The use of multiple stressors is important here because each stress system is differentially sensitive to different types of challenge. Therefore, use of single stressors in between-subject designs impedes full recognition of the role played by each system. Overall, we recommend measure of flexibility, attunement, and coordination in the context of multiple challenges to capture allostasis in environmental and physiological context. The simultaneous use of such inclusive and integrative metrics may yield more reliable findings than has hitherto been the case. The interrelation of these metrics can be understood in the context of the adaptive calibration model. [ABSTRACT FROM AUTHOR]

Background Pesticides are associated with poorer neurodevelopmental outcomes, but little is known about the effects on sensory functioning. Methods Auditory brainstem response (ABR) and pesticide data were available for 27 healthy, full-term 9-month-old infants participating in a larger study of early iron deficiency and neurodevelopment. Cord blood was analyzed by gas chromatography–mass spectrometry for levels of 20 common pesticides. The ABR forward-masking condition consisted of a click stimulus (masker) delivered via ear canal transducers followed by an identical stimulus delayed by 8, 16, or 64 milliseconds (ms). ABR peak latencies were evaluated as a function of masker-stimulus time interval. Shorter wave latencies reflect faster neural conduction, more mature auditory pathways, and greater degree of myelination. Linear regression models were used to evaluate associations between total number of pesticides detected and ABR outcomes. We considered an additive or synergistic effect of poor iron status by stratifying our analysis by newborn ferritin (based on median split). Results Infants in the sample were highly exposed to pesticides; a mean of 4.1 pesticides were detected (range 0–9). ABR Wave V latency and central conduction time (CCT) were associated with the number of pesticides detected in cord blood for the 64 ms and non-masker conditions. A similar pattern seen for CCT from the 8 ms and 16 ms conditions, although statistical significance was not reached. Increased pesticide exposure was associated with longer latency. The relation between number of pesticides detected in cord blood and CCT depended on the infant's cord blood ferritin level. Specifically, the relation was present in the lower cord blood ferritin group but not the higher cord blood ferritin group. Conclusions ABR processing was slower in infants with greater prenatal pesticide exposure, indicating impaired neuromaturation. Infants with lower cord blood ferritin appeared to be more sensitive to the effects of prenatal pesticide exposure on ABR latency delay, suggesting an additive or multiplicative effect. [ABSTRACT FROM AUTHOR]

The onset of walking is a developmental transition that sets in motion a cascade of change across a range of domains, including social interactions and language learning. However, research on the unfolding of such change in the infant across this transition is limited. This investigation utilized a longitudinal design to examine the effect of walking acquisition on infant social development and parent perceptions of the infant to explore how changes in these factors relate with infant language development. Parents reported on infant social behaviors and their perception of the infant, as well as motor and language development, in 2-week intervals from 10.5 to 13 months of age. Mixed linear models revealed infant initiation of joint engagement (e.g., pointing, bringing objects to the parent) and following of the parent's joint engagement cues (e.g., point following, gaze following) increased as a function of infant walking experience, particularly between 2- and 4-weeks after the onset of walking, independent of age. Additionally, the parent's perception of the infant as an individual increased between 2- and 4-weeks after the infant began to walk. Finally, the unique relations of infant walking experience, following of social cues, and the parents' perception of the infant as an individual with infant language development were examined. Infant following of joint engagement behaviors and parent perception of the infant as an individual were related to receptive, but not productive, vocabulary size. Additionally, infant walking experience remained a significant predictor of infant receptive and productive language. These findings provide insight on important factors that change as the infant begins to walk. Future research utilizing more direct assessment of these factors is described, as well as general patterning of developmental change across the transition from crawling to walking. [ABSTRACT FROM AUTHOR]

The present study examined 7- and 9-month-old infants' visual habituation to real objects and pictures of the same objects and their preferences between real and pictorial versions of the same objects following habituation. Different hypotheses would predict that infants may habituate faster to pictures than real objects (based on proposed theoretical links between behavioral habituation in infants and neuroimaging adaptation in adults) or to real objects vs. pictures (based on past infant electrophysiology data). Sixty-one 7-month-old infants and fifty-nine 9-month-old infants were habituated to either a real object or a picture of the same object and afterward preference tested with the habituation object paired with either the novel real object or its picture counterpart. Infants of both age groups showed basic information-processing advantages for real objects. Specifically, during the initial presentations, 9-month-old infants looked longer at stimuli in both formats than the 7-month olds but more importantly both age groups looked longer at real objects than pictures, though with repeated presentations, they habituated faster for real objects such that at the end of habituation, they looked equally at both types of stimuli. Surprisingly, even after habituation, infants preferred to look at the real objects, regardless of whether they had habituated to photos or real objects. Our findings suggest that from as early as 7-months of age, infants show strong preferences for real objects, perhaps because real objects are visually richer and/or enable the potential for genuine interactions. [ABSTRACT FROM AUTHOR]

Background: Lead is a pervasive neurotoxicant that has been associated with poorer cognitive, behavioral, and motor outcomes in children. The effects of lead on sensory function have not been well characterized. The aim of this study was to assess the effects of prenatal lead exposure on infant sensory function, as measured by auditory brainstem response (ABR) and grating visual acuity (VA).Methods: Lead was measured in maternal blood in mid- and late-pregnancy (mean gestational age = 15.5 and 39.0 weeks, respectively) and umbilical cord blood in a cohort of full-term infants in rural northeastern China. ABR latencies (peaks I, III, V) were measured in newborns during unsedated sleep (n = 315). The ABR central-to-peripheral (C-P) ratio was calculated as the ratio between the III-V and I-III interpeak intervals. VA was measured in 6-week-olds using Teller Acuity Cards (n = 1019) and assigned as the narrowest grid the infant fixated on. Multivariate linear regression was used to evaluate relationships between tertiles of mid-pregnancy, late-pregnancy, or cord lead and newborn ABR or 6-week VA.Results: Higher late-pregnancy lead levels were associated with higher ABR C-P ratios and lower VA. In covariate-adjusted analyses, mean C-P ratios were 4.6 and 3.2 % higher in infants whose mothers had lead > 3.8 μg/dL and lead = 2-3.8 μg/dL, respectively, than for infants whose mothers had lead < 2 μg/dL (p-trend =0.002). In adjusted analyses for VA, mean scores were 8.5 and 7.2 % lower for maternal lead > 3.8 μg/dL and lead = 2-3.8 μg/dL, respectively, compared to lead < 2 μg/dL (p-trend =0.009).Conclusion: Auditory and visual systems maturation appears delayed in infants with higher prenatal lead exposure during late-pregnancy, even at relatively low levels. Both systems start myelinating in late gestation and mature rapidly in infancy. Higher ABR C-P ratio and lower grating VA scores suggest effects of low-level lead exposure on sensory system myelination. [ABSTRACT FROM AUTHOR]

Background: CareToy is an intelligent system, inspired by baby gyms, aimed to provide an intensive, individualized, home-based and family-centred early intervention (EI) program.Aims: A pilot study was carried out to explore the feasibility of CareToy intervention in preterm infants, aged 3-9 months of corrected age.Methods: Twenty low-risk preterm infants, without brain lesion or other clinical complications (14 allocated to CareToy intervention and 6 to Standard Care) were recruited. The Infant Motor Profile (IMP) was predefined as the primary outcome measure and Alberta Infant Motor Scale and Teller Acuity Cards as secondary measures. Moreover, 202 pre-programmed training scenarios were developed and instructions for the management of CareToy intervention were defined as general guidelines.Outcomes and Results: All infants received 4 weeks of their allocated intervention and were evaluated with the selected tests before and immediately after the 4 weeks. The mean difference changes in IMP total score and Teller Acuity Cards over the intervention period were higher in the CareToy group than in the Standard Care group.Conclusions and Implications: CareToy seems a feasible device for providing EI. An adequately powered randomized clinical trial is warranted. [ABSTRACT FROM AUTHOR]

The importance of breast milk for the growing infant is undisputed; breastfeeding decreases infantile mortality by tenfold and decreases the incidence of infectious diseases. Despite its recognized benefits, the structural richness of breast milk has also impeded the characterization of the multiple effects of milk components on infant physiology. However, the important roles of some components of breast milk are beginning to be dissected. For instance, molecules such as immunoglobulin A (IgA) and milk oligosaccharides protect from gastrointestinal infections and influence the development of the gut microbiota. Deciphering the complex composition of breast milk brings to light multifaceted contributions that combine to make breast milk the ultimate personalized medicine. [ABSTRACT FROM AUTHOR]

Congenital heart disease is identified as the most common birth defect with single ventricle physiology carrying the highest mortality. Staged surgical palliation is required for treatment, with mortality historically as high as 22% in the four- to six-month period from the first- to second-stage surgical palliation, known as the interstage. A standardized postoperative feeding approach was implemented through an evidence-based protocol, parent engagement, and interprofessional team rounds. Five infants with single ventricle physiology preprotocol were compared with five infants who received the standardized feeding approach. Mann-Whitney U tests were conducted to evaluate the hypotheses that infants in the intervention condition would consume more calories and have a positive change in weight-to-age z-score (WAZ) and shorter length of stay (LOS) following the first and second surgeries compared to infants in the control condition. After the protocol, the change in WAZ during the interstage increased by virtually one standard deviation from 0.05 to 0.91. Median LOS dropped 32% after the first surgery and 43% after the second surgery. Since first- and second-stage palliative surgeries occur within the same year of life, this represents savings of $500,000 to $800,000 per year in a 10-infant model. The standardized feeding approach improved growth in single ventricle infants while concurrently lowering hospital costs. [ABSTRACT FROM AUTHOR]

Since maturational processes triggering increased attunement to native language features in early infancy are sensitive to dietary factors, infant-diet related differences in brain processing of native-language speech stimuli might indicate variations in the onset of this tuning process. We measured cortical responses (ERPs) to syllables in 4 and 5 month old infants fed breast milk, milk formula, or soy formula and found syllable discrimination (P350) and syntactic-related functions (P600) but not syllable perception (P170) varied by diet, but not gender or background measures. The results suggest breastfed and formula-fed infants differ in onset of this critical period in speech perception. [ABSTRACT FROM PUBLISHER]

Fetuin-A is a multifunctional protein which inhibits ectopic calcification and insulin receptor phosphorylation. It may also promote insulin resistance by activation of toll-like receptor 4 pro-inflammatory cascade. Increased levels of Fetuin-A have been associated with obesity and related comorbidities such as type 2 diabetes and cardiovascular disease, therefore, it has been suggested as a potential therapeutic target for intervention. However, in addition to its role in disease pathophysiology, Fetuin-A is also important for growth and development. Thus, before evaluating Fetuin-A as a biomarker or pharmacological target, an understanding of Fetuin-A variability throughout the life cycle is essential. This manuscript reviews the current body of knowledge surrounding Fetuin-A throughout the life cycle and discuss challenges to studying Fetuin-A. [ABSTRACT FROM AUTHOR]

Objective: To investigate the possible correlation between maternal characteristics, in utero and early neonatal life exposures, and the development of endometriosis in adult life.Design: Case-control study.Setting: University hospital.Patient(s): A group of 161 patients with endometriosis and a control group of 230 women undergoing laparoscopy for benign adnexal diseases and free of endometriosis.Intervention(s): All women included in the study were requested to answer a series of questions about their mothers' gestational data and on their own perinatal and early postnatal lives.Main Outcome Measure(s): Odds ratio, adjusted odds ratios, and 95% confidence intervals for the associations between maternal characteristics during the patient's pregnancy, in utero exposure to obstetrical and perinatal complications, and the type of feeding received during the neonatal period with the development of endometriosis in adult life.Result(s): Mothers of women with endometriosis were significantly more likely to be affected by endometriosis or uterine fibroids, with a higher incidence of smoking during pregnancy. Women with endometriosis were more frequently born prematurely, with a significantly lower birth weight, and their mothers experienced preeclampsia during their pregnancies more often than control subjects. They were also more frequently formula fed than breast fed in early life. However, only prematurity and formula feeding were retained in the multivariate analysis model.Conclusion(s): Among intrauterine and early neonatal exposures, prematurity and formula feeding were risk factors for the development of endometriosis in adult life. Further studies should evaluate the underlying biologic mechanisms. [ABSTRACT FROM AUTHOR]

Very low birth weight infants (VLBW; birth weight < 1500 g) are exposed to potentially harmful phthalates from medical devices during their hospital stay. We measured urinary phthalate concentrations among hospitalized VLBW infants participating in a nutritional study. Possible associations between different phthalates and birth weight (BW), septicemia and bronchopulmonary dysplasia (BPD) were evaluated. Forty-six VLBW infants were enrolled in this randomized controlled nutritional study. The intervention group (n = 24) received increased quantities of energy, protein, fat, essential fatty acids and vitamin A, as compared to the control group (n = 22). The concentrations of 12 urinary phthalate metabolites were measured, using high-performance liquid chromatography coupled to tandem mass spectrometry, at 3 time points during the first 5 weeks of life. During this study, the levels of di (2-ethylhexyl) phthalate (DEHP) metabolites decreased, whereas an increasing trend was seen regarding metabolites of di-iso-nonyl phthalate (DiNP). Significantly higher levels of phthalate metabolites were seen in infants with lower BW and those diagnosed with late onset septicemia or BPD. A significant positive correlation between the duration of respiratory support and DEHP metabolites was observed ( p ≤ 0.01) at 2.9 weeks of age. Birth weight was negatively associated with urinary phthalate metabolite concentrations. Infants with lower BW and those diagnosed with septicemia or BPD experienced prolonged exposure from medical equipment containing phthalates, with subsequent higher levels of phthalate metabolites detected. Clinical Trial Registration no.: NCT01103219 . [ABSTRACT FROM AUTHOR]

The rate at which infants develop can vary within species. This variation may be due to differences between infants in their nutritional intake and physiology, or the ability of females to adjust the amount and timing of maternal investment to maximize their lifetime reproductive success. This is the first primate study that uses a large sample size and multivariate analyses to investigate whether variation in early infant development (measured visually using durations of natal coat stages) is explained by differences in infanticide pressure, predation pressure or feeding competition among mothers. We recorded the number of days that infants took to transition through each of the two natal coat stages (white to grey: N = 32; grey to black-and-white: N = 22), as well as through their entire natal coats (white to black-and-white: N = 38) in a population of wild ursine colobus, Colobus vellerosus . Infant males, which are at greater risk of infanticidal attacks, transitioned coat colours earlier than females, and infants in multimale groups, where infanticide occurs more frequently, transitioned earlier than infants in unimale groups. Variation in group size did not affect natal coat durations, which suggests that the intensity of predation risk and feeding competition do not influence development. Instead of terminating investment in offspring before birth, as in the ‘Bruce effect’, females may invest more heavily in infants after birth in order to speed up infant development and reduce the time period during which offspring are the most vulnerable to infanticide. Mothers may therefore have flexible means of exerting choice over maternal investment in relation to infanticide risk. However, the extent to which mothers and infants are responsible for adjusting the speed of development is unknown. [ABSTRACT FROM AUTHOR]

Immunoglobulin A (IgA), the most abundantly secreted antibody isotype in mammals, not only provides direct immune protection to neonates via maternal milk but also helps program the infant immune system by regulating the microbiota. IgA continues to maintain dynamic interactions with the gut microbiota throughout life and this influences immune system homeostasis as well as other physiological processes. The secretory IgA produced independently of T-cell selection are commonly referred to as natural or innate antibodies. Our studies have shown that innate-IgA, while effective at excluding microorganisms from the gut, does not promote mutualism with the microbiota in the same way as adaptive-IgA that is selected in T cell-dependent germinal center reactions. Adaptive-IgA fosters more advanced mutualism with the microbiota than innate-IgA by selecting and diversifying beneficial microbial communities. In this review, we suggest that the diversified microbiota resulting from adaptive-IgA pressure was pivotal in promoting ecological adaptability and speciation potential of mammals. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this pilot study was to examine the interplay between the parasympathetic (PNS) and sympathetic nervous systems' (SNS) contributions to prefeeding, feeding and satiation in young, healthy infants.Method: This prospective study was completed on eleven full-term infants, less than 6 months old. Respiratory rate, heart rate, heart rate variability (HRV), electrodermal activity and low-frequency/high-frequency heart rate variability ratio were sampled from the infant during prefeeding, feeding and satiation periods.Results: A repeated-measures ANOVA revealed a significant difference in respiratory patterning during the three feeding phases (p = .049); however, none of the other physiological measures reached significance. An emerging trend across physiological measures suggests that the feeding phase was influenced by the SNS with increasing respiratory rate, heart rate, low-frequency HRV, electrodermal activity and decreasing high-frequency HRV compared to the prefeeding and satiation phases, which were influenced predominantly by the PNS.Conclusion: Respiration rate increased significantly during the feeding phase compared to prefeeding and postfeeding phases. Emerging trends indicate a pattern of alternating relative tone in PNS versus SNS across feeding phases - with SNS predominating the feeding phase. More clinical research examining the SNS and PNS contributions to feeding should be completed across patient populations. [ABSTRACT FROM AUTHOR]

The placenta is crucial for the overall development and lifelong health of the fetus. Abnormal placental development and function occur in pregnancies with fetal congenital heart disease. However, studies that use standardized diagnostic criteria and incorporate control populations are lacking. This limits the generalizability of current research and the ability to determine the specific placental abnormalities associated with congenital heart disease. This study applied consensus statement guidelines (known as the Amsterdam criteria) for placental pathology interpretation to compare the frequency and pattern of abnormalities in pregnancies with fetal congenital heart disease to demographically matched control pregnancies and evaluate for differences in placental abnormalities by cardiac physiology. A single-center retrospective cohort study was conducted from January 2013 to June 2019. Infants with a prenatal diagnosis of moderate-severe congenital heart disease who were born at ≥37 weeks of gestation were included. A control group born at ≥37 weeks of gestation but without fetal congenital heart disease or other major pregnancy complications was matched to the congenital heart disease group on maternal race and ethnicity and infant sex. Using the Amsterdam criteria, placental pathology findings were categorized as delayed villous maturation, maternal vascular malperfusion, fetal vascular malperfusion, and inflammatory lesions. The frequency of placental abnormalities was compared between groups, and logistic regression was performed to evaluate the association of clinical and sociodemographic factors with delayed villous maturation, maternal vascular malperfusion, and fetal vascular malperfusion. There were 194 pregnancies with fetal congenital heart disease and 105 controls included, of whom 83% in the congenital heart disease group and 82% in the control group were of non-Hispanic White race and ethnicity. Compared with controls, pregnancies with fetal congenital heart disease had higher rates of delayed villous maturation (6% vs 19%; P <.001) and maternal vascular malperfusion (19% vs 34%; P =.007) but not fetal vascular malperfusion (6% vs 10%; P=.23). Infants with congenital heart disease with 2-ventricle anatomy displayed the highest odds of delayed villous maturation compared with controls (odds ratio, 5.5; 95% confidence interval, 2.2–15.7; P <.01). Maternal vascular malperfusion was 2.2 times higher (P=.02) for infants with 2-ventricle anatomy and 2.9 times higher (P=.02) for infants with single-ventricle physiology with pulmonic obstruction. Within the congenital heart disease group, delayed villous maturation was associated with higher maternal body mass index, polyhydramnios, larger infant birth head circumference, and infant respiratory support in the delivery room, whereas maternal vascular malperfusion was associated with oligohydramnios. In multivariable models adjusting for cardiac diagnosis, associations of delayed villous maturation persisted for infant birth head circumference (odds ratio, 1.2; 95% confidence interval, 1.0–1.5; P=.02) and infant respiratory support in the delivery room (odds ratio, 3.0; 95% confidence interval, 1.3–6.5; P=.007). Pregnancies with fetal congenital heart disease displayed higher rates of delayed villous maturation and maternal vascular malperfusion than controls, suggesting that placental maldevelopment may relate to maternal factors. Future investigations are needed to determine the association of these abnormalities with postnatal infant outcomes. [ABSTRACT FROM AUTHOR]

Heart rate is commonly used in pediatric early warning scores. Age-related changes in the anatomy and physiology of infants and children produce normal ranges for electrocardiogram features that differ from adults and vary with age. Bradycardia is defined as a heart rate below the lowest normal value for age. Pediatric bradycardia most commonly manifests as sinus bradycardia, junctional bradycardia, or atrioventricular block. As a result of several different etiologies, it may occur in an entirely structurally normal heart or in association with concomitant congenital heart disease. Genetic variants in multiple genes have been described to date in the pathogenesis of inherited sinus node dysfunction or progressive cardiac conduction disorders. Management and eventual prognosis of bradycardia in the young are entirely dependent upon the underlying cause. Reasons to intervene for bradycardia are the association of related symptoms and/or the downstream risk of heart failure or pause-dependent tachyarrhythmia. The simplest aspect of severe bradycardia management is reflected in the Pediatric and Advanced Life Support (PALS) guidelines.Conclusion: Early diagnosis and appropriate management are critical in many cases in order to prevent sudden death, and this review critically assesses our current practice for evaluation and management of bradycardia in neonates and children.What Is Known: Bradycardia is defined as a heart rate below the lowest normal value for age. Age related changes in the anatomy and physiology of infants and children produce normal ranges for electrocardiogram features that differ from adults and vary with age. Pediatric bradycardia most commonly manifests as sinus bradycardia, junctional bradycardia, or atrioventricular block.What Is New: Management and eventual prognosis of bradycardia in the young are entirely dependent upon the underlying cause. Bradycardia may occur in a structurally normal heart or in association with congenital heart disease. Genetic variants in multiple genes have been described. Reasons to intervene for bradycardia are the association of related symptoms and/or the downstream risk of heart failure or pause-dependent tachyarrhythmia. Early diagnosis and appropriate management are critical in order to prevent sudden death. [ABSTRACT FROM AUTHOR]

The Wnt signalling pathway plays a crucial role in the development of the nervous system. This signalling cascade is initiated upon binding of the secreted Wnt ligand to a member of the family of frizzled receptors. In the present study, we analysed the presence of frizzled-4 in the enteric nervous system of human infants. Frizzled-4 could be identified by immunohistochemistry in a subpopulation of enteric neuronal and glial cells in the small and large intestine. Detection of frizzled-4 in the tunica muscularis by RT-PCR confirmed this receptor’s expression on the mRNA level. Interestingly, we observed distinct cell populations that co-expressed frizzled-4 with the intermediate filament protein nestin and the neurotrophin receptor p75NTR, which have been reported to be expressed in neural progenitor cells. Flow cytometry analysis revealed that 60% of p75NTR positive cells of the tunica muscularis were positive for frizzled-4. Additionally, in pathological samples of Hirschsprung’s disease, the expression of this Wnt receptor correlated with the number of myenteric ganglion cells and decreased from normoganglionic to aganglionic areas of large intestine. The expression pattern of frizzled-4 indicates that this Wnt receptor could be involved in postnatal development and/or function of the enteric nervous system. [ABSTRACT FROM AUTHOR]

Background: Infants with complex congenital heart disease requiring surgical intervention within the first days or weeks of life may be the most seriously ill infants needing intensive nursing and medical care. Skin-to-skin contact (SSC) is well accepted and practiced as a positive therapeutic intervention in premature infants but is not routinely offered to infants in cardiac intensive care units. The physiologic effects of SSC in the congenital heart disease population must be examined before recommending incorporation of SSC into standard care routines. Objective: The purpose of this case study was to describe the physiologic response to a single session of SSC in an 18-day-old infant with hypoplastic left heart syndrome. Methods: Repeated measures of heart rate, respiratory rate, oxygen saturation, blood pressure, and temperature were recorded 30 minutes before SSC, during SSC (including interruptions for bottle and breast feedings), and 10 minutes after SSC was completed. Results: All physiologic parameters were clinically acceptable throughout the 135-minute observation. Conclusion: This case study provides beginning evidence that SSC is safe in full-term infants after surgery for complex congenital heart disease. Further research with a larger sample is needed to examine the effects of SSC on infant physiology before surgery and earlier in the postoperative time period as well as on additional outcomes such as length of stay, maternal-infant interaction, and neurodevelopment. [ABSTRACT FROM AUTHOR]

There is a theoretical risk of adverse events following immunization with a preservative-free, 2-dose vial formulation of 10-valent-pneumococcal conjugate vaccine (PCV10). We set out to measure this risk. Four population-based surveillance sites in Kenya (total annual birth cohort of 11,500 infants) were used to conduct a 2-year post-introduction vaccine safety study of PCV10. Injection-site abscesses occurring within 7 days following vaccine administration were clinically diagnosed in all study sites (passive facility-based surveillance) and, also, detected by caregiver-reported symptoms of swelling plus discharge in two sites (active household-based surveillance). Abscess risk was expressed as the number of abscesses per 100,000 injections and was compared for the second vs first vial dose of PCV10 and for PCV10 vs pentavalent vaccine (comparator). A total of 58,288 PCV10 injections were recorded, including 24,054 and 19,702 identified as first and second vial doses, respectively (14,532 unknown vial dose). The risk ratio for abscess following injection with the second (41 per 100,000) vs first (33 per 100,000) vial dose of PCV10 was 1.22 (95% confidence interval [CI] 0.37–4.06). The comparator vaccine was changed from a 2-dose to 10-dose presentation midway through the study. The matched odds ratios for abscess following PCV10 were 1.00 (95% CI 0.12–8.56) and 0.27 (95% CI 0.14–0.54) when compared to the 2-dose and 10-dose pentavalent vaccine presentations, respectively. In Kenya immunization with PCV10 was not associated with an increased risk of injection site abscess, providing confidence that the vaccine may be safely used in Africa. The relatively higher risk of abscess following the 10-dose presentation of pentavalent vaccine merits further study. [ABSTRACT FROM AUTHOR]

Visual exploration in infants and adults has been studied using two very different paradigms: free viewing of flat screen displays in desk-mounted eye-tracking studies and real-world visual guidance of action in head-mounted eye-tracking studies. To test whether classic findings from screen-based studies generalize to real-world visual exploration and to compare natural visual exploration in infants and adults, we tested observers in a new paradigm that combines critical aspects of both previous techniques: free viewing during real-world visual exploration. Mothers and their 9-month-old infants wore head-mounted eye trackers while mothers carried their infants in a forward-facing infant carrier through a series of indoor hallways. Demands for visual guidance of action were minimal in mothers and absent for infants, so both engaged in free viewing while moving through the environment. Similar to screen-based studies, during free viewing in the real world low-level saliency was related to gaze direction. In contrast to screen-based studies, only infants - not adults - were biased to look at people, participants of both ages did not show a classic center bias, and mothers and infants did not display high levels of inter-observer consistency. Results indicate that several aspects of visual exploration of a flat screen display do not generalize to visual exploration in the real world. [ABSTRACT FROM AUTHOR]

The goal of the current study is to assess the temporal dynamics of vision and action to evaluate the underlying word representations that guide infants' responses. Sixteen-month-old infants participated in a two-alternative forced-choice word-picture matching task. We conducted a moment-by-moment analysis of looking and reaching behaviors as they occurred in tandem to assess the speed with which a prompted word was processed (visual reaction time) as a function of the type of haptic response: Target, Distractor, or No Touch. Visual reaction times (visual RTs) were significantly slower during No Touches compared to Distractor and Target Touches, which were statistically indistinguishable. The finding that visual RTs were significantly faster during Distractor Touches compared to No Touches suggests that incorrect and absent haptic responses appear to index distinct knowledge states: incorrect responses are associated with partial knowledge whereas absent responses appear to reflect a true failure to map lexical items to their target referents. Further, we found that those children who were faster at processing words were also those children who exhibited better haptic performance. This research provides a methodological clarification on knowledge measured by the visual and haptic modalities and new evidence for a continuum of word knowledge in the second year of life. [ABSTRACT FROM AUTHOR]

Objective To examine whether maternal reports of infant eating behaviors are stable over time and whether eating behaviors are prospectively associated with weight gain. Methods In an ongoing study of infant growth, weight and length were measured at 2 weeks, 3 months, and 5 months of age. Food responsiveness (FR), satiety responsiveness (SR), enjoyment of feeding (EF), and slow eating (SE) were assessed with the Baby Eating Behavior Questionnaire. Repeated measures ANOVA was used to examine changes in eating behaviors from 2 weeks to 5 months. Simple Pearson correlations examined associations among eating behaviors across time and associations of eating behaviors with subsequent change in weight-for-length z-scores. Results Among 31 infants studied from 2 weeks to 3 months, FR and SR remained consistent ( P < 0.05), and among 21 infants studied from 3 to 5 months, FR, EF, and SE were consistent ( P < 0.01). Infants ate more quickly ( P < 0.01) and tended to have greater SR with age ( P = 0.09). Only SE at 3 months was associated with subsequent gain in weight-for-length ( P < 0.05). Conclusions Consistent with previous research, SE was predictive of weight gain during infancy. Given that eating behaviors were largely consistent after 3 months of age, it may be important to encourage the development of healthy eating behaviors during early infancy. [ABSTRACT FROM AUTHOR]

Lutein is a dietary carotenoid well known for its role as an antioxidant in the macula, and recent reports implicate a role for lutein in cognitive function. Lutein is the dominant carotenoid in both pediatric and geriatric brain tissue. In addition, cognitive function in older adults correlated with macular and postmortem brain lutein concentrations. Furthermore, lutein was found to preferentially accumulate in the infant brain in comparison to other carotenoids that are predominant in diet. While lutein is consistently related to cognitive function, the mechanisms by which lutein may influence cognition are not clear. In an effort to identify potential mechanisms through which lutein might influence neurodevelopment, an exploratory study relating metabolite signatures and lutein was completed. Post-mortem metabolomic analyses were performed on human infant brain tissues in three regions important for learning and memory: the frontal cortex, hippocampus, and occipital cortex. Metabolomic profiles were compared to lutein concentration, and correlations were identified and reported here. A total of 1276 correlations were carried out across all brain regions. Of 427 metabolites analyzed, 257 were metabolites of known identity. Unidentified metabolite correlations (510) were excluded. In addition, moderate correlations with xenobiotic relationships (2) or those driven by single outliers (3) were excluded from further study. Lutein concentrations correlated with lipid pathway metabolites, energy pathway metabolites, brain osmolytes, amino acid neurotransmitters, and the antioxidant homocarnosine. These correlations were often brain region—specific. Revealing relationships between lutein and metabolic pathways may help identify potential candidates on which to complete further analyses and may shed light on important roles of lutein in the human brain during development. [ABSTRACT FROM AUTHOR]

Worldwide, about 15 million infants are born prematurely each year. Technological advances, including invasive mechanical ventilation, play a major role in the survival of extremely preterm babies. Those who survive may have prolonged morbid conditions that result in long-term sequelae. Nurses face several challenges during the hospitalization of these infants. Vigilant care, monitoring, and careful handling of the infants can prevent infections and long-term complications. Newer, less invasive technologies are promising for improved outcomes in extremely preterm infants. [ABSTRACT FROM AUTHOR]

Physical therapy involving newborns and young infants is a specialized area of practice reserved for therapists who have advanced training and the competence to help newborns, young infants and their families meet their goals. Beginning at birth, infants apply a significant amount of effort to actively participate in and shape their world. Infants make their intentions and requests for support known through their behaviors during social and physical therapy encounters. The therapeutic encounter viewed from the infant's perspective has received limited attention in the physical therapy literature. The purpose of this article is to discuss concepts related to phenomenology and synactive theory that are relevant to physical therapy with newborns and young infants during the first few months of life after birth. [ABSTRACT FROM AUTHOR]

Aim: To investigate changes in incidence and characteristics of congenital anomalies in infants in Henan Province of China over a period of 15 years. Methods: Population-based surveillance in Henan Province was conducted from 1997 to 2011 in 75 hospitals (40 urban districts and 35 rural counties, comprising about 20% of the total births). Basic population information was obtained from the healthcare network. All live births, intrauterine deaths after 28 weeks, and stillbirths were included. Congenital anomalies were diagnosed and reported to Henan Provincial Maternal and Pediatric Healthcare Hospital. Results: Of 1,815,920 births from 1997 to 2011, 15,660 cases of congenital anomalies were identified, resulting in an average incidence of 86.2 cases per 10,000 births. The incidence of congenital anomalies showed a significant downward trend (p < 0.0001) in rural areas and the whole province (p < 0.0001), but an increase in urban areas (p = 0.003). The incidence was much higher in rural than in urban areas in 1997, but this discrepancy decreased rapidly and no difference was seen between rural and urban areas in 2003. The incidence in females was higher than in males in 1997–1999 but decreased to a similar level as that in males in 2000. Maternal age exceeding 35 years was associated with a higher incidence of congenital anomalies. Among the 23 types of congenital anomalies recorded, neural tube defects were the most common; the incidence declined from 39.3 cases per 10,000 births in 1997 to 6.1 cases per 10,000 births in 2011. Conclusion: The incidence of congenital anomalies has decreased in Henan Province over the past 15 years due to significant reductions in rural areas and among girls. This decrease was partly related to a reduction in neural tube defects that was likely the result of a folic acid intervention in the province. [ABSTRACT FROM AUTHOR]

Objective To determine the heart rate response to atropine (<0.1 mg) in anaesthetised young infants. Design Prospective, observational and controlled. Setting Elective surgery. Patients Sixty unpremedicated healthy infants less than 15 kg were enrolled. Standard monitoring was applied. Anaesthesia was induced by mask with nitrous oxide (66%) and oxygen (33%) followed by sevoflurane (8%). Interventions Intravenous (IV) atropine (5 mg/kg) was flushed into a fast flowing IV. The ECG was recorded continuously from 30 s before the atropine until 5 min afterwards. Main outcome measures The incidence of bradycardia and arrhythmias was determined from the ECGs by a blinded observer. Results The median (IQR) age was 6.5 (4-12) months and the mean (95% CI) weight was 8.6 (8.1 to 9.1) kg. The mean (95% CI) dose of atropine was 40.9 (37.3 to 44) mg. Bradycardia did not occur. Two infants developed premature atrial contractions and one developed a premature ventricular contraction. When compared with baseline values, heart rate increased by 7% 30 s after atropine, 14% 1 min after atropine and 25% 5 min after atropine. Twenty-nine infants (48%) experienced tachycardia (>20% above baseline rate) after atropine lasting 222.7 s (range 27.9-286). The change in heart rate 5 min after atropine was inversely related to the baseline heart rate. Conclusions The upper 95% CI for the occurrence of bradycardia in the entire population of infants based on a zero incidence in this study is 5%. These results rebut the notion that atropine <0.1 mg IV causes bradycardia in young infants. Trial registration number ClinicalTrials.gov #NCT01819064. [ABSTRACT FROM AUTHOR]

This paper explores the role visual attention plays in the recognition of objects in infancy. Research and theory on the development of infant attention and recognition memory are reviewed in three major sections. The first section reviews some of the major findings and theory emerging from a rich tradition of behavioral research utilizing preferential looking tasks to examine visual attention and recognition memory in infancy. The second section examines research utilizing neural measures of attention and object recognition in infancy as well as research on brain–behavior relations in the early development of attention and recognition memory. The third section addresses potential areas of the brain involved in infant object recognition and visual attention. An integrated synthesis of some of the existing models of the development of visual attention is presented which may account for the observed changes in behavioral and neural measures of visual attention and object recognition that occur across infancy. [ABSTRACT FROM AUTHOR]

This study assessed the impact of SES on early means–end behavior. Sixty-one 6- to 8- and 10- to 12-month-old infants from high and low SES families were presented with two tasks requiring a two-step process to retrieve a toy. On the cloth task, overall performance improved with age, but low SES infants showed delays. Performance by the 10- to 12-month-old low SES infants was identical to that of the 6- to 8-month-old high SES infants. On the hook task, again overall performance improved with age, but significant SES differences emerged at 10 to 12 months, with only 20% of low SES infants succeeding at the task, compared to 73% of high SES infants. The results suggest a divergence in means–end behavior between high and low SES infants by 6 months of age, adding to the well-known documentation of gaps in cognitive skills evident between high and low SES infants. [ABSTRACT FROM AUTHOR]

Background: Phase contrast cardiovascular magnetic resonance (PC CMR) has emerged as a clinical tool for blood flow quantification but its use in the foetus has been hampered by the need for gating with the foetal heart beat. The previously described metric optimized gating (MOG) technique has been successfully used to measure foetal blood flow in late gestation foetuses on a 1.5 T CMR magnet. However, there is increasing interest in performing foetal cardiac imaging using 3.0 T CMR. We describe our pilot investigation of foetal blood flow measured using 3.0 T CMR. Methods: Foetal blood flows were quantified in 5 subjects at late gestational age (35-38 weeks). Three were normal pregnancies and two were pregnancies with ventricular size discrepancy. Data were obtained at 1.5 T and 3.0 T using a previously described PC CMR protocol. After reconstruction using MOG, blood flow was quantified independently by two observers. Intra- and inter-observer reproducibility of flow measurements at the two field strengths was assessed by Pearson correlation coefficient (R2), linear regression and Bland Altman analysis. Results: PC CMR flow measurements were obtained in 36 of 40 target vessels. Strong intra-observer agreement was obtained between measurements at each field strength (R² = 0.78, slope = 0.83 ± 0.11), with a mean bias of -1 ml/min/kg and 95% confidence limits of ±71 ml/min/kg. Inter-observer agreement was similarly high for measurements at both 1.5 T (R² = 0.86, slope = 0.95 ± 0.13, bias = 6 ± 52 ml/min/kg) and 3.0 T (R² = 0.88, slope = 0.94 ± 0.13, bias = 4 ± 47 ml/min/kg). Across all PC CMR measurements, SNR per pixel was expectedly higher at 3.0 T relative to 1.5 T (165 ± 50%). The relative differences in flow measurements between observers were low (range: 4-16%) except for pulmonary blood flow which showed much higher variability at 1.5 T (34%) versus that at 3.0 T (11%). This was attributed to the poorly visualized, small pulmonary vessels at 1.5 T, which made delineation inconsistent between observers. Conclusions: This is the first pilot study to measure foetal blood flow using PC CMR at 3.0 T. The flow data obtained were in good correlation with those measured at 1.5 T, both within and between observers. With increased SNR at 3.0 T, smaller pulmonary vessels were better visualized which improved inter-observer agreement of associated flows. [ABSTRACT FROM AUTHOR]

Objectives Infant cases frequently show a diffuse increase in the concentration of lung fields on post-mortem computed tomography (PMCT). However, the lungs often show simply atelectasis at autopsy in the absence of any other abnormal changes. Thus, we retrospectively reviewed the PMCT findings of lungs following sudden infant death and correlated them with the autopsy results. Materials and methods We retrospectively reviewed infant cases (0 year) who had undergone PMCT and a forensic autopsy at our institution between May 2009 and June 2013. Lung opacities were classified according to their type; consolidation, ground-glass opacity and mixed, as well as distribution; bilateral diffuse and areas of sparing. Statistical analysis was performed to assess the relationships among lung opacities, causes of death and resuscitation attempt. Results Thirty infant cases were selected, which included 22 sudden and unexplained deaths and 8 other causes of death. Resuscitation was attempted in 22 of 30 cases. Bilateral diffuse opacities were observed in 21 of the 30 cases. Of the 21 cases, 18 were sudden and unexplained deaths. Areas of sparing were observed in 4 sudden and unexplained deaths and 5 other causes of death. Distribution of opacities was not significantly associated with causes of death or resuscitation attempt. The 21 cases with bilateral diffuse opacities included 6 consolidations (4 sudden and unexplained deaths, 2 other causes of death), 4 ground-glass opacities (3 sudden and unexplained deaths and 1 other) and 11 mixed (11 sudden and unexplained deaths). Types of opacities were not significantly associated with causes of death or resuscitation attempt. Conclusion Atelectasis is very common in sudden and unexplained death of infants. Bilateral diffuse mixed opacity was observed only in sudden and unexplained deaths. Bilateral diffuse pure consolidation or ground-glass opacity was also observed in other causes of death. [ABSTRACT FROM AUTHOR]

Public concern over vitamin D deficiency has led to widespread use of over the counter (OTC) vitamin D (-D 3 or -D 2 ) supplements, containing up to 10,000 IU/unit dose (400 IU = 10 μg). Overzealous use of such supplements can cause hypercalcemia due to vitamin D toxicity. Infants are particularly vulnerable to toxicity associated with vitamin D overdose. OTC supplements are not subject to stringent quality control regulations from FDA and high degree of variability in vitamin D content in OTC pills has been demonstrated. Other etiologies of vitamin D induced hypercalcemia include hyperparathyroidism, granulomatous malignancies like sarcoidosis and mutations in the CYP24A1 gene. The differential diagnosis of hypercalcemia should include iatrogenic and genetic etiologies. C24-hydroxylation and C3-epimerization are two important biochemical pathways via which 25-hydroxyvitamin D 3 (25(OH)D 3 ) is converted to its metabolites, 24,25-dihydroxyvitamin D 3 (24,25(OH) 2 D 3 ) or its C3 epimer, 3-epi-25-OH-D 3 respectively. Mutations in the CYP24A1 gene cause reduced serum 24,25(OH) 2 D 3 to 25(OH)D 3 ratio (<0.02), elevated serum 1,25-dihydroxyvitamin D (1,25(OH) 2 D 3 ), hypercalcemia, hypercalciuria and nephrolithiasis. Studies in infants have shown that 3-epi-25(OH)D 3 can contribute 9–61.1% of the total 25(OH)D 3 . Therefore, measurements of parathyroid hormone (PTH) and vitamin D metabolites 25(OH)D 3 , 1,25(OH) 2 D 3 , 3-epi-25(OH)D 3 and 24,25(OH) 2 D 3 are useful to investigate whether the underlying cause of vitamin D toxicity is iatrogenic versus genetic. Here we report a case of vitamin D 3 associated toxicity in a 4-month-old female who was exclusively breast-fed and received an oral liquid vitamin D 3 supplement at a dose significantly higher than recommended on the label. The vitamin D 3 content of the supplement was threefold higher (6000 IU of D/drop) than listed on the label (2000 IU). Due to overdosing and higher vitamin D 3 content, the infant received ∼50,000 IU/day for two months resulting in severe hypercalcemia, hypercalciuria and nephrocalcinosis. We also review the relevant literature on vitamin D 3 toxicity in this report. [ABSTRACT FROM AUTHOR]

Two independent experiments ( n = 22 and n = 22) showed that 2-month-old infants displayed significantly more stepping movements when supported upright in the air than when supported with their feet contacting a surface. Air- and surface-stepping kinematics were quite similar (Experiment 2). In addition, when data were collapsed across both experiments, more air steps and more donkey kicks were seen when infants were exposed to optic flows that specified backward compared to forward translation. The findings challenge the currently accepted heavy legs explanation for the disappearance of stepping at 2 months of age and raise new questions about the visual control of stepping. [ABSTRACT FROM AUTHOR]

In paediatric patients, airway management can be challenging due to unique anatomical and physiological variations. Hence, a thorough history, examination and pre-operative planning are essential in securing difficult airway in paediatrics. We report a case of a 7-month-old infant with rhabdomyosarcoma of the upper lip with anticipated difficult airway. The airway was managed with three different conventional techniques (modified nasal trumpet, supraglottic airway and direct laryngoscopy) for three different procedures in the same infant. The procedures were uneventful and recovery was good. This case report emphasises the use of conventional techniques in the management of difficult airway. [ABSTRACT FROM AUTHOR]

Given that biological motion is both detected and preferred early in life, we tested the hypothesis that biological motion might be instrumental to infants’ differentiation of animate and inanimate categories. Infants were primed with either point-light displays of realistic biological motion, random motion, or schematic biological motion of an unfamiliar shape. After being habituated to these displays, 12-month-old infants categorized animals and vehicles as well as furniture and vehicles with the sequential touching task. The findings indicated that infants primed with point-light displays of realistic biological motion showed better categorization of animates than those exposed to random or schematic biological motion. These results suggest that human biological motion might be one of the motion cues that provide the building blocks for infants’ concept of animacy. [ABSTRACT FROM AUTHOR]

In many countries, routine data relating to growth of infants are collected as a means of tracking health and illness up to school age. These have potential to be used in research. For health monitoring and research, data should be accurate and reliable. This study aimed to determine the agreement between length/height and weight measurements from routine infant records and researcher-collected data. Methods Height/length and weight at ages 6, 12 and 24 months from the longitudinal UK birth cohort (born in Bradford; n=836-1280) were compared with routine data collected by health visitors within 2 months of the research data (n=104-573 for different comparisons). Data were age adjusted and compared using Bland Altman plots. Results There was agreement between data sources, albeit weaker for height than for weight. Routine data tended to underestimate length/height at 6 months (0.5 cm (95% CI -4.0 to 4.9)) and overestimate it at 12 (-0.3 cm (95% CI -0.5 to 4.0)) and 24 months (0.3 cm (95% CI -4.0 to 3.4)). Routine data slightly overestimated weight at all three ages (range -0.04 kg (95% CI -1.2 to 0.9) to -0.04 (95% CI -0.7 to 0.6)). Limits of agreement were wide, particularly for height. Differences were generally random, although routine data tended to underestimate length in taller infants and underestimate weight in lighter infants. Conclusions Routine data can provide an accurate and feasible method of data collection for research, though wide limits of agreement between data sources may be observed. Differences could be due to methodological issues; but may relate to variability in clinical practice. Continued provision of appropriate training and assessment is essential for health professionals responsible for collecting routine data. [ABSTRACT FROM AUTHOR]

Objectives To investigate the emergence of biological rhythms in the first months of life in human infants, by measuring age-related changes in core body temperature during night-time sleep, hormones (cortisol and 6-sulfatoxymelatonin) and the expression of a clock-controlled gene H3f3b in oral epithelial cells. Design Observational longitudinal study. Setting We measured overnight core body temperature, actigraphy, day-night urinary cortisol and 6- sulfatoxymelatonin, as well as circadian gene expression, in infants at home from March 2007 to July 2008 in Leicester. Participants We recruited 35 healthy Caucasian infants who were born at term. They were monitored from 6 to 18 weeks of age. Results At 8 weeks of age the day-night rhythm of cortisol secretion was the first to appear followed by 6-sulfatoxymelatonin 1 week later; at the same time that night-time sleep was established. At 10 weeks, the maximum fall in deep body temperature occurred with the onset of night-time sleep, followed at 11 weeks by the rhythmical expression of the H3f3b gene. Conclusions In human infants, there is a clear sequential pattern for the emergence of diurnal biological rhythms between 6 and 18 weeks of postnatal age, led by the secretion of cortisol and linked with the establishment of consolidated night-time sleep. It is likely that this represents part of a maturation and adaption process as infants gain equilibrium with their external environment after birth. [ABSTRACT FROM AUTHOR]

The maternal environment exerts important influences on offspring mass/growth, metabolism, reproduction, neurobiology, immune function, and behavior among birds, insects, reptiles, fish, and mammals. For mammals, mother's milk is an important physiological pathway for nutrient transfer and glucocorticoid signaling that potentially influences offspring growth and behavioral phenotype. Glucocorticoids in mother's milk have been associated with offspring behavioral phenotype in several mammals, but studies have been handicapped by not simultaneously evaluating milk energy density and yield. This is problematic as milk glucocorticoids and nutrients likely have simultaneous effects on offspring phenotype. We investigated mother's milk and infant temperament and growth in a cohort of rhesus macaque (Macaca mulatta) mother--infant dyads at the California National Primate Research Center (N = 108). Glucocorticoids in mother's milk, independent of available milk energy, predicted a more Nervous, less Confident temperament in both sons and daughters. We additionally found sex differences in the windows of sensitivity and the magnitude of sensitivity to maternal-origin glucocorticoids. Lower parity mothers produced milk with higher cortisol concentrations. Lastly, higher cortisol concentrations in milk were associated with greater infant weight gain across time. Taken together, these results suggest that mothers with fewer somatic resources, even in captivity, may be "programming" through cortisol signaling, behaviorally cautious offspring that prioritize growth. Glucocorticoids ingested through milk may importantly contribute to the assimilation of available milk energy, development of temperament, and orchestrate, in part, the allocation of maternal milk energy between growth and behavioral phenotype. [ABSTRACT FROM AUTHOR]

Background Mutual circadian rhythm is an early and essential component in the development of maternal–infant physiological synchrony. Aims The aim of this to examine the longitudinal pattern of maternal–infant circadian rhythm and rhythm synchrony as measured by rhythm parameters. Study design In-home dyadic actigraphy monitoring at infant age 4, 8, and 12 weeks. Subjects Forty-three healthy mother–infant pairs. Outcome measures Circadian parameters derived from cosinor and non-parametric analysis including mesor, magnitude, acrophase, L5 and M10 midpoints (midpoint of lowest 5 and highest 10 h of activity), amplitude, interdaily stability (IS), and intradaily variability (IV). Results Mothers experienced early disruption of circadian rhythm, with re-establishment of rhythm over time. Significant time effects were noted in increasing maternal magnitude, amplitude, and IS and decreasing IV ( p < .001). Infants demonstrated a developmental trajectory of circadian pattern with significant time effects for increasing mesor, magnitude, amplitude, L5, IS, and IV ( p < .001). By 12 weeks, infant phase advancement was evidenced by mean acrophase and M10 midpoint occurring 60 and 43 min (respectively) earlier than at 4 weeks. While maternal acrophase remained consistent over time, infants became increasingly phase advanced relative to mother and mean infant acrophase at 12 weeks occurred 60 min before mother. Mother–infant synchrony was evidenced in increasing correspondence of acrophase at 12 weeks ( r = 0.704), L5 ( r = 0.453) and M10 ( r = 0.479) midpoints. Conclusions Development of mother–infant synchrony reflects shared elements of circadian rhythm. [ABSTRACT FROM AUTHOR]

Little is known about the relationship between maternal behavior and the stability of premature infants' physiologic responses during feeding. In a secondary data analysis, we examined relationships between quality of maternal behavior and cardiorespiratory physiology during feeding in 61 premature and 53 term infants at four times over the first year of life. Measures included heart rate (HR), respiratory rate (RR), and oxygen saturation; Child Feeding Skills Checklist; and Parent-Child Early Relational Assessment. Birthweight, gestational age, and neurodevelopmental risk were covariates. Quality of maternal behavior did not predict infants' physiologic response to feeding. However, birthweight was related to infant feeding physiology among all infants over the first year of life. Stress during fetal life, which may lead to impaired intrauterine growth and low birthweight, may have longitudinal effects on cardiorespiratory functioning of premature infants. Research is needed to further investigate the biological pathways by which maternal-infant interaction supports behavioral and physiologic feeding outcomes of premature infants. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

A wide variety of factors have been shown to influence the male to female ratio at birth, which invariably displays a male excess. This paper will review and amplify recent work by the author, with specific references to individual countries, regions and entire continents in order to provide a global overview of this subject. It will be shown that stress, including stress related to political events, influences this ratio. Man-made radiation is also shown to have played a significant role in relation to the Windscale fire (1957) and Chernobyl (1986). [ABSTRACT FROM AUTHOR]

The very preterm birth of an infant is physiologically traumatic for the infant and physiologically and psychologically traumatic for the parents. The manner of care delivery in the first few days and weeks of the infant's life plays a large role in determining the impact of that trauma. For optimal outcomes parents need to be integrated into the care process as the primary practitioners of their infant's care in the neonatal intensive care unit. Supporting and enabling parents to be central to the care process establishes a consistent care environment where parents are in control and able to support their infant's physiological and psychological needs, thereby improving infant outcomes and reducing parent stress and anxiety. This article reviews the role of parents in the optimal development of preterm neonates, and discusses the elements crucial to promoting parent involvement in the neonatal intensive care unit and supporting parents following discharge. [ABSTRACT FROM AUTHOR]

Within the Pavlovian conditioning framework, extinction is a procedure in which, after conditioning, the conditioned stimulus (CS) is repeatedly presented without the unconditioned stimulus (US). During this procedure the conditioned response (CR) is gradually attenuated. It has been suggested that extinction during the early stages of ontogeny is a qualitatively different process from extinction in adulthood: during infancy, extinction may result in erasure of the memory, while during adulthood extinction involves new learning. This conclusion was supported by studies showing that renewal, reinstatement or spontaneous recovery procedures were not effective during infancy for recovering the CR once it had been extinguished. These studies used the freezing response as the only behavioral index, although some recent evidence indicates that the absence of freezing after conditioning or after extinction does not necessarily imply a deficit in memory, and that other behavioral indexes may be more sensitive to detecting conditioning effects. The goal of the present study was to analyze extinction in preweanling rats by examining the possibility of the spontaneous recovery of a conditioned fear response, measured through a different set of mutually-exclusive behaviors that constitute an exhaustive ethogram, and including control groups (Experiment 1: US-Only and CS-Only; Experiment 2: US-Only, CS-Only and Unpaired) in order to examine whether non-associative learning may explain quantitative or qualitative changes in the frequency of specific responses during extinction or recovery. Extinction produced changes in the expression of freezing, grooming and exploration, and the clearest evidence of spontaneous recovery came from the analysis of freezing behavior. The pattern of behavior observed during extinction is compatible with theoretical approaches which consider different dynamic behavioral systems, and it also fit in well with a molar approach to the analysis of behavior, which considers that extinction involves a transition from one allocation of time among behaviors to another allocation, rather than a loss of strength in any particular discrete response. These results have implications for the study of extinction during infancy, since they are compatible with the hypothesis that the original memory survives extinction, and highlight the importance of control conditions for detecting this effect during this ontogenetic period. [ABSTRACT FROM AUTHOR]

Following an application from Specialised Nutrition Europe (formerly IDACE), submitted pursuant to Article 14 of Regulation (EC) No 1924/2006 via the Competent Authority of France, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the scientific substantiation of a health claim related to zinc and normal growth. The food constituent, zinc, which is the subject of the health claim, is sufficiently characterised. Normal growth is a beneficial physiological effect for infants and young children. The Panel considers that the role of zinc in normal growth is well established. Growth retardation is one of the clinical manifestations of severe zinc deficiency. Zinc supplementation has been reported to stimulate growth and development in zinc-deficient infants and young children. The Panel concludes that a cause and effect relationship has been established between the dietary intake of zinc and normal growth. The following wording reflects the scientific evidence: 'zinc contributes to normal growth'. The target population is infants and children up to three years of age. [ABSTRACT FROM AUTHOR]

Digestion of nutrients is an essential function of the newborn infant gut to allow growth and development and understanding infant digestive function is essential to optimize nutrition and oral drug delivery. Ethical considerations prohibit invasive in vivo trials and as a consequence in vitro assays are often conducted. However, the choice of in vitro model parameters are not supported by an exhaustive analysis of the literature and do not mimic precisely the digestive conditions of the infant. This review contains a compilation of the studies which characterized the gastroduodenal conditions in full-term or preterm infants of variable postnatal age from birth up to six months. Important data about healthy full-term infants are reported. The enzymatic (type of enzymes and level of activity) and nonenzymatic (milk-based diet, frequency of feeding, bile salt concentrations) conditions of digestion in infants are shown to differ significantly from those in adults. In addition, the interindividual and developmental variability of the digestive conditions in infants is also highlighted. [ABSTRACT FROM AUTHOR]

Diffuse optical tomography is most accurate when an individual's MRI data can be used as a spatial prior for image reconstruction and for visualization of the resulting images of changes in oxy- and deoxy-hemoglobin concentration. As this necessitates an MRI scan to be performed for each study, which undermines many of the advantages of diffuse optical methods, the use of registered atlases to model the individual's anatomy is becoming commonplace. Infant studies require carefully age-matched atlases because of the rapid growth and maturation of the infant brain. In this paper, we present a 4D neonatal head model which, for each week from 29 to 44 weeks post-menstrual age, includes: 1) a multi-layered tissue mask which identifies extra-cerebral layers, cerebrospinal fluid, gray matter, white matter, cerebellum and brainstem, 2) a high-density tetrahedral head mesh, 3) surface meshes for the scalp, gray-matter and white matter layers and 4) cranial landmarks and 10-5 locations on the scalp surface. This package, freely available online at www.ucl.ac.uk/medphys/research/4dneonatalmodel can be applied by users of near-infrared spectroscopy and diffuse optical tomography to optimize probe locations, optimize image reconstruction, register data to cortical locations and ultimately improve the accuracy and interpretation of diffuse optical techniques in newborn populations. [ABSTRACT FROM AUTHOR]

Sulcal pits, the locally deepest points in sulci of the highly convoluted and variable cerebral cortex, are found to be spatially consistent across human adult individuals. It is suggested that sulcal pits are genetically controlled and have close relationships with functional areas. To date, the existing imaging studies of sulcal pits are mainly focused on adult brains, yet little is known about the spatial distribution and temporal development of sulcal pits in the first 2 years of life, which is the most dynamic and critical period of postnatal brain development. Studying sulcal pits during this period would greatly enrich our limited understandings of the origins and developmental trajectories of sulcal pits, and would also provide important insights into many neurodevelopmental disorders associated with abnormal cortical foldings. In this paper, by using surface-based morphometry, for the first time, we systemically investigated the spatial distribution and temporal development of sulcal pits in major cortical sulci from 73 healthy infants, each with three longitudinal 3 T MR scans at term birth, 1 year, and 2 years of age. Our results suggest that the spatially consistent distributions of sulcal pits in major sulci across individuals have already existed at term birth and this spatial distribution pattern keeps relatively stable in the first 2 years of life, despite that the cerebral cortex expands dramatically and the sulcal depth increases considerably during this period. Specially, the depth of sulcal pits increases regionally heterogeneously, with more rapid growth in the high-order association cortex, including the prefrontal and temporal cortices, than the sensorimotor cortex in the first 2 years of life. Meanwhile, our results also suggest that there exist hemispheric asymmetries of the spatial distributions of sulcal pits in several cortical regions, such as the central, superior temporal and postcentral sulci, consistently from birth to 2 years of age, which likely has close relationships with the lateralization of brain functions of these regions. This study provides detailed insights into the spatial distribution and temporal development of deep sulcal landmarks in infants. [ABSTRACT FROM AUTHOR]