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To evaluate the safety profile of measles, mumps and rubella (MMR) booster in children diagnosed with rheumatic diseases receiving biological agents. The study included retrospective safety data of children administered MMR booster dose receiving biologics or biologics with methotrexate. The files of 182 patients were accessed from the pediatric rheumatology biological therapy archive, and the vaccination status of these children was obtained by accessing electronic records. Of 182 patients, 14 patients were vaccinated with MMR booster dose. Thirteen of the patients were followed up with a diagnosis of juvenile idiopathic arthritis and one with colchicine-resistant familial Mediterranean fever. None of the patients had disease exacerbation after vaccination, and three patients had mild side effects consisting of rash, angioedema, joint pain, and fatigue. Conclusion: This study supports the data regarding evidence of the safety of MMR booster dose administration in children with rheumatic diseases receiving bDMARDs. What is Known: • MMR booster is avoided in immunocompromised pediatric patients receiving bDMARDs except in specific conditions. What is New: • The MMR booster dose may be safe in children with PedRD receiving bDMARDs or bDMARDs with MTX. These bullets can be added to the manuscript.

© 2022 European Sleep Research Society.Studies describing paediatric sleep patterns are needed by taking culture into consideration. The aim of this study was to identify parent-reported sleep–wake patterns in young children and explore possible factors influencing sleep problems. The mothers of 2,434 young children enrolled from well-child outpatient clinics in Turkey completed an online survey including sociodemographic variables, Brief Infant Sleep Questionnaire, Edinburgh Postnatal Depression Scale and Generalised Anxiety Disorder scales. Overall, young children in Turkey go to bed late (10:00 p.m.), awaken twice per night for 30 min, and obtain 11.5 h of total sleep, showing no sex-specific differences. Distinct night-time sleep patterns emerged after 18 months of age. Importantly, although currently breastfed healthy children were 3.8-times less likely to sleep through the night, total sleep duration and exclusive breastfeeding duration were higher in children who were not sleeping through the night. Overall, bedsharing was identified in 11.5%, and only room sharing was reported in 52.9%. Parental perception of a child's sleep as problematic was 35.8%. Mothers with higher educational attainment were more likely to perceive their children's sleep as a problem. Maternal depressive and anxious symptoms and a history of excessive infant crying were the determinants predicting the likelihood of both parent-perceived sleep problems and poor sleepers. The present analysis of sleep structure in infancy and toddlerhood provides reference data for well-child visits. These findings highlight the importance of considering maternal anxiety, depression and behaviour management techniques to cope with fussy infants in addressing childhood behavioural sleep problems.

Aim: The aim of the study was to learn the views of parents within the community on asylum seeker children and to learn their solution proposals for their problems. Materials and Methods: Our study was conducted with 231 voluntary parents who were admitted to five different child health clinics between June and October 2017. The survey, which consists of demographics information and questions about asylum seeker children were asked to the parents in a face to face interview. Results: Eighty percentage of participants (n=183) thought that asylum seeker children had the opportunity to use the health service. Sixty seven percentage (n=151) thought that they had the opportunity to be involved in the educational system. According to the participants, the biggest problems for asylum seeker children are; housing (34.2%), education (22.6%), poverty and child labour (13.7%), language related problems (11.6%) and health issues (6.3%). Their main solution proposals were; the education of parents and children (32.9%), their deportation back to their country (25%) and to have the asylum seeker children under government protection (15.1%). Conclusion: Health, education and housing were thought to be the biggest problems for asylum seeker children and the solution proposals mostly took place under those topics according to participant parents. They also thought that asylum seeker children had the opportunity to use health and education services. The efficiency of those services was questioned by parents because they also stated that asylum seeker children had problems in accessing those services.

Objective: Excessive crying is one of the most common complaints in the first months of life. Although various theories have been proposed to explain infantile colic, the etiology is still unclear. The aim of this study is to measure fecal calprotectin levels in infants with and without infantile colic and to investigate their possible relationship with inflammation. Methods: Infants attending a General Pediatrics Clinic in Medipol Mega University Hospital constituted the study population. Fecal calprotectin levels were measured using the Elisa Method in a total of 70 infants aged 1-3 months, 35 of which had infantile colic. A total of 42 infants, 22 of whom were in the colic group and 20 of them in the control group were followed for one year. Results: The socio-demographic features and feeding types of the infants with or without infantile colic were similar. Fecal calprotectin levels were significantly higher in the colicky babies, and all had calprotectin levels > 250 μgr/g. The median fecal calprotectin values of the colic and control groups were 651 μgr/g and 354 μgr/g, respectively. No significant difference was found between the cases where the calprotectin levels were higher or lower than 350 μg/g in terms of birth weight, gender, mode of delivery, diet and use of probiotics. During the follow-up, symptoms of food allergy occurred in 4 patients in the control group and in 3 patients in the study group. Conclusion: High fecal calprotectin levels in the colic infants suggest that infantile colic and intestinal inflammation may be associated., Amaç: Doğumu izleyen ilk üç ayda aşırı ağlama çok sık rastlanan bir yakın- madır. İnfantil kolik etyolojisi kesin olarak aydınlatılamamıştır. Son yıllarda intestinal mikrobiyatadaki değişikliklerin koliğe neden olabileceği ileri sürülmektedir. Çalışmamızın amacı dışkıda kalprotektin düzeylerinin ölçü- lerek kolik ile intestinal inflamasyon ilişkisinin araştırılmasıdır. Gereç ve Yöntem: Medipol Mega Üniversite hastanesi Genel Pediatri Polikliniğinde yapılan çalışmada 1-3 ay arası infantil kolikli 35 bebek (çalış- ma grubu) ile koliği olmayan 35 bebek olmak üzere toplam 70 bebeğin dışkıda kalprotektin düzeyleri İÜ Çocuk Gastroenteroloji Laboratuarında Elisa yöntemiyle ölçüldü. Kolik grubunda 22, kontrol grubunda 20 olmak üzere toplam 42 bebek bir yıl boyunca izlendi. Bulgular: Çalışma ve kontrol grubu bebekleri doğum tartısı, cins, doğum şekilleri, beslenme biçimleri açısından karşılaştırıldığında iki grup arasın- da fark saptanmadı. Çalışma grubunda kalprotektin düzeyleri anlamlı derecede yüksek olup, tüm olgularda fekal kalprotektin düzeyleri >250 μgr/g bulundu. Çalışma grubunun median kalprotektin değeri 651 μgr/g kontrol grubunun median değeri ise 354 μgr/g ölçüldü. Kalprotektin düzeyleri 350 μgr/g’den yüksek ve düşük olan olgular arasında doğum tartısı, cins, doğum şekli, beslenme biçimi ve probiyotik kullanımı açısın- dan anlamlı fark saptanmadı. Takipte kontrol grubunda 4, çalışma gru- bunda 3 olgu besin alerjisi tanısı aldı. Sonuç: Kolik bebeklerde yüksek dışkı kalprotektin seviyeleri, infantil kolik ve intestinal inflamasyonun ilişkili olabileceğini düşündürmektedir.

Purpose: The aim of this study was to investigate developmental milestones and risk factors for children with microcephaly. Methods: Personal health records of children followed in the Well Child Outpatient Clinic between 2002 and 2020 were evaluated. Children(n=49) with microcephaly constituted the study group. The control group(n=98) encompassed children with head circumference within the normal range for age. Microcephaly was defined as head circumference ≤ -2 SDS at birth or postnatal follow-ups. Results: In this retrospective case-control study, parental education levels were consistently low among children with microcephaly. Resolution of microcephaly was identified in 26(53.1%) children with microcephaly. Median age for resolution was two months. Children in the control group achieved unsupported sitting at a younger age than those in the case group. Developmental milestones were not significantly different according to the severity of microcephaly, but this difference was statistically significant between children with and without microcephaly. Conclusion: Low parental education, additional health problems, and consanguinity can be alarming to give extra support for the development of children with microcephaly. Not to miss children with microcephaly, head circumference ≤2SDS should be used for the definition of microcephaly. Further studies are needed to explain the roles of socioeconomic factors on microcephaly.

Background: The prevalence of allergic disorders is on the rise, affecting about 10% of the population. In this retrospective cohort, we investigated prevalence of allergic disorders, associated risk factors, and the outcome of food allergies. Material and methods: We analyzed data from birth cohorts of two university hospitals' well-child outpatient clinics. Factors related to onset and type of allergic diseases were assessed from demographic, socioeconomic, and clinical data. Results: Analyses were performed on 949 (431F/518M) infants at a mean current age of 28 +/- 6 months. Any allergic disease was established among 177 cases (22%); atopic dermatitis in 123 (12.8%), respiratory allergies in 55 (5.7%), and food allergy in 41 (4.3%). The risk for allergic disorders was found to be significantly increased for male gender (OR: 2.31, 95% CI; 1.54-3.46), and positive parental atopy (OR: 1.94, 95% CI; 1.31-2.86). The risk of food allergies was significantly higher in the male gender (OR: 2.47, 95% CI; 1.21-5.02), who consumed egg-white between 6 and 12 months (OR: 2.34, 95% CI; 1.22-4.48), and who were formula-fed before 6 months (OR: 2.16, 95% CI; 1.14-4.10). We found no significant association between the rate of food allergy outgrowth or food induced-anaphylaxis with regards to the timing of introducing egg-white into the diet. Conclusions: Although the introduction of egg-white into infant diet at 6-12 months of life appeared as an independent risk for any food allergy, none of the patients developed anaphylaxis. Age at symptom onset and outgrowing food allergy were similar compared to those introduced egg-white after 12 months. We recommend promoting exclusive breast-feeding during the first 6 months of life, and avoidance of prolonged restrictive diets for children with food allergy. (C) 2021 Codon Publications. Published by Codon Publications.

Aralık 2019 başında Çin’de ortaya çıkan Yeni Korona Virüs salgını Mart 2020 tarihinde ülkemizde görülmeye başlandıktan sonra koruyucu sağlık hizmetlerinin önemi bir kez daha ortaya çıkmıştır. Olağanüstü koşullarda sağlığın korunması ve sürdürülmesinde anne sütü ile beslenme çok önemlidir. Bu salgın da bir olağanüstü durumdur. Enfeksiyonlardan korunmada anne sütünün anti-infektif ve immunmodülator etkisi öne çıkmaktadır. Anne sütü içeriğinde bulunan özellikle yüksek salgısal IgA ve diğer biyoaktif madddeler ile pasif doğal bağışıklık sağlanmaktadır. COVID-19 pandemisinin yaşandığı bu dönemde anne sütü ile beslenmenin sürdürülmesi ve desteklenmesi enfeksiyondan korunmak için gereklidir. Mevcut bilimsel verilere göre temas ya da enfeksiyon varlığında annenin maske takarak, gereken hijyen kurallarını sağlayarak emzirmeye ya da sağarak anne sütü vermeye devam etmesi önerilmektedir., After the New Corona Virus epidemic emerged in China at the beginning of December 2019, authorities announced the appearance of cases in our country in March 2020. This epidemic reminds us of the importance of preventive healthcare. Breastfeeding is very important for child health. The anti-infective and immunomodulatory properties of breast milk play an important role in protection against infections. Passive immunity is provided especially by the high secretory IgA concentration and other antipathogen factors in breastmilk. During emergency situations, protection and promotion of breastfeeding is very important. The COVID-19 pandemic is also an emergency situation, and it is recommended that mothers should continue breastfeeding or giving expressed milk by wearing a mask, and taking necessary hygiene measurements during this epidemic.

AIM A high faecal calprotectin (FC) level is a non-invasive marker for inflammatory bowel disease. Nevertheless, healthy infants have elevated levels of FC with large variations. The aim of our study was to determine the levels of FC and associated factors in healthy infants aged 0-12 months. METHODS Infants younger than 1 year of age were in the follow-up programme of the Well Child Unit. Data on the clinical characteristics, including birth, anthropometric measurements and feeding types of infants in the unit, were obtained from their personal health records. One fresh stool sample was collected from each infant. ELISA was used to measure FC. RESULTS We included 84 infants younger than 1 year of age. The median FC value was 313 μg/g. The FC levels were greater in the youngest (0-30 days) group of infants than in the oldest (181-365 days) group (P

Background: Cow's milk is one of the most common of the foods that cause food allergies in children. Here, we present a 10-month-old male who was diagnosed with having an allergy to cow's milk and who developed an anaphylactic reaction after being recently vaccinated with a measles vaccine. Case: The patient had been diagnosed with atopic dermatitis and cow's milk allergy at 40 days old after a rash appeared on his face and arms while exclusively breastfeeding. At 9 months, on his routine welfare outpatient appointment, he developed a facial rash and swelling, wheezing, difficulty breathing, and cyanosis within 10 min of having his first measles vaccination (M-VAC(®); Serum Institute of India, Hadapsar, Pune, India). After an allergy evaluation and a physical examination that showed that he was otherwise healthy, he was diagnosed with an allergy to cow's milk, which was then eliminated from his diet. Laboratory evaluations were as follows: serum immunoglobulin E (IgE) to cow's milk: 36.2 kU/L, α-lactalbumin: 9.39 kU/L, β-lactoglobulin: 8.74 kU/L, casein: 34.2 kU/L, latex-specific (sp)IgE: 0.10 kU/L, gelatin spIgE

Aim. Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH). Methods. In this retrospective case-control study, the health records of all children, who were followed up between 2004 and 2014 at a well-child unit, were investigated for the diagnosis of DDH in Turkey. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings (according to Graf classification) and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors. Results. A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings. When the two groups were compared, breech presentation, multiple pregnancy, and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani, and Barlow signs were important clinical findings in the case group. Conclusion. According to our findings, breech presentation, female sex, torticollis, and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH.

Aim A recent improvement was made on the law regulating maternity leave in 2011 in Turkey. The leave without pay period was increased, the right to stop working on night shifts was granted, and work hours were improved. It is a known fact that returning to work is a barrier against exclusive and total breastfeeding duration. Legal regulations have crucial importance on the ability of working mothers to breastfeed their infants. The aim of this study was to calculate the effect of the improved law on breastfeeding rates among female physicians. Moreover, the difference in the duration of exclusive breastfeeding and total breastfeeding were evaluated in relation to the new law. Material and methods Three of the major hospitals in Istanbul were included in the study. A pilot study was planned and our questionnaire was tried. The actual study included 40 female physicians from each hospital. Mothers who went through antenatal or postnatal complications were excluded from the study. Infants who required intensive care after birth or were never breastfed were similarly excluded. A total of 109 female physician resident mothers' questionnaires were included in the study. Results The effects of the improvement in the law were statistically significant on the duration of maternity leave and improved working hours after returning to work (OR: 2.74 and OR: 2.52). Exclusive breastfeeding rates and total breastfeeding for more than 12 months significantly increased after the new law (OR: 4.47 and OR: 2.56). Conclusions This study showed that legal improvements did reflect on positive outcomes. There is more to be done, especially with condition of the work places and distributing rights equally to women practicing in surgical disciplines as well. If the physicians can breastfeed after they become mothers, their experience may affect their breastfeeding advocacy and the guidance they will provide for their patients.

Amac: Koronavirus hastaligi-19 (COVID-19) tanisi almis annelerin anne sutunde Siddetli Akut Solunum Sendromu koronavirus-2 (SARS-CoV-2) antijeni ile IgM ve IgG antikorlarinin belirlenmesi amaclanmistir. Gerec ve Yontem: Calisma 11 anne-cocuk cifti ile gerceklestirildi. Calismaya PCR testine gore pozitif olan veya negatif olup ancak COVID semptomlari olan emziren anneler dahil edildi. Sagilmis anne sutu, analiz asamasina kadar -20/-80°C’de saklandi. Anne sutu SARS-CoV-2 antijeni ve IgM ve IgG antikorlari olculdu. Bebekler en az 15 gun takip edildi. Bulgular: Nazofarengeal suruntude SARS-CoV-2 PCR testleri 11 annenin 10’unda pozitifti. Dokuz annede COVID-19 semptomlari vardi. Annelerin semptomlarindan veya pozitif PCR sonuclarindan ortalama 15 gun sonra anne sutu ornegi alindi. Nazofarengeal suruntu testlerinde SARS-CoV-2 PCR testleri 11 anne bebeginin 7’inde pozitifti. SARS-CoV-2 antijeni hicbir annenin anne sutunde saptanmadi. Ancak PCR testi pozitif olan ve klinik semptomlar yasayan iki annenin sutunde SARS-CoV-2 IgG ve IgM antikorlari tespit edildi. Bu iki annenin cocuklari hicbir belirti gostermedi. Sonuc: SARS-CoV-2 salgininda resmi kurumlar tarafindan emzirme tavsiye edilmis ve desteklenmistir. Bulgularimiz bu oneriyi desteklemektedir. Emzirmenin acil kosullarda tesviki ve korunmasi, cocugun, annenin ve toplumun sagligi acisindan cok onemlidir.

Karaciger nakli oncesi ve sonrasi cocuklarda canli asi uygulamalarinin degerlendirilmesidir. Calismamiz Sosyal Pediatri Bilim Dali Cocuk Sagligi Izlem Birimi'nde yapilmistir. Birimde saglikli cocuklarin yani sira ozel ihtiyaclari olan cocuklar da takip edilmektedir. Birimde takipli her cocugun saglik kaydi bulunmaktadir. 1 yasin altinda karaciger nakli oncesinde veya karaciger nakli sonrasinda zayiflatilmis canli asi almis hastalarin saglik kayitlari degerlendirildi. Her cocugun saglik kayitlarindan demografik ozellikler, asilama oncesi immunolojik durumu gosteren veriler, asi ile ilgili reaksiyonlar ve serolojik yanitlar kaydedildi. Takipte olan 5 hastanin geriye donuk dosya incelemendi. Bunlardan dordune nakilden en erken 2 yil sonra olmak uzere zayiflatilmis cansi asi (kizamik-kizamikcik-kabakulak ve/veya sucicegi asilari) uygulanmistir. Bu dort hastanin hicbirinde asi sonrasi bir sorun gelismemistir. Nakil oncesi zayiflatilmis canli asi uygulanan 6 ay 15 gunluk bebekte kizamik- kizamikcik-kabakulak ve sucicegi asilari uygulanmistir. Asi sonrasi herhangi bir istenmeyen reaksiyon gozlenmeyen bebekte asi sonrasi serolojik yanitin tam olmadigi belirlenmistir. Bulgularimiz nakil sonrasi immunsupresif kullanmakta olan cocuklarda gerekli degerlendirmeler sonrasinda zayiflatilmis canli asi uygulanmasinin guvenli oldugunu ortaya koymaktadir. Diger yandan karaciger nakli planlanan, acil asilanmasi gereken 1 yas altindaki hastalarda KKK ve sucicegi asi uygulamalari sonrasi yeterli yanit olusmasi konusunda ayrintili degerlendirme gerekmektedir.

Introduction There is limited information about problems of feedback inhibition of lactation which should be considered as a rare cause of breast engorgement. We report the management of excessive breast engorgement in a mother with a presumptive diagnosis of a defect in the feedback inhibition of lactation. Main issue The participant, who had been discharged on postpartum Day 2 while breastfeeding her infant, was readmitted to the hospital the next day with engorgement of the breasts and cessation of milk flow. Pumping and application of cold dressings alone did not work effectively. The severity of the symptoms decreased only after the addition of an anti-inflammatory drug and a prolactin inhibitor. Management The participant received breastfeeding counseling, family-centered care, and support for pumping equipment. An anti-inflammatory drug was started and a low dose prolactin inhibitor was given. The difficulty was the management of extensive and painful breast engorgement and the re-establishment of milk flow. At postpartum Day 14, the participant and her infant were discharged with effective breastfeeding status. Conclusions The recognition of a problem in the feedback inhibition of lactation as a cause of breast engorgement is important because it may be unresponsive to classical treatment methods resulting in cessation of milk flow. With the cautious use of low-dose cabergoline, in addition to other treatment strategies, milk flow can be reduced in a controlled manner while ensuring the continuity of milk production. An early diagnosis, interdisciplinary approach, and a close follow-up of the mother–infant pair are essential for preserving lactation.

OZET Amac: Bu calismanin amaci; Tekirdag bolgesinde yasayan COVID-19 aile ici yuksek riskli temasi olan veya kesin laboratuvar tanisi konmus emziren annelerin, pandemi doneminde anne sutu ve emzirme ile ilgili bilgi ve tutumlari hakkinda bilgi edinmektir. Gerec ve Yontem: Calismada, Tekirdag il sinirlari icinde ikamet etmekte olan ve COVID-19 enfeksiyonu tanisi alan kisi ile ev ici yakin temas oykusu olan ya da kendisi laboratuvar ile kanitlanmis, minimal semptom gosteren ve evde tedavi edilen COVID-19 (+) hasta olan 30 gun-6 ay arasi bebegi olan annelerin iletisim bilgilerine Namik Kemal Universitesi Tip Fakultesi Hastanesi ve Cocuk Sagligi Izlem Poliklinigi kayitlarindan ulasilarak, arastirmaya dahil olmayi kabul eden gonullulere telefon yoluyla demografik verileri iceren ve bu surecteki emzirme deneyim ve tutumlarini inceleyen bir anket uygulanmistir. Calisma kriterlerine uygun 31 anneye ulasilmis ve bunlardan 28 anne calismaya katilmayi kabul etmistir. Tum calisma grubuna ulasildiktan sonra anket verileri toplanarak demografik ozellikleri ve COVID-19 surecinde emzirme deneyimleri, bilgi kaynaklari ve bu surecteki tutumlari IBM SPSS 20.0 paket programi kullanilarak islenmis ve p

Aşı programları, aşı ile önlenebilir hedef bulaşıcı hastalığı önlemek ve bu hastalığa bağlı oluşabilecek komplikasyon ve ölümleriengellemeyi amaçlar. Bununla beraber, aşı uygulamalarının yaygınlaşması ile toplumda hedef patojeni bulaştırma potansiyeli olanbireylerin sayısı azalır, böylece aşılanmamış bireylerin hastalık etkeni ile teması azalır ve bu bireylerde dolaylı yoldan korunmuş olur.Ayrıca aşıların, toplumdaki genel morbidite ve ölüm oranları üzerine hedef hastalığın önlenmesi ile açıklanamayacak olan ikincil olumluetkileride bulunmaktadır. Aşı uygulamalarına bağlı oluşan ikincil etkiler son yıllarda araştırmacıların daha fazla ilgisini çekmeyebaşlamıştır. Aşı uygulamalarına dair ikincil etkileri belirleyebilmek için doğru, açık ve standart gözlem metotları uygulanmalıdır.Epidemiyolojik sürveyans, hastalığın yükünün belirlenmesi, hedef grupların ortaya çıkarılması ve bağışıklama programlarının etkisininbelirlenmesi için dikkatle yürütülmelidir. Bu sayede bir ülkenin ulusal bağışıklama programı belirlenirken basit ve kanıta dayalı bilgilerlehareket edilebilir. Vaccination programs aim to prevent the target infectious disease and also prevent complications and mortality related to this disease. However, with the widespread use of vaccines, the number of individuals with the potential to infect the pathogen in the community decreases, so that the contact of the non-vaccinated individuals with the pathogen decreases, and these individuals are protected indirectly. In addition, vaccines have secondary positive effects on overall morbidity and mortality rates in the community, which cannot be explained by the prevention of target disease. Secondary effects due to vaccine applications have attracted more attention from researchers in recent years. Accurate, clear, and standard observation methods should be applied to identify secondary effects on vaccine applications. Epidemiological surveillance should be carried out carefully to determine the burden of the disease, to reveal target groups and to determine the effect of immunization programs. In this way, it is possible to act with simple and evidence-based information when determining a national immunization program.

Amac: Cocuk Sagligi Izlem Poliklinigimizde (CSIP) takip edilen bebeklerin 4. ve 6. aylardaki sadece anne sutu (SAS) ile beslenme durumlarinin yillara gore degisimlerini ve anne egitim durumu ile iliskisini incelemektir. Gerec ve Yontem: Tanimlayici tipteki calismamizda 2013-2017 yillari arasinda dogan ve CSIP’de izlenen cocuklarin kisisel takip dosyalari retrospektif olarak incelenmistir. Cocuklarin beslenme sekilleri ve anne egitim durumlari ile ilgili bilgiler incelenen dosyalardan elde edilmistir. Bulgular: Dorduncu ayda SAS ile beslenme oraninin 2013 yilinda %60,6 iken 2017 yilinda %75,5 oldugu; 6. ayda SAS ile beslenme oraninin 2013 yilinda %28,2 iken 2017 yilinda %46 oldugu saptanmistir. Dorduncu ay ve 6. ayda sadece formula ile beslenme oranlari 2013 yilinda sirasiyla %9,9 ve %11,5 iken, 2017 yilinda sirasiyla %3,4 ve %2,5 e gerilemistir. 2013 ve 2017 yillari arasinda SAS ile beslenme istatiksel olarak anlamli derecede artmistir. Sadece formula ile beslenme oranlarinda ise istatistiksel olarak anlamli bir azalma olmustur. Dorduncu ayda ve 6. ayda SAS ile beslenme, universite mezunlarinda daha yuksek bulunmustur. Sonuc: CSIP’de sadece anne sutu ile beslenme oranlari yillar icerisinde artis gostermektedir. Cocuk sagliginin duzenli izlemi, emzirme danismanligi ve bebek dostu hastane uygulamalarinin bu artista etkili oldugunu dusunmekteyiz.

COVID-19, which spread around the world starting from China in December 2019, is an infection that affects every stage of life from birth. The number of pregnant women and children infected with COVID-19, which is reported to be asymptomatic or to show mild symptoms in most young children, is increasing. Breastfeeding is paramount in terms of sustaining good health during these exceptional conditions. Breast milk is known to have many positive effects for both the mother and the baby in the short and long term. Breast milk has unique nutritious properties that can be regulated according to neonatal requirements, bioactive substances in breast milk, hormone, and growth factors that affect growth and development factors that regulate the immune system and anti-inflammatory substances which protect the baby from various infections. In addition, antibodies detected in breast milk within 7 days of maternal infection reduce the risk of infection in the baby. In this way, otitis media, lower respiratory tract infections, gastroenteritis, and necrotizing enterocolitis are rare in infants who are breastfed. It has not been reported that COVID-19 infection can be transmitted through breast milk from the mother to the baby. Taking into account the benefits of breast milk and skin to skin contact in contrast with the harms of feeding with formula milk, the WHO advices mothers with COVID-19 to use masks and to pay close attention to hand hygiene. Health care personnels should support the mother in starting and maintaining breastfeeding under the guidance of these recommendations., Aralık 2019’da Çin’den başlayarak tüm dünyaya yayılan COVID-19 enfeksiyonu doğumdan itibaren yaşamın her evresini etkileyen bir enfeksiyondur. Küçük çocukların çoğunda asemptomatik ya da hafif şiddette seyrettiği bildirilen COVID-19 enfeksiyonuna yakalanan gebe ve çocuk sayısı giderek artmaktadır. Olağanüstü koşullarda sağlığın korunması ve sürdürülmesinde anne sütü ile beslenme çok önemlidir. Anne sütünün hem anne hem de bebek için kısa ve uzun vadede pek çok olumlu etkisi olduğu bilinmektedir. Yenidoğan gereksinimlerine göre düzenlenebilen eşsiz besleyici özelliği yanı sıra anne sütü içinde bulunan biyoaktif maddeler, büyüme ve gelişmeyi etkileyen hormon ve büyüme faktörleri, immün sistemi düzenleyen faktörler ve antienflamatuvar maddeler bebeği enfeksiyonlardan korumaktadır. Ayrıca maternal enfeksiyonda 7 gün içinde anne sütünde saptanan antikorlar da bebekte enfeksiyon riskini azaltmaktadır. Bu sayede anne sütü ile beslenen bebeklerde otitis media, alt solunum yolu enfeksiyonları, gastroenterit ve prematüre bebeklerde nekrotizan enterokolit nadir görülmektedir. Bu zamana kadar yapılan çalışmalarda anne sütünden bebeğe COVID-19 enfeksiyonu bulaştığı bildirilmemiştir. DSÖ anne sütünün yararlarını, formül sütle beslenmenin zararlarını da hesaba katarak COVID-19 enfekte annelerin maske ve el hijyenine dikkat ederek ten temasını ve anne sütüyle beslenmeyi önermektedir. Sağlık personelleri bu önerilerin rehberliğinde emzirmeyi başlatma ve sürdürme konusunda anne-bebek çiftine destek olmalıdır.

Background: Infants lose some of their birth weight before hospital discharge. This loss, which is accepted as “physiological” up to a certain level (5-7%), is supplemented with food in early period for infants with over 7% of loss. While food supplementation does not have the benefits of mother’s milk, it may cause low breastfeeding success in the long run. In newborns, the identification of risk factors affecting weight loss in a few days following birth will increase exclusive breastfeeding success. The aim of this study is to evaluate the risk factors that cause weight loss in newborns before hospital discharge. Methods: Weight loss in infants born in a private trust hospital of Koc University American Hospital between 1 January 2011 and 31 December 2014 was evaluated. The hospital records of 3812 babies who completed the inclusion criteria were included in the study. The variables giving meaningful results in binary tables were evaluated with “Multivariate Logistic Regression”.Results: The increase in maternal age, Caesarean section birth, primiparity, female gender and being early term were statistically significant risk factors for early weight loss in newborns.

Bu çalışmada çocuk onkoloji servisinde solid organ malignitesi tanısı ile takip edilmiş olan hastaların kemoterapi öncesi ve sonrası hepatit b virusu (HBV) ve varisella zoster virusu (VZV) serolojilerinin değerlendirilme oranları, antikor yanıtlarının tedavi sonrası değişip değişmediğinin saptanması ve buna neden olabilecek faktörlerin araştırılması amaçlanmıştır. Çalışmamızda Mart 2016-Nisan 2019 tarihleri arasında çocuk onkoloji servisinde solid organ malignitesi tanısı ile takip edilen ve kemoterapi almış olan hastaların dosyaları geriye dönük olarak değerlendirilmiştir. Çocukluk çağı kanseri (lösemi dışı) nedeni ile takip edilmiş olan 75 hastanın 24’ü (%32) kız idi. Anti Hbs antikoru bakılan 70 hastanın 44’ünde (%58.6) anti Hbs pozitif, anti VZV antikoru bakılan 62 hastadan, 48’inde (%64) anti VZV pozitif idi. Kemoterapi öncesi anti Hbs pozitif olan 44 hastanın 8’inde (%18.1) kemoterapi sonrası anti Hbs negatifleşmiştir. Kemoterapi öncesi anti VZV pozitif saptanan 48 hastanın 4’ünde (%8.3) kemoterapi sonrası anti VZV negatifleşmiştir. Tek doz suçiçeği aşı yanıtının kemoterapi sonrası kaybolma oranı, doğal yol ile gelişmiş antikor yanıtının negatifleşme oranından daha yüksek saptanmıştır. Daha önce bu iki durumu karşılaştıran çalışma olmadığı için verilerimiz yol gösterici olabilir. Pürin analoğu, siklofosfamid, steroid kullanımı ve hastalık evresi ile anti HBs ve anti VZV serolojilerinin negatifleşmesi arasında ilişki saptanmamıştır. Onkoloji hastalarının tedavi öncesi ve sonrası bağışıklık durumlarının değerlendirilmesi konusunda daha geniş çaplı çalışmalara ihtiyaç vardır ve bu hastalar için rehberler oluşturulması uygun olacaktır., The aim of this study was to determine the rates of hepatitis b virus (HBV) and varicella zooster virus (VZV) serology assesment before and after chemotherapy, antibody response changes after therapy, and factors affecting this situation. In our study we evaluated the files of patients who were followed up with malignancy in the pediatric oncology department between March 2016 and April 2019 retrospectively. Twenty four (32%) of the 75 patients followed for childhood cancer other than leukemia were girls. Anti Hbs antibody was evaluated in 70 patients and 44 (58.6%) were positive, anti VZV antibody was evaluted in 62 patients and 48 (64%) was positive. Of the 44 patients who had anti Hbs seropositivity before chemotherapy, 8 (18.1%) were seronegative after therapy. Anti VZV was negative after therapy in 4 (8.3%) of 48 patients who had anti VZV seropositivity before chemotherapy. The rate of disappearance of vaccine response after a single dose varicella vaccine was found to be higher than the rate of negative response of naturally developed varicella antibody response. Since there were no studies comparing these two situations before, this data may be a guide. There was no correlation between purine analogue, cyclophosphamide, steroid use, disease stage and disappearance of anti Hbs and VZV antibodies. Further studies are needed to evaluate the pre-and post-treatment immune status of oncology patients, and guidelines should be developed for these patients.

Objective: early weight loss percentile charts can be used to determine the expected weight loss of newborns. Mode of delivery has a marked effect on weight loss in the immediate postpartum period. The aim in the present study was to construct weight loss percentile charts according to mode of delivery in exclusively breastfed, healthy term infants during hospital stay. Method: weight loss in a large Turkish cohort of infants, born between January 1, 2011 and December 31, 2014, was evaluated retrospectively. Data on healthy, term and exclusively breastfed neonates during the immediate postpartum hospital stay were collected. Weight change percentile charts were plotted according to mode of delivery. Results: the study encompassed 3247 exclusively breastfed neonates. Of infants 48.1% were girls. Mean gestational age was 38.94 +/- 0.84 (range 37-41) weeks and birth weight of infants was 3381.1 +/- 380.9 (range 2150-5190) grams. The rate of caesarean delivery was 69.3%. The time of hospital stay of infants born by caesarean delivery was significantly longer than infants born vaginally. The frequency of weight measurements of infants showed a statistically significant difference according to the type of delivery. Weight loss as a percentage of birthweight for infants born by caesarean delivery were significantly greater at 24, 48, 72 and 84 hours after birth compared to those born via vaginal delivery. Conclusion: plotted percentile charts according to mode of delivery will enable prediction of early weight loss immediately post-partum. In addition, these percentile charts will help to reassure mothers and encourage breastfeeding exclusivity., NA

Background/aim: Understanding the causes of under-five deaths is key to realizing sustainable developmental goals. The aim of this descriptive study was to investigate the causes of under-five mortality in İstanbul during 2011 and compare the findings to those of 1988 and 2000. Materials and methods: All burial records of İstanbul were evaluated, and cemetery records of 1494 children, who died at under five years of age and were buried in İstanbul Metropolitan Municipality Cemeteries between 1 January and 31 December 2011, were analyzed. Several sociodemographic characteristics and causes of death were compared with the results of studies carried out in 1988 and 2000 in İstanbul with similar methods. Results: Under-five mortality rate was lower in 2011 than in 1988 and 2000. Of all deaths, 58.8% had occurred in the neonatal period and most were in the first day of life, similarly to those of 1988 and 2000. The proportion of deaths in the age group of 1-4 years was found to be increasing. Prematurity and perinatal causes remained the main cause of death under five years of age in İstanbul during the 23-year period. Unknown causes, due to misclassification, were still seen in a relatively high proportion. Conclusion: Under-five mortality rate and death due to infectious diseases decreased in İstanbul from 1988 to 2011. Our findings showed a need for more emphasis on perinatal events and better evaluation of causes of death in clinical practice.

Amaç: Hepatit A enfeksiyonu epidemiyolojisi yaşam koşullarına göre farklılık gösteren bir sorundur. Bu nedenle hastalığın değişen epidemiyolojisini değerlendirmek koruyucu hekimlik uygulamaları açısından önemlidir. Çalışmanın amacı anne ve bebek çiftlerinde hepatit A antikoru seropozitifliğinin belirlenmesi ve bunu etkileyen faktörlerin değerlendirilmesidir. Gereç ve Yöntem: Çalışmada 209 anne-bebek çiftinin verileri değerlendirilmiştir. Kan örnekleri annelerden doğumdan 1 ay sonra ve bebeklerinden ise 1. ve 6. aylarda alınmıştır. Hepatit A IgG antikor düzeyleri ELİSA yöntemi ile belirlenmiştir. Ailelerin sosyo-ekonomik ve demografik özelliklerine yönelik bilgiler yüz yüze uygulanan bir anket yolu ile toplanmıştır. Bulgular: Annelerde 1. ayda hepatit A seropozitifliği %67, bebeklerde 1. ayda %66,1, 6. ayda %68,9 olarak saptanmıştır. Ebeveynlerin eğitim süresinin, ailenin aylık gelirinin, gravida ve paritenin hepatit A seropozitiflik düzeyine istatistiksel açıdan ileri düzeyde anlamlı etkisi olduğu saptanmıştr. Eğitim düzeyi, aylık gelir arttıkça seropozitiflik oranı düşmekte; gravida ve parite artıkça yükselmektedir. Sonuç: Süt çocuklarında hepatit A seropozitiflik düzeyinin sosyo-ekonomik faktörlerden etkilendiği düşünülmüştür., Objective: Epidemiology of hepatitis A infection differs according to living conditions. Therefore, evaluating the changing epidemiology of the disease is important for preventive medicine. The aim of the study was to determine the seropositivity of hepatitis A antibody in mothers and their babies and to evaluate the factors affecting it. Materials and Methods: The data of 209 mother-infant pairs were evaluated. Blood samples were collected from mothers one month after birth and at 1 and 6 months of age from their babies. Hepatitis A IgG antibody levels were determined by ELISA method. The socio-economic and demographic characteristics of the families were collected by a questionnaire. Results: The seropositivity of the hepatitis A antibody was 67% in mothers at one month after birth, 66.1% and 68.9% in their babies at 1 and 6 months of age respectively. Parental education, family monthly income, gravity and parity were found to have a statistically significant effect on hepatitis A seropositivity. As the level of education and monthly income increased, hepatitis A seropositivity decreased. On the other hand as parity and gravida increased, seropositivity increased as well. Conclusion: Hepatitis A seropositivity in infants is thought to be affected by socio-economic factors.

Objective: Our aim was to determine the prevalence of maternal and neonatal vitamin B12 (vit-B12) and folate deficiencies, a new cutoff value of serum vit-B12 in newborns using vit-B12-related metabolites and also cutoff values of homocysteine (Hcy), propionyl (C3) carnitine, and methyl malonic acid (MMA) in newborns using a vit-B12 cutoff value of 200 pg/mL. Methods: Healthy pregnant women (without iron deficiency) and 98 healthy, term, singleton babies were included. Blood samples were obtained from women 0-8 h before birth and from cord blood during birth for hemogram and to measure serum vit-B12, folate, and Hcy levels. Maternal and cord blood serum vit-B12 levels were classified as low < 200 pg/mL, marginal 200-300 pg/mL, and normal >= 300 pg/mL. Neonatal urine MMA levels were analyzed in mothers with a vit-B12 concentration < 300 pg/mL. C3 carnitine levels of newborns were acquired from extended newborn screening. Receiver operating characteristics curve (ROC) analysis was used for serum vit-B12, urine MMA, C3 carnitine, and Hcy. Results: Of total, 98 pregnant women (28.6 +/- 5.5-year-old) and 98 newborn were included. Vit-B12 level was lower than 300 pg/mL in 93% of the pregnant women and 61% of cord blood samples. Folate deficiency was not found in either group. There was statistically significant negative correlation between baby C3 carnitine, cord blood folate (r = -0.265, p = .008) and cord blood vit-B12 (r = -0.220, p = .029). In backward stepwise linear regression analysis, maternal vit-B12 level exerted the most marked effect on cord blood vit-B12 level (adjusted R-2 = 0.457). In ROC analysis, the Hcy cutoff value was 4.77 mu mol/L (68.4% sensitivity, 58.3% specificity, p = .012) for the detection of vit-B12 deficiency. Conclusion: Vit-B12 deficiency remains an important health issue for pregnant women and newborns. Our study revealed a cutoff value for Hcy for the detection of nutritional vit-B12 deficiency that could be used in practice for newborns. Scientific Research Projects Coordination Unit of Istanbul UniversityIstanbul University [4107] This work was supported by Scientific Research Projects Coordination Unit of Istanbul University [Project no: 4107]. WOS:000474100800001 31204544 Q3

Aim Risk based screening for developmental dysplasia of the hip (DDH) with ultrasound is common. However, risk factors vary from one country to the other since data are insufficient to give clear recommendations. We aimed to evaluate the risk factors for developmental dysplasia of the hip (DDH). Methods In this retrospective case-control study; the health records of all children, who were followed up between 2004 and 2014 at a well-child unit were investigated for the diagnosis of DDH. Of 9758 children, 57 children were found to have abnormal ultrasonographic findings and these constituted the case group. As the control group, healthy 228 children who matched the case children in birth months were selected. Two groups were compared for the risk factors. Results A total of 19516 hips of 9758 children were examined for DDH. 97 hips of 57 children were found to have abnormal ultrasonographic findings (according to Graf classification). When the two groups were compared; breech presentation, multiple pregnancy and torticollis were identified as risk factors. The female sex was also found to have a significantly high prevalence among the children in the case group. Limited hip abduction, positive Ortolani and Barlow signs were important clinical findings in the case group. Conclusion According to our findings; breech presentation, female sex, torticollis and multiple pregnancy were found to be the risk factors of this disorder. Infants with these risk factors should be investigated carefully for DDH.

Amaç: Çocuklarda dil gelişimi birçok faktörden etkilenebilir. Cep telefonları ve televizyon olmak üzere çeşitli elektronik iletişim araçları yolu ile ekran maruziyeti günümüzde hızla artmaktadır. Çalışmada izole dil gelişim gecikmesi olan çocuklarda ekran maruziyetini incelemek amaçlanmıştır. Gereç ve Yöntem: İstanbul Üniversitesi İstanbul Tıp Fakultesi Sosyal Pediatri Bilim Dalı Çocuk Sağlığı İzlem Polikliniğine Ocak 2018 ve Mart 2018 tarihleri arasında başvuran 18-36 aylık çocuklardan izole dil gelişme gecikmiş olanlar vaka grubunda yer aldılar. Global gelişim geriliği olan, bilinen süreğen hastalığına bağlı dil gelişimi geri olan vakalar değerlendirme dışı tutuldu. Aynı zamanda başvuran aynı yaş grubundan olup dil gelişimine sorun olmayanlar kontrol grubu oluşturuldu. Ön ve arka fonda ekran maruziyet sıklığı ve süreleri açısından gruplar karşılaştırıldı. Bulgular: Yüzseksenyedi çocuktan dil gelişimi geciken 22 çocuğun ekran maruziyeti %81,8 olarak belirlenmiştir. Vaka grubunda arka fonda ekran maruziyeti ise %40,9, günlük ortanca maruziyet süresi 120 dakikadır. Kontrol grubunda (n=21) ise ekran maruziyeti %66,6, arka fonda ekran maruziyeti %23,8 ve günlük maruziyet süresinin ortanca değeri 60 dakika olarak saptanmıştır. Maruz kalınan süre riski vaka grubunda kontrol grubundan 1,01 kat fazla ve fark istatistiksel olarak anlamlı bulunmuştur Sonuç: Bulgularımıza göre ekran maruziyeti çocuklarda dil gelişimini etkileyen bir faktör olarak gözükmektedir. Bu alanda geniş ölçekte prospektif araştırmaların yapılmasına gereksinim vardır., Objective: Many factors can affect language development. Screen exposure is increasing rapidly nowadays and the aim of this study was to investigate the effect of screen exposure on children with a delay in speech and language development. Material and Method: Children with an isolated language delay between the ages of 18 and 36 months and who were admitted to the İstanbul University İstanbul Medical Faculty Social Pediatrics, Outpatient Clinic, between January 2018 and March 2018 were evaluated as the case group. Children with a global developmental delay or with a chronic disease were excluded. Children with normal development admitted during the same period at the same age constituted the control group. Screen exposure times in terms of foreground and background activity, and total exposure times were evaluated. Results: In the case group (n=22) the screen exposure rate was 81.8%, background screen exposure was 40.9% and the median daily duration of exposure was 120 minutes. These figures were 66.6%, 23.8%, and 60 minutes respectively in the control group. The risk associated with duration of screen exposure in the case group was 1.01 times higher than that of the control group and the difference was found statistically significant. Conclusion: Screen exposure appears to be an important factor in language development in children. Further prospective studies on screen exposure and language delay are needed.

BACKGROUND The prevalence of obesity in childhood is increasing all over the world and the World Health Organization (WHO) regards obesity as one of the most important public health problems. The aim of our study was to investigate the changes in body mass index (BMI) in children between 6 and 11 years of age and to evaluate the factors affecting this change in two different schools. METHODS We conducted a cross-sectional epidemiological study between January and March 2016 in two different schools. School age children from two different ages (6 and 11 years) participated in the study. Children`s sociodemographic characteristics and daily habits were evaluated by a questionnaire. Weight, height, body fat ratio were measured. RESULTS Of all 495 students, 270 were in the 6-year old group. According to BMI classification 21.2% of students were overweight and 14.5% obese. From 6 to 11 years of age percentages of overweight and obese students increased slightly (1%). The mean daily screen time was high among overweight and obese students (p < 0.05). The obesity rate (15.9%) was higher in public school, than in private school (6%). There was an obesogenic environment in the public school; sport facilities were limited, there was a canteen selling junk food and fizzy drink, but there was no free drinking water. Screen times of 11 year-old students were longer, and regular breakfast rates were lower than those of 6 year-old group (p < 0.05). CONCLUSIONS In our study prevalence of obesity was 14.5%, and overweight was 21.2%. According to our findings obesogenic environment seemed to be a contributing factor of obesity. Screen time should also be considered in attempts to prevent obesity.

INTRODUCTION Most head circumference growth references are useful during the first years of life, but they are also useful for older children when screening for developmental, neurological, and genetic disorders. We aimed to develop head circumference growth reference charts for age, height, and waist circumference for Turkish children aged 5-18 years. METHODS Head circumference, height, and waist circumference measurements were obtained from 5079 students aged 5-18 years from Izmit, Kocaeli Province, Turkey. The LMS method was used to construct reference centile curves. RESULTS Head circumference measurements were strongly correlated with height (r=0.74), weight (r=0.76), and waist circumference (r=0.68). The mean head circumference values for boys were larger than those for girls at all ages. Compared with data from the United States, the World Health Organization, and other studies from Turkey, our data showed a decrease in head circumference at all ages for both sexes. CONCLUSION Local growth charts can be used to evaluate head circumference growth in older Turkish children and adolescents.

Amaç: Yaşamın ilk altı ayında anne sütü ile beslenen bebeklerde dışkılama özellikleri değişebilmektedir. Normal dışkılama özelliklerinin bilinmesi, normal ve anormal dışkılama arasındaki farkın ayırt edilerek gereksiz tetkik ve tedavi maliyetini azaltmasının yanı sıra ailelerin önemli boyutlara ulaşabilen kaygılarının giderilmesine de yardımcı olacaktır. Bu çalışma; anne sütü ile beslenen 0-6 aylık bebeklerin dışkılama özellikleri ve bunu etkileyen faktörleri araştırma amacıyla yapılmıştır. Gereç ve Yöntemler: Çalışma, İstanbul Üniversitesi İstanbul Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Anabilim Dalının, Sosyal Pediatri Çocuk Sağlığı İzlem Polikliniğinde Haziran 2010-Ocak 2011 tarihleri arasında 0-6 aylık 100 bebek ile yürütülmüştür. Ailelerin polikliniğe geldikleri gün yapılandırılmış anket formları doldurulup, bebeklerin antropometrik ölçümleri kaydedilmiştir. Bebeklerin son 24 saat içinde yaptıklar dışkılar alınmıştır. Dışkılar renk, kıvam, pH ve steatokrit açısından değerlendirilmiştir. Verilerin analizi SPSS 15.0 ve SigmaStat 3.5 paket programında yapılmıştır. İstatistiksel karşılaştırmalarda p0.05 in statistical comparisons. Results: Seventy four percent of infants defecated daily. Stool frequency of infants decreased with age and infants breastfed in frequent intervals defecated more frequently (p>0.05). Exclusively breast-fed infants had more frequent defecation than the ones receiving complementary foods/formula in addition to breast milk. Conclusion: In conclusion, our results led us to think that defecation and growth patterns of infants aged 0-6 months show diversity according to the age and feeding characteristics.

The protection of infants against infections during the first few months of life is provided mainly by maternal antibodies. The presence of maternal antibodies can decrease vaccine efficacy. The waning time of maternal antibodies shows variations therefore seroepidemiological studies are important for the development of vaccination schedules. Some recent studies showed that the maternal measles antibodies may disappear around 3 months of age especially in infants born from mothers who were vaccinated. There are few cross-sectional studies from Turkey evaluating the maternal antibody levels of infants against measles in recent years. The aim of this prospective, multicentre study is to evaluate the seropositivity of measles, rubella, mumps, and varicella in mothers and their infants at 1 and 6 months after birth. The study was carried out at the Social Pediatrics Units of two university hospitals, a private hospital and a state hospital. The exclusion criteria were known impaired immune system or immune deficiency disorder in mother or child, preterm delivery (37 gestational week), administration of immunoglobulins or any blood products before admission or during the follow-up period, and history of vaccination or exposure to one of these diseases during the study period. The final analysis encompassed 209 mother-infant pairs. Blood samples were collected 1 month after birth from mothers and 1 and 6 months after birth from their babies. Antibody levels were determined by ELISA (Enzyme-Linked ImmunoSorbent Assay) method. Information on the socio-economic and demographic characteristics of the families were collected by a face-to-face questionnaire. Seropositivity was found as 95.7%, 92.8%, 92.8% and 96.7% for measles, mumps, rubella and varicella (MMRV) respectively. Majority of infants lost maternal antibodies at 6 months of age. Of all 6 month-old infants 25% were seropositive for measles,14.6% for mumps, 23.2% for rubella and 17.1% for varicella. The proportion of seropositive infants born from seropositive mothers was higher than those born from seronegative mothers for all four diseases. This difference was statistically significant only at 1 month of age (p= 0.001). Our study showed that maternal antibodies against MMRV decreased rapidly by 6 months of age therefore necessary measures should be taken to close this gap between the loss of maternal protection and the vaccination of infants for MMRV. As the epidemiology of the diseases changes in time, it is important to carry out such studies with large series in different countries and settings. Important results were determined in our study within this respect.

DOI : 10.26650/IUITFD.351723 Anne sutu ile beslenme, cocugun sagligi ve gelisimi icin temeldir. Bebeklerin dogumdan itibaren ilk alti ay boyunca sadece anne sutuyle beslenmeleri, 6.aydan sonra uygun tamamlayici besinler baslanarak emzirmenin en az 2 yasina kadar surdurulmesi onerilmektedir. Anne bebek ikilisinin birlikte uyuduklarinda emzirme sikligi ve suresinin arttigina dair kanitlar bulunmaktadir. Diger taraftan Ani Bebek Olumu Sendromu ve birlikte uyuma arasinda iliski oldugu belirtilmektedir. Bu makalede son arastirmalar isiginda anne-bebek ikilisinin birlikte uyumasinin anne ve bebek sagligina olan etkilerinin incelenmesi amaclanmistir.

The prevalence of obesity in childhood is increasing all over the world and The World Health Organization shows obesity as one of the most important public health problems. Most of the obese children continue to be obese adults in their lives. Obesity causes type 2 diabetes mellitus, hypertension, cardiovascular diseases, osteoporosis and some cancers. Also obese children have low selfesteem and have some social problems. Treatment of obesity is not much effective once it develops, therefore community- based preventive measures in early stages of life seem to be more important. In this review our aim is to look over the etiologic factors leading to childhood obesity and precautions to prevent its development.

Healthy Nutrition and Improving the Habit of Healthy Nutrition in Early Two Years Healthy nutrition is an important issue in each stage of life, even during the intrauterine life, until twenties when various organs still go on developing. Healthy nutrition during early childhood has important effects on health in both short -and long- terms. It is possible to gain a habit of healthy nutrition by establishing a rapport between the baby and the parents in which verbal and non-verbal signals are exchanged and interpreted. Nutrition skills develop together with the child’s motor, emotional and social maturation which differ from child to child. If any stage of all these processes is disrupted, thenj the issue of poor appetite can emerge.