Impact of a prenatal education intervention in pregnant women to prevent overweight in infants.

INTRODUCTION: During the first 1000 days of life is the basis for a child's future health established. OBJECTIVE: To evaluate the impact of a prenatal educational intervention in pregnant women on the nutritional status of the child from birth to 4 months of age. METHODS: Quasi-experimental intervention design in women with at least 12 weeks of gestation, who were randomly assigned to an intervention group (IG) to participate in five group and three individual sessions on feeding practices and maternal perception of the child's weight and signals of hunger-satiety; the control group (CG) received routine care that included at least three prenatal consultations. RESULTS: Thirty women were included in each group. After the intervention, women in the CG practiced less exclusive breastfeeding, were more likely to underestimate or overestimate the children's weight, and perceived hunger-satiety signals with less intensity (p < 0.05). 80 % of the infants in the IG had normal weight, whereas 63 % of those in the CG had a combination of overweight and obesity (p < 0.05). CONCLUSIONS: The prenatal education program in pregnant women showed a significant effect on postnatal nutritional status of infants four months after birth.

INTRODUCCIÓN: Durante los primeros 1000 días de vida se establece la base para la salud futura de un niño. OBJETIVO: Evaluar el impacto de una intervención educativa prenatal en mujeres embarazadas sobre el estado nutricional del hijo desde el nacimiento hasta los cuatro meses de edad. MÉTODOS: Diseño cuasiexperimental de intervención con mujeres a partir de la semana 12 de gestación, asignadas aleatoriamente a un grupo de intervención (GI) para recibir cinco sesiones grupales y tres individuales sobre prácticas de alimentación y percepción materna del peso del hijo y de señales de hambre-saciedad; el grupo control (GC) recibió atención de rutina que incluía al menos tres consultas prenatales. RESULTADOS: 30 mujeres conformaron cada grupo. Después de la intervención, las mujeres del GC practicaron menos lactancia materna exclusiva, fueron propensas a subestimar o sobrestimar el peso del hijo y percibieron con menor intensidad las señales de hambre-saciedad (p < 0.05). El 80 % de los lactantes del GI presentaron peso normal y 63 % de los niños del GC, una combinación de sobrepeso y obesidad (p < 0.05). CONCLUSIONES: El programa de educación prenatal en mujeres embarazadas mostró un efecto significativo en el estado nutricional de los lactantes después de cuatro meses del nacimiento.

Tuberculosis in infants less than 3 months of age. / Tuberculosis en lactantes menores de 3 meses.

A review was conducted on infants less than 3 months of age diagnosed with tuberculosis between 1978 and 2014. Eight patients were diagnosed (1.4% of paediatric tuberculosis cases): 3 confirmed congenital tuberculosis, 3 suspected (endometrial biopsy was not performed), and 2 postnatal tuberculosis. Tuberculin skin test was negative in two patients. Diagnostic performance of culture (7/7, 100%) and PCR (3/3, 100%) of gastric aspirates was higher than that of acid-fast bacilli smears (5/8, 62%) and IGRA test (1/3, 33%). Three patients developed miliary disease, and one died. In conclusion, tuberculosis in this age group is rare, severe, and difficult to diagnose. In cases lacking known postnatal contacts, maternal genital tuberculosis should be ruled out by endometrial biopsy.

Hypoxaemia in Mozambican children <5 years of age admitted to hospital with clinical severe pneumonia: clinical features and performance of predictor models.

OBJECTIVE: To determine the prevalence of hypoxaemia among under-five children admitted to hospital with clinical severe pneumonia and to assess the performance to diagnose hypoxaemia of models based on clinical signs. METHODS: We conducted a hospital-based survey in a district hospital from Southern Mozambique. RESULTS: A total of 825 children were recruited after obtaining an informed consent. The prevalence of hypoxaemia on admission was 27.9%, and 19.8% of these children died (OR compared with non-hypoxaemic children 3.22, 95% CI 1.98-5.21, P < 0.001). The model with larger area under the ROC curve (AUC-ROC) to predict hypoxaemia included cyanosis or thoracoabdominal breathing or respiratory rate ≥70 breaths per minute. None of the models performed well when tested in different case scenarios of oxygen availability through mathematical modelling, with over 50% of hypoxaemic children not receiving oxygen even in favourable case scenarios. CONCLUSIONS: Clinical signs alone or in combination are not suitable to diagnose hypoxaemia. The use of pulse oximeters should be strongly encouraged.

[Septic shock secondary to non-congenital chikungunya fever in a young infant: A clinical case]. / Choque séptico secundario a fiebre por chikungunya no congénita en un lactante menor: caso clínico.

INTRODUCTION: A chikungunya outbreak took place in the State of Yucatan starting in the second half of 2015 OBJECTIVE: To analyse the clinical course of a case of chikungunya in a previously healthy infant, providing practical evidence to guide future diagnoses and treatment during outbreak seasons in endemic areas CASE REPORT: Clinical manifestation started with a sudden onset of fever and a diffuse macular-papillary erythema, originally treated in the community with non-steroidal anti-inflammatory drugs. Two days later, the fever relapsed with hypoactivity, severe thrombocytopenia and neutropenia (without lymphopenia), respiratory distress, liver dysfunction, sepsis, followed by septic shock with a fatal outcome. IgM test was positive to chikungunya, while her mother tested negative. Pseudomonas aeruginosa was isolated from the blood culture possible due to contamination, without ruling out the possibility of a mixed origin sepsis. CONCLUSIONS: Chikungunya is a disease in which the manifestations in neonates and young infants can be severe, and even fatal. It is important to suspect it in this age group at risk of vector contact, in the presence of fever without apparent source of infection and cutaneous manifestations. It is important to use the antipyretics cautiously, considering the possibility of aggravating the underlying infection, and the potential hepatic and haematological damage.

[Etiology and clinical course of urinary tract infections in infants less than 3 months-old]. / Etiología y curso clínico de la infección del tracto urinario en los lactantes menores de 3 meses.

BACKGROUND: Infants less than 3 months of age with urinary tract infection are usually hospitalized. Recent studies show that a less aggressive management for those patients aged ≥ 29 days may be feasible. OBJECTIVES: To determine the complication rate in infants<3 months of age with urinary tract infection, and to identify the causative agents and their antibiotic susceptibility. METHODS: A retrospective study was conducted on infants<3 months of age with positive urinalysis results, together with a positive urine culture from a catheterized specimen and seen in the Emergency Department from 2007 to 2012. Demographics, clinical and microbiology (microorganism isolated and antibiotic susceptibility) data were collected. The complications rate (bacteremia, bacterial meningitis, renal abscess, surgical intervention, Intensive Care Unit admission, or death) were calculated for the overall sample and for different age groups (<29, 29-60, and 61-90 days). RESULTS: A total of 460 patients are included; 137 (29.8%)<29, 166 (36.1%) 29-60, and 157 (34.1%) 61-90 days of age. Twenty four (5.4%; 95% CI: 3.6-7.8) had bacteremia; 15 (10.9%; 95% CI: 6.7-17.3) were<29 days; 8 (4.9%; 95% CI: 2.5-9.4) were 29-60 days, and one (0.7%; 95% CI: 0.1-3.7) was 61-90 days of age (P<.001). One neonate (0.8%; 95% CI: 0.1-4.1) had bacterial meningitis, and 2, renal abscess. Escherichia coli was the common pathogen identified (87.2%) in the urine culture, with a susceptibility to amoxicillin-clavulanate, gentamicin, and cefixime of 89.2, 97.0, and 96.0%, respectively. CONCLUSION: Complications are low in infants<3 months of age with UTI, especially in those ≥ 29 days of age. The identification of patients at very low risk for complications would allow a less aggressive management. Escherichia coli antibiotic susceptibility remains stable, but continuing careful surveillance is essential to optimize empirical antibiotic treatment.

[Children less than 3 months hospitalised due to acute febrile syndrome. 5 years clinical experience]. / Lactantes menores de 3 meses hospitalizados por síndrome febril agudo. Experiencia clínica de 5 años.

INTRODUCTION: Acute fever of unknown origin (AFUO) is established when the anamnesis and physical examination cannot identify the cause. In infants less than 3 months-old this is situation for concern, due to the risk of a serious bacterial infection. OBJECTIVE: To describe the clinical and laboratory variable of patients with AFUO, in order to look for clues in order to base studies on the decisions arising drom this problem. PATIENTS AND METHODS: A report is presented on a retrospective study conducted on a cohort of children less than three months-old admitted to the Hospital Roberto del Río (2007-2011) due to an AFUO. Clinical histories were reviewed and the patients were grouped, according to the severity of the admission diagnosis, into severe and non-severe. They were compared in strata determined by the variables of clinical interest. RESULTADOS: A total of 550 children were admitted with AFUO during the study period. There was low agreement between the severity on admission and at discharge (kappa=0.079; P=.26). There were 23.8% of children in the severe group and 76.2% in the non-severe group. Urinary tract infection predominated in the severe group (68.7%) and 40.7% with acute febrile syndrome in the non-severe group. The cut-off levels for C-reactive protein, white cells, and neutrophils per mm(3), to calculate the fixed and variable indices, only showed negative predictive values of some use for ruling out serious bacterial infection. The ROC curves with white cell and neutrophil counts and C-reactive protein, did not provide andy fixed indices of clinical use. More than one-third (34.6%) of lumbar punctures were traumatic or failures. CONCLUSIONS: According to the results of this study, there is an obvious excess of hospital admissions, little usefulness in the examinations to identify serious bacterial infection, a high percentage lumbar punctures traumatic and lumbar punctures failures, and an excess of antibiotic treatments. A review of clinical criteria and procedures is needed.

New reference nomograms for the study of ventricular size in preterm infants.

INTRODUCTION: Transfontanellar brain ultrasound is an essential tool for monitoring the size of the ventricles in preterm neonates and has many advantages over other alternative diagnostic techniques, including its accessibility and non-use of ionizing radiation. When considering the normal ventricular size, it is essential to have reference measurements based on age-matched populations. The objective of this article is to present our reference measures, based on a sample of preterm infants that we have studied. METHODS: A retrospective observational study was conducted. Measurements of the Levene index, frontal horn thickness, and Evans index were obtained in preterm neonates from 25 to 45 weeks, over a period of 5 years, between January 2016 and December 2020. After applying the exclusion criteria, a sample of 199 patients and 350 ultrasound scans were obtained. The independent samples t-test and the Mann-Whitney test were used for the comparison of samples. RESULTS: The distribution of the right and left Levene indices was normal (Shapiro-Wilk test with p = 0.16 and 0.05, respectively), unlike the thickness distribution of the frontal horns (p < 0.05 on both sides). No significant differences were detected between the sexes (p = 0.08). A linear correlation was found between the biparietal diameter and the Levene index. CONCLUSION: From the results obtained in our study, we present reference tables for ventricular size, with the 3rd, 25th, 50th, 75th, and 97th, being the first ones made in our country.

The consensus of the Asociación Mexicana de Gastroenterología on the diagnosis and treatment of gastroesophageal reflux and gastroesophageal reflux disease in infants.

Gastroesophageal reflux (GER) is a frequent normal phenomenon in children of any age. It is more common in infants, in whom the majority of episodes are short-lived and cause no other symptoms or complications, differentiating it from gastroesophageal reflux disease (GERD). The diagnosis and management of GER and GERD continue to be a challenge for the physician. Therefore, the aim of the Asociación Mexicana de Gastroenterología was to adapt international documents to facilitate their adoption by primary care physicians, with the goal of standardizing quality of care and reducing the number of diagnostic tests performed and inappropriate medication use. The ADAPTE methodology was followed, and the recommendations were approved utilizing the Delphi strategy. The executive committee carried out the review of the guidelines, position papers, and international reviews that met the a priori quality criteria and possible applicability in a local context. The recommendations were taken from those sources and adapted, after which they were approved by the working group. The consensus consists of 25 statements and their supporting information on the diagnosis and treatment of GER and GERD in infants. The adapted document is the first systematic effort to provide an adequate consensus for use in Mexico, proposing a practical approach to and management of GER and GERD for healthcare providers.

Antibiotic consumption in the first months of life: A cross-sectional study.

INTRODUCTION: The factors and patterns associated with antibiotic consumption in infants are unclear. Our aim was to assess the cumulative incidence of antibiotic consumption from birth to 16 months and identify factors associated with antibiotic consumption among infants aged 4-16 months. MATERIAL AND METHODS: We conducted a cross-sectional study in 2016 in a sample of 18 882 women from Galicia, Spain, who had given birth to a live child between September 1, 2015 and August 31, 2016. We calculated the cumulative incidence of antibiotic consumption based on maternal reports regarding the infant's consumption from birth to 14 months obtained through interviews; we did not estimate consumption at ages 15 and 16 months due to the small sample size. To assess which factors were associated with antibiotic consumption, we carried out a nested case-control study matching cases and controls for birth month on a 1:1 ratio. RESULTS: The cumulative incidence of antibiotic consumption among infants aged 0-14 months increased from 7.5% to 66.0%. The case-control study included data for 1852 cases and 1852 controls. Daycare attendance (OR: 3.8 [95% CI: 3.2-4.6]), having older siblings (OR: 1.8 [95% CI: 1.6-2.1]), health care visits to private clinics (OR: 1.6 [95% CI: 1.4-2.0]), and passive smoking (OR: 1.3 [95% CI: 1.1-1.6]) were associated with an increased probability of antibiotic consumption. Maternal age between 30-39 years or 40 years and over at the time of birth was associated with a decreased probability of antibiotic consumption (OR: 0.8 [95% CI, 0.7-1.0] and OR: 0.6 [95% CI: 0.5-0.8], respectively). CONCLUSIONS: Some of the factors associated with antibiotic consumption in infants are modifiable and should be considered in the development of public health measures aimed at reducing antibiotic consumption.

Immunisation schedule of the Spanish Association of Pediatrics: 2024 recommendations.

The AEP Immunization Calendar for 2024, with its immunization recommendations for pregnant women, children and adolescents residing in Spain, marks the 25th edition since the first one was introduced in 1995, being annual since 2003, as a vaccination calendar, and since 2023 as immunization schedule due to the inclusion of a monoclonal antibody for the prevention of RSV disease. Novelties for this year include the following: The rest of the recommendations from the previous calendar remain unchanged.

[The pathogenicity of Cronobacter in the light of bacterial genomics]. / La patogenicidad de Cronobacter a la luz de la genómica bacteriana.

Introduction: Cronobacter spp. is a genus of Gram-negative bacteria belonging to the family Enterobacteriaceae. Species of the genus Cronobacter, particularly C. sakazakii, are implicated in the development of severe disease in newborns, which occurs with necrotizing enterocolitis, sepsis and meningitis. The disease has been frequently associated with powdered infant formula (PIF) and can therefore occur in the form of outbreaks. The genus Cronobacter has undergone extensive diversification in the course of its evolution, with some species being clearly pathogenic to humans while the impact of other species on human health is uncertain or unknown. Whole genome sequencing is used both in population genetic studies to identify the limited number of genotypes associated with the disease and to detect genes associated with antibiotic resistance or virulence, ultimately allowing more precise epidemiological links to be established between pediatric disease and infant foods.

Introducción: Cronobacter es un género de bacterias gramnegativas perteneciente a la familia Enterobacteriaceae. Algunas especies del género Cronobacter, en particular C. sakazakii, están implicadas en el desarrollo de infecciones neonatales graves, incluyendo meningitis, sepsis y enterocolitis necrotizante. La enfermedad se ha relacionado frecuentemente con los preparados en polvo para lactantes (PPL) y se puede presentar, por tanto, en forma de brotes. El género Cronobacter ha experimentado una amplia diversificación en el curso de su evolución, siendo algunas especies claramente patógenas para los humanos mientras que el impacto de otras especies sobre la salud humana es incierto o desconocido. La secuenciación genómica se utiliza en los estudios de genética de poblaciones tanto para identificar el limitado número de genotipos asociados a la enfermedad como para detectar los genes asociados a la virulencia, la adaptación al estrés o la resistencia a antibióticos, lo que permite, en definitiva, establecer vínculos epidemiológicos más precisos entre la enfermedad pediátrica y los alimentos infantiles.

Variability in the management of infants under 3 months with minor head injury in paediatric emergency departments.

INTRODUCTION: In the assessment of infants younger than 3 months with minor traumatic head injury (MHI), it is essential to adapt the indication of imaging tests. The Pediatric Head Injury/Trauma Algorithm (PECARN) clinical prediction rule is the most widely used to guide clinical decision making. OBJECTIVES: To analyse the variability in the performance of imaging tests in infants under 3 months with MHI in paediatric emergency departments (PEDs) and the adherence of each hospital to the recommendations of the PECARN rule. POPULATION AND METHODS: We conducted a prospective multicentre observational study in 13 paediatric emergency departments in Spain between May 2017 and November 2020. RESULTS: Of 21 981 children with MHI, 366 (1.7%) were aged less than 3 months; 195 (53.3%) underwent neuroimaging, with performance of CT scans in 37 (10.1%; interhospital range, 0%-40.0%), skull X-rays in 162 (44.3 %; range, 0%-100%) and transfontanellar ultrasound scans in 22 (6.0%; range, 0%-24.0%). The established recommendations were followed in 25.6% (10/39) of infants classified as high-risk based on PECARN criteria (range, 0%-100%); 37.1% (36/97) classified as intermediate-risk (range, 0%-100%) and 57.4% (132/230) classified as low-risk (range, 0%-100%). CONCLUSION: We found substantial variability and low adherence to the PECARN recommendations in the performance of imaging tests in infants aged less than 3 months with MHI in Spanish PEDs, mainly due to an excessive use of skull X-rays.

Ecological determinants of obesity risk in Mexican infants: a scoping review.

BACKGROUND: Childhood obesity is a multifactorial disease. Most of these factors start to develop before birth and worsen throughout life. Therefore, prevention efforts should begin in the first 1000 days of life. This study aimed to quantify published studies on risk factors according to the Six-Cs model of childhood obesity (cell, child, clan, culture, community, and country) and determine which of them have been related to anthropometric indicators of overweight or obesity in children under 2 years of age in Mexico. METHODS: A systematic scoping review (PRISMA-ScR) was performed. PubMed, Scopus, and EBSCOhost databases were reviewed. RESULTS: We found that 88% of the studies were observational. The child and family spheres were the most studied, individually and as a whole. The least studied were community, culture, and country. The main risk factors related to obesity indicators were high birth weight, birth by cesarean section, and inadequate feeding practices, in addition to mothers with obesity and those who underestimate their child's weight, stressful parenting style, and food insecurity in the home, together with living in urban areas, family income, and beliefs about preference for ultra-processed products. CONCLUSION: In Mexico, the study of obesity in early childhood is emerging at the research level. However, further efforts are required to close the knowledge gap at the socioecological level to design evidence-based interventions and reduce early obesity.

INTRODUCCIÓN: La obesidad infantil es una enfermedad multifactorial en la que varios factores comienzan a desarrollarse antes del nacimiento y se agravan a lo largo de la vida. Por ello, los esfuerzos de prevención para evitar su desarrollo deben comenzar durante los primeros 1000 días de vida. Los objetivos de este estudio fueron cuantificar los estudios publicados sobre factores de riesgo según el modelo de obesidad infantil de las 6-Cs (célula, niño, familia, cultura, comunidad y país) y determinar cuáles de ellos se han relacionado con indicadores de sobrepeso u obesidad en niños menores de 2 años en México. MÉTODOS: Se realizó una revisión sistemática de alcance (PRISMA-ScR). Se revisaron las bases de datos de PubMed, Scopus y EBSCOhost. RESULTADOS: Se encontró que el 88% de los estudios fueron de tipo observacional. La esfera niño y familia fueron las más abordadas, tanto individual como en conjunto. Las menos estudiadas fueron comunidad, cultura y país. Los principales factores de riesgo relacionados con indicadores de obesidad fueron alto peso al nacer, nacer por vía cesárea y prácticas inadecuadas de alimentación; además, madres con obesidad y que subestiman el peso del hijo, estilo de crianza presionante e inseguridad alimentaria en el hogar, aunado el vivir en zonas urbanas, ingreso económico-familiar y creencias sobre la preferencia por productos ultraprocesados. CONCLUSIONES: En México, el estudio de obesidad durante los primeros 1000 días es emergente a nivel de investigación, pero se requiere continuar con el esfuerzo para cerrar la brecha de conocimiento a nivel socio-ecológico, diseñar intervenciones basadas en la evidencia y disminuir la obesidad temprana.

Immunisation schedule of the Spanish Association of Paediatrics: 2023 Recommendations.

As it does every year, the CAV-AEP publishes the update of its recommendations for the use of vaccines in children, adolescents and pregnant women residing in Spain. The 2 + 1 schedule is maintained in infants (at 2, 4 and 11 months), including preterm infants, with the hexavalent vaccine (DTaP-IPV-Hib-HB) and the pneumococcal 13-valent conjugate vaccine. A booster dose with DTaP-IPV is needed at 6 years for those who received the 2 + 1 series with hexavalent vaccine as infants, in addition to 1 dose of dTap in adolescence. Routine vaccination of pregnant women with a dose of dTap is recommended in each pregnancy, preferably between weeks 27 and 32 of gestation, although can be given from 20 weeks if there is risk of preterm delivery. All infants should receive the rotavirus vaccine (2-3 doses) and the 4CMenB vaccine (2 + 1 series). All children aged 6-59 months should be vaccinated against influenza each year. The MenACWY vaccine should be given routinely at 12 months of age and in adolescence between ages 12 and 18 years. The recommendations for the MMR vaccine (12 months and 3-4 years) and varicella vaccine (15 months and 3-4 years) also remain unchanged, using the MMRV vaccine for the second dose. Recommendations for the use of SARS-CoV-2 vaccines in the paediatric age group will be updated periodically on the CAV-AEP website. The HPV vaccine is indicated in all adolescents, regardless of sex, at age 12 years. Novelties include the recommendation of routine administration of nirsevimab to neonates and infants aged less than 6 months for passive immunization against RSV, and the recommendations regarding the hexavalent vaccine are consolidated in a single section.

Determinantes de la inseguridad alimentaria y su asociación con prácticas de alimentación y lactancia materna en el primer año de vida.

OBJETIVO: analizar los determinantes de la Inseguridad Alimentaria (IA) y su relación con las Prácticas de Alimentación (PA) y las Prácticas de Lactancia Materna (PLM) en el primer año de vida. MÉTODOS: análisis de tipo cuantitativo sobre el binomio madre-hijo de una cohorte en México. Los datos de interés fueron el estado de seguridad alimentaria (SA), las PA y las PLM. Se desarrolló un modelo de regresión para evaluar determinantes asociados a la IA y un análisis de medias para determinar el impacto de la IA en las PA y las PLM. RESULTADOS: el 54.1% de hogares presentó algún grado de IA. Las madres con pareja (OR = 0.25; p = 0.05) y con escolaridad superior (OR = 0.50; p = 0.04) tuvieron menor riesgo de padecer IA. En contraste, los hogares con mujeres mayores de 25 años estuvieron más expuestos a la IA (OR = 3.0; p = 0.00). Los hogares con IA introducen alimentos no recomendados como dulces, galletas o pastelitos (p = 0.00) y bebidas no lácteas azucaradas (p = 0.05) de forma prematura.Conclusiones:la IA requiere mayor atención por sus efectos en las PA y las PLM, las cuales son consideradas como factores asociados al desarrollo de mala nutrición.

Evaluation of the prescription pattern of ferrous sulfate as a therapy for preventing iron deficiency anemia in infants.

BACKGROUND: Iron deficiency prevalence in infants is high. Therefore, iron supplementation has been recommended and specified as a program. This study aimed to determine the characteristics of the prescription of ferrous sulfate as a preventive therapy for iron deficiency anemia in young infants. METHODS: We conducted a descriptive cross-sectional study of clinical records of young infants with eight visits per year. We analyzed a total of 287 records. The prescription characteristics included five criteria prescription indication, age at prescription, dosage, periodicity, and time. These characteristics were scored as follows 1 point when it was considered adequate and 0 when it was considered inadequate; the minimum possible score was 0, and the maximum possible score was 5 points. Statistical analysis included percentages and 95% confidence intervals (CI). RESULTS: The prescription pattern of ferrous sulfate as preventive therapy in infants under one year of age was indicated in 100% of the records reviewed. All five criteria were met in 18.1% of the reviewed records (95%CI 13.6-22.6). The lowest compliance corresponded to adequate dosage (29.2%; 95%CI 23.9-34.5). Age at prescription was correct in 75.9% (95%CI 70.9-80.9); duration of prescription was correct in 44.2% (95%CI 38.4-50.0), and periodicity was proper in 31.1% (95%CI 25.9-36.7) of the files reviewed. CONCLUSIONS: Compliance with the prescription of ferrous sulfate as a preventive measure for anemia in infants was not as expected; interventions are needed to reverse this behavior.

INTRODUCCIÓN: Debido a que la prevalencia de deficiencia de hierro en el lactante es alta, el aporte de hierro se ha recomendado como suplemento y se ha concretado como programa. El objetivo del estudio fue determinar las características de la prescripción de sulfato ferroso como terapia de prevención de anemia ferropénica en el lactante menor. MÉTODOS: Se llevó a cabo un estudio descriptivo con diseño transversal de expedientes clínicos de lactantes menores con ocho consultas al año. Se analizaron 287 expedientes. Las características de prescripción incluyeron cinco criterios: indicación de prescripción, edad de indicación, dosificación, periodicidad y tiempo. Se calificó con 1 punto cuando la característica se consideró adecuada y con 0 cuando se consideró inadecuada; la puntuación mínima posible fue 0 y la puntuación máxima posible de 5 puntos. El análisis estadístico incluyó porcentajes e intervalos de confianza (IC) al 95%. RESULTADOS: El patrón de prescripción del sulfato ferroso como terapia preventiva en el menor de un año se encontró indicado en 100% de los expedientes revisados. Se cumplió exactamente con los cinco criterios en el 18.1% de los expedientes revisados (IC95% 13.6-22.6); el cumplimiento más bajo correspondió a la dosificación adecuada (29.2%; IC95% 23.9-34.5). La edad de inicio fue correcta en el 75.9% (IC95% 70.9-80.9); la duración de la prescripción fue correcta en el 44.2% (IC95% 38.4-50.0) y la periodicidad fue correcta en el 31.1% (IC95% 25.9-36.7) de los expedientes revisados. CONCLUSIONES: El cumplimiento de la prescripción de sulfato ferroso como medida preventiva de la anemia en lactantes no fue el esperado, por lo que se requiere adoptar intervenciones para revertir este comportamiento.

Knowledge and attitudes towards baby-led-weaning by health professionals and parents: A cross-sectional study.

OBJECTIVE: Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain. METHODS: This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test. RESULTS: 92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW "always" in 39.8% and 69.3% of the cases, and "sometimes" in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest. CONCLUSION: Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.

Immunization schedule of the Pediatric Spanish Association: 2022 recommendations.

After reviewing the best available scientific information, CAV-AEP publishes their new recommendations to protect pregnant women, children and adolescents living in Spain through vaccination. The same recommendations as the previous year regarding hexavalent vaccines, pneumococcal conjugate vaccine of 13 serotypes, booster with tetanus, diphtheria, pertussis and inactivated poliomyelitis (Tdpa-IPV) at 6 years and with tetanus, diphtheria and pertussis (Tdpa) at 12-14 years and pregnant women from week 27 (from week 20 if there is a high risk of preterm delivery). Also with rotavirus, tetraantigenic meningococcal B (2+1), meningococcal quadrivalent (MenACWY), MMR, varicella and human papillomavirus (HPV) vaccines, for both genders. As novelties this year the CAV-AEP recommends: Influenza vaccination from 6 to 59 months of age whenever feasible and does not harm the vaccination program aimed at people at higher risk. According to official national recommendations, the CAV-AEP recommends the systematic use of COVID mRNA vaccines since 5 years old.

Dexmedetomidine and perioperative analgesia in children.

Dexmedetomidine (DEX) is an anaesthetic agent that mimics natural deep sleep and produces minimal cardiorespiratory depression. As such, it is a very valuable option in the management of such a challenging population as paediatric patients. The main objective of this mini review was to evaluate the role of DEX as a perioperative analgesic in children receiving anaesthesia. We searched Google, Pubmed, Embase and the Cochrane Library for articles published between 2010 and 2021, and reviewed various of aspects of DEX, such as pharmacology, effectiveness, safety, and the most recent evidence on its clinical use as an analgesic in paediatric anaesthesia. We also include a cost estimate of perioperative analgesia with DEX.

Nonpharmacological pain management in vaccination. Perception of paediatricians, patients and guardians.

INTRODUCTION: The use of nonpharmacological measures to reduce pain during vaccination has been studied extensively in infants, but there are fewer studies on its effectiveness in older children and on the parental perception of pain in children. METHODS: We conducted a multicentre, quasi-experimental interventional study with a control group. PATIENTS: infants aged 2-11 months and children aged 4 years that attended routine vaccination appointments. SETTING: Primary care. Intervention during vaccination: infants were breastfed and 4-year-old children blew a party horn. CONTROL: vaccination performed following routine practice. MEASUREMENT: NIPS (Neonatal Infant Pain Scale) and duration of crying in infants, Wong-Baker FACES pain rating scale in older children and parents. RESULTS: The study included 125 children (intervention: 60; control: 65). There was a significant decrease in perceived pain in the intervention groups: NIPS score in infants, 3.8 ± 1.1 compared to 5.2 ± 0.7 (P < .001); Wong-Baker FACES score at 4 years of 3.3 ± 1.7 compared to 4.2 ± 1.6 (P = .042). These same differences in support of the intervention were reflected in the parental assessments (3.4 ± 1.3 vs 4.5 ± 1.5; P < .001). The correlation between child and parent scores was strongly positive: 0.7 (95% CI, 0.59-0.78). However, the duration of crying was longer in the intervention group. CONCLUSION: The use of distraction techniques reduces pain in children and the pain perceived by parents in their children, thus increasing their satisfaction with the procedure.