Breast-feeding and hospitalization for asthma in early childhood: a nationwide longitudinal survey in Japan.

OBJECTIVE: Whether or not breast-feeding is protective against asthma among children is still controversial. Therefore, we examined the effects of breast-feeding on hospitalization for asthma in early childhood. DESIGN: Secondary data analyses of a nationwide longitudinal survey of children in Japan ongoing since 2001, with results collected from 2001 to 2004. We used logistic regression models to evaluate the associations of breast-feeding with hospitalization for asthma in children between the ages of 6 and 42 months, adjusting for children's factors (sex, day-care attendance and presence of older siblings) and maternal factors (educational attainment and smoking habit). Setting All over Japan. SUBJECTS: Term singleton children with information on feeding practices during infancy (n 43367). RESULTS: After adjusting for maternal factors and children's factors, exclusive breast-feeding at 6-7 months of age was associated with decreased risk of hospitalization for asthma in children. The adjusted odds ratio was 0.77 (95% CI 0.56, 1.06). One-month longer duration of breast-feeding was associated with a 4% decreased risk of hospitalization for asthma (OR = 0.96; 95% CI 0.92, 0.99). CONCLUSIONS: The protective effects of breast-feeding on hospitalization for asthma were observed in children between the ages of 6 and 42 months.

Current incidence of clinical kernicterus in preterm infants in Japan.

Clinical kernicterus in preterm infants has recently been reported in Japan, diagnosed on the basis of clinical findings during the neonatal and infancy periods. We investigated the incidence of clinical kernicterus in preterm infants <30 weeks gestational age (GA) based on a nationwide survey conducted in 233 certified educational facilities for neonatologists. The numbers of infants admitted and infants who died within 14 days after birth during 2011, and the number of infants who subsequently developed clinical kernicterus, were recorded. A total of 2720 infants were analyzed, representing 59% (2720/4623) of all preterm live births <30 weeks GA in Japan in 2011. Of these, 159 (5.8%) died within 14 days after birth, similar to the national rate. Five infants developed clinical kernicterus in infancy (5/2720, 0.18%). The current incidence of clinical kernicterus in Japan is therefore estimated at 1.8 per 1000 live births <30 weeks GA.

Japanese trends in breastfeeding rate in baby-friendly hospitals between 2007 and 2010: a retrospective hospital-based surveillance study.

BACKGROUND: The goal of Japan's national "Healthy and Happy Family 21" campaign is to increase the nationwide breastfeeding rate for babies in the first month of life, which is currently below 50%, to a level of 60%. In this article, we summarize the breastfeeding rate for all of Japan's baby-friendly hospitals (BFHs) and extract their strengths in conjunction with the structural and legislative support that they have in place and finally draw up a policy for dispersing BFH activities to non-BFH delivery facilities, which could be useful for increasing the breastfeeding rate. METHODS: This study included all of the 61 BFHs that are registered in Japan. These hospitals account for approximately 2% of nearly 3,000 Japanese delivery facilities. The surveillance data, which were collected anonymously by the Japan Breastfeeding Association in 2007-2010, were summarized. The numbers of babies who were breastfed after delivery, at discharge from BFHs and at one month of age, were collated. The length of hospital/clinic stay was also collected. RESULTS: The collection rate was 100% in each year (2007, 2008, 2009 and 2010). The breastfeeding rates during hospital stay, at discharge, and one month were >70%, ~90%, and >75%, respectively. The median length of stay was 5 days (minimum/maximum: 5/8) for primipara. CONCLUSIONS: The breastfeeding rate at BFHs at one month of age was more than 75%. This surpassed the current national average (<50%). The median length of hospital/clinic stay was 5 days. In this 5-day period, BFH activities can play an important role in increasing the breastfeeding rate. Since hospitalization for the reported national median length of stay of 6 days, is legally guaranteed, the disbursement of BFH activities to non-BFH delivery facilities, with special support to mothers who delivered by cesarean delivery, would be a useful strategy for achieving a 60% breastfeeding rate at one month of age.

Risk factors and pathogen profile of ventilator-associated pneumonia in a neonatal intensive care unit in China.

BACKGROUND: The aim of the present study was to explore the incidence and risk factors of, and summarize the involved pathogens in, neonates with ventilator-associated pneumonia (VAP) in the authors' neonatal intensive care unit (NICU) to determine the effective strategies for prevention. METHODS: A retrospective case-control study including 117 VAP patients and 232 controls was conducted from January 2002 to July 2008. The antibiotics sensitivity spectrum was determined on quantitative microbiological evaluation. Multiple logistic regression and Cox model analysis were performed to determine independent and accumulative risk factors for VAP. RESULTS: Multivariate analysis showed that birthweight, mechanical ventilation (MV), parenteral alimentation, dexamethasone and other respiratory disease were associated with the development of VAP. The cumulative risk for developing VAP increased over the duration of stay in the NICU. The most common isolated bacteria of the pathogen spectrum in VAP were Klebsiella spp. (33/146), Acinetobacter baumannii (26/146), Pseudomonas aeruginosa (18/146) and Staphylococcus aureus(13/146). Meanwhile, we found that previous use of antibiotics before VAP diagnosis was not associated with the onset of VAP. CONCLUSIONS: The daily risk for VAP increases with duration of stay in the NICU after ventilation. Drug-resistant bacteria are common pathogens for neonatal VAP in the authors' NICU.

New transcutaneous jaundice device with two optical paths.

OBJECTIVES: To confirm the accuracy and precision of transcutaneous bilirubin (TcB) values measured by a new device with two optical paths (JM-103) and the value of total serum bilirubin (TSB) level in clinical units of measurement. METHODS: For comparison of the levels of accuracy and precision of JM-103 and the old device (JM-102), serum samples were collected from 77 Japanese infants in three different hospitals including 24 preterm infants and 53 term infants. Measurement of TcB by JM-103 and JM-102 were performed on the forehead of each infant within 30 min before or after blood sampling. RESULTS: The range of TSB was limited to 19.6 mg/dL and to 17 mg/dL for preterm infants. The correlation coefficients for all subjects (r = 0.94) and for term and preterm subjects between TcB measured by JM-103 and TSB was higher than that between TcB measured by JM-102 and TSB. The regression line in term infants between TcB measured by JM-103 and TcB was similar to that in preterm infants. The error distribution of TcB measured by JM-102 and TSB for all subjects (0.00 +/- 2.21) and for term and preterm subjects was larger than that of TcB measured by JM-103 and TSB (all subjects, 0.30 +/- 1.55).