RESUMEN
PURPOSE OF REVIEW: The present article addresses recent research related to three important determinants of newborn health: postpartum depression, teenage parents and their offspring, and breast-feeding. RECENT FINDINGS: Postpartum depression can impact the entire family unit, and fathers may be affected more than previously recognized. Teenage mothers and their infants are at risk of a number of poor physical and mental health outcomes. New research continues to support the benefits of breast-feeding infants, and hospitals have adopted policies to improve breast-feeding rates. SUMMARY: Recognizing both maternal and paternal depression during outpatient visits is key to family well-being, as well as to infant development and attachment. Pediatric providers should address the unique emotional, socioeconomic, educational, and health needs of teen mothers. Hospital implementation of evidence-based policies may increase the number of mothers who are successful in establishing breast-feeding, and pediatric healthcare providers should be prepared to support mothers of breast-feeding infants.
Asunto(s)
Lactancia Materna/psicología , Depresión Posparto/epidemiología , Acontecimientos que Cambian la Vida , Madres/psicología , Responsabilidad Parental/psicología , Embarazo en Adolescencia/psicología , Adolescente , Depresión Posparto/prevención & control , Práctica Clínica Basada en la Evidencia , Padre/psicología , Femenino , Humanos , Recién Nacido , Atención Posnatal , Embarazo , Medio Social , Apoyo SocialRESUMEN
Infantile hemangiomas (IHs) occur in as many as 5% of infants, making them the most common benign tumor of infancy. Most IHs are small, innocuous, self-resolving, and require no treatment. However, because of their size or location, a significant minority of IHs are potentially problematic. These include IHs that may cause permanent scarring and disfigurement (eg, facial IHs), hepatic or airway IHs, and IHs with the potential for functional impairment (eg, periorbital IHs), ulceration (that may cause pain or scarring), and associated underlying abnormalities (eg, intracranial and aortic arch vascular abnormalities accompanying a large facial IH). This clinical practice guideline for the management of IHs emphasizes several key concepts. It defines those IHs that are potentially higher risk and should prompt concern, and emphasizes increased vigilance, consideration of active treatment and, when appropriate, specialty consultation. It discusses the specific growth characteristics of IHs, that is, that the most rapid and significant growth occurs between 1 and 3 months of age and that growth is completed by 5 months of age in most cases. Because many IHs leave behind permanent skin changes, there is a window of opportunity to treat higher-risk IHs and optimize outcomes. Early intervention and/or referral (ideally by 1 month of age) is recommended for infants who have potentially problematic IHs. When systemic treatment is indicated, propranolol is the drug of choice at a dose of 2 to 3 mg/kg per day. Treatment typically is continued for at least 6 months and often is maintained until 12 months of age (occasionally longer). Topical timolol may be used to treat select small, thin, superficial IHs. Surgery and/or laser treatment are most useful for the treatment of residual skin changes after involution and, less commonly, may be considered earlier to treat some IHs.