Novedades en colecho y SMSL / News in co-sleeping and SIDS

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¿Hay que hacer profilaxis de hierro en lactantes? / Do we have to give prophylactic iron supplementation to infants?

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Prevención y cribado de la ferropenia en lactantes / Prevention and screening of iron deficiency in infants

La ferropenia es un problema frecuente en el lactante. Distintos estudios relacionan la ferropenia con potenciales efectos sobre el neurodesarrollo, aunque aún no existe evidencia suficiente. La mayoría de organizaciones no recomiendan la suplementación universal en lactantes sanos nacidos a término, aunque hay consenso en suplementar si hay factores de riesgo. También es tema de controversia el cribado de la ferropenia en el lactante, mientras algunas organizaciones lo recomiendan solo a grupos de riesgo, otras entidades, proponen el cribado universal. El objetivo de este artículo es revisar las necesidades de hierro durante el primer año, así como las recomendaciones de los principales comités (AU)

Iron deficiency is a frequent condition during infancy. Recent studies relate it with neurodevelopment, although there are not conclusive results. Most organizations are not recommending iron supplementation in normal infants but there is consensus about supplementing if there are risk factors. There is also controversy about screening and some groups recommend screening infants at risk, and others propose general screening. The purpose of this article is to review the requirements of iron during infancy and the different current recommendations (AU)

Prevención del síndrome de muerte súbita del lactante / No disponible

El síndrome de muerte súbita del lactante (SMSL) se define como la muerte brusca de unniño menor de un año a la cual no se le encuentra explicación después de una investigación minuciosa.El SMSL es la primera causa de muerte postneonatal en países desarrollados, suponiendoun 40-50% de dicha mortalidad.La prevención se basa en recomendaciones dirigidas a los padres para evitar todos aquellosfactores de riesgo relacionados con este proceso, desde la visita prenatal hasta el final del primeraño. Dichas recomendaciones se centran en evitar la posición prono durante el sueño hastalos seis meses de edad, desaconsejar el tabaquismo de los padres, evitar colchones blandos oexcesivo arropamiento, mantener la habitación a temperatura agradable (entre 20-22 ºC) y promover la lactancia materna (AU)

Sudden infant death syndrome (SIDS) is defined and the unexpected death of an infant of lessthan one year that remains unexplained after a thorough investigation.SIDS is the leading cause of postneonatal death in developed countries, counting up to 40-50% of this mortality.Prevention is based on recommendations addressed to parents to avoid all those risk factors related to this condition, starting in the prenatal visit to the end of the first year. These recommendationsfocus on avoiding prono position during sleep up to six months of age, advise against smokingin parents, avoid soft mattresses or too much clothing, keep room in a mild temperature (between 20-22 ºC) and promote beast feeding (AU)

[Validity of diagnostic methods in detection of congenital hip luxation in primary care]. / Validez de los métodos diagnósticos en la detección de la luxación congénita de cadera en atención primaria.

OBJECTIVE: To find the validity of the clinical and radiological methods used within Primary Care in the early diagnosis of Congenital Hip Luxation (CHL). DESIGN: A prospective observation study. SETTING: Zaidín-Sur Basic Health Area (HA), Granada. An urban Health Centre. PATIENTS: All new-born and nursing babies born in our HA between October 1991 and March 1993 (N = 352), followed and studied over an average period of 22.4 months (SD = 5.6) (Range, 12 to 30 months). RESULTS: The prevalence of clinically and/or radiologically-based suspected CHL was 19% (Cl 95%; 12.7-25.3%) and the prevalence of confirmed CHL was 4.2% (Cl 95%; 1.96-6.44%). Ortolani-Barlow sensitivity (O-B) was 46.7%, specificity 85.2%; positive predictive value 12.3%, negative predictive value 97.6%, false positives 14.8% and false negatives 53.3%. When positive O-B and/or other positive clinical signs were taken into consideration, sensitivity rose to 73.3% and false negatives went down to 26.7%. If we had not performed radiologies systematically on all the nursing children, we would have missed CHL diagnosis in 1.14% of our basic HA's population-group. CONCLUSION: We question the clinical diagnosis of CHL due to its low sensitivity and an excessive number of false negatives. We recommended systematic testing by means of a diagnostic image method, which could be X-Rays at 3 to 5 months.

[Levels of maternal anxiety and their use in pediatric primary health care]. / Niveles de ansiedad materna y utilización pediátrica en atención primaria.

Of a total population of a pediatric office of the Zaidin South Health Care Center, all of the mothers that were frequent users (69) were chosen and compared with a random sample of normal users (82). Both groups carried out the anxiety scale STAI. Significant differences were found in that the high users have greater levels of anxiety about trait (p = 0.0003), as well as state (p = 0.000). The high levels of anxiety of trait are associated with being a house wife, having a child with a chronic illness, non maternal lactation, low levels of studies, health education and family income. Family income was the variable with the greatest association with the anxiety of trait (multiple regression). When we took into consideration the variables of predisposition, availability and ease of use, the maternal anxiety continued to have a significant influence. We point out the importance of maternal anxiety in the high frequency of pediatric health care use and we underline the modifiable characteristics of the anxiety factor, and therefore the possibility of reducing the high use of health care services addressed.

[Maternal health knowledge and its use in pediatrics in primary care]. / Cultura sanitaria materna y utilización pediátrica en atención primaria.

OBJECTIVE: To find the nature of the relationship between the general level of mothers' health knowledge and the over-use of paediatric facilities at the Primary Care level. DESIGN: A crossover study with a control group. SITE. Zaidin-Sur Health Centre (Granada). PATIENTS OR OTHERS PARTICIPANTS: We selected all the over-users (69) of a Paediatric office and compared them to a random sample, grouped by age, of normal users (82); n = 151. MAIN MEASUREMENTS AND RESULTS: To control confusion, we measured a total of 31 variables, grouped as to need, predisposition and expediting factors. After validating the scales, the average scores for general health understanding and the score for clinical attitudes and knowledge were significantly lower in the over-user group (p = 0.017 and p = 0.000). The scale for attitudes to and knowledge of prevention did not attain any importance (p = 0.104). We worked out a model of multiple logistical regression which included in the equation the scale of clinical attitudes and knowledge (p less than 0.005). CONCLUSIONS: We emphasised the importance of mothers' health knowledge to the question of over-use of paediatric facilities. It is desirable to attempt to intervene on this question in order to lessen excessive use of health facilities.