Effect of Frenotomy on Maternal Breastfeeding Symptoms and the Relationship Between Maternal Symptoms and Problematic Infant Feeding

The relationship between maternal symptoms and problematic infant feeding in the context of tongue-tie is unknown. In a sample of infants with tongue-tie undergoing frenotomy and their mothers, the aims of this study were to: (1) describe changes in maternal symptoms pre- and post-frenotomy, and (2) evaluate the relationships between maternal symptoms and symptoms of problematic feeding pre- and post-frenotomy. Mother-infant dyads were recruited from 1 pediatric dental office between July and November 2020. The sample included 102 mother-infant dyads; 84 completed the follow-up survey. Maternal symptoms of painful and difficult latch, creased/cracked nipples, bleeding, or abraded nipples, chewing of the nipple, and feelings of depression were significantly less common after tongue-tie revision. Poor latch onto the breast was associated with feeding difficulties at both time points. Frenotomy resulted in a decrease of symptoms in breastfeeding mothers. Maternal symptoms and feeding problems persisting post-frenotomy warrant further evaluation.

A Qualitative Examination of Perceived Stigma and its Sources Among Adolescents Living With HIV in Western Kenya

Introduction. Adolescents (10-19 years) living with HIV (ALWH) face unique challenges in controlling HIV long-term, including stigma and perception of stigma within their communities. Methods. We conducted a qualitative investigation of the sources of perceived HIV-related stigma with ALWH in western Kenya. Forty-six ALWH on ART, aware of their status, and engaged in care were enrolled. Interviews explored perceived stigma by probing the individuals and experiences that adolescents identify as causing or perpetuating their ongoing fears. Results. Participants (54% male, mean age 17.4) reported ongoing fears of stigmatization related to friends and peers not living with HIV. They described previous enacted and first-hand observations of stigma, most often occurring in pre-adolescence, by age mates or peers at school as the most common cause for their ongoing fears. Conclusions. Perceived stigma is prevalent among ALWH and develops from experiences in pre-adolescence. Anti-HIV stigma interventions addressing educators and children in school settings to combat perceived stigma at its source should be investigated.

Respiratory Modalities in Preventing Reintubation in a Pediatric Intensive Care Unit

Post-extubation respiratory failure requiring reintubation in a Pediatric Intensive Care Unit (PICU) results in significant morbidity. Data in the pediatric population comparing various therapeutic respiratory modalities for avoiding reintubation is lacking. Our objective was to compare therapeutic respiratory modalities following extubation from mechanical ventilation. About 491 children admitted to a single-center PICU requiring mechanical ventilation from January 2010 through December 2017 were retrospectively reviewed. Therapeutic respiratory support assisted in avoiding reintubation in the majority of patients initially extubated to room air or nasal cannula with high-flow nasal cannula (80%) or noninvasive positive pressure ventilation (100%). Patients requiring therapeutic respiratory support had longer PICU LOS (10.92 vs 6.91 days, P-value = .0357) and hospital LOS (16.43 vs 10.20 days, P-value = .0250). Therapeutic respiratory support following extubation can assist in avoiding reintubation. Those who required therapeutic respiratory support experienced a significantly longer PICU and hospital LOS. Further prospective clinical trials are warranted.

Prelacteal Feeding Practices and Its Associated Factors among Mother of Children Less Than 2 Years of Age in Kersa District, Eastern Ethiopia

Background. Prelacteal feeding is defined as administration of any substances other than breast milk to newborn babies during the first 3 days after birth. Despite its negative health outcomes, it is commonly practiced in developing countries. Therefore, this study aimed at assessing the prevalence of pre-lacteal feeding practices and associated factors among mothers of children aged less than 2 years of age in Kersa district, Eastern Ethiopia. Method. A community-based cross-sectional study design was conducted among 465 mothers having children aged less than 2 years in Kersa district. A multistage sampling technique was used to select study participants. Binary logistic regression analysis was fitted to identify factors associated with prelacteal feeding practices. Variables with a P-value <.05 were identified as statistically significant factors. Results. The prevalence of pre-lacteal feeding in Kersa district was 46.4% (95% CI; 42.0%, 51.5%). Initiating breastfeeding after 1 hour of delivery (AOR = 10.80, 95% CI: (5.79, 20.17)), giving birth at home (AOR = 2.77, 95% CI: (1.41, 5.46)), not knowing risks associated with pre-lacteal feeding (AOR = 3.25, 95% CI: (1.72, 6.15)) and perceiving pre-lacteal feeding as beneficial (AOR = 9.56, 95% CI: (4.45, 20.52)) were factors significantly associated with practice pre-lacteal feeding practices. Conclusion. Significant proportions of mothers were practicing pre-lacteal feeding in the study area. Late initiation of breastfeeding, home delivery, not knowing risks of prelacteal feeding, and perceiving pre-lacteal feeding as beneficial were contributing factors for practicing of pre-lacteal feeding. Therefore, promoting institutional delivery and timely initiation of breastfeeding would reduce prelacteal feeding in Kersa district.

Characteristics of Pediatric Emergency and Risk Factors for Life-saving Interventions

Pediatric emergency patients are vulnerable population and require special care or interventions. Nevertheless, there is limited data on the prevalence and risk factors for life-saving interventions. This study is a retrospective analytical study. The inclusion criteria were children aged 15 years or under who were triaged as level 1 or 2 and treated at the resuscitation room. Factors associated with LSI were executed by logistic regression analysis. During the study period, there were 22 759 ER visits by 14 066 pediatric patients. Of those, 346 patients (2.46%) met the study criteria. Triage level 1 accounted for 16.18% (56 patients) with 29 patients (8.38%) with LSI. Trauma was an independent factor for LSI with adjusted odds ratio (95% CI) of 4.37 (1.49, 12.76). In conclusion, approximately 8.38% of these patients required LSI. Trauma cause was an independent predictor for LSI.

The Predictive Value of the Mother’s Risk Factors in Formation of Fetal Developmental Delay

The research aimed at studying the mother’s social-hygienic and medical biological risk factors and determining their predictive value. The retrospective case-control study was conducted with 142 pregnant women participating in it. In the case group there were involved 92 mothers whose pregnancy was completed by the birth of a newborn baby suffering from the intrauterine growth restriction. The control group was made of 50 pregnant women, whose pregnancy was completed by the birth of a healthy neonate. The research resulted in specifying the risk factors of high priority: the low standards of living (OR 3.61), chronic stress (OR-3.06), sleeping disorder (OR-3.33) and poor nutrition (OR-3.81). As regards the coexisting pathology the following was revealed: endocrine pathology (OR-3.27), ischemic heart disease (OR-4.35), arterial hypertension (OR-6.47), iron deficiency anemia (OR-4.11), pathology of respiratory system (OR-3.42), chronic genital inflammatory and infectious processes. The preeclampsia (92%) and low amniotic fluid (89%) were detected to have the high predictive value. The awareness of risk factors allows us to employ the timely measures for the reduction of negative impact on the fetus and neonate.

An International Review to Characterize the Role, Responsibilities, and Optimal Setting for Health Literacy Mediators

Health literacy is a critically important determinant of health and is influenced by access to supportive social networks and services. Global investment in education throughout the life course is required to support health literacy development. The aim of this review is to characterize the role, responsibilities, and the optimal setting for the emergent role of a Health Literacy Mediator (HLM). A scoping review of recent literature was conducted. The review revealed a lack of consensus on who should be teaching health literacy, and variability in confidence when teaching health literacy. Professionals reported facing barriers such as a lack of time, a lack of knowledge, and recognized that the health literacy needs of children worldwide are not being met. Further research into the role of HLM is required to determine who is best suited to this role and what their responsibilities will be to ensure consistent health literacy education.

The Differential Diagnosis of Sterile Pyuria in Pediatric Patients: A Review

Sterile pyuria is a common finding in pediatric patients. Literature describing the diagnoses as well as clinical characteristics of children with sterile pyuria is lacking. This review was performed to establish an evidence-based approach to the differential diagnosis by way of an extensive literature search. The definition of pyuria is inconsistent. The various causes of pediatric sterile pyuria identified were classified as either Infectious or Non-Infectious. Sub-categories of Infectious causes include: Viral Infection, Bacterial Infection, Other Infections (tuberculosis, fungal, parasitic), Sexually Transmitted Infections, Recent Antibiotic Therapy. Non-Infectious causes include: Systemic Disease, Renal Disease, Drug Related, Inflammation adjacent to Genitourinary Tract. Clinicians that encounter pediatric patients with sterile pyuria and persistent symptoms should consider the substantial differential diagnosis described in this study.

Feasibility of Kangaroo Mother Care (KMC) Implementation in Depok City, Indonesia

Background: The infant and neonatal mortality rate in Depok City is still high, with low birth weight (LBW) and premature births being one of the main causes. In 2018, 14 out of 41 cases of early neonatal death were due to LBW. Studies show that Kangaroo Mother Care (KMC) can prevent or reduce LBW deaths caused by hypothermia, but the implementation is still not evenly distributed. Objective: Describe KMC feasibility as a supporting material for a KMC policy umbrella at Depok City. Method: Qualitative research was conducted with a Rapid Assessment Procedure (RAP) design. A total of 56 informants were divided into 8 discussion groups, 7 in-depth interviews and 2 Focus Group Discussions (FGD). The types of informants were families and inter-sectoral officers. Thematic analysis was used to analyze the data. Results: KMC implementation feasibility in Depok City in terms of facilities and infrastructure was still limited and the quality was insufficient. The number of human resources was still limited, and the competency was still not evenly distributed. LBW family readiness can be maintained if provided with complete and accurate knowledge; therefore, a strong commitment may develop to continue KMC at home. The potential sources of KMC financing are found at health facilities and inter-sectoral; however, to use it, a legal umbrella at the city district level is necessary. Conclusions: The factors of potential financing sources need to be followed up into a priority. This is to overcome the constraints of KMC feasibility implementation.