Journal of Pediatric Perspectives
Volume:12 Issue: 131, Nov 2024

Breast milk provides essential and irreplaceable nutrients for an infant’s growth and development. Consequently, exclusive breastfeeding for the first 6 months of an infant’s life is important for their health and survival.  This study aimed to determine predictors of exclusive breastfeeding in the first 6 months among infants in Iran. A cross-sectional study was conducted on 379 lactating women with infants >6 months. Participants attended health care centers in Ardabil city, Iran during 2020. Information about mothers and infants was collected via a questionnaire. Differences in characteristics of women that engaged in exclusive breastfeeding for the first 6 months (EBF-6) compared to no exclusive breastfeeding for the first 6 months (NEBF-6) was analyzed via T-tests. Predictors of exclusive breastfeeding among the infants were examined via logistic regression analyses. There were 196 respondents (51.7%) categorized into EBF-6 compared to 183 respondents (48.3%) categorized into NEBF-6. A greater number of women in EBF-6 compared to NEBF-6 were housewives (p=0.034). Additionally, the time of the first breastfeeding after birth was earlier for EBF-6 compared to NEBF-6 (p<0.001). Among the variables related to exclusive breastfeeding, only the predictive power of breastfeeding in the first half hour after birth was confirmed (p=0.002). This finding suggested that breastfeeding soon after birth led to an increase of almost 6 times in the probability of engaging in exclusive breastfeeding for 6 months. Breastfeeding soon after birth appears to strongly influence the likelihood of exclusive breastfeeding for 6 months. Considering the important role of this practice in maintaining and ensuring maternal and child health, early initiation of breastfeeding after birth should be prioritized.

Nutritional support in the Pediatric Intensive Care Unit (PICU) is critical for promoting recovery and reducing complications in critically ill children. Although guidelines exist, variability in Enteral Nutrition (EN) practices underscores the need for standardized protocols tailored to the unique needs of PICU patients. This study aimed to develop a standardized enteral feeding protocol for PICU patients, informed by current evidence and expert consensus, to improve feeding tolerance and clinical outcomes. A two-phase study was conducted. Phase 1 involved a systematic review of global guidelines and evidence-based practices for EN in PICUs to identify key variables in EN delivery. In Phase 2, a multidisciplinary panel of PICU experts, including nutritionists and pediatric intensivists, used a structured focus group approach to develop a consensus on feeding initiation, volume advancement, prokinetic use, and complication management. The resulting protocol recommends initiating EN within 24 hours for hemodynamically stable patients, with gradual, weight-based volume advancement tailored to patient tolerance. Prokinetic agents (metoclopramide, domperidone, and erythromycin) were incorporated to improve feeding tolerance; and guidelines for managing potential complications, such as refeeding syndrome, gastrointestinal issues, and electrolyte imbalances, were established. This protocol provides a comprehensive, evidence-based framework for EN in PICUs, offering structured guidance to support the nutritional needs of critically ill pediatric patients. While rigorous development ensures relevance and adaptability, further clinical evaluation is necessary to assess its impact across diverse PICU settings.

The present study was an effort for the validation and confirmatory factor analysis of the impulsive behaviors scale among a group of Iranian children. The present study was a descriptive correlational study. The statistical population of the study included all children aged 8 to 12 years old in Tehran. 315 people were selected using available sampling methods. The scale’s face validity was confirmed after its translation with the acquisition of experts’ and subjects’ perspectives. SPSS and AMOS were used for statistical analyses. The results of the confirmatory factor analysis, based on AMOS software, showed that the five-factor structure had a good fit with data of the Iranian sample. Internal consistency coefficients for the lack of perseverance, positive urgency, negative urgency, lack of premeditation and sensation seeking subscales were 0.69, 0.79, 0.66, 0.79 and 0.72, respectively. The results of the present research generally revealed that the children’s impulsive behaviors scale was a valid and reliable instrument capable of measuring impulsive behaviors and could be employed to evaluate impulsive behaviors in research and therapy centers.

Vitamin D deficiency has been linked to an elevated risk of cancer and poor outcomes. This study was conducted to explore the potential impact of vitamin D status on cancer progression and severity in pediatric patients. The current study adopted a case-control design to investigate the relationship between serum vitamin D levels and cancer stage and grading in pediatric patients. The case group comprised newly diagnosed cases of children and adolescents with various types of cancer admitted to Ali Asghar Hospital between 2023 - 2024. Statistical analysis was performed using SPSS software version 24, with a significance level set at less than 0.05. A total of 155 patients were included in the study, with 72 patients in the case group and 86 patients in the control group. Among the participants, 26 (36.1%) and 32 (38.6%) subjects in the case and control groups were girls, respectively. Acute lymphoblastic leukemia (ALL) accounted for 16.1% of the cases, followed by retinoblastoma (5.8%) and acute myeloid leukemia (AML) (4.5%) as the most frequent cancer types observed. Notably, the analysis of vitamin D serum levels revealed no significant difference between the case group (median: 25, range: 76-4) and the control group (median: 27, range: 69.5-12). Furthermore, the comparison of vitamin D serum levels across different cancer stages did not show any significant differences. Our findings show that children with newly diagnosed cancer have 25 (OH) D3 levels identical to their healthy matches. However, the importance of our findings to cancer progression is unclear and needs further investigations.

The need for early detection and supportive therapy of Autism Spectrum Disorder (ASD) underlined the influence of screening for ASD in children with epilepsy as well as screening for epilepsy in ASD. This study aimed to explore the prevalence of autism in epileptic children in the northwest of Iran. A case-control study was performed on 80 children aged 16 to 30 months, consisting of 40 with epilepsy as the case group and 40 with febrile seizure as a control group. The case group included children diagnosed with epilepsy, and the control group comprised children with recurrent febrile seizures who were matched by age and sex. Two questionnaires, Ages and Stages Questionnaire (ASQ) and Modified Checklist for Autism in Toddlers (m-CHAT), were utilized for developmental assessment and ASD screening, respectively. An experienced child and adolescent psychiatrist clinically diagnosed autism through relevant DSM-5 criteria. The studied children comprised 22 (55%) males and 18 (45%) females. Based on the M-CHAT screening questionnaire, 19 (47.5%) patients in the case group were positive for ASD. M-CHAT-positive patients were referred to the comprehensive autism center, and of whom, 4 (10%) patients met DSM-5 diagnostic criteria for ASD (definite ASD). In epileptic children with developmental delay, the overall prevalence of definite ASD was 18.2%. The present study showed a high prevalence of autism among epileptic children, especially in developmentally delayed children; this demonstrated the need for autism screening in epileptic patients.

The effect of treatment on lung function in children with pulmonary hydatid cyst is not determined yet. Regarding the high prevalence of pulmonary involvement in pediatric patients with hydatid cyst and its destructive effects on the lungs, we aimed to evaluate the lung function tests before and after treatment in children with pulmonary hydatid cyst. 30 pediatric patients with pulmonary hydatid cyst were included in this study. Data was gathered using a checklist which consisted of demographic data and patient characteristics, radiologic findings and diagnostic tests. For all 30 patients, spirometry was performed before and after the treatment. The mean age of patients was 8.5±2.2 years. Most of the patients were male (76%) and living in rural areas (80%). Lower zone of the right lung was the most common site of involvement. Simultaneous involvement of the lung and liver was observed in 13.3% of the patients. Pulmonary function tests were evaluated before and after surgical treatment of the hydatid cyst. The Forced Expiratory Volume 1 (FEV1) and Forced Vital Capacity (FVC) were not significantly different before and after the treatment (P>0.05), but FEV1 to FVC ratio was significantly increased after treatment (P<0.001). The results of this study revealed positive effects of the treatment on the pulmonary function tests in children with pulmonary hydatid cysts. However, further studies are needed in this area.