Considerable advances have occurred in recent years in the scientific knowledge of the benefits of breastfeeding, the mechanisms underlying these benefits, and in the clinical management of breastfeeding. This policy statement on breastfeeding replaces the 1997 policy statement of the American Academy of Pediatrics and reflects this newer knowledge and the supporting publications. The benefits of breastfeeding for the infant, the mother, and the community are summarized, and recommendations to guide the pediatrician and other health care professionals in assisting mothers in the initiation and maintenance of breastfeeding for healthy term infants and high-risk infants are presented. The policy statement delineates various ways in which pediatricians can promote, protect, and support breastfeeding not only in their individual practices but also in the hospital, medical school, community, and nation.

/pdf/breastfeeding-and-the-use-of-human-milk-2m74a0njro.pdf

Breastfeeding and the Use of Human Milk

Background: Over the last few years, probiotics have been one of the most studied interventions in neonatal medicine. Objectives: </

/pdf/the-golden-age-of-probiotics-a-systematic-review-and-meta-pka4l553p3.pdf

The “Golden Age” of Probiotics: A Systematic Review and Meta-Analysis of Randomized and Observational Studies in Preterm Infants

Objectives—This report presents the revised growth charts for the United States. It summarizes the history of the 1977 National Center for Health Statistics (NCHS) growth charts, reasons for the revision, data sources and statistical procedures used, and major features of the revised charts. Methods—Data from five national health examination surveys collected from 1963 to 1994 and five supplementary data sources were combined to establish an analytic growth chart data set. A variety of statistical procedures were used to produce smoothed percentile curves for infants (from birth to 36 months) and older children (from 2 to 20 years), using a two-stage approach. Initial curve smoothing for selected major percentiles was accomplished with various parametric and nonparametric procedures. In the second stage, a normalization procedure was used to generate z-scores that closely match the smoothed percentile curves. Results—The 14 NCHS growth charts were revised and new body mass index-for-age (BMI-for-age) charts were created for boys and girls (http://www.cdc.gov/growthcharts). The growth percentile curves for infants and children are based primarily on national survey data. Use of national data ensures a smooth transition from the charts for infants to those for older children. These data better represent the racial/ethnic diversity and the size and growth patterns of combined breast- and formula-fed infants in the United States. New features include addition of the 3rd and 97th percentiles for all charts and extension of all charts for children and adolescents to age 20 years. Conclusion—Created with improved data and statistical curve smoothing procedures, the United States growth charts represent an enhanced instrument to evaluate the size and growth of infants and children.

/pdf/cdc-growth-charts-united-states-37tvkrteku.pdf

CDC growth charts; United States

Few microorganisms are as versatile as Escherichia coli. An important member of the normal intestinal microflora of humans and other mammals, E. coli has also been widely exploited as a cloning host in recombinant DNA technology. But E. coli is more than just a laboratory workhorse or harmless intestinal inhabitant; it can also be a highly versatile, and frequently deadly, pathogen. Several different E. coli strains cause diverse intestinal and extraintestinal diseases by means of virulence factors that affect a wide range of cellular processes.

Pathogenic Escherichia coli

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)01024-7.pdf

Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect

Committee on improving birth outcomes

Reducing Fetal Mortality

Blood stream infection is associated with altered heptavalent pneumococcal conjugate vaccine immune responses in very low birth weight infants

The Problem of Low Birth Weight

We have previously reported that less than 20% of eligible VLBW infants receive antenatal steroid (ANS) treatment. The purpose of this analysis was to compare the rates of ANS therapy and characteristics of women treated with ANS in the Network before and after the Consensus Development Conference (CDC), 2/28/94. ANS treatment of mothers of VLBW infants in the 34 mos before (n = 7610) and the 16 mos after the CDC (n = 3151) were compared. Overall, ANS use increased from 20.6% (center range 1-39%) to 45.9% (27-66%); during the latest available 4-mo period, 55% of VLBW mothers were treated. During both periods patients with prenatal care, multiple gestation, hypertension/preeclampsia, diabetes, c-section, tocolytics or antibiotics were more likely (OR 1.09- 4.58) and those with antepartum hemorrhage or labor were less likely (OR 0.62- 0.76) to receive ANS. Patients with PROM and prolonged ROM were less likely before the CDC (OR 0.74 and 0.76, respectively) and more likely after the CDC(OR 1.66 and 1.87, respectively) to receive ANS. The OR for ANS plus antibiotics increased from 1.86 to 3.78 post CDC. ANS increased approximately 2-fold in all GA groups after the CDC: Table

/pdf/impact-of-the-nih-consensus-development-conference-on-y06iuaqlby.pdf

Impact of the nih consensus development conference on corticosteroids for fetal maturation: increased antenatal steroid use in nichd network vlbw infants. † 1507

Barbara J. Stoll

Papers

Committee on improving birth outcomes

Reducing Fetal Mortality

Blood stream infection is associated with altered heptavalent pneumococcal conjugate vaccine immune responses in very low birth weight infants

The Problem of Low Birth Weight

Impact of the nih consensus development conference on corticosteroids for fetal maturation: increased antenatal steroid use in nichd network vlbw infants. † 1507