Background Esophageal multichannel intraluminal impedance-pH monitoring has become one of the preferred tests to correlate observed reflux-like behaviors with esophageal reflux events. The Gastroesophageal reflux disease Assessment Symptom Questionnaire is a validated tool used to distinguish infants with gastroesophageal reflux disease from healthy children. The aim of this study was to determ...

BACKGROUND To ensure the suitability of an infant formula as the sole source of nutrition or provide benefits similar to outcomes in breastfed infants, advancements in formula composition are warranted as more research detailing the nutrient composition of human milk becomes available. This study was designed to evaluate growth and tolerance in healthy infants who received one of two investigat...

BACKGROUND Human milk provides necessary macronutrients (protein, carbohydrate, fat) required for infant nutrition. Lactoferrin (Lf), a multifunctional iron-binding protein predominant in human milk, shares similar protein sequence, structure, and bioactivity with bovine Lf (bLf). This large-scale pediatric nutrition study was designed to evaluate growth and tolerance in healthy infants who rec...

Ann E. Hyslop, MD Brian S. Droker, MD Laura A. Jansen, MD, PhD SECTION 1 A 4 month-old former full-term male infant presented with 4 days of lethargy, fussiness, low-grade fever, and dehydration, prompting hospital admission. His mother had tested positive for H1N1 influenza the week before, and treatment with oseltamivir was started. Oseltamivir treatment was started empirically in the infant,...

BACKGROUND Because early life growth has long-lasting metabolic and behavioral consequences, intervention during this period of developmental plasticity may alter long-term obesity risk. While modifiable factors during infancy have been identified, until recently, preventive interventions had not been tested. The Intervention Nurses Starting Infants Growing on Healthy Trajectories (INSIGHT). St...

Practical advice for treating newborns and toddlers. Y ou have recently encountered 4 children with a very distinct, well-demarcated, flat erythro-derma of the facial area. You must determine whether this rash is due to erysipe-las, which presents with an erythematous flat, painful, cellulitis-like rash most commonly on the face or lower extremities. The differential diagnosis in each of these ...

Many breastfeeding mothers struggle with an overabundant milk supply, or hypergalactia, beyond the first few weeks of engorgement. There has been very little research done to define, to explain, or to assist in managing this problem. Lactation specialists have identified several challenges for women with hypergalactia. Hypergalactia is also termed hyperlactation, oversupply, and engorgement, de...

In this issue of Pediatric Annals, we present four articles describing various presentations of cardiac or vascular disease. Patients with eventual diagnoses of cardiac pathology often present with common pediatric symptoms including dyspnea, dizziness, or fussiness. Each of the following cases with common presentations but uncommon diagnoses had subtle clues to cardiac pathology. Jarrett Linde...

Objective. Perceived intolerance to infant formula is a frequently reported reason for formula switching. Formula intolerance may be related to perceived symptoms of constipation, fussiness, abdominal cramps, and excessive spit-up or vomit. Commercially available formulas differ from each other in processing and in sources and levels of protein, lipids, and micronutrients. These differences may...

Objective. Perceived intolerance to infant formula is a frequently reported reason for formula switching. Formula intolerance may be related to perceived symptoms of constipation, fussiness, abdominal cramps, and excessive spit-up or vomit. Commercially available formulas differ from each other in processing and in sources and levels of protein, lipids, and micronutrients. These differences may...