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Objectives: The EQ-TIPS was developed to measure the Health-Related Quality of Life in infants/toddlers. Considering the rapid development in this period, this study aimed to investigate age-related variations in EQ-TIPS performance. Methods: Data from 551 infants/toddlers living with a health condition were analysed. Infants/toddlers were grouped by age: 0–6 months (n = 100), 6–12 months (n = 95), 12–24 months (n = 147), and 36–48 months (n = 97). Differences in item responses and item correlations across age groups were calculated by Kruskal–Wallis and Spearman's correlations, respectively. Results: The report of problems was significantly higher for movement, play, and communication in the 36–48-month group compared to the 0–6-month group. There were strong correlations (r > 0.50) across all age groups between play and movement and communication and social interaction/play; neither pain nor eating showed a clear pattern of association. Conclusions: There is an age-related difference in the reporting of items linked to developmental milestones (movement, play, and communication) with most problems reported in the 36–48-month group when deviation from peers and continued dependence on caregivers is notable. Consideration should be given to including broader examples of play in the EQ-TIPS. Redefining the items to represent social communication and/or (social) emotion, rather than communication and social interaction, may be warranted. Future research should explore the psychometric performance of items to further inform item inclusion and/or revision. [ABSTRACT FROM AUTHOR]

Background: Health service providers closely monitor the developmental state of toddlers to identify the factors affecting this process because any defect during this period will cause irreversible damage. Therefore, this study investigated the relationship of nutritional behaviors and parent–child interactions with the developmental domains of Iranian toddlers. Methods: This cross-sectional, descriptive-analytical study was conducted on 341 toddlers aged 12–36 months covered by comprehensive health centers in the south of Tehran in 2021–2022. The participants were selected through single-stage cluster sampling. To this end, 16 comprehensive health centers were randomly selected, and then some of the clients from each center were randomly selected as the sample. The required data were collected through the Ages and Stages Questionnaire (ASQ), the Children's Eating Behavior Questionnaire (CEBQ), the Child-Parent Relationship Scale (CPRS), and a demographics form. They were then analyzed statistically using descriptive and inferential statistics in SPSS-21, considering a significance level of p < 0.05. Results: The results showed that most participants were normal in all developmental domains (communication, gross motor, fine motor, personal-social, and problem-solving), with a mean developmental delay ranging from 1.8 to 7%. The most serious problem of participants requiring medical referral was related to gross motor (7%) with a mean of 54.35 ± 7.28 followed by communication (6.5%) with a mean of 49.41 ± 9.67. The mean nutritional behavior of participants was 77.9 ± 21.7. A significant relationship was found between the nutritional behaviors of participants and the problem-solving domain of development (p = 0.018). The results also indicated a mean parent-child interaction score of 94.26 ± 12.63. There was a significant relationship between parent-child interactions and the communication area of development (p = 0.04). Conclusion: Since some areas of toddler development are influenced by children's nutritional behavior and parent-child interactions, it is necessary to train families to identify, monitor, and correct the factors affecting the development of their children. Health system officials and planners are also recommended to develop interventions to improve the nutritional behaviors of children and parent-child interactions. [ABSTRACT FROM AUTHOR]

Penjaringan Sari Flats is a solution implemented by the Surabaya City Government to overcome the limited housing in Surabaya. Due to the high number of residents, Penjaringan Sari Flats have a rapid and spread infectious rate. One of the impacts of infectious diseases that may be experienced by pregnant women and also children under five aged is low birth weight (LBW) babies and stunting. One solution to reduce the number of stunting and LBW that can be done is screening at early conditions of infection in pregnant women and toddler using the urine examination method (urinalysis). In examining a urine sample which is examined using the dipstick method (urinalysis using strips), 11 parameters can be read. Three of the eleven dipstick parameters (nitrite, leukocytes, and protein) were stated to be sufficient to screen a patient's initial infection profile. Participants in this community service activity are residents of Penjaringan Sari flats who are female, pregnant, and/or small children aged up to 5 years. The first stage carried out was the introduction of this program and activity plan to the Head of Penjaringan Sari Subdistrict. Data collection on the number of pregnant women and toddlers in Penjaringan Sari Village using observational methods. Data collection was carried out personally by the Head of Community Service accompanied by local women community. The number of pregnant women is 40 and toddlers are 60 as of August 2023. The results of urine sample examinations from 74 patients from residents of Penjaringan Sari Subdistrict are divided into two different categories: pregnant women and toddlers. In the category of pregnant women, around 90% of patients had positive leukocyte results, 60% had proteinuria, and 10% showed positive urine nitrite. In the second group, namely toddlers, the results showed that around 58.13% showed positive leukocytes, around 16.27% experienced proteinuria, and 4.65% of toddler patients had positive nitrite values. [ABSTRACT FROM AUTHOR]

The Merdeka Belajar curriculum is the current curriculum developed by the Indonesian Ministry of Education, which should be implemented thoroughly in 2024. Project-based learning is identically engaged with this curriculum, which offers many advantages to enrich the quality of education. This method has been promoted and implemented in several schools across the region in Indonesia, yet many teachers still need help applying it. This research explores the project-based learning steps for preschool teachers in Bandung through a community service program by Industrial Engineering lecturers in Indonesia. There were 42 participants from 35 kindergarten and playgroup schools who joined the PJBL workshop. With an active learning workshop delivery, a significant result has been achieved that could increase their understanding of the PJBL concept. The "A Healthy House" project was an example of the topic covered in the workshop. To check the participant's knowledge of the PjbL steps, the questionnaire was distributed two times, before and after the workshop ended. Using the Mc Nemart test, the PJBL workshop has significantly impacted the teachers. They could understand the principles of PjBL and the steps of the methods. [ABSTRACT FROM AUTHOR]

Cereals are an important source of nutrients, especially used in complementary feeding. The objective of this study is to review the nutritional composition of cereal-based foods for infants from 4 months and toddlers that are offered in Spain and Ecuador, countries selected because of the opportunity to work in them, and due to their socio-economic differences (industrialized and developing countries, respectively). The number of these products was 105 cereals in Spain and 22 in Ecuador. The products were classified as gluten-free cereals, five cereals, eight cereals, multigrain cereals, and cookies. A 25 g serving was used to determine the percentage in which the samples analyzed can cover the Reference Nutrient Intake (RNI) for micronutrients in infants from 7 months and toddlers according to the European Food Safety Authority (EFSA). Nutritional information per 100 g of dry product was collected according to medium, minimum, and maximum units, and nutrient density was calculated. The age range in which these products are recommended is different in both countries. The nutritional composition presents some differences; Spanish cereals show a lower content of sodium, added sugars, hydrolyzed cereals, and maltodextrin than Ecuadorian cereals. Commercialized cereals could contribute to satisfying the nutritional needs of infants and toddlers; however, they can also be a source of non-recommended components. [ABSTRACT FROM AUTHOR]

Background: Stunting is a nutrition problem that can slow down the growth. With prevalence at 32.5%, Landak Regency in West Kalimantan has been designated as a stunting hotspot. The lack of a maximum penalty for the stunting case in Landak Regency is not based on factors causing the stunting itself, because there is no identifiable factor causing the stunting in certain area due to narrow roads and sharp curves. Objectives: The objective of this study was to identify causes and distribution of the stunting case in Landak Regency. Methods: A total of 330 households in Meranti, Sebangki, and Senakin were included in this cross-sectional study because they were at a risk of the stunting. Toddlers, mothers, health care, and environmental factors were among the found variables. The researchers employed a basic random sampling strategy for the sampling and used the secondary health center data to find out whether or not toddlers were stunted. Researchers in this study collected data on the independent variables by observing and interviewing participants. Using the chi-square test, the data was analyzed. Results: The results showed that determinants of the stunting in Landak Regency were the history of early breastfeeding initiation (p-value=0.032), exclusive breastfeeding (p-value=0.042), frequency of exclusive breastfeeding (p-value=0.040), the continued breastfeeding (p-value=0.024), complementary feeding (p-value=0.042), immunization history (p-value=0.007), infectious disease history (p-value=0.000), maternal height (p-value=0.046), delivery assistance (p-value=0.000), access to health services (p-value=0.004), the role of health workers (p-value=0.002), and family latrine ownership (p-value=0.000). Conclusions: Several factors were found to be associated with incidence of the stunting among toddlers in Landak Regency.

Background: Lack of nutritional intake is a significant factor causing stunting in children, affecting their growth and development. The role of maternal knowledge and parenting practices is crucial in preventing stunting. Objective: In This study aims to determine the relationship between maternal knowledge and stunting in toddlers in Forestry Hamlet, Secanggang Village, Langkat Regency. Methods: A descriptive quantitative research design was employed. Data were collected using questionnaires from a sample of 30 mothers of toddlers. The study analyzed the knowledge levels of these mothers regarding stunting. Results: The analysis revealed that 70% of mothers had good knowledge, 26.7% had sufficient knowledge, and 3.3% had poor knowledge about stunting. The findings suggest that higher education levels among mothers are associated with better knowledge about preventing stunting. Conclusion: There is a significant relationship between maternal knowledge and the incidence of stunting in toddlers. Enhancing health education and promoting better understanding of toddler nutrition among mothers can contribute to reducing stunting rates. Health services and authorities should focus on disseminating information through various media to improve maternal knowledge and practices related to child nutrition.

Abstract Background Health service providers closely monitor the developmental state of toddlers to identify the factors affecting this process because any defect during this period will cause irreversible damage. Therefore, this study investigated the relationship of nutritional behaviors and parent–child interactions with the developmental domains of Iranian toddlers. Methods This cross-sectional, descriptive-analytical study was conducted on 341 toddlers aged 12–36 months covered by comprehensive health centers in the south of Tehran in 2021–2022. The participants were selected through single-stage cluster sampling. To this end, 16 comprehensive health centers were randomly selected, and then some of the clients from each center were randomly selected as the sample. The required data were collected through the Ages and Stages Questionnaire (ASQ), the Children’s Eating Behavior Questionnaire (CEBQ), the Child-Parent Relationship Scale (CPRS), and a demographics form. They were then analyzed statistically using descriptive and inferential statistics in SPSS-21, considering a significance level of p

Aspiration of foreign body is not an uncommon life threatening emergency in pediatric practice. Objects that are commonly aspirated include nuts, beans, toys, and in very rare instances jewelries among others. This is a 2 year old female toddler who presented in our facility on account of sudden onset of cough which became recurrent with associated difficulty with breathing of one month duration. Symptoms were first observed immediately after she was noticed to have aspirated a piece of her rigid earrings that was left on a table at home. She had chest x-ray that showed evidence of an opaque foreign body in the left main bronchus for which she had fluoroscopy-guided bronchoscopy with removal of a rigid metallic ear-ring. The patient was subsequently discharged on the second day post-operation. Ear-ring aspiration is uncommon in children, but when it occurs it could result in grave consequences. Parents and guardians should suspect possibility of such aspiration if there is a missing earring belonging to a child who has sudden onset of respiratory difficulty.

Rates of Blount disease and childhood obesity have increased in parallel, although the co-management of this acquired comorbidity and obesity is not well described. This report shares the course of a toddler with severe obesity who experienced rapid and persistent weight gain without success from nutrition and behavior changes. After repeat subspeciality evaluation, the patient was ultimately diagnosed with signs of early-onset Blount disease, urging the need for adjunct medical therapy. Initiation of topiramate was shown to achieve weight neutrality and improve the patient's body mass index (BMI), appearing to halt the progression of Blount disease and avoiding escalation to surgical treatment. This report suggests topiramate can be an effective and well-tolerated medication in young patients with a pressing need for weight intervention.

Abstract Background In recent years, smart devices have become an integral part of daily life. However, longitudinal studies, particularly those regarding the relationship between toddlers’ smart device usage and behavioral outcomes, are limited. Understanding the impact of parent–child interactions on this relationship is crucial for enhancing toddlers’ developmental outcomes. Accordingly, this study examined the influence of early screen time and media content exposure on toddlers’ behaviors, as well as the positive effects of mother–child interactions on this influence. Methods We used relevant data related to 277 children born between November 2016 and July 2020 and who were part of an ongoing prospective follow-up study conducted across five hospitals in Taipei City, Taiwan. We analyzed (1) data from maternal reports regarding children’s behavior by using the Child Behavior Checklist (for ages 11/2–5 years), (2) assessments of mother–child interactions by using the Brigance Parent–Child Interactions Scale, and (3) self-reported parental data covering the first 3 postpartum years. Statistical analyses involved group-based trajectory modeling and multiple linear regression. Results A considerable increase in screen time between the ages of 1 and 3 years was associated with less favorable behavioral outcomes at age 3. These outcomes included somatic complaints [adjusted beta coefficient (aβ) = 2.17, 95% confidence interval (CI) = 0.39–3.95, p-value = 0.01], withdrawal (aβ = 2.42, 95% CI = 0.15–4.69, p-value = 0.04), and aggressive behavior (aβ = 6.53, 95% CI = 0.25–12.81, p-value = 0.04). This association was particularly evident among children with lower levels of mother–child interaction. Nevertheless, positive mother–child interactions mitigated most of the adverse effects. Additionally, increased exposure to games and cartoons was associated with poorer behavioral outcomes in all children except for those experiencing positive mother–child interactions. Conclusion Early mother–child interactions play a crucial role in mitigating the risk of behavioral problems in toddlers who spend prolonged periods looking at screens and who are frequently exposed to game and cartoon content.

Abstract Background Limited data are available regarding the risk factors for fistula-in-ano (FIA) in infants and toddlers, potentially affecting their daily lives. Objectives The purpose of this study was to identify potential risk factors for FIA in infants and toddlers, in order to implement early preventive interventions, avoid disease progression, and develop therapeutic strategies. Design and settings A retrospective case-control study was conducted, comparing 41 infants and toddlers diagnosed with FIA with 41 healthy controls, between August 2020 and December 2021. Independent variables (a) maternal characteristics during pregnancy and delivery, (b) perinatal characteristics, dietary behaviors, and defecation-related behaviors in infants and toddlers, (c) family dietary behaviors. Results Mothers of infants and toddlers with FIA had given birth more times in the past, while the infants and toddlers themselves had less mealtime, a higher rate of exclusive breastfeeding, frequent loose stools, and a larger proportion of used wipes, experiencing perianal skin anomalies. The logistic regression analysis revealed that there are four significant risk factors associated with the development of FIA in infants and toddlers, including the number of previous deliveries by the mother (OR 6.327), defecation frequency score (OR 5.351), stool consistency score (OR 5.017), and cleaning with wipes after defecation (OR 8.089). Conclusion Based on our data, it appeared that FIA in infants and toddlers could be attributed to several factors. These included an increased number of previous deliveries by mothers, frequent loose stools, and repeated wipe use. To prevent the occurrence and worsening of the disease, it is important to improve the frequency and consistency of stooling and provide proper care. Further research is required to verify these findings in other clinical settings.

Objective: The aim of this study was to identify sleep problems in children aged 0-3 years and the factors influencing them. Methods: This descriptive correlational study was conducted online with 366 parents of children aged 0-3 years. Children’s sleep problems and influencing factors were assessed using a seven-question demographic form, and the Brief Infant Sleep Questionnaire was used to assess infant sleep. Results: Children aged 0-3 years had a late bedtime (21:30) and were awake more than twice a night. They slept an average of 2 hours during the day and 5 hours of uninterrupted sleep at night. Regardless of gender, they slept a total of 10 hours per night. Children who did not have a regular bedtime (54.2%) and had late sleep onset (51.5%) had more sleep problems. In total, 21.5% of the children were awake more than three times a night, 12.7% were awake for more than one hour at night, 8.8% had a total sleep time of less than 9 hours and 34.4% had sleep problems. Children with a total sleep time of less than 9 hours were more likely to have sleep problems. Conclusion: Children aged 0-6 months living in extended families and sleeping out of bed had more sleep problems. The results of the study shed light on factors such as the prevalence of sleep problems in children aged 0-3 years, sleep ecology and hygiene.

Background: In recent years, smart devices have become an integral part of daily life. However, longitudinal studies, particularly those regarding the relationship between toddlers' smart device usage and behavioral outcomes, are limited. Understanding the impact of parent–child interactions on this relationship is crucial for enhancing toddlers' developmental outcomes. Accordingly, this study examined the influence of early screen time and media content exposure on toddlers' behaviors, as well as the positive effects of mother–child interactions on this influence. Methods: We used relevant data related to 277 children born between November 2016 and July 2020 and who were part of an ongoing prospective follow-up study conducted across five hospitals in Taipei City, Taiwan. We analyzed (1) data from maternal reports regarding children's behavior by using the Child Behavior Checklist (for ages 11/2–5 years), (2) assessments of mother–child interactions by using the Brigance Parent–Child Interactions Scale, and (3) self-reported parental data covering the first 3 postpartum years. Statistical analyses involved group-based trajectory modeling and multiple linear regression. Results: A considerable increase in screen time between the ages of 1 and 3 years was associated with less favorable behavioral outcomes at age 3. These outcomes included somatic complaints [adjusted beta coefficient (aβ) = 2.17, 95% confidence interval (CI) = 0.39–3.95, p-value = 0.01], withdrawal (aβ = 2.42, 95% CI = 0.15–4.69, p-value = 0.04), and aggressive behavior (aβ = 6.53, 95% CI = 0.25–12.81, p-value = 0.04). This association was particularly evident among children with lower levels of mother–child interaction. Nevertheless, positive mother–child interactions mitigated most of the adverse effects. Additionally, increased exposure to games and cartoons was associated with poorer behavioral outcomes in all children except for those experiencing positive mother–child interactions. Conclusion: Early mother–child interactions play a crucial role in mitigating the risk of behavioral problems in toddlers who spend prolonged periods looking at screens and who are frequently exposed to game and cartoon content. [ABSTRACT FROM AUTHOR]

Grit is known to be effective for long-term academic and social success. However, few studies have focused on the role of grit in parenting and its effect on the development of grit in children. Therefore, this study investigated the effect of maternal grit on children's effortful control (EC), which is thought to be a precursor to grit, using parenting as a mediating factor. Participants in the current study were 412 children (age range: 18-21 months, M = 34.67 months, SD = 4.51 months) and their mothers. We assessed maternal grit, parenting style, maternal EC, and child EC, and found that maternal grit, maternal EC, and parenting style were positively correlated with child EC. Furthermore, maternal grit was related to EC in children not only directly, but also indirectly through responsive parenting. Additionally, maternal grit was found to be directly related to child EC only when assessed separately from maternal EC. The current study's findings suggest that maternal grit is directly related to EC in children in a way that differs from the mother's EC in child-rearing situations. [ABSTRACT FROM AUTHOR]

Background: Limited data are available regarding the risk factors for fistula-in-ano (FIA) in infants and toddlers, potentially affecting their daily lives. Objectives: The purpose of this study was to identify potential risk factors for FIA in infants and toddlers, in order to implement early preventive interventions, avoid disease progression, and develop therapeutic strategies. Design and settings: A retrospective case-control study was conducted, comparing 41 infants and toddlers diagnosed with FIA with 41 healthy controls, between August 2020 and December 2021. Independent variables: (a) maternal characteristics during pregnancy and delivery, (b) perinatal characteristics, dietary behaviors, and defecation-related behaviors in infants and toddlers, (c) family dietary behaviors. Results: Mothers of infants and toddlers with FIA had given birth more times in the past, while the infants and toddlers themselves had less mealtime, a higher rate of exclusive breastfeeding, frequent loose stools, and a larger proportion of used wipes, experiencing perianal skin anomalies. The logistic regression analysis revealed that there are four significant risk factors associated with the development of FIA in infants and toddlers, including the number of previous deliveries by the mother (OR 6.327), defecation frequency score (OR 5.351), stool consistency score (OR 5.017), and cleaning with wipes after defecation (OR 8.089). Conclusion: Based on our data, it appeared that FIA in infants and toddlers could be attributed to several factors. These included an increased number of previous deliveries by mothers, frequent loose stools, and repeated wipe use. To prevent the occurrence and worsening of the disease, it is important to improve the frequency and consistency of stooling and provide proper care. Further research is required to verify these findings in other clinical settings. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify sleep problems in children aged 0-3 years and the factors influencing them. Methods: This descriptive correlational study was conducted online with 366 parents of children aged 0-3 years. Children's sleep problems and influencing factors were assessed using a seven-question demographic form, and the Brief Infant Sleep Questionnaire was used to assess infant sleep. Results: Children aged 0-3 years had a late bedtime (21:30) and were awake more than twice a night. They slept an average of 2 hours during the day and 5 hours of uninterrupted sleep at night. Regardless of gender, they slept a total of 10 hours per night. Children who did not have a regular bedtime (54.2%) and had late sleep onset (51.5%) had more sleep problems. In total, 21.5% of the children were awake more than three times a night, 12.7% were awake for more than one hour at night, 8.8% had a total sleep time of less than 9 hours and 34.4% had sleep problems. Children with a total sleep time of less than 9 hours were more likely to have sleep problems. Conclusion: Children aged 0-6 months living in extended families and sleeping out of bed had more sleep problems. The results of the study shed light on factors such as the prevalence of sleep problems in children aged 0-3 years, sleep ecology and hygiene. [ABSTRACT FROM AUTHOR]

PURPOSE: Understanding parental experiences with managing their toddlers screen use is important to inform the design of interventions addressing early childhood screen use, yet current evidence is limited. To enhance our understanding of the context of toddler screen use, this study characterizes the screen-related discord and dismay parents experience in families with toddlers. DESIGN AND METHODS: In-depth interviews were conducted to explore everyday experiences with screen use among low-income Mexican American caregivers of toddlers (21 mothers, 10 fathers, 1 grandmother). Transcripts were content analyzed to identify prominent themes. RESULTS: Three themes were identified. Experiences of screen-related discord and dismay arose (1) between parent and child, (2) between parents, and (3) surfaced as parental internal dissonance about toddler screen use. Parent-child discord resulted from parental limit setting and child reactions to parental screen use, which often included tantrums. Parent-partner discord included patterns of agreeing to disagree and direct disagreement between partners. Parents also reported their own feelings of ambivalence and dismay as they struggled to reconcile their preferences against their toddlers actual screen use, while living in a screen-saturated world. CONCLUSIONS: Findings offer insight into types of screen-related discord and dismay low-income Mexican American parents experience as they attempt to manage their toddlers screen use. PRACTICE IMPLICATIONS: Although discord in families is normal, the screen-specific discord reported by participants warrants consideration in efforts promoting healthy screen use in families. Providers can tailor their counseling to consider the range of screen-related discord families of toddlers may experience.

Background: fulfillment of the basic physical biomedical needs of children under five affects their growth and development. Most poor families pay little attention to the basic needs of their children due to lack of knowledge and the economy. To overcome this, the Ministry of Social Affairs of the Republic of Indonesia has issued social security to reduce the number of poverty and social welfare cases called the Family Hope Program (PKH). Within the health sector, KPM (Beneficiary Families) are required to ensure the provision of fundamental healthcare services for children under the age of five. These services include monthly regular vaccines, biannual administration of Vitamin A, and monthly monitoring of the children's weight.Objectives: this study aims to analyze the impact of conditional cash transfer programs on the fulfillment of basic physical-biomedical needs. Methods: we conducted a quantitative study using a cross sectional design. Our research sample was 83 of 289 children under five years in Patempuran-Kalisat-Jember taken using simple random sampling technique. Results: the results showed that there were no differences in the completeness of immunization (Sig = 0.501), exclusive breastfeeding (Sig = 0.378), routine weighing (Sig = 0.445) and utilization of health services (Sig = 0.845) between conditional cash transfer program recipients and non recipients. Conclusions: This program is considered effective because the majority of children under five have received complete basic immunization and routinely have their weight weighed at the posyandu, but children under the age of five are not given exclusive breast milk. The social service and primary health care need to increase collaboration to provide education about the importance of exclusive breastfeeding.

Background: Diarrhea is one of the leading causes of child morbidity and mortality in low and middle-income countries. 23.8% prevalence of diarrhea was found among children under five years of age. Area-based management is required to address and provide specific interventions. Purpose: The study aims to analyze the effect of unsafe toddler feces management and incomplete primary immunization on the incidence of diarrhea using a spatial analysis in East Java, Indonesia. Methods: The data used is the 2018 Basic Health Research data. The measurement of the relationship between region and diarrhea was carried out by studying Moran's I index. Lisa Cluster Map and the Lisa Significance Map were also studied to understand distribution and significance. The regression used is OLS regression, spatial lag, and spatial error. The best model is assessed by comparing various parameters. Data were analyzed using GeoDA. Results: Moran's I result shows an index value of 0.489 with a pseudo-value of 0.001 (p

Objective: To estimate the proportion of healthy under-fives whose physical activity, sedentary behavior, sleep and screen time adhered to WHO 2019 recommendations and to identify risk factors for non-adherence. Methods: A cross-sectional study was conducted among 480 healthy children (6 mo - 4 years) who attended 20 selected urban anganwadis or immunization clinics in South Kerala, India. Sociodemographic, anthropometric and outcome variables (duration of physical activity, sedentary behavior, sleep and screen time) were collected for all participants. Results: Physical activity, sedentary behavior, sleep and screen time recommendations were adhered by 63.3%, 22.7%, 82.2% and 22.7% under-five children, respectively. Risk factors for inadequate physical activity were female sex, nuclear family, maternal education below college level, unskilled maternal occupation/housewife, unskilled paternal occupation and low monthly income. Risk factors for non-adherence to recommended sedentary behavior duration included joint family, paternal education college level/above, unskilled maternal occupation/housewife, unskilled paternal occupation and low monthly income. Conclusion: Under-fives should reduce sedentary behaviors and screen time and spend more time on physical activities. [ABSTRACT FROM AUTHOR]

Background: Diarrhea is one of the leading causes of child morbidity and mortality in low and middle-income countries. 23.8% prevalence of diarrhea was found among children under five years of age. Area-based management is required to address and provide specific interventions. Purpose: The study aims to analyze the effect of unsafe toddler feces management and incomplete primary immunization on the incidence of diarrhea using a spatial analysis in East Java, Indonesia. Methods: The data used is the 2018 Basic Health Research data. The measurement of the relationship between region and diarrhea was carried out by studying Moran's I index. Lisa Cluster Map and the Lisa Significance Map were also studied to understand distribution and significance. The regression used is OLS regression, spatial lag, and spatial error. The best model is assessed by comparing various parameters. Data were analyzed using GeoDA. Results: Moran's I result shows an index value of 0.489 with a pseudo-value of 0.001 (p <0.05) and a z-value of 3.7515. Lisa Cluster Map shows seven high-high category areas, five low-low category areas, and one high-low category area. Lisa's Significance Map shows six areas p=0.05, three areas p=0.01, and four areas p=0.001. The unsafe management of toddler feces and incomplete primary immunization related to diarrhea shows a significance of p<0.05. By comparing the R square, log-likelihood, p(sign), and sigma square values, the better model is the spatial lag model. Conclusion: The unsafe toddler feces management and incomplete primary immunization related to diarrhea. [ABSTRACT FROM AUTHOR]

Indonesia, the country in Asia with the highest stunting rate (ranked fifth), has a program to accelerate reducing the number of cases with Banyuwangi Regency being one of the pilot projects for the Healthy Children's Movement to Prevent Stunting Toddlers and accelerating stunting prevention issued by the Regent of Banyuwangi in April 2022. On the other hand, Bangorejo District, which is close to the south coast in Banyuwangi, means that this area has a lot of marine products in the form of fish and has cheap prices. The problem is, the community, especially mothers, most of whom are housewives, do not yet have the skills to increase the use value of these marine products. This program aims to improve skills in extending the shelf life of products made from lemuru fish and increase the use value of these products. The methods used are counseling and direct practice through training. The target partners are 27 mothers/women in Padukuhan Kedungrejo, Sambirejo, and Pasembon, Bangorejo District, Banyuwangi Regency. Training activities were held on 23 and 31 August 2023. The results of this activity were that participants had knowledge of making processed fish food which increased by 29.6%, and skills in making processed fish food which increased by 33.3%. The conclusion is that people's knowledge and skills in making processed lemuru fish have increased. The target community is able to make dragon legs and nuggets from lemuru fish.

Vitamin A plays a crucial role as a micronutrient, particularly in relation to vision and growth. However, excessive intake of Vitamin A can lead to impaired vision and growth in toddlers. This study aimed to examine the impact of the frequency and amount of Vitamin A from food sources, as well as the intake of Vitamin A supplements, on the sufficiency status of Vitamin A in toddlers aged 12-59 months. The research design employed a quantitative approach using an analytical cross-sectional survey with a sample of mothers and toddlers aged 12-59 months, totaling 100 respondents. The relationship between the independent variables and the dependent variable was analyzed using the Chi-Square (α=0.05) statistical test with a 95% confidence interval. Quantitative results indicated a Vitamin A sufficiency status (71%), frequency of intake (56%), amount of intake (64%), and intake of Vitamin A supplements (60%) in the 'more' category. The results of the chi-square test showed the effect of Vitamin A food source intake on Vitamin A sufficiency status with a p-value of 0.002. Optimizing Vitamin A sufficiency among toddlers aged 12-59 months requires a multifaceted approach, focusing on frequency, amount, and appropriate food sources.

الملخص: أهداف البحث: التهاب الجلد الناتج عن الحفاظ هو أحد أكثر الأمراض الجلدية شيوعا لدى الأطفال. الأدوية شائعة الاستخدام للعلاج لها العديد من الآثار الجانبية، مما يفرض الحاجة إلى تقييم استراتيجيات علاجية آمنة. لذلك، فإننا نهدف إلى مقارنة فعالية زيت الأرغان سبينوزا ومرهم الهيدروكورتيزون 1٪ على شفاء التهاب الجلد الحفاظي. طريقة البحث: أجريت دراسة شبه تجريبية في الأردن على أطفال تتراوح أعمارهم بين عامين أو أقل يعانون من التهاب الجلد الحفاظي الخفيف إلى الشديد. في البداية، تم تسجيل 73 مشاركا في مجموعة زيت الأرغان سبينوزا و 74 مشاركا في مجموعة مرهم الهيدروكورتيزون 1 ٪. تم تعيينهم بشكل عشوائي، بعد إجراء القياس الأساسي لالتهاب الجلد الحفاظي. تم قياس الشفاء في الأيام 1و3 و 7 من خلال الزيارات المنزلية، باستخدام مقياس تصنيف مكون من 5 نقاط. تم تحليل البيانات باستخدام نماذج فيشر، مان ويتني يو، ومعادلات التقدير المعممة من خلال برنامج اس بي اس اس الإصدار 25. النتائج: من بين 147 طفلا تم تسجيلهم، أكمل 140 منهم الدراسة. لوحظ انخفاض في درجات التهاب الجلد الحفاظي في كلا المجموعتين. بعد استبعاد العوامل المربكة، كشفت نماذج معادلات التقدير المعممة أن الأطفال الذين استخدموا علاج زيت الأرغان سبينوزا كانوا أقل عرضة بنسبة 25 مرة للإصابة بدرجات التهاب الجلد الحفاظي الحاد وتحسنوا بشكل أسرع من الأطفال الذين استخدموا الهيدروكورتيزون 1٪. كشف الانحدار اللوجستي المتعدد على بيانات خط الأساس أن استخدام كريم الحاجز وتكرار الاستحمام مرة واحدة في الأسبوع كانت تنبؤية بحدوث التهاب الجلد الحفاظي. الاستنتاجات: يعتبر زيت الأرغان سبينوزا أكثر فعالية في علاج التهاب الجلد الحفاظي ويمكن استخدامه كخيار تكميلي. ومع ذلك، ستكون التجارب السريرية الإضافية على عينات أكبر ضرورية لتأكيد النتيجة وإصدار حكم موثوق. Abstract: Objectives: Diaper dermatitis (DD) is one of the most common dermatological disorders in children. Commonly used drugs for treatment have several adverse effects; therefore, assessment of safe therapeutic strategies is necessary. We, therefore, aimed at comparing the efficacy of argan spinosa oil and 1% hydrocortisone ointment on DD healing. Methods: A quasi-experimental study was conducted in Jordan on children 2 years old or younger with mild to severe DD. Initially, 73 participants were enrolled in the argan spinosa oil group, and 74 participants were enrolled in the 1% hydrocortisone ointment group. Participants were assigned to groups randomly after the baseline measurement of DD. Healing was measured on a 5-point scale on days 1, 3, and 7, through home visits. Data were analyzed with Fisher's exact test, the Mann–Whitney U test, and generalized estimating equation (GEE) models in SPSS version 25 software, with a significance level of p

Health cadres are an extension of the health workers at the Community Health Center who take part in the monitoring program for the growth and development of toddlers. Cadre development is an important means of improving cadre skills in monitoring the growth and development of toddlers. This activity aims to increase the capacity of cadres in optimally monitoring the growth and development of toddlers. The respondents in this activity were 60 posyandu cadres. The training provided includes measuring height or body length, body weight, LiLA of toddlers, and detecting toddler development using KPSP. Respondents were given a pre-post test to measure the increase in cadres' ability to monitor the growth and development of toddlers. As many as 86.7% of posyandu cadres were able to monitor the growth of toddlers correctly after attending the training. As many as 45% of posyandu cadres were able to properly monitor the development of toddlers using KPSP after attending training. Training related to monitoring the growth and development of toddlers needs to be provided periodically so that cadres' abilities continue to increase.

Abstract Background There is a lack of large, nationwide, birth cohort studies in Japan that examine the relationships of initial feeding habits and breastfeeding period duration with offspring functional constipation at 3 years of age. This study assessed the impact of breastfeeding during infancy on early childhood functional constipation. Methods The fixed data of 70,078 singleton births from the ongoing Japan Environment and Children’s Study cohort study that commenced in 2011 were used to identify functional constipation as estimated by Rome III at 3 years of age. The exposure variables were breastfeeding period duration until 12 months of age (never, up to 6 months, or ≥ 7 months) as well as breastfeeding status at 1 month and 6 months of age (breastfeeding exclusively, partial breastfeeding, or infant formula feeding only). Multiple logistic regression analysis was employed to search for correlations for functional constipation development with breastfeeding period duration until 12 months of age and breastfeeding status during infancy. Results We identified 8,118 toddlers (11.6%) who met the Rome III criteria at 3 years of age. After controlling for potential covariates, a breastfeeding period duration of 7 months or more was inversely related to functional constipation development (≥ 7 months: adjusted odds ratio [OR] [95% confidence interval (CI)] 0.76 [0.65, 0.88] versus never breastfed, P for trend

Andrew Campbell,1 Avery A Rizio,2 Kristen L McCausland,2 Serban Iorga,3 Glorian P Yen,3 Jincy Paulose,3 Soyon Lee3 1Children’s National Hospital, Washington, DC, USA; 2QualityMetric Incorporated LLC, Johnston, RI, USA; 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USACorrespondence: Avery A Rizio, QualityMetric Incorporated, LLC, 1301 Atwood Avenue, Suite 216E, Johnston, RI, 02919, USA, Tel +1 401-903-4631, Email arizio@qualitymetric.comBackground: Children with sickle cell disease (SCD) experience a multiplex of disease-related symptoms and complications, including vaso-occlusive crises (VOCs), episodes characterized by extreme pain.Methods: A cross-sectional observational survey examined the health-related quality of life (HRQoL) and school experiences of children with SCD 2 months– 11 years, burden experienced by their caregivers, and associations between these outcomes and VOC frequency. Caregivers (N=167) of children with SCD in the US completed the Infant-Toddler Quality of Life-Short Form 47 (ITQoL-SF47) for children 2 months– 4 years, the Child Health Questionnaire–Parent Form 50 (CHQ-PF50) and PROMIS Pain Interference and Sleep Disturbance Parent Proxy short forms for children 5– 11 years, and a study-specific survey of school experiences.Results: Children with SCD 2 months– 4 years had lower ITQoL-SF47 scores (ie, worse HRQoL, p< 0.001) than a normative sample of children; across domains, differences ranged from 18.73– 45.03 points and exceeded minimal important difference (MID) thresholds. Except for the behavior domain, children with SCD 5– 11 years had lower scores on all CHQ-PF50 domains than the normative sample (p< 0.001); differences ranged from 6.78– 36.37 points and exceeded MID thresholds. Children with more frequent VOCs had lower HRQoL and worse school experiences than children with less frequent VOCs (p< 0.05, except for behavior domains). The largest differences based on VOC frequency were observed for overall health and bodily pain/discomfort among children 2 months– 4 years (differences=40.88 and 32.50 points, respectively), and bodily pain and role/social limitations due to physical health among children 5– 11 years (differences=38.99 and 37.80, respectively). Caregivers of children with more frequent VOCs experienced greater burden than caregivers of children with less frequent VOCs, though specific areas of impact (eg, caregiver emotions, time) differed across child age groups.Conclusion: VOC frequency is negatively associated with HRQoL, highlighting the burden experienced by children with SCD and their caregivers.Keywords: pediatric, child, toddler, well-being, pain crisis, vaso-occlusion

Objectives: The EQ-TIPS was developed to measure the Health-Related Quality of Life in infants/toddlers. Considering the rapid development in this period, this study aimed to investigate age-related variations in EQ-TIPS performance. Methods: Data from 551 infants/toddlers living with a health condition were analysed. Infants/toddlers were grouped by age: 0–6 months (n = 100), 6–12 months (n = 95), 12–24 months (n = 147), and 36–48 months (n = 97). Differences in item responses and item correlations across age groups were calculated by Kruskal–Wallis and Spearman’s correlations, respectively. Results: The report of problems was significantly higher for movement, play, and communication in the 36–48-month group compared to the 0–6-month group. There were strong correlations (r > 0.50) across all age groups between play and movement and communication and social interaction/play; neither pain nor eating showed a clear pattern of association. Conclusions: There is an age-related difference in the reporting of items linked to developmental milestones (movement, play, and communication) with most problems reported in the 36–48-month group when deviation from peers and continued dependence on caregivers is notable. Consideration should be given to including broader examples of play in the EQ-TIPS. Redefining the items to represent social communication and/or (social) emotion, rather than communication and social interaction, may be warranted. Future research should explore the psychometric performance of items to further inform item inclusion and/or revision.

Background: The prevalence of stunting in East Java Province in 2022 reached 19.2%, showing a decrease compared to 2021, which recorded a prevalence rate of 23.5%. Despite the declining trend in stunting prevalence in East Java, the province has not yet achieved the Renstra target, which stipulates that the prevalence of stunting should decrease to 18.4% by 2022. Objectives: This study aims to investigate further the causes of stunting incidents in East Java Province. Methods: The method employed in this research is a literature review, where data sources are obtained using the Google Scholar electronic database. The research search process follows the PICOS protocol, formulating keywords using Boolean Operator techniques. The keywords used are "factors" AND "causes" OR "relationships" OR "risks" AND "stunting" AND "infants" OR "toddlers" OR "children." The selection of studies to be included in the review is adjusted to inclusion criteria: studies published in the last ten years (2013-2023), written in Indonesian and English, full-text, published, and open access. Exclusion criteria include age range, non-observational research, and studies that do not discuss the causes of stunting. Results: A total of 13 studies were used in compiling this review. The location characteristics of the studies were found in 10 Districts/Cities in the East Java Province. Over the past ten years, various factors have been recognized as causes of stunting based on the identified research publications. These factors include parenting styles, Clean and Healthy Living Behavior (PHBS), economic status, educational history of birth, history of infectious diseases, and maternal pregnancy history. Conclusions: The primary research focus on stunting incidents in toddlers in East Java Province is the parenting style provided by mothers. The level of maternal knowledge regarding Exclusive Breastfeeding (ASI), provision of Complementary Feeding (MPASI), and the intake of foods consumed by toddlers has a significant correlation with the occurrence of stunting and the developmental progress of children. [ABSTRACT FROM AUTHOR]

Background: A double burden of malnutrition can occur at individual, household, or community levels. Objectives: This study analyzed the relationship between responsive feeding practices and Stunted Children and Obese/Overweight Mothers (SCOM) as a type of doubleburden malnutrition at the household level. Methods: An observational analytical study with a case-control design was conducted in Semarang City between May and October 2022. The subjects of this study were mother-toddler pairs (children < 3 years old) with SCOM and non-SCOM conditions in Semarang. Inclusion criteria were as follows: mothers and toddlers in good health (mothers do not have diseases that require special diets, and toddlers are in good health at the time of the study) and the mother did not smoke or drink alcohol. Ratio SCOM: non-SCOM groups was 1:2. Maternal nutritional status was measured using the Body Mass Index (BMI). Stunting classification (PB/U or TB/U) used the WHO Anthro software version 1.03. Data analysis was performed using chi-square, Pearson correlation, and multiple logistic regression. Results: Poor responsive feeding practices occurred in 95.8% of the SCOM families. There was a correlation between the parents' educational level and the practice of responsive feeding. There was a correlation between responsive feeding attitudes and practices and SCOM. After controlling for sociodemographic characteristics, responsive feeding practice predicted SCOM with an Odd Ratio (OR) of 0.012 (0.001-0.191). Responsive feeding practices were correlated with the prevalence of SCOM. Conclusions: Most families with SCOM practice responsive feeding in poor categories. Responsive feeding practices were a predictor of SCOM. [ABSTRACT FROM AUTHOR]

Background: Cadre Management is an implementation of the 3rd pillar of handling stunting. The role of good cadres influence the toddlers nutritional status because they become motivators and educators. Through Strength, Weakness, Opportunity, Threat (SWOT) analysis, cadre is an appropriate strategy to reduce stunting. Objectives: To explore the role of cadres through Lawrence Green Theory in the stunting reduction program in the Wori Community Health Center. Methods: Qualitative research with a case study approach in the Wori Community Health Center working area. Total informants were 15 and they were selected by using purposive sampling. Data collection techniques used in-depth interviews, Focus Group Discussion (FGD) and observation. The research instrument used interview guides, camera and voice recorders. Data processing used open code. Results: The predisposing factors are cadre's motivation and skills to reduce stunting rates. The supporting factors are community health centers and village supports. The obstacles are mothers with stunted toddlers received information difficulty and absence in Posyandu, but this problem can be overcome by cadres' communication skills. Conclusions: The role of cadres is important and strategic to reduce stunting. The internal and external factors support keep cadres enthusiastic in carrying out their duties. The importance of regular training and refreshing can improve their knowledge. [ABSTRACT FROM AUTHOR]

Aim To organize a cross-cultural adaptation study and analyze the reproducibility and test-retest reliability of a Brazilian version of the Toddler Sensory Profile 2 (TSP2Br) for children aged 7-35 months. Methods The English language version of the profile was translated and culturally adapted into Brazilian Portuguese, administered to 168 caregivers of toddlers aged 7-35 months, and then re-administered to a portion of the sample (39 caregivers; 23%) for 7-14 days for test-retest reliability. The internal consistency and test-retest reliability was analyzed using the Cronbach's alpha and kappa coefficient, respectively. As it is a norm-referenced standardized assessment, the cut-off scores used were 1.0 and 2.0 standard deviations above and below the mean for each group of items established as the preliminary cut-off scores for the Brazilian children. Results The TSP2Br showed good internal consistency (>0.70) when measured on the total scale; however, when it was analyzed for sensory areas, five to seven areas presented alpha values <.70. By quadrants, alpha was <.70, for all items. The test-retest values fell into the category of near-perfect agreement (.89-.97). The preliminary cut-off points of the Brazilian scores were distinct from those of the Americans. Conclusions The TSP2Br showed preliminary reliability and validity in the identification of sensory processing problems in Brazilian children aged 7--35 months; however, it would be necessary to increase the sample size to generalize our findings to the general Brazilian population. [ABSTRACT FROM AUTHOR]

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Background: There is a lack of large, nationwide, birth cohort studies in Japan that examine the relationships of initial feeding habits and breastfeeding period duration with offspring functional constipation at 3 years of age. This study assessed the impact of breastfeeding during infancy on early childhood functional constipation. Methods: The fixed data of 70,078 singleton births from the ongoing Japan Environment and Children's Study cohort study that commenced in 2011 were used to identify functional constipation as estimated by Rome III at 3 years of age. The exposure variables were breastfeeding period duration until 12 months of age (never, up to 6 months, or ≥ 7 months) as well as breastfeeding status at 1 month and 6 months of age (breastfeeding exclusively, partial breastfeeding, or infant formula feeding only). Multiple logistic regression analysis was employed to search for correlations for functional constipation development with breastfeeding period duration until 12 months of age and breastfeeding status during infancy. Results: We identified 8,118 toddlers (11.6%) who met the Rome III criteria at 3 years of age. After controlling for potential covariates, a breastfeeding period duration of 7 months or more was inversely related to functional constipation development (≥ 7 months: adjusted odds ratio [OR] [95% confidence interval (CI)] 0.76 [0.65, 0.88] versus never breastfed, P for trend < 0.001). Other initial feeding methods were significantly related to an increased risk of functional constipation as compared with breastfeeding exclusively at 1 month of age (partial breastfeeding: adjusted OR [95% CI] 1.17 [1.11, 1.23], formula feeding only: 1.23 [1.07, 1.40]) and 6 months of age (partial breastfeeding: adjusted OR [95% CI] 1.18 [1.12, 1.24], formula feeding only: adjusted OR [95% CI] 1.42 [1.20, 1.68]). Conclusion: This large nationwide survey revealed a possible protective effect of a prolonged breastfeeding period duration and early exclusive breastfeeding in infancy on functional constipation at 3 years. [ABSTRACT FROM AUTHOR]

Objectives: In light of the youth mental health crisis, as 1 in 5 children have a mental disorder diagnosis by age 3, identification of transdiagnostic behavioral vulnerability prior to impairing psychopathology must occur at an earlier phase of the clinical sequence. Here, we lay the groundwork for a pragmatic irritability measure to identify at‐risk infant‐toddlers. Methods: Data comprised N = 350 diverse infant‐toddlers and their mothers assessed at ∼14 months old for irritability (Multidimensional Assessment Profiles‐ Temper Loss‐Infant/Toddler (MAPS‐TL‐IT) and impairment (Early Childhood Irritability‐Related Impairment Interview, E‐CRI; and Family Life Impairment Scale (FLIS). Bimonthly follow‐up surveys assessed impairment (FLIS) over the following year. Results: Stepwise logistic regression indicated that 5 MAPS‐TL‐IT items were most informative for differentiating concurrent impairment on the FLIS: "frustrated about small things"; "hit, bite, or kick during tantrums"; "trouble cheering up when grumpy"; "grumpy during fun activities" and "tantrums in public". With this summed score, Receiver Operating Characteristics analysis differentiating concurrent impairment on the E‐CRI indicated good classification accuracy for (Area under the curve = 0.755, p < 0.05), with a cutoff of 5 maximizing sensitivity (71.4%) and specificity (70.6%). Elevated irritability on this MAPS‐TL‐IT clinically optimized screener increased likelihood of persistently elevated FLIS impairment trajectories over the following year more than fourfold (OR = 4.37; Confidence intervals = 2.40–7.97, p < 0.001). Conclusions: Our findings represent the first step toward a pragmatic tool for screening for transdiagnostic mental health risk in toddlers, optimized for feasibility in clinical care. This has potential to strengthen resilience pathways via earlier identification of mental health risk and corollary prevention in toddlers. [ABSTRACT FROM AUTHOR]

Health cadres are an extension of the health workers at the Community Health Center who take part in the monitoring program for the growth and development of toddlers. Cadre development is an important means of improving cadre skills in monitoring the growth and development of toddlers. This activity aims to increase the capacity of cadres in optimally monitoring the growth and development of toddlers. The respondents in this activity were 60 posyandu cadres. The training provided includes measuring height or body length, body weight, LiLA of toddlers, and detecting toddler development using KPSP. Respondents were given a pre-post test to measure the increase in cadres' ability to monitor the growth and development of toddlers. As many as 86.7% of posyandu cadres were able to monitor the growth of toddlers correctly after attending the training. As many as 45% of posyandu cadres were able to properly monitor the development of toddlers using KPSP after attending training. Training related to monitoring the growth and development of toddlers needs to be provided periodically so that cadres' abilities continue to increase. [ABSTRACT FROM AUTHOR]

Background and Objectives: Early childhood caries (ECC) is a multifactorial, biofilm-mediated, sugar-related, dynamic disease of primary dental hard tissues occurring in varying degrees of severity in infants and toddlers. Untreated ECC may lead to pain, infections, and severe systemic complications. The aim of this study was to systematically review and evaluate the scientific evidence on the cost-effectiveness of treatment decisions in ECC in infants and toddlers. Materials and Methods: Observational epidemiological studies, i.e., cohort studies, case–control studies, and randomized controlled trials, reporting cost-effectiveness of treatment decisions in ECC in infants and toddlers were included in the systematic review following the PRISMA guidelines. Using an ad hoc search with search terms or keywords (MeSH), electronic databases Embase, MEDLINE via PubMed, Scopus, and gray literature were searched. Results: The search identified 494 articles, of which 446 remained after removing duplicates. A total of 417 articles were excluded after title and abstract evaluation; 29 full-text articles were screened for eligibility, and five articles were discarded. Twenty-four full-text articles were included in the systematic review, assigning 17 to prevention and seven to restoration. Results were heterogeneous; comparability of included studies is difficult because of the different methodologies used. Conflicting efficacies were demonstrated for different interventions implemented, and cost-effectiveness data were documented. Conclusions: Socioeconomic, cultural, and ethnic differences must be considered when comparing conditions in terms of cost-effectiveness. A paradigm shift from surgical towards preventive treatment decisions can be observed. Cost-effectiveness studies on therapies for ECC in infants and toddlers are needed to identify the best practice approach and the most cost-effective therapy decisions. [ABSTRACT FROM AUTHOR]

BackgroundInitial choices of antimicrobial therapy for most cases of community-acquired pneumonia (CAP) in children under 5 years of age are typically based on local epidemiology, risk factors assessment, and subsequent clinical parameters and positive cultures, which can lead to the underdiagnosis and underestimation of lung infections caused by uncommon pathogens. Contezolid, an orally administered oxazolidinone antibiotic, gained approval from the National Medical Products Administration (NMPA) of China in June 2021 for managing complicated skin and soft tissue infections (cSSTI) caused by staphylococcus aureus (SA), streptococcus pyogenes, or streptococcus agalactis. Owing to its enhanced safety profile and ongoing clinical progress, the scope of contezolid's clinical application continues to expand, benefiting a growing number of patients with Gram-positive bacterial infections.Case summaryIn this report, we present the first use of contezolid in a toddler with severe CAP caused by SA, aiming to avoid potential adverse drug reactions (ADRs) associated with vancomycin and linezolid.ConclusionAlthough contezolid has not been officially indicated for CAP, it has been shown to be effective and safe in the management of SA-induced severe CAP in this toddler, suggesting its potential as an alternative option in the dilemma, especially for patients who are susceptible or intolerant to ADRs associated with first-line anti-methicillin-resistant staphylococcus aureus (MRSA) antimicrobial agents.

Hemophagocytic lymphohistiocytosis (HLH) is a rare, potentially life-threatening clinical syndrome characterized by hyperactivation of inflammatory mediators and harmful end-organ damage. Visceral leishmaniasis (VL)-induced HLH is a rare disease with significant diagnostic and management implications. Herein, we present a case of secondary HLH as a complication of visceral leishmaniasis in a two-year-old toddler. A 2-year-old male toddler was admitted for evaluation of a prolonged 4-week fever. Accompanying the fever, he developed progressive abdominal swelling, intermittent bilateral nasal bleeding, and repeated chest-focus infections of similar duration. The patient was acutely sick, with chronic signs of malnutrition (mid-upper arm circumference of 10.5 cm), fever (39 °C), tachypnea (70 breaths/min), tachycardia (132 beats/min), pallor, and hepatosplenomegaly. Initial investigation revealed leukopenia (2240/μl), anemia (7.3 g/dl), and severe thrombocytopenia (26,000/μl). With consideration of febrile neutropenia, the patient was started on cefepime with further revision to vancomycin and meropenem based on the culture result. After 10 days of persistent fever and poor clinical condition, an immunochromatographic rapid test with the rK39 antigen was conducted, and the patient was found to be positive for Leishmania spp. Intravenous liposomal amphotericin B (AmBisome) was initiated. On the 6th day of treatment, the patient’s clinical and laboratory profiles severely deteriorated, and further laboratory investigation showed elevated triglyceride (524 mg/dl) and ferritin levels (1500 ng/mL). VL-induced secondary HLH was confirmed, and intravenous dexamethasone was initiated. Subsequently, his clinical and laboratory findings significantly improved, and he was discharged with PO dexamethasone. Our case highlights the intricate nature of VL-induced HLH and the need for high index of suspicion and timely management.

The toddler period is a golden period or golden age. At the age of 0-5 years, the growth and development of the toddler's brain increases rapidly. Growth is related to changes in size, quantity, or size that can be measured in units of weight (grams, kilograms) and units of length (centimeters, meters). What affects toddlers' growth can come from the family and the environment. This research aims to analyze to analyze the relationship between family profiles and characteristics with the growth of toddlers 36-59 months in Palembang City. A cross sectional method was conducted on 148 respondents from mothers of toddlers aged 36-59 months in Palembang City, and the sample collection method used cluster sampling. The results showed there are six factors that affect the growth of children under five: The father's smoking status, milk formula, breakfast habits, the child's gender, the mother's occupation, and the influence of the mother's knowledge. The most dominant factor affecting children's growth is the habit of breakfast with Prevalence Risk 5.833, which means that toddlers who have no habit have a growth risk of 5.833 times to experience abnormality compared to toddlers who have breakfast habits after controlling for variables such as father smoking status, milk formula, child gender, mother’s occupation, and mother's knowledge.

BackgroundAlthough poor dietary habits have a great effect on the health status of children, especially in toddlers, a few questionnaires exist for the assessment of dietary imbalances. This study aims to assess the validity and reliability of the NutriCHEQ in Iranian healthy toddlers.MethodsIn this cross-sectional study, first, the NutriCHEQ was translated to Persian and culturally adapted by the forward-backward translation technique. In order to assess the face validity, we used a cognitive interviewing technique of 25 parents/caretakers of healthy toddlers. In the next step, experts assessed content validity, respectively. One item was removed during the content validity process. Then, a blueprint of NutriCHEQ was distributed among 156 parents/caretakers of healthy toddlers in different focal points in Tehran for assessing construct validity by nonlinear principal components analysis. In addition, the anthropometric indices checklist and Food Frequency Questionnaire (FFQ) were filled out for toddlers. Then, construct validity was assessed. The Varimax rotation ran for two sections separately. The four-factor structure was confirmed.ResultsThe model showed a good fit, and all the extracted variance of four factors were satisfactory (F1 = 20.77; F2 = 22.30; F3 = 14.75; and F4 = 13.71). All of the extracted items of the NutriCHEQ in two parts showed 71.53% cumulative variance. For criterion-related validity, there was a statistically significant positive correlation between the NutriCHEQ and Z-score (rho = 0.632, P < 0.001). The Bland-Altman result indicates 95% limits of agreement between the NutriCHEQ questionnaire and Z-score.ConclusionsTherefore, we concluded that NutriCHEQ is a valid, reliable, and convenient instrument to identify the Iranian toddlers' nutritional status. Therefore, it can be used for research and clinical settings.

Stunting is a condition of growth failure in children under five years old (toddlers) due to chronic malnutrition and recurrent infections, especially in the first 1,000 days of life. One of the indirect causes is the availability of clean water and poor sanitation. Lampihong Community Health Center Balangan Regency is one of the areas with the highest stunting cases in South Kalimantan. This study aims to analyze the relationship between home sanitation and clean water facilities with the incidence of stunting in the Lampihong Community Health Center, Balangan Regency. The research method is analytic observational with a case control approach. The research sample consisted of 30 mothers of stunted toddlers as the case group and 30 mothers of non-stunted toddlers as the control group. Data analysis used the chi square test at a 95% confidence level. The research results showed that the majority of stunted toddlers lived in houses with unhealthy water closet, wastewater disposal and waste management that did not meet the requirements. Most of the stunted and non-stunted toddlers use clean water that meets the requirements. The results show that there is a significant relationship between home sanitation that does not meet the requirements and the incidence of stunting in toddlers, but there is no significant relationship between clean water facilities and the incidence of stunting in toddlers in the Lampihong Health Center, Balangan Regency.

The general objective of this study was to identify and analyze the factors that influence wasting in toddlers at the Health Center. The research design used in this study was quantitative and qualitative with a cross-sectional approach. These approaches are carried out to answer research questions that cannot be fully answered with just one approach. Based on the study's results, there was no relationship between family income and the incidence of wasting in toddlers, as indicated by the results of the chi-square test analysis, p = 0.230 > 0.05 with a prevalence rate of 1.296 (95% CI) with a 1.29 chance. The chi-square test obtained p = 0.230 > 0.05 with a prevalence rate of 1.296 (95% CI), meaning there is no relationship between family income and wasting in toddlers, but families with income < Rp. 2,246,725 has a 1.29 times chance of having underweight toddlers compared to families with income ≥ Rp. 2,246,725. Based on the results of the study, there was no relationship between mother's knowledge and the incidence of wasting in toddlers, as indicated by the results of the chi-square test analysis obtained a p-value of 0.001

Stunting is a condition of failure to thrive in toddlers due to chronic malnutrition, especially in the first 1000 days of pregnancy, in rural families, there is no term-stunting even mothers with toddlers stunting have different meanings to the condition of toddlers stunting this is motivated by the meaning obtained from the stock of knowledge.Stunting itself is divided into 2 namely short toddlers(stunted) namely short and very short toddlers(severely stunted) namely toddlers with body length (PB/U) or height (TB/U) based on age with a comparison of WHO-MGRS standards (Multicentre Growth Reference Study) 2006. In this study uses the type or research literature approach to analys and described stunting in Indonesia. Conditions of stunting measured by height or body length that is minus two standard deviations of the median standard of toddler growth from WHO. The focus of this study is to look at the meaning of mothers with toddlers stunting and the actions of mothers with toddlers stunting. According to data from the Ministry of Health of the Republic of Indonesia, approximately 9 million toddlers experience it stunting with a prevalence of 37% in 2013. To the Ministry of Health's Basic Health Research in 2018, one of the factors for the high stunting seen directly is the low intake of nutrition and health. Decline stunting is considered important, therefore a multi-sectoral approach is planned through the synchronization of national, local, and community programs at the central and regional levels.

Background: Nutrition is crucial for sustaining a golden phase over the first two years. Nutritional problems that develop early on will lead to more difficult future health problems. The most prevalent nutritional problems are found within the ages of 12 to 24 months. Purpose: to analyze the effect of parenting style on nutritional status of under two years babies. Methods: This study is an observational reasearch with cross-sectional approach. 685 toddlers and their parents made up the study's population, and a total of 75 were selected by accidental sampling. Anthropometric measures and questionnaires were used to gather the data. PSDQ (Parenting Style and Dimension Questionnaire) were used to identify parenting style. Results: Parenting styles for children's nutritional status were examined using the chi-square test, which revealed a value of 0.018. Conclusions: The study's findings suggest that parenting style and children's nutritional status are related.

BackgroundBreastfeeding is associated with a lower risk of subsequent overweight or obesity, but it is uncertain whether this is a causal relation because most studies have not adequately reduced risk of bias due to confounding.ObjectivesThe aim of this review was to examine whether 1) ever compared with never consuming human milk and 2) different durations of human milk consumption among infants fed human milk are related to later risk of overweight or obesity, with emphasis on sibling-pair and intervention studies.MethodsThe 2020 Dietary Guidelines Advisory Committee, together with the Nutrition Evidence Systematic Review team, conducted a systematic review of articles relevant to healthy full-term infants in countries with a high or very high level of human development. We searched PubMed, Embase, Cochrane, and CINAHL; dual-screened the results using predetermined criteria; extracted data from and assessed the risk of bias for each included study; qualitatively synthesized the evidence; developed conclusion statements; and graded the strength of the evidence.ResultsThe review included 42 articles, including 6 cohorts with sibling-pair analyses and 1 randomized controlled trial of a breastfeeding promotion intervention. Moderate evidence suggested that ever, compared with never, consuming human milk is associated with a lower risk of overweight and obesity at ages 2 y and older, particularly if the duration of human milk consumption is >6 mo. However, residual confounding cannot be ruled out. Evidence was insufficient to determine the relation between the duration of any human milk consumption, among infants fed human milk, and overweight and/or obesity at age 2 y and older.ConclusionsFurther research, using strong study designs, is needed to disentangle the complex relation between infant feeding practices and the risk of subsequent overweight or obesity, as well as the biological and behavioral mechanisms if the relation is causal.