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Evidence suggests autistic individuals at elevated familial likelihood of autism spectrum disorder (by virtue of having an autistic sibling) have stronger cognitive abilities on average than autistic individuals with no family history of the condition, who have a low familial likelihood of autism. Investigating phenotypic differences between community-referred infants and toddlers with autism symptoms at elevated or low familial likelihood of autism may provide important insight into heterogeneity in the emerging autism phenotype. This study compared behavioral, cognitive, and language abilities of community-referred infants and toddlers with confirmed autism symptoms at elevated (EL) or low familial likelihood of autism (LL). Participants were 121 children aged 12 to 36 months who participated in two larger randomized trials of parent-mediated interventions for children with autism symptoms. Behavioral phenotypes were compared across three groups: children with at least one autistic sibling (EL-Sibs, n = 30), those with at least one older, non-autistic sibling and no family history of autism (LL-Sibs, n = 40), and first-born children with no family history of autism (LL-FB, n = 51). EL-Sibs had less severe autism symptoms and stronger cognitive abilities than children in LL groups. While the rate of receptive language delay was similar across groups, the rate of expressive language delay was markedly lower among EL-Sibs. After controlling for age and nonverbal cognitive ability, EL-Sibs were significantly less likely to present with expressive language delay than LL-Sibs. Familial likelihood of autism may play an important role in shaping the emerging autism phenotype in infancy and toddlerhood.

Children begin to show symptoms of neurodevelopmental disorders early on in their development. Providing early intervention that is culturally responsive to both families and the child receiving the service is vital for the child's growth. The purpose of this study was to qualitatively explore 14 Latin American Spanish-speaking parents' reactions to and perceptions of Communication Interaction Training on Autism for Spanish-speaking caregivers (CITAS), a waitlist-style parent-mediated program that focuses on teaching parents strategies to support their child's language development and enhance learning. Focus group, interview, and field note data were analyzed using the Ecological Validity Framework to determine areas of cultural fit and cultural misalignment. Notably, participants demonstrated appreciation for the CITAS program, including several specific elements that provided unique cultural fit. Some logistical and contextual challenges were also identified. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Few studies examine the effectiveness of community-based early interventions in unselected samples of autistic children, especially those from minoritized backgrounds. These types of studies require attention to strategies for recruitment, retention, data collection, and support for community providers beyond those used in university-based trials. We conducted a pilot trial of Project ImPACT, a promising caregiver-mediated naturalistic developmental behavioral intervention, in partnership with the early intervention system in a poor, large city. We assessed recruitment and retention strategies, training protocol, and measurement battery. We recruited representative provider and family samples, and had good measure completion among retained participants. Retention varied by study arm, providers had relatively poor fidelity to the intervention despite substantial support, and our measures did not appear sensitive to change. Lessons learned include the need for (a) a ramp-up training period prior to starting the study, (b) intensive implementation supports, and (c) additional strategies for family retention. [ABSTRACT FROM AUTHOR]

Pediatric urolithiasis is a less common disease with a steadily increasing incidence of 10.6 % per year. The comprehensive management of pediatric urolithiasis is more challenging than in adults, and published studies of endourological treatment in children have small sample sizes and older mean ages, which may not be representative of the overall pediatric population, especially in infants and toddlers. This study aimed to report results of retrograde ureteroscopy for treating pediatric ureteral stones in infants and toddlers (<3 years) from a single center in China. Demographic and surgical data of infants and toddlers with ureteral stones who underwent retrograde URS were retrospectively analyzed from January 2015 to September 2022. The mean age of 100 infants (73 boys and 27 girls) was 19.6 ± 7.6 months and stone burden was 0.27 (0.11–0.52) cm³. 111 procedures were performed for all children due to 11 patients with bilateral ureteric stones were simultaneously treated. Among them, 70.3 % were semi-rigid URS, 12.6 % were Micro-URS and 17.1 % were flexible URS. SFR was up to 96 %, the median operation time and hospitalization days were 35.0 (25.0–50.0) minutes and 6.0 (5.0–6.0) days, respectively. 15 (15.0 %) infants had postoperative fever (Grade I), and complications above grade I were not observed. This research reported the largest sample size of infant and toddler ureteric stones (under 3 years old) and shared optimal management strategies for these special populations. Compared to other related studies, we had a higher SFR due to diverse management strategies and reasonable application of pre-operative ureteric stents. The most important potential reason why our complication rate was relatively higher might be the younger population under 3 years old. In additionally, the reason of long hospitalization was maybe some patients underwent staged surgeries during one hospitalization. Those results indicated the robust effectiveness of URS for infants. This study has limitations, including its retrospective single-center design, absence of long-term follow-up data, and potential variability in surgical outcomes due to differences in surgeons' experience. The experience of endourologic procedures for 100 infant and toddler patients with ureteric stones from a Chinese single center was reported. And URS showed its effectiveness and safety for those special populations based on its high SFR and low complication rate. [ABSTRACT FROM AUTHOR]

ObjectiveTo evaluate the effect of nutritional risk management program on the growth and development of infants and toddlers with congenital heart disease (CHD) after discharge.MethodsInfants and toddlers with CHD discharged from a children's specialized hospital in southeast China were selected as the research subjects. The subjects were divided into the intervention group and the control group. The intervention group underwent a nutritional risk management program combined with traditional follow-up after discharge, whereas the control group received traditional follow-up after discharge. The primary outcome measure were the height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and weight-for-height Z-score (WHZ) at different time point and the percentage of growth and development curves were also recorded and analyzed.ResultsThere were no statistically significant differences in general characteristics between the two groups. However, in the intervention group, the percentages of HAZ

Background Melatonin use in the pediatric population is on the rise in the United States, where it is available as an over-the-counter and online supplement. There are no data regarding the safety and efficacy of melatonin in children less than 2 years old. The aim of this study was to examine various aspects of melatonin use by caregivers of infants and toddlers in the US. Methods Caregiver users of the Nanit baby monitoring system with a child aged 0-36 months were invited to complete an online survey regarding melatonin use, sources of information/recommendations about melatonin, formulations used and reasons for administering melatonin to their child. Participants also completed the Brief Infant Sleep Questionnaire-Revised (BISQ-R). Results A total of 3063 caregivers (1.93%) responded to the survey, of whom 1.7% had ever used melatonin for their child. About half of those caregivers had received a recommendation for melatonin from a source other than a healthcare professional. Caregiver perception of 'sleep as a problem' as assessed by the BISQ-R was not significantly different between those who had or had not used melatonin for their child, and reasons for use included non-supported indications such as sleeping later or promoting "more restful and better sleep". Conclusions The results of this study support mounting concerns regarding the widespread use of melatonin in the US pediatric population, especially given the lack of regulatory oversight and the documented inaccuracy of label claims versus actual melatonin content. • Please see the attached revisions requested by Reviewer 1; we appreciate the opportunity to make the minor requested edits to the original manuscript as detailed in the Revision Notes. • We believe that this Brief Report adds to the growing literature documenting the extent and characteristics of melatonin use in the pediatric population in the US. [ABSTRACT FROM AUTHOR]

Baseline child characteristics may predict treatment outcomes in children with or at elevated likelihood of developing autism (EL-ASD). Little is known about the role of child sensory and language features on treatment outcome. Participants were randomly assigned to a parent-mediated intervention or control condition. Analyses explored the relationship between baseline child sensory and language characteristics and changes in ASD symptoms over approximately 9 months. Higher baseline sensory hyporeactivity was significantly related to less improvement in social communication (SC) for the treatment group only. More baseline atypical vocalizations were significantly related to less improvement on SC across treatment and control groups. This work provides an initial framework to encourage the tailoring of interventions for EL-ASD children, suggesting sensory reactivity and atypical vocalizations may be useful behaviors to consider in treatment planning.

Context: One of the essential components for successful caries management is caries risk assessment (CRA). Among CRA tools (CRATs) published in the literature: Caries management by risk assessment (CAMBRA) 123 and American Academy of Pediatric Dentistry (AAPD) CRATs are specifically designed for infants and toddlers. Aims: The aim of this study is to compare readily available internationally accepted CRAT for infants and toddlers and check the usability of these tools in assigning caries risk among the Indian population. Settings and Design: The study was conducted at Baby Oral Health Promotion Clinic, Department of Pediatrics, Tertiary Care Hospital using a cross-sectional study design. Subjects and Methods: Data were collected using CAMBRA 123 and AAPD CRATs from 379 children aged 0–6 years. The caries risk of the children was recorded with each CRAT and a comparison was made between the two tools used. Statistical Analysis Used: The percentage of agreement and Cohen's kappa coefficient were used to know the agreement between the CAMBRA 123 and AAPD CRATs using the SPSS statistical tool. The significance level was set at 5% (α = 0.05). Results: For children aged

Early exposure to digital media has become an integral part of everyday life, which is frequently being reported as one of potential risk factors for a number of developmental disorders, including language development in infants and toddlers. The current article represents introduction to a research study which will be dealing with a potential link between the risk of language delay and excessive screen media time in children. With this in mind, we will present three case reports involving young children who experienced a language delay, but did not have any health problems diagnosed, nor did they have any of the physical high-risk factors for language and other developmental disorders detected. What these three children have in common is the fact that they were all excessively exposed to digital media during the first two years of life. The existing empirical findings suggest that different forms of digital content may be overstimulating for the developing brain, which is true both for active and background screen viewing. Moreover, screen time may be seen as a distraction from other more developmentally important activities. Keeping parents informed about a potential negative influence of prolonged media exposure can prompt parents to make informed decisions about whether and to what extent they will expose their children to digital media in the earliest period of their development. [ABSTRACT FROM AUTHOR]

Context: One of the essential components for successful caries management is caries risk assessment (CRA). Among CRA tools (CRATs) published in the literature: Caries management by risk assessment (CAMBRA) 123 and American Academy of Pediatric Dentistry (AAPD) CRATs are specifically designed for infants and toddlers. Aims: The aim of this study is to compare readily available internationally accepted CRAT for infants and toddlers and check the usability of these tools in assigning caries risk among the Indian population. Settings and Design: The study was conducted at Baby Oral Health Promotion Clinic, Department of Pediatrics, Tertiary Care Hospital using a cross-sectional study design. Subjects and Methods: Data were collected using CAMBRA 123 and AAPD CRATs from 379 children aged 0-6 years. The caries risk of the children was recorded with each CRAT and a comparison was made between the two tools used. Statistical Analysis Used: The percentage of agreement and Cohen's kappa coefficient were used to know the agreement between the CAMBRA 123 and AAPD CRATs using the SPSS statistical tool. The significance level was set at 5% (α = 0.05). Results: For children aged <2 years, the study showed slight agreement between the CAMBRA 123 and AAPD, whereas, for children more than 2 years, there was a fair agreement between the two methods which was statistically significant. This indicates that the agreement between the two methods is still not perfectly established, and AAPD CRA assigns a higher risk category than CAMBRA 123. Conclusions: CAMBRA 123 is a promising user-friendly quantitative method for CRA in clinical practice. Since there is ambiguity in assessing the caries risk in children <2 years, there is a need to establish a CRAT that can be used exclusively for children below 2 years. [ABSTRACT FROM AUTHOR]

ObjectiveTo explore the clinical value of ultrasound examination in evaluating the presence of ovarian torsion in female infants with inguinal ovarian hernia.MethodsWe conducted a retrospective analysis of 91 cases of ovarian hernia diagnosed by ultrasonography at our institution. Among them, 6 cases were identified as ovarian strangulation, while 85 cases were classified as non-ovarian strangulation. All cases underwent high-frequency ultrasound examination. We analyzed whether there were differences in the associated factors between the two groups and compared the disparities in the urgency of surgery between the two groups.ResultsSignificant differences were observed between the ovarian strangulation group and the non- strangulation group in terms of ovarian volume, ovarian blood flow, and the presence of incarceration. The need for emergency surgery was significantly associated with the presence of incarceration and ovarian torsion.ConclusionUltrasound has good clinical value in diagnosing ovarian hernia and determining the presence of ovarian strangulation. It can assist clinical physicians in determining the timing of surgery for children with ovarian hernia.

Objective To investigate the safety, effectiveness and fitting method of rigid gas permeable (RGP) contact lens after cataract surgery in infants and toddlers. Methods A retrospective analysis was performed on 6 eyes of 5 cataract children who visited our Aier Eye Hospital from November 2019 to December 2021. All patients were treated with RGP contact lens after cataract extraction and followed up for 6 months. RGP loss and replacement cycle, as well as changes in nystagmus and visual acuity were observed and evaluated to summarize the experience and analyze the safety and efficacy of lens therapy. Results All patients were healthy in ocular surface condition. One case abandoned to wear the lens. The period of lenses loss and replacement was 2.4~5.4 months per piece; The dropout frequency was 1~3 times per year; Displacement frequency was 3~4 times per day; Nystagmus was observed at 0~23 times per minute before wearing the lenses, and disappeared in the later follow-up period; The vision acuity was 0.5 (case 1 with lenses, optomotor nystagmus) and 0.2~0.67 (at 24 weeks after wearing lenses, self-made short-distance vision test card), respectively. Conclusion RGP contact lens are safe and effective for improving visual function in infants and toddlers after cataract surgery, which can be further popularized. Improving fitting techniques, optimizing examination methods, and strengthening follow-up education can improve the clinical therapeutic effectiveness of RGP and reduce costs in clinical practice.

An early diagnosis of autism spectrum disorder (ASD) can improve outcomes for children and assist families in accessing services. Part C providers are often tasked with screening for ASD. The purpose of this study was to survey Part C providers nationwide to understand their ASD screening practices and training needs and extend a survey conducted by Tomlin and colleagues. A total of 327 providers participated. Results indicated a majority of respondents (75.8%) screen for ASD using a variety of different measures, while only 26.9% are required by their program to conduct universal screenings. Most participants reported feeling confident in screening for ASD, discussing a child's red flags with a family, referring a child for further evaluation, and discussing recent evidence surrounding ASD. An area where providers were less confident was working with interpreters to screen for ASD or discuss screening results and ASD with families with cultural or linguistic diversity. Despite high confidence levels in screening for ASD, a vast majority of participants reported they would be interested in attending a training on screening for ASD. Professional development surrounding screening for ASD and discussing ASD with families from diverse backgrounds may assist in improving Part C provider screening practices. [ABSTRACT FROM AUTHOR]

Les jeunes enfants admis en pouponnières constituent une population particulièrement vulnérable du fait des expériences traumatiques auxquelles ils ont été confrontés. À ces évènements négatifs qui sont à l'origine de la mesure de protection, s'ajoutent les traumas susceptibles d'être générés par la rupture, la séparation et le placement. En outre, des recherches convergentes ont mis en évidence des trajectoires négatives de grande ampleur attribuable aux conséquences à court et à long termes des abus et de la négligence et à leur impact neurobiologique sur la santé et le développement. De ce fait, alors que les maltraitances des enfants étaient autrefois considérées comme un problème social, elles sont désormais reconnues par l'OMS comme un problème de santé publique mondial. Il est urgent d'outiller les services de protection de l'enfance pour qu'ils puissent répondre le plus rapidement possible aux besoins uniques, spécifiques et particuliers des enfants exposés à des traumatismes. À cet effet, les premiers mois dans un service de protection de l'enfance peuvent constituer une puissante opportunité. Le programme PEGASE d'un parcours de soins coordonnés, mise en place en avril 2019 par l'État, vise une amélioration du repérage des retards de développement et des troubles psychiques chez les enfants de moins de trois ans, ainsi que la mis en place de soins précoces. Young children in residential nurseries constitute a particularly vulnerable population due to their overexposure to traumatic experiences. In addition to these negative events that are at the origin of the protection measure, there are traumas that can be generated by the rupture, the separation and the placement. Additionally, convergent research has highlighted wide-ranging negative trajectories attributable to both the short and long-term consequences of abuse and neglect and their neurobiological impact on health and development. As a result, while child maltreatment was once considered a social problem, it is now recognized by the WHO as a global public health problem. There is an urgent need to equip child protection services to be able to respond to the unique, specific and particular needs of trauma-exposed children as soon as possible; the first months in child welfare service can provide a powerful opportunity. The PEGASE experiment of a coordinated care pathway, implemented in April 2019, aims to improve the identification of developmental delays and psychological disorders in children under the age of three, as well as the provision of early care. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child's sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants' regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group. [ABSTRACT FROM AUTHOR]

Young children with visual impairment and their families often require specialized assistance through early intervention to develop adaptive routines, cues, and environmental settings during mealtimes and other daily tasks. There is little empirical data in the area of mealtime routines available to support families of young children with visual impairment, and the need for research-based interventions is great. The purpose of this initial needs assessment survey was to gather information as little is already known about what teachers of students with visual impairment trained in early intervention (TSVI-EIs) and other early interventionists who work with infants and toddlers with visual impairment already know about the development of independent mealtime skills. The results of this survey indicate that early intervention professionals would like additional opportunities to learn about mealtime routine strategies for young children with visual impairment, confirm their current experiences and knowledge, and identify additional training and resources. [ABSTRACT FROM AUTHOR]

This study took place in the University of West Attica, Department of Early Childhood Education and Care (ECEC) in Greece, founded in 2018, which focuses on the learning, development and education of children under four years of age. Greece has a split early childhood education system, and there is minimal attention given to infant and toddler research. This study explored students' views before and after their final practicum through two online questionnaires to identify the effectiveness of the undergraduate programme of studies in preparing ECEC educators for their professional roles. The study also interviewed in-service educators in their first year of employment and graduates who have completed their practicum in a foreign country under the Erasmus+ programme. Findings revealed an overall satisfaction with the existing programme and the effectiveness of the final practicum. Students who completed an Erasmus+ practicum were particularly positive about their experience and the knowledge they acquired, and they encouraged more students to apply for the Erasmus+ mobility scheme. All participants provided useful insights and suggestions for further improving the programme, such as extending the placement and practicum. Implications for ECEC educators' education are discussed, along with recommendations for future research. [ABSTRACT FROM AUTHOR]

Undertaking infant-toddler practicum during initial teacher education is critical to ensuring preservice teachers (PSTs) are well prepared for their future role as early childhood teachers. PSTs, however, can face challenges in infant-toddler practicum given the demands of this unique teaching and learning context. A knowledgeable, experienced educator as a guide is key to supporting PSTs' learning during placement. This paper illuminates the practices of an infant-toddler educator who supported an international PST's learning during her first nappy change on an infant-toddler practicum in an early childhood service in Australia. The paper addresses the scarce literature on PSTs' experiences in infant-toddler settings, which can guide their relationships with colleagues. Drawing on the theory of practice architectures, we analyse a video vignette of the PST and educator during a nappy changing practice. We highlight the practices of both the educator and PST which helped the PST learn by being 'stirred in' to this common but unfamiliar practice for her and many other PSTs who may never have held a baby before. Implications call for cooperative and experienced educators who can support PSTs with pedagogical and practical elements of the practicum. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had massive impacts across the globe. Children with developmental delays are an increasingly vulnerable population, highlighting the importance of ensuring they have access to high-quality virtual services during this time. The Early Discovery program currently provides therapeutic interventions for children with mild developmental delays. We sought to compare the outcomes of 2 cohorts within the Early Discovery program using different delivery approaches (n = 238 families): children who received services in person before the pandemic (n = 126) and children who received services via telehealth in the acute phase of the pandemic (n = 112). Both groups of children showed significant improvements in language skills posttreatment, and, with regard to auditory comprehension, both groups showed similar rates of improvement. However, children receiving in-person services before the pandemic showed greater improvements in expressive communication skills than children receiving telehealth services during the pandemic. Results indicate that the Early Discovery program was able to make adjustments during the pandemic that assisted families in maintaining progress in improving their child's language skills. [ABSTRACT FROM AUTHOR]

Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions. Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0-6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups. Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients.

Introduction: The purpose of the present paper is to provide step-by-step guidelines for dental healthcare providers to manage dental caries based upon caries risk assessment (CRA) for ages 0-6 years and 6 years through adult. The manuscript reviews and updates the CAMBRA (caries management by risk assessment) system which includes CRA and caries management recommendations that are guided by the assessed risk level. Caries Risk Assessment: CAMBRA CRA tools (CRAs) have been evaluated in several clinical outcomes studies and clinical trials. Updated CAMBRA CRAs for ages 0-6 years and 6 years through adult are provided. These CRAs have been refined by the addition of a quantitative method that will aid the health care provider in determining the caries risk of individuals. Caries Management Based Upon Risk Assessment: Guidelines for individualized patient care are provided based upon the caries risk status, results of clinical exams and responses of the patient to questions in the CRA. These guidelines are based upon successful outcomes documented in several clinical outcomes studies and clinical trials. The paper includes a review of successful caries management procedures for children and adults as previously published, with additional emphasis on correct use of silver diamine fluoride (SDF) for children. The caries management plan for each individual is based upon reducing the caries risk factors and enhancing the protective factors with the additional aid of behavior modification. Beneficially altering the caries balance is coupled with minimal intervention restorative dentistry, if appropriate. These methods are appropriate for the management of dental caries in all patients.

Objectives: To assess maternal knowledge, attitude, and practices toward vitamin D supplements in Saudi infants and toddlers. In addition, we investigated predictors of maternal knowledge, attitude, and practices related to vitamin D supplements. Methods: Cross-sectional data of 156 Saudi infants and toddlers were collected from mothers via online survey. Data collected included sociodemographics, maternal knowledge, attitude, and practices toward vitamin D supplements. Results: Our data show a limited maternal knowledge toward vitamin D. Maternal knowledge and attitude as well as maternal knowledge and practices were not correlated. Spearman correlation between maternal attitude and practices was positively low (rs= 0.47). Child's age and family monthly income predicted maternal knowledge towards vitamin D. Maternal age and maternal education level predicted maternal attitude toward vitamin D supplements. Order of the child, maternal age, and maternal employment status predicted maternal practices toward vitamin D supplements in infant and toddlers. Conclusions for Practice: Maternal knowledge, attitude, and practices toward vitamin D supplements can be predicted by certain sociodemographic characteristics. Interventions that focus on improving maternal knowledge, attitude, and practices toward vitamin D supplements are urgently needed. [ABSTRACT FROM AUTHOR]

Abstract Background The WHO recommends daily use of micronutrient powder for infants and toddlers at risk of micronutrient deficiencies in low-and-middle-income countries. China has established a micronutrient powder distribution program in many rural townships and villages, yet adherence to micronutrient powder remains suboptimal; a little is known about the behavioral inputs that may influence adherence. This study examines direct and indirect behavioral inputs in micronutrient powder adherence among caregivers in rural western China following the Integrated Behavioral Model (IBM) framework. Methods Cross-sectional data were collected from April to May 2019 among 958 caregivers of children aged 6 to 24 months in six counties. Data were collected on micronutrient powder adherence behavior, direct behavioral inputs (knowledge and skills, intention, salience, environmental constraints, and habits), and indirect behavioral inputs (attitudes, perceived social norms, and personal agency). Structural equation modeling (SEM) adjusted for sociodemographic covariates was used to evaluate the IBM framework. Results Mean micronutrient powder adherence in the previous seven days was 53.02%, and only 22.86% of caregivers consistently fed micronutrient powder from the start of micronutrient powder distribution at six months of age. The SEM model revealed small- to medium-sized effects of salience (β = 0.440, P

Background: Developmental delays (DDs) in children are rising and necessitate routine screening for early recognition and management. Objective(s): To estimate the prevalence of developmental delays among children 2-36 months of age in a Primary Health Care (PHC) center in Cairo, Egypt. Methods: This cross-sectional study was conducted in Saraya El-Koba PHC center involving 193 children 2-36 months of age. Data were collected using Ages and Stages Questionnaire (ASQ-3) to assess five domains of development: communication, gross motor, fine motor, problem-solving, and personal-social. Some parents’ characteristics were also included. Results: Frequency of developmental delays was 9.3%. The domains with the most frequent delays were the communication and gross motor (3.1% each) and the least was the fine motor domain (1.04%). Girls scored significantly higher than boys in the problem-solving domain (p=0.037). First to third order of birth had higher communication and social scores (p=0.025, p=0.003 respectively). Highly educated mothers had children with higher fine motor and total developmental scores (p < 0.001 and 0.014 respectively), while highly educated fathers had children with higher communication scores (p=0.009). Duration of breast feeding was positively correlated with gross motor and social scores (p=0.001, p=0.042 respectively). Conclusion: The frequency of DDs was 9.3%. This prevalence is considered high compared to previous studies. It showed several associated factors and recommended early screening of preschool children for prompt recognition and timely intervention.

The article highlights connections between music and movement activities and emergent literacy development among infants and toddlers. I review how music is linked to phonological awareness, oral language, vocabulary, and other related skills that support reading, like executive function. I also highlight the benefits of including teacher‐facilitated, hands‐on, active music experiences, even when teachers may lack confidence in their musical abilities and music training. The article provides teachers with easy‐to‐implement activities to use in the classroom to explicitly support literacy through developmentally appropriate and engaging music and movement activities, including songs, instruments, movement, and song‐based picture books. [ABSTRACT FROM AUTHOR]

The importance of the first three years of life for children's development and the consequences for their general health in adulthood have been widely documented in the international literature, including the benefits of early identification and intervention programs. Additionally, convergent research has highlighted wide‐ranging negative trajectories attributable to both the short and long‐term consequences of abuse and neglect and their neurobiological impact on health and development. However, formal identification processes and the use of standardised screening tools in child protection remain relatively rare despite the potential societal impact of child maltreatment in terms of public and economic health. Moreover, delays between the initial identification of mental health problems and health and developmental disorders, and the introduction of appropriate interventions persist. Abused and neglected infants risk an exacerbation of the consequences of early maltreatment due to insufficient access to prompt assessment and treatment, including appropriate responses to their health needs. The aim of this article is to present the PEGASE program, an innovative French program for very young children in care, which is modelled on the care of premature babies. By setting up an early care pathway, it aims to ensure adequate medical follow‐up – both somatic and psychiatric – through standardised examination and tailored interventions in order to limit the adverse health and developmental consequences of abuse. The presentation of the PEGASE program is supplemented by a case study. [ABSTRACT FROM AUTHOR]

Background: Compliance with the requirements of the Individuals with Disabilities Education Act (IDEA) in the United States is monitored through review of cross‐sectional reports from three discrete, age‐defined programmes (early intervention [EI], early childhood special education [ECSE)] and school‐age special education [SE]) to promote the timely, efficient and effective delivery of appropriate services to all eligible children. Analysis of longitudinal data is required to discern how children use services across programmes to provide the necessary context for IDEA oversight and to identify areas for programme or policy interventions to reduce barriers to service use and promote equity. Methods: We applied sequence analysis to a data linkage across five public record systems among 15 626 New York City children born in 1998 who had records from birth through third grade. Results: Five predominant patterns of service use were identified: (1) multiple therapies across EI/ECSE/SE (13%), (2) EI without transition to Department of Education schools or services (24%), (3) EI and intermittent ECSE/SE (16%), (4) older entry into EI and both speech and occupational therapy throughout ECSE/SE (9%) and (5) limited EI use and mostly speech therapy in ECSE/SE (38%). Each pattern had distinct demographics (e.g., pattern 2 was disproportionately White and from low poverty neighbourhoods; pattern 4 was disproportionately male and Black; pattern 5 was disproportionately Latino) and academic outcomes (e.g., pattern 1 had largest proportion in a SE school and not tested in third grade; pattern 3 had third grade tests scores that were similar to overall citywide mean scores). Conclusions: The differences in demographic profiles across the five patterns of service use illustrate the systemic inequities in the delivery of these important services. Delayed entry and limited use of EI services among children of colour underscore the need for equity goals to increase early referral and optimize service use. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child’s sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants’ regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group.

Family routines provide young children with predictable, repeatable, and functional contexts for learning about the world. Participating in family routines is a critical pathway by which all children learn. While the use of family routines in caregiver-implemented interventions (CIIs) is supported by theories, research, and recommended practices, few investigations examine the degree to which interventions take place within routines across developmental domains in early childhood intervention research. We conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist to examine an interdisciplinary body of CIIs. We coded 42 articles for the presence and types of routines, child and family demographics, developmental targets, and how routines were identified within CIIs. Autism spectrum disorder was the highest represented disability; many studies included play routines or a combination of play with another routine. In this article, we discuss the importance of family routines in CIIs, how to jointly identify a range of routines with caregivers, and we describe the need for research on family routines in CIIs across disabilities and diverse family backgrounds. [ABSTRACT FROM AUTHOR]

The coaching service delivery model is often implemented within parent-mediated interventions for infants at an elevated likelihood of autism spectrum disorder. However, less is known about the exact coaching behaviors used within intervention sessions. Therefore, we examined the coaching behaviors implemented within the Adapted Responsive Teaching intervention. We also investigated the associations between coaching behaviors and parent education levels and the associations between the coaching behaviors and a parent outcome, that is, parent responsiveness. Results indicated that the interventionists demonstrated joint interaction and child-focused behaviors the most frequently. The interventionists much less frequently demonstrated guided practice, caregiver practice, and problem-solving behaviors. The use of joint interaction behaviors was positively associated with parent education levels, whereas the use of child-focused behaviors was negatively associated with parent education level. More information sharing by the interventionists predicted a greater change in parent responsiveness, whereas more child-focused behaviors predicted less change in parent responsiveness. [ABSTRACT FROM AUTHOR]

Background: The WHO recommends daily use of micronutrient powder for infants and toddlers at risk of micronutrient deficiencies in low-and-middle-income countries. China has established a micronutrient powder distribution program in many rural townships and villages, yet adherence to micronutrient powder remains suboptimal; a little is known about the behavioral inputs that may influence adherence. This study examines direct and indirect behavioral inputs in micronutrient powder adherence among caregivers in rural western China following the Integrated Behavioral Model (IBM) framework.Methods: Cross-sectional data were collected from April to May 2019 among 958 caregivers of children aged 6 to 24 months in six counties. Data were collected on micronutrient powder adherence behavior, direct behavioral inputs (knowledge and skills, intention, salience, environmental constraints, and habits), and indirect behavioral inputs (attitudes, perceived social norms, and personal agency). Structural equation modeling (SEM) adjusted for sociodemographic covariates was used to evaluate the IBM framework.Results: Mean micronutrient powder adherence in the previous seven days was 53.02%, and only 22.86% of caregivers consistently fed micronutrient powder from the start of micronutrient powder distribution at six months of age. The SEM model revealed small- to medium-sized effects of salience (β = 0.440, P < 0.001), intention (β = 0.374, P < 0.001), knowledge and skills (β = 0.214, P < 0.001), personal agency (st. effect = 0.172, P < 0.001), environmental constraints (β=-0.142, P < 0.001), and caregiver generation (β = 0.119, P < 0.05) on micronutrient powder adherence. Overall, 54.7% of the variance in micronutrient powder adherence was explained by the IBM framework. Salience had the largest impact on micronutrient powder adherence (Cohen's f 2 = 0.227). Compared to parent caregivers, grandparents had a higher degree of micronutrient powder adherence on average (P < 0.001), and behavioral inputs were consistent among both parent and grandparent caregivers.Conclusion: There is a need to improve micronutrient powder adherence among rural caregivers. The IBM framework showed a high degree of explanatory power in predicting micronutrient powder adherence behavior. The findings suggest that increased reminders from doctors regarding micronutrient powder and coaching to improve personal agency in micronutrient powder feeding may increase adherence. [ABSTRACT FROM AUTHOR]

Supplementation of infant and follow-up formula with probiotics or synbiotics has become a common practice. In 2011 and 2017, the evidence regarding the impact of these interventions was analysed systematically. Recently new evidence was published. To evaluate through a systematic review with network meta-analysis the evidence on the impact of infant formula supplemented with probiotics or synbiotics for healthy infants and 36-month-old toddlers. RCTs published between 1999–2019 for infant formulas supplemented with probiotics alone or synbiotics in healthy infants and toddlers were identified. Data analysis included clinical (gastrointestinal symptoms, risk reduction of infectious diseases, use of antibiotics, weight/height gain and frequency of adverse events) and non-clinical outcomes (changes in faecal microbiota and immune parameters). A random effect model was used. Hedges' standard mean difference (SMD) and risk ratio (RR) were calculated. Rank analysis was performed to evaluate the superiority of each intervention. Twenty-six randomised controlled trials with 35 direct comparisons involving 1957 children receiving probiotic-supplemented formula and 1898 receiving control formula were reviewed. The mean duration of intervention was 5.6 ± 2.84 months. Certain strains demonstrated a reduction in episodes of colic, number of days with fever and use of antibiotics; however, there was considerable heterogeneity which reduced the level of certainty of effect. No significant effects were observed on weight, height or changes in faecal proportions of Bifidobacteria, Lactobacillus, Bacteroides or Clostridia. Although there is some evidence that may support a potential benefit of probiotic or synbiotic supplementation of infant formulas, variation in the quality of existing trials and the heterogeneity of the data preclude the establishment of robust recommendations. [ABSTRACT FROM AUTHOR]

Objective: This study sought to explain results of the Water Up!@Home randomised controlled trial where low-income parents were randomised to receive an educational intervention +a low-cost water filter pitcher or only the filter. Parents in both groups had reported statistically significant reductions in sugar-sweetened beverages (SSB) and increases in water intake post-intervention.Design: Qualitative explanatory in-depth interviews analysed thematically and deductively.Setting: Washington, DC metropolitan area, USA.Participants: Low-income Latino parents of infants/toddlers who had participated in the Water Up! @Home randomised controlled trial.Results: The filter-stimulated water consumption in both groups by (1) increasing parents' perception of water safety; (2) acting as a cue to action to drink water; (3) improving the flavour of water (which was linked to perceptions of safety) and (4) increasing the perception that this option was more economical than purchasing bottled water. Safe and palatable drinking water was more accessible and freely available in their homes; participants felt they did not need to ration their water consumption as before. Only intervention participants were able to describe a reduction in SSB intake and described strategies, skills and knowledge gained to reduce SSB intake. Among the comparison group, there was no thematic consensus about changes in SSB or any strategies or skills to reduce SSB intake.Conclusions: A low-cost water filter facilitated water consumption, which actively (or passively for comparison group) displaced SSB consumption. The findings have implications for understanding and addressing the role of water security on SSB consumption. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore current practices adopted by frontline healthcare providers for the early detection of developmental delays in infants and toddlers in Saudi Arabia, with a specific focus on motor and speech delays and caregivers' perceptions of early detection of developmental delays and their awareness of well-child visits. Methods: Two cross-sectional surveys were conducted and distributed. The first survey was performed among healthcare providers who worked directly with infants and toddlers in the first 3 years of life, and the second survey was performed among caregivers of infants and toddlers who received healthcare services. Participants were recruited via online groups, social media platforms, and clinics. Results: Overall, 60% of the healthcare providers played a role in identifying medical conditions that could be associated with delays and disabilities. However, they did not consistently check for normal development or developmental delays. Furthermore, the healthcare providers reported low frequencies of documenting developmental growth. The caregivers' survey results showed that 67% were familiar with the concept of "well-child visits", and the most frequently discussed topic by the healthcare providers was motor development. Conclusions: Well-defined, government-supported standards are needed to encourage regular well-child visits and implement efficient practices for the early detection of developmental delays. [ABSTRACT FROM AUTHOR]

• The results suggest adequate internal consistency for most of the parent- and staff-reported measures. • We found stronger rater effects for staff-reported than observational measures. • The rater effects in the staff-reported measures varied by staff characteristics. • There was some evidence of validity at ages 2 and 3, but little evidence at age 1. • The estimates of sensitivity were low for all of the measures examined. Using longitudinal data from the Early Head Start Family and Child Experiences Survey 2009 (Baby FACES 2009), this study examines the psychometric properties of infant and toddler measures of language and cognitive development and social-emotional competence collected from multiple sources, including parent and Early Head Start staff reports and direct assessments from trained assessors. We examined the validity and reliability of parent/staff ratings and observational measures derived from adult/child play-based interactions using independently administered standardized measures from direct assessments as the criteria or comparison measures. Participants included 846 children and families with low incomes enrolled in Early Head Start in spring 2009 who were followed from ages 1 to 3, drawn from a nationally representative sample of programs. The results suggest adequate internal consistency reliability for most of the measures. We found stronger rater effects for staff-reported measures compared with assessor effects for direct child assessment and observational measures. Moreover, the rater effects in the staff-reported measures varied by staff characteristics. There was some evidence of validity for the staff- and parent-reported measures at ages 2 and 3, but little evidence of validity for the age 1 measures. We discuss the implications of these findings for research on infants and toddlers from families with low incomes. It is important to consider the purpose of the assessments and their psychometric properties for the particular group of children with whom the assessments will be used when selecting assessment tools. [ABSTRACT FROM AUTHOR]

Abstract Background Infant and young child feeding practices (IYCF) impact the early and later health status of the population. Limited data is available regarding IYCF in the United Arab Emirates (UAE). This study aimed to evaluate the nutritional status and adequacy of feeding practices, energy, food, and nutrient intakes of UAE infants and toddlers ages 0-23.9 months. Methods This study is a population-based cross-sectional survey of 276 infants and toddlers aged 0-23.9 months of which 180 were nationals and 96 were Arab non-nationals living in the UAE. Data were collected from the three major emirates: Abu Dhabi, Dubai, and Sharjah. Anthropometry was collected and assessed using WHO Anthro-Survey Analyzer, and a multicomponent age-specific questionnaire was used to evaluate IYCF and sociodemographic characteristics. Usual intake of energy, micronutrients, and macronutrients, including supplements, were collected using multiple-pass 24-h dietary recall and analyzed using the PC-side software. IYCF practices were assessed using the WHO indicators. Results Overall, 4% of children were malnourished, 8% wasted, 15% stunted, 18% at risk of overweight, and 7% overweight and obese. 95% of infants were ever breastfed and 37% exclusively breastfed at 6 months. Around 98% of infants had a timely introduction of complementary food. Macronutrient intake exceeded AMDR for fat, carbohydrates, and protein for 27%, 8% and 2% of toddlers respectively. As for the percentage of those exceeding the ESPGHAN cut-off for free sugars set at 5% of energy intake, 28.6% had excessive intakes overall, 10% in 0-5.9, 21.9% in 6-11.9 and 56.7% in 12-23.9 month. Usual iron intake was below the Estimated Average Requirement (EAR) in 47% of infants 6-11.9 months. Above 12 months, the usual intake of iron and vitamin D were below EAR in 11% and 49% of toddlers respectively. Usual intake exceeded the tolerable upper intake levels (UL) for vitamin A (14 to 18%) and zinc (11 to 22%) across all ages. Approximately 93% of toddlers ages 12–23.9 months did not meet food groups’ recommendations for vegetables, 87% for fruits, 48% for milk/dairy, 54% for lean meat and beans, and 33% for grains. Conclusions This study revealed that a high percentage of infants and toddlers aged 0-23.9 m suffer from a double burden of malnutrition, which is the coexistence of both undernutrition, and overweight and obesity in the same population. In addition to suboptimal feeding practices and inadequate/overconsumption of various nutrients. The findings highlight the need for the development of culturally specific programs aiming to improve the nutritional status of infants and toddlers in the UAE.

Although it is widely known that caregivers advocate for their school-aged children with disabilities, little is understood about how caregivers who have infants and toddlers with delays or disabilities advocate for their young children. The birth-to-three period may be the beginning of some parents’ advocacy efforts and it is possible their efforts may change over time. Given the relevance of this topic and the limited literature, the purpose of this study was to use qualitative inquiry, specifically auto-photography and photo-elicitation interviews, to explore 13 caregivers’ advocacy experiences in their children’s early years. Thematic and constant comparative analyses were used and subsequently 41 major codes within seven categories were identified. The two major findings were (a) caregivers engaged in both individual (i.e., for their children) and outreach advocacy activities (i.e., for other families and children) and (b) their experiences extended beyond interactions with professionals and included everyday interactions with their children, family members and other parents. Directions for future research and implications for practice are discussed. [ABSTRACT FROM AUTHOR]

Despite the restrictions on polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDDs), these chemicals are still ubiquitous environmental pollutants. In this study, we measured the concentrations and profiles of 17 PBDE congeners and 3 HBCDD isomers in indoor dust samples collected from 23 provinces and cities across China. The summed concentrations of PBDEs (Σ17PBDEs) ranged from 4.19 to 817 ng/g, with an average of 171 ± 184 ng/g. BDE-209 was the most abundant congener. The concentrations of HBCDDs ranged from 6.65 to 1335 ng/g, with an average of 236 ± 324 ng/g. Unlike commercial HBCDD formulations, α-HBCDD was the predominant isomer in the indoor dust samples analyzed. Geographical distributions showed that the concentrations of PBDEs and HBCDDs varied significantly among different regions. Higher PBDE and HBCDD levels were observed in samples from eastern coastal and economically developed regions. Further, we estimated the daily intakes of PBDEs and HBCDDs through the routes of dust ingestion and dust dermal absorption for different age groups. Dust dermal absorption is an unneglectable exposure pathway to PBDEs and HBCDs for the Chinese population. Among the age groups, infants had the highest exposure via dust dermal absorption, and toddlers had the highest exposure via dust ingestion. Compared with the threshold values, the exposure doses of PBDEs and HBCDDs are unlikely to pose significant health concerns for both infants and adults in China. This is the first national survey of PBDEs and HBCDDs in indoor dust samples across China after the restriction. [ABSTRACT FROM AUTHOR]

This article conceptualises Pepe Meamea (Samoan concept of infant/toddler) to ground Samoan cultural understandings, values and beliefs of the Samoan child as a collective, holistic and relational being. The Samoan worldview of children and childhood prioritises the whole child, and this has implications when positioned within a dominant Eurocentric early childhood curriculum (ECE) curriculum and pedagogy framework. The semiotics of the Samoan language references a collective position for personhood rather than an individual one which warrants further examination into Samoan conceptualisations of Pepe Meamea pushing back at normative assumptions. As an innovative practice and philosophy for teaching, Pepe Meamea already has deep Samoan cultural knowledges associated with its term. Pepe Meamea is understood and commonly referred to as infants or newborns. This presents initial tala- noa (dialogue) with teachers from six Aoga Amata (Samoan early childhood centres) in a two-year research Teaching and Learning Research Initiative (TLRI) project (2021-2022). Using Samoan language as the conduit for creation and cultural reference ensures Samoan children's cultural rights are adhered to through an Indigenous Samoan paradigm. As an innovative practice and concept, Pepe Meamea already has deep cultural Indigenous knowledge associated with its term; however, this article presents the possibilities of Pepe Meamea through the development of a pedagogical and relational framework that promotes its imple mentation in the Aotearoa New Zealand ECE environment. How the New Zealand Te Whariki early childhood education (ECE) curriculum is responsive to Pepe Meamea is another dimension this paper will consider as the majority of the New Zealand Samoan population are born and raised in a New Zealand context. This research paper reports on the first phase of the project, the process of co-designing a Pepe Meamea pedagogical framework with Samoan teachers. [ABSTRACT FROM AUTHOR]

Purpose: Oncological diseases, especially if experienced in the first 3 years of life, expose young children to conditions of serious physical and emotional stress causing delays in their physical development, cognitive acquisitioning and issues related to their emotional and social functioning. This study examines the effects of the participation in an early childcare intervention to support the children's development, which was proposed to children from 0 to 36 months, at the moment of cancer diagnosis in their hospital setting. Method: A prospective multicenter programme was offered to young children (<3 years) newly diagnosed with cancer. These children were treated in three pediatric oncology centers affiliated to the Italian Association of Pediatric Hematology-Oncology. The children's strengths and weaknesses, in different developmental areas, were examined pre-programme and 6 months post-programme. Results: Fifty-three young children were enrolled in the study. The data showed that at the moment of diagnosis the majority of the children demonstrated low scores across all the abilities in the subscales examined, highlighting a mental age below their chronological age (ΔT0 = 3.5 months). However, post-programme, the children were shown to have significantly reduced the gap between their chronological and mental age (ΔT1 = 1 month), demonstrating improvements in all their developmental abilities. Conclusion: The study confirms significant implications for early childcare programmes, delivered in hospitals for young children with cancer, in terms of support for their ongoing physical, cognitive and social development. Therefore, the study demonstrated the necessity, for all pediatric oncology centers, to invest in early childhood education programmes. [ABSTRACT FROM AUTHOR]

Childhood trauma continues to be a silent epidemic in South Africa. Institutional childcare centres do not have sufficient funding or resources to render daily therapeutic services for abandoned children. The first line of professional care for these children encompasses their daily interactions and relationships formed with the centre caregivers. This article advances a greater understanding of the views, perceptions and experiences of caregivers caring for abandoned infants and toddlers living in institutional care, on the basis of information obtained from 15 participants interviewed through semi-structured interviews in this qualitative study. Understanding their views, perceptions and experiences provides vital information to develop social work practices. [ABSTRACT FROM AUTHOR]

Objective: To investigate and analyze the current status and challenges of infant and toddler nutritional services in urban and rural medical facilities in Sichuan Province., Methods: In 2022, a questionnaire survey was conducted to collect data on infant and toddler nutritional services, including feeding guidance, physical growth assessment, and micronutrient deficiency screening, as well as information on personnel and tools in medical facilities throughout Sichuan Province. The provision of nutritional services was analyzed and the urban-rural disparities were assessed., Results: A total of 2206 medical facilities (29.1% from urban areas and 70.9% from rural areas) were investigated. Only 35.8% of medical facilities provided all three types of nutritional services. Specifically, the overall service provision rates were high for feeding guidance (94.6%) and physical growth assessment (85.0%), but lower for micronutrient deficiency screening (37.4%). Rural facilities exhibited significantly lower rates than their urban counterparts for both physical growth assessment and micronutrient deficiency screening ( P <0.05). The provision rates of feeding guidance ranged from 70.6% to 93.2%, with responsive feeding guidance being the least implemented (70.6%), particularly in rural areas compared to urban areas ( P <0.05). Rates for physical growth assessment and micronutrient deficiency screening ranged from 75.3% to 81.8% and 23.6% to 30.8%, respectively, both showing lower rates in rural settings compared to urban ones ( P <0.05). Nutrition service providers were predominantly nurses (52.3%) and clinical practitioners (43.4%). The availability of dietary assessment tools ranged from 7.7% to 15.9%, significantly lower in rural areas compared to urban areas ( P <0.001), while physical measurement tools were widely available at rates of 94.6% to 98.5%., Conclusion: At present, the infant and toddler nutritional service provisions of medical facilities in Sichuan Province are incomplete, particularly so in the implementation of feeding guidance, physical growth assessment, and micronutrient deficiency screening. There is a notable shortage of personnel and necessary tools, with rural areas facing more significant challenges. Enhancing the overall capacity of infant and toddler nutritional services in Sichuan Province is essential, with specific attention needed for rural healthcare settings., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Office of Journal of Sichuan University (Medical Sciences).)