Objective To explore the effect of in-home fortification of complementary feeding on intellectual development of Chinese children aged below 24 months. Methods One thousand and four hundred seventy eight children aged 4-12 months were recruited and divided into study groups (formula 1 group and formula 2 group) and control group. In two study groups, in addition to the usual complementary food, children were fed with a sachet of fortified food supplement each day. Protein and micronutrients were provided in formula 1 group. Formula 2 group had the same energy intake as the formula 1 group. In addition to measurement of physical growth and detection of hemoglobin level, Development Quotient (DQ) or Intelligence Quotient (IQ) was assessed. Results The DQ of children aged below 24 months was 97.2, 95.5, and 93.8 in formula 1 group, formula 2 group and control group, respectively, and the differences were statistically significant (P<0.05), The DQ of children in formula 1 group, formula 2 group, and control group was 92.7, 90.4, and 88.3 respectively in the first follow up showing statistically significant differences (P<0.05). And, DQ of children in formula 1 group, formula 2 group and control group were 96.7, 94.5, and 93.7 respectively in the second follow up, showing statistically significant differences (P<0.05). Full-IQ of children in the formula 1 group was 3.1 and 4.5 points higher than that in formula 2 group and in control group respectively. Verbal IQ of children in the formula 1 group was 2.1 and 5 points higher than that in formula 2 group and control group respectively. Performance IQ was 2.5 and 3.1 points higher than that in formula 2 group and control group respectively. All above mentioned comparisons were statistically significant. Conclusion Fortification of complementary feeding showed persistent effect on intelligence development of young children which could persist to 6 years of age. The critical time for correction of anemia could be under 18 months.

Objective To summarizethe status of screening of developmental dysplasia of the hip ( DDH ) in infants and young children 0 - 36 months of age and to generate a standardized process for DDH screening in infants and young children.Methods Preliminary DDH screening was carried out by obstetricians for newborns, and by pediatricians for infants and young children 0 - 36 months inpatients in ward, and by pediatric surgeon for infants and young children 0 - 36 months of age outpatient. Secondary screening was performed by pediatric orthopedic surgeons. In addition, ultrasound or radiograph examination of bilateral hip joints was performed. Suspected cases were followed up regularly until patients were diagnosed with DDH or excluded.Results From January 2012 to December 2014, 22 396 infants and young children were screened at the First Afifliated Hospital of Zhengzhou University, Zhengzhou, China. Ultrasound examination was performed for 2669 patients, 591 of whom ( 775 hips ) with suspected and abnormal ifndings were transferred to the Department of Pediatric Orthopedics. Among the referrals, a positive Ortolani or Barlow test was observed in 61 patients ( 89 hips ). Anteroposterior hip radiography showed acetabular dysplasia in 94 cases ( 131 hips ). Finally, 76 patients ( 121 hips ) were diagnosed with DDH. Among them, 21 ( 29 hips ) were males and 55 ( 92 hips ) were females. The left side was involved in 91 hips, and the right side was involved in 30 hips. Thirteen cases ( including 3 newborns ) were 1 - 6 months old ( 1.95‰, 13 / 6676 ), 49 cases were 7 - 18 months old ( 7.09‰, 49 / 6909 ), and 14 cases were 19 - 36 months old ( 1.59‰, 14 / 8811 ). Among the 76 cases of DDH, 49 ( 64.47% ) were 7 - 18 months old. The incidence of hip dysplasia was 3.39‰ ( 76 / 22 396 ).Conclusions During the present study, we screened infants and young children 0 - 36 months old for early detection and diagnosis of DDH and generated a standardized screening process based on the actual status of patients in our district.

Objective:To observe the clinical efficacy of tuina plus ultrasonic therapy in treating infantile muscular torticollis.
Methods:Seventy kids with muscular torticollis were intervened by tuina plus ultrasonic therapy, and the efficacy was evaluated after 8-month treatment.
Results: After 8-month treatment, 41 subjects were cured, accounting for 58.6%, 27 were improved, occupying 38.6%, 2 failed, occupying 2.8%, and the total effective rate was 97.2%.
Conclusion: Tuina plus ultrasonic therapy can produce a significant efficacy in treating infantile muscular torticollis, without adverse effects.

The impact of socioeconomic status on growth during infancy versus puberty in a developing country

Objective:To explore the relationship between socioeconomic status from one side and physi-cal growth and nutritional status from the other side, in infants versus adolescents in Egyptians. Methods: Three samples were investigated:a) A sample of 605 infants aged 6 months+1 week (287 girls and 318 boys). B) A sample of 992 infants of age 4-24 months (465 girls and 527 boys). C) A sample of 1864 chil-dren and adolescents aged 6-14 years of (744 girls and 1120 boys). All samples are from Big Cairo area of both urban and rural localities and of various socioeconomic strata. Body weight and length/height had been measured and body mass index (BMI) had been calculated for every subject. Assessment of the impact of pa-rental education level, locality and number of sibs, on growth and nutrition as indicated by BMI was attemp-ted. Results: a) Breastfed infants (6 months +1 week) grow bigger in low socioeconomic strata and in rural areas than artificially fed infants. The practice of breast feeding was more common and lasted longer in low so-cioeconomic stratum than in middle and high one. B) A significant positive association between body mass in-dex of infants (4-24 months) and the socioeconomic status (particularly level of father education reflecting family income) was proved. C) The socioeconomic factors had insignificant influence on BMI of school chil-dren aged 6～9 years, but it showed significant influence in the period 10～14 years. After the age of 9 years, children started the pubertal stage earlier and had higher BMI in the high socioeconomic strata as com-pared to those of low socioeconomic strata. D) In the low socioeconomic status, breast feeding compensates the deleterious influences of the environment on growth and physique of infants. Conclusion: children of educated parents have significantly low number of siblings'size in comparison to those of uneducated parents. Also chil-dren of educated parents are significantly more in number in urban areas than in rural areas, and vice versa. The interdependence between parental education and locality shows the highest level of significance in both se-xes and at all ages.

Assesment of polyunsaturated fatty acids in cord blood of infants of diabetic mothers

Objective:To assess whether infants of diabetic mothers [pre pregnancy diabetics (PPD) and gestational diabetics mellitus (GDM)] have compromised arachidonic and docosahexaenoic acids in their plasma and the relationship with deficiency of the same compounds in their mothers. Methods:This study was conducted on 30 diabetic mothers (both PPD and GDM) and their infants. Twenty healthy infants and their mothers with age and sex matched were included as controls. All infant (of diabetic and non diabetic mothers) were subjected to assessment of APGAR Scoring, thorough history taking and anthropometric measures. Lipid profile components as well as polyunsaturated fatty acids(PUFA) were assessed in diabetic GDM and PPD and non diabetic mothers as well as in their babies. Results: High-density lipoproteir(HDL) level was found to be significantly lower in diabetic mothers (specially those with PPD) compared to non diabetic ones, whereas no significant difference was found between babies of the two groups. Also, the current study revealed that diabet-ic mothers (GDM and PPD) and their babies had significantly higher levels of PUFA precursors linoleic acids (LA) and alpha linoleic acids (ALA). PUFA arachidonic acid (AA) and docosahexaenoic acids (DHA) were found to be significantly lower in diabetic mothers (GDM and PPD) compared to non diabetic mothers, and same results were found in the babies of the two groups. Conclusion: Neonates with diabetic mothers (both GDM and PPD) have highly compromised plasma levels of AA and DHA PUFA, which affects the child well being by far, and produces hazardous multi-system complications on the long run.

Background: Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality. This study was undertaken to determine the cut-off value of hemoglobin for infant anemia.
Methods: A cross-sectional retrospective study was carried out at well-baby clinics of a tertiary care hospital. A total of 1484 healthy infants aged between 4 to 24 months were included in the study. The relationship of hemoglobin (Hb) levels with mother age, birth weight, weight gain rate, feeding, and gender was evaluated.
Results: The Hb levels were assessed in four age groups (4 months, 6 months, 9-12 months, and 15-24 months) and the cut-off values of Hb were determined. Hb cut-off values (5th percentile for age) were detected as 97 g/L and 93 g/L at 4 months and 6 months, respectively. In older infants, the 5th percentile was 90.5 g/L and 93.4 g/L at 9-12 months and 15-24 months, respectively. The two values were lower than the World Health Organization criteria for anemia, which could partly due to the lack of information on iron status in our population. However, this difference highlights the need for further studies on normal Hb levels in healthy infants in developing countries. Hb levels of females were higher in all age groups; however, a statistically significant difference was found in gender in only 6 month-old infants. No statistically significant difference was found among Hb levels, mother's age, birth weight, weight gain rate, and nutritional status.
Conclusion: Hb cut-off values in infants should be re-evaluated and be compatible with growth and development of children in that community.

Background: To investigate the clinical characteristics and analyze risk factors for severe respiratory syncytial virus (RSV) infection in hospitalized infants with acute lower respiratory tract infections (ALRIs).
Methods: A retrospective review of the medical records of infants with RSV-associated ALRIs between March 1st, 2011 and February 29th, 2012 was conducted. Subjects were followed up over the phone or by outpatient visit six and twelve months after discharge.
Results: Among 913 RSV-associated ALRIs infants, 288 (31.5%) had severe infections, which accounted for 4.2% of hospitalized children. The hospital RSV mortality rate was 1.0%. The proportions of cases with tachypnea, apnea, cyanosis, and fine rales were significantly higher in the severe ALRIs group (all P<0.001). Multivariate logistic regression showed that low-birth-weight [1.698 (1.028-2.805)], age less than 3 months old [3.385 (2.174- 5.271)], congenital heart disease [1.667 (1.149-2.418)], bronchopulmonary dysplasia [8.505 (1.731-41.780)], and airway abnormalities [2.246 (1.008-5.005)] were independent risk factors for severe ALRIs. The incidence of bronchitis, pneumonia and readmission in the severe group was significantly higher than that of the non-severe group during the one-year follow-up (all P<0.001).
Conclusions: Younger age, low birth weight and underlying disease are associated with severe RSVassociated ALRIs. Furthermore, severe RSV infections may be associated with a higher frequency of subsequent bronchitis, pneumonia and re-hospitalization in the following year.