Lege Artis Medicinae

[The Wonderful Infant ]

LŐRINCZ Jenő

DECEMBER 15, 2015

Lege Artis Medicinae - 2015;25(11-12)

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[Feeding and eating in infancy and early childhood part III. - Development of self-feeding skills in the large-sample of the “For Healthy Offspring” project ]

NÉMETH Tünde, VÁRADY Erzsébet, DANIS Ildikó, SCHEURING Noémi, SZABÓ László

[Feeding and eating in infancy and early childhood part III. - Development of self-feeding skills in the large-sample of the “For Healthy Offspring” project INTRODUCTION - After introducing adequate complementary food to the diet of breastfed/formula-fed babies, the frequency and amount of semisolid/solid food is increasing, the breastmilk/formula intake is decreasing and finally the weaning process is completed. During this process the developing feeding skills of the infant enables them to self-feed. The self-feeding infant and toddler should participate in family meals. SUBJECTS AND METHODS - In the Healthy Offspring project self reported questionnaires were received from 1133 parents of 0-3 year old children. Issues concerning the development of self-feeding skills were analyzed. RESULTS - With advancing age the proportion of infants/toddlers, reported to be able to (partially) self-feed, has increased. The age, at which the majority of toddlers (83.1%) were reported to self-feed, was at 13-15 months. By the age over 2 years 57.2% of the toddlers were fully self-feeding, 39.3% were self-feeding with some assistance, and 3.5% were still completely fed by their mother/caregiver. While self-feeding became more prevalent, the proportion of toddlers with feeding problems and insufficient weight gain has increased. With more prevalent complementary feeding more parents assessed their feeding style rather scheduled than on demand. In the whole sample the proportion of infants/toddlers, who ate with the family, was 43.8%. CONCLUSIONS - In our sample, as previously described in the scientific literature, the developmental readiness to self-feed has developed in the majority of infants by the age of 13-15 months. During progres­sion of weaning an increasing proportion of parents thought, that feeding was rather scheduled than on demand. This finding points at the importance of educating parents about the importance of responsive feeding during and after weaning. For self-feeding toddlers, responsive feeding means, that the mother/caregiver offers a choice of healthy and adequate amount of food, at a proper place, at proper times, responds to the hunger and satiety cues of the child and the toddler decides, whether to eat, what and how much to eat.]

Hungarian Radiology

[Heterotopic pregnancy]

SARLÓS Géza, VARGA Tamás, HEGEDŰS Géza

[INTRODUCTION - Simultaneous presence of intrauterine and extrauterine gestations is very rare. CASE REPORT - A 26 year old multiparous woman known to be 10 weeks pregnant presented with severe abdominal pain. Transabdominal sonography revealed a concomitant ectopic pregnancy with large amount of intraperitoneal fluid. Cardiac activities of both the intrauterine and the ectopic fetuses were clearly visible on abdominal ultrasound. Emergency laparoscopy confirmed intraabdominal hemorrhage and rupture of the left fallopian tube. The laparoscopic salpingectomy did not affect the ongoing intrauterine pregnancy. The woman subsequently delivered a healthy infant. CONCLUSION - Though heterotopic pregnancy especially without previous ovarian hyperstimulation is extremely rare. The confirmation of an intrauterine pregnancy does not exclude a co-existing ectopic pregnancy as well as in case of extrauterine pregnancy the simultaneous presence of an intrauterine pregnancy must be considered.]

Hungarian Radiology

[A rare pancreatic mass in childhood]

TORDAS Adél, PALOTAI Andrea, KISS Imre, KIS Éva

[INTRODUCTION - Malignant pediatric pancreas tumors are rare in the pediatric age group. Among these tumors the malignant hemangiopericytoma is an even more rare condition. CASE REPORT - We have diagnosed this soft tissue sarcoma in a three month old infant during a screening abdominal ultrasound examination. The examination showed a space-occupying lesion in the region of the pancreas and the adrenals. Following further diagnostic imaging, a complete surgical resection was performed. Histology showed malignant hemangiopericytoma. The child received a 5 month long, successful adjuvant chemotheraphy. CONCLUSIONS - Malignant hemangiopericytoma belongs to the non-rhabdomyosarcoma group of diseases. Two subtypes have been described: infantile-type ( hemangiopericytoma) in infants under 1 year, and the adult-type disease in children over 1 year of age. About one third of the infantile subtype are considered congenital. Most common anatomic locations are the retroperitoneum, the pelvis, the extremities, the head and neck region. Prognosis is favorable, the 10-year-survival rate is 80%. Differential diagnosis includes other tumors of the region, such as lesions of the adrenal gland, kidney, stomach and pancreas.]

Lege Artis Medicinae

[Pain and opportunities for non-pharmacological pain management in intensive neonatological care]

ANDREK Andrea

[Neonatal intensive care and therapeutic process is accompanied with a range of painful interventions. Research data from the past decades revealed that repeated and/or prolonged pain has long-term consequences on the neurobiological development of the premature infant, which has led to an increased attention to the measurement and alleviation of pain. In addition to pharmacological pain relief, more and more alternative pain management methods of varying efficacy are appearing in the provision of care for premature infants. In this study, we introduce non-pharmacological pain treatment methods with proven efficiency that can be applied to complement the pharmacological pain management or as a therapy before any painful interventions in intensive neonatological care. These methods include heart sound and music therapy, nutritive and non-nutritive sucking, swaddling, touching and kangaroo care.]

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[Feeding and eating in infancy and early childhood part I. - data on breastfeeding in the large-sample “For Healthy Offspring” project]

NÉMETH Tünde, VÁRADY Erzsébet, DANIS Ildikó, SCHEURING Noémi, SZABÓ László

[INTRODUCTION - Breastfeeding is the ideal and natural source of nutrition for infants, is associated with a reduced risk of many diseases in infants and mothers. It has a positive impact on the mother-infant relationship and also has considerable economic and environmental benefits. Subjects and methods - In the “For Healthy Offspring” Project parents of 1164, 0-3-year-old children completed a ques-tionnaire about breastfeeding and their feeding routine. The sample is not representative of the general population, but the sociodemographic and housing variables indicate an adequate spectrum. RESULTS - Breastfeeding was perceived by 60% of mothers enjoyable, while 20% of them had a negative experience with it. More than 50% of mothers had some breastfeeding difficulties, but it did not have a significant correlation with the negative perception of breastfeeding. The most common problem was the perception of inadequate milk supply. Among the studied variables maternal smoking, lower maternal education and the lack of antenatal breastfeeding education had the strongest correlation with the duration of breastfeeding. CONCLUSIONS - Adequate antenatal education on breastfeeding, proactive support of women and promptly attending their breastfeeding difficulties increases the duration of exclusive and any breastfeed-ing, helps mothers to reach their breastfeed-ing goals and to perceive breastfeeding enjoyable.]