Journal of Mother and Child Feed

Immunohaematological Testing, Monitoring, and Treatment of Haemolytic Disease of the Newborn: Where are we in this Field after 25 Years?

Fri, 25 Sep 2026 00:00:00 GMT

ContextPrevention of pregnancy-related alloimmunisation and the management of haemolytic disease of the foetus and newborn (HDFN) has significantly improved over the past decades.AimConsidering the improved HDFN care in recent years, the goal of this 25-year analysis is to determine the epidemiological aspects of alloimmunisation during pregnancy and the presentation, diagnosis, and treatment of different types of haemolytic disease of newborns (HDN).Materials and methodsThe retrospective study encompasses all pregnant women whose immunohaematological screening detected antibodies against any of the antigens in ABO, Rhesus, Kell, Duffy, Kidd, and/or other blood group systems or had newborns who developed HDN.ResultsOver the 25-year study period, 830/38,898 (2.1%) of immunohaematologically tested pregnant women developed alloimmunisation, while 556 (1.42%) of their newborns developed HDN. The most common form of HDN in our study was ABO HDN at 73.2% (407/556). RhD HDN was treated in 12.9% (72/556) of the newborns. Exchange transfusions (ET) were administered to 5.76% (32/556) of newborns with HDN. ET was performed on 24 (75%) with ABO HDN, and 8 (25%) with RhD HDN.The conclusion of this 25-year study is that alloimmunisation is still present, as are its consequences for the newborn. Despite better screening of pregnant women, diagnosis, and treatment of the consequences of alloimmunisation, we must know that there is no universal cure for HDN; therefore, continuous research and new guidelines in this field are needed.

Breastfeeding Education Across the Perinatal Period: A Descriptive Exploratory Pre-Implementation Study

Fri, 25 Sep 2026 00:00:00 GMT

BackgroundBreastfeeding is the optimal infant feeding method; however, cessation rates remain high across many developed nations. Support for mothers can be improved through breastfeeding education that spans the entire perinatal period. Due to the number of healthcare providers involved, delivery of breastfeeding education must be consistent and tailored to individual needs. Digital innovations are a potential solution to enhance accessibility and consistency in breastfeeding education delivery. How to best implement these solutions in clinical settings is not yet known.Materials and methodsWe used a non-experimental, exploratory descriptive survey to collect mothers’ and providers’ experiences of breastfeeding education, and their perceptions of how an eHealth resource can be adapted and implemented to standardise breastfeeding education.ResultsThe surveys were completed by 93 providers and 78 mothers. Mothers reported receiving education from diverse providers across the perinatal period, with varying information at different time points. Information was received on many topics that changed at various times. Oral communication was ranked as the most frequent education method. Both groups reported that online videos and websites would be the most effective digital solutions to support breastfeeding education.ConclusionProviders play a crucial role in supporting mothers through education delivery that spans the entire perinatal period. By integrating the findings, accessibility and consistency of breastfeeding education could be enhanced by implementing the eHealth resource across organisations in a health region.

The New Landscape of Cystic Fibrosis in the Era of Highly Effective Cystic Fibrosis Transmembrane Conductance Regulator Modulator Therapy

Fri, 25 Sep 2026 00:00:00 GMT

BackgroundFor many years, the management of cystic fibrosis has had a personalised character. We have now entered an era of therapy based on a patient’s specific genotype. Clinical trials have confirmed the efficacy and safety of cystic fibrosis transmembrane conductance regulator modulator therapies, including ivacaftor as monotherapy and triple-drug combinations, such as elexacaftor/tezacaftor/ivacaftor and vanzacaftor/tezacaftor/deutivacaftor. These therapies result in substantial and sustained improvements in lung function, a reduction in the frequency of bronchopulmonary exacerbations, enhanced nutritional status, and an improved quality of life. These clinical outcomes have been correlated with a marked reduction of sweat chloride values.Material and methodsEarly initiation of therapy is crucial to halt disease progression or even reverse disease-related complications, which have even been observed in children aged six to twelve years. Initiating treatment in even younger children before the onset of clinical symptoms offers the possibility of a much later disease manifestation or even absence of symptoms. Nevertheless, careful evaluation of these therapies’ long-term effects on the respiratory system and other organs remains necessary.ResultsAccording to current knowledge, patients continue to require regular follow-up by a multidisciplinary care team and ongoing adjustment of both modulator and symptomatic therapies to meet individual needs.ConclusionAs patient life expectancy continues to increase, comorbidities such as arterial hypertension, hypercholesterolaemia, cardiovascular disease, and malignancies will assume greater clinical importance. Selecting optimal therapeutic strategies remains a significant clinical challenge due to the numerous potential interactions between modulators and other medications.

Maternal Sleep Disturbances as an Upstream Modulator of the Immunological Biomarker Profile in Early-Onset Preeclampsia

Fri, 25 Sep 2026 00:00:00 GMT

Prenatal Glucocorticoid Exposure and Autism Spectrum Disorder: Current Evidence, Mechanisms, and Clinical Implications

Sat, 18 Jul 2026 00:00:00 GMT

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterised by social difficulties and repetitive behaviours. Genetic and environmental factors play a key role in its aetiology. Antenatal glucocorticoids, widely used to improve outcomes in preterm infants, have raised questions about potential long-term neurodevelopmental effects. This review aims to summarise the current literature on the association between prenatal glucocorticoid exposure and neurodevelopmental outcomes, including ASD, explore proposed biological mechanisms, and discuss clinical and public health implications. A comprehensive literature search was conducted in PubMed, Web of Science and Google Scholar using relevant keywords, focusing on observational studies, meta-analyses, and clinical studies that addressed neurodevelopmental consequences of prenatal glucocorticoid exposure, with priority given to studies evaluating ASD risk. Glucocorticoids reduce neonatal respiratory complications in preterm infants. Long-term neurodevelopmental outcomes, including ASD, are uncertain: some observational studies suggest increased risk, especially in late-preterm or term infants, while randomised trials show minimal adverse effects. Potential mechanisms include epigenetic changes, HPA axis disruption, and altered hippocampal development. Glucocorticoids are essential for improving the survival of preterm infants. Current evidence does not establish a causal link with ASD, but potential long-term neurodevelopmental effects warrant cautious use, careful patient selection, and continued long-term follow-up. Further well-controlled studies using standardised neurodevelopmental assessments are needed.

Doppler Evaluation of Foetal Pulmonary Artery in Intrahepatic Cholestasis of Pregnancy: A Prospective Study

Sat, 18 Jul 2026 00:00:00 GMT

BackgroundIntrahepatic cholestasis of pregnancy (ICP) is the most prevalent liver disease specific to pregnancy, with higher incidence of adverse pregnancy outcomes. Keeping this in mind, this study has been framed to compare the changes in foetal pulmonary artery Doppler in pregnancies complicated with ICP with normal pregnancies.Materials and methodsThis prospective study included total of 100 patients as per the inclusion and exclusion criteria. These patients were divided into two groups: the case group (ICP pregnancies) and control group (normal pregnancies). The Doppler parameters were analysed in terms of acceleration time/ejection time (AT/ET) ratio and the maternal and foetal outcome were evaluated.ResultsSignificant differences were found in Doppler parameters between the groups, with longer acceleration times (AT), shorter ejection times (ET), and higher PATET ratios in the ICP cases, which signify altered right ventricular outflow parameters, suggesting compromised pulmonary hemodynamics in newborns of ICP-affected pregnancies. These parameters were significantly influenced by the severity of ICP. The AT and ET, which are measures of cardiac function, show weak correlations with the liver function markers (all below 0.23), suggesting minimal direct relationships between these cardiac parameters and liver dysfunction in ICP patients.ConclusionThe altered Doppler parameters reflect changes in foetal pulmonary vascular resistance and could be indicative of lung immaturity or altered hemodynamics secondary to the toxic effects of elevated maternal bile acid levels.

Fat Mass Obesity Gene Predisposing in Preeclampsia in the Madura Population: A Case-Control Study

Sat, 18 Jul 2026 00:00:00 GMT

BackgroundPreeclampsia (PE) is a common complication of pregnancy characterised by hypertension, severe headaches, and protein in the urine, usually developing after 20 weeks of pregnancy. High body mass index before pregnancy is a risk factor for PE. One gene associated with obesity is the Fat Mass Obesity (FTO) gene. This study aimed to analyse the FTO gene predisposing to PE in the Madura population.Material and MethodsThe research design is a case-control design. A total of 110 pregnant women participated: 55 with severe PE and 55 healthy pregnant women. The inclusion criteria for the case group were patients with a history of PE who visited Syamrabu Bangkalan Regional Hospital and the independent midwifery practice, and who were of Madurese ethnicity. Blood samples were collected for FTO gene analysis; a questionnaire was used to obtain demographic data from pregnant women; and the FTO gene was analysed by tetra-primer amplification refractory mutation system polymerase chain reaction method, followed by sequencing and statistical analysis using Statistical Package for the Social Sciences (SPSS).ResultsIn normotensive pregnant women, the AA homozygous genotype was less common than in the PE group (1.8% vs 12.7%). The results were statistically significant (p = 0.018) between normotensive and preeclamptic pregnant women.ConclusionThe FTO gene may be a risk factor for PE and is associated with the AA homozygous genotype; further research with large sample sizes across diverse ethnicities is needed.

King-Denborough Syndrome-Dysmorphic Features Suggesting Risk of Malignant Hyperthermia

Sun, 28 Jun 2026 00:00:00 GMT

BackgroundKing-Denborough syndrome is a rare disorder within the spectrum of RYR1-related myopathies. It is a congenital myopathy, with characteristic dysmorphic features, and susceptibility to malignant hyperthermia. Early recognition is clinically important because the diagnosis may affect anesthetic management and perioperative safety.Case presentationWe report a 4.5-year-old boy with delayed motor development, generalized hypotonia, characteristic dysmorphic features, and mildly elevated serum creatine kinase levels. The MRI showed features of asymmetrical atrophy and fatty degeneration in the proximal muscles of the lower limbs.ResultsMolecular testing identified a heterozygous RYR1 variant. In the context of the clinical phenotype and muscle imaging findings, the presentation was considered suggestive of King-Denborough syndrome within the spectrum of RYR1-related disorders.ConclusionThis case highlights the importance of another RYR1-related myopathy in children presenting with myopathic features, dysmorphism, and muscle MRI abnormalities. Recognition of this phenotype is particularly important because of the potential risk of malignant hyperthermia and the need for appropriate anesthetic precautions.

Assessment of Renal Changes in Bardet–Biedl Syndrome with Particular Emphasis on Kidney Size, Function, and Blood Pressure Control

Sun, 28 Jun 2026 00:00:00 GMT

IntroductionBardet-Biedl syndrome (BBS) is a genetically heterogeneous ciliopathy characterized by obesity, retinal dystrophy, cognitive impairment, hypogonadism, and congenital renal anomalies, which represent a leading cause of morbidity and mortality in affected patients.Material and methodsWe followed four patients with BBS (three boys, one girl) from birth to ten years of age. In all children, we assessed physical development, laboratory tests, including assessment of renal function, renal ultrasound examination, and blood pressure control.ResultsPatients (three males) with Bardet-Biedl syndrome, demonstrated prenatal and postnatal evidence of structural and functional renal abnormalities, including kidney injury and bilateral renal dysplasia. Neonatal serum creatinine ranged from 0.70 to 1.66 mg/dL, with persistently abnormal renal morphology on follow-up imaging and variable but overall stable renal function (latest creatinine 0.68–1.03 mg/dL). Arterial hypertension occurred in one male and one female patient and was effectively controlled with angiotensin-converting enzyme inhibitor therapy. All patients exhibited multisystem involvement characteristic of ciliopathy, including polydactyly, obesity, ophthalmologic abnormalities, neurodevelopmental impairment, and hypogonadism in three of four individuals.ConclusionsThe broad spectrum of renal manifestations in BBS underscoring the importance of early diagnosis and individualized nephrological monitoring.

Comparative Performance of Machine Learning Models Using Food Intake Frequency Versus Vegetable Intake Data to Predict Problematic Mealtime Behaviour in Japanese Preschool Children

Mon, 08 Jun 2026 00:00:00 GMT

BackgroundSelective eating often leads to nutritional imbalance and mealtime stress, making early identification essential.ObjectiveThis study aimed to compare the predictive performance of machine learning (ML) models using two types of input data—namely, vegetable intake and food frequency questionnaire (FFQ) responses—to identify children with selective eating behaviour (cutoff score ≥1.59).Material and methodsWe analysed a cross-sectional dataset of 283 children aged 3–6 years using up to 8 predictors selected from 15 food-frequency items or 15 designated vegetables, along with age and sex. Selective eating behaviour was defined as a selective eating score of ≥ 1.59. Eleven ML algorithms were trained and evaluated, resulting in 11,253 feature–model combinations. Model performance was assessed using 5-fold cross-validation based on accuracy, precision, recall, F1 score, and ROC-AUC. Permutation importance analysis was conducted to identify key predictive features.ResultsAmong the 11 ML algorithms tested, vegetable intake-based L1 logistic regression showed the best performance (ROC-AUC = 0.717, accuracy = 0.647, precision = 0.722, recall = 0.659, F1 = 0.808). Permutation importance further identified tomato, green onion, and taro as key contributors in the vegetable intake-based L1 logistic regression model. In contrast, the FFQ-based Naïve Bayes model showed relatively good discrimination (ROC-AUC = 0.619) despite moderate recall.ConclusionVegetable intake-based ML models were more effective than those using FFQ data in identifying children with selective eating behaviour. Detailed dietary assessment aids early detection.

Assessing Awareness of Genetic Risks among Pregnant Mothers in Consanguineous Marriages: A Cross-Sectional Study in Government Healthcare Settings

Sun, 31 May 2026 00:00:00 GMT

BackgroundConsanguineous-marriages are highly prevalent among the Pakistani population, leading to an increased risk of genetic disorders in offspring. However, awareness of these genetic risks remains low, which delays diagnosis and contributes to poor health outcomes. This study's objective is to assess awareness of the genetic risks of consanguineous marriage and examine its effects on pregnancy outcomes.Materials and methodsA descriptive cross-sectional-study was conducted among 365 pregnant women attending antenatal clinics in Peshawar. Data were collected using a self-structured questionnaire. Sample size was calculated using an estimated prevalence of 36% from prior NCBI-indexed studies. Participants were selected through systematic random sampling, including women in consanguineous marriages who consented to participate. Data were analyzed using descriptive statistics and Chi-square test, with p ≤ 0.05 considered statistically significant.ResultsAmong 365 pregnant women, 41.0% had low awareness of genetic risks, 29.3% had no knowledge, and only 10.6% demonstrated good understanding of consanguineous marriage. Genetic screening was reported by 20.4%. Higher awareness was associated with older age, higher education, and prior screening. Family history of genetic disorders was significantly associated with age (p = 0.003), education (p = 0.010), duration of marriage (p = 0.003), awareness (p = 0.004), prior screening (p < 0.001), and consanguinity (p = 0.011). It was strongly linked to adverse pregnancy outcomes, including miscarriages, stillbirth, and developmental delay (p < 0.001).ConclusionAwareness of genetic risks in consanguineous marriages is low among pregnant women in this setting. Improving education and genetic counseling during antenatal care could help increase understanding and screening.

ReNU Syndrome and the RNU4-2 Mutation: A Missed Cause of Childhood Neurodevelopmental Delay

Sun, 31 May 2026 00:00:00 GMT

ReNU syndrome is a rare but increasingly recognized syndromic neurodevelopmental disorder caused by heterozygous de novo variants in the non-coding gene RNU4-2, which encodes the U4 small nuclear RNA (snRNA), a critical component of the major spliceosome. Recurrent pathogenic variants cluster within an 18-base-pair critical region of RNU4-2 and disrupt normal spliceosome function by altering 5′ splice-site usage. In large cohorts, most affected individuals harbor a recurrent single-base insertion (n.64_65insT), accounting for the majority of pathogenic variants, and RNU4-2 variants may explain ~0.4% of undiagnosed neurodevelopmental disorders. Clinically, ReNU syndrome is characterized by global developmental delay, intellectual disability, hypotonia, delayed motor milestones, limited speech, feeding difficulties, distinctive facial features, and structural brain anomalies. Given the emerging understanding of its prevalence and severe phenotype, we highlight the urgent need to incorporate RNU4-2 analysis into diagnostic genomic testing for pediatric neurodevelopmental disorders. Increasing awareness and equitable access to comprehensive genetic testing will improve diagnosis and counseling for affected families worldwide.

Successful Management of a Huge Pulmonary Hydatid Cyst in a Young Child: A Case Report

Thu, 30 Apr 2026 00:00:00 GMT

Hydatid cyst disease is a parasitic disease induced by Echinococcus granulosus, which is still endemic in northern African countries. We report the case of a late-discovered pulmonary hydatid cyst in a four-year-old boy revealed by recent dyspnoea. The chest X-ray showed a complete white-out of the left hemithorax with mediastinal deviation, and the thoracoabdominal CT scan showed a giant pulmonary hydatid cyst encompassing the entire left lung associated with a hepatic cyst. An emergent superior pulmonary lobe resection was performed under deep general anaesthesia and selective intubation to prevent contralateral lung inundation. The evolution was favourable postoperatively.

Randomised Controlled Trial of Elective Induction of Labour at 40 and 41 Weeks to Prevent Prolonged Pregnancy

Thu, 30 Apr 2026 00:00:00 GMT

BackgroundThere have been discussions as to the time of elective induction of labour to curb the continuation of pregnancy that might endanger the lives of both the mother and child. This research was conducted to assess foetal and maternal consequences of planned delivery at 40 and 41weeks in women with low-risk singleton pregnancy.Material and methodsA randomised controlled trial with equal allocation of participants (96 pregnant women in each arm) into 40weeks and 41weeks. Participants were randomised at the antenatal clinic at 39 weeks for induction of labour. The main outcome was the caesarean section rate. Secondary outcomes were maternal (genital tract laceration rate) and foetal (rates of meconium staining of amniotic fluid, SCBU admission, perinatal mortality, birth trauma, birth weight, and neonatal APGAR score at 1 and 5 minutes). Student t-test and chi-square test were used for inter-group comparison.ResultsIncidence of caesarean delivery (26.6% vs. 21.3%; p=0.406), and genital laceration (2.1% vs. 5.6%; p=0.268) did not differ between groups. Significantly higher birth weight was noted among women induced at 41weeks (3.41 ± 0.37kg) than 40weeks (3.28 ± 0.46kg) (p=0.043). Also, there was significant variation in meconium staining of amniotic fluid between 40weeks (11.7%) and 41weeks (25.8%) (p=0.014). Other foetal outcomes showed no significant difference.ConclusionInducing labour at 40weeks is safe for low-risk women as it does not significantly increase the cesarean delivery rate and adverse perinatal outcomes. Therefore, elective induction of labour at 40weeks should be recommended and introduced into obstetric practice without the fear of adverse outcomes.

Development and Validation of a Clinical Risk Score for Predicting Postpartum Hemorrhage in Women with Antepartum Hemorrhage

Thu, 30 Apr 2026 00:00:00 GMT

BackgroundPostpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality globally, particularly in women with antepartum hemorrhage (APH). Current risk assessment methods lack standardized predictive tools that are both simple and reliable for clinical application.Material and methodsWe conducted a secondary analysis of a prospectively collected cohort of 100 pregnant women presenting with APH at ≥28 weeks’ gestation at a tertiary care centre in northern India. Multivariable logistic regression was used to identify significant predictors of PPH. A point-based clinical risk score was then developed based on the multivariable model and internally validated using bootstrap techniques with 1000 replicates.ResultsPPH occurred in 30% of patients (n=30). Multivariable analysis identified four independent predictors of PPH: maternal age (adjusted odds ratio [OR] 1.29 per year; 95% confidence interval [CI] 1.10–1.51; p=0.002), gravidity (OR 2.11 per unit; 95% CI 1.00–4.43; p=0.049), gestational age at delivery (OR 0.64 per week; 95% CI 0.44–0.94; p=0.021), and antepartum blood transfusion (OR 2.44; 95% CI 1.02–5.84; p=0.045). The prediction model demonstrated excellent discrimination with an area under the receiver operating characteristic (ROC) curve of 0.86 (95% CI 0.80–0.92) and good calibration (slope 0.95). Bootstrap internal validation yielded an optimism-corrected AUC of 0.84. The resulting four-factor risk score stratified patients into four risk categories with PPH rates ranging from 4% (low risk) to 100% (very high risk).ConclusionThe four-variable score provides an accurate, easily applicable tool with excellent predictive performance. The score is a promising tool that, pending external validation, may facilitate early identification of high-risk patients and improve maternal outcomes. Further research should focus on external validation of this tool in diverse populations and its integration into clinical practice.

Combination of Markers, Including hsCRP, TGFβ 1, IL-6, and T-regs, and their Predictive Value as Early Warning Signs for Preeclampsia: Insights from a Tertiary Care Medical Centre in Eastern India

Sun, 15 Mar 2026 00:00:00 GMT

BackgroundRegulatory T cells (T-regs), a subset of CD4+ T-lymphocytes play a crucial role in the maintenance of immunological tolerance and immune homeostasis. The study has been done to evaluate the threshold values and reference intervals of Regulatory T cells, TGF-β1, IL-6, and hsCRP as a comprehensive panel for preeclampsia.Materials and MethodsIn this cross-sectional study the T-regulatory cells (CD4, CD25, FOXP3) were assessed using a flow-cytometer, and TGF-β1, and IL-6 were analysed by sandwich ELISA method and hsCRP analysed by Beckman Coulter autoanalyser.Statistical AnalysisThe reference range for the parameters in the studied groups was estimated based on CLSI C28-A3 guidelines. The lower and upper limits were estimated by a non-parametric method with 90% CI. Threshold values were estimated from the ROC curve based on optimal sensitivity and specificity measured by the Youden Index.ResultsThe study established a threshold value level for CD3+CD4+T-cells, CD4+CD25+T-regs, and CD4+FOXP3+ T-regs to separate individuals with preeclampsia from those without the condition. The threshold values for TGF-β1, IL-6, and hsCRP were chosen as they demonstrated significant differences between the two groups, indicating an association with the presence of preeclampsia.ConclusionThe statistical analysis of the study population aimed to establish a clear difference between the two groups, thereby providing a dependable foundation to differentiate impending preeclampsia from a normal pregnancy in order to assist in theranostics.

To Do Or Not To Do: Therapeutic Hypothermia Treatment For An Infant With HIE And Prenatal Spinal Muscular Atrophy With Congenital Bone Fractures

Fri, 06 Mar 2026 00:00:00 GMT

Spinal muscular atrophy with congenital bone fractures is a rare, severe neuromuscular disorder with autosomal recessive inheritance, characterised by hypotonia, congenital contractures, and respiratory distress. We present the case of a newborn girl with a homozygous mutation in the ASCC1 gene, who was diagnosed with hypoxic-ischaemic encephalopathy after birth and underwent therapeutic hypothermia (TH). Although TH did not cause any side effects, it also did not improve the prognosis or quality of life of the patient. The decision whether to perform TH in neonates with congenital or genetic abnormalities remains challenging. Current exclusion criteria for TH should be re-evaluated to support clinicians in determining whether to include newborns with severe congenital abnormalities but favourable neurological prognosis, and conversely, to exclude those with congenital or suspected genetic syndromes associated with poor life expectancy and quality of life, in order to avoid futile interventions.

Use of Topical Nitroglycerin in the Treatment of Acute Limb Ischemia: Four-Year Experience in a Mixed Neonatal and Pediatric Intensive Care Unit

Fri, 06 Mar 2026 00:00:00 GMT

BackgroundPediatric Acute Limb Ischemia (ALI) is a rare condition, sometimes encountered in the Intensive Care Unit (ICU). Optimal treatment remains to be established. Topical nitroglycerin has been suggested as a vasodilator agent, used to improve limb reperfusion.Materials and MethodsWe performed a retrospective descriptive study, with data from a PICU of a tertiary hospital, from 2021 to 2024.ResultsSeven children presented with ALI treated with topical nitroglycerin, with a median age of 244 days. Wrongful arterial catheterization was established as the cause of ALI in four out of seven children. Six out of seven children showed at least partial recovery. Complete recovery was achieved in three children. Three children underwent partial or total amputation. No adverse side effects were recorded.ConclusionTopical nitroglycerin appears to be a beneficial and safe intervention in children with ALI.

Novel Therapeutic Approaches for Treating Moderate-to-Severe Atopic Dermatitis in Infants with Polyvalent Allergic Sensitisation

Thu, 12 Feb 2026 00:00:00 GMT

The aim of this study was to evaluate the therapeutic efficacy of a comprehensive treatment approach in infants with moderate-to-severe eczema complicated by polyvalent allergic sensitisation. The methodology involved a randomised controlled trial that included 87 children aged 3 to 12 months. Participants were divided into two groups. The experimental group received combined therapy comprising pseudoceramides, a calcineurin inhibitor, and an oral synbiotic, while the control group received standard therapy with emollients and antihistamines. The results demonstrated that by the eighth week, patients in the experimental group exhibited a reduction in SCORAD index of more than 60% (to 21.4 ± 6.5); a 2.7-fold decrease in pruritus severity according to the VAS scale (to 2.9±1.3); and a 61% reduction in POEM score (to 7.3). This was accompanied by improved sleep, reduced irritability, and decreased behavioural disturbances. The control group showed less-pronounced positive dynamics. Immunological changes included a significant decrease in total and specific IgE levels, as well as a marked reduction in IL-4 and IL-13 concentrations, indicating attenuation of the Th2-mediated immune response. The prevalence of severe sensitisation decreased by 20%. Microbiota analysis demonstrated increased Bifidobacterium spp. abundance (+89%; p = 0.011); higher alpha-diversity (Shannon index + 27%; p = 0.004); and reduced E. coli levels (−36%; p = 0.018), suggesting restoration of microbial balance. Thus, this combined therapy demonstrated significant superiority, providing clinical improvement, suppression of the Th2 response, and normalisation of gut microbiota in infants with atopic dermatitis and multiple allergic sensitisation.

Diagnosis and Non-Surgical Treatment of Cranial Deformities in Children Under 2 Years of Age: Modern Methods and Approaches

Tue, 10 Feb 2026 00:00:00 GMT

BackgroundCranial deformities in children under 2 can lead to functional and cosmetic issues, with their frequency increasing due to sleep positioning practices. This study aimed to evaluate the effectiveness of custom-made corrective helmets in treating these deformities.Material and methodsThe study included 30 children under 2 in Astana, Kazakhstan, using 3D scanning to create custom corrective helmets worn for 23 hours a day over 5 months.ResultsThe results showed a significant improvement in the shape and symmetry of the skull after therapy. The asymmetry between the left and right front dimensions decreased from 9 mm to 3 mm, which corresponds to the age norm. The anterior-posterior size of the skull increased from 129 mm to 142 mm, the lateral size – from 123 mm to 129 mm, and the head circumference – from 41.5 cm to 43.5 cm, which indicates normal development of the skull. The majority of parents (90%) noted that children adapted easily to wearing helmets and experienced high levels of comfort. The data obtained indicate that the use of corrective helmets is an effective and safe method of non-surgical treatment of cranial deformities in young children. This avoids surgery and the associated risks, ensuring an improvement in the shape of the skull and the quality of life of patients.ConclusionsThis study highlights the effectiveness of orthotic therapy for treating cranial deformities in young children, emphasizing the importance of early intervention and the potential for improved outcomes with timely, non-invasive treatment.