Issue highlights

Abstract

Dahlén and Kimland analysed nearly 4.6 million prescriptions dispensed to more than 2 million children aged 0–17 years in Sweden.¹ Just under half of the children (47%) received at least one drug in 2019 and 34% received three or more different drugs. The most common drugs were for respiratory tract issues, followed by psychoanaleptics and melatonin for the nervous system and dermatologicals. The average number of prescriptions almost doubled from 2.3 in 2007 to 4.5 in 2019. Garnemark and Kindblom comment on the findings in an editorial.² https://doi.org/10.1111/apa.17425.

Height velocity is a key tool for monitoring growth and detecting serious health conditions early. Scherdel et al. have produced new annual and biannual height velocity charts for French children up to 15 years of age, using values routinely collected in primary care settings.³ The median curves were close to the 1979 French and 2009 World Health Organization values, but there were important differences in the standard deviation curves. An editorial by Van Dommelen states that the same data collection method could be used by other countries to produce velocity charts with minimal extra effort.⁴ https://doi.org/10.1111/apa.17454.

Cholestasis is highly prevalent in very low birth weight infants. It is predominantly caused by parenteral nutrition, and Oh et al. found that this condition developed at about 1 month of age.⁵ They report that it took approximately 2 months for direct bilirubin to normalise, even when parenteral nutrition ceased and full enteral feeding was established. More time was required to normalise aspartate transferase and alanine aminotransferase levels. An editorial by Teng et al. states that understanding the dynamics of biochemical liver markers in pre-term infants with parenteral nutrition-associated cholestasis may prevent unnecessary invasive examinations.⁶ https://doi.org/10.1111/apa.17427.

Tracheomalacia causes considerable morbidity in children and the best treatment options are still being debated. Møller et al. present a case series of seven Danish children who underwent surgical interventions, including tracheopexy and aortopexy, to reduce the respiratory symptoms caused by tracheal collapse. They report favourable clinical outcomes, particularly when there was an early intervention, and discuss the indications, timing and potential benefits of this surgery.⁷ https://doi.org/10.1111/apa.17452.

Neonatal intensive care has improved for infants born extremely preterm, but it has not been matched by similar progress in post-discharge interventions. Baraldi et al. conducted a randomised clinical trial of 130 children born extremely preterm, to evaluate an interaction-based home-visiting programme during the first year after discharge.⁸ The controls received standard care. No difference in overall parent–child emotional availability was found between the two groups. However, when their mothers were depressed, children in the intervention group showed superior involvement behaviour to the controls. In another paper, Lapage et al. report that parenting stress in infancy was associated with poorer neurodevelopment in 24-month-old children with congenital heart disease.⁹ https://doi.org/10.1111/apa.17399.

Figures: istockphoto