Children-Basel最新文献

{"title":"Music-Based Interventions in Childhood Hearing Loss: A Comprehensive Narrative Review.","authors":"Mirko Aldè, Letizia Casella, Umberto Ambrosetti, Stefania Barozzi, Eleonora Gandolfo, Federica Di Berardino, Diego Zanetti","doi":"10.3390/children13040574","DOIUrl":"10.3390/children13040574","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Childhood hearing loss (HL) affects auditory, linguistic, and social development. Alongside conventional rehabilitation, music-based interventions have gained increasing attention for their potential to support both auditory and non-auditory domains. This narrative review aims to summarize current evidence on the use of music-based interventions in children with HL. <b>Methods:</b> A narrative review of the literature was conducted, examining studies involving pediatric cochlear implant or hearing aid users. Publications were categorized into three main areas: musical auditory perception, musical training, and music therapy. <b>Results:</b> Studies on musical auditory perception demonstrate persistent limitations in pitch and timbre perception in children with HL, while rhythmic abilities appear relatively preserved. Musical training interventions, particularly those targeting rhythm, have been associated with improvements in auditory perception, linguistic processing, and selected cognitive skills, although parental involvement and long-term designs remain limited. Existing literature on music therapy is scarce but suggests potential benefits extending beyond auditory skills to emotional regulation, social interaction, and quality of life. <b>Conclusions:</b> Music-based interventions represent a promising complementary approach in pediatric hearing rehabilitation. While musical training is more widely studied, music therapy is still underrepresented despite its holistic focus. Further structured studies are needed to define standardized protocols and outcome measures for music therapy in children with HL.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Wilms Renal Tumours in Children: The Republic of Ireland Experience.","authors":"Kris Hughes, Charles Lee, Michael Capra, Jane Pears, Cormac Owens, Michael McDermott, Maureen O'Sullivan, Sri Paran, Israel Fernandez-Pineda","doi":"10.3390/children13040575","DOIUrl":"10.3390/children13040575","url":null,"abstract":"<p><p><b>Background</b>: Non-Wilms renal tumours (NWRTs) are rare paediatric malignancies and account for a small but clinically significant proportion of childhood renal cancers. Due to their low incidence and biological heterogeneity, outcome data are limited, and management is largely extrapolated from international collaborative protocols. No national data describing the incidence and outcomes of NWRTs in children in the Republic of Ireland (ROI) have previously been published. <b>Objective</b>: To determine the incidence, treatment strategies, and survival outcomes of NWRTs in children in the ROI. <b>Methods</b>: A retrospective cohort study was conducted of all children under 16 years of age with histologically confirmed renal tumours diagnosed and treated at Children's Health Ireland (CHI) at Crumlin between January 2005 and December 2025. As CHI Crumlin is the single national paediatric oncology centre in the ROI, this cohort represents national case ascertainment for the study period. A total of 143 paediatric renal tumours were identified; Wilms tumours (<i>n</i> = 118) were excluded, leaving 25 children (17.48%) with NWRTs for analysis. No cases of bilateral renal tumours were identified. Histological subtypes included renal cell carcinoma (RCC), clear cell sarcoma of the kidney (CCSK), congenital mesoblastic nephroma (CMN), malignant rhabdoid tumour of the kidney (MRTK), and anaplastic sarcoma of the kidney. Demographic characteristics, treatment strategies, and survival outcomes were analysed. <b>Results</b>: Twenty-five children with NWRTs were identified: CCSK (<i>n</i> = 9), RCC (<i>n</i> = 7), CMN (<i>n</i> = 6), MRTK (<i>n</i> = 2), and anaplastic sarcoma of the kidney (<i>n</i> = 1). At a median follow-up of 107.9 months (range 4.5-181.3 months), overall survival for the cohort was 76%. Overall survival by histology was 100% for CMN, CCSK and anaplastic sarcoma, 43% for RCC, and 0% for MRTK. Treatment strategies varied by histology, with 68% undergoing upfront surgery, 32% receiving neoadjuvant chemotherapy, 60% receiving adjuvant systemic therapy, and 44% receiving radiotherapy. Tumour recurrence occurred in 4/25 patients (16%), confined to the RCC (3) and CMN (1) subgroups. Seven Event-Free Survival events were observed, comprising three RCC relapses and one RCC progression, one CMN relapse, and two MRTK progression-related deaths. No recurrences occurred in CCSK. <b>Conclusions</b>: NWRTs comprised 17.5% of all paediatric renal tumours diagnosed nationally during the study period and demonstrated marked heterogeneity in outcomes according to histological subtype. CMN showed excellent survival with six out of seven requiring surgery alone, whereas MRTK remained associated with dismal outcomes despite multimodal therapy. These national data support histology-driven, risk-adapted management and highlight the importance of continued international collaboration to improve outcomes in NWRTs.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fruit and Vegetable Accessibility in the Home: Intervention Changes and Cross-Sectional Associations with Diet Quality.","authors":"Adriana Verdezoto Alvarado, Shannon M Robson","doi":"10.3390/children13040577","DOIUrl":"10.3390/children13040577","url":null,"abstract":"<p><strong>Background/objectives: </strong>Fruit and vegetable (FV) availability/accessibility are associated with increased intake of FVs and are important determinants of intake. The aim of this analysis was to evaluate the pre-post changes in an FV accessibility intervention and examine cross-sectional associations between accessibility domains and diet quality categories at pre- and post-intervention.</p><p><strong>Methods: </strong>Thirty parent-child dyads (mean age = 41.2 ± 4.7; 9.2 ± 1.9) completed an 8-week pre-post intervention. Assessments included perceptions of accessibility, the Home Food Inventory with added accessibility domains, and three-day diet records used to calculate HEI-2020 scores. Stuart-Maxwell tests were used to evaluate changes in categorical responses, paired <i>t</i>-tests assessed pre-post changes, and independent <i>t</i>-tests compared accessibility by HEI category.</p><p><strong>Results: </strong>Parents reported a perceived increase in frequency of having the form of FVs prepared/ready for use (<i>p</i> = 0.034). No significant pre-post changes were observed in objective FV availability/accessibility domains, FV intake, or HEI scores for children and parents. Exploratory analyses showed that children and parents with HEI-total scores above national averages had higher mean FV location and visibility, with post-intervention visibility being significantly associated with higher HEI among children (<i>p</i> = 0.048) and location being significantly associated with higher HEI among parents at pre- (<i>p</i> = 0.033) and post-intervention (<i>p</i> = 0.046).</p><p><strong>Conclusions: </strong>The FV accessibility intervention did not significantly improve objective HFE accessibility or diet quality in this small sample. Exploratory findings suggest that FV accessibility domains may be associated with diet quality; however, these observations are preliminary. Larger and longer-term studies are needed to determine whether modifying FV accessibility can meaningfully improve children's dietary intake.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mid- to Long-Term Clinical Outcomes After Lumbar Microdiscectomy in Adolescent Patients: A Descriptive Study.","authors":"Lawrence Sanchez, Johanna Austeen Gjestland, Per-Henrik Randsborg, Ole Kristian Alhaug","doi":"10.3390/children13040578","DOIUrl":"10.3390/children13040578","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Adolescent lumbar disc herniation (ALDH) is rare. Evidence on long-term surgical outcomes remains limited. The objective of this study was to evaluate mid- and long-term clinical outcomes following lumbar microdiscectomy in adolescents with lumbar disc herniation (LDH). <b>Methods</b>: A single-institution retrospective cohort study of patients under 19 years who underwent lumbar microdiscectomy over a ten-year period. Baseline clinical and radiological data were obtained from electronic patient records (EPR) and Magnetic Resonance Imaging (MRI). Patient-reported outcomes were collected at follow-up using the Oswestry Disability Index (ODI) as the primary outcome and Numeric Rating Scales (NRS) for back and leg pain and Global Perceived Effect (GPE) as secondary outcomes. Descriptive statistics were used to summarize results. <b>Results</b>: Seventeen of 27 patients (63%) participated. Mean age at surgery was 16.9 years, and mean symptom duration prior to surgery was 11.3 months. All patients underwent disc-preserving microdiscectomy. At a mean follow-up of 67.7 months, mean ODI was 9.5, mean NRS back pain was 2.8, and mean NRS leg pain was 2.3. Fourteen patients (82%) reported being completely recovered or much improved. <b>Conclusions</b>: Lumbar microdiscectomy in adolescents with LDH showed acceptable mid- to long-term outcomes, low disability, and low pain levels at more than five years of follow-up. Clinical and imaging findings resembled those seen in adults, though symptom duration before surgery was prolonged.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potentially Hazardous Drugs in the Paediatric ICU: A Narrative Review on the Exemplary Cases of Propofol, Chloramphenicol, and Acetylsalicylic Acid.","authors":"Laura Beckers, Joery Verbruggen, Vera Saldien, Jozef De Dooy, Eva van Zanten, Thomas Peros, Miranda Wiggelinkhuizen, Philippe G Jorens","doi":"10.3390/children13040579","DOIUrl":"10.3390/children13040579","url":null,"abstract":"<p><p><b>Background:</b> In the paediatric intensive care unit (PICU), certain drugs should be avoided or administered with strict precautions and close monitoring. This is due to their potential for toxicity or adverse effects or a lack of safety data, especially for critically ill children with organ failure. Additionally, practitioners must assess the unique pharmacokinetic and pharmacodynamic properties of drugs when treating critically ill children. In this narrative review, we highlight the risks, advantages, and disadvantages of three exemplary cases of drugs for paediatric patients hospitalised in the PICU: chloramphenicol, acetylsalicylic acid, and propofol. <b>Methods:</b> Apart from key papers on these drugs, a retrospective analysis of the English literature on chloramphenicol, acetylsalicylic acid (ASA), and propofol was performed on PubMed for papers from January 2014 to December 2025. <b>Results:</b> Chloramphenicol should be avoided in neonates due to the risk of grey baby syndrome. Acetylsalicylic acid (ASA) is contraindicated in children ≤18 years with suspected viral illness because of the risk of Reye's syndrome, but remains essential for Kawasaki disease and post-cardiac surgery antiplatelet therapy. Propofol should be avoided when used for a longer period at high doses. With proper dosing and monitoring, propofol-related infusion syndrome (PRIS) is preventable, but high-risk patients should receive alternative treatment. <b>Conclusions:</b> This narrative review highlights the significant risks associated with the use of chloramphenicol, ASA, and propofol in paediatric intensive care settings. Their potential for life-threatening and severe adverse reactions emphasises the need for cautious and informed use. Clinicians must carefully consider the risks and benefits of these drugs. To minimise adverse events, strict monitoring, dose adjustments, and the use of safer alternatives are essential. However, it appears that their use in well-defined circumstances in acute illness in children is still warranted. The findings of this narrative review underscore the need for further research to focus on identifying high-risk biomarkers, genetic predispositions, and safer alternatives to improve evidence-based guidelines and reduce morbidity and mortality in paediatric intensive care.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics and Diagnostic Correlation of Pediatric Lymphadenopathy in a Secondary-Level Hospital in Colombia.","authors":"Eyleen Pacheco Narváez, Karina Pastor-Sierra, Nany Castilla Herrera","doi":"10.3390/children13040576","DOIUrl":"10.3390/children13040576","url":null,"abstract":"<p><strong>Background: </strong>Pediatric lymphadenopathy is a common reason for consultation, but information from secondary-level care in Latin American middle-income settings remains limited.</p><p><strong>Objective: </strong>The objective of this study is to describe the clinical profile, documentation quality, and use of complementary tests among pediatric patients with lymphadenopathy treated at a secondary-level hospital in Córdoba, Colombia.</p><p><strong>Materials and methods: </strong>A retrospective descriptive study was conducted through a review of 246 medical records of children with lymphadenopathy evaluated between January 2020 and June 2024. Sociodemographic variables, lymph node characteristics, local inflammatory signs, associated clinical conditions, and complementary tests were extracted from the charts. An exploratory composite variable of predefined clinical assessment features recorded in the charts was analyzed descriptively.</p><p><strong>Results: </strong>The median age was 6 years, with 58.9% being male, and 79.7% lived in urban areas. Cervical involvement predominated (87.8%); most documented nodes were ≤1 cm (59.3%), and local inflammatory signs were uncommon (7.3%). Complementary testing was limited (complete blood count: 37.8%, serology: 17.9%, tuberculin skin test: 6.9%, ultrasound: 7.7%, and biopsy: 4.1%), without significant rural-urban differences. At least one predefined clinical assessment feature was recorded in 83.7% of charts, most often multiple nodes or bilateral involvement; these findings should be interpreted descriptively rather than as direct indicators of malignancy or infection.</p><p><strong>Conclusions: </strong>In this secondary-level, record-based series, pediatric lymphadenopathy was usually documented as small cervical node enlargement with limited complementary testing. The main contribution of this study is to describe documentation patterns and real-world initial work-up in a Colombian secondary-level hospital, which may inform standardized assessment and referral pathways.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publication Bias in Epidemiological Studies of Malocclusions in Mexican Children and Teenagers: A Systematic Review and Meta-Analysis.","authors":"Liliana Argueta-Figueroa, Karina Alejandra Quiroz-Carlín, Mario Alberto Bautista-Hernández, Rafael Torres-Rosas, María Eugenia Marcela Castro-Gutiérrez, Yobana Pérez-Cervera, Adriana Moreno-Rodríguez, Alfonso Enrique Acevedo-Mascarúa, Enrique Antonio Martínez-Martínez","doi":"10.3390/children13040580","DOIUrl":"10.3390/children13040580","url":null,"abstract":"<p><strong>Objective: </strong>To determine the publication bias of the reported prevalence of malocclusions in Mexican children and adolescents.</p><p><strong>Background: </strong>Publication bias determination is crucial in a systematic review, helping to ensure the conclusions' validity and reliability. Nevertheless, without accurate knowledge of disease prevalence and patterns, the health system risks inefficiency, inequity, and failure to meet the population's needs. On the other hand, malocclusions can impair proper chewing efficiency, contributing to digestive alterations, and nutritional deficiencies among other functional, psychological, and social problems. The data of the prevalence of malocclusion is imperative to implement early interventions in health services that prevent more severe skeletal discrepancies and reduce the need for invasive treatments in adolescence or adulthood.</p><p><strong>Methods: </strong>Studies were collected from five databases, following the PRISMA and Cochrane guidelines for systematic reviews. Eligibility criteria were full-text research in which the prevalence of malocclusions was reported. The risk of bias (Hoy tool), publication bias (the Doi plot and the Luis Furuya-Kanamori (LFK) index), and quality assessments (GRADE tool) were performed. The data were combined using a random-effects meta-analysis.</p><p><strong>Results: </strong>The result of the meta-analysis suggests a high prevalence of malocclusions in mixed dentition was 50.2% (95% confidence interval [CI]: 38.9-61.5%). However, the studies showed a risk of bias and publication bias.</p><p><strong>Conclusions: </strong>In Mexico, there is a high prevalence of malocclusions among children and adolescents. However, these results are not robust enough to draw solid conclusions, due to the low certainty of the evidence.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving LISA Practice: An Ongoing Observational Quality Improvement Initiative Following Initiation of Less-Invasive Surfactant Administration in a Level IV NICU.","authors":"Tynisha Koenigsaecker, Shreya Patel, Stephanie C Martinez, Kevin Ives, Julie Bodie, Chad Weagraff, Monika Bhola, Rita M Ryan","doi":"10.3390/children13040571","DOIUrl":"10.3390/children13040571","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Surfactant has been delivered via less-invasive surfactant administration (LISA) in our neonatal intensive care unit (NICU) since 2020. Data have been monitored and the literature regularly reviewed to improve our LISA practice. The purpose of this project is to share the clinical practice changes made to help other NICU providers fine-tune their LISA practice. <b>Methods</b>: The original LISA criteria included babies with GA 27-36 6/7 w, on > 21% O₂, on continuous positive airway pressure (CPAP), pCO₂ < 70 if a blood gas was obtained, and radiographic and/or clinical evidence of respiratory distress syndrome (RDS). Current criteria include GA 25-35 6/7 w and minimum CPAP + 6. This manuscript highlights the changes made since 2023. To monitor these changes, targeted data from the entire cohort were examined before and after each change. <b>Results</b>: LISA was attempted on 399 babies (average (SD) GA 31.7 (2.7), birth weight 1752 (590), with a procedural success rate of 97%. Overall, 18% required intubation within 7 days after LISA. The median (IQR) for FiO₂ was 32 (28, 40) prior to LISA and 23 (21, 30) post-LISA and the hour of age of LISA was 4 (2.5, 9.9). LISA procedure success rate was increased by the use of video laryngoscopy as well as reinforcement of the use of sucrose sedation and swaddling; our first attempt success increased overall from 39% to 52%. After the introduction of a clinical RDS score (Downes), there was an expected and logical increase in the number of infants requiring intubation within 7 days of LISA indicating likely over-treatment prior to this change. After implementation of a clearly described plan for babies <28 w gestation there was a decrease in the hour of age of LISA from 3 (2.5, 4.5) to 2 (0.8, 3) h. <b>Conclusions</b>: It is critical to continually evaluate a new practice and identify strategic changes. We offer our changes to assist others starting or using LISA.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phototherapy Alone or Combined with Adjuvant Drugs for Neonatal Hyperbilirubinemia: A Systematic Review and Network Meta-Analysis.","authors":"Qiang Fei, Huazi Liu, Xinning Wang, Tianming Yuan","doi":"10.3390/children13040573","DOIUrl":"10.3390/children13040573","url":null,"abstract":"<p><p><b>Objectives</b>: Neonatal hyperbilirubinemia is a common disease in the neonatal period. In this meta-analysis, we aim to evaluate the efficacy of adjuvant drugs combined with phototherapy in the treatment of neonatal hyperbilirubinemia. <b>Methods</b>: Randomized controlled trials (RCTs) published before September 2025 were searched from PubMed, Embase, Web of Science, and the Cochrane Library. A Bayesian random-effects network meta-analysis was performed to calculate mean differences and 95% confidence intervals. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA) and probability of being the best treatment (PbBT). <b>Results</b>: Thirty-five RCTs involving 4060 neonates were included. Compared with phototherapy alone, clofibrate, ursodeoxycholic acid, fenofibrate, and calcium phosphate significantly reduced bilirubin levels and shortened admission duration. Clofibrate showed the greatest efficacy in bilirubin reduction within 48 h (SUCRA = 0.91, PbBT = 60.9%) and in shortening hospitalization (SUCRA = 0.84, PbBT = 40.83%). Probiotics, zinc, and agar exhibited relatively modest effects, while phenobarbital showed no significant benefit. <b>Conclusions</b>: Adjunctive therapies were associated with greater reductions in bilirubin levels compared with phototherapy alone. Future high-quality RCTs are needed to confirm the long-term efficacy and safety of these adjuvant therapies.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13114378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Daily Mother-Infant Skin-to-Skin Contact on Breastfeeding Outcomes in the First Four Weeks and Maternal Postnatal Mental Health: A Quasi-Experimental Study.","authors":"Chia-Wen Hung, Li-Min Wu","doi":"10.3390/children13040570","DOIUrl":"10.3390/children13040570","url":null,"abstract":"<p><strong>Background/objectives: </strong>Skin-to-skin contact (SSC) between mother and infant is known to promote breastfeeding initiation and early bonding. However, evidence regarding the sustained effects of daily SSC during the postpartum period on breastfeeding outcomes and maternal mental health remains limited. This study aimed to evaluate the effects of structured daily SSC on breastfeeding outcomes, lactation status, and maternal postnatal mental health in a real-world clinical setting.</p><p><strong>Methods: </strong>A quasi-experimental design was used to compare mothers who performed daily SSC (SSC group) with those receiving care as usual (control group). Data were collected on postpartum Day 1, Day 3, Week 2, and Week 4. Primary outcomes included exclusive breastfeeding duration, continued breastfeeding duration, and lactation status. Multiple linear regression analyses adjusted for baseline breastfeeding intention and maternal age.</p><p><strong>Results: </strong>A total of 50 mother-infant dyads were included (SSC: <i>n</i> = 40; control: <i>n</i> = 10). The SSC group was associated with longer exclusive and continued breastfeeding durations and better lactation status (<i>p</i> < 0.05). Depressive symptoms did not differ significantly between groups, although both groups showed decreasing trends over time. After adjustment, daily SSC remained significantly associated with longer exclusive breastfeeding duration (adjusted <i>β</i> = 9.18 days, <i>p</i> = 0.034) and continued breastfeeding duration (adjusted <i>β</i> = 10.57 days, <i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>Daily SSC is a simple and feasible intervention that may be associated with improved breastfeeding outcomes and lactation performance. Incorporating structured SSC into routine postpartum care may support breastfeeding sustainability and maternal recovery.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":"13 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13115455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}