Children

13 pages, 231 KiB

Open AccessArticle

Enhancing Preschoolers’ Motor Creativity Through Playfulness and Social Engagement

by Despoina Ourda, Polyzoudi Eleni, Athanasios Gregoriadis and Vassilis Barkoukis

Children 2025, 12(8), 969; https://doi.org/10.3390/children12080969 (registering DOI) - 23 Jul 2025

Background/Objectives: Motor creativity is a vital component of preschoolers’ growth and development. However, its underlying determinants remain largely underexplored. This study investigates the interrelationship among playful behavior, social profile, and motor creativity in preschool children, emphasizing its implications for holistic health and [...] Read more.

Background/Objectives: Motor creativity is a vital component of preschoolers’ growth and development. However, its underlying determinants remain largely underexplored. This study investigates the interrelationship among playful behavior, social profile, and motor creativity in preschool children, emphasizing its implications for holistic health and development. Methods: A total of 200 children and their kindergarten teachers from Greece participated in the study. The Children’s Playfulness Scale (CPS) was employed to assess the children’s playfulness, while a sociometric test was used to evaluate their social standing within peer groups. Motor creativity was measured through TCAM, a performance-based test focusing on fluency, imagination, and originality. Results: The findings revealed that the dimensions of playful behavior, particularly motor and social playfulness, significantly and positively influenced motor creativity, a core component of physical and mental health in early childhood. Conversely, certain aspects of social behavior had a negative association with imaginative capacities. Conclusions: The study underscores the critical role of movement-based playful activities in fostering children’s physical, emotional, cognitive, and social health. It highlights the need for educators to design developmentally appropriate motor play activities that cultivate creativity and social integration, promoting a balanced and health-oriented early education framework. The results contribute to educational policy and practice by reinforcing the importance of structured motor play in supporting preschoolers’ well-being and comprehensive development. Full article

(This article belongs to the Section Global Pediatric Health)

15 pages, 1251 KiB

Open AccessArticle

Training, Awareness, and Clinical Perspectives of Pediatric Dentists on Headache and Migraine Management: A National Survey Study

by Samantha Glover, Linda Sangalli and Caroline M. Sawicki

Children 2025, 12(8), 968; https://doi.org/10.3390/children12080968 (registering DOI) - 23 Jul 2025

Abstract

Background/Objectives: Migraine affects approximately 3–10% of school-aged children and up to 28% of adolescents, with prevalence increasing during adolescence. For pediatric specialty providers, increased awareness of this condition may influence patient care. This study examined pediatric dentists’ education, clinical exposure, and perceived knowledge [...] Read more.

Background/Objectives: Migraine affects approximately 3–10% of school-aged children and up to 28% of adolescents, with prevalence increasing during adolescence. For pediatric specialty providers, increased awareness of this condition may influence patient care. This study examined pediatric dentists’ education, clinical exposure, and perceived knowledge gaps related to pediatric migraine, with the goal of identifying barriers to recognition and referral, as well as informing future training to support accurate diagnosis and interdisciplinary care. Methods: A 28-item electronic questionnaire was distributed to all members of the American Academy of Pediatric Dentistry, including pediatric dentists and postgraduate pediatric dental residents, assessing knowledge, beliefs, clinical experience, and interest in further training regarding pediatric headache/migraine management. Respondents with and without previous training were compared in terms of general understanding using t-tests; a linear regression model analyzed predictors of provider awareness regarding links between oral conditions and headache/migraine. Results: Among 315 respondents, the mean self-perceived awareness score was 2.7 ± 1.3 (on a 0–5 scale). The most frequently identified contributing factors were clenching (73.7%), bruxism (72.4%), and temporomandibular disorders (65.7%). Nearly all respondents (95.2%) reported no formal education on headache/migraine prevention, yet 78.1% agreed on the importance of understanding the relationship between oral health and headache/migraine. Respondents with prior training were significantly more aware (p < 0.001) than those without prior training. Educating families (p < 0.001), frequency of patient encounters with headache (p = 0.032), coordination with healthcare providers (p = 0.002), and access to appropriate management resources (p < 0.001) were significant predictors of providers’ awareness. Conclusions: Pediatric dental providers expressed strong interest in enhancing their knowledge of headache/migraine management, highlighting the value of integrating headache/migraine-related education into training programs and promoting greater interdisciplinary collaboration. Full article

(This article belongs to the Special Issue Pediatric Headaches: Diagnostic and Therapeutic Issues)

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13 pages, 583 KiB

Open AccessReview

Chronic Disease in Pediatric Population—A Narrative Review of Psychosocial Dimensions and Strategies for Management

by Francesca Mastorci, Maria Francesca Lodovica Lazzeri, Lamia Ait-Ali, Pierluigi Festa and Alessandro Pingitore

Children 2025, 12(8), 967; https://doi.org/10.3390/children12080967 - 23 Jul 2025

Abstract

Children living with chronic diseases represent a great challenge for the health care system, their families, and communities. These young patients face continuous medical needs that affect not only their health but also their daily routines, emotional well-being, and family dynamics. In response, [...] Read more.

Children living with chronic diseases represent a great challenge for the health care system, their families, and communities. These young patients face continuous medical needs that affect not only their health but also their daily routines, emotional well-being, and family dynamics. In response, clinical practice is increasingly integrating psychosocial indicators alongside traditional medical parameters. Consequently, there is a growing consensus that the evaluation of pediatric chronic diseases should address not only clinical dimensions but also the disease’s impact on socialization, emotional health, and daily functioning. This narrative review explores the role of psychosocial variables in the management of pediatric chronic illnesses, including the experiences of parents and siblings, with a focus on effective strategies to improve everyday life. The integration of quality of life and well-being within a multidimensional care model could be instrumental in both symptom management and psychosocial support. Recognizing that children with chronic conditions are at increased risk for long-term adverse outcomes, it is critical to develop interventions that go beyond clinical care, encompassing education, coping reinforcement, and family-centered approaches. Full article

(This article belongs to the Section Pediatric Mental Health)

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13 pages, 896 KiB

Open AccessArticle

Impact of Delivery Method on Initiation and Continuation of Breastfeeding: A Prospective Cohort Study

by İlke Özer Aslan, Mustafa Törehan Aslan, Nebibe Can, Özlem Sevinç Ergül and Nihal Çallıoğlu

Children 2025, 12(8), 966; https://doi.org/10.3390/children12080966 - 23 Jul 2025

Abstract

Background/Objectives: Cesarean delivery often leads to delayed breastfeeding initiation, potentially affecting infant health compared with vaginal delivery. This prospective observational study (conducted between August 2022 and January 2024) comparatively evaluates the impact of delivery method—vaginal, planned cesarean, and emergency cesarean—on breastfeeding initiation [...] Read more.

Background/Objectives: Cesarean delivery often leads to delayed breastfeeding initiation, potentially affecting infant health compared with vaginal delivery. This prospective observational study (conducted between August 2022 and January 2024) comparatively evaluates the impact of delivery method—vaginal, planned cesarean, and emergency cesarean—on breastfeeding initiation and continuation and examines the maternal factors influencing these outcomes. Materials and Methods: We enrolled 338 mother–infant pairs at a tertiary university hospital. Breastfeeding effectiveness was assessed using the Bristol Breastfeeding Assessment Tool (BBAT) at birth and at one, three, and six months postpartum. Rates of breastfeeding continuation and formula supplementation were documented through structured interviews. Results: The mothers who delivered vaginally had a significantly higher rate of breastfeeding within one hour after birth (85.5%) compared with planned (57.9%) and emergency cesarean sections (64.9%) (p < 0.001). Baseline BBAT scores were higher for vaginal births but converged across the groups by one month postpartum (p > 0.05). At six months, breastfeeding continuation rates remained high (94.4–95.2%) irrespective of delivery method. Conclusions: Delivery method exerts a transient effect on breastfeeding initiation. With lactation support, the mothers delivering by cesarean section achieved comparable breastfeeding outcomes within the first month postpartum. These findings reinforce the importance of Baby-Friendly Hospital Initiative (BFHI) practices, including immediate skin-to-skin contact, effective pain management, and lactation counseling, in ensuring equitable breastfeeding outcomes. Full article

(This article belongs to the Section Pediatric Neonatology)

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14 pages, 1030 KiB

Open AccessArticle

Lumen-Apposing Metal Stents for Endoscopic Transgastric Drainage of Pancreatic Fluid Collections in Children—A Case Report and Review of Safety and Efficacy

by Irene Wen Hui Tu, Zong Jie Koh, Khek-Yu Ho, Sivaramakrishnan Venkatesh Karthik and Vidyadhar Padmakar Mali

Children 2025, 12(8), 965; https://doi.org/10.3390/children12080965 - 23 Jul 2025

Abstract

Background/Objectives: Pancreatic fluid collections (PFCs) in acute pancreatitis require drainage when symptomatic or infected. Walled-off necrosis (WON) is difficult to drain with plastic stents alone. A lumen-apposing metal stent (LAMS) offers larger calibre drainage, lower migration risk than conventional methods, and the option [...] Read more.

Background/Objectives: Pancreatic fluid collections (PFCs) in acute pancreatitis require drainage when symptomatic or infected. Walled-off necrosis (WON) is difficult to drain with plastic stents alone. A lumen-apposing metal stent (LAMS) offers larger calibre drainage, lower migration risk than conventional methods, and the option of direct endoscopic necrosectomy through the stent. However, the paediatric literature on LAMSs is sparse. We report our institutional experience, and summarise current evidence on the feasibility, efficacy and safety of LAMSs for PFC drainage in children. Methods: We performed a retrospective study at the National University Hospital (NUH) and a full review of the literature on LAMS use in children for endoscopic trans-gastric drainage of PFCs from April 2012 to September 2024. Results: There were, respectively, 2 (males, 10 and 17 years) and 18 children who underwent endoscopic trans-gastric LAMS insertion for drainage of PFCs in acute pancreatitis in the NUH and across the nine included studies, which were published between 2015 and 2024. The technical and clinical success was 100%. There were no complications during insertion or indwell time (28 and 50 days in the NUH and 40 days, range of 7–100 days in the systematic review, respectively). Endoscopic removal of LAMSs was uneventful. There were no recurrent PFCs over a 4-month (1,7 months) and 12-month (range, 2–44 months) follow-up, respectively. Migration of LAMSs to colon following the collapse of the WON was reported in one case. Conclusions: An transgastric LAMS (with trans-stent necrosectomy) is a technically feasible method of drainage of WON following acute pancreatitis in children with minimal complications. Full article

(This article belongs to the Section Pediatric Surgery)

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13 pages, 694 KiB

Open AccessArticle

Lifestyle and SSRI Interventions in Pediatric Cyclic Vomiting Syndrome: Rethinking First-Line Management

by Cansu Altuntaş, Doğa Sevinçok, Merve Hilal Dolu and Ece Gültekin

Children 2025, 12(8), 964; https://doi.org/10.3390/children12080964 - 23 Jul 2025

Abstract

Background: Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder characterized by recurrent episodes of intense nausea and vomiting. Despite increasing awareness, a standardized treatment approach remains lacking in pediatric populations. Lifestyle factors and anxiety are common triggers, yet their systematic management [...] Read more.

Background: Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder characterized by recurrent episodes of intense nausea and vomiting. Despite increasing awareness, a standardized treatment approach remains lacking in pediatric populations. Lifestyle factors and anxiety are common triggers, yet their systematic management has not been fully incorporated into therapeutic strategies. Objective: To evaluate the effectiveness of lifestyle modifications and selective serotonin reuptake inhibitors (SSRIs) in the management of pediatric CVS and to compare their outcomes with standard cyproheptadine prophylaxis. Methods: This retrospective study included 119 patients aged 1.2–17.5 years who were diagnosed with CVS according to Rome IV criteria between September 2021 and January 2025. Clinical, psychiatric, and lifestyle data were retrieved from the university’s digital medical records. Patients were grouped according to treatment modality: cyproheptadine, SSRI, or acute attack management alone. Treatment success at 12 weeks was defined as complete cessation of vomiting episodes or absence of hospitalization, prolonged attacks, and school/work absenteeism. Results: Anxiety symptoms were present in 78.2% of patients. SSRIs were prescribed to 34 patients with moderate to severe anxiety, all of whom achieved treatment success. Lifestyle adherence was observed in 73.9% and was found to be a predictor of treatment success. Cyproheptadine was administered to 66 patients but did not provide additional benefit over effective lifestyle modification. Six patients discontinued cyproheptadine due to drowsiness or weight gain. Conclusions: Lifestyle interventions significantly improve outcomes in pediatric CVS. SSRIs represent a safe and effective prophylactic option for patients with comorbid anxiety or poor adherence to behavioral recommendations. These findings support the integration of psychosocial and lifestyle-based strategies into standard CVS treatment protocols. Full article

(This article belongs to the Section Pediatric Mental Health)

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12 pages, 603 KiB

Open AccessArticle

Pediatric-Onset Multiple Sclerosis and Primary Headache: Is There a Link?

by Giuseppe Tiralongo, Gabriele Monte, Michela A. N. Ferilli, Fabiana Ursitti, Giorgia Sforza, Claudia Ruscitto, Giuseppe Mazzeo, Alessandro Borrelli, Massimiliano Valeriani and Laura Papetti

Children 2025, 12(8), 963; https://doi.org/10.3390/children12080963 - 22 Jul 2025

Abstract

Background: Pediatric-onset multiple sclerosis (POMS) is a rare but often more aggressive form of multiple sclerosis, associated with early cognitive impairment and significant impact on quality of life. Multiple sclerosis and primary headaches, particularly migraine, are well established in adults, but data on [...] Read more.

Background: Pediatric-onset multiple sclerosis (POMS) is a rare but often more aggressive form of multiple sclerosis, associated with early cognitive impairment and significant impact on quality of life. Multiple sclerosis and primary headaches, particularly migraine, are well established in adults, but data on pediatric populations remain limited. Methods: The purpose of this retrospective study was to examine 64 POMS patients, divided into groups with and without headaches, to determine potential correlations between headache presence, age at POMS onset, and MRI lesion burden. Results: Headaches were reported by 78% of patients, predominantly migraines (68%), with a significantly higher prevalence in females (74%). No significant differences were found in age at MS onset or lesion load on brain MRI between patients with and without headaches. Among those with headaches, migraines represented a higher frequency of attacks and a greater need for prophylactic treatment compared to other headache types. Headache characteristics, including pain location and associated symptoms, showed no correlation with age at MS onset or lesion burden. Conclusions: These findings indicate that while headaches are common in POMS and more frequent in females, their presence and features do not appear to directly influence the clinical or neuroradiological course of the disease. Further research with larger cohorts and longitudinal follow-up is warranted to better understand the underlying mechanisms and long-term impact of headaches in pediatric MS. Full article

(This article belongs to the Special Issue Management of Chronic Pain in Adolescents and Children: 2nd Edition)

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17 pages, 477 KiB

Open AccessArticle

COVID-19 Stress and Family Well-Being: The Role of Sleep in Mental Health Outcomes for Parents and Children

by Alzena Ilie, Andy J. Kim, Danika DesRoches, Elizabeth Keys, Simon B. Sherry, Sherry H. Stewart, S. Hélène Deacon and Penny V. Corkum

Children 2025, 12(8), 962; https://doi.org/10.3390/children12080962 - 22 Jul 2025

Abstract

Background/Objectives: The COVID-19 pandemic introduced various stressors for families, including changes to daily routines, work, and schooling. Studies have linked these stressors to increased mental health challenges for parents and children. Sleep difficulties were also common during the pandemic, with some children and [...] Read more.

Background/Objectives: The COVID-19 pandemic introduced various stressors for families, including changes to daily routines, work, and schooling. Studies have linked these stressors to increased mental health challenges for parents and children. Sleep difficulties were also common during the pandemic, with some children and parents experiencing poorer sleep quality and shorter sleep duration. However, it remains unclear whether the effects of COVID-19 stress on mental health challenges are explained, at least in part, by effects of COVID-19 stress on child and/or parent sleep challenges. This study examined the impacts of COVID-19 stress on sleep and, in turn, mental health difficulties in school-aged children and their parents in Canada and the United States. Methods: Parents (N = 961) completed validated measures of COVID-19 stress, and of their own and their child’s sleep and mental health. Path analyses tested direct and indirect effects of COVID-19 stress on mental health outcomes with sleep problems as the potential mediator. Results: Child sleep problems partially mediated COVID-19 stress effects on both parent (β = 0.33) and child (β = 0.20) mental health difficulties, while parent sleep problems contributed significantly but to a lesser degree (parent mental health: β = 0.07; child mental health: β = 0.03). There also remained significant direct effects of COVID-19 stress on both child and parent mental health difficulties that were not mediated through sleep difficulties. Conclusions: Our findings underscore the interconnected nature of sleep and mental health, demonstrating that stress-related disruptions in sleep (particularly children’s sleep) can exacerbate mental health difficulties for both parents and children during crises like the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Parental Mental Health and Child Development)

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11 pages, 810 KiB

Open AccessArticle

Pediatric Hematology–Oncology Provider Attitudes and Beliefs About the Use of Acupuncture for Their Patients

by Holly L. Spraker-Perlman, Kenneth M. Busby, Amy Ly, Maggi Meyer, Justin N. Baker and Deena R. Levine

Children 2025, 12(8), 961; https://doi.org/10.3390/children12080961 - 22 Jul 2025

Abstract

Background/Objectives: Children with cancer suffer due to the underlying disease and prescribed cancer-directed therapies, and non-pharmacologic modalities may offer improved symptom control without additional medications. We sought to elicit knowledge, attitudes, and beliefs of Pediatric Hematology Oncology (PHO) providers surrounding the incorporation [...] Read more.

Background/Objectives: Children with cancer suffer due to the underlying disease and prescribed cancer-directed therapies, and non-pharmacologic modalities may offer improved symptom control without additional medications. We sought to elicit knowledge, attitudes, and beliefs of Pediatric Hematology Oncology (PHO) providers surrounding the incorporation of acupuncture for symptom management for their patients. Methods: A cross-sectional survey instrument was created, formatted, and delivered to physicians and advanced practice providers (APPs) at a single US pediatric cancer center. Survey responses were summarized by descriptive statistics. Results: A total of 78 PHO clinicians participated (response rate 29%). Most participants were interested in learning more about acupuncture (n = 42, 56.0%), yet rarely (n = 17, 22.7%) or never (n = 46, 61.3%) recommend acupuncture to patients. Most (n = 51, 73.9%) noted that they would support institutional development of an acupuncture program. Over half (n = 37, 52.2%) indicated their threshold for minimum hematologic indices for acupuncture includes a platelet count greater than 20,000 and absolute neutrophil count (ANC) greater than 500 (n = 37, 54.4%). Approximately two-thirds (n = 52, 66.7%) of participants noted that acupuncture could improve their patient’s quality of life, and most (n = 46, 67.6%) were not worried about harm. Conclusions: Acupuncture for symptom management is an evidenced-based, guideline-concordant recommendation for adults with cancer, but robust data in the pediatric oncology population are lacking. PHO providers do not routinely recommend acupuncture for patients but note that it may improve quality of life. Given their high symptom burden, rigorous studies of non-pharmacologic strategies for pediatric symptom management are vital. Acupuncture should be examined as a potential beneficial adjunct. Full article

(This article belongs to the Special Issue Integrative Medicine Approaches in Children and Adolescents with Cancer)

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11 pages, 219 KiB

Open AccessArticle

Evaluation of the Dental Caries Status of New Pediatric Patients in Tertiary Dental Institutions in 2013, 2018, and 2023

by Eimi Tabata, Ami Kaneki, Masashi Ogawa, Taku Nishimura, Yuya Ito, Shunya Ikeda, Yasuko Tsuge, Shuma Hamaguchi, Tatsuya Akitomo and Ryota Nomura

Children 2025, 12(8), 960; https://doi.org/10.3390/children12080960 - 22 Jul 2025

Abstract

Background: Although the prevalence of dental caries in children has been decreasing in recent years, many patients still visit tertiary dental institutions with dental caries as their chief complaint. In addition, the COVID-19 pandemic that occurred around the world in 2020 may have [...] Read more.

Background: Although the prevalence of dental caries in children has been decreasing in recent years, many patients still visit tertiary dental institutions with dental caries as their chief complaint. In addition, the COVID-19 pandemic that occurred around the world in 2020 may have affected the lifestyle and oral condition of children. Methods: We investigated the oral condition of new patients whose chief complaint was dental caries, and compared the results for 3 fiscal years: 2013, 2018, and 2023. The caries status was evaluated using the dmft/DMFT index. Results: The number of subjects was 129 in 2013, 163 in 2018, and 127 in 2023. The number of preschoolers in 2023 was lower than in the other years, whereas the number of elementary school students was higher, showing a statistically significant difference (p < 0.05). For the 3 years investigated, there was no change in the incidence of dental caries in primary teeth in elementary school children; however, the incidence in permanent teeth increased over time. Additionally, in the age group, the df and DMF scores were higher in 2023 than in the other years. Conclusions: At this tertiary dental institution, the number of elementary school patients, especially females, increased over the 10-year period, and the amount of dental caries in their permanent teeth also increased. It is important for dental professionals to understand this trend and focus on providing oral hygiene education to this age group. Full article

(This article belongs to the Section Pediatric Dentistry & Oral Medicine)

13 pages, 1220 KiB

Open AccessArticle

Investigating Different Clinical Manifestations of Staphylococcus aureus Infections in Childhood—Can D-Dimer and Fibrinogen Predict Deep Tissue Invasion?

by Pınar Önal, Gözde Apaydın Sever, Beste Akdeniz Eren, Gülşen Kes, Ayşe Ayzıt Kılınç Sakallı, Fatih Aygün, Gökhan Aygün, Haluk Çokuğraş and Fatma Deniz Aygün

Children 2025, 12(8), 959; https://doi.org/10.3390/children12080959 - 22 Jul 2025

Abstract

Background: Staphylococcus aureus is a significant pathogen causing both local and systemic infections in children, with deep tissue involvement leading to severe complications. This study aimed to assess clinical manifestations and identify risk factors for deep tissue involvement in pediatric S. aureus [...] Read more.

Background: Staphylococcus aureus is a significant pathogen causing both local and systemic infections in children, with deep tissue involvement leading to severe complications. This study aimed to assess clinical manifestations and identify risk factors for deep tissue involvement in pediatric S. aureus infections. Methods: All children between 1 month and 18 years who had S. aureus growth in blood, pus, or joint fluid culture were included. Results: A total of 61 patients (median age 55 months) were included, with 22.9% having deep tissue infections. Osteoarticular infections, pyomyositis, and pulmonary involvement were common. Deep-seated infections were significantly associated with community-acquired infections and positive hemocultures after 72 hours (p < 0.01). Laboratory results showed significantly higher levels of C-reactive protein, sedimentation rate, D-dimer, and fibrinogen in the group with deep-seated infections (p = 0.02, p = 0.018, p = 0.01, and p = 0.015, respectively). The decision tree model showed that the first indicator of deep-seated infection was a D-dimer level above 1.15 mg/L, followed by a fibrinogen level above 334 mg/dL. Conclusions: Deep-seated S. aureus infections are more frequently associated with community-acquired cases, persistent hemoculture positivity, and methicillin-susceptible Staphylococcus aureus (MSSA) strains. Additionally, elevated D-dimer and fibrinogen levels may serve as valuable markers for identifying deep-seated infections in pediatric patients. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

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Children, Volume 12, Issue 8 (August 2025) – 11 articles

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