Search Results (1,008)

Background/Objectives: The long-term impact of intubation during infancy or early childhood on later childhood or adolescence remains unclear. This study investigates the association between early-life intubation and subsequent mental health outcomes. Methods: We conducted a retrospective cohort study using nationwide data on children born in Korea between 2002 and 2005. Those who underwent intubation (exposed cohort) were compared with 1:10 matched unexposed controls who did not undergo intubation. Results: The exposed cohort (n = 18,799) had a significantly higher incidence rate of mental health disorders than controls (28.2 vs. 13.9 per 1000 person-years; HR 1.82, 95% CI 1.74–1.93). Autism spectrum disorder (HR 3.09) and attention-deficit/hyperactivity disorder (HR 1.61) increased in early childhood, while bipolar disorders (HR 2.36), schizophrenia spectrum disorders (HR 2.27), depressive disorders (HR 1.94) and anxiety disorders (HR 1.84) increased in adolescence. Higher incidence was noted in females, children not admitted to intensive care units, and those without congenital heart disease or bronchopulmonary dysplasia (p < 0.05). Hospitalization length correlated with mental health outcomes (p < 0.001), but ventilator duration did not (p = 0.694). Conclusions: Early-life intubation is associated with an increased risk of mental health disorders, highlighting the need for long-term follow-up and support for these children. In particular, increased clinical awareness is needed during follow-up care for patients at higher risk, such as females, children without congenital heart disease or bronchopulmonary dysplasia, those intubated at an older age, and those with longer hospitalizations. Full article

Background/Objectives: This qualitative study examines strengths and strains faced by professionals working with young carers throughout the United Kingdom (UK) in the context of society’s youngest carers; young carers in early childhood (YCEC) (0–8 years). Methods: The Power Threat Meaning Framework (PTMF) was utilised to map key findings of three focus groups. This conceptual lens offers a narrative-based understanding of ways in which power operates in society. Increasingly applied to explore experiences of individuals, communities, and groups, the PTMF proposes that concepts of distress are founded in broader contexts of injustice and social inequalities. Twenty-four participants were recruited from throughout the UK via the Carers Trust Young Carers Alliance. Results: Findings highlight the strength of legal, ideological, and economic power shaping societal beliefs and policy concerning YCEC. This informs constructs of perceived social norms regarding who young carers are most likely to be, and where they may be found. This power threatens the health and well-being of YCEC, impacting the ability of professionals to provide optimal support. Inappropriate policy formed from these assumptions disempowers those providing services to young carers at the frontline of service delivery. Professionals and adults with living experience of caring in their early childhoods reflect upon silent tensions that exist within society, suggesting that YCEC remain the ‘elephant in the room’. Conclusions: We make recommendations to review the efficacy of statutory mandates concerning the needs assessment of young carers in England, and to align policy concerning early childhood and young carers to embed young carers’ rights consistently, starting in early childhood. Full article

Objective: This study aims to investigate the dietary assessment and trends of preschoolers aged 3 to 5 years in Korea from 2012 to 2021 and to provide basic data for early childhood dietary education and policy development. Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2012 to 2021 were analyzed for 2510 children in the 3–5 age group. Dietary intake was assessed using a 24 h recall. Intakes of food groups, dishes, and nutrients were calculated, and trends across years were tested using generalized linear models adjusted for gender, age, household income, energy intake, mother’s age, and mother’s education. Results: Over the tenyear period, intakes of carbohydrates, phosphorus, iron, sodium, potassium, carotene, thiamine, niacin, and vitamin C, as well as the carbohydrate energy ratio, showed significant declines. Meanwhile, protein, fat, retinol, and riboflavin increased, as did the protein and fat energy ratios. Fruit intake decreased by approximately 42 g among food group intakes. Analysis of foods contributing to total food intake revealed that milk, white rice, apples, and eggs consistently accounted for a high proportion of total intake in all survey years. Average calcium intake was approximately 100 mg below the estimated average requirement. Conclusions: The results of this study showed that preschoolers exhibit insufficient intake of certain nutrients, such as calcium, and a decrease in fruit intake. Interventions are needed to establish regular meal patterns, promote plant food intake such as fruit, and improve calcium intake. These results provide valuable evidence for designing dietary education programs and dietary guidelines tailored to early childhood. Full article

Background/Objectives: Even with solid proof of its benefits for cardiovascular health and metabolism, adherence to the Mediterranean Diet (MD) in Spain has noticeably declined in recent years. The socioeconomic changes occurring in recent decades have prompted shifts in cooking habits and in how food is socially experienced, particularly among children and adolescents. The MD is more than just food: it is a cultural tradition and a lifestyle, rich in food and cooking skills, and food wisdom passed down over generations. When these practices fade, it affects both health and the environment, making them vital components in strengthening support for food knowledge, cooking abilities, and a healthier lifestyle. Considering these shifting dietary patterns and the growing need for targeted educational strategies, the present study aimed to investigate the association between cooking skills, MD-related health literacy, and adherence to the Mediterranean Diet across different developmental stages: childhood, adolescence, and adulthood in a sample of the Spanish population. Additionally, a secondary objective was to identify potential critical windows for intervention based on the strength of these associations. Methods: This cross-sectional study included 832 Spanish participants grouped by age: children and early adolescents (n = 408), older adolescents (n = 136), and adults (n = 288). Cooking skills were assessed using CooC11 for children and FCSk for older groups. Adults also completed Lit_MEDiet to assess MD-related health literacy. Adherence was measured with KIDMED (children/adolescents) and MEDAS (adults). Spearman correlations and standardized linear regressions were used. All statistical tests were two-sided, and statistical significance was set at p < 0.05. Results: In children, no significant association was found between cooking skills (CooC11) and KIDMED scores (β = 0.008; p = 0.875). Among adolescents, a strong positive association emerged between FCSk and KIDMED (β = 0.313; p < 0.001; ρ = 0.371), indicating a large, standardized effect and suggesting that this stage is particularly sensitive to food skills. In adults (18+), both food and cooking skills (FCSk) (β = 0.189; p = 0.001) and MD-related health literacy (Lit_MEDiet) (β = 0.187; p = 0.004) were moderately associated with MEDAS scores. Conclusions: These findings suggest that mid-adolescence could represent a favourable developmental window where food skills may hold potential to influence positive dietary behaviours. Regarding adults, the results indicate that combining practical and educational components appears to beneficial for dietary quality. Overall, this study supports the relevance of age-tailored public health strategies to potentially enhance long-term adherence to the Mediterranean Diet. Full article

Background: Tumor necrosis factor-α (TNFα) inhibitors have significantly improved outcomes in children with non-systemic juvenile idiopathic arthritis (JIA), achieving long-term clinical remission for many patients. However, the optimal strategy for TNF-α inhibitor withdrawal remains unknown, whether through abrupt discontinuation, gradual dose reduction, or interval extension. Objective: We aim to identify patient-, disease-, and treatment-related predictors of successful TNF-α inhibitor withdrawal in children with non-systemic JIA. Methods: In this prospective, randomized, open-label, single-center study, 76 children with non-systemic JIA in stable remission for ≥24 months on etanercept or adalimumab were enrolled. At the time of TNF-α inhibitor discontinuation, all patients underwent a comprehensive evaluation, including a clinical examination, laboratory tests (serum calprotectin [S100 proteins] and high-sensitivity C-reactive protein [hsCRP]), and advanced joint imaging (musculoskeletal ultrasound and magnetic resonance imaging [MRI]) to assess subclinical disease activity. Patients were randomized (1:1:1, sealed-envelope allocation) to one of three predefined tapering strategies: (I) abrupt discontinuation; (II) extension of dosing intervals (etanercept 0.8 mg/kg every 2 weeks; adalimumab 24 mg/m² every 4 weeks); or (III) gradual dose reduction (etanercept 0.4 mg/kg weekly; adalimumab 12 mg/m² every 2 weeks). Follow-up visits were scheduled at 3, 6, 9, 12, and 18 months to monitor for disease relapse. Results: Higher baseline Childhood Health Assessment Questionnaire (CHAQ) scores (≥2), elevated serum calprotectin [S100 proteins] and hsCRP levels at withdrawal, imaging evidence of subclinical synovitis, and a history of uveitis were all significantly associated with increased risk of flare. No significant associations were found for other clinical or demographic characteristics. Conclusions: Early significant clinical response, absence of subclinical disease activity, and concomitant low-dose methotrexate therapy were key predictors of sustained drug-free remission. These findings may inform personalized strategies for biologic tapering in pediatric JIA. Full article

Background: Early childhood caries (ECC) compromise the nutrition, growth, and quality of life in young children, and their relationship with breastfeeding practices remains disputed. Aim: To determine if prolonged breastfeeding increases the risk of dental caries in children aged under 71 months. Material and Methods: A systematic review of PubMed, Multidisciplinary Digital Publishing Institute, and Evidence-Based Dentistry, was conducted through August 2025, including observational studies, randomized trials, narrative reviews, and meta-analyses on breastfeeding and ECC. Results: Thirty-one studies involving 28,000 children were included. Exclusive breastfeeding for under six months halves ECC probability (OR 0.53–0.58), whereas breastfeeding beyond 12 months and nocturnal feeds increase probability by 60–86% (OR 2.35–7.14). Parental factors—high plaque levels, feeding-to-sleep, and skipped post-feed cleaning—strongly predict ECC (OR 8.51–75.6). Interventions combining feeding counseling with home visits or visual aids reduce ECC incidence by 22–32% (RR 0.68–0.78). Conclusions: Exclusive breastfeeding through six months is protective against ECC, but prolonged or nocturnal feeding heightens risk. Integrating structured oral health education into breastfeeding promotion is recommended. Full article

Housing insecurity is a growing public health concern linked to adverse health outcomes and lifelong vulnerability. Although housing is a well-established social determinant of health, this review employs a life-course framework to explain how housing insecurity contributes to the accumulation of health inequities and chronic disparities across the different stages of human development. A rapid review was conducted across PubMed, Google Scholar, SCOPUS, and Web of Science, focusing on peer-reviewed studies published between 1991 and 2025. Studies were screened using predefined eligibility criteria, and the selection process was documented through a PRISMA flow diagram. Fifty-five studies met the inclusion criteria. Housing insecurity was consistently associated with adverse health outcomes across pregnancy, infancy, childhood, adolescence, adulthood, and older age. Each life stage presents distinct vulnerabilities shaped by environmental and social conditions, which are manifested through physiological and psychosocial pathways. While physical health effects were most frequently reported, developmental and mental health impacts accumulated over time, amplifying overall burden. The findings demonstrate a clear life-course pathway linking housing insecurity to immediate and long-term health risks. Early-life disadvantages create lasting, preventable consequences, underscoring the urgent need for policies that embed housing stability within broader public health planning. Full article

Timely recognition of type 1 diabetes (T1D) in children and adolescents is crucial to prevent acute complications such as diabetic ketoacidosis (DKA). This narrative review examines the pathophysiology, clinical presentation, and diagnostic challenges of childhood T1D, including the young age of onset, clinician training gaps, and overlapping symptomatology between T1D and other common pediatric illnesses. Despite increased awareness, a significant proportion of children still present with DKA at diagnosis due to misinterpretation of symptoms, such as polydipsia, polyuria, and weight loss. This work emphasizes the importance of early recognition, timely intervention, and the use of structured management algorithms for primary care clinicians. Strategies to reduce DKA incidence, based on existing literature, successful real-world examples, and current guidelines, include enhanced screening for high-risk populations, educational initiatives, and improved diagnostic protocols. By implementing systematic approaches and public health campaigns, healthcare providers can improve early T1D detection and prevent severe DKA complications, ultimately enhancing patient outcomes and reducing long-term morbidity. Full article

Background/Objectives: Childhood metabolic dysregulation exerts a profound influence on the development of obesity and metabolic diseases. The human gut microbiota, with highly personalized characteristics, plays an important role in host metabolism. However, the dynamics of gut microbial features during this developmental phase are still unclear. This longitudinal observational study collected 204 fecal samples and 153 blood samples from 51 children (aged 8.90 ± 0.78 years) at four timepoints over 52 weeks, aiming to identify dynamic changes in individual gut microbiota and underlying mechanistic interactions that predict measures of pediatric metabolic health. Methods: Fecal samples were subjected to 16S rRNA gene amplicon sequencing and short-chain fatty acid quantification. Serum samples were analyzed for biochemical tests. Dietary intake, physical activity, clinical phenotypes, early-life factors, and fecal characteristics were further assessed. Results: In the results, the fecal microbiota dynamics exhibit inter-individual variation among children, allowing classification into high- and low-stability subgroups based on intra-individual β-diversity variability. Children with low-stability microbiota had adverse blood lipid profiles (p < 0.05). Compared to the high-stability group, the low-stability microbiota demonstrated significant association with low dietary fiber and highly variable amino acid consumption (|r| > 0.3, q < 0.05). Low-stability microbiota exhibited marked fluctuations in Phocaeicola vulgatus, which was strongly linked to both blood triglycerides and lipoprotein(a) levels, as well as dietary fiber and amino acid intake. Baseline depletion of P. vulgatus and Faecalibacterium duncaniae, combined with the children’s physiological status, lifestyle behaviors, and early-life factors, predicted microbial stability classification (AUROC = 0.93). Conclusions: These findings suggested that the variation in the gut microbiota dynamics could be considered as a possible complementary biomarker to understand the individualized responses within dietary interventions aimed at improving metabolic health in childhood. Further well-designed intervention study is needed to define these observational associations. Full article

Background/Objectives: Speech and language delay (SLD) is one of the most prevalent developmental conditions in childhood, with post-pandemic data indicating a notable increase in identified cases. Within this group, expressive language disorder (ELD) frequently appears alongside neurodevelopmental disorders such as autism spectrum disorder (ASD), epilepsy, and intellectual disability. Although awareness of ELD has grown, the role of genetic testing in its evaluation remains unclear, as such testing is not routinely pursued for isolated expressive language concerns. This gap highlights the need to better define the diagnostic value of genetic analysis and to examine the interval between an ELD diagnosis and the return of genetic testing results. Methods: This study investigated genetic contributions to ELD using the National Brain Gene Registry (BGR), a multisite database of rare neurodevelopmental disorders. Participants with ICD-10 code F80.1 were identified through electronic health records; demographic data, comorbidities, genetic variants, inheritance patterns, age at diagnosis, and timing of interventions were analyzed. Results: Of 687 BGR participants, 32 (4.7%) had documented ELD. The cohort, aged 3–19 years, presented with common comorbidities like developmental delays, ASD, epilepsy, and hypotonia. Across 42 genes, 49 unique variants were identified: 26 pathogenic or likely pathogenic, 22 variants of uncertain significance, and one benign variant. Seventeen variants were de novo, and 10 participants carried multiple variants. Most children (80%) received an expressive language diagnosis prior to genetic testing, with reports returned an average of 1.5 years following the diagnosis. Conclusions: Overall, children with ELD commonly carry genetic variants and neurodevelopmental comorbidities, yet genetic testing is typically pursued well after diagnosis and does not currently alter early management. These findings underscore the need for clearer, evidence-based guidelines to define when genetic testing adds diagnostic or prognostic value in the evaluation of ELD. Full article

Background: The rising prevalence and enduring impact of mental health problems in youth have intensified the call for population-level prevention. Low positive and high negative affect in childhood are vulnerability factors for mental health problems in adolescence. Supporting youth in managing affect during early adolescence may foster mental health preventively. Self-regulation training has shown promise in this regard. Moreover, its parallels with Behavioral Activation (BA) align with the recommendation to adapt evidence-based clinical interventions into scalable, accessible formats for prevention. Methods: This study examined whether a 12-day mobile-based self-regulation training, consistent with BA principles and delivered in an innovative digital format, could increase positive and decrease negative affect in a sample of 156 youths (M_age = 10.0). Results: No significant group differences emerged in affect change over time, and neither baseline levels of self-control nor emotion regulation strategies moderated the effects. Conclusions: The findings suggest that low-intensity mobile-based interventions may be insufficient to produce meaningful affect change in youth. The potential need to shift from universal prevention strategies to more selective approaches targeting at-risk youth is discussed. Full article

The national obesity prevalence for children between 2 and 5 years old was 12.7% from 2017 to 2020. These prevalence rates are concerning because as obesity in youth increases, so do long-term health and psychosocial risks. Preschool children can spend up to 50% of their day in childcare with their educators, consuming meals and snacks together. Therefore, the role modeling of healthy eating behaviors by these educators may have an impact on children’s eating behaviors and future weight status. The purpose of this paper is to examine the relationship between Head Start educators’ self-reported dietary intake patterns and BMI. Variables included BMI and 8 items from the Starting the Conversation brief dietary assessment screener. Data were collected at educators’ respective Head Start centers in the spring of 2019. Pearson correlations were calculated to examine the relationship between educators’ self-reported dietary intake patterns and BMI. Of 66 teachers and teacher assistants who completed all items and BMI assessment, significant relationships were found between consumption of snack chips or crackers and fast food (r = 0.33, p = 0.007 and r = 0.27, p = 0.031, respectively). This study’s findings call attention to the importance of supporting healthier diets among early childhood educators. Full article

Background/Objectives: This study examines factors associated with child overweight/obesity (OW/OB), pre-COVID-19 and during the COVID-19 pandemic, among all U.S. children aged 10–17 years, with or without developmental disabilities (DD) and, separately, among the subgroup of children diagnosed with a DD. Methods: Using data from the National Survey of Children’s Health (NSCH, 2018–2021), we applied descriptive statistics and multivariate logistic regression analyses to estimate the odds ratios of associations between family resilience, screen time, and childhood overweight/obesity. Family resilience measures families’ communication and problem-solving behaviors. Screentime is time spent on TV, computer, cellphone or electronic devices. Results: In descriptive analyses, during COVID-19, 35.8% of all children were identified as OW/OB compared to 32.8% pre-COVID-19—a weighted increase of 3.0%. Among children with developmental disabilities, OW/OB increased from 37.4% to 39.3%. Children reporting ≥4 h of screentime use increased from pre-COVID-19 to during COVID-19 in both groups (All Children: pre-COVID: 33.5%, during COVID: 41.6%; Developmental Disabilities: pre-COVID: 39.9%, during COVID: 49.4%). Among all children, there was a positive and strong association between screentime use and OW/OB at both pre- and during COVID-19 years. Children belonging to households with low family resiliency had 1.31 times the odds of being overweight/obese (95% CI, 1.06–1.63, p < 0.05) before the pandemic. However, these results were not significant after the pandemic. Conclusions: Prevalence of overweight/obesity in all children and children with DD during the COVID-19 pandemic continued to rise. Screentime was found to be a key determinant in increased weight status. Contrary to our hypothesis, family resilience failed to emerge as a significant protective factor for OW/OB; additional research is needed to explore the protective role of family resiliency on childhood obesity. Study findings may provide insights into developing best practices and tailored interventions with early OW/OB screening and programs tailored towards the youngest group of children aged 10–12 years or below. Full article

Background: Childhood undernutrition and overnutrition continue to be major public health challenges in South Africa. There is limited evidence on how socio-economic factors and dietary behaviors influence nutritional outcomes among school-aged children, particularly in rural areas such as Thulamela Municipality. Objective: This study aimed to examine the socio-demographic determinants, dietary patterns, and nutritional status among school-aged children in Thulamela Municipality, Limpopo Province, South Africa. Methods: A cross-sectional survey was conducted with 347 children aged 8–12 years. Simple random sampling was used to select eight villages from a total of 227 within the municipality. A snowball sampling method was used to recruit eligible children. Data on socio-demographic characteristics, including the child’s sex, parental education level, marital status, and employment status, were collected. Additionally, their dietary habits and meal frequency patterns were collected using structured questionnaires. Anthropometric measurements including height, weight, and BMI-for-age were obtained following WHO growth standards. Associations between variables were assessed using chi-square tests, with p-values < 0.05 considered statistically significant. Results: The prevalence of severe and moderate stunting was 20.5% and 21.0%, respectively. Overweight conditions and obesity affected 32.6% and 16.2% of participants, respectively. Parental education (p = 0.027), marital status (p = 0.001), and household income (p = 0.043) showed significant associations with height-for-age and BMI-for-age Z-scores. Additionally, regular breakfast consumption and the frequent intake of vegetables and dairy products were positively associated with improved nutritional outcomes (p < 0.05). Conclusions: The nutritional profile of school-aged children in Thulamela Municipality reflects a double burden of malnutrition, with concurrent high rates of stunting, overweight conditions, and obesity. Interventions that promote balanced diets and address socio-economic disparities are crucial for improving child growth and overall health. Socio-economic factors, including parental education, marital status, and household income, were significantly associated with children’s height-for-age and BMI-for-age. Furthermore, the regular consumption of breakfast, vegetables, and dairy products was associated with better nutritional outcomes, highlighting the influence of both dietary behaviors and socio-demographic determinants on child growth and health. Implementing nutrition education programs within schools that emphasize the value of balanced diets and highlighting the significance of eating breakfast regularly and incorporating vegetables and dairy products into daily meals is important. These programs should include both children and their caregivers to support regular healthy eating behaviors at home and in school. Additionally, schools should carry out regular growth monitoring and nutritional assessments to identify early indications of undernutrition or overnutrition, enabling prompt referrals and interventions for children who may be at risk. Full article

Early Childhood Mental Health Consultation (ECMHC) promotes children’s social–emotional development and reduces challenging behaviors in early care and education (ECE) centers, yet implementation barriers increase teacher stress and reduce confidence. Scalable, efficient, and accessible approaches are needed to meet ECE center demands. This quasi-experimental match-controlled study evaluated two ECMHC programs in promoting children’s social–emotional development and improving teachers’ skills/attitudes compared to an attention control condition in 22 ECE centers in lower-resourced areas of BLINDED. We compared Jump Start (JS; traditional human consultation model), Jump Start Go (JS Go; AI-enhanced consultation model), and Healthy Caregivers–Healthy Children (HC2; obesity-prevention consultation model). Child social–emotional development, teacher workplace stress/confidence, and classroom practices were assessed at pre-and post-intervention. Children in JS and JS Go interventions demonstrated significant social–emotional gains (F = 13.55, p < 0.001), with the largest reductions in internalizing problems observed in children who received JS Go (−2.91 points; F = 9.65, p < 0.001). JS Go classrooms also showed greater improvements in prosocial behavior (F = 5.05, p = 0.012) and resiliency (F = 8.95, p < 0.001) than HC2 classrooms. Findings suggest that both traditional and AI-enhanced ECMHC approaches can promote teachers’ capacity to support children’s social–emotional development. Full article