Search Results (317)

In humans, the master circadian clock, present in the suprachiasmatic nucleus, plays an important role in controlling life-sustaining functions. The development of the circadian clock begins in the fetal period and is almost completed during infancy to early childhood, based on the developmental program that is influenced by the mother’s daily rhythms and, after birth, with the addition of information from the daily life environment. It is known that circadian rhythms are deeply related not only to the balance of a child’s mental and physical development but also to maintaining mental and physical health throughout one’s life. However, it has been suggested that various health problems in the future at any age may be caused by the occurrence of circadian disturbances transmitted by the mother during the fetal period. This phenomenon can be said to support the so-called DOHaD theory, and the involvement of the mother in the maturation of appropriate and stable circadian rhythms cannot be ignored. We consider the problems and countermeasures during the fetal and infant periods, which are important for the formation of circadian clocks. Full article

This article examines training itineraries for early childhood education professionals in Portugal, focusing on promoting social and human development through music and the arts for infants. The training models discussed are categorized as short-term and long-term, encompassing both theory and practice through a transdisciplinary approach. Based on initiatives promoted by the Companhia de Música Teatral (CMT) and the Education and Human Development Group of the Centre for the Study of Sociology and Musical Aesthetics (CESEM) at NOVA University Lisbon, the article highlights projects such as: (i) Opus Tutti and GermInArte, developed between 2011 and 2018; (ii) the Postgraduate Course Music in Childhood: Intervention and Research, offered at the University since 2020/21, which integrates art, health, and education, promoting collaborative work between professionals; and (iii) Mil Pássaros (Thousand Birds), developed since 2020, which exemplifies the integration of environmental education and artistic practices. The theoretical basis of these training programs combines neuroscientific and educational evidence, emphasizing the importance of the first years of life for integral development. Studies, such as those by Heckman, reinforce the impact of early investment in children’s development. Edwin Gordon’s Music Learning Theory and Malloch and Trevarthen’s concept of ‘communicative musicality’ structure the design of these courses, recognizing music as a catalyst for cognitive, emotional, and social skills. The transformative role of music and the arts in educational and social contexts is emphasized, in line with the Sustainable Development Goals of the 2030 Agenda, by proposing approaches that articulate creation, intervention, and research to promote human development from childhood onwards. Full article

Background: Despite decades of high childhood vaccination coverage, pertussis has re-emerged in the Autonomous Province of Vojvodina (AP Vojvodina), Serbia. We aimed to describe the temporal, seasonal, and age-specific patterns of pertussis in AP Vojvodina and to analyze trends by vaccination status in order to highlight changes in epidemiology and potential gaps in vaccine-induced protection. Methods: We retrospectively analyzed 2796 pertussis cases reported between January 1997 and December 2024, examining temporal, seasonal, and age-specific trends, stratifying by vaccination status across four consecutive periods (1997–2003, 2004–2010, 2011–2017, and 2018–2024). Results: Throughout the 28-year period, after low and sporadic cases in the pre-2012 period, a dramatic rise was observed in 2014, 2017, and 2018, culminating in the highest annual number of reported cases in 2024 (1011 cases). Throughout this period, primary vaccination coverage with the DTwP/DTaP three-dose series ranged between 91% and 98%, while first booster coverage gradually declined from 98% in the early 2000s to 83% in 2024. Regarding seasonality, a sharp increase in cases began in 2012, peaking in November 2023 (>350 cases) and early 2024 (312 in January, 268 in February), with a seasonal shift from summer peaks in the 2011–2017 period to higher incidence rates during colder months more recently. Adolescents aged 10–14 years had the highest cumulative incidence (1149.4/100,000), followed by infants under 12 months (978.5/100,000), despite the latter representing fewer absolute cases. The proportion of pertussis in fully vaccinated individuals rose from 6.3% (1997–2003) to 49.7% (2018–2024). Conclusions: These findings suggest that booster immunization in adolescence and routine maternal vaccination during pregnancy could reduce transmission, particularly to infants. Enhanced surveillance and updated immunization policies are critical to mitigating future pertussis outbreaks. Full article

Hurricanes and flooding events substantially elevate indoor fungal spore levels, which have been associated with increased risks of developing childhood asthma and other adverse respiratory outcomes. Although environmental fungal compositions following major hurricanes have been well characterized, the fungal communities within the nasal cavity (i.e., the nasal mycobiome) of exposed individuals remain unexplored. We collected nasal swab samples from infants following Hurricane Maria in San Juan, Puerto Rico, during two periods (March to August 2018 and February to September 2019). We processed a total of 58 samples (26 from the first year and 32 from the second year post-Hurricane Maria) and performed internally transcribed spacer (ITS) rRNA gene sequencing to characterize and compare the infant nasal mycobiome between the two groups. Although alpha-diversity did not differ significantly, beta-diversity analyses revealed significantly different fungal compositions between the two groups (p <0.01). Infants exposed during the first year post-Hurricane Maria had significantly higher abundances of Alternaria, Eutypella, Schizophyllum, and Auricularia, compared to infants from the second year. Alternaria was also more prevalent in the first-year than in the second-year infants (42% vs. 9%, p = 0.01). Our study provides evidence linking early-life hurricane exposures to elevated risks of developing childhood asthma. Full article

Background: Extremely premature neonates are at increased risk for respiratory complications, often resulting in recurrent hospitalizations during early childhood. Early identification of preterm infants at highest risk of respiratory hospitalizations could enable targeted preventive interventions. While clinical and demographic factors offer some prognostic value, integrating transcriptomic data may improve predictive accuracy. Objective: To determine whether early-life gene expression profiles can predict respiratory-related hospitalizations within the first four years of life in extremely preterm neonates. Methods: We conducted a retrospective cohort study of 58 neonates born at <32 weeks’ gestational age, using publicly available transcriptomic data from peripheral blood samples collected on days 5, 14, and 28 of life. Random forest models were trained to predict unplanned respiratory readmissions. Model performance was evaluated using sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC). Results: All three models, built using transcriptomic data from days 5, 14, and 28, demonstrated strong predictive performance (AUC = 0.90), though confidence intervals were wide due to small sample size. We identified 31 genes and eight biological pathways that were differentially expressed between preterm neonates with and without subsequent respiratory readmissions. Conclusions: Transcriptomic data from the neonatal period, combined with machine learning, accurately predicted respiratory-related rehospitalizations in extremely preterm neonates. The identified gene signatures offer insight into early biological disruptions that may predispose preterm neonates to chronic respiratory morbidity. Validation in larger, diverse cohorts is needed to support clinical translation. Full article

Background/Objective: A growing body of international research continues to show evidence of worsening youth mental health since the beginning of the COVID-19 global pandemic, yet very little research in this area has included young children under 6 years. Given the potential impact of early life stress during this critical period of development, it is crucial to better understand the effects on this age group. The objective of this study was to better understand the impact of the COVID-19 pandemic on the emotional health of very young children. Methods: This study utilized retrospective chart review of primary care records to compare the prevalence of markers of stress in two cohorts of children under the age of 6 years, comparing children presenting for care prior to the pandemic (1 April 2019–31 March 2020; control period) with those presenting for care during the first year of the pandemic (1 April 2020–31 March 2021; study period) in a large pediatric primary care clinic in Washington, DC, USA. Based on power calculations, charts of 200 patients from each cohort were reviewed and prevalence of stress markers were summarized using counts and percentages and compared between groups using chi-squared tests. Multivariable logistic regression models were also conducted for each domain adjusting for age, gender, and insurance type. Results: Overall, sleep difficulties were significantly more prevalent during the pandemic period compared to the control period (14% vs. 6.5%, p = 0.013). In addition, signs of stress presented differently across age groups. For example, during the pandemic period toddlers (13–35 months) were 13 times more likely (OR = 13, 95% CI [2.82, 60.4], p < 0.001) and preschool-aged children (36–71 months) were 18.5 times more likely (OR = 18.5, 95% CI [4.0, 86], p < 0.001) than infants to present with behavior problems, indicating substantially higher risk of externalizing symptoms in older children compared to infants. Toddlers were less likely than infants to present with mood changes (e.g., fussiness or crying) (OR = 0.15, 95% CI [0.03, 0.65], p = 0.011). In addition, toddlers (OR = 0.55, 95% CI [0.31, 0.97], p = 0.038) and preschool-aged children (OR = 0.15, 95% CI [0.06, 0.4], p < 0.001) were also less likely to present with feeding difficulties compared to infants. Conclusions: One of the very few studies of young children under 6 years (including infants) during the COVID-19 pandemic, this study found that even very young children experienced stress during the pandemic. Signs of emotional stress were identified in a primary care office during routine care, highlighting an important opportunity for early intervention and/or prevention, such as counseling and resources for caregivers, in settings where young children are already presenting for routine care. Full article

Background/Objectives: Childhood stunting remains a critical public health issue in low- and middle-income countries. Despite Malaysia’s economic growth, there is limited large-scale evidence on the determinants of stunting among children from infancy to primary school age. This cross-sectional study, part of South East Asian Nutrition Surveys II (SEANUTS II), aimed to determine sociodemographic and environmental risk factors for stunting among 2989 children aged 0.5–12 years. Methods: Children were recruited from four regions in Peninsular Malaysia (Central, East Coast, 2022–2030Northern, Southern). Standing height or recumbent length was measured, and stunting was classified based on WHO criteria (height-for-age Z-score below −2 standard deviations). Parents reported information on socioeconomic status, sanitation facilities, and hygiene practices. Multivariate binary logistic regression was used to determine the determinants of stunting. Results: Stunting prevalence was 8.9%, with infants (aOR = 2.92, 95%CI:1.14–7.52) and young children (aOR = 2.92, 95%CI:1.80–4.76) having higher odds than school-aged children. Key biological predictors included low birth weight (aOR = 2.41; 95%CI:1.40–4.13) and maternal height <150 cm (aOR = 2.24; 95%CI:1.36–3.70). Chinese (aOR = 0.56; 95%CI:0.35–0.88) and Indian children (aOR = 0.16; 95%CI:0.05–0.52) had a lower risk of stunting compared to Malays. Conclusions: This study highlights the ongoing challenge of childhood stunting in Malaysia, with age, birth weight, ethnicity, and maternal height identified as key determinants. These findings call for early identification of at-risk households and targeted support, especially through education and financial aid to foster healthy child growth. Full article

Climate change and air pollution are reshaping viral circulation patterns and increasing host vulnerability, amplifying the burden of respiratory illness in early childhood. This narrative review synthesizes current evidence on how environmental exposures, particularly to nitrogen dioxide, ozone, and fine particulate matter, contribute to the incidence and severity of bronchiolitis, with a focus on biological mechanisms, epidemiological trends, and public health implications. Bronchiolitis remains one of the leading causes of hospitalization in infancy, with Respiratory Syncytial Virus (RSV) being responsible for the majority of severe cases. Airborne pollutants penetrate deep into the airways, triggering inflammation, compromising mucosal defenses, and impairing immune function, especially in infants with pre-existing vulnerabilities. These interactions can intensify the clinical course of viral infections and contribute to more severe disease presentations. Children in urban areas exposed to high levels of traffic-related emissions are disproportionately affected, underscoring the need for integrated public health interventions. These include stricter emission controls, urban design strategies to reduce exposure, and real-time health alerts during pollution peaks. Prevention strategies should also address indoor air quality and promote risk awareness among families and caregivers. Further research is needed to standardize exposure assessments, clarify dose–response relationships, and deepen our understanding of how pollution interacts with viral immunity. Bronchiolitis emerges as a sentinel condition at the crossroads of climate, environment, and pediatric health, highlighting the urgent need for collaboration across clinical medicine, epidemiology, and environmental science. Full article

There is an increasing number of multilingual children attending early childhood education and care (ECEC) settings around the world. Early childhood teachers play a crucial role in supporting these multilingual young children. As teachers’ teaching practices are directed by their beliefs, it is significant to understand early childhood teachers’ beliefs about multilingualism in the existing literature in order to better support multilingual children. From 14 studies, this review categorised three main themes of early childhood teachers’ beliefs about multilingualism: multilingualism as a problem, multilingualism as a right, and concerns about multilingualism as a resource. Two studies examined factors associated with the variation in teachers’ beliefs. The findings of this review summarised various perspectives of teachers’ misconceptions and negative beliefs about multilingualism, although a small number of studies reported teachers’ positive beliefs about multilingualism in ECEC. This review addresses early childhood teachers’ knowledge gaps in child language development and multilingual pedagogies. In addition, this review identifies several research gaps for future studies. For example, more studies conducted in non-Western contexts and studies on teachers’ beliefs about supporting multilingual infants and toddlers are much needed. This review also contributes to informing future directions for professional development to empower early childhood teachers to support multilingualism. Full article

Human metapneumovirus (hMPV), a member of the Pneumoviridae subfamily, has emerged as a significant etiological agent of acute respiratory tract infections across diverse age groups, particularly affecting infants, the elderly, and immunocompromised individuals. Since its initial identification in 2001, hMPV has been recognized globally for its seasonal circulation pattern, predominantly in late winter and spring. hMPV is a leading etiological agent, accounting for approximately 5% to 10% of hospitalizations among pediatric patients with acute respiratory tract infections. hMPV infection can result in severe bronchiolitis and pneumonia, particularly in young children, with clinical manifestations often indistinguishable from those caused by human RSV. Primary hMPV infection typically occurs during early childhood; however, re-infections are frequent and may occur throughout an individual’s lifetime. hMPV is an enveloped, negative-sense RNA virus transmitted through respiratory droplets and aerosols, with a 3–5-day incubation period. The host immune response is marked by elevated pro-inflammatory cytokines, which contribute to disease severity. Advances in molecular diagnostics, particularly reverse transcription–quantitative polymerase chain reaction (RT-qPCR) and metagenomic next-generation sequencing (mNGS), have improved detection accuracy and efficiency. Despite these advancements, treatment remains largely supportive, as no specific antiviral therapy has yet been approved. Promising developments in vaccine research, including mRNA-based candidates, are currently undergoing clinical evaluation. This review synthesizes current knowledge on hMPV, highlighting its virological, epidemiological, and clinical characteristics, along with diagnostic advancements and emerging therapeutic strategies, while underscoring the critical role of continued research and sustained preventive measures—including vaccines, monoclonal antibodies, and non-pharmaceutical interventions—in mitigating the global burden of hMPV-related disease. Full article

Background/Objectives: Early care and education programs promote children’s social–emotional development, predicting later school success. The COVID-19 pandemic worsened an existing youth mental health crisis and increased teacher stress. Therefore, we applied an infant and early childhood mental health consultation model, Jump Start Plus COVID Support (JS+CS), aiming to decrease behavioral problems in children post-pandemic. Methods: A cluster randomized controlled trial compared JS+CS to an active control, Healthy Caregivers–Healthy Children (HC2), at 30 ECE centers in low-income areas in South Florida. Participants were not blinded to group assignment. Teachers reported on children’s social–emotional development at baseline and post-intervention using the Devereux Early Childhood Assessment and Strengths and Difficulties Questionnaire. We assessed whether teacher stress, classroom practices, and self-efficacy mediated the relationship between JS+CS and child outcomes. We also explored whether baseline behavior problems moderated JS+CS effects on child protective factors, relative to HC2. Results: Direct group-by-time differences between JS+CS and HC2 were limited. However, JS+CS demonstrated significant within-group improvements in teacher-reported child protective factors, behavior support practices, and classroom safety practices. Classroom safety practices consistently mediated positive changes in child behaviors, including the DECA total protective factor score and subdomains of initiative and self-regulation. Additionally, teacher perceptions of behavior support mediated gains in child attachment. Conclusions: JS+CS shows promise in building protective systems around children through intentional support for teachers, underscoring the value of whole-child, whole-environment approaches in early intervention. Full article

Background: Maternal pre-pregnancy body mass index (BMI) has been linked to childhood growth. However, its effects on growth delay at different early life stages are not well understood. This study aimed to evaluate the relationship between maternal pre-pregnancy BMI and growth delay in Korean children, using data from the National Health Screening Program for Infants and Children. Methods: Data from 258,367 children born between 2014 and 2021 who underwent health screenings at both 18–24 and 30–36 months of age were analyzed. Maternal BMI within three years before childbirth was classified into five categories: <18.5, 18.5–22.9 (reference), 23–24.9, 25–29.9, and ≥30 kg/m². Growth delay was defined as measurements below the 10th percentile for height, weight, and head circumference. Adjusted relative risks (RRs) were estimated using regression models controlling for maternal age, comorbidities, and perinatal factors. Results: An increased risk of height growth delay was observed with higher maternal BMI, and this association persisted at both 18–24 and 30–36 months. In contrast, maternal underweight was not significantly associated with a height delay. Low maternal BMI was associated with underweight status in children. Head circumference growth delay was linked to both high and low maternal BMI; children of mothers outside the normal BMI range had an increased risk. Conclusions: Maternal pre-pregnancy obesity and underweight were associated with growth delays in height, weight, and head circumference in children up to 36 months of age. These findings underscore the importance of individualized weight management before pregnancy. Full article

Adequate and diverse diets are essential for children’s physical and cognitive development, yet food insecurity and malnutrition continue to threaten this fundamental right, which remains a pressing concern in many resource-poor settings. This study investigated food and nutrition security in Early Childhood Development (ECD) centres in Makhanda, South Africa, through a community-based participatory research approach. Using a mixed-methods approach combining questionnaire interviews, focus group discussions, direct observations, and community asset mapping across eight ECD centres enrolling 307 children aged 0–5 years, the study engaged ECD facilitators and analysed dietary practices across these centres. Results indicated that financial constraints severely affect the quality and diversity of food provided at the centres, thus undermining the ability to provide nutritionally adequate meals. The average amount spent on food per child per month at the centres was R90 ± R25 (South African Rand). Although three meals were generally offered daily, cost-driven dietary substitutions with cheaper, less diverse alternatives, often at the expense of nutritional value, were common. Despite guidance from Department of Health dieticians, financial limitations contributed to suboptimal feeding practices, with diets dominated by grains and starchy foods, with limited access to and rare consumption of protein-rich foods, dairy, and vitamin A-rich fruits and vegetables. ECD facilitators noted insufficient parental contributions and low engagement in supporting centre operations and child nutrition provision, indicating a gap in awareness and limited nutrition knowledge regarding optimal infant and young child feeding (IYCF) practices. The findings emphasise the need for sustainable, multi-level and community-led interventions, including food gardening, creating ECD centre food banks, parental nutrition education programmes, and enhanced financial literacy among ECD facilitators. Strengthening local food systems and establishing collaborative partnerships with communities and policymakers are essential to improve the nutritional environment in ECD settings. Similarly, enhanced government support mechanisms and policy-level reforms are critical to ensure that children in resource-poor areas receive adequate nutrition. Future research should focus on scalable, locally anchored models for sustainable child nutrition interventions that are contextually grounded, community-driven, and should strengthen the resilience of ECD centres in South Africa. Full article

Background/Objectives: Increased burdens on caregivers of infants and toddlers significantly affect caregivers’ quality of life and health. Although adequate care during infancy contributes to child development and special health care needs affect caregiver burden, the risk factors for and protective factors against increased caregiver burden remain unclear. We aimed to evaluate children’s health care needs and required caregiving time and identify factors associated with increased caregiver burden. Methods: We conducted an online survey of 287 Japanese caregivers who were randomly selected from a web panel and were raising children aged <4 years. The survey comprised a sociodemographic data form, Children with Special Health Care Needs (CSHCN) Screener, caregiving time survey form, and questions on increased burden. Needs and caregiving time were evaluated by dividing the participants into CSHCN and non-CSHCN groups. Related factors were analyzed using increased burden as the dependent variable. The chi-square test, Mann–Whitney U test, and modified Poisson regression were used for data analysis. Results: Among the children of the 287 participating caregivers, 16.4% were identified as CSHCN, while 96.9% had no specific diagnosis. Overall, 38.3% of the CSHCN group met only one of the five CSHCN Screener items. The CSHCN group spent significantly more time providing and arranging/coordinating health care. The non-CSHCN group spent significantly more time providing daily care. After adjusting for covariates, increased caregiver burden was significantly associated with a younger age of the child, more caregiving time required 6 months prior to the survey, and providing care for CSHCN. Conclusions: To help reduce the burden of childcare on caregivers of infants and young children, children’s needs should be identified and generous childcare provided from an early age. Early identification of CSHCN and appropriate support for families may help reduce caregiver burden during early childhood. Full article