Category: Paediatrics

Categories : Paediatrics Respiratory DiseasesTags :

Combination Inhaler Cuts Asthma Attacks in Children by Nearly Half

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Findings from a trial comparing the real-world effectiveness of asthma inhalers could reshape how children with asthma are treated.

In the first randomised controlled trial to investigate the use of a 2-in-1 inhaler as the sole reliever therapy for children aged 5 to 15, an international team found the combined treatment to be more effective than salbutamol, the current standard for asthma symptom relief in children, with no additional safety concerns.

The results show that using a single 2-in-1 anti-inflammatory reliever inhaler – which combines the inhaled corticosteroid (ICS) budesonide and the fast-acting bronchodilator formoterol – reduced children’s asthma attacks by an average of 45%, compared to the widely-used salbutamol inhaler.

Asthma attacks in children may be life-threatening and reducing their frequency and severity is a public health priority.

The 2-in-1 budesonide-formoterol inhaler is widely recommended as the preferred reliever treatment for adults, but children are still usually prescribed salbutamol.

Researchers say the findings, published in The Lancet, provide the evidence needed to bring children’s global asthma guidelines into line with adults’, which could benefit millions of children around the world with mild-to-moderate asthma.

The CARE study (Children’s Anti-inflammatory REliever) was designed and led by the Medical Research Institute of New Zealand (MRINZ), in collaboration with Imperial College London, University of Otago Wellington, Starship Children’s Hospital, and the University of Auckland. It recruited 360 children across New Zealand who were then randomly assigned to receive either budesonide-formoterol or salbutamol for on-demand symptom relief.

The trial lasted a year and the budesonide-formoterol reliever resulted in a lower rate of asthma attacks than salbutamol reliever, with rates of 0.23 versus 0.41 per participant per year. This means that for every 100 children with mild asthma who are switched from salbutamol to a 2-in-1 budesonide-formoterol inhaler, there would be 18 fewer asthma attacks per year. Importantly, the study also confirmed the safety of the combined-inhaler approach, with no significant differences in children’s growth, lung function, or asthma control between the two groups.

Dr Lee Hatter, lead author of the study and Senior Clinical Research Fellow at the MRINZ, said: “This is a key step in addressing the evidence gap that exists between asthma management in adults and children. For the first time, we have demonstrated that the budesonide-formoterol 2-in-1 inhaler, used as needed for symptom relief, can significantly reduce asthma attacks in children with mild asthma. This evidence-based treatment could lead to improved asthma outcomes for children worldwide.”

Professor Richard Beasley, Director of MRINZ and senior author of the study, said: “Implementing these findings could be transformative for asthma management on a global scale. The evidence that budesonide-formoterol is more effective than salbutamol in preventing asthma attacks in children with mild asthma has the potential to redefine the global standard of asthma management.”

The burden of asthma in the estimated 113 million children and adolescents with asthma worldwide is substantial. The latest study builds on previous studies in adults led by MRINZ researchers which shaped international asthma treatment guidelines. These findings contributed to the recommended use of the 2-in-1 ICS–formoterol reliever inhaler as the preferred reliever treatment for adults with asthma around the world.

The incorporation of findings from the CARE study into global asthma treatment strategies could help reduce disparities in care and ensure that more children access effective, evidence-based treatments.

The researchers say that global health organisations have long advocated for child-targeted asthma interventions, and their findings provide crucial evidence to support those efforts.

However, the authors acknowledge some limitations of the clinical trial. It was undertaken during the COVID-19 pandemic, during which stringent public health measures and fewer circulating respiratory viruses contributed to the lower than predicted rate of severe asthma attacks. The authors also acknowledge the challenges with the identification of asthma attacks in children, and the potential bias with the lack of blinding of the randomised treatments. They say though that the study’s findings are generalisable to clinical practice due to its pragmatic, real-world design.

Professor Andrew Bush, from Imperial College London, senior respiratory paediatrician and co-author of the CARE study, said: “Having an asthma attack can be very scary for children and their parents. I’m so pleased that we’ve been able to prove that an inhaler that significantly reduces attacks – already a game-changer for adults – is safe for children with mild asthma too. We believe this will transform asthma care worldwide and are excited to be building on this work with the CARE UK study.”

Professor Helen Reddel, Chair of the Science Committee of the Global Initiative for Asthma (GINA), commented on the global significance of the study, saying that it fills a critically important gap for asthma management globally. Professor Reddel said: “Asthma attacks have a profound impact on children’s physical, social and emotional development and their prevention is a high priority for asthma care. It is in childhood, too, that lifelong habits are established, particularly reliance on traditional medications like salbutamol that only relieve symptoms and don’t prevent asthma attacks.”

Professor Bob Hancox, Medical Director of the New Zealand Asthma and Respiratory Foundation, said: “This is a very important study for children with mild asthma. We have known for some time that 2-in-1 budesonide/formoterol inhalers are better than the traditional reliever treatment in adults, but this had not been tested in children. This research shows that this 2-in-1 inhaler is effective and safe for children as young as 5. This information will help to reduce the burden of asthma for many children, and both they and their families will breathe easier because of it.”

Source: Imperial College London

Categories : COVID PaediatricsTags :

COVID Controls Linked to Decline in Immunity to Life-threatening Paediatric Infections

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Photo by Kelly Sikkema on Unsplash

Scientists have uncovered a link between COVID-19 control measures and a surge in serious infections in children following the pandemic.

The findings, which come from a large European study led by researchers at Imperial, suggest that non-pharmaceutical interventions (NPIs) including lockdowns, school closures and social distancing may have inadvertently delayed the development of young children’s immunity to specific infectious diseases, leaving them more vulnerable to severe illness. 

The researchers explain that while this impact was anticipated for viral infections (such as influenza and RSV), a surge in other infections, including the bacterial infection Strep A, had not been expected.

The authors advise the need to carefully weigh the impact of restrictions on children during future pandemics and stress the importance of development and delivery of vaccines to reduce the impact of severe infections across all age groups.  

The findings are published in the journal JAMA Network Open.

Associate Professor Tom Parks from Imperial’s Department of Infectious Disease, co-lead author on the study, said: “During the COVID-19 pandemic there was huge uncertainty about the spread and severity of a new disease and difficult decisions had to be made to protect vulnerable groups, as well as to maintain the health service. Restrictions like lockdowns and social distancing played a vital role in limiting the transmission of the SARS-CoV-2 virus, which undoubtedly, saved countless lives, reduced the impact on health systems including the NHS and bought countries time to roll out vaccine programmes.

“However, our study shows they also disrupted how children built immunity during these critical early years. Children aged 3-4 tested for Strep A immunity after the pandemic were approximately a year behind children tested before the pandemic. This difference in immunity appears to have contributed to the alarming rise in severe Strep A infections seen across Europe during 2022 and 2023.” 

Strep A infections

Strep A (Group A Streptococcus) is a common type of bacteria that typically causes throat infections and scarlet fever. While most infections are mild, in rare cases Strep A can cause invasive infections which can be fatal. Each year, around half a million people, including many children and young people, die around the world because of serious Strep A infections.

Previous research has shown that while rates of Strep A infections fell dramatically during the pandemic, many countries recorded a surge in infection rates once restrictions were lifted.

In the latest study, the team examined immune responses in 452 children aged 0-4 year old across 10 European countries that participated in two EU-funded studies: PERFORM and DIAMONDS.

They found that children aged 3-4 who were exposed to NPIs during the pandemic had significantly lower levels of antibodies to Strep A compared to children of the same age who were sampled before the pandemic. The findings correspond exactly with the age group that experienced the greatest increase in life-threatening Strep A infections after NPIs were removed in England.

The researchers also found similar delays in immunity to respiratory syncytial virus (RSV), another common and potentially serious childhood infection, and a small reduction in immunity to some common cold viruses.

Professor Shiranee Sriskandan, co-director of Imperial’s Centre for Bacterial Resistance Biology and co-lead author said: “Strep A is one of the leading causes of unexpected death from sepsis in otherwise healthy children, and we know that sadly disease progression can be exceptionally rapid, making prevention – rather than intervention – our best option to reduce deaths. This study underlines the importance of immunity among young children in preventing outbreaks of serious strep A infections and highlights the value of developing a vaccine for Strep A.  

Professor Mike Levin, from Imperial’s Department of Infectious Disease, who led the DIAMONDS and PERFORM studies, said: “Many of the children who had Strep A infections also had viral infections at the same time. Children appear to have been vulnerable to several infections all at once most likely because they had encountered fewer infections and so had little chance to build up immunity.”

Source: Imperial College London

Categories : General Interest PaediatricsTags :

A Decade of Hope and Healing: Surgeons for Little Lives Marks 10 Years of Transforming Paediatric Care

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Every day for ten years, Surgeons for Little Lives has stood beside children and families, providing life-saving care and support.

Professor Jerome Loveland, Founder and Chair of Surgeons for Little Lives at the Chris Hani Baragwanath Academic Hospital paediatric surgery department

For the past ten years, Surgeons for Little Lives has stood as a lifeline for thousands of children at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto – the largest hospital in the southern hemisphere. In a healthcare system often stretched to its limits, this dedicated non-profit organisation has filled critical gaps with compassion, resilience and an unwavering belief that every child deserves the best possible care.

Since its founding in 2015, Surgeons for Little Lives has walked hand-in-hand with doctors, nurses, patients and families, not only providing vital resources but transforming the hospital experience for young patients. From upgrading surgical wards and equipment, to nurturing the next generation of paediatric specialists and creating welcoming, family-friendly spaces that offer comfort in the darkest moments – its work has made healing more than just a medical process. It’s become a human one.

“Our first ten years have shown what’s possible when people come together with one shared purpose: to save and uplift the lives of children,” says Professor Jerome Loveland, Founder and Chair of Surgeons for Little Lives. “We are deeply proud of what has been accomplished – but we know the need is growing. That’s why we will continue, every single day, to build capacity, inspire future leaders, and give every child a fighting chance at a brighter future.”

Why this work matters

South Africa has one of the highest burdens of paediatric surgical disease in the region. Children make up nearly 40% of the population, yet there are too few specialists and limited facilities to meet the demand. Severe burns, congenital conditions, childhood cancers and trauma are common, and without surgery many children would not survive.

At CHBAH alone, the paediatric surgery department sees more than 11,000 patients each year and performs over 2,300 operations. Surgeons for Little Lives works closely with the Department of Health to turn overstretched wards into spaces where children can recover with dignity.

3,650 days of achievement

Hospitals can be intimidating places for children. Surgeons for Little Lives has transformed the hospital environment with projects like an outdoor play area for recovering patients, family sleep-over facilities, and a fully revamped Ward 32 with a library, playroom, and upgraded bathrooms. Most recently, the organisation launched the Wells Paediatric Burns Unit, which doubled ICU beds, improved infection control, and added rehab spaces. For families, these changes mean children receive life-saving surgery and care in an environment designed with their needs in mind.

Beyond facilities, Surgeons for Little Lives has created programmes that focus on children’s emotional and physical wellbeing. Healing Through Art & Music gives young patients a way to process trauma through creativity and the SCAN programme, launched in 2023, helps to detect and prevent child abuse. In partnership with the South African Breastmilk Reserve, Surgeons for Little Lives also set up lactation support for new mothers. Other practical initiatives – from discharge packs to Mandela Day donations – have provided small comforts that make a big difference in long hospital stays.

Training for the future

Paediatric surgeons are scarce, and training takes years. Over the past decade, Surgeons for Little Lives has supported the journey of 17 qualified surgeons and backed another 15 registrars currently in training, supplying equipment like surgical loupes and funding access to academic opportunities. In 2024, the first Rolls Royce Oncology Fellow, Dr Andinet Beza from Ethiopia, trained at CHBAH before returning home with new skills. “This initiative, along with other training efforts, is helping to build the next generation of paediatric surgeons equipped to deliver world-class care. Training these specialists is a responsibility we take seriously and a privilege we don’t take for granted,” says Prof Loveland.

Community and partnerships

Community engagement has been central to the success of Surgeons for Little Lives. Fundraising events such as Bara Ride and Joberg2C, together with job shadowing opportunities for young people, have brought South Africans closer to the realities of paediatric care. Volunteers and donors provide not just resources but also comfort to families who spend weeks or months at a child’s bedside.

“This impact has only been possible thanks to the support of partners,” says Prof Loveland. “Contributions from corporates, foundations, and philanthropists have funded essential equipment, upgraded facilities, supported family-centred programmes, and helped fill critical gaps in care, ensuring that more children receive the treatment they need.”

10 years in numbers

  • 11,000+ patients seen in the paediatric surgery department each year
  • 2,300+ operations performed annually at CHBAH
  • 3,000+ burns patients treated since 2015
  • Mortality halved in the burns unit after upgrades
  • ICU beds increased from 6 to 11 in 2025
  • 17 paediatric surgeons trained; 15 registrars in training
  • Hundreds of families supported with sleep-over spaces, counselling, lactation services and more

Join us

Surgeons for Little Lives invites supporters, partners and the wider community to join in building the next chapter. By funding new projects, volunteering time or raising awareness, everyone can help ensure that more children get the surgery and support they deserve.

For its 10th anniversary, the organisation is calling on the public to donate R365 – one rand for every day of the year. In hospital that amount can cover burn dressings for a child, a week of meals for a parent at their child’s bedside or supplies for play therapy to make recovery less frightening, among many other things.

Every rand counts. Every day makes a difference.

For more information or to get involved, visit surgeonsforlittlelives.org.

Categories : PaediatricsTags :

Immune Benefits from Key Lipids from up to Six Months of Breastfeeding

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Photo by Wendy Wei

Breastfeeding until at least six months helps babies to fight off infections and reduces chronic inflammation, according to a new study. And better understanding the way specific nutrients in breast milk impact the immune system will improve health outcomes for all infants including those not breastfed.

The study, led by Murdoch Children’s Research Institute (MCRI) and the Baker Heart and Diabetes Institute (Baker Institute), discovered more clues as to why infants who were breastfed to at least six months of age had fewer infections and less chronic inflammation. Preventing these infections could reduce the rates of many childhood conditions, such as allergies, diabetes and asthma.

Published in BMC Medicine, the researchers identified several types of lipids (essential nutrients) in blood samples from breastfed babies that help reduce inflammation, which may reflect the unique nutritional composition of breastmilk.

MCRI’s Dr Toby Mansell said plasmalogens, a unique type of lipid abundant in breastmilk, appeared key to lowering inflammation. 

“Plasmalogens are only found in breastmilk and are generally absent in formula milk, so a better understanding of how plasmalogens and other lipids unique to breastmilk protect against chronic inflammation will help pave the way for new treatments for infants who don’t receive breastmilk,” he said.

The study involved almost 900 infants from the Barwon Infant Study, a collaboration between MCRI, Barwon Health and Deakin University.

The study explored about 800 different lipids and other metabolic markers in babies up until 12 months of age. It found breastfeeding was associated with broad effects on different classes of lipids and metabolic markers.

Baker Institute’s Dr Satvika Burugupalli said the findings would lead to a new understanding of how breastfeeding and specific components of breast milk could benefit infants.

“Breast milk performs a central role in supporting a newborn’s immune system,” she said. “It’s loaded with essential nutrients, including lipids, as well as antibodies and white blood cells.

“This study has identified key biological pathways for how breastfeeding improves immune health and reduces inflammation that can lead to many childhood conditions, such as allergies and asthma, and the risk of adult cardiovascular disease and diabetes.” 

Researchers from the University of Melbourne, Deakin University, Barwon Health, Northwestern University and the Florey Institute of Neuroscience and Mental Health also contributed to the study.

Source: Murdoch Children’s Research Institute

Categories : Neurology PaediatricsTags :

The Power of Touch: Skin-to-skin Contact Linked to Preemie Brain Growth

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Preterm infants born before 32 weeks who received more skin-to-skin contact while in the hospital showed stronger brain development in areas tied to emotion and stress regulation than babies who received less skin-to-skin care, according to a study published in Neurology®, the medical journal of the American Academy of Neurology. The study can only show an association and cannot establish causation.

“Skin-to-skin contact in preterm infants has been shown to have many benefits, with previous studies linking it to improved bonding, sleep, heart and lung function and growth, as well as reduced pain and stress,” said study author Katherine E. Travis, PhD, of Burke Neurological Institute in White Plains, New York. “Our findings in infants born very preterm suggest skin-to-skin care may also play a role in shaping early brain development, highlighting the potential importance of caregiving experiences during the earliest weeks of a preemie’s life.”

he study included 88 preterm infants with an average gestational age of 29 weeks who weighed an average of 2.65 pounds. The average stay in the hospital was two months. The goal was to find out whether skin-to-skin holding, also called kangaroo care, was linked to brain development in areas that help regulate emotions and stress. Researchers tracked skin-to-skin care with family members throughout each infant’s hospitalisation, including how long each session lasted and the total minutes per day. Families visited an average of once per day. When they provided skin-to-skin care, the average session was around 70 minutes with 73% of sessions provided by mothers. For the entire hospital stay, the average amount of skin-to-skin care per day was 24 minutes.

Each infant received a brain scan before going home from the hospital – around the time they would have reached full-term age of around 40 weeks. The brain scans measured how water moves through brain tissue. This movement helps reveal how white matter – the brain’s communication network – is developing. Researchers then compared the markers of white matter with the amount of time the preemies received skin-to-skin care per session and per day.

For skin-to-skin duration per session, researchers found longer sessions were linked to higher mean diffusivity – how freely water moves through the brain – in two key brain regions: the cingulum, which supports attention and emotion regulation; and the anterior thalamic radiations, which connects areas involved in emotional processing and memory.

Longer sessions were also linked to lower fractional anisotropy – how water movement is influenced by developing cellular tissues – in the anterior thalamic radiations. For daily total minutes of skin-to-skin care, researchers found higher amounts were linked to higher mean diffusivity in the anterior thalamic radiations. They were also linked to lower fractional anisotropy in the anterior thalamic radiations. These associations remained significant even after researchers accounted for factors that could influence brain development, including gestational age at birth, age at time of scan, socioeconomic status and how often family visited.

“Our findings add to growing evidence that white matter development is sensitive to a preterm infant’s experience while in the hospital,” said Travis. “Skin-to-skin care not only provides preterm infants with family connections through bonding, it may also be encouraging new connections within the brain itself, improving a baby’s brain health overall.”

A limitation of the study is that it was conducted at a single hospital and researchers reviewed existing medical records. The authors note that future research should explore how early caregiving experiences – like skin-to-skin care – might shape brain development and support later behavioural outcomes as preterm infants grow.

Source: American Academy of Neurology

Categories : Dermatology PaediatricsTags :

Decoding Baby Eczema and Reassurance for Parents

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Photo by William Fortunato

For many South African parents, few things are more stressful than watching their baby’s delicate skin flare up with redness, dryness, or tiny itchy patches. Baby eczema, also called atopic dermatitis, affects up to 1 in 5 children worldwide – and while it’s common, it can leave parents feeling worried and overwhelmed.

But the good news is, with the right skincare routine, baby eczema is manageable. And no, it doesn’t mean your little one will always struggle with sensitive skin.

“Parents are often surprised to learn that baby eczema is not a sign that they’re doing something wrong,” says Karen Van Rensburg, spokesperson for Sanosan South Africa. “It’s a common skin condition linked to an underdeveloped skin barrier, and the key is to protect and strengthen that barrier with gentle care.”

Baby eczema usually shows up between two and six months of age. It can appear on the face, behind the ears, on the arms, legs, or even the chest. The skin becomes dry, red, itchy and, in some cases, scaly.

“Triggers vary,” explains Van Rensburg. “It could be heat, dry air, soaps with harsh ingredients, or even certain fabrics. Understanding what sparks your baby’s flare-ups is an important step in managing the condition.”

So what can parents do at home? Here are some dermatologist-approved tips:

1. Keep baths short and sweet
Stick to lukewarm water and limit bath time to 5–10 minutes. Avoid bubble baths and fragranced soaps.

2. Moisturise immediately after bathing
Lock in hydration by applying a fragrance-free, gentle moisturiser while your baby’s skin is still slightly damp.

3. Choose your products wisely
Opt for creams specifically designed for sensitive baby skin. Look for formulas enriched with natural oils, chamomile, or panthenol – like those found in Sanosan’s baby skincare range.

4. Watch the wardrobe
Dress your baby in soft, breathable cotton and avoid scratchy fabrics like wool. Always wash new clothes before wearing.

5. Spot and soothe flare-ups early
At the first sign of redness or irritation, apply a gentle, protective cream to calm the skin.

6. Don’t overheat the room
Babies with eczema are often sensitive to heat. Keep the nursery cool and use a humidifier if the air feels very dry.

7. See a healthcare professional when needed
If the rash is severe, infected, or your baby seems very uncomfortable, always seek medical advice.

“Parents sometimes think stronger products will ‘fix’ eczema faster,” says Van Rensburg. “But baby skin is incredibly delicate. Harsh ingredients strip away natural oils and make things worse. Gentle, consistent care is far more effective in the long run.”

Baby eczema can feel daunting, but with the right care and patience, most little ones outgrow it as their skin barrier matures. In the meantime, gentle skincare, lots of cuddles, and a watchful eye on triggers can make the world of difference.

“Think of it as supporting your baby’s skin while it learns to protect itself,” Van Rensburg adds. “You’re not just treating eczema – you’re helping build a healthy foundation for life.”

Sanosan focuses on natural ingredients and gentle formulas for healthy skin. Using active ingredients specially tailored to your baby’s skin, natural milk protein is the central ingredient in Sanosan and is especially nourishing. More than 90 % of the ingredients are of natural origin such as organic olive oil, and the formulations are biodegradable.

Safety first: all products are clinically tested and are free from parabens, silicones, paraffins, SLS / SLES and phenoxyethanol. For more info visit sanosan.co.za

Categories : Cancer Neurology PaediatricsTags :

Combination of Diet and Medication Reprograms Paediatric Neuroblastoma

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Credit: National Cancer Institute

Researchers at Children’s Hospital of Philadelphia (CHOP) found that combining a specialised diet with an approved medication interrupts the growth of high-risk neuroblastoma, a deadly paediatric cancer, by reprogramming tumour behaviour. The findings were published in the journal Nature.

Neuroblastoma originates from primitive cells meant to form nerve tissues but that remain “undifferentiated,” indicating cancer cells that haven’t specialized, often suggesting a more aggressive and unfavourable prognosis. These tumours rely on a steady supply of chemicals called polyamines that are essential for rapid cell growth and tumour progression. A medicine called difluoromethylornithine (DFMO) was approved by the Food and Drug Administration (FDA) to treat children with high-risk neuroblastoma, as DFMO blocks polyamine production. However, researchers sought to improve the effectiveness of the drug by using it at high doses and combining it with a diet that is depleted of the nutrients used by the body to make polyamines (arginine). This two-step approach was anticipated to lower polyamines substantially more than low dose DFMO alone.

“Our findings show that this treatment reduced polyamines in tumours to roughly 10% of their usual levels. This reduction greatly slowed tumour growth, and in many cases, completely eliminated the tumours,” said Michael D. Hogarty, MD, a lead author and an Attending Physician in the Division of Oncology at Children’s Hospital of Philadelphia. “Notably, the treatment altered the way the tumour cells make proteins, making it harder for them to grow and easier for them to mature, or differentiate.”

Hogarty and his team used a preclinical model to mimic MYCN-driven neuroblastoma, directly addressing the strong association between extra MYCN gene copies and aggressive neuroblastoma with poor prognosis. Animal models with tumours were divided into groups: one fed a normal diet and the other lacking amino acids for polyamine production. Each group either received DFMO in their drinking water or did not. The special diet or DFMO alone partially lowered polyamines and extended survival, but the combination had the most significant impact on tumours due to the profound polyamine depletion it caused.

The researchers plan to conduct additional preclinical studies, followed hopefully by clinical trials in children to determine the safety and efficacy of targeting this specific metabolic dependency of neuroblastoma cells. By complementing existing treatments, they hope to substantially improve patient outcomes, and because the therapy targets polyamines it may be effective in many other types of cancer that have frequent MYC gene activation. 

Source: Children’s Hospital of Philadelphia

Categories : Antibiotics PaediatricsTags :

‘Alarming’ Rise in Newborn Babies with Antibiotic-resistant Infections, Researchers Find

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Photo by Christian Bowen on Unsplash

Researchers are calling for an urgent overhaul of diagnostic and treatment guidelines for infections in newborn babies, after a University of Sydney-led study revealed frontline treatments for sepsis are no longer effective to treat the majority of bacterial infections. 

The study, published in The Lancet Regional Health – Western Pacific, analysed almost 15 000 blood samples collected from sick babies in 2019 and 2020 at 10 hospitals across five countries in Southeast Asia, including Indonesia and the Philippines. 

It found that most infections were caused by bacteria unlikely to respond to the currently applied WHO recommended treatments. These were developed using data from high-income countries, instead of using localised data which could be more accurate and therefore effective. 

“Our study highlights the causes of serious infections in babies in countries across Southeast Asia with high rates of neonatal sepsis, and reveals an alarming burden of AMR that renders many currently available therapies ineffective for newborns,” said senior author Associate Professor Phoebe Williams, a Senior Lecturer and NHMRC Fellow in the Sydney School of Public Health.

“Guidelines must be updated to reflect local bacterial profiles and known resistance patterns. Otherwise, mortality rates are only going to keep climbing.”

The problem is further compounded by a lack of new antimicrobial medications in development for infants and babies, added co-author Michelle Harrison, PhD candidate and Project Coordinator of NeoSEAP in the Sydney School of Public Health. 

“It takes about 10 years for a new antibiotic to be trialled and approved for babies,” Harrison said.

“With so few new drug candidates in the first place, we need a significant investment in antibiotic development.”

Gram-negative bacteria responsible for 80% of infections

For the samples which tested positive for fungal or bacterial infections, the team analysed whether they were caused by gram-positive or gram-negative bacteria – referring to the structure of the bacteria’s cell wall which influences how likely it is to develop and acquire antibiotic resistance. 

Gram-negative bacteria like E. coli, Klebsiella and Acinetobacter were responsible for nearly 80% of infections and are more likely to develop (and spread) antibiotic resistance.

“These bugs have long been considered to only cause infections in older babies, but are now infecting babies in their first days of life,” said Associate Professor Williams. 

When treating babies, doctors don’t have time to wait for lab tests to confirm the exact cause of the infection, and often make an educated guess from published data, most often based on high-income populations, to guide treatment. These tests are also frequently delayed or falsely negative due to the difficulty of collecting blood samples.

Harrison explained that the findings showcase the importance of locally relevant data to guide routine medical decision-making.

“We need more region-specific surveillance to guide treatment decisions. Otherwise, we risk reversing decades of progress in reducing child mortality rates,” she said.

“Our results also revealed fungal infections caused nearly one in 10 serious infections in babies – a much higher rate than in high-income countries. 

“We need to ensure doctors are prescribing treatments that have the best chance at saving a baby’s life.”

Source: University of Australia

Categories : Cancer PaediatricsTags :

Study Assesses Cancers in Children Exposed to Medical Imaging

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Study of nearly 4 million children and adolescents finds that 10% of paediatric blood and bone marrow cancers may have stemmed from radiation exposure.

Credit: Pixabay CC0

A study led by UC San Francisco and UC Davis has concluded that radiation from medical imaging is associated with a higher risk of blood cancers in children.

For the study, which appears in NEJM, the researchers examined data from nearly 4 million children and estimated that 1 in 10 blood cancers – some 3000 cancers in all – may be attributable to radiation exposure from medical imaging. The risk increased proportionally based on the cumulative amount of radiation the children received.

The investigation is the first comprehensive assessment using data from children and adolescents in North America that quantifies the association between radiation exposure from medical imaging and blood and bone marrow cancers, such as leukaemia and lymphoma, which are the most common forms of cancer in children and adolescents.

Medical imaging saves lives by enabling timely diagnosis and effective treatment, but it also exposes patients to ionizing radiation, a known carcinogen, particularly through computed tomography (CT).

The authors caution that doctors and parents should avoid excessive radiation doses and minimize exposure when clinically feasible.

“Children are particularly vulnerable to radiation-induced cancer due to their heightened radiosensitivity and longer life expectancy,” said Rebecca Smith-Bindman, MD, a radiologist and professor of Epidemiology and Biostatistics, as well as Obstetrics, Gynecology and Reproductive Sciences at UCSF and the first author of the paper.

“While medical imaging can be lifesaving, our findings underscore the critical need to carefully evaluate and minimise radiation exposure during paediatric imaging to safeguard children’s long-term health,” said Smith-Bindman, who is also a member of the Philip R. Lee Institute for Health Policy Studies. “This involves ensuring that imaging is performed only when it provides essential information for the child’s care and, in cases such as CT scans, using the lowest possible radiation doses.”

Documenting risks in children

The study uses a retrospective cohort design, looking back at the complete imaging histories of 3.7 million children who were born between 1996 and 2016. The children were treated at six health care systems in the U.S. and Ontario, Canada. Investigators found a significant relationship between cumulative radiation dose and the risk of a hematologic malignancy, which includes tumours affecting the blood, bone marrow, lymph, and lymphatic system.

The risk of developing cancer varied significantly by imaging modality. CT, which is used to detect many abnormalities such as tumours, heart disease, and injuries of the spinal cord and brain, entails significant radiation exposure. But radiographs, which are used to diagnose both broken bones and pneumonia, expose children to much lower doses.

Among all the forms of medical imaging, the study found that chest radiography was the most common imaging exam that doctors performed. The most common form of CT was of the head and brain.

For children who underwent a head CT, the researchers attributed about a quarter of the children’s subsequent hematologic malignancies to radiation exposure. For those who had radiographs, by contrast, they estimated that only a small fraction of the children’s subsequent cancers were associated with radiation exposure.

Getting one or two head CTs was associated with a 1.8-fold increased risk of a cancer diagnosis, and this rose to 3.5 times for children who received more scans and were therefore exposed to more radiation.

Altogether, 2961 haematologic malignancies were diagnosed during the study period. Lymphoid malignancies accounted for 79.3%, while myeloid malignancies and acute leukaemia together accounted for 15.5%. About 58% of cancers occurred in males, and about half were diagnosed in children under 5.

The authors said that up to 10% of haematologic malignancies in children and adolescents could be prevented by reducing unnecessary imaging and optimising radiation doses. In many cases, the authors said, substituting non-ionising imaging modalities like ultrasound or MRI may be feasible without compromising diagnostic accuracy.

Benefits vs risks

The authors emphasised that while medical imaging remains an invaluable tool in paediatric care, their findings highlight the need to carefully balance its diagnostic benefits with potential long-term risks.

“This study provides robust, directly observed evidence of a clear dose–response relationship between radiation from medical imaging and hematologic malignancy risk in children and adolescents,” said Diana Miglioretti, PhD, UC Davis Health professor and chief of the Division of Biostatistics.

“Our findings align with international research highlighting that children are especially radiosensitive,” Miglioretti added. “It’s crucial for clinicians to weigh the immediate benefits of imaging against potential long-term health risks and to optimise imaging protocols to minimize radiation exposure.”

Source: University of California – San Francisco

Categories : Paediatrics Respiratory DiseasesTags :

Study Finds that Even Healthy Children Are Vulnerable to RSV

On By ModernMedia
Photo by William Fortunato

It is not only premature babies and children with underlying diseases who suffer from serious respiratory syncytial virus (RSV) infections. Even healthy, full-term babies are at significant risk of intensive care or prolonged hospitalisation – especially during the first three months of life. This is according to a comprehensive registry study from Karolinska Institutet published in The Lancet Regional Health – Europe.

RSV is a common cause of respiratory infections in young children and accounts for around 245,000 hospital admissions annually in Europe. Researchers have now analysed data from over 2.3 million children born in Sweden between 2001 and 2022 to find out who is at greatest risk of suffering serious complications or dying from an RSV infection.

Preventive treatment available

It is well-known that premature babies and children with chronic diseases are at increased risk of developing severe illness when infected with RSV. It is also known that children under three months of age are particularly vulnerable, but it has not been entirely clear how common severe disease is among previously healthy children. The study shows that the largest group among the children who needed intensive care or were hospitalised for a long period of time were under three months of age, previously healthy and born at full term.

“When shaping treatment strategies, it is important to take into account that even healthy infants can be severely affected by RSV,” says the study’s first author, Giulia Dallagiacoma, a physician and doctoral student at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “The good news is that there is now preventive treatment that can be given to newborns, and a vaccine that can be given to pregnant women.”

Starting September 10, 2025, all newborns in Sweden are being offered preventive treatment with antibodies during the RSV season. The drug works much like a vaccine and protects against severe RSV infection for about six months.

Several risk factors identified

A total of 1.7 per cent of the children in the study were diagnosed with RSV infection. Among those, just under 12 per cent (4,621 children) had a severe course of illness. The median age of children who needed intensive care was just under two months, and the majority of them had no underlying disease.

The researchers identified several factors that were linked to an increased risk of needing intensive care or dying. Children who were born in the winter, or had siblings aged 0–3 years or a twin, had approximately a threefold increased risk, while children who were small at birth had an almost fourfold increased risk. Children with underlying medical conditions had more than a fourfold increased risk of severe illness or death.

“We know that several underlying diseases increase the risk of severe RSV infection, and it is these children who have so far been targeted for protection with the preventive treatment that has been available,” says the study’s last author, Samuel Rhedin, resident physician at Sachs’ Children and Youth Hospital and associate professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “However, the study highlights that a large proportion of children who require intensive care due to their RSV infection were previously healthy. Now that better preventive medicines are available, it is therefore positive that the definition of risk groups is being broadened to offer protection during the RSV season to previously healthy infants as well.”

Source: Karolinska Institutet

Publication

“Risk factors for severe outcomes of respiratory syncytial virus infection in children: a nationwide cohort study in Sweden”, Giulia Dallagiacoma, Cecilia Lundholm, Awad I Smew, Emma Caffrey Osvald, Pekka Vartiainen, Santtu Heinonen, Tobias Alfvén, Catarina Almqvist, Samuel Rhedin, The Lancet Regional Health – Europe, online 10 September 2025, doi: 10.1016/j.lanepe.2025.101447.