International Journal of Child Health and Nutrition

Effects of Birth Delivery Mode and Antibiotic Use on Gut Microbiota in Preterm Newborns: A Cohort Study

Raji Fatiha — 2025-02-10

Background: The establishment of the gut microbiome begins very early in life. Bacterial colonization is influenced by several factors, especially the mode of delivery and antibiotic intake. In this study, we examined the composition of the neonatal gut microbiota within the first three weeks after birth, focusing on the impact of delivery mode and antibiotic use.

Methods: This cohort study included 29 preterm newborns recruited between the first and second day of life at the National Reference Center for Neonatology and Nutrition. Stool samples were collected from diapers and stored at 4°C for up to 6 hours before being stored at -80°C until analysis. The gut microbiota was identified using RT-PCR targeting four phyla: Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria.

Results: The comparison of gut microbiota by delivery mode shows that the microbiota of newborns delivered by cesarean section was less diverse than that of those delivered vaginally. During the first 48 hours of life, Enterobacteriaceae, including Escherichia coli, were predominantly present in vaginal births, while Enterococcus spp. (25%), Staphylococcus spp. (20%) and Lactobacillus spp. (5%) were present only in vaginal births. From the second week onwards, Bacteroides fragilis (15%) and Bifidobacterium spp. (10%) were mainly present in vaginal births. By the end of the third week, Enterobacteriaceae and Enterococcus spp. were present in all newborns. All newborns received empiric antibiotic therapy upon admission, with 41% receiving antibiotics for more than 5 days.

Conclusion: This study made it clear that microbiota requires time to progress inside the newborn's intestine, depending on the birth mode, either natural or cesarean section.

Evaluating the Effectiveness of STRONGkids in Identifying Nutritional Risk in Outpatients of Child Health Care Clinics

Li Wu — 2025-02-10

Aim: To investigate the value of the STRONGkids tool for screening malnutrition risk among pediatric outpatients in China.

Methods: This multicenter, cross-sectional, observational study included pediatric outpatients at the Maternity and Child Health Care Hospital in Changzhou, China, from March 2021 to March 2022. More specifically, we performed anthropometric assessments and screened pediatric patients under 2 years of age for nutritional risk using the STRONGkids tool.

Results: The total number of samples assessed for malnutrition risk was 1,062, of which 81.4% (n = 865) were low risk, 16.4% (n = 174) were medium risk, and 2.2% (n = 23) were high risk. In terms of sex, 81.2% (n = 448) of all males included in the present study were classified as low risk, while 16.5% (n = 91) and 2.3% (n = 13) were medium and high risk, respectively. Furthermore, the sensitivity and specificity of STRONGkids were 0.906 and 0.837, respectively, and the AUC was 0.872 (p < 0.01).

Conclusion: Although our findings failed to reveal any significant association between malnutrition risk and sex, malnutrition risk was significantly associated with age category and was more likely to occur within the first year of life. The STRONGkids tool demonstrated diagnostic efficacy in screening outpatient children for nutritional risk and could accurately identify children at risk of malnutrition. It promotes children's growth and development, reduces the risk of disease, and is beneficial to long-term health.

Children Allergies in Saudi Arabia: The Situation and Challenges‒ Narrative Review

Noha Farouk Tashkandi — 2025-02-10

Pediatric allergic diseases like asthma, allergic rhinitis, eczema, and food allergies are highly prevalent in Saudi Arabia. This narrative review synthesizes diverse evidence on the prevalence, clinical presentation, and management of pediatric allergic diseases in Saudi Arabia, highlighting gaps in knowledge and practice to inform future healthcare strategies. Studies report allergy rates between 13-45% among Saudi children. Common medications used include antihistamines, nasal steroids, bronchodilators, and topical creams. While specific immunotherapy is growing in popularity for persistent IgE-mediated conditions. This paper reviews recent literature on the burden, management strategies, treatment options, and challenges regarding pediatric allergies in Saudi Arabia. Key challenges include a lack of awareness among families and even healthcare professionals, a shortage of pediatric allergy specialists, limited accessibility, high treatment costs, and a lack of standardized protocols. However, advancements in immunotherapy and oral food desensitization provide promising prospects. More research, public health initiatives, specialized workforce capacity building, improving affordability, and national guidelines will help address this major pediatric concern in the kingdom.

A Study on the Effect of Breakfast Habits on Blood Pressure and Academic Performance among University Students in Saudi Arabia

Rafia Bano — 2025-02-10

Introduction: Skipping breakfast is becoming common and can significantly affect a person's physiological and psychological health.

Objectives: To determine the prevalence and factors associated with skipping breakfast among undergraduate students of Saudi Arabia.

Methods: A cross-sectional survey was conducted in two regions of Saudi Arabia using a self-designed and validated questionnaire that included demographic and anthropometric measurements with both open-ended and closed-ended questions. The sample size was 236 students, both adult males and females of age ≥ 18 years of age. Breakfast consumption was assessed using the single-question item: "How often do you eat breakfast?" (Almost every day, sometimes, rarely, or never). Skipping breakfast was defined as respondents indicating that they "sometimes," "rarely," or "never" have breakfast.

Results: Out of a total sample of 236, only 108 participants (45.8%) were consuming breakfast, and 128 participants (54.2%) skipped breakfast in the morning. Cereals were consumed daily by only approximately 20% of the participants. Toast or bread, eggs, and tea/coffee were the most consumed breakfast by more than 50% of the subjects. The highest recognized reason for skipping breakfast is no time to eat in the morning. Age, Systolic Blood pressure, and BMI were found to be significantly associated with breakfast skipping.

Conclusions: Evidence from observational studies suggests that skipping breakfast in real-world settings may contribute to weight gain and the development of overweight and obesity. Future research should explore other anthropometric measures beyond BMI and account for potential confounding factors.

Approaches to Speech Therapy for Children with Autism Spectrum Disorders (ASD)

Mariana Нryntsiv — 2025-02-10

Background: The article analyzes methods of correcting speech disorders in children with autism spectrum disorders (ASD). It is based on a literature review and practical cases on this issue.

Methods: The study used observation methods of behavior, speech, and communication of children with ASD, questionnaires from parents, educators, and correctional teachers, and experimental research based on the information obtained. The main methods of correction of speech disorders in children with ASD are highlighted, which include speech therapy, alternative and augmentative communication (AAC), therapy using games and imitation techniques, the use of behavioral techniques, and multisensory approaches. Traditional and innovative means for implementing the outlined methods of correction of speech disorders in children with autism spectrum disorders are outlined. A methodology for determining the effectiveness of the use of methods for the correction of speech disorders in children with autism spectrum disorders is proposed.

Results: Criteria and indicators for evaluating the outlined methods of correcting speech disorders have been developed. The main criteria include speech development, development of communication and social skills, reduction of stereotypical and repetitive forms of speech, emotional and behavioral regulation, use of alternative means of communication, and individual progress. Based on the developed criteria, a survey was conducted among parents, educators, and therapy specialists on the effectiveness of using the outlined methods of correcting speech disorders. The effectiveness of the use of traditional and innovative means of correction of speech disorders in the context of the implementation of the outlined methods of speech correction in children with ASD was experimentally tested. The effectiveness of the above methods was tested for different groups of children with ASD, including preschool, school, and adolescent age. In the course of the test, the control group used traditional means, and the experimental group used a combination of traditional and innovative means of correcting speech disorders in children with autism spectrum disorders (ASD).

Conclusion: The positive influence of the combination of traditional and innovative means of correction of speech disorders in children with autism spectrum disorders (ASD) on the development of language skills is noted.

Post-Operative Haemodynamic Monitoring of Patients undergoing Corrective Open Heart Surgery for Structural Heart Defects

Hanan Mohamed Ibrahim — 2025-02-10

Background: Accurate hemodynamic monitoring is essential when identifying and treating critically ill pediatric patients. Effective perioperative care directed by sophisticated hemodynamic monitoring can lower problems and enhance results, even though the best monitoring method is still up for debate.

Objective: to compare monitoring methods of cardiac output and systemic hemodynamics post-cardiac surgery and its correlation to the clinical status of patients (reflected by clinical signs and laboratory assessment) and outcome, focusing on non-invasive cardiometry and echocardiography.

Methodology: A cross-sectional study was conducted on 40 pediatric patients under five years old who underwent corrective cardiac surgery for congenital heart lesions. Hemodynamic parameters were assessed using echocardiography and ICON, alongside clinical evaluation and biomarkers (BNP and lactate), at 6 and 24 hours postoperatively. Statistical analysis was employed to identify significant correlations and trends.

Results: Significant hemodynamic changes were observed in the immediate post-operative period. Clinical assessment detected low cardiac output in 47% of patients at 6 hours, decreasing to 45% at 24 hours. TAPSE and ejection fraction, measured via echocardiography, showed significant correlations with clinical signs of low cardiac output at 6 and 24 hours, respectively. ICON parameters, such as thoracic fluid content (TFC), demonstrated significant trends, correlating with fluid balance and time on bypass. However, ICON lacked the precision of echocardiography for certain measures; its continuous, non-invasive monitoring provided valuable insights into hemodynamic trends.

Conclusion: Hemodynamic monitoring post-operative cardiac surgery with early management of instability decreases the risk of complications and prolonged hospital stay. Clinical assessment of low cardiac output symptoms is crucial in the hemodynamic monitoring of patients, paying attention to vital data. Echocardiography and electrical cardiometry parameters have significant correlations with each other, including contractility (TAPSE, CI) and fluid assessment values (IVC collapsibility and TFC). BNP levels are best used not as a "stand-alone" test but in conjunction with existing multivariable risk indexes.

Effect of Maternal Adverse Childhood Experiences on the Stress Level of Mothers of Children Diagnosed with Attention-Deficit/Hyperactivity Disorder: A Case-Control Study

Malak A. Alshareef — 2025-02-10

Attention deficit-hyperactivity disorder (ADHD) is a psychiatric disorder that affects children’s ability to function and could be carried into adolescence and adulthood with a prevalence of approximately 66-85%. However, few studies have assessed the association between prenatal maternal stress and ADHD in children in Jeddah, Saudi Arabia. This study aimed to assess the impact of adverse childhood experiences on parents of children with ADHD. This was a case-control study with a sample size of 180 mothers of children with ADHD diagnosed in a child psychiatric clinic at King Abdulaziz University Hospital from 2015 to 2020. We recruited 94 mothers of non-ADHD children for the control group. We investigated stress with a validated questionnaire using the Perceived Stress Scale and Adverse Childhood Experience questionnaire and considered ADHD symptoms as determined using the Conners’ Parent Rating Scale–revised (CPRS-R). The one-way ANOVA revealed a significant association (p=0.002) between multiple early-life traumas and elevated adult stress. Mothers with ADHD children affected severely by past traumas displayed significantly higher stress (p<0.05), unlike the control group, which showed no notable link between PSS levels, ACE questionnaire scores, or the effect of past experiences on maternal health (p>0.05). Of note, mothers of children with ADHD had higher levels of stress than control participants. Boys had a higher prevalence (67.8%) of ADHD than girls.

Bridging the Gap: Knowledge, Awareness, and Practices on Vitamin D Deficiency among Adolescent and Young Adults – A Cross-Sectional Study

Ali Elamin — 2025-02-10

Background: Vitamin D deficiency is a significant public health issue, impacting bone health, immune function, and overall well-being. Despite abundant sunlight in Saudi Arabia, deficiency rates remain high, potentially due to limited sun exposure, cultural practices, and low dietary intake of vitamin D. University students are a key demographic for assessing public health awareness and behaviors related to vitamin D. This study aimed to assess the knowledge, attitudes, and practices (KAP) related to vitamin D deficiency among Jazan University students, and to identify demographic factors influencing these aspects.

Methods: A cross-sectional study was conducted among 429 students at Jazan University, Saudi Arabia, from March to June 2024. Data on KAP regarding vitamin D deficiency were collected via a validated bilingual online questionnaire. Statistical analysis was performed using SPSS version 26, employing descriptive statistics and multivariate logistic regression to evaluate demographic predictors of KAP scores.

Results: Among the participants, 47.3% exhibited high knowledge, 55% demonstrated high awareness, and 45.6% had high practice levels concerning vitamin D deficiency. Female students had significantly higher KAP scores than males (p < 0.01), and health college students showed greater knowledge and awareness than their non-health peers (p < 0.05). Multivariate analysis confirmed that gender was a significant predictor, with females displaying higher odds of better outcomes across all domains (Knowledge: AOR 2.66, 95% CI 1.73–4.07; Awareness: AOR 3.0, 95% CI 1.94–4.62; Practices: AOR 1.65, 95% CI 1.10–2.49).

Conclusions: The findings highlight a need for targeted educational programs and routine screening initiatives to address vitamin D deficiency among young adults. Public health strategies should prioritize awareness campaigns across all academic disciplines to improve vitamin D literacy and mitigate deficiency-related health risks.