Child abuse, sudden infant death syndrome, infectious disease, and vaccinations. 1994

A Walker, and R Chernoff, and A Joffe, and M E Wilson
Johns Hopkins University, School of Medicine, Division of General Pediatrics, Baltimore, MD 21205.

Clinicians all too often face the difficult dilemma of deciding whether a bone fracture in a young child was intentional. A structured expert consensus process suggests that all rib fractures; midshaft or metaphyseal fractures of the humerus; and fractures of the radius, ulna, tibia, or fibula in children younger than 1 year of age are highly likely to have been caused by abuse. Abused children are more likely to have negative social relationships with other children than their school-aged peers. Research on the causes of sudden infant death syndrome is still confounded by the likelihood that some deaths for which the label was misapplied are included in many studies; however, the presence of smokers in the household in the postnatal period appears to be yet another factor associated with increased risk. Congenital syphilis is on the rise. Detection of infants who have been infected is incomplete. Lack of prenatal care is strongly associated with infection. Cord serology is not sensitive enough to detect all possible cases. Testing of both maternal and neonatal sera results in detection of more infants at risk. Current tests still result in the treatment of some infants who are not themselves infected. Amoxicillin clavulante given twice daily rather then thrice, cefixime given once a day, and a single intramuscular dose of ceftriaxone have all shown acceptable--though not exceptional--cure rates for otitis media. Price is a consideration. Fewer courses of antibiotics would be necessary if more infants were breastfed. Exclusively breastfeeding to at least 4 months cuts the number of bouts of otitis media almost in half.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D009819 Office Visits Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up. Office Visit,Visit, Office,Visits, Office
D010033 Otitis Media Inflammation of the MIDDLE EAR including the AUDITORY OSSICLES and the EUSTACHIAN TUBE. Middle Ear Inflammation,Inflammation, Middle Ear
D011135 Polysaccharides, Bacterial Polysaccharides found in bacteria and in capsules thereof. Bacterial Polysaccharides
D001942 Breast Feeding The nursing of an infant at the breast. Breast Fed,Breastfed,Milk Sharing,Wet Nursing,Breast Feeding, Exclusive,Breastfeeding,Breastfeeding, Exclusive,Exclusive Breast Feeding,Exclusive Breastfeeding,Sharing, Milk
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002649 Child Abuse Abuse of children in a family, institutional, or other setting. (APA, Thesaurus of Psychological Index Terms, 1994) Abuse Experiences, Childhood,Child Neglect,Child Neglect Experiences,Child Neglect, Physical,Childhood Abuse Experiences,Childhood Neglect Experiences,Neglect Experience, Childhood,Neglect Experiences, Childhood,Physical Neglect, Childhood,Child Maltreatment,Child Mistreatment,Abuse Experience, Childhood,Abuse, Child,Child Neglect Experience,Childhood Abuse Experience,Childhood Neglect Experience,Childhood Physical Neglect,Childhood Physical Neglects,Experience, Child Neglect,Experience, Childhood Abuse,Experience, Childhood Neglect,Maltreatment, Child,Mistreatment, Child,Neglect Experience, Child,Neglect, Child,Neglect, Childhood Physical,Neglect, Physical Child,Physical Child Neglect,Physical Child Neglects
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006192 Haemophilus Infections Infections with bacteria of the genus HAEMOPHILUS. Hemophilus Infections,Haemophilus influenzae Infection,Haemophilus influenzae Type b Infection,Hib Infection,Infections, Haemophilus,Infections, Hemophilus,Haemophilus Infection,Haemophilus influenzae Infections,Hemophilus Infection,Hib Infections,Infection, Haemophilus,Infection, Haemophilus influenzae,Infection, Hemophilus,Infection, Hib

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