Noguchi Y, Murase M, Ujiie G
… +4 more, Mizukoshi Y, Asai H, Igawa M, Ikeda H
J Paediatr Child Health
· 2026 May · PMID 42144843
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INTRODUCTION: Low-birthweight infants have high nutrient requirements; however, early parenteral nutrition (EPN) and human milk fortification (HF) are provided in very low-birthweight infants. We changed the indications...INTRODUCTION: Low-birthweight infants have high nutrient requirements; however, early parenteral nutrition (EPN) and human milk fortification (HF) are provided in very low-birthweight infants. We changed the indications for EPN and HF from very low birth weight to birth weight < 1750 g in our hospital in April 2019. AIM: This study aimed to assess the growth and neurodevelopmental relationships in infants with birth weights between 1500 and 1750 g, with or without EPN and HF. METHODS: A retrospective cohort study was conducted using the medical records of infants with birth weights between 1500 and 1750 g from April 2016 to March 2022, who were divided into two groups: before and after the change in indication. RESULTS: EPN and HF promoted head circumference expansion during hospitalization. However, no relationships on growth were noted after hospital discharge. Furthermore, no difference in the incidence of complications was observed among the preterm infants, and relatively few adverse events associated with EPN and HF led to safe nutritional management. CONCLUSION: For infants with birth weights between 1500 and 1750 g, EPN and HF may improve short-term growth, but may not have an impact in the long term.
Al Salmi W, Johnston N, Birrell E
… +4 more, Bartlett AW, Palasanthiran P, McMullan BJ, Williams PCM
J Paediatr Child Health
· 2026 May · PMID 42136058
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AIM: In high tuberculosis (TB) incidence countries, accelerated Bacille Calmette-Guérin (BCG) reactions are considered markers of prior Mycobacterium tuberculosis exposure and may prompt investigation. Their significance...AIM: In high tuberculosis (TB) incidence countries, accelerated Bacille Calmette-Guérin (BCG) reactions are considered markers of prior Mycobacterium tuberculosis exposure and may prompt investigation. Their significance in low-incidence countries is unclear. We aimed to describe the frequency, clinical characteristics and outcomes of accelerated BCG reactions in children vaccinated in Australia. METHODS: We conducted a retrospective case series at a quaternary hospital in Sydney, NSW. All children receiving intradermal Danish strain 1331 BCG between December 2023 and December 2024 were included. Accelerated reaction was defined as induration (≥ 0.5 cm) within 72 h, pustule formation within 5-7 days, or healing with scar formation at 10-15 days. Demographics, TB exposure risks, investigations and outcomes were collected. RESULTS: Among 304 vaccinated children, 14 (5%) developed accelerated reactions. Median age was 3 years (IQR 6-45 months). Four had recently travelled to high-incidence countries; none had close contact with an individual with TB. Most reactions (12/14) occurred within 24-48 h. Six children underwent investigation due to epidemiological risk or young age; all results were negative. No child was diagnosed with M. tuberculosis infection or disease. All reactions resolved without antimycobacterial therapy. CONCLUSIONS: In this single-centre cohort in a low TB incidence setting, accelerated BCG reactions occurred in one in 20 vaccinated children and were self-limiting. No association with M. tuberculosis infection was identified. These findings should be interpreted with caution and warrant confirmation in larger, multicentre studies. In the interim, a risk-based approach to investigation may be appropriate in low-incidence settings such as Australia.
J Paediatr Child Health
· 2026 May · PMID 42124326
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AIM: Families increasingly turn to artificial intelligence (AI) tools for information about autism spectrum disorder (ASD), often during early childhood when concerns about development, diagnosis and intervention first e...AIM: Families increasingly turn to artificial intelligence (AI) tools for information about autism spectrum disorder (ASD), often during early childhood when concerns about development, diagnosis and intervention first emerge. From a paediatric perspective, these tools increasingly function as informal sources of health information alongside primary care and developmental services. This study aimed to evaluate the quality of autism-related information generated by widely used AI platforms. METHODS: Using a descriptive research design, responses generated by six freely accessible AI platforms (ChatGPT, Gemini, Microsoft Copilot, Perplexity, Brave and Grok) were examined. Each platform was asked 15 autism questions with well-established scientific answers. Responses were evaluated across five dimensions relevant to paediatric health communication: accuracy, readability, language framing, actionability and reference quality. RESULTS: Substantial variability was observed across AI platforms. Several tools produced generally accurate explanations of ASD; however, readability levels consistently exceeded recommended guidelines for paediatric health materials (i.e., the 6th-8th grade reading level). Most responses relied primarily on medicalized language rather than neurodiversity-affirming framing. Actionable guidance was limited, with only a minority of responses offering concrete next steps for families navigating early paediatric decision-making. Reference practices varied widely, with some platforms providing numerous credible sources and others offering few or none. CONCLUSIONS: Although AI tools can support parental understanding of ASD, differences in clarity, tone, usability and transparency may shape families' expectations prior to or during paediatric consultations. These findings highlight the need for thoughtful use of AI-generated autism information and suggest that families may benefit from guidance from paediatric professionals when interpreting AI-based responses.
Verryt C, Gray P, McNaughton P
… +15 more, Peake J, Wong M, Aho G, Best E, Brewerton M, Lutui F, Tulifau LE, Qin R, Viali S, White P, Wood A, Woon ST, Cole T, Charry AP, Hsiao KC
J Paediatr Child Health
· 2026 May · PMID 42116640
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Autosomal recessive interferon alpha and beta receptor subunit 1 (IFNAR1) deficiency is a rare and heritable inborn error of immunity (IEI) predisposing individuals to severe and life-threatening viral infections. It is...Autosomal recessive interferon alpha and beta receptor subunit 1 (IFNAR1) deficiency is a rare and heritable inborn error of immunity (IEI) predisposing individuals to severe and life-threatening viral infections. It is more common in people of Western Polynesian ancestry, with estimates of around one in six thousand live births affected, due to being homozygous for or having two copies of the regionally relevant pathogenic IFNAR1 variant c.1156G>T, p.Glu386*. IFNAR1 deficiency confers an increased risk of severe and life-threatening infections caused by naturally circulating viruses including influenza, SARS-CoV-2, herpes simplex virus, respiratory syncytial virus (RSV), arboviruses and viruses in live attenuated vaccines (LAVs) including measles-mumps-rubella (MMR) and yellow fever. Complications including virus induced systemic hyperinflammation (VISH) are associated with significant mortality. This document outlines expert consensus regarding early identification, diagnostic workup and management of IFNAR1 deficiency in Australia, Aotearoa New Zealand and Western Pacific nations.
Tay J, Ta J, Rilett A
… +3 more, Mulcaster A, Cruz E, Saari M
J Paediatr Child Health
· 2026 May · PMID 42116638
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Aim To synthesise evidence on how home care providers' readiness to care for children and youth with medical complexity (CYMC) is conceptualised, what shapes it in practice and what approaches have been used to support o...Aim To synthesise evidence on how home care providers' readiness to care for children and youth with medical complexity (CYMC) is conceptualised, what shapes it in practice and what approaches have been used to support or enhance readiness. Methods This scoping review was conducted in accordance with PRISMA-ScR and Joanna Briggs Institute guidelines, with the protocol registered on the Open Science Framework. MEDLINE, Scopus, CINAHL, PsycINFO, Cochrane databases and ProQuest (Nursing & Allied Health; Dissertations & Theses) were searched from 30 April 2025, with an update on 29th December 2025. Quantitative, qualitative, mixed-methods studies, reviews and relevant grey literature examining provider readiness to care for CYMC (0-18 years) at home were eligible. Two reviewers independently screened and charted data. Results A total of 19 studies were included following screening of 3530 records and 64 full-text reviews. Providers described limited paediatric-specific education, mentorship and supervision, variable training quality and reliance on experiential learning. Readiness was shaped by home conditions, isolation, unclear roles, family dynamics and equipment reliability. No tool measured readiness as a unified construct. Lower readiness was related to safety concerns, readmissions, family stress and provider moral distress. Conclusion Provider readiness appears to be a key safety and quality concern in paediatric home care, shaped by clinical, relational and system-level supports. Future work should clarify the construct, develop measures and test multicomponent strategies combining paediatric-specific education, mentorship, supported practice and service redesign.
Bhat JI, Dhochak N, Kumar P
… +6 more, Goyal JP, Jat KR, Varkki S, Lodha R, Kabra SK, CF study group in alphabetical order with equal contribution
J Paediatr Child Health
· 2026 May · PMID 42108567
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BACKGROUND: Cystic fibrosis (CF) is considered to be extremely rare in India, but over the past few decades, multiple reports suggest that CF occurs in India and clinical features may be different. Reports on clinical fe...BACKGROUND: Cystic fibrosis (CF) is considered to be extremely rare in India, but over the past few decades, multiple reports suggest that CF occurs in India and clinical features may be different. Reports on clinical features are limited to case series. In this multisite nationwide prospective study, we report the clinical profile of CF in Indian children. METHODS: Children below 18 years of age presenting with suggestive symptoms were enrolled at all the sites using a uniform protocol over a 5-year period at four sites across India. Diagnosis of CF was based on either elevated sweat chloride levels or the presence of two pathogenic CF-causing mutations, together with a clinical phenotype suggestive of the disease. Data collection included demographic, clinical, laboratory profiles, results of the aquagenic wrinkling test and overall outcomes of children diagnosed with CF. RESULTS: A total of 811 children were enrolled and 313 were diagnosed as CF during the study period. The median age at symptom onset and diagnosis was 2.25 months and 2.58 years, respectively. The common presenting symptoms included chronic cough (280, 89.5%), poor growth (213, 76.9%) and chronic diarrhoea (195, 62.3%). At the time of diagnosis, bronchiectasis on chest CT was present in 233 (90%) patients. Airway cultures grew Pseudomonas aeruginosa in 63 (36.8%), and Staphylococcus aureus in 32 (18.7%) patients. The common mutation was delta F508del, present in 31.3% of patients. CONCLUSION: CF is prevalent across all the geographic regions of India. Delay in diagnosis remains a significant challenge and contributes to the development of severe complications.
Wildes D, Corley L, O'Sullivan D
… +5 more, Selewski DT, Costigan C, Awan A, Quinlan C, Boyle MA
J Paediatr Child Health
· 2026 May · PMID 42108540
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AIMS: Acute kidney injury (AKI) affects up to one-third of neonates admitted to neonatal intensive care units (NICUs). NICUs are highly data-rich environments, offering opportunities to develop clinical prediction rules...AIMS: Acute kidney injury (AKI) affects up to one-third of neonates admitted to neonatal intensive care units (NICUs). NICUs are highly data-rich environments, offering opportunities to develop clinical prediction rules (CPRs) that use clinical and demographic data to estimate AKI risk. We sought to identify and critically appraise existing CPRs for predicting neonatal AKI. METHODS: A systematic search of PubMed and OVID-MEDLINE was conducted for literature published from 1946 to Q2-2025. Eligible studies reported the development or validation of CPRs for neonatal AKI in NICU populations. The review followed PRISMA guidelines and was prospectively registered with PROSPERO (CRD420250653606). Data extraction followed the CHARMS checklist, and risk of bias was assessed using the PROBAST tool. RESULTS: From 685 identified articles, 11 underwent full-text review and three met inclusion criteria. Sample sizes ranged from 276 to 706 participants. One CPR was derived from multi-centre data; two used prospectively collected datasets. The number of predictor variables ranged between 4 and 10. Internal validation methods varied, with those who reported commenting on apparent performance only and none performing external validation. Hosmer-Lemeshow testing and calibration plots were the most commonly used forms of analysis. CONCLUSIONS: Current CPRs for neonatal AKI show potential but remain underdeveloped and poorly validated. Rigorous research, including external validation prior to integration into clinical workflows, is essential to enable effective early detection of neonatal AKI.
Irwin N, Ey S, Chen X
… +2 more, Raina D, Richardson D
J Paediatr Child Health
· 2026 May · PMID 42089248
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AIM: To assess changes in Respiratory Syncytial Virus (RSV) epidemiology and hospitalisations following implementation of a limited-eligibility nirsevimab program. METHODS: This observational cohort study included all in...AIM: To assess changes in Respiratory Syncytial Virus (RSV) epidemiology and hospitalisations following implementation of a limited-eligibility nirsevimab program. METHODS: This observational cohort study included all infants aged < 2 years residing in our jurisdiction with laboratory-confirmed RSV and/or receipt of an RSV monoclonal antibody between April 2022 and March 2025. Cases were followed for emergency department (ED) presentations and hospital admissions. Primary outcomes were RSV incidence, ED presentation, and hospitalisation rates. RESULTS: We identified 2355 RSV cases, with 1625 infants presenting to ED and 701 hospitalised. Among 308 infants receiving nirsevimab, the most common indication was prematurity; 2.4% experienced breakthrough RSV infection. RSV incidence increased post-nirsevimab (April 2024-March 2025: 89.06/1000 infant-years) compared with the pre-nirsevimab period (April 2022-March 2024: 67.99/1000 infant-years), consistent with local and national trends. Characteristics of hospitalised infants changed in the post-nirsevimab period: age increased (from 9.4 to 10.7 months, p = 0.019), the proportion aged < 3 months decreased (from 27.6% to 19.7%, p = 0.013) and prematurity prevalence nearly halved (from 13.3% to 7.3%, p = 0.041). Clinical characteristics also changed, with an 8-h reduction in length of stay (p = 0.010), and a one fifth reduction in the need for respiratory support (p < 0.001). No significant differences were observed for Aboriginal and Torres Strait Islander infants. CONCLUSIONS: Hospitalisations among infants at greatest risk for severe RSV disease reduced following introduction of the limited-eligibility nirsevimab program. However, Aboriginal and Torres Strait Islander infants remained over-represented in hospital admissions and under-served by the program in its first year, warranting further investigation.
J Paediatr Child Health
· 2026 May · PMID 42089207
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A paediatrician is a specialist medical practitioner committed to the health and well-being of infants, children and young people. However, curricula for training in paediatrics are predominantly process and content focu...A paediatrician is a specialist medical practitioner committed to the health and well-being of infants, children and young people. However, curricula for training in paediatrics are predominantly process and content focussed, with some emphasis on professional behaviours, but because of their length do not distil the essence of what it is to be a paediatrician. In this paper, I explore some of the history of paediatrics to build a modern conception of this most marvellous vocation.
Çirkin G, Güzin Y, Doğan G
… +2 more, Uzan GS, Baydan F
J Paediatr Child Health
· 2026 Jun · PMID 42084007
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Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder characterized by prominent nutritional and gastrointestinal challenges. This study aimed to evaluate the nutritional status, gastrointestinal symp...Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disorder characterized by prominent nutritional and gastrointestinal challenges. This study aimed to evaluate the nutritional status, gastrointestinal symptoms and biochemical deficiencies in children with DMD, with a particular focus on the clinical utility of supplementary anthropometric indicators such as mid-upper arm circumference Z-score (MUAC-Z) and triceps skinfold thickness Z-score (TSF-Z). This cross-sectional study included 65 genetically confirmed DMD patients aged 5-18 years. Anthropometric data (BMI-SDS, MUAC-Z, TSF-Z), gastrointestinal complaints, serum vitamin D levels and clinical features were analysed. ROC curve analysis was conducted to determine age thresholds associated with symptom onset. The most frequently reported gastrointestinal complaints were abdominal bloating (50.8%), constipation (32.3%) and regurgitation (30.8%). Swallowing difficulties and prolonged meal times were significantly associated with older age and loss of ambulation. ROC analysis identified > 14.5 years as the age threshold for solid food dysphagia. A moderate, significant positive correlation was observed between MUAC-Z and BMI-SDS (r = 0.520; p < 0.001), whereas no significant association was found between TSF-Z and BMI-SDS. Vitamin D deficiency (< 30 ng/mL) was widespread (86.2%) and more prevalent among non-ambulatory patients (96.6% vs. 77.8%; p = 0.036). Malnutrition was more frequently observed in steroid-naïve children than in those receiving corticosteroid therapy (50% vs. 19%; p = 0.041). Nutritional deficiencies and gastrointestinal symptoms are commonly encountered in paediatric DMD and tend to increase with advancing age and functional decline. MUAC-Z and TSF-Z may offer complementary insights into muscle mass and fat distribution beyond BMI. These simple and non-invasive measurements could be useful additions to routine nutritional surveillance in DMD management.