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Objective: To compare the effect of two-hourly (Q2H) vs. three-hourly (Q3H) feeding on time to achieve full enteral feeding, growth metrics and respiratory tolerance in very preterm infants with birth weight ≤1,250g. Study Design: Retrospective study review of 18 months before and after a change in our feeding guideline from Q3H to Q2H feedings. Results: 113 infants were included, 59 in Q3H and 54 in Q2H groups. Q2H infants required 10% more days to achieve full enteral feeding, however it was not statistically significant (P = 0.054). Q2H feeding was associated with 16% more central catheter days (P = 0.02) and 17% more parenteral nutrition days (P = 0.019). There were no differences in respiratory outcomes or growth metrics between the groups. Conclusion: Very preterm infants fed Q3H had less central catheter and parenteral nutrition days when compared to those fed Q2H, without significant differences in growth or respiratory outcomes.

BACKGROUND AND OBJECTIVES: The effects of in utero methamphetamine exposure on behavioral problems in school-aged children are unclear. Our objective for this study was to evaluate behavior problems in children at aged 3, 5, and 7.5 years who were prenatally exposed to methamphetamine. METHODS: Subjects were enrolled in the Infant Development, Environment, and Lifestyle study, a longitudinal prospective study of prenatal methamphetamine exposure and child outcomes. Exposed and comparison groups were matched on birth weight, race, education, and health insurance.  At ages 3, 5, and 7.5 years, 339 children (171 exposed) were assessed for behavior problems by using the Child Behavior Checklist. Generalized estimating equations were used to determine the effects of prenatal methamphetamine exposure, age, and the interaction of exposure and age on behavior problems. Caregiver psychological symptoms were assessed by using the Brief Symptom Inventory. RESULTS: Analyses adjusted for covariates revealed that relative to age 3, children at 5 years had less externalizing and aggressive behavior and more internalizing behavior, somatic complaints, and withdrawn behavior.  By age 7.5, aggressive behavior continued to decrease, attention problems increased and withdrawn behavior decreased. There were no main effects for methamphetamine exposure and no interactions of exposure and age.  Caregiver psychological symptoms predicted all behavior problems and the quality of the home predicted externalizing problems and externalizing syndrome scores. CONCLUSIONS: Behavioral effects longitudinally from ages 3 to 7.5 years were not associated with prenatal methamphetamine exposure, whereas caregiver psychological symptoms and the quality of the home were predictors of behavior problems.

LITTLE REFERENCE has been made to the size of the breast of the newborn except that hyperplasia, engorgement, and milk secretion is physiologic, and that hyperplasia is seen with equal frequency in mature infants of both sexes. It also has been stated that breast development is rarely seen in premature infants, but a detailed study of the latter point has not been presented.* 1 In this study, the relationship between the size of the breast nodule and the birth weight and gestation was examined. The data are interpreted to indicate that the presence and size of the breast nodule are, in a general way, correlated with the maturity of the premature infant. MethodsData were obtained in 196 consecutive premature infants who were born from 1960 through 1962. One hundred and sixteen were white, and the remainder nonwhite, primarily Negro. The observers who evaluated the breast nodules were experienced in this technique. The size of the breast nodule was estimated by pinching the breast and noting the approximate amount of firm subcutaneous tissue. The appearance of the areola was not considered. Examinations were made at birth and weekly intervals until discharge. The breast nodules were graded according to size as follows :