Objective: To assess relationships between characteristics of the home environment and preschool children's physical activity and dietary patterns. Methods:Homes of 280 preschool children were visited and information obtained by direct observation and parent interview regarding physical and nutritional characteristics of the home environment. Children's physical activity, sedentary behaviour and dietary patterns were measured using standardised parent-report questionnaires. Associations were analysed using analysis of variance and correlation.Results: Parental physical activity (p = 0.03-0.008), size of backyard (p = 0.001) and amount of outdoor play equipment (p = 0.003) were associated with more outdoor play. Fewer rules about television viewing (p < 0.001) and presence of playstation (p = 0.02) were associated with more indoor sedentary time. Higher fruit and vegetable intake was associated with restricting children's access to fruit juice (p = 0.02) and restricting high fat/sugar snacks (p = 0.009). Lower intake of noncore foods was associated with restricting children's access to fruit juice (p = 0.007), cordial/ carbonated drinks (p < 0.001) and high fat/sugar snacks (p = 0.003). Lower fruit and vegetable intake was associated with reminding child to 'eat up' (p = 0.007) and offering food rewards to eat main meal (p = 0.04). Higher intake of non-core foods was associated with giving food 'treats' (p = 0.03) and offering food rewards to eat main meal (p = 0.04). The availability of food groups in the home was associated with children's intake of these foods (fruit and vegetables, p < 0.001; fat in dairy, p = <0.001; sweetened beverages, p = 0.004-<0.001; non-core foods, p = 0.01-<0.001). Conclusion:Physical attributes of the home environment and parental behaviours are associated with preschool children's physical activity, sedentary behaviour and dietary patterns. Many of these variables are modifiable and could be targeted in childhood obesity prevention and management.

The CDQ shows acceptable reliability and relative validity for assessing group level child dietary patterns with key aspects of healthy eating guidelines.

To evaluate the effects of behavioral interventions on the sleep/wakefulness of infants, parent and infant stress, and later child emotional/behavioral problems, and parent-child attachment. METHODS:A total of 43 infants (6-16 months, 63% girls) were randomized to receive either graduated extinction (n = 14), bedtime fading (n = 15), or sleep education control (n = 14). Sleep measures included parent-reported sleep diaries and infant actigraphy. Infant stress was measured via morning and afternoon salivary cortisol sampling, and mothers' self-reported mood and stress. Twelve months after intervention, mothers completed assessments of children's emotional and behavioral problems, and mother-child dyads underwent the strange situation procedure to evaluate parent-child attachment.RESULTS: Significant interactions were found for sleep latency (P < .05), number of awakenings (P < .0001), and wake after sleep onset (P = .01), with large decreases in sleep latency for graduated extinction and bedtime fading groups, and large decreases in number of awakenings and wake after sleep onset for the graduated extinction group. Salivary cortisol showed small-to-moderate declines in graduated extinction and bedtime fading groups compared with controls. Mothers' stress showed small-to-moderate decreases for the graduated extinction and bedtime fading conditions over the first month, yet no differences in mood were detected. At the 12-month follow-up, no significant differences were found in emotional and behavioral problems, and no significant differences in secureinsecure attachment styles between groups.CONCLUSIONS: Both graduated extinction and bedtime fading provide significant sleep benefits above control, yet convey no adverse stress responses or long-term effects on parent-child attachment or child emotions and behavior. Women's and Children's Health Network, Adelaide, South Australia, Australia Dr Gradisar provided co-conception and design of the study, supervision of most of the analyses and conducted the rest of analyses, signifi cant contribution to the interpretation of analyses, and was main contributor to writing of manuscript; Dr Jackson provided co-conception and design of the study, collected most of the data (pretreatment to 3 months), conducted most of the analyses, provided signifi cant input to the literature reviewed, was a minor contributor to writing of the manuscript, and provided critical evaluation of manuscript drafts; Dr Spurrier provided co-conception and design of the study, critical evaluation of manuscript drafts, and interpretation of fi ndings; Ms Gibson provided input into study design, collected most of the 12-month follow-up data, and provided interpretation of fi ndings and critical evaluation of manuscript drafts; Dr Whitham provided input into the study design, conducted data scoring and analyses of 12-month 2 Large declines in nocturnal wakefulness occur (on average) over the first 6 months of age, and plateau thereafter, 2, 5 occurring after 24-hour circadian rhythm stabilization ...

Abstract SARS-CoV-2 is a novel coronavirus and causative pathogen to the pandemic illness COVID-19. Although RNA has been detected in various clinical samples, no reports to date have documented SARS-CoV-2 in human milk. This case report describes an actively breastfeeding patient with COVID-19 infection with detectable viral RNA in human milk.

BackgroundInterventions that encompass behavioural modifications of dietary intake and physical activity are essential for the management of obesity in children. This study assessed the effectiveness of a stage-based lifestyle modification intervention for obese children.MethodsA total of 50 obese children (7–11 years old) were randomized to the intervention group (IG, n = 25) or the control group (CG, n = 25). Data were collected at baseline, at follow-up (every month) and at six months after the end of the intervention. IG received stage-based lifestyle modification intervention based on the Nutrition Practice Guideline for the Management of Childhood Obesity, while CG received standard treatment. Changes in body composition, physical activity and dietary intake were examined in both the intervention and control groups.ResultsBoth groups had significant increases in weight (IG: 1.5 ± 0.5 kg; CG: 3.9 ± 0.6 kg) (p < 0.01) and waist circumference (IG: 0.1 ± 0.5 cm; CG: 2.2 ± 0.7 cm) (p < 0.05), but the increases were significantly higher in CG than IG. Body Mass Index (BMI)-for-age z scores decreased significantly in IG (− 0.2 ± 0.0, p < 0.01) but not in CG. The physical activity of the IG significantly increased (0.44 ± 0.13) compared with that of CG (− 0.28 ± 0.18), and the difference in mean change between groups was statistically significant (p < 0.05). Dietary intake was not significantly different between the two groups. However, calorie and carbohydrate intake decreased significantly in both groups.ConclusionsA stage-based intervention that modified dietary and physical activity behaviour may be effective in weight management for obese children.Trial registrationNCT03429699 retrospectively registered 9 February 2018.

GPs and paediatricians have the opportunity to screen children for overweight and obesity during their everyday practice. Accurate determination of weight status cannot be performed by visualisation alone and all children should have height and weight measured and correctly interpreted. Some areas of current GP and paediatrician management of overweight and obese children fall short of the NHMRC clinical guidelines and areas for improvement are highlighted in this paper.

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Objective: To examine differences in health-related quality of life (HRQL) of children living in different socio-economic contexts in Australia.Methods: Parental reports describing the HRQL and socio-economic status of a random national sample of 3,597 schoolage children were obtained using the Child Health Questionnaire (CHQ) and a standardised socio-economic interview.Response rate was 70%.Results: Children in families of higher income, whose parents had more years of schooling and were employed and children who lived in two-parent, original families had significantly higher HRQL across a range of domains assessed by the CHQ. Conclusion:Children from lower socioeconomic backgrounds in Australia have a significantly more negative experience of health and wellness. Such differences may well increase unless deliberate political attention is given to addressing the widening differences in relative wealth in Australia.