The edition · Paediatrics
Enhanced home visits with kangaroo care likely cut deaths in small babies, and childhood cancer survivors carry double the heart risk
A Cochrane review, weighted heavily by an Indian trial, finds more intensive post-discharge home visits reduce mortality in preterm and low-birthweight infants; a meta-analysis of 2.3 million people quantifies cardiovascular risk after childhood cancer; and late-night phone use is tracked against Fitbit sleep.
The edition in brief
A Cochrane review of 35 trials found that, compared with no home visits, home visits after discharge for preterm and low-birthweight infants likely increase breastfeeding at six months (RR 1.26) but have little effect on development or growth. Where home visits are already standard, more intensive visits with community-initiated kangaroo mother care likely reduce mortality at six months (HR 0.75) and serious bacterial infection (RR 0.89), from one trial of about 8,400 infants in India. A meta-analysis of 39 cohorts found childhood, adolescent and young adult cancer survivors had about twice the risk of cardiovascular disease (RR 1.99), highest when cancer was diagnosed in childhood (RR 2.48), and the excess persisted beyond 20 years. In 425 adolescents with 7,591 nights of passive phone and Fitbit data, nights with more phone use after 10 pm than usual were associated with sleep starting about an hour later and about 20 minutes less sleep. A randomised crossover simulation found emergency medical clinicians delivered guideline tidal volumes to a toddler manikin in only 16% of breaths without feedback, rising to 87% with a feedback device. The pearl is on bag–mask ventilation in children.
Childhood cancer survivors have twice the cardiovascular risk, for decades
Treat childhood cancer survivors as a high cardiovascular risk group for life and keep their treatment history visible.
Phone use after 10 pm was linked to later, shorter sleep in teenagers
Advise adolescents to stop using their phone well before bed; late use was linked to later, shorter sleep.
Bag–mask ventilation for a toddler met tidal volume targets in only one breath in six
Manual ventilation of small children is usually off target; train with feedback and watch for chest rise.
Bag–mask ventilation in a child: watch the chest, not the bag
Ventilate a child to gentle chest rise and no more.
Enhanced home visits with kangaroo care likely cut deaths in small babies after discharge
For preterm and low-birthweight babies after discharge, support home visits with kangaroo mother care; it likely reduces deaths.
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