Establishment of Normative Data for the Amount of Breast Tissue Present in Healthy Children up to Two Years of Age

ObjectiveTo establish a set of normal values for breast size in children up to two years of age, and to assess the effects of gender, gestational age, and type of feeding and growth parameters on breast size.DesignProspective cohort study over 20 monthsSettingThe Mayo Clinic Rochester, MN, neonatal nursery and Community Pediatrics Clinic.ParticipantsWell term infants and children through two years of age.InterventionsMeasurement of breast size based on previously described methods to yield a figure called the breast unit.Main outcome measureTransformation of breast unit size into percentiles according to age.ResultsThe 50^th to 99^th percentiles for 810 healthy term Caucasian infant visits were calculated. The 50th breast unit percentile was similar in males and females at birth and declined with age following a quadratic relationship for females and a cubic relationship for males. Breast tissue in female infants remained larger and persisted longer. Palpable breast tissue was still present in 45.2% of male and 61.6% of female visits after 10 months of age. At age 18 months, 5% of girls had a breast size unit greater than 2.88 cm² and 5% of boys had a breast size unit greater than 1.00 cm².ConclusionsThese data allow creation of normal standards of breast size for age, which could provide a future clinical tool to assist clinicians in the evaluation of early childhood breast enlargement in similar populations.     

A review of infantile capillary hemangiomas and their current treatment modalities

Infantile capillary hemangiomas (IHs) are common, benign, high flow, vascular tumors affecting children. These lesions typically involute spontaneously leaving no long-term sequelae and require no treatment. IHs can, however, be life and vision threatening depending on their extent and location. These lesions can be addressed with a number of treatment options including corticosteroids, surgical excision, and laser. Most recently, β-blockers have shown promising results when used both systemically and topically to treat IH. Beta-blockers are an exciting new treatment option for IH and have shown promising results with few reported side effects.     

Humoral immune response of childhood acute lymphoblastic leukemia survivors against the measles,mumps, and rubella vaccination

ABSTRACT

Background: There is a great risk of infection with viral-vaccine-preventable diseases like measles, mumps, and rubella (MMR) infections after the end of chemotherapy treatment of children with acute lymphoblastic leukemia (ALL), which could have been prevented with MMR vaccination. Previous studies reported widely variable rates of seropositivity (seroprotection) for MMR after ALL treatment ends. Also, few studies evaluated the response to MMR booster vaccinations after the end of ALL treatment and reported unclear and difficult to interpret results.

Material and methods: This retrospective cross-sectional study evaluated the prevalence of seropositive (protection) antibody titer levels for MMR among ALL childhood survivors who were followed-up at Jeddah Oncology Center, Saudi Arabia. The aim of the study was also to investigate and analyze the response of seronegative patients to a booster MMR vaccination.

Results: Fifty-seven ALL children were evaluated. Thirty-five patients (61.4%) were seropositive/seroprotected and the remaining 22 patients (38.6%) were seronegative for MMR. ALL Children under the age of 5 years had a higher prevalence of seronegative titers. Interestingly, the prevalence of seroprotection decreased as the time interval increased post-treatment, while seroconversion rates after administering a booster MMR vaccine were 57.1%, 87.5%, and 78.6%, respectively for MMR.

Conclusion: We suggest the need for booster MMR vaccination, especially for ALL children under the age of 5 years and those who experienced a protracted time interval post-treatment.