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In This Issue of JAMA Pediatrics |

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JAMA Pediatr. 2014;168(3):197. doi:10.1001/jamapediatrics.2013.3327.
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RESEARCH

Infantile colic, gastroesophageal reflux, and constipation are the most common functional gastrointestinal disorders that lead to referral to a pediatrician during the first 6 months of life. Indrio and colleagues randomized 589 newborns to receive Lactobacillus reuteri or placebo during the first 3 months of life. Five drops of the probiotic daily resulted in a reduction of crying time from 71 to 38 minutes per day and reduction in the mean number of regurgitations per day. In their editorial, Chumpitazi and Shulman discuss the implications of the study and the need for long-term examination of the effects on the microbiome.

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Schools present highly desirable marketing environments for food and beverage companies, but most marketed items are nutritionally poor. Terry-McElrath and colleagues examined national trends in student exposure to selected school-based commercialism measures from 2007 through 2012. Most US elementary, middle, and high school students attended schools where they were exposed to commercial efforts aimed at obtaining food or beverage sales or developing brand recognition and loyalty for future sales. Vending contracts remain prevalent but contribute minimal financial support: approximately $2 to $4 per student annually. In their editorial, Harris and Fox discuss the implications for policy makers, school boards, and parents to ensure healthy nutritional environments for children.

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While caffeine is often used in premature infants, no prior studies have examined the effect of continuing treatment for a longer period. Rhein and colleagues studied prematurely born infants who were 34 to 37 weeks’ postmenstrual age and randomized them to either restart caffeine treatment or continue off caffeine treatment. Extended caffeine treatment reduced the mean time with oxygen saturations less than 90% by 47% at 35 weeks and 45% at 36 weeks. Extending caffeine treatment beyond current clinical indications significantly decreases the frequency and severity of intermittent hypoxia.

Designed to give children and families (especially those with disadvantaged backgrounds) a structured opportunity to accumulate assets, child development accounts (CDAs) are savings accounts that provide financial access, information, and incentives to encourage lifelong asset building and to promote child development. In this statewide experiment in Oklahoma with parents of 2704 infants by Huang and colleagues, intervention mothers received additional financial incentives and information about participating in the CDAs, while control parents could open a CDA on their own. The CDAs positively and significantly affected the social-emotional development of children, especially those from households with the lowest income and level of education. An editorial by Zimmerman discusses the possible mechanisms for this effect on child development and the policy implications for the United States.

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