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Background & Aims: Establishing commensal gut microbiota is important for optimal immune development. Dysbiosis increases risk of food sensitization and atopic eczema. Partially-hydrolysed formula (pHF) is recommended for infants at risk of developing allergies if breastfeeding is insufficient or not possible. Synbiotic supplementation can prevent or correct dysbiosis, improving immune outcomes by balancing immune response. Given pHF’s differ in protein hydrolysis process, in sources and level of macronutrients, this study’s objective is to demonstrate growth equivalence in healthy Chinese infants, assess safety and tolerance of a specific pHF with synbiotics (pHF-synbiotics) compared to standard infant formula (IF-prebiotics) as well as explore effects on immune and microbiota parameters.

Methods: A randomized controlled double-blind study (NCT03520764) with healthy infants ≤44d of age who received either pHF-synbiotics or IF-prebiotics until 17w of age. Full breastfed infants served as reference group. Infants continued the BF or intervention until 6m of age or switched to any other feeding. Anthropometrics, adverse events, gastrointestinal-tolerance and allergic-manifestations were assessed until 12m of age. Stools were collected at baseline, 17w and 12m of age to measure immune parameters and microbial composition and activity.

Results: In total 224 infants were randomised, 60 breastfed; 131 boys/153 girls; 176 East/78 South/30 North China. Full study demographics will be presented.

Conclusion: DRAGON is the first study in Chinese infants to provide insights into growth, safety and tolerance of pHF-synbiotics. Ad interim, an independent Data Monitoring Committee concluded that there were no signals for safety concerns and recommended continuation of the trial without modifications.

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Background and aims: The riverside population living in the brazilian amazonic region struggle to access healthcare and may present various morbidities. The aim of this research is to describe the prevalence of breastfeeding and infectious and parasitary diseases among children under five years old from riverside communities in Pará, Brazil.

Methodology: Observational cross-sectional study based on assistance from a social project conducted in 2018 and 2019 for riverside communities located by the Tapajós and Cupari rivers in Pará, Brazil. 238 children between 0 and under 5 years old participated in the study. The statistical analysis was descriptive and the variables expressed as simple mean and frequencies. Project approved by the Institutional Ethics Committee.

Results: The average age os pacients was 2,49 years. Male gender was predominant (51,26%) and 92,85% had breastfeeding. The prevalence of infectious and parasitary diseases (scabies, worms, fungal infection, for example) was 9,8% among children under one year old, 30,39% between one and 2 years, eleven months and twenty nine days old and 34,11% between three and five years old.

Conclusions: The breastfeeding rate in this region is higher than the average of the rest of the country. The prevalence of infectious and parasitary diseases is significantly high, even in children under one year old and being breastfed. This data suggests the need for public policies that aim to improve the sanitary conditions and health education measures aiming at better health indicators and reaching the full development potential of this population.

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Background

Till now, there is no evidence of effectiveness of nebulized solution to treat infants hospitalized with acute bronchiolitis. Some authors considered that epinephrine combined to 3% hypertonic saline could improve bronchiolitis outcomes.

Aim : We aimed to evaluate the efficacy of epinephrine-hypertonic saline combination compared to three other nebulized solutions.

Patients and Methods

We performed a randomized, double-blind, placebo-controlled clinical trial in 211 infants hospitalized with acute moderate bronchiolitis. Infants were randomly assigned to receive as nebulization either combined epinephrine-hypertonic saline, 3% hypertonic saline, epinephrine or normal saline administered every four hours. The primary outcome measure were clinical improvement according to modified Wood scoring and the length of hospital stay.

Results

A total of 142 infants were analyzed: 36 in the combination group (A), 35 in the epinephrine group (B), 39 in the hypertonic saline group (C) and 32 in the normal saline group (D). Baseline demographic and clinical characteristics were similar in all groups. There is no difference in length of hospital stay between the four groups (4.56 ±3.2 days, 4.49±3.05 days, 4.4±2.8 vs 4.47±2.38 respectively in A, B, C and D groups ; p = 0.9). There is also no difference in modified Wood score at day 1, day 2 and day 3 of hospitalization between all groups .

Conclusions:

In our study, we did not noticed a superior effect of the nebulized epinephrine-serum 3% hypertonic combination. A large-scale study would be wise to confirm our hypothesis.