Pediatric Medicine Research Update

Research news articles are produced in order to keep practitioners up to date on impactful research that is relevant to the field of integrative medicine. 

This issue includes studies involving infants, children, and adolescents. The following four article summaries look at whether or not:

• Lavender aromatherapy reduces pain in newborns undergoing tongue-tie surgery
• Lacticaseibacillus rhamnosus GG improves atopic dermatitis in infants
• A multispecies synbiotic, in addition to dietary and physical activity interventions, induces greater weight loss than diet and activity alone in adolescents
• Omega-3 fatty acid status is associated with attention and impulsivity in healthy adolescents

Can lavender aromatherapy reduce pain associated with frenotomy in healthy newborns? (April 2022)

Background

Approximately 4 to 10% of infants are diagnosed with ankyloglossia (tongue-tie). Frenotomies are a common treatment among infants with tongue-tie, especially if they are struggling to breastfeed. (1)

Unfortunately, pain management for newborns is limited, and studies have shown that repeated, unrelieved pain in newborns can adversely impact various aspects of their well-being and long-term development. 

The authors of this study wished to determine the effectiveness of lavender aromatherapy as an analgesic for newborns undergoing a frenotomy. 

Methods

142 healthy full-term newborns diagnosed with type 3 tongue-tie were included in this single-blinded randomized clinical trial. Newborns in the experimental group had a gauze pad with one drop of pure lavender essential oil held 2 cm under their noses for two minutes before and during the surgery. A dry gauze was used for the control group. 

Pain intensity was assessed using the Neonatal Infant Pain Scale (NIPS) and by measuring crying time, heart rate, and oxygen saturation. 

Takeaways 

The newborns from the experimental group had significantly shorter crying times (14.8 vs. 25.6 seconds) and lower NIPS scores (1.88 vs. 2.92) than the control group. No adverse effects were observed within the experimental group. The authors concluded that lavender aromatherapy is a safe and cost-effective way to reduce pain in newborns following a frenotomy.

Although lavender aromatherapy was used specifically within the specific context of a frenotomy, it could potentially help decrease pain associated with other common procedures conducted in infants and children, such as blood draws and vaccinations. (3) 

Can supplementation with Lacticaseibacillus rhamnosus GG improve atopic dermatitis in children? (August 2022)

Background

Globally, approximately 20% of children are affected by atopic dermatitis (AD). Emerging evidence suggests that the health of the gut microbiome may play a role in the pathophysiology of AD.

The ProPAD trial investigated the therapeutic effects of the probiotic Lacticaseibacillus rhamnosus GG (LGG) in children with AD.

Methodology

In this randomized, double-blind, placebo-controlled trial, 100 children with AD between the ages of six to 36 months were assigned to either receive one placebo capsule or one capsule containing 1 x 10¹⁰ CFU of LGG once per day for 12 weeks.

AD severity was determined using the Scoring Atopic Dermatitis (SCORAD) index. Parents were instructed to complete the Infant Dermatitis Quality of Life questionnaire (IDQOL) and were given a diary with instructions to record treatment adherence, the use of emollients and topical steroids, and any adverse events. 

Takeaways

At 12 weeks, approximately 60% of the experimental group and 20% of the placebo group achieved the minimum clinically important difference on the SCORAD index. 

There were no differences in emollient use between the groups. However, there was reduced use of topical steroids and improved quality of life in the experimental group. 

Reduced AD severity and topical steroid use were maintained for four weeks post-trial. (2)

Can multispecies synbiotics induce weight loss in children with obesity? (July 2022)

Background

Globally, approximately 340 million children between the ages of five and 19 years of age are overweight or obese. Unfortunately, children often remain obese throughout their life which negatively impacts their quality of life and mortality.

The researchers of this study aimed to determine whether a multispecies synbiotic could induce weight loss and alter glucose and lipid metabolism in obese children.

Methodology

61 children between the ages of eight and 17 diagnosed with exogenous obesity were included in this randomized, double-blind, placebo-controlled clinical study.

A nutritional history and full physical exam were conducted. The following blood tests were done at baseline and again at 12 weeks: fasting glucose, fasting insulin, liver markers (AST and ALT), and lipid parameters (TC, HDL-C, LDL-C, and TG). 

All participants were instructed to reduce their caloric intake by 10% and engage in moderate-to-vigorous physical activity for 30 minutes per day. Participants were then randomly assigned to either the placebo or the experimental group. The experimental group received daily sachets containing the following nutrients:

• Lactobacillus acidophilus (4.3×10⁸ CFU/sachet)
• Lacticaseibacillus rhamnosus (4.3×10⁸ CFU/sachet)
• Bifidobacterium bifidum (4.3×10⁸ CFU/sachet)
• Bifidobacterium longum (4.3×10⁸ CFU/sachet)
• Enterococcus faecium (8.2 x 10⁸ CFU/sachet)
• Fructooligosaccharide (625 mg/sachet) 
• Lactulose (400 mg/sachet) 
• Vitamins: A (6 mg/sachet), B1 (1.8 mg/sachet), B2 (1.6 mg/sachet), B6 (2.4 mg/sachet), E (30 mg/sachet), C (75 mg/sachet) 

The placebo group received a sachet of similar shape, taste, and smell.

Takeaways

At the end of 12 weeks, body weight (4.0 ± 3.1 vs. 1.2 ± 4.19), body mass index (BMI) (5.1 ± 3.1 vs. 1.1 ± 3.4), waist circumference (6.0 ± 4.8 vs. 3.7 ± 3.4), and waist circumference-height ratio (4.43 ± 3.25 vs. 6.58 ± 4.77) were all significantly lower in the experimental group compared to the placebo group. 

There were no significant differences between the groups when comparing blood test results at 12 weeks.  

Adding a multispecies synbiotic to your treatment plan along with dietary and physical activity could help children and adolescents with obesity attain better body composition sooner than diet and activity alone. (5)

Are red blood cell omega-3 fatty acid levels associated with attention in healthy adolescents? (August 2022)

Background

Omega-3 fatty acids are vital for brain function and development. Deficiencies in docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA) during adolescence may have long-term negative effects such as memory issues, attention-deficit hyperactivity disorder (ADHD), depression, and anxiety.

This study examined the association between DHA and ALA and attention function among healthy adolescents between the ages of 11 and 16.

Methodology

This cross-sectional study uses data from a randomized controlled trial: Walnuts Smart Snack Dietary Intervention Trial. Participants in the current study were those with fully available data on red blood cell (RBC) omega-3 status (DHA and ALA) and neuropsychological tests (n= 332).

Omega-3 status was established using gas chromatography, and attention function performance was assessed using the Attention Network Test (ANT). 

Takeaways 

Participants at the highest DHA tertile had shorter Attention Network Test Hit Reaction Times (ANT HRT) (-28.13 ms vs. -20.90 ms) and Attention Network Test Hit Reaction Times Standard Error (ANT HRT-SE) (-38.30 ms vs. -13.84 ms) than participants at the lowest DHA tertile. Low ANT HRT and ANT HRT-SE indicate better attention.

In contrast, participants at the highest ALA tertile had longer ANT HRT (46.14 ms vs. 27.30 ms) and ANT HRT-SE (20.84 ms vs. 20.68 ms) than participants at the lowest ALA tertile. However, participants at the highest ALA tertile had lower impulsivity responses which may explain the longer hit reaction times (-66.22 ms vs. 14.12 ms). 

The authors concluded that RBC DHA is associated with attention performance in healthy adolescents, whereas RBC ALA is associated with impulsivity. 

Although this study does not establish causation, it is possible that consuming DHA-rich foods and/or supplementing with DHA could improve attention in adolescents, whereas ALA supplementation could help reduce impulsivity. (4)