RCPCH Annual Conference 22-24 May 2012, Glasgow

Paediatricians from across the country come together to share new research and findings on key areas of child health at this year’s RCPCH Conference in Glasgow.

Abstract highlights

• Child development
• Obesity
• Vitamin D deficiency

Child development

New UK growth charts 2-18 years

Presented by: Professor Charlotte Wright

Overview: New growth charts developed by the Royal College of Paediatrics and Child Health combine data from the ‘UK 1990 growth reference for children at birth’ and from ‘4 -18 years with WHO growth standards’.

Key features:

The new growth charts boast several new features, including:

• A BMI centile lookup and plotting grid
• Scales to estimate adult height and compare with parents’ height
• A simplified way of assessing puberty without the need for intimate examinations

Health of children born to older mothers

Presented by: Dr Alastair Sutcliffe

Overview: Given the strong trend towards women having children later, this study looks at the effect maternal age has on children age nine months to five years.

Key findings:

• Older motherhood was associated with more favourable outcomes for accidents, hospital admissions, and language development
• Immunisation rates were better for babies of older mothers

The effect of smoking on newborn babies

Presented by: Dr Kamal Ali

Overview: Infants born to mothers who smoke during pregnancy have an increased chance of cot death. A possible explanation of this is because these babies have neurodevelopment abnormalities of ventilatory control. The aim of this research was to see if there was a difference of ventilatory control in babies born to mothers who smoked during pregnancy and babies born to non-smoking mothers.

Key findings:

• The median birth weight of the infants of the smoking mothers was lower than that of the infants of the non-smoking mothers
• The two groups had comparable baseline tidal breathing, oxygen saturation, heart rate and ETC02 levels
• Results suggested exposure to tobacco smoking when in the uterus may result in impairment of the infant peripheral chemoreceptor response (i.e. the ability to detect variance in the oxygen content of blood)

Obesity

Knowledge, attitude and skills of health and non health professionals treating paediatric obesity in Scotland

Author: Miss Shaza Aboouf

Overview: Childhood obesity has risen up the political agenda in the UK, nonetheless evidence indicts poor skills and confidence in engaging with obese children and their families amongst professionals. The aim of the study was to assess the Knowledge, Attitudes and Skills (KAS) of health and non-health professionals in two geographic areas in Scotland to evaluate the changes in KSA after one day training in paediatric obesity.

Key findings: This present study highlighted alarming gaps in the KAS of health and non health professional participating in the engagement of obese children and their families. KAS improved after attending a specific tailored training course. This training course could be a step forward to accomplishing a higher standard of health for obese children.

Vitamin D deficiency

Vitamin D deficiency in children with dental caries – a prevalence study

Author: Dr. Tara Brown

Overview: Vitamin D deficiency is a re-emerging public health concern, despite being preventable with supplementation. Dental caries also remain a significant chronic disease of childhood, affecting up to 41% of five year olds in England. There is a known association between dental caries and vitamin D deficiency, but this has not been investigated since the 1940s.

This study aimed to determine the prevalence of vitamin D deficiency in children aged one to five years with dental caries.

Key findings:

•  66% were vitamin D deficient, 27% insufficient, and only 7% of children were replete
• Mean Vitamin D levels were significantly lower in children of Black and mixed race or Asian backgrounds, compared to white children
• Importantly, 50% of white children were also noted to be Vitamin D deficient.
• Compliance with the Department of Health’s Guidelines was poor: only 34% of mothers took vitamins during their pregnancy, and 33% of children were taking vitamin supplements
• An increased awareness of vitamin D deficiency, and its association with dental caries amongst professionals is imperative
• Prevention should remain the primary goal, and existing recommendations regarding vitamin D supplementation require implementing

Vitamin D deficiency presenting to an emergency department of a children’s hospital: a growing concern

Author: Dr. Lisa Kheler

Overview: The last few years have seen a concerning trend with a rise in the numbers of children who are diagnosed with Vitamin D deficiency in the UK. This study aimed to provide further information about this trend by looking at children who were diagnosed with Vitamin D deficiency in the emergency department between March 2009 and March 2010.
 

Key findings:

• The most common presenting complaints were abdominal pain (19%), seizures (17%) and limb pain (15%)
• Many children were picked up due to raised alkaline phosphatise after non specific presentations
• This data adds further evidence to the wide scale problem of undiagnosed Vitamin D deficiency. It should be considered in non caucasian children, not only presenting with hypocalcaemic seizures or bone manifestations, but also in more non specific presentations such as abdominal pain
• It was felt that the numbers detected represent the tip of the iceberg of the true prevalence of Vitamin D Deficiency
• Legislation to fortify foods should be debated further on a national level

A novel pathway to reduce vitamin D deficiency in a high risk population
Author: Dr Lucinda Winckworth

Overview: The aim of this review was to design a screening and treatment pathway for children who are classed as 'high risk' for vitamin D deficiency- and to evaluate the steps and outcome measures resulting in ongoing service improvements.

Key findings:

• After introducing the new pathway, there have been significant improvements in several clinically-relevant areas. A greater proportion of 'high-risk' children are being appropriately screened and started successfully on the correct vitamin D replacement therapy
• After completing one cycle, significantly more had vitamin D levels in the acceptable range and underwent appropriate hip radiology screening

To find out more about RCPCH Annual Conference 2012 visit the College's dedicated web pages.