Part-time work and reduced work hours in anticipation of retirement are options that are used and desired by older pediatricians. Results of this study suggest that making provisions for gradual reduction in work hours or other forms of phasing out of the workforce could benefit the practice of pediatrics by extending the career length of the most experienced pediatricians.

No abstract

Two families have been presented. In one, asplenia occurred with and without gastrointestinal malformations. In the other, cardiovascular malformations occurred in one member and Ivemark syndrome in the other. All three children with asplenia died in infancy, two with evidence of sepsis. Sudden death in infancy may be due to sepsis in a child with isolated asplenia syndrome and impaired resistance to infection. Both isolated asplenia and some cases of congenital heart disease without asplenia may be related to Ivemark syndrome. New infants born in families with a history of congenital cardiovascular malformations, visceral heterotaxy, or other malformations associated with Ivemark syndrome should be tested for asplenia, primarily by searching for Howell-Jolly bodies. infants with asplenia should be protected with prophylactic antibiotics. Pneumococcal polysaccharide vaccine is indicated at the age of 2 years. It would appear worthwhile for pediatric surgical or pediatric cardiologic services to perform a screening program for Howell-Jolly bodies.

A nonprofit voluntary community hospital, the Hunterdon Medical Center, has made a commitment to encourage breast-feeding among employees. In support of this commitment, arrangements were made for time off during the work day for nursing mothers to pump their breasts. An electric breast pump in a suitably accessible location and supportive professional advice were offered. Among those who chose to nurse their babies, it was found that mothers nursed for longer times and were more likely to continue nursing after return to employment when this program was available.