Aim:  We examined whether previous experience of repeated skin punctures altered the correlation between prefrontal cortical pain responses and Premature Infant Pain Profile (PIPP) scores, compared with infants who had no experience of skin puncture. Methods:  Eighty infants at 37–42 weeks of gestational age were observed during clinically required blood sampling: full‐term infants with no experience of painful skin‐breaking procedures before data collection (controls; n = 30), full‐term infants with the experience of painful skin‐breaking procedures (n = 20) and preterm infants with the experience of painful skin‐breaking procedures (n = 30). Results:  We found no significant differences in PIPP scores among groups. In controls, prefrontal activation in both hemispheres correlated with facial expression score of the PIPP (r = 0.53 for right prefrontal area; r = 0.37 for left prefrontal area) and the total score. In full‐term infants with the experience of pain, there was no correlation between cortical activation and clinical pain scores. In preterm infants, prefrontal activation in both hemispheres correlated with the physiological component of the PIPP score (r = 0.36 for right prefrontal area; r = 0.41 for left prefrontal area). Conclusion:  Our findings may be useful in considering the effects of cumulative painfulexperience on emotion and stress in neonates.

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Previous studies have demonstrated that afternoon naps can have a negative effect on subsequent nighttime sleep in children. These studies have mainly been based on sleep questionnaires completed by parents. To investigate the effect of napping on such aspects of sleep quality, we performed a study in which child activity and sleep levels were recorded using actigraphy. The parents were asked to attach actigraphy units to their child’s waist by an adjustable elastic belt and complete a sleep diary for 7 consecutive days. 50 healthy young toddlers of approximately 1.5 years of age were recruited. There was a significant negative correlation between nap duration and both nighttime sleep duration and sleep onset time, suggesting that long nap sleep induces short nighttime sleep duration and late sleep onset time. We also found a significant negative correlation between nap timing and nighttime sleep duration and also a significant positive correlation between nap timing and sleep onset time, suggesting that naps in the late afternoon also lead to short nighttime sleep duration and late sleep onset. Our findings suggest that duration-controlled naps starting early in the afternoon can induce a longer nighttime sleep in full-term infants of approximately 1.5 years of age.

Higher cord hemoglobin may increase neonatal jaundice in newborns in Japan, therefore the present results support the Japan Resuscitation Council guideline 2010, which does not recommend delay of umbilical cord clamping by at least 1 min, in contrast to the ILCOR guidelines.

N atale et al 1 recently reported that race/ethnicity is independently associated with head computed tomography (CT) use among children with minor blunt head trauma. They showed parental anxiety as an important factor influencing head CT orders in non-Hispanic white children regardless of brain injury risk. 1 In a Japanese pediatric cohort of patients with minor blunt head trauma, we conducted a study with similar objectives attempting to identify factors that influence a physician's decision to order a head CT in children.