Background Genetically mediated sensitivity to bitter taste has been associated with food preferences and eating behavior in adults and children. The aim of this study was to assess the association between TAS2R38 bitter taste genotype and the first complementary food acceptance in infants. Parents of healthy, breastfed, term-born infants were instructed, at discharge from the nursery, to feed their baby with a first complementary meal of 150 mL at 4 to 6 months of age. They recorded the day when the child ate the whole meal in a questionnaire. Additional data included food composition, breastfeeding duration, feeding practices, and growth at 6 months. Infants’ TAS2R38 genotypes were determined at birth, and infants were classified as “bitter-insensitive” (genotype AVI/AVI) and “bitter-sensitive” (genotypes AVI/PAV or PAV/PAV). Results One hundred seventy-six infants and their mothers were enrolled; completed data were available for 131/176 (74.4%) infants (gestational age 39.3 ± 1.1 weeks, birth weight 3390 ± 430 g). Bitter-insensitive were 45/131 (34.3%), and bitter-sensitive were 86/131 (65.6%). Thirty-one percent of bitter-insensitive infants consumed the whole complementary meal at first attempt, versus 13% of bitter-sensitive ones ( p = 0.006). This difference was significant independently of confounding variables such as sex, breastfeeding, or foods used in the meal. Growth at 6 months did not differ between the two groups. Conclusions Differences in TAS2R38 bitter taste gene were associated with acceptance of the first complementary food in infants, suggesting a possible involvement in eating behavior at weaning.

Powdered infant formulas (PIF) are usually not sterile and may frequently be contaminated by several bacteria strains. Among them, Cronobacter species, previously known as Enterobacter sakazakii, is one of the most harmful, since it might be the causative agent of sepsis and meningitis in newborns and preterm infants during the first weeks of life. The mortality rate of these infections is up to 80 %. Therefore, some precautions are required in the home handling and dilution of PIF. Whereas there is wide consensus about the need that a PIF should be used immediately after being diluted or, if not, stored at < “5 °C”, still recently the optimal temperature of the water used to dilute PIF is controversial among scientific societies and health agencies. The current knowledge is reviewed in this paper and provides sufficient evidence to cautiously advise the use of hot water at a temperature of “70 °C” in the dilution of PIF in order to prevent the Cronobacter sp. contamination and growth.

The case of a 4-month-year-old infant presenting with blood vomiting eventually diagnosed as food protein-induced enterocolitis syndrome (FPIES) is described. The main clinical and diagnostic aspects of FPIES are also discussed.

Although appreciating the findings of the study regarding the use of cord blood sampling in preventing anemia in extremely preterm infants, the authors omitted to emphasize that routine search for coagulation and polymerase chain reaction test abnormalities during the first hours of life is of limited value, providing unreliable results for patient management and potentially unnecessary blood loss. 1-3 We suggest that a possible bias in the difference in transfusion rate between the 2 studies could be due to the relevant amount of blood sampled from venous access in the control group. Assuming that the blood volume in extremely preterm infants is about 80 mL/kg, drawing about 5 mL from each patient would mean a blood loss of about 8% of the circulating volume that could be critical in this delicate setting. Furthermore, although cord blood sampling could be the right direction for preventing anemia in extremely preterm infants, cord blood it is not always available. We suggest that avoidance of sampling for unreliable tests and widespread implementation of point-of-care analyzer with micro-methods technology for blood count, electrolytes, and blood gas could be an adjunctive and even more efficient approach for limiting blood losses in this specific population.

A 6-year-old boy was evaluated for a 6-week history of low back pain. Initially, the pain was exacerbated by movements, eventually showing a milder and fluctuating trend. History was unremarkable for previous traumatic events, fever or nocturnal pain. Physical examination revealed localised pain at palpation of the spinous processes at the lumbosacral level. Blood tests showed a normal blood count, negative C reactive protein (CRP) and erythrocyte sedimentation rate, normal lactic acid dehydrogenase (LDH) and creatine phosphokinase.A posterior–anterior radiograph of the lumbar spine resulted normal. An MRI scan revealed a lumbosacral transitional vertebra with bone oedema of the posterior arch until the spinous process.For better bone definition, a CT scan was performed (figure 1).Figure 1CT scan of the transitional lumbosacral (L5) vertebra.QuestionsWhich causes of persistent low back pain should be ruled out in children under 10 years of age?OsteochondrosisNeoplasmFunctional painInfectionsWhat is the diagnosis in this patient?How is the diagnosis performed?How is this condition managed?Answers can be found on page 2.