Procalcitonin (PCT) has been reported as a sensitive marker for neonatal bacterial infections. Recently, small numbers of studies reported usefulness of PCT/C-reactive protein (CRP) ratio in detection of infectious conditions in adults. Thus, we conducted this study to evaluate PCT/CRP ratio in late onset neonatal sepsis. Serum PCT and CRP was measured in blood samples from 7 to 60 days after birth in 106 of neonates with late onset sepsis and 212 of controls who were matched with gestational age, postnatal age, birth weight, and gender. Areas under ROC curve (AUC) were calculated, and pairwise comparisons between ROC curves were performed. As a result, CRP (AUC 0.96) showed best performance in detection of sepsis from healthy controls compared with PCT (AUC 0.87) and PCT/CRP ratio (AUC 0.62); CRP > PCT > PCT/CRP ratio in pairwise comparison (p < .001). Both of CRP (AUC 0.94) and PCT (AUC 0.96) were found to discriminate proven sepsis from healthy controls compared with PCT/CRP ratio (AUC 0.54); CRP = PCT > PCT/CRP ratio in pairwise comparison (p < .001). However, in the detection of blood culture proven sepsis from suspected sepsis, PCT (AUC 0.70), and PCT/CRP ratio (AUC 0.73) showed better performance compared with CRP (AUC 0.51); PCT = PCT/CRP ratio > CRP in pairwise comparison (p < .001 and p = .006, respectively). In conclusion, CRP and PCT showed good performance in discrimination between sepsis and healthy controls. However, PCT/CRP ratio seems to be helpful in distinguishing proven sepsis from suspected sepsis together with PCT. Further studies are warranted to elucidate the efficacy of PCT/CRP ratio with enrollment of enough numbers of infants.

Purpose: We evaluated the association between macronutrients of human milk (HM), and interactions between maternal age and body mass index(BMI) in matched conditions. Material and methods: Totally, 80 HM samples were collected from healthy breast-feeding mothers at fourth week of lactation. HM macronutrients and maternal data were analyzed. Mothers were subgrouped into four groups by maternal age (20 s/30 s) and BMI (overweight/normal). Results: Two-way ANOVA revealed significant interactions between age and BMI to affect macronutrients; fat, carbohydrate, and calories. Moreover, different responses of fat and calorie to BMI were found in different age groups. Conclusions: The evaluation of over- or under-weighted infants warrants considering both of maternal age and BMI.

Background: Procalcitonin (PCT) may be a more sensitive marker for neonatal bacterial infections than C-reactive protein (CRP). However, the reference intervals of serum PCT were not sufficiently studied in neonates older than 1 week of age, especially for very low birth weight infants. Objectives: This study investigated the reference level of serum PCT for neonates according to gestational age (GA) and postnatal age (PNA). Methods: Serum PCT was measured in 914 blood samples from 7-60 days after birth in 415 neonates including 184 premature infants. Infants with sepsis, congenital anomaly, or clinically evident intra-amniotic infections were excluded. Multivariate analysis of covariance was used to detect the interaction between GA and PNA. To compare subgroups dichotomized by GA and PNA, analysis of covariance was performed with clinical parameters as covariates to obtain an adjusted p value. Results: Serum PCT levels were negatively correlated with GA, PNA, birth weight, birth height, and platelet count, and positively correlated with white blood cell count, absolute neutrophil count, hematocrit, and serum CRP after logarithmic transformation. Reference intervals of serum PCT were established according to GA and PNA. High PCT levels were found in infants with GA ≤32 weeks and PNA 7-30 days. Conclusion: The reference levels of serum PCT were determined according to GA and PNA. As the reference PCT levels of infants with GA ≤32 weeks were affected by PNA, cautious interpretation of PCT levels in these infants is warranted.

Background: Although the benefits of breastfeeding are broadly acknowledged with the efforts of the government and several medical societies, the rate of exclusive breastfeeding through 6 months is lower in Korea than in developed countries.Purpose: This study aimed to investigate pediatricians’ perceptions of breastfeeding barriers and the current breastfeeding counseling environment and propose government policies to encourage breastfeeding in Korea.Methods: Fourteen survey questions were developed during meetings of Korean Society of Breastfeeding Medicine experts. The Korean Pediatric Society emailed a structured questionnaire to domestic pediatricians registered as official members of the Korean Pediatric Society on May 4, 2021, and June 3, 2021. This study examined the survey responses received from 168 pediatricians.Results: The 168 respondents included 62 professors, 53 paid doctors, and 53 private physicians. Breastfeeding was recommended by 146 Korean pediatricians (86.9%). However, only 99 responders (59%) currently provide breastfeeding counseling in hospitals. Most respondents stated providing less than 15 minutes of breastfeeding counseling time in the clinic. Moreover, 89.88% of the respondents responded that they would participate in breastfeeding counseling education if an appropriate breastfeeding counseling program was newly established.Conclusion: This study showed that, although Korean pediatricians had a positive attitude toward breastfeeding, limited counseling was provided for parents. Along with policy support to improve the medical environment through the establishment of an appropriate breastfeeding counseling program, high-quality counseling and an increased breastfeeding rate are expected.