Case 2: Sisters - A 2-Month-Old With Colic and an 18-Month-Old With Diarrhea

Program Description:

Probiotics can help modulate the microbial content of the infant’s gut. Certain bacteria—particularly Lactobacilli and Bifidobacteria—have antimicrobial effects that influence both local and systemic immunity in the infant gut. In cases of diarrhea or colic, pediatric clinicians need to be aware of the most current therapeutic options as well as strategies for parent education.

INTENDED AUDIENCE:

This activity has been designed to meet the educational needs of pediatricians, nurses, pediatric nurse practitioners, registered dieticians, and other health care professionals involved in the care of children.

MEDIA:

Activity Objectives:

After taking part in this educational activity, participants should be better able to:

• Outline factors that affect bacterial colonization of the intestinal tract


• Describe evidence for the use of probiotics and prebiotics in preventing and/or treating diarrhea and colic


• Implement strategies to improve parent education about infant nutrition choices and their effect on the infant intestinal tract and health


• For Registered Nurses: Provide appropriate care and counsel for patients and their families

Faculty:

Author
Michael D. Cabana, MD, MPH
Professor of Pediatrics, Epidemiology and Biostatistics
University of California, San Francisco
   School of Medicine
San Francisco, California

Reviewer
Michelle M. Pietzak, MD
Head, Division of Pediatric Gastroenterology
LAC & USC Medical Center
Assistant Professor of Clinical Pediatrics
Department of Pediatrics
University of Southern California Keck School of Medicine
Los Angeles, California

Course Directors
Marguerite M. Mayers, MD
Attending Physician, Children’s Hospital at Montefiore
Professor of Clinical Pediatrics
Albert Einstein College of Medicine
Bronx, New York

Kathleen Ronca, MSN, PNP, ANP, APRN-BC, DNPc
Nurse Practitioner
Montefiore Learning Network
Bronx, New York

Disclosures:

Conflicts of Interest Disclosure Statements
The “Conflict of Interest Disclosure Policy” of Albert Einstein College of Medicine of Yeshiva University requires that faculty participating in any CME activity disclose to the audience any relationship(s) with a pharmaceutical or equipment company. Any presenter whose disclosed relationships prove to create a conflict of interest with regard to their contribution to the activity will not be permitted to present.

It is the policy of Montefiore to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty participating in our programs are expected to disclose any relationships they may have with commercial companies whose products or services may be mentioned, so that participants may evaluate the objectivity of the presentations. In addition, any discussion of off-label, experimental, or investigational use of drugs or devices will be disclosed by the faculty.

Michael D. Cabana, MD, MPH, has received grant/research support for Nestlé Nutrition Institute and has served as a consultant for Pfizer.

Reviewer
Michelle M. Pietzak, MD, has received grant/research support for Prometheus Laboratories and has served as a consultant and is on the speakers’ bureaus for Nestlé/Gerber nutrition and Prometheus Laboratories.

Course Directors
Marguerite M. Mayers, MD, has nothing to disclose with regard to commercial support.

Kathleen Ronca, MSN, PNP, ANP, APRN-BC, DNPc, has nothing to disclose with regard to commercial support.

Publishing Staff
Mary Jo Krey, Marian Freedman, Sharon Hill-Ingram, Lynne Callea, and Anne Bardsley, Haymarket Medical Education, have nothing to disclose with regard to commercial support.

Accreditor Staff
The staff of the Center for Continuing Medical Education of Albert Einstein College of Medicine of Yeshiva University and Montefiore Learning Network has nothing to disclose with regard to commercial support.

Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Nestlé Nutrition Institute, Albert Einstein College of Medicine of Yeshiva University, Montefiore Learning Network, and Haymarket Medical Education do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Nestlé Nutrition Institute, Albert Einstein College of Medicine of Yeshiva University, Montefiore Learning Network, and Haymarket Medical Education. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Accredited Provider:

This activity is jointly sponsored by Albert Einstein College of Medicine of Yeshiva University, Montefiore Learning Network, and Haymarket Medical Education.

          

Commercial Supporter:

This activity is supported by an educational grant from Nestlé Nutrition Institute.

Instructions:

To obtain credit, a score of 70% or better is required. This CME is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all post-test questions, completed the post-test survey, and received your digital copy of your credit certificate. Your online certificate will be saved on myCME.com within your Profile/Exam History, which you can then access at any time.

For questions about CME and CPEU, please call Einstein CME at 718-920-6674.

For questions about CE, please call Montefiore Learning Network at 718-920-8580 or e-mail mmclough@montefiore.org.

If you have any other questions relating to your certificate or other issues with this activity, please contact myCME.Support@haymarketmedical.com.

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SYSTEM REQUIREMENTS:

WINDOWS PC SYSTEM REQUIREMENTS:
266-MHz Pentium II; Windows 98 or higher; 64 MB RAM; 800 x 600 screen resolution set for “High Color (16-Bit)”; Macromedia Flash Player 6 or higher.

MACINTOSH^® SYSTEM REQUIREMENTS:
Power Mac g3 at 300 MHz; System 8.5 or higher (excluding Mac OSX); 96 MB RAM; 20 MB minimum hard disk space available; 800 x 600 screen resolution set to “Thousands of Colors”; Macromedia Flash Player 6 or higher.