Your Baby

Acetaminophen Ranks Highest in Infants’ Accidental Poisonings

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Infants are just as susceptible to accidental poisonings as toddlers and older children, according to a new study. Acetaminophen (such as Tylenol) was the most common medication error for infants. Some of the other products associated with accidental poisonings may surprise you.

The researchers look at data from all poison control center calls in a national database from 2004 to 2013 that related to babies younger than 6 months old.

Acetaminophen was the most reported medication mistake followed by H2-blockers (for acid reflux), gastrointestinal medications, combination cough / cold products, antibiotics and ibuprofen (such as Motrin or Advil).

The most common non-medication exposures were diaper care and rash products, plants and creams, lotions and make-up, the investigators found.

"I was surprised with the large number of exposures even in this young age group," said lead author Dr. A. Min Kang, a medical toxicology fellow at Banner-University Medical Center Phoenix in Arizona.

"Pediatricians typically do not begin poison prevention education until about 6 months of age, since the traditional hazard we think about is the exploratory ingestion -- that is when kids begin to explore their environment and get into things they are not supposed to," Kang added.

The research team found that there were more than 270,000 exposures reported during the decade of data, 97 percent of which were unintentional. However, over 37 percent were related to medication mistakes.

Acetaminophen was involved in more than 22,000 medication exposures and nearly 5,000 general exposures. This high rate reflects its frequent use because it's recommended instead of ibuprofen for infants, Kang pointed out.

"The concern with too much acetaminophen is liver failure although, luckily, young children are considered to be somewhat less likely to experience this than an adult because the metabolism is a little different," Kang said.

The current rate of acetaminophen mistakes may actually be lower notes Dr. Michael Cater, a pediatrician with St. Joseph Hospital in Orange, California, because infant drops are now standardized across manufacturers.

The number of ibuprofen exposures, however, surprised Cater since ibuprofen isn't recommended for those under 6 months old.

"Also surprising was the number of ethanol poisonings," likely from parents leaving empty glasses or bottles of alcohol around, he said. "Low-lying plants, some of which are toxic, are a source of concern, and this was a bit of a surprise to me."

Diaper creams and lotions likely top the list because they're easily reachable by infants when left on the diaper-changing areas, Cater added.

The AAP has a policy statement recommending that all liquid medications use metric units for dosing and that they include administration devices, such as syringes, to reduce the chance of an overdose.

Perhaps doctors should offer poison prevention education to caregivers earlier, even starting when a baby leaves the hospital, Kang suggested.

The poison control hotline phone number- 1-800-222-1222 – should also be posted in the home and programmed into parents and caregiver’s cell phones Kang said.

The findings were published online in the January edition of the journal Pediatrics, and in the February print edition.

Source: Tara Haelle, http://www.webmd.com/children/news/20160113/acetaminophen-tops-list-of-accidental-infant-poisonings

Your Baby

Eating Fish During Pregnancy Benefits Baby’s Brain Development

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Can eating more fish during pregnancy help babies’ brains function better as they grow older? Yes, according to a new study from Spain. The researchers say that mothers who eat three substantial servings of fish – each week- during pregnancy may be giving their children an advantage as they mature.

Researchers followed nearly 2,000 mother-child pairs from the first trimester of pregnancy through the child’s fifth birthday and found improved brain function in the kids whose mothers ate the most fish while pregnant, compared to children of mothers who ate the least.

Even when women averaged 600 grams, or 21 ounces, of fish weekly during pregnancy, there was no sign that mercury or other pollutants associated with fish were having a negative effect that offset the apparent benefits.

“Seafood is known to be an important source of essential nutrients for brain development, but at the same time accumulates mercury from the environment, which is known to be neurotoxic,” lead author Jordi Julvez, of the Center for Research in Environmental Epidemiology in Barcelona, said in an email to Reuters Health.

This important health concern prompted the U.S. Food and Drug Administration (FDA) to come up with a guideline for pregnant women in 2014. It encourages women to eat more fish during pregnancy, but limit the intake to no more than 12 ounces per week.

For this study, researchers analyzed data from the Spanish Childhood and Environment Project, a large population study that recruited women in their first trimester of pregnancy, in four provinces of Spain, between 2004 and 2008.

Julvez and colleagues focused on records of the women’s consumption of large fatty fish such as swordfish and albacore tuna, smaller fatty fish such as mackerel, sardines, anchovies or salmon, and lean fish such as hake or sole, as well as shellfish and other seafood.

Women were tested for blood levels of vitamin D and iodine, and cord blood was tested after delivery to measure fetal exposure to mercury and PCB pollutants. At ages 14 months and five years, the children underwent tests of their cognitive abilities and Asperger Syndrome traits to assess their neuropsychological development.

On average, the women had consumed about 500 g, or three servings, of seafood per week while pregnant. But with every additional 10 g per week above that amount, children’s test scores improved, up to about 600 g. The link between higher maternal consumption and better brain development in children was especially apparent when kids were five.

The researchers also saw a consistent reduction in autism-spectrum traits with increased maternal fish consumption.

Mothers’ consumption of lean fish and large fatty fish appeared most strongly tied to children’s scores, and fish intake during the first trimester, compared to later in pregnancy, also had the strongest associations.

“I think that in general people should follow the current recommendations,” Julvez said. “Nevertheless this study pointed out that maybe some of them, particularly the American ones, should be less stringent.”

Julvez noted that there didn’t appear to be any additional benefit when women ate more than 21 ounces (about 595 g) of fish per week.

“I think it's really interesting, and it shed a lot more light on the benefits of eating fish during pregnancy,” said Dr. Ashley Roman, director of Maternal Fetal Medicine at NYU Langone Medical Center in New York.

“I think what's interesting about this study compared to some data previously is that they better quantify the relationship between how much fish is consumed in a diet and then the benefits for the fetus and ultimately the child,” said Roman, who was not involved in the study.

Roman also noted that pregnant women should avoid certain fish such as tilefish, shark, swordfish and giant mackerel. These are larger fish with longer life spans that may accumulate more mercury in their tissue.

While fish may be a great source of protein and benefit brain development in utero, most experts agree that women should consult their obstetrician about what fish are safer to eat and how much they should eat during pregnancy.

The study was published online in the January edition of the American Journal of Epidemiology

Source: Shereen Lehman, http://www.reuters.com/article/us-health-pregnancy-fish-idUSKCN0UW1S4

 

 

 

Your Baby

Preventing Peanut Allergies with Peanuts

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As the number of U.S. children with peanut allergies continues to grow, researchers are looking for ways to help these youngsters overcome or manage their allergy better.

The American Academy of Pediatrics (AAP) is now endorsing a recommendation that infants at high risk of peanut allergies be given foods containing peanuts before their first birthday.

How can you tell if your infant might be at risk for developing a peanut allergy?  Children are considered at high risk if they've had a previous allergic reaction to eggs or experienced a severe eczema skin rash. Allergy tests are recommended before exposing at-risk infants to peanut-containing foods.

An earlier published allergy study found that exposure to peanuts in infancy seemed to help build tolerance -- contrary to conventional thinking that peanuts should be avoided until children are older.

Here’s how the study was conducted.  Researchers in Britain followed 640 babies, 4 months to 11 months old, who were considered at high risk of developing peanut allergies. One group avoided peanuts; the others ate a small amount of peanut protein or peanut butter every week. After five years, the group that ate peanut products had 81 percent fewer peanut allergies than the group that didn't.

"There is now scientific evidence," the AAP says, "that health care providers should recommend introducing peanut-containing products into the diets of 'high-risk' infants early on in life (between 4 and 11 months of age) in countries where peanut allergy is prevalent because delaying the introduction of peanut can be associated with an increased risk of peanut allergy."

The advice comes in a consensus statement that the American Academy of Pediatrics helped prepare and endorsed in June along with the American Academy of Allergy, Asthma & Immunology and major allergy groups from Canada, Europe, Japan and elsewhere. The recommendations are meant to serve as interim guidance until more extensive guidelines can be prepared for release next year, the consensus statement said.

While getting the exact percentage of children with peanut allergies is difficult, peanut allergy is one of the most common food allergies. The Centers for Disease Control and Prevention states that four out of ten children suffer from a food allergy. It also notes that hospitalizations resulting from severe attacks have been increasing.

Severe cases can cause an allergic child to experience anaphylactic shock, a potentially life-threatening reaction that disrupts breathing and causes a precipitous drop in blood pressure.

Parents who are interested in the idea of treating peanut allergies with peanuts should not attempt to do this themselves. Children, particularly infants, should only be treated under the care of their pediatrician or pediatric allergist.

The AAP’s recommendation on treating peanut allergies with small doses of peanut protein will be published in the August 31 edition of the journal Pediatrics.

Source: http://www.cbsnews.com/news/new-advice-for-parents-on-peanut-allergies/

http://www.cdc.gov/nchs/data/databriefs/db10.htm

Your Baby

Never Leave a Child Unattended in a Car Seat, Swing or Bouncer

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Placing an infant in a car seat, swing or bouncer as a substitute for a crib can be a fatal decision. These objects work fine when used properly for their intended purpose, but when a child is left unattended – they can quickly turn deadly according to a new study.

Using these devices as directed and not as substitutes for a crib would reduce the risk of death, according to lead author Dr. Erich K. Batra of Penn State College of Medicine in Hershey, Pennsylvania.

“The overarching advice goes back to a more basic message of safe sleep,” Batra told Reuters Health. “In an infant, a safe sleep environment includes the ABCs: they sleep alone, not in bed between parents, on their backs, and in a crib or bassinet without any loose bedding.”

The study reviewed young children’s death in devices like car seats, swings and bouncers and found that most were due to suffocation by improper positioning or strangulation in straps.

The researchers reviewed the reports of 47 deaths of children under two years old that happened in car seats, bouncers, swings, strollers or slings and were recorded by the U.S. Consumer Product Safety Commission between 2004 and 2008.

The study used only reports submitted by consumers or manufacturers, so the number of deaths may actually be higher.

Most of the deaths occurred in car seats (31 of 47). Five happened in slings, four each in swings and bouncers and three in strollers.

About half of deaths in car seats were due to strangulation by the straps, while the other half were caused by suffocation due to positioning, the authors reported in The Journal of Pediatrics.

Strap strangulation usually happens when the restraints are not fastened as directed, Batra said. Whenever a child is in a car seat, the harness should be secured.

“If people leave an older infant or young toddler in a car seat and undo the straps thinking that it makes them more comfortable, that’s a significant hazard,” he said.

“A child properly secured in a car seat is in very little risk of danger,” he said.

However, many times the child falls asleep in the car seat and a parent or caregiver decides to bring the car seat, with baby still attached, into the home.

Dr. Shital N. Parikh, an orthopedic surgeon at Cincinnati Children’s Hospital Medical Center in Ohio, has studied the risk factors for injury in these devices in infants up to age one. He also found car seats to be the most common setting.

“The commonest mechanism of injury was infants falling from car seats when not used in the car, used in the home,” Parikh told Reuters Health. Often parents would bring the car seat in the house while the infant still slept, undo the straps and place it on an elevated surface, he said.

Even four-month-old babies are mobile enough to wiggle out of the top straps and fall, or topple the whole seat from an elevated surface, he said.

“These are very simple things, very basic things,” Parikh said. “The basic idea is that you use (the devices) for their intended purpose only. For infants, you should not use it to make them sleep or carry them around if it’s not intended for that.”

Batra notes that baby in slings need to be “visible and kissable,” as a sling may put baby’s head in a hazardous position.

It only takes four to five minutes for an unattended baby to suffocate in one of these devices.

“That is one of the things we need to draw attention to,” Batra said. Sometimes a few minutes unattended is all it takes.

“If your infant is sleeping and you’re not observing them, then they need to be in a safe sleeping environment,” adhering to the ABCs, he said.

While it may seem safe to leave a baby in a car seat, swing, sling or bouncer for a few minutes unattended, go ahead and place the child in his or her crib. It may wake them up if they are sleeping, but it’s much safer than allowing them to continue to sleep in a device that was never intended for that purpose.

Source: Kathryn Doyle, http://www.reuters.com/article/2015/04/29/us-car-seat-infant-safety-idUSKBN0NK21E20150429

Your Baby

Protect Your Child Against Whooping Cough

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Pertussis, often called whooping cough, is a common disease that peaks every 3 to 5 years. Because the disease is highly infectious, once an outbreak starts it can spread rapidly.  Before a vaccine was available, pertussis killed 5,000 to 10,000 people in the U.S. every year. Currently, documented cases are on the increase and Texas could see the highest number of recorded cases in 50 years.

The Texas Department of State Health Services has issued a health alert. Officials are urging people to make sure that their vaccinations and their children’s vaccination are up-to-date.

Whooping cough mainly affects infants younger than 6 months and kids 11-18 whose immunity has started to fade from earlier vaccinations.

The first symptoms are similar to those of the common cold. Children may experience a runny nose, sneezing, a mild cough and a low- grade fever. After about 1 to 2 weeks the dry cough evolves into a much harsher coughing spell that can last more than a minute. A child can turn red or purple from coughing so hard and may make the characteristic whooping sound when breathing in. Some children may actually vomit. Between coughing spells the child may look and feel okay.

Sometimes infants don’t cough or whoop like older kids do, but look as if they are gasping for air. Their face can turn red and they may actually stop breathing for a few seconds during a bad session.

The bacteria that causes pertussis is spread from person to person through tiny drops of fluid from an infected person's nose or mouth. These may become airborne when the person sneezes, coughs, or laughs. Adults and children become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses. The time that someone is most contagious is during the earliest stages after the cough begins and continues for up to about 2 weeks.

Prevention begins with the pertussis vaccine. It’s part of the DTaP immunization that includes diphtheria, tetanus and acellular pertussis. The immunizations are routinely given in 5 doses before the child’s sixth birthday. The AAP recommends that kids ages 11 to 12 get a booster shot of the new combination vaccine, Tdap, to boost their immunity. Young adults entering college should also make sure that they are up-to-date on their pertussis vaccination. Crowded classrooms and dorms are the perfect breeding ground for contagious diseases. 

Infants younger than 2 months cannot be vaccinated. To help protect those babies the Centers for Disease Control and Prevention (CDC) recommends that pregnant women receive the pertussis vaccine between 27 and 36 weeks of gestation.

The name “whooping cough” sounds a little comical, but if you’ve ever witnessed a child in the throws of a pertussis coughing attack, it’s anything but funny. This disease can be fatal for little ones, so make sure you’re child is current on all of his or her DTap vaccinations and Tdap booster shots. If you are pregnant you can help protect your infant by getting the pertussis vaccination while you are carrying.

Research shows that adults and children who are not vaccinated are 8 times more likely to get whooping cough. Those that have received the vaccine may still get the disease but it tends to be less severe and doesn’t last quite as long.

Many of the cases in Texas are concentrated in the Fort Worth and Arlington area.  Statewide there have been 2 deaths, both were infants that were too young to recieve the vaccine. 

If your child has been diagnosed with whooping cough and is being treated at home, seek immediate medical care if he or she has difficulty breathing or shows signs of dehydration.

Sources: Gordon Dickson, http://www.star-telegram.com/2013/09/03/5130886/whooping-cough-outbreak-could.html

http://kidshealth.org/parent/infections/bacterial_viral/whooping_cough.html#

Your Baby

Danger! Lidocaine and Teething Babies

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If you’ve ever received a prescription for lidocaine, you might be tempted to try it on your teething baby to ease the pain. Lidocaine solution is sometimes used to reduce a child’s gag reflex during dental procedures and to treat mouth and throat ulcers.

The U.S. Food and Drug Administration (FDA) has issued a warning to parents about using a lidocaine solution as a pain reliever on babies’ gums, saying it can lead to death and serious injuries in infants and toddlers.

"When too much viscous lidocaine is given to infants and young children or they accidentally swallow too much, it can result in seizures, severe brain injury, and problems with the heart," the statement said.

Overdoses or accidental swallowing have led to infants and children being hospitalized or dying, the FDA said.

While the number is not high, some parents or caregivers have tried it as a gum pain reliever during teething. There have been 22 reports this year of serious complications, including deaths, in children ages 5 months to 3 to 5 years who were given lidocaine or accidently swallowed it.

The agency will require a boxed warning on the label for prescription oral viscous lidocaine 2 percent solution to highlight that it should not be used for teething pain, the FDA said in a statement.

Instead of lidocaine, the FDA urges parents to follow the American Academy of Pediatricians' (AAP) recommendations for treating teething pain. They call for using a teething ring, or gently massaging the child's gums with your finger.

Other products containing benzocaine are sometimes used for oral pain relief. The FDA recommends against using these products for children under 2 years of age except under a physician’s supervision. Like viscous lidocaine, benzocaine is a local anesthetic.

The AAP offers these tips for helping your child through the discomfort of teething.

  • Give her firm objects to chew on—teething rings or hard, unsweetened teething crackers. Frozen teething toys should not be used; extreme cold can injure your baby’s mouth and cause more discomfort.
  • If your baby is clearly uncomfortable, talk to your pediatrician about a possible course of action. Your pediatrician may suggest that you give a small dose of acetaminophen (Tylenol) or ibuprofen (Advil, Motrin).

The first thing a parent wants to do when they see their baby in pain is to find a way to relieve the discomfort. Teething is one of those times that can be trying for everyone involved. Babies can start teething as early as 3 months.

Pain relievers that are used on a baby’s gums aren’t typically very helpful; a teething baby drools so much that the medication is quickly washed away. In addition, pediatricians warn that such medications can numb the back of the throat and interfere with your baby’s ability to swallow.

Rubbing your baby’s gums or providing a safe teething ring can help ease your infant’s pain until those pesky teeth break through and the gums heal.

Sources: Ian Simpson, http://www.reuters.com/article/2014/06/26/us-usa-fda-teething-idUSKBN0F129120140626

http://www.healthychildren.org/English/ages-stages/baby/teething-tooth-care/Pages/Teething-Pain.aspx

Your Baby

No Recall For Enfamil Infant Formula

1.45 to read

U.S. health officials said they found no trace of Cronobacter, the bacteria that killed two infants in recent weeks, in sealed cans of Enfamil baby formula and that there was no need to recall the Mead Johnson Nutrition product.

Several department store chains, including Walmart, pulled the infant formula from their shelves after a 10 day-old baby, in Missouri, died from suspected Cronobacter bacteria, sometimes found in powdered milk-based formula.

A second baby has also died in Florida. That information was not available until last Friday when the U.S. Food and Drug Administration (FDA)  and the Centers for Disease Control and Prevention (CDC) released an update. The report was released after samples, from the babies’ home and company facilities were taken for testing.

"Parents may continue to use powdered infant formula, following the manufacturer's directions on the printed label," the agencies said in a joint statement.

"We're pleased with the FDA and CDC testing, which should reassure consumers, health care professionals and retailers everywhere about the safety and quality of our products," Tim Brown, Mead Johnson's general manager for North America, said in a statement.

The Glenview, Illinois-based company added it undertook the highly unusual retesting due to continuing misinformation and confusion in the marketplace. Mead Johnson said it conducted a new round of rigorous testing on samples of a batch of Enfamil Premium Newborn powdered formula related to a U.S. Food & Drug Administration (FDA) investigation.

Two more babies, one in Illinois and one in Oklahoma, also were reported with infections in recent weeks, but both have recovered.

The U.S. health agencies, which tested samples taken from several of the families' homes, said they found Cronobacter in an open container of infant formula, an open bottle of nursery water and prepared infant formula.

They said it was unclear how the contamination occurred, which suggests that it could have happened after the packages were opened. The agencies also said there was no evidence indicating that the infections were related.

The U.S. FDA and the U.S. CDC are seeking to determine the origin of the Cronobacter involved in the Missouri case and are expected to be testing a variety of possible environmental sources.

Mead Johnson has not had a recall, but has gone through many of the same steps, he said, such as working with the government, being transparent and communicating with retailers and the press.

Sources: http://articles.chicagotribune.com/2011-12-31/business/ct-biz-1231-mead-...

http://www.ibtimes.com/articles/272551/20111225/enfamil-recall-mead-john...

Your Baby

Baby's First Tooth!

Many dentists like to see a child by age one, not because there are a lot of problems to detect, but because it’s a good time to help parents learn more about dental health care and to establish a good relationship with the child.After all the crying, and teething fits, midnight trips to the crib, and endless time soothing and rubbing gums.... it’s finally here. Baby’s first tooth!  It’s also time to start thinking about your child’s dental health, and baby’s first visit to the Dentist.

It is generally recommended that an infant sees a dentist by the age of 1 or within 6 months after his or her first tooth comes in.

Many dentists like to see a child by age one, not because there are a lot of problems to detect, but because it’s a good time to help parents learn more about dental health care and to establish a good relationship with the child. The average age for continuing visits is about 2 to 2.5 years old depending on your child’s dental heredity and overall health. Many dentists like to see children every 6 months to build up the child's comfort and confidence level in visiting the dentist, to monitor the development of the teeth, and promptly treat any developing problems. What Happens at the First Dental Visit? The first dental visit is usually short and involves very little treatment. This visit gives your child an opportunity to meet the dentist in a non-threatening and friendly way. Some dentists may ask the parent to sit in the dental chair and hold their child during the examination. The parent may also be asked to wait in the reception area during part of the visit so that a relationship can be built between your child and your dentist. During the exam, your dentist should check all of your child's existing teeth for decay, examine your child's bite, and look for any potential problems with the gums, jaw, and oral tissues. If indicated, the dentist or hygienist will clean any teeth and assess the need for fluoride. He or she will also educate parents about oral health basics for children and discuss dental developmental issues and answer any questions. Topics your dentist may discuss with you might include: 1. Good oral hygiene practices for your child's teeth and gums and cavity prevention 2. Fluoride needs 3. Oral habits such as thumb sucking, tongue thrusting, lip sucking. 4.  Developmental milestones 5. Teething 6. Proper nutrition You will be asked to complete medical and health information forms concerning the child during the first visit. Come prepared with the necessary information. What's the Difference Between a Pediatric Dentist and a Regular Dentist? A pediatric dentist has at least two additional years of training beyond dental school. The additional training focuses on management and treatment of a child's developing teeth, child behavior, physical growth and development, and the special needs of children's dentistry. Although either type of dentist is capable of addressing your child's oral health care needs, a pediatric dentist, his or her staff, and even the office décor are all geared to care for children and to put them at ease. If your child has special needs, care from a pediatric dentist should be considered. Ask your dentist or your child's doctor what he or she recommends for your child. When Should Children Get Their First Dental X-Ray? There are no hard-and-fast rules for when to start dental X-rays. Some children who may be at higher risk for dental problems. Children prone to baby bottle tooth decay or those with cleft lip or palate should have X-rays taken earlier than others. Usually, most children will have had X-rays taken by the age of 5 or 6. As children begin to get their adult teeth around the age of 6, X-rays play an important role in helping your dentist. X-rays allow your dentist to see if all of the adult teeth are growing in the jaw, to look for bite problems and to determine if teeth are clean and healthy. Once a child’s diet includes anything besides breast-milk or baby formula, erupted teeth are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

Your Baby

Breastfeeding Helps Moms Lose Weight

Breastfeeding is good for your-baby and great for mom!The pediatrician always says breast is best for your your-baby. Now, moms have more reason to give breastfeeding a try...it can help you lose weight. A new studypublishedin the American Journal of ClinicalNutritionreveals women who breastfeed are more likely to lose their pregnancy weight six months after giving birth. 25,000 mothers participated in the Danish National Birth Cohort.

Researchers concluded that women who gain a reasonable amount of weight during pregnancy and breastfeed exclusively are likely to lose all their pregnancy weight six months after giving birth. The study also found that women who breastfeed weighed 4.4 pounds less than women who did not breastfeed six months after giving birth.

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