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Your Baby

AAP Reissues Warning About Drinking Alcohol During Pregnancy

2:00

The medical community has long stressed the importance of not drinking alcohol while pregnant.  But repeated claims that it is safe for a mother-to-be to drink small amount of alcohol has prompted the American Academy of Pediatrics to publish an updated report in its online journal Pediatrics.

There is no amount of alcohol that is safe to drink during any trimester of pregnancy notes the new report.

Alcohol-related disorders in newborns occur at even greater frequency than previously thought, it found, because such disorders have been “significantly unrecognized.”

Such disorders, in fact, are the most commonly identifiable cause of developmental delays and intellectual disabilities in children, said Janet F. Williams, a University of Texas physician and lead author of the report.

“The research suggests that the smartest choice for women who are pregnant is to just abstain from alcohol completely,” she said. “This message has been out there for a long time, that alcohol use is not healthy, and a lot of people just want that to be wrong.”

The report stated “about half of all childbearing-age women in the United States report consuming alcohol within the past month. In truth, some don’t yet realize they are pregnant. But nearly 8 percent of women said they continued consuming alcohol during pregnancy.

Women that binge-drink when they are not pregnant may be more likely to consume alcohol during pregnancy, researchers said.

Williams noted that there’s more than 30 years of research that clearly connects alcohol use during pregnancy with birth defects.

The academy reports that another study found an increased risk of retardation of growth in infants even when a pregnant woman’s consumption was limited to one alcoholic drink per day — a 1.5-ounce shot of distilled spirits, 5 ounces of wine or 12 ounces of beer.

Drinking in the first trimester of pregnancy compared with no drinking resulted in 12 times the odds of giving birth to a child with fetal alcohol spectrum.

First- and second-trimester drinking increased those odds by 61 times, with those drinking throughout the duration of pregnancy increasing the odds by a factor of 65.

Children affected by fetal alcohol spectrum, Dr. Williams said, are notably smaller with smaller or less apparent facial features and flatness in the middle region of the face. Attention deficit hyperactivity disorder also is strongly associated with alcohol, while neurological and cognitive problems can include the inability to form concepts, make plans and speak fluently. Additional problems can occur with social interaction and relationships.

“No alcohol is the safe choice,” Dr. Williams said. “No alcohol means no [fetal alcohol spectrum disorders]. I don’t want people to feel badly if they were using alcohol and found out they were pregnant. That happens. But they must know at that moment, if they stop, they have a definitely lower risk of their child having problems than they would if they continue drinking.”

Sources: David Templeton, http://www.post-gazette.com/news/health/2015/10/19/Study-reinforces-avoiding-alcohol-while-pregnant/stories/201510190008

Carl Nierenberg, http://www.livescience.com/52515-pregnant-women-no-drinking-alcohol.html

 

 

 

Your Teen

AAP: Raise the Smoking Age to 21 for Tobacco, e-Cigarettes

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The American Academy of Pediatrics (AAP) wants the minimum age to purchase tobacco products and e-cigarettes raised to 21 across the United States. In new policy recommendations, the AAP released a statement urging more than two- dozen tough regulations to help reduce youth smoking and addiction to nicotine.

Nicotine is considered physically and psychologically addictive, with some experts claiming that it is as additive and hard to kick as heroin and other hard narcotics.

The AAP also calls for the U.S. Food and Drug Administration (FDA) to finally regulate e-cigarettes the same way it regulates other tobacco products. The FDA has issued a proposed rule that would extend the agency’s tobacco authority to cover additional products that meet the legal definition of a tobacco product, such as e-cigarettes.

"Most adolescents don't use just one nicotine product but will commonly use or experiment with several," said Dr. Harold Farber, lead author of two of the statements and a pediatric pulmonologist at Texas Children's Hospital. "Research to date shows that adolescents who experiment with e-cigarettes and conventional cigarettes are much more likely to go on to become regular cigarette smokers and less likely to stop cigarette smoking."

Currently, only Hawaii and about 90 cities and communities in several other states have a law requiring a minimum age of 21 to purchase tobacco products, according to the Campaign for Tobacco-Free Kids.

"As the brain matures, the ability to make decisions with important health consequences should likewise improve," said Dr. Danelle Fisher, vice chair of pediatrics at Providence Saint John's Health Center in Santa Monica, Calif. "Thus, slightly older young adults may choose to forgo tobacco products," suggested Fisher, who was not involved with the new policy recommendations.

Not only would the AAP like to see e-cigarettes regulated, but also their candy-like flavors and menthol eliminated.

According to the U.S. Centers for Disease Control and Prevention,  more adolescents used e-cigarettes than any other tobacco product in 2014.

In addition to calling for FDA control of e-cigarettes, the AAP recommended that smoke-free laws expand to include e-cigarettes. The group recommends that use of any tobacco or nicotine products, including e-cigarettes, be banned in all workplaces, schools, dormitories, bars, restaurants, health care facilities, sidewalks, parks, recreational and sports facilities, entertainment venues and multi-unit housing.

"The jury on e-cigarettes remains out, but it is clear that carcinogens and potentially harmful substances are nonetheless present in this alternate nicotine delivery system," said Dr. Jack Jacoub, director of thoracic oncology at Orange Coast Memorial Medical Center's MemorialCare Cancer Institute in Fountain Valley, Calif.

Other policy recommendations include a ban on Internet sales of e-cigarettes, a tax on e-cigarettes at the same rate as traditional cigarettes and a requirement for adult ratings on any entertainment depicting e-cigarette use.

The AAP also recommended banning advertising of tobacco products and e-cigarettes in all media, including television, radio, print, billboards, signs and online, and in stores where children and teens might see them..

Another concern is the number of young children who have suffered nicotine poisoning from accidently ingesting liquid nicotine. Poison control centers receive more than 200 calls per month for accidental ingestion of nicotine for e-cigarettes, the AAP noted, and one toddler died last year from swallowing some. The APP recommends child-resistant packaging for these products.

"Toddlers and young children love to explore new things and to put things in their mouths, so it is imperative that packaging and childproofing be done to enhance the safety of their environments," Fisher said. "This is analogous to having childproof caps on pill bottles."

The new policies were presented Monday at the group's national conference and published online simultaneously in the journal Pediatrics.

Source: Tara Haelle, http://consumer.healthday.com/cancer-information-5/misc-tobacco-health-news-666/raise-smoking-age-to-21-u-s-pediatricians-group-urges-704535.html

Parenting

AAP: Poverty Threatens Children’s Health

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The American Academy of Pediatrics (AAP) is recommending that pediatricians include a question about poverty to their wellness exams.  Many experts agree, and studies support, that poverty can have a major impact on a child’s heath.

The AAP’s new recommendation states that pediatricians should start assessing children for their poverty status. The screening begins with a single question — asking parents whether they have difficulty in making ends meet at the end of the month.

According to the National Center for Children in Poverty (NCCP), there are more than 16 million U.S. children (22% of all children) living below the federal poverty level of $23,550 a year for a family of four.

Growing evidence suggests that the stress of not having safe and secure housing, regular meals and a stable home environment can lead to significant health problems in children.

“We know children living in poverty have more chronic disease, more severe chronic disease, and have poor early brain development which can impact them when they get to school, and lead to poor academic performance,” says Dr. Benard Dreyer, president of the AAP. “Pediatricians deal on a daily basis with the intersection between poverty and health and the well being of children. They understand that they actually aren’t separate.”

The recommendation offers a process to make it easier for doctors who aren’t sure about how to address the issue. The screening doesn’t have to be performed by the doctor, but can be part of a checklist that parents fill out while waiting for their well child visit, or, in larger practices, could be conducted by a quick interview with office staff or social workers.

Pediatricians are also given guidelines to help connect financially struggling families with the proper resources to help them find local housing bureaus, food pantries and even job listings. The hope, says Dreyer, is to help the 50% of families who currently qualify for additional support but aren’t getting it to access the resources they need.  “Many pediatricians are already doing this, and helping families who have been evicted or connecting them to local food pantries. What we want to do is to give them more resources,” says Dreyer.

Children in deep poverty, whose family income is below 50 percent of the federal poverty line, do even worse on health and development indicators than children in poverty according to a study released by the National Center for Children in Poverty (NCCP) at Columbia University's Mailman School of Public Health. The study compared the wellbeing of children in deep poverty to children that are poor, but not in deep poverty, and to non-poor children.

The worse off the family’s financial situation is, the more likely a child will suffer from health and developmental problems such as stress, anxiety, obesity and elevated lead levels.

With the recommendation, the academy is also urging state and federal lawmakers to expand existing housing, food and health programs. “In order for kids to thrive, we recognize that the community, family and social aspects of their existence may be even more important than many of the medical things they may be dealing with,” says Dreyer. “Poverty is the most serious non communicable disease that children have — and it’s the most common.”

The new recommendations were published in the journal Pediatrics.

Story Source: Alice Park, http://time.com/4251653/pediatricians-should-screen-all-children-for-poverty/

http://www.nccp.org/topics/childpoverty.html

 

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