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Your Child

Is MiraLAX Safe for Young Children?

2:30

Constipation is a common problem in kids. It can become a painful elimination process if not treated quickly. Children will sometimes “hold” their poop to avoid the experience, making the situation worse.

Pediatricians often prescribe MiraLax for treatment. MiraLax contains PEG 3350, which is not habit-forming and is easy to give to kids because it has no taste or odor. You can mix it in their beverages, and they typically won't complain.

MiraLax is not a natural product. It does not completely clean a colon out, like an enema does, but it works well enough to unclog a child. Over time, constipation can cause other serious health consequences, so the condition needs to be treated promptly.

While the majority of children do fine when given MiraLax, a group of parents have reported dramatic changes in their child’s personality after being given the laxative.

For the past few years, the Children's Hospital of Philadelphia (CHOP) has quietly been conducting an FDA-grant funded study into parents' reports of devastating side effects from their kids' use of the over-the-counter constipation relief drug.  

But until that study is completed, the hospital won't comment on the experiences of individual families.

A FaceBook page called, Parents Against MiraLax (PEG 3350) has been created, and more than 3,500 people have joined to organize and voice concerns about PEG 3350.

When the FDA grant was awarded to CHOP in early 2014, the federal agency disclosed that MiraLAX powder contains small amounts of Polyethylene glycol 3350 (PEG 3350), which may under certain conditions degrade into ethylene glycol or diethylene glycol — toxic ingredients found in antifreeze.

"The Food and Drug Administration has received a number of reports of adverse events in children taking PEG products," the FDA said in its grant description. "The Agency has conducted a review that documented a number of reports of neurological and psychiatric events associated with chronic PEG use in children. A number of these pediatric patients received an adult dose of PEG (17 grams) for a duration ranging from a few days to a couple of years."

MiraLAX, manufactured by Bayer, is not recommended for patients under the age of 17, but the FDA concluded that it is often suggested to parents in clinical practice.

Bayer has responded in a statement, referencing existing clinical studies confirming the long and short-term safety of PEG 3350 in pediatric patients, though the company acknowledged the product is not labeled for use in the pediatric population.

An article in the New York Times, published in 2015, reported that the FDA had raised questions about the safety of an “an adult laxative routinely given to constipated children, “ sometimes for years.

The article also mentioned that buried in the FDA’s brief to researchers, it had tested eight batches of MiraLax and found tiny amounts of ethylene glycol (EG) and diethylene glycol (DEG), ingredients in antifreeze, in all of them. The agency said the toxins were impurities resulting from the manufacturing process.

Those tests were conducted in 2008, but the results were not disclosed. Jeff Ventura, an F.D.A. spokesman, said batches were tested because “many of the reported adverse events were classic symptoms of ethylene glycol ingestion.”

Psychiatric illnesses like those reported in children taking the laxatives have also been observed in cases in which a child took substantial amounts of ethylene glycol. Some children taking MiraLax chronically (over long periods of time) also have developed acidic blood, according to F.D.A. records, which can be a consequence of ingesting EG.

MiraLAX primarily is recommended for short-term use up to seven days to relieve constipation. The FDA does not approve chronic use, although many use it regularly or even daily to treat severe issues with digestion.

The North American Society of Pediatric Gastroenterology, Hepatology and Nutrition and the American Academy of Pediatrics said in statement after the study began, that they welcome “an investigation into the safety of treatment through data and research in the prolonged use of PEG 3350.”

A timeline for the CHOP study results is not immediately known.

For many children, MiraLax works well as a short-term laxative. However, parents should discuss the dosage and the pros and cons of giving it to the their child with their pediatrician.

Story sources: Michael Tanenbaum, http://www.phillyvoice.com/chop-leading-fda-study-parents-alarming-claims-about-over-counter-drug-miralax/

Catherine Saint Louis, https://www.nytimes.com/2015/01/06/science/scrutiny-for-a-childhood-remedy.html?_r=1

Steve Hodges, MD, http://www.parents.com/blogs/parents-perspective/2015/01/07/health/is-miralax-safe-for-kids-an-expert-weighs-in/

Your Child

Harsh Parenting May Hurt a Child’s Physical Health

2:00

While it is generally known that harsh parenting often leaves psychological scars on children, a new study suggests it may also impact their physical health with problems like obesity.

Researchers also note that having at least one kind and caring parent doesn’t necessarily counteract the effects of the harsh parent.

"Harshness, as we measured it, is always bad for kids. But it is particularly bad if the adolescent perceives high levels of warmth and support from the other parent," said study lead author Thomas Schofield.

The researchers defined "harsh" parenting as angry, hostile and antisocial.

Schofield and his colleagues assessed the results of a study of 451 children.

All were seventh-grade students in eight Iowa counties in 1989.

The researchers studied their families, even videotaping how they interacted in their homes. Then, the investigators followed the children's health through age 20. All of the families lived in small towns or on farms. All were white and spoke English.

The study authors also asked kids questions about their health and whether their parents showed warmth to them by expressing caring or appreciation.

The findings showed evidence that harsh parenting appears to have a measurable impact on the health of kids. When parents were "hostile, angry, and antisocial towards their adolescent," Schofield said, the kids were more likely to report declines in their physical health and to gain extra weight.

Meanwhile, "warmth from the second parent did not consistently buffer or protect the adolescent from the harshness from the first parent," he said.

When the researchers looked at body mass index (BMI) -- a ratio of weight to height -- they found that the harmful effects of the harsh parent on BMI increased even as the warmth of the other parent went up.

The study showed an association between the harsh parenting and childhood health problems, but did not prove cause and effect.

The study didn't reveal possible reasons why a harsh parent might cause lasting physical harm. But, Schofield said, stress in childhood does hurt people's health over their lives.

Michael MacKenzie is an associate professor of social work and pediatrics at Rutgers University in New Jersey. He said stress may indeed be the cause of health issues in kids with harsh parents. The reason: there's evidence that stress disrupts the functioning of the immune system and growth hormones, he said.

Schofield said the new study findings should help show parents that their behavior matters. "Parents reacting emotionally to life stress or parenting stress is natural, and can require concerted effort to master," he added.

Schofield said parents should consider their actions with their kids and think about whether they'd act differently in public when people are watching.

"If we're behaving one way at home and another way in public, some part of us knows we're doing something we feel the need to hide," he said. "And if a child ever begins to behave as though they're on edge, afraid, or timid around the parent, that's a sign that something needs to shift."

Schofield says that there are ways parents can change their own behaviors and self-help books as well as therapy may offer new options for them.

"All of these options require parents to admit 'We may have in the past done things that hurt our children,' and 'We can improve [our] parenting behaviors,' " he said. "Acknowledging those two truths is very hard, but it is probably the first step, and it is universally true because none of us are perfect parents."

The study was published recently in the journal Social Science & Medicine.

Story source: Randy Dotinga, http://www.webmd.com/parenting/news/20160506/harsh-parenting-may-harm-a-childs-physical-health

Your Child

Gluten-Free Diet Not Recommended for Healthy Children

2:00

A “gluten-free “ label on a food product is one sure way to increase sales as the popularity of such items continues to rise.

For people with Celiac disease or gluten sensitivity, eating gluten can cause diarrhea, abdominal pain, upset stomach and bloating. However, for healthy adults and particularly children, there are many reasons to avoid going gluten-free according to a commentary recently published in the Journal of Pediatrics, by Norelle Reilly.

Dr. Norelle Reilly is Assistant Professor of Pediatrics at Columbia University Medical Center and the director of pediatric celiac disease in the Division of Pediatric Gastroenterology and the Celiac Disease Center at Columbia University.

In a recent Time Magazine article, Reilly lays out four reasons why healthy children should not be on a gluten-free diet.

1. Gluten is not naturally toxic except for people with celiac disease, however, in almost all children, gluten travels through the intestine without causing disease and will never lead to problems. To date, science has not shown that there is a toxin in gluten that makes it bad for our bodies. A balanced diet containing fresh fruits and vegetables, lean proteins, and a variety of carbohydrate sources is the best way for healthy children to stay healthy, Reilly notes.

2. A gluten-free diet may not provide balanced nutrition for children. Some people assume that gluten-free food and healthy food as the same thing. Not necessarily so, says Reilly.

Many gluten-free substitutes for items such as breads and cookies are actually higher in fat and calories than gluten-containing varieties. Gluten-free items such as some cereals and breads may also not be nutrient fortified to the same degree as those with gluten. Folate and B-vitamins are often added to our usual starch staples, silently protecting people whose diets may not be very balanced from deficiency. Without these quiet sources of nutrition, vitamin deficiencies could develop, she writes.

Gluten-free foods are often fiber deficient, which is important for gastrointestinal health, including maintaining regular bowel movements. Quite commonly, children who initiate a gluten-free diet become constipated. Increased consumption of rice, a common gluten substitute, may also expose children to more arsenic in their diets, as arsenic is frequently present in the earth where rice is grown.

Reilly says that growing bodies and brains require balanced nutrition. For those children who need a gluten-free diet, balance can be implemented safely and healthfully with the guidance of an experienced registered dietitian to help avoid all of these and other nutritional pitfalls.

3. Have your child tested for celiac disease before putting them on a gluten-free diet. You can’t know for sure whether your child is gluten sensitive or has celiac disease until a physician has tested them. Symptoms alone are not enough to determine whether your child has celiac disease. Being on a gluten-free diet before having your child tested can make it more difficult to determine whether he or she actually does or does not have the disease.

Reilly suggests that if you are concerned that your child may have a problem with gluten, speak to your child’s doctor before banning it from your child’s diet. A child with celiac disease needs special monitoring over time and their family members may need to be tested. Even if you plan to give the diet a try regardless of the test result, it is extremely important for your child and family’s health to know why the diet is necessary.

4. A gluten-free diet is hard to maintain and expensive. For children who require this limited diet for long-term health, parents, schools, and the medical teamwork to make the child’s experience in school and at home as easy as possible.

Reilly notes that the children she has treated for celiac disease would trade in their gluten-free diet in an instant if they knew gluten would not make them sick.

In addition she adds, gluten-free foods are incredibly expensive and for many families the diet can be challenging to financially sustain in the long run.

Many adults prefer a gluten-free diet, but Reilly cautions that parents should check with their pediatrician or family doctor before putting their healthy children on the same eating plan.

Story source: Norelle Reilly, http://time.com/4329517/4-reasons-why-your-kids-should-not-be-gluten-free/

Your Child

Making Sure Public Pools Are Safe

1:30

With temperatures on the rise, it wont be long before families start heading to the nearest public pool to cool down; however, some public pools may pose a serious health hazard.

Each year, thousands of public pools, hot tubs, and water playgrounds are forced to close due to serious health and safety violations, including contamination problems that could make people sick, according to a recently released report from the Centers for Disease Control and Prevention (CDC).

Swimming is one of the best exercises you can participate in and it’s a lot of fun. Health officials say they don’t want to discourage people from swimming, but that individuals should be aware of certain issues with public pools and know what steps they can take to make sure their families are safe.

"No one should get sick or hurt when visiting a public pool, hot tub, or water playground," Dr. Beth Bell, director of CDC's National Center for Emerging and Zoonotic Infectious Diseases, said in a statement. "That's why public health and aquatics professionals work together to improve the operation and maintenance of these public places so people will be healthy and safe when they swim."

For the report, the CDC collected data in the five states with the most public pools and hot tubs -- Arizona, California, Florida, New York, and Texas in 2013. They reviewed over 84,000 routine inspections of nearly 50,000 public pools, hot tubs, and water playgrounds.

The results showed that almost 80 percent of all inspections identified at least one violation, with 1 in 8 inspections resulting in immediate closure because of serious health and safety problems.

The highest proportion of closures were in "kiddie" or wading pools, with 1 in 5 needing to be closed down.

The most common violations were improper pH levels, lack of safety equipment and inadequate disinfectant concentration. The correct pH level is critical for killing germs.

Pools contaminated with fecal matter pose a direct threat to health. This usually occurs when people suffering from diarrhea go in to a pool or when fecal matter washes off of children or leaks from dirty diapers.

Officials suggest that parents check their children’s diapers and take them for regular bathroom breaks. Swim diapers do not prevent feces, urine, or infectious pathogens from contaminating the water, the authors note.

To check the pH level of any pool you enter, you can use a pool water test strip.

The CDC recommends the following levels:

·      Free chlorine concentration of at least 1 ppm in pools and at least 3 ppm in hot tubs/spas.

·      Free bromine concentration of at least 3 ppm in pools and at least 4 ppm in hot tubs/spas.

·      pH of 7.2-7.8.

Another safety hazard is improper drain covers. Make sure that the drain cover appears secure and is not in need of repair.

While some public pools provide lifeguards, not all do. Check to see if your neighborhood pool has a lifeguard trained in CPR. Even if your pool does provide a lifeguard, keep your eyes on your children at all times. The more people watching out for your child, the better.

If you find any problems, avoid getting into the water and tell someone in charge so the problems can be fixed.

"Environmental health practitioners, or public health inspectors, play a very important role in protecting public health. However, almost one third of local health departments do not regulate, inspect, or license public pools, hot tubs, and water playgrounds," said Dr. Michele Hlavsa, chief of CDC's Healthy Swimming Program. "We should all check for inspection results online or on site before using public pools, hot tubs, or water playgrounds and do our own inspection before getting into the water"

Checking the pool you swim in for contamination and other safety issues is good advice for anyone using a pool, whether it’s public or private. Pool test strips are available online or at superstores, such as Walmart, Lowes and Home Depot.

Story source: Ashley Welch, http://www.cbsnews.com/news/alarming-number-of-public-pools-cited-for-health-violations-cdc/

Your Child

Is Childhood Obesity Linked to Late Dinners?

1:30

For years, health experts have suggested that eating dinner later at night may contribute to weight gain. With so many families struggling with varied work schedules and after-school activities, researchers in London wanted to know if late dinners might be a contributing factor in childhood obesity.

Much to their surprise, they discovered no link between later supper times and children’s weight gain.

British researchers looked at data from more than 1,600 children, aged 4 to 18. They found that the risk of overweight or obesity was no higher among those who had meals between 8 p.m. and 10 p.m. than among those who ate between 2 p.m. and 8 p.m.

"The findings of our study are surprising. We expected to find an association between eating later and being more likely to be overweight, but actually found that this was not the case. This may be due to the limited number of children consuming their evening meal after 8 p.m.," said study author Gerda Pot, visiting lecturer in the diabetes and nutritional sciences division at King's College London.

"'Alongside changes in dietary quality and levels of physical activity, meal timing is one of many possible factors that has been suggested as influencing the trends in weight gain seen in children in the U.K.," Pot said in a school news release.

"However, the significance of its role is under-researched. As this is one of the first studies investigating this link, it would be useful to repeat the analysis in other studies," she added.

Pol said that she and her team would continue researching other factors that may contribute to childhood obesity such as eating breakfast and different sleep habits.

Others have suggested that the most important factor in childhood obesity is not when a child eats, but what they eat and if they have gotten a sufficient amount of exercise during the day.

This study was recently published in the British Journal of Nutrition.

Story source: Robert Preidt, https://consumer.healthday.com/vitamins-and-nutrition-information-27/obe...

Your Child

Study: More and Younger Children Suffering From Concussion

2:00

In order to develop statistics on how many U.S. children and teens are being diagnosed with concussion, the Centers for Disease Control and Prevention (CDC) analyzes emergency room data from around the country.

But, a new study finds that children’s concussions may be vastly underreported because family pediatricians, not ER doctors, are doing the examinations.

In the study, published today in the Journal of the American Medical Association Pediatrics, researchers from Children's Hospital of Philadelphia (CHOP) and the CDC used CHOP's regional pediatric network to figure out when and where children were diagnosed with a concussion.

They found approximately 82 percent had their first concussion visit at a primary care site like a pediatrician's office, 12 percent were diagnosed in an emergency department, 5 percent were diagnosed from a specialist, such as a sports medicine doctor or neurologist, and 1 percent were directly admitted to the hospital.

The authors noted that the findings indicate that many more children have suffered a concussion than recent stats suggest.

In another surprising turn, researchers found that one-third of those injured were under the age of 12.  Many reports have been focused on teen athletes instead of younger children.

"We learned two really important things about pediatric concussion healthcare practices," Kristy Arbogast, lead author and Co-Scientific Director of CHOP's Center for Injury Research and Prevention, said in a statement today. "First, four in five of this diverse group of children were diagnosed at a primary care practice -- not the emergency department. Second, one-third were under age 12, and therefore represent an important part of the concussion population that is missed by existing surveillance systems that focus on high school athletes."

Alex Diamond, a pediatric sports medicine specialist at Vanderbilt University Medical Center and director of the injury prevention program, told ABC News that these findings are important to help health officials understand how prevalent concussions really are. Diamond was not involved in the study.

Pediatricians are a good choice for seeking advice and diagnosis on concussions because they know the history of the child, Diamond said.

"That’s why it’s great for a pediatrician to deal with this," Diamond said. "They know the kid at baseline and they know the family."

The findings may have far-reaching implications for what we know about the number of concussions in the U.S., the authors said, noting that this study suggests that the condition is extremely underreported if the vast majority of concussions are diagnosed outside the emergency department.

"We need surveillance that better captures concussions that occur in children and adolescents," Dr. Debra Houry, director of CDC's National Center for Injury Prevention and Control, said in a statement today. "Better estimates of the number, causes, and outcomes of concussion will allow us to more effectively prevent and treat them, which is a priority area for CDC's Injury Center."

Concussions often happen without a loss of consciousness and can have long-term effects.

In fact, a brief loss of consciousness or "blacking out" doesn't mean a concussion is any more or less serious than one where a child didn't black out.

If your child might have had a concussion, go to the emergency room or see your pediatrician if he or she has any of these symptoms:

•       Loss of consciousness

•       Severe headache, including a headache that gets worse

•       Blurred vision

•       Trouble walking

•       Confusion and saying things that don't make sense

•       Slurred speech

•       Unresponsiveness (you're unable to wake your child)

•       Ringing in the ears

•       Nausea

•       Vomiting

Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury, such as:

•       Concentration and memory complaints

•       Irritability and other personality changes

•       Sensitivity to light and noise

•       Sleep disturbances

•       Psychological adjustment problems and depression

•       Disorders of taste and smell

Symptoms in infants and toddlers may be more difficult to recognize because they cannot express how they feel. Nonverbal clues of a concussion might include:

•       Appearing dazed

•       Listlessness and tiring easily

•       Irritability and crankiness

•       Loss of balance and unsteady walking

•       Crying excessively

•       Change in eating or sleeping patterns

•       Lack of interest in favorite toys

Experts recommend that parents take their child in for an evaluation if their child receives more than a light bump on the head.

Story sources: Gillian Mohney, http://abcnews.go.com/Health/concussions-children-vastly-underreported-study-finds/story?id=39506549

http://www.mayoclinic.org/diseases-conditions/concussion/basics/symptoms/con-20019272

Your Baby

BPA Consumed During Pregnancy Linked to Obesity in Kids

1:45

Bisphenol A (BPA) is a chemical produced in large quantities and used primarily in polycarbonate plastics and epoxy resins.

You’ll find polycarbonate plastics in some plastic water bottles, food storage containers and plastic tableware. Epoxy resins are used in lacquers to coat metal products such as food cans, bottle tops, and water supply pipes.

The primary source of exposure to BPA for many people is through food and beverages.

Why should you be concerned about Bisphenol A?

BPA is thought to act as an endocrine disruptor--a compound that mimics or disrupts hormones produced by the human body. Previous research has linked BPA to asthma, ADHD, depression, anxiety and early puberty in girls. It has also been linked to diabetes, obesity and heart disease in adults.

A new study has also found a possible link between BPA and child obesity.

Researchers at Columbia University found that children of women exposed to BPA during pregnancy were likely to have more body fat by age seven. Increased body fat has been linked to a higher risk of obesity.

"This study provides evidence that prenatal exposure to BPA may contribute to developmental origins of obesity as determined by measures of body fat in children as opposed to the traditional indicator of body mass index, which only considers height and weight,” lead author of the study. Lori Hoepner, DrPH, said in a press release.

Dr. Hoepner and her colleagues studied 369 maternal-child pairs from pregnancy through early childhood.

The researchers collected urine samples during the last three months of pregnancy.

Urine samples were also collected from the children at ages three and five. The children's heights and weights were measured at age five and age seven.

At age seven the researchers also measured waist circumference and fat mass.

The researchers found 94 percent of the women had BPA in their urine--an indication that they had been exposed to the chemical.

Dr. Hoepner and colleagues found that children who had been exposed to BPA in the womb had a higher body fat mass. Even though the children might have been within the normal ranges for height and weight, they had a greater percentage of fat than would be normal at that age.

The researchers found a strong association between BPA, fat mass and waist circumference in girls. They also found that childhood exposure to BPA was not associated with fat mass, indicating that the prenatal exposure was the problem.

Some studies indicate that infants and children may be the most vulnerable to the effects of BPA. This new study also suggests that pregnant women might want to avoid BPA products.

The National Institute of Environmental Health Sciences offers these tips for reducing BPA exposure:

•       Don’t microwave polycarbonate plastic food containers. Polycarbonate is strong and durable, but over time it may break down from over use at high temperatures. Use glass or ceramics for microwaving foods.

•       Plastic containers have recycle codes on the bottom. Some, but not all, plastics that are marked with recycle codes 3 or 7 may be made with BPA.

•       Reduce your use of canned foods. Choose glass or other safe packaging or fresh or frozen foods when possible.

•       Opt for glass, porcelain or stainless steel containers, particularly for hot food or liquids.

•       Use baby bottles that are BPA free. 

The study was published in the May issue of Environmental Health Perspectives.

Story sources: Beth Greenwood, http://www.dailyrxnews.com/prenatal-exposure-bpa-was-associated-increased-fat-mass-children-columbia-university-study-found

http://www.niehs.nih.gov/health/topics/agents/sya-bpa/

 

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