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Parenting

Mumps Reach 10 Year High; Hitting Colleges and Kids Hard

1:45

Mumps are making a comeback, particularly on college campuses and in daycare centers.

A recent U.S. Centers for Disease Control and Prevention report shows that mumps are at a 10-year high. As of November, 45 states and the District of Columbia had reported a total of 2,879 mumps infections — more than double the mumps cases reported in 2015.

Mumps is a contagious disease caused by a virus. Common symptoms can include swollen glands in front of and below the ear or under the jaw, pain with opening and closing the jaw, fever, fatigue and malaise, headache and earache.

Currently, college campuses are taking the brunt of the mumps outbreak.

Dr. Michael Grosso, medical director and CMO of Huntington Hospital/Northwell Health, said close quarters such as dormitory living, can make it easier to pick up the virus.

“It’s spread through respiratory secretions, coughing, sneezing, close contact and sharing the same cups and utensils,” Grosso told CBS News.

Some colleges, such as The University of Missouri’s Columbia, are asking students to restrict their social activities and to make sure they get immunized. Typically, two doses of vaccine are recommended by the American Academy of Pediatrics and the CDC, but the school is asking students to get a third measles-mumps-rubella (MMR) vaccine “based on discussions with public health officials and consistent with guidance from The Centers for Disease Control and Prevention.”

College students aren’t the only ones being hit hard by mumps; younger children are also experiencing a rise in reported cases. More parents have opted-out of getting their children the MMR vaccine - putting non-immunized children at a higher risk.

Daycare centers are similar to college dormitories in that they provide an environment where a virus can be easily spread.

While most mumps cases are mild, albeit, uncomfortable, others can be more serious.

“Most individuals recover uneventfully from mumps, however as many as 10 percent of males who get mumps will get an inflammation of the testes which can lead to permanent sterility,” Grosso said.

The brain can also be affected. About 1 percent of people who come down with the mumps get serious brain infections and can experience meningitis, encephalitis and deafness associated with a brain infection.

“That small risk was behind the original impetus to create a vaccine,” Grosso said.

 Physicians are urging students to get the immunizations and to practice good hygiene. Simple steps such as covering your cough or sneeze, washing your hands with soap and water or using an alcohol-based hand sanitizer, avoiding sharing food, drinks, cups or utensils can help prevent the spread of viruses.

Vaccines are still the most effective way to lower your risk of getting the mumps.  No vaccine is a 100 percent protective, Grosso notes, but it can help you avoid the risk of serious illness and lifelong health issues.

“Receiving two doses of mumps vaccines is said to confer about an 88 percent reduction in risk of getting mumps if you’re exposed,” said Grosso. A third dose may increase those odds.

The American Academy of Pediatrics recommends the first dose of MMR vaccine should be administered between 12 and 15 months of age, and the second dose between 4 to 6 years of age.

Grosso emphasizes that parents need to get their children vaccinated early.

“Being immunized late is better than not being immunized ever. But being immunized late is not nearly as good as being immunized on time,” Grosso said.

Story sources: Mary Brophy Marcus, http://www.cbsnews.com/news/mumps-cases-10-year-high-college-outbreaks-vaccination/

https://www.cdc.gov/mumps/

Parenting

Pregnancy May Actually Modify a Mom’s Brain

Baby, motherhood, health

Moms often feel like they have a “sixth sense” when it comes to their newborn’s needs and survival. What they may really be experiencing are the physical changes that pregnancy can have on the brain.

Researchers in Spain wanted to know if pregnancy could actually change the structure of a woman’s brain, impacting how she reacts to her newborn. What they found was that long-term changes to the brain do occur and that they may have evolved over time to improve a mother’s ability to protect and nurture her child.

The researchers used information gathered from MRI scans that compared the brain structures of 25 women before and after their first pregnancies.

After giving birth, the women had significant reductions of gray matter in areas of the brain associated with social interactions, the findings showed. Those brain regions overlapped with ones that activated when mothers watched images of their own babies.

“The changes concern brain areas associated with functions necessary to manage the challenges of motherhood," study co-lead author Erika Barba said in a news release from the Autonomous University of Barcelona.

Some women feel like they have trouble remembering things during and after their pregnancy, sometimes referred to as having “baby brain.” The good news is that researchers reported the participants had no changes in memory or other thinking functions during pregnancy. That means the loss of gray matter does not lead to problems in those areas. The brain changes, which lasted for at least two years after the women gave birth, probably help them adapt to motherhood, the study authors suggested.

According to study co-director Oscar Vilarroya: "The findings point to an adaptive process related to the benefits of better detecting the needs of the child, such as identifying the newborn's emotional state. Moreover, they provide primary clues regarding the neural basis of motherhood, perinatal mental health and brain plasticity in general."

Researchers also found that they were able to use the brain changes to predict a mother’s attachment to her baby. The changes were similar whether women got pregnant naturally or through fertility treatments.

This is the first research to show that pregnancy involves long-lasting changes -- at least for two years postpartum.

The term “mama bear” has often been used to describe the fierceness that some mothers’ exhibit when they feel their child is in danger or has been wronged. Now science may have found out why that is.

The study was published in the journal Nature Neuroscience.

Story source: Robert Preidt, http://www.webmd.com/baby/news/20161219/pregnancy-may-spur-mothering-changes-in-a-womans-brain

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Your Child

Kids: Mouthguards For All Contact Sports

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Youth sports participation has grown steadily over the years and so have injuries. The National Youth Sports Foundation for Safety reports dental injuries as the most common type of face and mouth injury kids experience in sports related accidents.

A new report issued by dental experts at the University of Alabama at Birmingham, says that mouthguards should be included in safety gear for all contact sports.  

Sports-related dental injuries send more than 600,000 people to the emergency room every year, the U.S. Centers for Disease Control and Prevention reports.

Most of these injuries involve the front teeth, but the tongue and cheeks can also be hurt while playing sports, the UAB team said.

The best way to protect the mouth and teeth during sports is to wear a mouthguard, says Dr. Ken Tilashalski, associate dean for academic affairs at the UAB School of Dentistry. Mouthguards have been shown to reduce the risk of sports-related dental injury by 60 times, he said.

"Wearing a mouthguard reduces the chances of tooth fractures, tooth dislocations and soft tissue cuts," Tilashalski said in a university news release. "The guards also protect against jaw fractures and concussions by absorbing the energy of a traumatic blow to the chin."

The American Dental Association (ADA) recommends wearing custom mouthguards for the following sports: acrobats, basketball, boxing, field hockey, football, gymnastics, handball, ice hockey, lacrosse, martial arts, racquetball, roller hockey, rugby, shot putting, skateboarding, skiing, skydiving, soccer, squash, surfing, volleyball, water polo, weightlifting, and wrestling. Other experts include baseball and softball infielders on that list. They further recommend the mouthguard to be worn during all practices and competition.

There are basically three types of mouthguards to choose from:

·      Stock: These are preformed and ready to wear, but they may not fit well inside the mouth.

·      Boil and bite: These may be customized and molded to the mouth by softening in boiling water before biting down.

·      Custom-made: A dentist tailor-makes these mouthguards to fit an individual's mouth. These mouthguards provide the best fit and the highest level of protection.

"For my kids, I have chosen to use custom mouthguards as they fit and feel better, do not interfere with speech, and are essentially invisible," Tilashalski said. "Mouthguards need to be replaced as they wear down, and athletes in the tooth-forming years will have to have these replaced more often as the mouth grows and the teeth change."

These mouthguards vary in price and comfort, yet all provide some protection. According to the ADA, the most effective mouthguard should be comfortable, resistant to tearing, and resilient. A mouthguard should fit properly, be durable, easily cleaned, and not restrict speech or breathing.

After each use, rinse your mouthguard and store it in a hard container to prevent the buildup of germs, Tilashalski said. Players should also avoid chewing on their mouthguard to extend its life.

It is important to remember damaged teeth do not grow back. Protect your child’s teeth by making sure he or she wears a mouthguard during practice, competition or just out having fun in a sport where falls are common such as biking, skating and skateboarding.

Story sources: Mary Elizabeth Dallas, https://consumer.healthday.com/dental-and-oral-information-9/misc-dental-problem-news-174/mouthguards-key-defense-against-sports-related-injuries-716284.html

http://www.nationwidechildrens.org

Daily Dose

Penicillin Allergy

1:30 to read

Has your child ever been labelled “penicillin allergic”?  Interestingly, up to 10% of people (of all ages) report having a penicillin allergy, but only about 1% are truly allergic. I see this often in my own practice, especially when seeing a new patient and inquiring about drug allergies, and the parent replies, “ she is penicillin allergic, and developed a rash when she was younger”.  In many if not most of those cases the child is not allergic to penicillin.

 

Penicillins are a class of antibiotics known as beta-lactams and include not only penicillin but  amoxicillin, augmentin, oxacillin and nafcillin, just to name a few.  If you are incorrectly identified as penicillin allergic, when your doctor needs to prescribe an antibiotic they may resort to another class of antibiotic, which are not only more expensive but often may cause more side effects.  

 

Penicillins are the antibiotic of choice and the first line treatment for many pediatric bacterial illnesses including otitis ( ear infections ), strep throat, and sinus infections. They are not only effective, but they are typically inexpensive and have few side effects….which includes allergic reactions.

 

Penicillin allergy is an immune - mediated reaction which usually causes hives ( raised rash ), face or throat swelling, difficulty breathing and in some cases life threatening anaphylaxis.  Intolerance to penicillin is different than being allergic, and in this case symptoms are more likely nausea, diarrhea, headache or dizziness, which may make you uncomfortable but are not immune mediated. 

 

In pediatrics, many children present with a viral illness that includes several days of fever and upper respiratory symptoms, and are then also found to have an ear infection. They are given a prescription for amoxicillin and several days later develop a rash. Many viral infections in children also cause a rash, which is typically red, flat and covers the trunk, face and extremities and does not cause any other symptoms which are seen with a true penicillin allergy.  This rash is benign, but unfortunately many young children will be seen at an urgent care or even an ER due to the rash. The parents are told that their child is penicillin allergic and the antibiotic is changed…and the label “pen allergic” sticks….for many years or even life.  I even saw this rash occur in one of my own sons while on an antibiotic. He is NOT allergic!

 

The good news is that most children are truly not penicillin allergic, and if possible I try to see all of my patients who report a rash while they are on an antibiotic. At times this is not possible, and now with the advent of “smart phones” I have parents send me a picture of the child and the rash. This often helps in determining if the rash truly appears allergic and to identify if there are other symptoms.  Back to the “get a good history”. 

 

If I see an older patient who has had a rash on amoxil when they were little and had no other adverse effects (get a good history), I will sometimes try using a penicillin again, as most people also “outrgrow” their sensitivity after about 10 years. If it is my patient and I have seen the rash I tell the parents that this is not a “pen allergy” and I will use penicillins again.  Some  patients will report a “pen-allergy” but say I can take “augmentin” which is penicillin derivative, so that makes it easy to know they are not allergic.  If I am unsure if a child has had a true penicillin allergy I will refer them to a pediatric allergist for skin testing.  Skin testing is not painful and is an important method for documenting a true allergy. 

 

 

   

Daily Dose

Homeopathic Medicine

1:30 to read

I am sitting here writing this while “sucking” on a honey-lemon throat lozenge and drinking hot tea…as it is certainly cough and cold season and unfortunately I woke up with a scratchy throat. I am trying to “pray” it away and drink enough tea to drown it out. While I am not sure it will work, drinking hot tea all day will not hurt you!

 

At the same time (multi-tasking) I am also reading an email from a mother with a 4 month old baby, and they are out of town. Her baby now has a fever and runny nose and she sent me a picture of a homeopathic product for “mucus and cold relief” and wonders if it is safe to give to her infant.  The short answer is NO…even though the product says BABY on the label and has a picture of an infant.

 

Although homeopathic medicines were first used in the 18th century and are “probably safe” it is still unclear if they really work. Unfortunately,  there have been adverse events and deaths associated with some products ( see articles on teething tablets). The principle of homeopathy is that “ailments can be cured by taking small amounts of products that, in large amounts, would cause the very symptom you are treating. In other words, “like cures like” as these products contain “natural ingredients” that cause the symptoms that you are trying to treat, but that have been so diluted as to hopefully stimulate your body’s immune system to fight that very symptom. In this case, congestion and runny nose due to a cold.

 

So…I looked at all of the ingredients which included Byronia, Euphrasia, Hepar and Natrum…to name a few. Byronia is used as a laxative for constipation, Euphrasia is supposed to help with inflammation, Hepar is for people who tend to get “cold and therefore cranky and irritable” and Natrum is used for inflammation due to “too much lactic acid”.  This is the short version. The bottle also says contains less than 0.1% alcohol, but it has alcohol! 

 

While the FDA does monitor how homeopathic medications are made, they do not require these companies to show proof that these medications do what they say they do, as they are “natural”.   With that being said, natural does not always mean effective or safe.  Just as over the counter cold and cough medications are not recommended for children under the age of 2, I too would not recommend homeopathic products be given to an infant.

 

Best treatment for a cold and cough in young children?  Use a saline nasal spray followed by nasal suctioning to relieve the nasal congestion and mucus. I would also use a cool mist humidifier in the baby’s room to keep moisture in the air and help thin the mucus ( especially once the heat is on in the house). Make sure the baby is still taking fluids (breast or bottle) but you may also add some electrolyte solution to give your baby extra fluids if you feel as if they are not eating as well.  Lastly, always watch for any respiratory distress or prolonged fever and check in with your pediatrician!

Your Baby

FDA Warning: No Homeopathic Teething Tablets or Gels

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Some babies have little to no symptoms during teething, while others experience quite a bit of pain for months. When teething pain occurs, infants may cry and be irritable until they find relief.

Homeopathic tablets and gels aimed at helping soothe babies’ pain may be dangerous for infants and toddlers, the Food and Drug Administration (FDA) recently announced in a statement. 

The FDA is investigating reports of seizures in infants and small children who were given homeopathic teething products, which may contain "natural" compounds but are not regulated as drugs by the FDA.

In addition, the FDA said in the statement that "consumers should seek medical care immediately if their child experiences seizures, difficulty breathing, lethargy, excessive sleepiness, muscle weakness, skin flushing, constipation, difficulty urinating or agitation" after using homeopathic teething tablets and gels.

According to the National Center for Complimentary and Integrated Health, homeopathy relies on two theories: “like cures like”—the notion that a disease can be cured by a substance that produces similar symptoms in healthy people; and “law of minimum dose”—the notion that the lower the dose of the medication, the greater its effectiveness.

The FDA said in the statement that the agency is not aware of any proven health benefit of using homeopathic teething tablets and gels.

In 2010, the FDA issued a safety alert about a homeopathic teething tablet that contained belladonna. Belladonna — also called deadly nightshade — is a poisonous plant that contains a chemical called atropine. At high levels, atropine can be deadly. In homeopathy, it is used to treat redness and inflammation.

At the time, the FDA found that the teething tablets contained inconsistent amounts of belladonna. The company that made the tablets, Hyland, subsequently recalled the product.

Hyland issued a statement and video in response to the current FDA warning against the use of homeopathic teething remedies.

"As you may have seen, on September 30, 2016, the Food and Drug Administration issued a surprise statement recommending that consumers discontinue use of homeopathic teething tablets and gels because they may pose a risk," Hyland's stated. "We are fully cooperating with FDA’s inquiry and we’re providing them with all the data we have. We also hope to learn from FDA what facts, if any, the Agency has based its action on."

Hyland also noted “The safety and effectiveness of Hyland’s natural homeopathic medicines is our top priority. That’s why we work with regulators to ensure that our products meet the highest standards. If we ever had reason to be concerned of that safety, we would act immediately."

"Teething can be managed without prescription or over-the-counter remedies," Dr. Janet Woodcock, director of the FDA's Center for Drug Evaluation and Research, said in the FDA statement. 

The American Academy of Pediatrics (AAP) recommends teething rings or hard, unsweetened teething crackers. Do not use frozen teething toys because they can cause more discomfort by injuring a baby's mouth, the AAP advises.

Be sure and check with your pediatrician about teething pain relief if your little one is having a hard time getting through the teething process.

Story sources: Sara G. Miller, http://www.livescience.com/56352-fda-warning-homeopathic-teething-tablets.html

Michael Johnsen, http://www.drugstorenews.com/article/hylands-responds-fda-teething-tablet-warning

 

Your Teen

Amateur Athletes May Be at Greater Risk For CTE

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Former NFL player and sportscaster, Frank Gilford, passed away in August. Not only was he well known for his on and off the field talents, but his name suddenly became associated with a terrible brain disease that is becoming all too common among former athletes, chronic traumatic encephalopathy or CTE. Gilford’s family said although he died from natural causes he also suffered from the debilitating effects of CTE which can affect thinking, memory, behavior and a person’s mood. His family decided to have his brain studied in hopes of shedding some light on the link between football and traumatic brain injury.  

A new study suggests that an increase of risk for CTE can begin much earlier in life for those who play contact sports where concussions and head trauma are common.

Researchers analyzed the brains of 66 men who had donated their organs to the Mayo Clinic Brain Bank and participated in sports such as football, rugby, wrestling, boxing and basketball while in school. Their brains were compared to the brains of 198 people, including 66 women, who never played contact sports.

CTE was found in the brains of a third of the men who played amateur contact sports. But no sign of the disease was detected in the brains of those who never played contact sports, the researchers said.

"The 32 percent of CTE we found in our brain bank is surprisingly high for the frequency of neurodegenerative pathology within the general population," wrote study author Kevin Bieniek, a pre-doctoral student in Mayo Graduate School's Neurobiology of Disease program.

"If one in three individuals who participate in a contact sport goes on to develop CTE pathology, this could present a real challenge down the road," Bieniek said.

Dr. Dennis Dickson, senior study author and neuropathologist at Mayo Clinic, noted that this study is the first to use newly developed government criteria to diagnose CTE in nonprofessional athletes.

"The frequency with which he [Bieniek] found CTE pathology in former [amateur] athletes exposed to contact sports was surprising," Dickson said. "It is pathology that had gone previously unrecognized."

Some individuals may be at an even greater risk of developing CTE if they have a genetic marker. Researchers have found two genetic markers that may affect the possibility of developing CTE.

"These markers need to be further studied in a larger group of CTE cases, but they could be very important in determining whether an individual is at greater risk of developing these brain changes," Bieniek said.

"The purpose of our study is not to discourage children and adults from participating in sports because we believe the mental and physical health benefits are great," he noted.

"It is vital that people use caution when it comes to protecting the head. Through CTE awareness, greater emphasis will be placed on making contact sports safer, with better protective equipment and fewer head-to-head contacts," Bieniek concluded.

The study was published in the December issue of journal Acta Neuropathologica.

Source: Robert Preidt, http://consumer.healthday.com/cognitive-health-information-26/concussions-news-733/playing-contact-sports-in-youth-may-raise-risk-for-degenerative-brain-disease-705847.html

Your Child

Study: Bedtime Routine Offers Kids Many Benefits

1:45

If your child doesn’t have a nightly bedtime routine, he or she is missing out on a tremendous amount of health and behavioral benefits according to a new study. And you’re not alone.

A multinational study consisting of over 10,000 mothers from 14 counties reported that less than 50 percent of their infants, toddlers and preschoolers had a regular bedtime routine every night.

Researchers determined that the participant’s children who did have a regular bedtime routine benefitted on many levels. The study found that children with a consistent bedtime routine had better sleep outcomes, including earlier bedtimes, shorter amount of time in bed before falling asleep, reduced night waking, and increased sleep duration. Children with a bedtime routine every night slept for an average of more than an hour longer per night than children who never had a bedtime routine. Institution of a regular bedtime routine also was associated with decreased sleep problems and daytime behavior problems, as perceived by mothers.


“Creating a bedtime routine for a child is a simple step that every family can do,” said principal investigator and lead author Jodi Mindell, PhD, professor of psychology at Saint Joseph’s University and associate director of the Sleep Center at Children’s Hospital of Philadelphia. “It can pay off to not only make bedtime easier, but also that a child is likely to sleep better throughout the entire night.”

According to the American Academy of Sleep Medicine, positive bedtime routines involve the institution of a set sequence of pleasurable and calming activities preceding a child’s bedtime. The goal is to establish a behavioral chain leading up to sleep onset. Activities may include giving your child a soothing bath, brushing teeth and reading a bedtime story.

“It’s important that parents create a consistent sleep schedule, relaxing bedtime routine and soothing sleep environment to help their child achieve healthy sleep,” said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler.


Researchers found that consistency was an important factor in helping children sleep well

“For each additional night that a family is able to institute a bedtime routine, and the younger that the routine is started, the better their child is likely to sleep,” said Mindell. “It’s like other healthy practices:  Doing something just one day a week is good, doing it for three days a week is better, and doing it every day is best.”

Mothers participated in the study by completing a validated, online questionnaire that included specific questions about their child’s daytime and nighttime sleep patterns, bedtime routines and behavior. The questionnaire was translated into each language and back-translated to check for accuracy.

“The other surprising finding is that we found that this effect was universal,” said Mindell.  “It doesn’t matter if you are a parent of a young child in the United States, India, or China, having a bedtime routine makes a difference.”

Sleep deprivation is becoming an all too common problem with today’s children and adults. The earlier a good sleep routine can be established and practiced, the better for a child in the long run.

Study results are published in the May issue of the journal Sleep.

Source: http://www.healthcanal.com/disorders-conditions/sleep/63298-study-shows-that-children-sleep-better-when-they-have-a-nightly-bedtime-routine.html

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