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Your Baby

Spit-Cleaning Your Infant’s Binky

1.45 to read

Have you ever sucked on your baby’s pacifier to clean it? Many parents have. Babies drop their binkies all the time and if you’re in a hurry or just figure a little spit-cleaning won’t hurt, you’re more likely to stick it in your own mouth and give it a quick once over.

A new study out of Sweden says the spit-cleaning technique may actually help your infant avoid eczema and asthma.

“It was surprising that the effect was so strong,” says pediatric allergist Dr. Bill Hesselmar of Queen Silvia Children’s Hospital in Gothenburg, Sweden, lead author of the study published Monday in the journal Pediatrics.

The study involved 136 infants who used a pacifier in their first 6 months. 65 of the infants had parents that reported sucking the pacifier to clean it. In those children, both eczema and asthma were strongly reduced when they were examined at 18 months of age. At 36 months of age, the protective effect remained for eczema but not for asthma.

Scientists didn’t know why the sucking on the baby’s pacifier acted as a protector or whether it was filtering out germs. The technique didn’t have any impact on respiratory illness, meaning that the babies were not more likely to get a cold or the flu from their parents. Common sense would dictate that if you have a cold or the flu or any other contagious condition, then it’s not a good idea to suck on your baby’s binky. Otherwise, maybe it’s not such a bad idea.

Why is sucking on your infant’s pacifier possibly helpful in preventing asthma or eczema in your child? Scientists hypothesize that tiny organisms in the saliva of the parents may be why. Parent’s saliva introduces gut micoflora that live in the digestive tract of the baby. “We know that if infants have diverse microflora in the gut, then children will have less allergy and less eczema,” says Hesselmar. “When parents suck on the pacifier, they are transferring microflora to the child.”

Many pediatricians and family doctors are concerned that children are being “excessively cleaned” into illness. With anti-bacterial soaps and swipes being used on everything, and kids not allowed to get dirty, their immune system isn’t getting the workout it needs to help fight off common illnesses. The bacterial microorganisms provided in the parent’s saliva might help stimulate the baby’s immune system.

“The most exciting result was the eczema,” says Christine Johnson, chair of the public health department at Detroit’s Henry Ford Hospital. “I’m a bit more skeptical about the asthma findings because asthma is hard to measure before a child is five or six years old.”

Hesselmar also urges moms to lick the baby’s pacifier if their child was delivered by C-section. Vaginal delivered babies receive quite a bit of microbes during delivery. C-section babies can be more prone to allergies. “If they are using a pacifier and those parents think it’s OK to suck on the pacifier, then yes, I would recommend it,” Hesselmar says.

Some parents may find the idea of picking up a pacifier that’s fallen on the floor and putting it in their mouth kind of disgusting. That’s fine, there’s no need to worry about it. If the idea doesn’t bother you, all the better says Hesselmar, “I haven’t heard of anyone getting ill from it,” he says. “There isn’t much bacteria on the floor.”

Source: Barbara Mantel, http://www.today.com/moms/why-it-may-be-ok-spit-clean-your-babys-binkie-6C9773378

Your Child

Diving Safety Tips

1:30

Diving into a pool or lake is one way to cool off during the hot summer months, but if you aren’t careful, fun can turn to tragedy in a few quick seconds.

Every year there are hundreds of people who are paralyzed from neck and spine injuries after diving head first into shallow lakes and pools according to the American Academy of Orthopaedic Surgeons (AAOS), the American Spine Injury Association and the Cervical Spine Research Society.

"Everyone needs to be trained to dive safely," AAOS spokesperson and orthopedic surgeon Dr. Brett Taylor, said in a news release from the group. "Safe diving skills don't come naturally, they have to be learned. With neck and spine injuries being the most common diving injuries, a good rule of thumb for divers is to dive feet first in unknown water."

The biggest obstacle to safe diving is shallow water. Experts say that you should always check the depth of the water and make sure that it is deep enough for diving. If you're diving from a high point, make sure the bottom of the body of water is double the distance from which you're diving.

Murky water in lakes and oceans can also present a danger. With unclear water you can’t see sand bars or objects below the surface. The heavy rains during the spring have lifted some lake levels far above normal making it difficult to see what may be lurking just below the surface.

Experts also warn that kids and adults should never dive into an above ground pool. These pools tend to be shallower than in-ground pools.

Only one person at a time should stand on a diving board. Dive only off the end of the board and do not run on the board. Do not bounce more than once, because the rebound effect could knock you off your legs or throw you off balance.

After diving, immediately swim away from the area of the diving board to clear the way for the next diver. It’s easy to forget that another child may be right below the next eager diver. It’s particularly important for parents to keep an eye on who is in the pool or lake and where they are.

Don't body surf near the shore. Doing so puts you at risk for neck injuries, as well as shoulder dislocations and fractures. These waves can pack a heavier punch especially when a beach has been recently replenished.

Pools, lakes and oceans can be a refreshing retreat when the temperatures reach into the 90s and 100s, but make sure your kids are playing it safe when diving in.

Source: Robert Preidt, http://consumer.healthday.com/fitness-information-14/diving-health-news-247/experts-offer-diving-safety-tips-701129.html

Daily Dose

E-Cigarettes

1:30 to read

E- cigarettes which were a relatively obscure curiosity only 5 years ago are now available at not only “vape shops” but are also easy found at gas stations and pharmacies and the e-cigarette market has exploded. Unfortunately,  with the increased availability of e- cigarettes, there has been a steady rise in adolescent e-cigarette use (vaping).  

 

The Surgeon General stated, “exposing the developing brain to nicotine has been shown to alter its structure and function in a way that introduces long-lasting vulnerability for addiction to nicotine and other substances of abuse”. Yearly studies in high school students about their use of e-cigarettes showed that the percentage of students reporting e-cigarette use in the past 30 days went from 1.5% in 2011 to 16% in 2015.  The use of e-cigarettes by teens is becoming a major public health issue.

 

In a study recently reported in JAMA (Journal of the American Medical Association), 10th grade students were surveyed in the Los Angeles public schools and found that about 37% of 10th graders have used e-cigarettes. In the same study it was reported that “teens who vaped frequently were about 10 times more likely to become regular smokers six months later, compared to teens who never vaped”. Additionally, “20% of the regular e-cig users transitioned into frequent smokers, while less than 1% of kids who had never vaped smoked cigarettes at follow-up”. It would seem from this and other studies that e-cigarettes may serve as a “gateway” to smoking cigarettes.

 

Those teens who were more frequent “vapers” might sensitize their brain to the addictive effects of nicotine and find even more “pleasure” when they start using cigarettes and may progress to adult smokers.

 

The FDA published its “deeming” rule and regulatory authority over e-cigarettes in May of 2016, and banned the sale of e-cigarettes to minors, as well as requiring warning labels on e-cigs. But the FDA did not ban e-cigarette TV ads, nor did it address the role of flavoring in attracting youths to use e-cigarettes.  (flavors such as cotton candy and gummy bear - really targeting teens) . Youth oriented advertising, not only on TV, but in stores and on the internet must be addressed as well, as studies again show that greater exposure to ads is associated with higher odds of e-cigarette use. 

 

So…once again parents  and pediatricians)  need to be discussing the use of e-cigarettes, “vaping” and life long risk for nicotine addiction.   

Your Baby

Online Breast Milk May Be Cow’s Milk Instead

1:30

There are many reasons that someone may want to purchase breast milk online; but typically it’s because mothers cannot produce enough or any breast milk themselves.

A new study published in Pediatrics, found that more than 10 percent of samples of breast milk bought online contained cow’s milk in significant quantities.

That can be a real problem for infants that cannot tolerate cow’s milk.

Researchers anonymously bought 102 samples from sites that use classified advertising to connect milk buyers with sellers. The sites are generally not involved in the transactions beyond helping make the initial connection.

They isolated mitochondrial DNA from the samples by polymerase chain reaction, the same technique used for forensic and medical purposes. Every sample contained human DNA, but 11 of them contained cow’s milk, 10 of them at levels higher than 10 percent.

“This was high enough to rule out minor or accidental contamination,” said the lead author, Sarah A. Keim, a principal investigator at Nationwide Children’s Hospital in Columbus, Ohio. “This is deliberate adulteration no matter how you look at it.”

Children under one-year-old should not be fed cow’s milk according to the American Academy of Pediatrics (AAP.) Cow’s milk contains nutrients that are too high for a baby’s system such as protein, sodium and potassium. If breast milk is not available, infant formulas are a good substitute.

“In a previous study, we found that a fifth of these people were online because their infants were having trouble tolerating cow’s milk. Additionally, it is clearly not recommended for infants under 12 months to be on cow’s milk.” said Keim.

Much of online breast milk is unregulated and may contain bacteria, but there are certified milk-banks that are regulated and safe.

Source: Nicholas Bakalar, http://well.blogs.nytimes.com/2015/04/06/online-breast-milk-may-contain-cows-milk/?_r=0

 

 

Your Child

What Food is Best for Your Child's Breakfast?

1:30

What’s the best choice for your child’s breakfast? According to a new study, eggs. Researchers found that children who eat eggs for breakfast tend to consume fewer calories at lunch and benefited from the protein and vitamins they provide.

The study looked at 40 eight to ten year olds who ate a 350 calorie breakfast-of eggs, porridge or cereal. Between breakfast and lunch they played physically active games.

The children were asked throughout the morning how hungry they were and parents kept a food journal of what else the children ate.

The research, led by Tanja Kral of the university’s Department of Biobehavioural Health Science, found children who ate the eggs for breakfast reduced their calorie intake by about four percent (70 calories) at lunch.

The scientists noted that children who regularly eat more than their daily calorie limit could gain weight, leading to obesity. Eggs contain about 6 grams of high quality protein and are a good source of vitamins and amino acids.

 "I'm not surprised that the egg breakfast was the most satiating breakfast," said Kral. He was however, surprised that the children said that the egg breakfast didn’t actually make them feel fuller than cereal or oatmeal even though they ate less at lunchtime.

”It's really important that we identify certain types of food that can help children feel full and also moderate caloric intake, especially in children who are prone to excess weight gain.“

The study was published in the International journal, Eating Behaviours.

Source: Emma Henderson, http://www.independent.co.uk/life-style/health-and-families/health-news/best-breakfast-for-children-eggs-what-is-scientists-research-a6850501.html

 

 

Daily Dose

SIDS Risks

1.30 to read

Sudden Infant Death Syndrome (SIDS) is every parent’s worst nightmare. From the time a family has their new baby until that child is 1 year of age, SIDS is of a concern. 

Most new parents in 2012 know about the Back to Sleep campaign (BTS), which was recommended by the AAP in 1994. After  the recommendation for newborn’s sleep position was changed from prone (tummy) to supine (back) the incidence of SIDS in the U.S. showed a sharp decline (more than 50%) over the first 10 year period. Unfortunately, the overall SIDS rate has plateaued since that time, and SIDS is still the leading cause of infant mortality in the U.S. 

A study in the April 2012 issue of the journal Pediatrics looked at risk factors for SIDS. Parents need to know that greatest risk for SIDS is during the first 12 months of life (the so named “Critical” development period). There are also both intrinsic and extrinsic risk factors for SIDS as well. All of these factors contribute to the vulnerability for SIDS. 

The peak incidence for SIDS is still between 2-4 months of a baby’s life. (postnatal age). The intrinsic risk factors for SIDS include, male gender, prematurity, genetic differences (now being found called polymorphisms) and a child’s prenatal exposure to cigarettes and/or alcohol. Extrinsic risk factors include tummy or side sleep position, bed sharing, over bundling, soft bedding and a child’s face being covered.  In this study 99% of SIDS infants had at least 1 risk factor, and 57% had at least 2 extrinsic and 1 intrinsic risk factors. Only 5% of the SIDS victims studied had no extrinsic risk. I think this is important for all parents to know! 

So what can parent’s do to lower the risk of SIDS for their baby?  Well, while you cannot change the peak incidence of SIDS between 2-4 months of a baby’s life there is a lot you can do! 

Looking at intrinsic factors:  gender is a 50-50 deal and seeing that I have 3 sons, I don’t know a lot about gender selection, so will not even touch that topic. But, you can prevent prenatal cigarette and alcohol exposure, and every pregnant mother (and father due to second had smoke issues) should eliminate smoking. That sounds easy enough. 

Prematurity may be lessened when a mother is healthy prior to her pregnancy and continues to do as much as possible during her pregnancy to ensure a full term birth. Basically maintaining a healthy diet, getting good prenatal care and listening to your doctor will help to prevent many pre-term births. 

Extrinsic factors are the easiest to change. While prone sleep positioning is a large risk factor for SIDS, there is now evidence that some other risks may appear in conjunction with sleep position.  Putting a baby on their side where they may roll to their tummies may be one issue.  Leaving soft objects or blanket in the crib may be another. Bed sharing is also not advised. 

So, the so-called “triple risk factors” for SIDS may be important information in providing risk reduction strategies for parents and caregivers. Any change that may lessen the risk of SIDS is meaningful and beneficial and will help new parents sleep a bit better as well!  I also did not see any mention of video cameras in the room as a reduction in risk, just saying..... 

That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Should Children Lift Weights?

I am often asked by both young patients and their parents if children can participate in weight lifting and strengthening exercises.

I think the appropriate term is strength training and conditioning, rather than weight lifting, which connotes competition and the need for heavier and heavier weights. When done appropriately, strength training and conditioning is great for kids of all ages, and really encourages being physically fit. Weightlifting is not appropriate for a growing child as it can put too much strain on the tendons and cartilage. This is especially true when kids become competitive about lifting bigger and bigger weights at the risk of long-term injury. Allowing children to weight lift in hopes of “bulking up” or “building the biggest muscles” before pubertal development and their growth spurt is inappropriate. All of that can be deferred for the post pubertal athlete. On the other hand, an age appropriate strength training and conditioning program may actually be protective of a child’s joints by increasing their muscle strength and their endurance. By participating in supervised and structured strengthening programs, a child as young as eight may improve their endurance, body awareness and balance, all of which are beneficial. A strength-training program can be done without weights, as in resistance training, by simply using the child’s body weight. Examples of this would be abdominal crunches, push-ups and pull-ups. These are great ideas for the younger children. For older children free weights or resistance bands may be added. Parents or coaches who are familiar with the use of free weights should always supervise. Start out with lighter weights, and make sure that the child can do at least 10 repetitions with the weight, if not, drop to a lower free weight. Have the adult watch the child for form and technique and supervise any increase in weights or repetitions. There are also many programs through local gyms and YMCA’s tailored just for kids to participate in strength training. When beginning a conditioning program encourage your child to have a warm up period, with a little aerobic activity like walking or running as this his will help to warm the muscles and prevent injury. After the strength training it is equally important to have a cool down period with gentle stretching. Many children enjoy working out with their parents and this can become a family activity (we can all use the exercise) to promote coordination, healthy bones, joints, cholesterol and blood pressure. Most importantly make it fun! That’s your daily dose, we’ll chat again tomorrow.

Parenting

HPV Vaccine: Fewer Doses Recommended for Preteens

1:30

Based on recent studies, the Centers for Disease Control and Prevention (CDC), is recommending that children 11 to 14 years old receive only two doses of the HPV vaccine instead of three.

The vaccine protects against cervical and other cancers caused by the human papillomavirus (HPV).

However, the CDC says that teenagers and young adults who start the vaccinations later, between at ages 15 to 26, should continue with the three doses.

The new advice is based on a review of studies showing that two doses in the younger group “produced an immune response similar or higher than the response in young adults (aged 16 to 26 years) who received three doses,” the C.D.C. said in a statement. The two doses should be given at least six months apart, the agency said.

The government agency noted that the two-dose schedule should make the process easier for families and hopefully will increase the number of preteens getting the vaccine.  So far, despite the vaccine’s proven effectiveness, immunization rates have remained low.

HPV is a group of more than 150 related viruses, according to the disease centers. They are spread by intimate, skin-to-skin contact, and by vaginal, oral and anal intercourse. HPV is so common that nearly all sexually active people become infected at some point. In most people, the immune system destroys the virus. But in some, the infection lingers. Some viral strains cause genital warts, and others can cause cancers of the cervix, vagina, vulva, penis and back of the throat.

The vaccine is recommended for preteens and young teenagers, ideally before they become sexually active, because it works best if given before a person is exposed to HPV.

The CDC still recommends vaccination for young people who have already had sex, saying that it should provide “at least some protection.”

HPV vaccination rates are slowly rising for boys and girls as parents begin to understand the health benefits for their children. Many pediatricians are now recommending the vaccine as a regular part of a child’s inoculation routine.

Story source: Denise Grady, http://www.nytimes.com/2016/10/20/health/children-14-or-under-need-fewer-hpv-vaccine-doses.html

Your Child

Unhealthy TV Snack Ads Work on Preschoolers

1:30

Kids love snacks and advertisers count on that to sell products.  That’s why so many commercials on children’s TV shows promote snacks packed with sugar and salt. According to a new study, preschoolers who are exposed to these types of ads will eat more of those foods, even if they are not hungry.

The study, led by Jennifer Emond, an assistant professor of pediatrics at Dartmouth College, in Hanover, New Hampshire, involved a small study of 60 children, 2 to 5 years old. Emond’s team monitored the kids as they watched a 14-minute segment of “Sesame Street.”

The preschoolers got a filling snack before the show, so they were not hungry, and then had unlimited access to snacks during it.

Some of the children watched the "Sesame Street" segment without food commercials, while others watched the show with commercials for a popular salty snack. The ads depicted kids happily playing and eating the snack.

While viewing the segment, the children were provided with two snacks: corn snacks and graham snacks. The same corn snacks provided were featured in the food advertisements shown to some of the children.

The researchers found that the preschoolers who watched the segment embedded with food ads consumed more calories in snacks on average than those who watched the department store ads.

Additionally, the children who watched the food ads ended up eating more of the advertised corn snack than the graham snack -- even if they had never eaten the corn snack before and, therefore, were not familiar with it.

"That was surprising because it demonstrated the powerful effect food advertising can have on priming potentially unhealthy eating behaviors at a young age," Emond said.

The results of this small study replicate the findings of other studies with older children.

About 40% of all food and beverage ads that children and teens see on television are for unhealthy snacks, according to a 2015 report by the University of Connecticut's Rudd Center for Food Policy and Obesity (PDF).

"Parents should not shrug off food marketing. These ads really do influence children," said Marlene Schwartz, director for the center and a professor of human development and family studies at the University of Connecticut, who was not involved in the new study.

"If the ads were for healthy foods, that would be an asset to parents, but when the ads are for unhealthy foods, they make parents' job harder," she said.

Story sources: Jacqueline Howard, http://www.cnn.com/2016/11/21/health/food-ads-kids-preschool/

https://consumer.healthday.com/vitamins-and-nutrition-information-27/obesity-health-news-505/tv-snack-food-ads-get-preschoolers-snacking-more-study-shows-716956.html

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