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Parenting

AAP Says Lice Shouldn’t Keep Kids Out of School

1:30

Typically, when a student has head lice or nits (the eggs of head lice), the school requires that he or she go home and not return until the lice are gone. The American Academy of Pediatrics (AAP) recently proposed new guidelines that say, "No healthy child should be excluded from school or allowed to miss school time because of head lice or nits."

The AAP says that while head lice may be annoying and cause itching, they don’t actually make people sick or spread disease. Many people believe that the insects are easily spread, but experts say that direct head-to-head contact is required.

The AAP notes that most doctors who care for children agree that school policies requiring children to be free from nits before returning to school should be abandoned.

The AAP also reported that screening kids at school for head lice does not reduce the occurrence in classrooms over time. However, pediatricians advise parents to check their children’s heads for lice and school nurses may check children who are showing symptoms such as repeated head scratching.

To treat lice, the AAP recommends parents start with over-the-counter medications that contain 1 percent permethrin or pyrethrins (types of insect-killing chemicals).

Parents should carefully follow the treatment instructions, and when using permethrin or pyrethrin products, should apply the treatment at least twice (about 9 days apart).

Because these medications do not kill 100 percent of the lice eggs, the treatments should be followed by manual removal of the eggs, the guidelines say. This can be a tedious process, but fine-tooth combs called "nit-combs" can make the process easier.

Some head lice have become resistant to OTC treatment, these cases may benefit from prescription medications such as spinosad or topical ivermectin.

Once a person is diagnosed with head lice, everyone in the family should be checked for the condition. Lice are usually transmitted by direct contact, so it's less likely that people will get lice from touching household items, but it is still wise to clean all hair-care items and bedding used by the person who had lice, the guidelines say.

Children should be taught not to share items such as combs, brushes and hats, although such precautions may not prevent all cases of head lice, they can reduce the risk of transmission.

Source: Rachel Rettner, http://www.livescience.com/50629-head-lice-recommendations.html

Your Toddler

Tricycles Cause Almost 9500 Injuries a Year

2:00

The brightly colored, tripled wheeled tyke-bikes may appear pretty harmless, but tricycles injuries send thousands of children to the hospital every year according to a new study.

Researchers found that lacerations were the most common type of injury kids suffered.  

But in an indication that some kids might need more or better quality protective gear, researchers also estimated that about 30 percent of injuries were to the head and another 8 percent involved the elbow, noted lead study author Sean Bandzar.

“Head injuries in particular are very common with any kind of moving toy and that’s why we recommend helmets, and based on our findings I would also encourage parents to have kids wear elbow pads,” said Bandzar, a researcher at the Medical College of Georgia in Augusta.

Based on the 328 tricycle injuries reported by participating hospitals in 2012 and 2013, researchers estimated that there were about 9,340 injuries nationwide during the two-year study period.

The total included 2,767 injuries to the head and 767 at the elbow, as well as 1,880 accidents damaging the face, 954 hurting the mouth and 483 harming the lower arms, researchers estimated.

The study noted that on average, three year-olds were the typical age group injured and one to two-year olds, made-up slightly more than 50 percent of the cases.

Boys made up almost two-thirds of the cases.

With this age group, it came as no surprise that about 72 percent of the injures occurred at home.

There were a couple shortcomings of the study, the authors acknowledge in the journal Pediatrics, is that researchers lacked data on how accidents happened, whether kids wore helmets or other protective gear, what types of tricycles children rode and whether adults were present.

It’s also possible that the study didn’t have data on enough accidents to draw broad conclusions about tricycle injuries nationwide, said Dr. Gary Smith, president of the Child Injury Prevention Alliance and a professor of Pediatrics, Emergency Medicine and Epidemiology at The Ohio State University in Columbus.

“Tricycles are safe, especially if a few simple steps are taken to prevent injuries,” Smith, who wasn’t involved in the study, he told Rueters by email.

Children should always wear helmets any time they are on wheels above a hard surface – including tricycles, skateboards, scooters, skates and bicycles, Smith said. Tricycle riders in particular should only ride in areas separated from cars, and when parents can keep a close eye on them.

“Tricycles are somewhat riskier than other toys children use but that doesn’t mean they are highly risky toys,” said David Schwebel, a researcher at the University of Alabama at Birmingham.

While Schwebel, who wasn’t involved in the study, echoed the need for parental supervision, he also stressed that tricycles can be good for kids.

“Tricycles are valuable tools to help children develop critical gross motor skills like balance, coordination and strength,” Schwebel said by email. “Any tricycle, when used carefully in a supervised situation, is likely to be a positive activity for children.”

Source: Lisa Rapaport, http://www.reuters.com/article/2015/09/14/us-health-children-tricycle-injuries-idUSKCN0RE1TQ20150914

 

Your Baby

Eating During Labor May Speed Up Delivery

1:45

In many hospitals, when a woman is in labor, all she is allowed to eat are a few ice chips. That rule may need updating, according to a new study that finds women who were allowed to eat before delivery had a slightly shorter labor than those who were restricted to ice chips or sips of water - although the study can't prove that eating caused deliveries to happen sooner.

The practice of limiting food during labor goes back a study in the 1940s in which women who delivered under general anesthesia were at risk of inhaling their stomach contents and choking in it, writes senior author, Dr. Vincenzo Berghella, of Thomas Jefferson University in Philadelphia, and his colleagues in Obstetrics and Gynecology.

“We really don’t know how much if anything people can eat or drink in labor," said Berghella,.

Whether women can have more than water or ice chips as they labor to give birth is a common discussion among healthcare providers, he told Reuters Health.

General anesthesia is not commonly used during delivery these days, but the old guidelines are still in use.

For the new study, the researchers compiled data from randomized controlled trials that compared the labor outcomes of women who were allowed to eat only ice chips or water and those who were allowed to eat or drink a bit more.

For example, one study allowed women to drink a mixture of honey and date syrup. Another study allowed all types of food and drinks. A few others allowed women to drink liquids with carbohydrates.

Overall, the researchers analyzed 10 trials that included 3,982 women in labor. All were only delivering one child - not twins or triplets - and were not at risk for cesarean delivery.

The women with the less restrictive diets were not at increased risk for other complications, including vomiting or choking, during the use of general anesthesia.

And women who were allowed to eat and drink more than the traditional ice chips and water had labors that were shorter, by an average of 16 minutes, compared to women with the more restrictive diets.

Speaking from experience, 16 minutes less of labor pains is a real bonus. How does adding more liquid or food during delivery help reduce the time before delivery? The researchers presented some ideas.

"If we’re well hydrated and have adequate carbohydrate in our body, our muscles work better," said Berghella. A woman's uterus is largely made of muscle.

Another of his studies, which found women who received more fluid than normal delivered faster than other women, reinforces the finding.

Berghella said it's still common practice for women with uncomplicated births to be restricted to water or ice chips during labor.

"The evidence from well-done studies is they can have more than that," he said.

Do women really want to eat much during labor? Probably not, there’s a lot going on in the body as labor progresses.  But more liquids and some light carbohydrates during the early part of labor may be welcomed – especially if they shorten the time between labor and when baby enters the world.

Story source: Andrew M. Seaman, http://www.reuters.com/article/us-health-pregnancy-labor-food-idUSKBN15O2ZR

 

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.   

Parenting

Is Your Child Becoming an Emotional Eater?

2:00

You may be tempted to appease your child with food after a fall or tears for short-term relief, but this could actually set your child up for long-term unhealthy eating patterns.

What happens is that children begin to identify eating with self-comforting or relieving boredom instead of nutrition or eating when they’re actually hungry.

Almost all children, teens, and adults may engage in emotional eating at one time or another.

Hunger associated with emotional eating comes on quickly and feels urgent. It's often triggered by a specific event or mood. It's not like typical physical hunger, which gradually builds and is a result of an empty stomach. Physical hunger can be satisfied by a number of different foods, but cravings usually involve particular foods. Examples might be ice cream or candy after a fight with a friend or a tough day at school.

Why is emotional eating unhealthy? Emotional eating isn’t really about hunger or nutrition; it’s about filling an emotional need. It can lead to overeating and over time, lead to extra weight gain or obesity. It also sets up a pattern of handling uncomfortable situations by eating instead of by learning how to solve social and psychological problems.

There are lots of reasons kids may seek out food for comfort such as:

  • Anger
  • Boredom
  • Change
  • Confusion
  • Depression
  • Frustration
  • Loneliness
  • Loss
  • Resentment
  • Stress

Even positive emotions such as excitement and happiness can result in emotional eating once it becomes a go-to as a reward. 

If you notice signs of emotional eating in your child, talk to him or her about your concerns. Be gentle. Stay positive. Helping your child might be as simple as having a warm and loving conversation.

Help your child develop a healthy response to his or her problems, such as focusing on solutions. Encourage your child to talk about the emotions that trigger his or her emotional eating. Brainstorm other ways to deal with those emotions. For example, your child could exercise or become involved in sports when he or she feels stressed out, or call a friend when he or she is bored.

Emotional eating can be learned, so your influence as a parent or primary caregiver is one key to prevention. Be sure to model healthy eating habits for your child. Also, avoid using food to celebrate occasions or to reward your child for good behavior. Instead, use verbal praise and give other types of rewards (for example, stickers for a young child or a fun activity with an older child).

There are signs you can look for in children to let you know if your child is an emotional eater. They are:

  • Eating in response to emotions or situations, not to satisfy hunger
  • Feeling an urgent need to eat
  • Craving a specific food or type of food
  • Eating a larger amount of food than usual
  • Eating at unusual times of day (for example, late at night)
  • Gaining excess weight
  • Feeling embarrassed or guilty about eating
  • "Sneaking" food during high-stress times
  • Hiding empty containers of food

A recent study from Norway found that kids offered food for comfort at ages 4 and 6 displayed more emotional eating at ages 8 and 10.

Also, the researchers found signs that kids who felt more easily comforted by food were fed more by parents for that purpose.

Emotional eating typically starts early in life but can really begin at any age; it seems like an easy fix for anxiety at the time, but can lead to health problems if not brought under control.

Story source: https://familydoctor.org/emotional-eating-in-children-and-teens/

Parenting

Why Moms-To-Be Might Want to Hire a Doula

2:00

Ever heard of a doula?  You’re not alone if the answer is no.  The word “doula” comes from the ancient Greek meaning “ a woman who serves.”

According to DONA International, a doula is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth; or who provides emotional and practical support during the postpartum period.

A recent study found that women with doula care had 22% lower odds of giving birth prematurely, and were less likely to have a C-section. (Among the women with doulas, 20.4% gave birth via cesarean, compared to 34.2% of women without doulas.)

For pregnant women, doulas can offer emotional and physical support throughout the pregnancy and labor; either in a hospital setting or at home.  There are also doulas that are certified to help mothers postpartum.

While many people may not have heard of doulas, they are beginning to gain some recognition.  TIME Magazine recently published an article on the 4 reasons why moms-to-be should consider hiring one.  The author spoke with Jada Shapiro, founder of the doula referral service, Birth Day Presence, in New York City.

1. They provide extra care and support:

Although every doula has a unique approach, their main role is to care for the mom-to-be. 

“Doulas offer continuous support to women both during pregnancy and after childbirth,” Shapiro explains.

“In a way, we are trying to recreate what was typical in old-world communities when women were surrounded by a vast support system of female friends and relatives during pregnancy.”

And while doulas are not medical professionals, they possess a wealth of knowledge about pregnancy and childbirth that can be extremely helpful for expectant moms.

“We work closely with our clients to de-mystify pregnancy terminology and help women interpret their options,” says Shapiro. 

That said, one of the most common misconceptions about doulas is that they interfere with a woman’s obstetrician. Shapiro says it’s important to note that this is not the case. “Doulas complement the care a woman receives from her doctor,” she says. “We don’t get in the way of medical decisions.”

She also adds that while many people believe you can only work with a doula if you want a medicine-free birth, this is also untrue: Women with all kinds of birth plans can find it helpful to consult a doula during their pregnancy.

2. They can assist with pain management:

Moms-to-be are well aware of the stories of pain during labor and delivery as well as the growing physical un-comfortableness that comes with being pregnant.

“Doulas are well-trained in physical comfort and can offer a wide range of pain relief techniques and tools,” says Shapiro, including acupressure, hydrotherapy, birthing balls, massage, and suggesting position changes during labor. Doulas can also help moms relax with soothing imagery, music, and breathing exercises.

This individualized level of care can help moms feel a little calmer during one of the most physically and emotionally challenging days of their lives. “I believe that many mothers just feel generally more cared for and less alone during the experience of childbirth with the help of a doula,” Shapiro says.

 

3.They provide support to both moms and their partners:

“Something I hear from many of my clients is that they can’t believe how intimate their childbirth experience was, even with a doula there,” says Shapiro.

She adds that because childbirth can be such an overwhelming experience for families, having the support of a third party can be just as useful for partners as it is for moms-to-be: 

“Doulas can help recall important information from midwife or doctor appointments, lend a helping hand if mom needs a massage, or just generally absorb some of the stress from the partner,” she says. “In this way, a doula can allow partners to be fully present in the experience.”

4. They’re there for you on the big day:

“Doulas are typically on-call 24/7 during a client’s ‘due window’ of 36 to 42 weeks,” says Shapiro.

When a woman goes into labor, her doula will be available for physical and emotional support both while she’s laboring at home as well as accompanying her to the hospital.

And in addition to the aforementioned relaxation and pain relief techniques, doulas know a lot about childbirth (Shapiro, for example, has attended “more than 350” births in her 13 years as a professional doula).

“During labor, doulas might suggest alternate positions; encourage different non-medical techniques to potentially help speed up dilation, such as walking around; and just generally act as a sounding board for difficult medical decisions,” she says.

If you’re interested in learning more about doulas, you can check out the DONA International website at www.dona.org. It has information on where you can find a certified doula and how the process works.

Sources: Kathleen Mulpeter, http://news.health.com/2016/01/28/what-is-a-doula-4-reasons-pregnant-women-might-want-one/

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

Your Baby

Does Your Unborn Baby Hear You?

2.00 to read

More than twenty years ago I remember reading that fetuses can learn to recognize their mothers and father’s voices and then respond to those voices as newborns. I thought… well maybe… but it seemed to me that voices from outside of the womb would sound muffled from inside. Of course, I don’t remember my in utero experience so I don’t really know how words sound.

Over the years though, scientists have continued to examine how and what babies learn before they are born.

A recent study by researchers at the University of Helsinki in Finland have determined that fetuses not only hear and recognize voices but they can become familiar with different words and different pitches used when saying those words.

The study involved 33 moms-to-be, and examined their babies after birth. While pregnant, 17 mothers listened at a loud volume to a CD with (2), four-minute sequences of the made-up words “tatata” or “tatota.” The words were said with several different pitches. The moms-to-be listened to the recordings beginning at 29 weeks of pregnancy -about 7 months along- until birth. They heard them around 50 to 71 times.

Following birth, researchers tested the babies for normal hearing and then performed an electroencephalograph (EEG) brain scan to see if the newborns would respond to the made-up words and different pitches. And sure enough, the brain scans showed increased activity from the babies who had been listening to the CD in utero when the words were played to them after birth. Not only did they respond to the words, but also seemed to recognize the different pitches used when they heard them.  

The babies born to the mothers who had not listened to the CDs while pregnant showed little reaction to the words or pitches.

 “We have known that fetuses can learn certain sounds from their environment during pregnancy,” Eino Partanen, a doctoral student and lead author on the paper, said via email.

“We can now very easily assess the effects of fetal learning on a very detailed level—like in our study, [we] look at the learning effects to very small changes in the middle of a word.”

Some experts believe the finding shows that not only can a third-trimester fetus hear and recognize voices; he or she can also detect subtle changes and process complex information.

“Interestingly, this prenatal exposure also helped the newborns to detect changes which they were not exposed to: the infants who have received additional prenatal stimulation could also detect loudness changes in pseudo words but the unexposed infants could not,” Partanen says.

“However, both groups did have responses to vowel changes (which are very common in Finnish, and which newborns have been many time previously been shown to be capable of).”

You may be wondering why is it even important that scientists know if fetuses can recognize voices or words.  Partanen says because sounds heard in utero may shape the developing human brain in ways that affect speech and language development after birth.

“The better we know how the fetus’ brain works, the more we’ll know about early development of language,” Partanen says. “If we know better how language develops very early, we may one day be able to develop very early interventions [for babies with abnormal development].” 

An abstract for the Finnish study is published on the Proceedings of the National Academy of Sciences website.

Does talking and singing to your baby before it’s born actually stimulate his or her brain activity and increase language learning? Some experts say definitely yes, others say it has no impact. But really, most moms and dads enjoy baby bump bonding whether it’s productive or not. And who knows, maybe your pre-born hears you loud and clear. 

Source: Meghan Holohan, http://www.nbcnews.com/health/unborn-babies-are-hearing-you-loud-clear-8C11005474

Your Child

Healthier Choices for Students in School Lunch Lines

1:30

School lunches have changed over the years and in many school cafeterias, food options are healthier than ever before, according to a new study.

Elementary school cafeterias are offering more vegetables, fresh fruit, salad bars, whole grains and more healthy pizzas, while the availability of high-fat milks, fried potatoes and regular pizza has decreased, researchers report.

"School food service programs have worked hard to improve the nutritional quality of school lunches, and largely have been very successful," said lead researcher Lindsey Turner, director of the Initiative for Healthy Schools at Boise State University, in Idaho.

Although in some schools food choices are improving, that’s not the case everywhere. Turner noted that more work needs to be done to make sure every student has the same healthy choices in the lunch line.

In the study of more than 4,600 elementary schools that are part of the U.S. National School Lunch Program, researchers found that school lunches improved significantly between 2006-2007 and 2013-2014.

Despite improvements in food choices, disparities were still found. For example, schools in the West were more likely to offer salad bars than schools in the Northeast, Midwest or South, the researchers found.

Schools with a majority of black or Hispanic children were less likely to offer fresh fruit than schools with a preponderance of white students.

Also, schools in poor areas were less likely to offer salads regularly.

Over the course of the study, Midwestern schools slightly reduced offering pre-made salads in favor of salad bars, but Southern schools were more likely to offer pre-made salads and less likely to have salad bars, the researchers found.

On the other side of offering healthier foods is choosing to eat those foods. Just because there are better food options available, doesn’t mean that kids will eat them. One expert noted that it takes time and effort for kids to change their eating habits. It not only has to look good, it has to taste good.

"It is not only important to improve the quality of school lunches but to make these foods attractive, tasty, easily seen and accessible," said Samantha Heller, a senior clinical nutritionist at New York University Medical Center, in New York City.

Studies have found that putting fresh fruit in a nice bowl, in a conveniently located, well-lit area in the school cafeteria increased sales of fruit by 102 percent, she noted.

"A brightly lit, hot-and-cold salad bar filled with colorful fresh fruits, vegetables, beans and nuts, mushroom and spinach pizza, and veggie tacos center-stage in the lunchroom would be very attractive to students and staff alike," Heller said.

This approach works well at home, too, she added.

"Kids are more likely to grab healthy foods like cut-up melon, carrots, peppers, edamame and hummus when they are upfront and easy to grab in the fridge," Heller said.

The study was published in the journal Preventing Chronic Disease.

Story source: Steven Reinberg, http://consumer.healthday.com/vitamins-and-nutrition-information-27/food-and-nutrition-news-316/america-s-school-lunches-getting-healthier-study-709097.html

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