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Your Teen

HPV Vaccine, Proving Effective in Teenage Girls

2:00

While the controversy over the HPV vaccine may continue in some circles, a new study says the vaccine is proving effective in teenage girls.

The human papillomavirus (HPV) vaccine was introduced 10 years ago and its use immediately became a hot topic. The vaccine is recommended for young girls and boys ages 11 and 12, to protect them from the sexually transmitted virus that can cause cervical as well as anal, penile, mouth and throat cancers. 

The study found that in teenage girls, the virus’s prevalence has been reduced by two-thirds.

Even for women in their early 20s, a group with lower vaccination rates, the most dangerous strains of HPV have still been reduced by more than a third.

“We’re seeing the impact of the vaccine as it marches down the line for age groups, and that’s incredibly exciting,” said Dr. Amy B. Middleman, the chief of adolescent medicine at the University of Oklahoma Health Sciences Center, who was not involved in the study. “A minority of females in this country have been immunized, but we’re seeing a public health impact that is quite expansive.”

HPV vaccinations rates, in young girls and boys, have slowly been increasing, since the vaccine was introduced, but 4 out of 10 adolescent girls and 6 out of 10 adolescent boys have not started the recommended HPV vaccine series, leaving them vulnerable to cancers caused by HPV infections.

That is partly because of the implicit association of the vaccine with adolescent sexual activity, rather than with its explicit purpose: cancer prevention. Only Virginia, Rhode Island and the District of Columbia require the HPV vaccine.

The latest research examined HPV immunization and infection rates through 2012, but just in girls. The recommendation to vaccinate boys became widespread only in 2011; they will be included in subsequent studies.

Using data from a survey by the Center for Disease Control and Prevention (CDC), the study examined the prevalence of the virus in women and girls of different age groups during the pre-vaccine years of 2003 through 2006. (The vaccine was recommended for girls later in 2006.) Researchers then looked at the prevalence in the same age groups between 2009 and 2012.

By those later years, the prevalence of the four strains of HPV covered by the vaccine had decreased by 64 percent in girls ages 14 to 19. Among women ages 20 to 24, the prevalence of those strains had declined 34 percent. The rates of HPV in women 25 and older had not fallen.

“The vaccine is more effective than we thought,” said Debbie Saslow, a public health expert in HPV vaccination and cervical cancer at the American Cancer Society. As vaccinated teenagers become sexually active, they are not spreading the virus, so “they also protect the people who haven’t been vaccinated,” she said.

Many doctors are pressing for primary care providers to strongly recommend the HPV vaccine in tandem with the other two that preteen children now typically receive.

Many health experts are hoping that the positive results from this study will encourage more pediatricians and primary care physicians to discuss getting the vaccine with parents of young children.

The study was published in the online journal Pediatrics.

Source: Jan Hofman, http://www.nytimes.com/2016/02/22/health/vaccine-has-sharply-reduced-hpv-in-teenage-girls-study-says.html?ref=health

Your Baby

“Revolutionary” Newborn Has 3 Parents

1:45

There’s been a first in the use of in vitro fertilization (IVF) to help parents avoid passing on a fatal rare disease to their baby.

In what many medical experts are calling a “revolutionary” medical event, a baby with DNA from three donors has been born.

As first reported in New Scientist, a science and technology magazine published in the U.K., the baby boy was born on April 6, 2016 and doctors say he appears healthy. His parents were treated by U.S. fertility specialists in Mexico, where there are no laws prohibiting such methods. His mother carries a genetic mutation for Leigh syndrome, a rare neurological disorder that usually becomes apparent in the first year of life and is generally fatal.

The newborn’s mother had suffered four miscarriages and had two children who died from Leigh syndrome, one at age six and one at eight months. It’s a devastating disease for parents and children. Symptoms of Leigh disease usually progress rapidly and lead to generalized weakness, a lack of muscle tone and a buildup of lactic acid in the body, which can cause respiratory and kidney problems. Children rarely live more than six or seven years.

While the mother herself is healthy, a gene for the disease resides in her DNA, in the mitochondria that powers cells. In this mother’s case, about 25 percent of her mitochondria reportedly carries the disease-causing mutation.

In order to avoid transferring the disease, the couple sought help from Dr. John Zhang, a reproductive endocrinologist at New Hope Fertility Center in New York City. 

“This mitochondrial disease is usually a very devastating situation for the babies and the family,” Zhang told CBS News.

The controversial procedure involved using the three-parent IVF technique to ensure that the disease mutation would not be passed along to the baby. So far, it seems to have worked.

The procedure, called spindle nuclear transfer, involves removing the healthy nucleus from one of the mother’s eggs and transferring it to a donor-egg, which had, had its nucleus removed. The resulting egg – with nuclear DNA from the mother and mitochondrial DNA from a donor – was then fertilized with the father’s sperm. 

The resulting embryo contained genetic material from three parents – the mother, the egg donor, and the father.

According to New Scientist, the scientists in this case created five embryos using the technique. Only one developed normally and that embryo was implanted in the mother.

The baby has not shown any signs of developing the illness, Zhang said. His mitochondria have been tested and less than one percent carries the mutation, believed to be too low a level to lead to disease.

The controversial fertility method is not legal in the United States. Zhang told New Scientist that they conducted the procedure in Mexico because “there are no rules” there.

The procedure received widespread media attention when lawmakers in the U.K. became the first to approve its use last year.

Sian Harding, a medical professor and bioethics adviser who reviewed the ethics of the technique in the U.K., told New Scientist the case seems to have been handled according to ethical standards.

“It’s as good as or better than what we’ll do in the U.K.,” said Harding.

Much of the controversy surrounding this procedure involves safety and religious concerns.

Harding notes that this is not the first time multiple DNA has been used to try and create a healthy baby. “Last time embryologists tried to create a baby using DNA from three people was in the 1990s, when they injected mitochondrial DNA from a donor into another woman’s egg, along with sperm from her partner. Some of the babies went on to develop genetic disorders, and the technique was banned. The problem may have arisen from the babies having mitochondria from two sources.”

In Britain, where the procedure allowing DNA from three parents was approved in February 2015, leaders disagreed heatedly on the issue while it was up for debate in the House of Commons, with some raising concerns about “designer babies” and “playing God.” Leading churches in Britain – both Protestant and Catholic – opposed the procedure on religious and ethical grounds.

Medical and moral concerns about this IVF method are most likely going to continue as experts look for ways to refine the controversial procedure.

But for one couple, being able to cradle their newborn - that shows no sign of carrying the deadly Leigh disease - will forever be a precious gift. 

Story source: Mary Brophy Marcus, http://www.cbsnews.com/news/first-3-parent-dna-baby-born-rare-disease/

 

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

Dog Bites & Kids

1.15 to read

I saw a young boy (this week) who was bitten by a dog.  Very sad as I began to think this is the time of the year that I will start seeing more bites. Why? Warmer weather brings families outdoors and I’ve noticed more dog parks popping up. I have experience with dog bites as a pediatrician and mom.

We are a dog family and my husband and I had our first dog, Mrs. Brown, before our oldest son was born. She was the “perfect” dog, a mutt that my brother (who is a vet) had found and gave yo us.

 When the boys came along she was wonderful and would follow them around the yard and to the closest neighbors, I would always know where the kids were as  Mrs. Brown would be waiting on the porch for them.

Our next dog was a golden retriever, Maddie, that our middle son wanted, and she too was a member of our family for 12 years.  Sweet (but a bit lazy), she was so sad as each of our sons left for college. She was suddenly the only child left at home. It broke our hearts when she died and the boys had not gotten a chance to get home to see her. 

Thinking we didn’t need a dog in a “empty” house was a mistake.  The youngest son felt like he should have a dog (even though he was away at college) and I thought a little dog might be nice.  No way, according to the youngest son, we “are a big dog family”, and so we now have 4 year old Maggie, a yellow lab. Sweet, smart and spoiled is all I can say.

Now, back to dog bites. I think it is important for children to be around dogs (and other pets as well) but to have a respect for them. Just like we teach children, “stranger danger”, the same goes for dogs. Teach your children not to approach strange dogs, or reach through a fence to pat a dog. Always ask the owner before trying to pet a dog.  

I would not recommend buying your child a dog until they are around 4 years of age. But, if you already have a dog, bringing that new baby into the home gives the dog some time to get adjusted before they are having a toddler around.  You as a pet owner should also know the temperament of your dog and if you sense any issues with your pet and aggression it may be best to find another home for the dog before your child is mobile. It doesn’t matter how careful one is, toddlers like to explore and that may mean that they are touching and petting the dog as well.

I know about dog bites from experience as our youngest son was bitten in the face by a friends dog. The bite was not provoked, but the dog came over while he was laying on the floor eating popcorn and watching a movie  and went right for his face. A late night phone call, trip to ER and plastic surgeon and 20 stitches later my son still wanted to play at that friends house!!  He loved dogs before, and still does.  Just a freak “accident” but I can still see the scars.  But, you know I am the mom!

 

 

Your Child

5 Fitness and Health APPS for Kids This Summer

2:00

Want to be more productive, creative, improve your gaming skills, write the next great best seller, explore new recipes or edit photos in your phone? There’s an app for that! If you can imagine it- there’s probably software designed for that very purpose.

There are numerous health apps out there, and many adults swear that they are getting and staying healthier by using them. But, what about apps dedicated to children’s health and fitness?

Here’s are five from the list of apps that have been reviewed and found a good fit for kids by commonsensemedia.org. The website provides a list of apps accompanied by reviews, appropriate age group, ease of play, violence, sex, consumerism and privacy & security ratings.

1.     Weight Loss for Kids and Teens by Kurbo Health - Age group -10 +

Weight Loss for Kids and Teens by Kurbo Health is a health app that helps kids age 8 to 18 track food choices, exercise minutes, and personal goals. The app and its related Kurbo coaching system are based on the Traffic Light Diet System developed at Stanford University. It categorizes food into green, yellow, and red choices to help kids learn to choose healthy options more often, without totally restricting any foods. There's also an exercise log, a goal-setting and weight-tracking tool, health-education games, and videos explaining each concept. Although the app is free, more personalized help is available through the Kurbo program's website, which includes live coaches. An Android version is scheduled for release soon.

2.     Zombies, Run! Age group – Age group 16-18

ZOMBIES, RUN! Runners become "Runner 5" in a post-apocalyptic community running from zombies and collecting supplies for survival. The story unfolds in episodes interspersed with the runner's own music playlist. Seasons one through three are included with the purchase, and additional episodes can be purchased in-app. Players can use the supplies they collect during their runs to build up their base and continue the fun after their runs.

3.     Stop, Breathe & Think – Age group 10 +

Stop, Breathe & Think is an app that encourages kids to learn the three skills in its title. Kids will stop and take stock of their thoughts and feelings; they'll breathe through guided meditations; and they'll think with increased kindness and compassion for the world around them. It's a great tool for developing positive habits of mind for kids and adults.

4.     LiVe – Age group 10+

LiVe is a fitness and nutrition app geared toward teens and tweens. Based on "8 Healthy Habits," the app encourages kids to set nutrition goals (such as eating a certain number of fruits and veggies and limiting sugary drinks), get more physical activity, eat meals with their families, and keep a positive attitude about food and body image. The easy, fun teen-centric graphics, solid (yet brief) information, and simple trackers give tweens and teens concrete ways to set these goals and track their progress.

5.     FitFu- Age group 13 +

FitFu is a combination of several other "Fu" fitness apps that teaches teens basic exercises, tracks their progress, and shares the information with friends. Because your device must move with your body, this app may encourage you to buy a strap or armband and is not intended for use on the iPad. There are 13 exercises included, such as lunges, pull-ups, and crunches. For each exercise, you hold or strap your device onto your body, and the accelerometer counts your reps. When finished, you can share your workouts with friends via email or Facebook or by connecting with friends who also have the app. Setting up a profile requires an email address or Facebook. You are not able to track exercises that are not included in the app. FitFu users must be 13 or older according to FitFu's terms of service.

The list above offers just a few of the apps parents can check out but there are other websites that also offer kid’s health apps and information.  Take a few moments and investigate and see what is out there; you may find some that fit your child better.

With school out and kids ready to enjoy the summer, parents can point them towards apps that can actually encourage moving, health and fitness in a fun and engaging way.

And of course, the kidsdr.com not only keeps you up on all the latest pediatric medical studies and news, but also provides in-depth discussions on kids health with pediatrician Dr. Sue Hubbard, videos, parenting q&a and safety recalls related to children’s products. You can also download the kidsdr app for quick and easy access to information - and it's free! 

Source: https://www.commonsensemedia.org/reviews/category/app/genre/health-fitness-65

http://www.kidsdr.com

 

Your Child

Melatonin May Help Kids with Eczema Sleep Better

2:00

Eczema is a common skin disease that affects as many as 30 percent of all kids.  It’s an itchy red rash that often causes continuous scratching. Numerous children with eczema have trouble sleeping through the night. A new study suggests that over-the-counter melatonin may help them sleep longer and better.

These sleep problems can be difficult to treat in these children, said Dr. Yung-Sen Chang, an attending physician in pediatrics at Taipei City Hospital Renai Branch in Taiwan. Antihistamines can stop working after a few days, and tranquilizers have potentially serious side effects, Chang said.

But giving children melatonin, his study found, "is safe and effective for helping children with atopic dermatitis fall asleep faster."

The link between the skin condition and insufficient sleep "has an impact on people with eczema at all ages," said Dr. Lawrence Eichenfield, chief of pediatric and adolescent dermatology at the University of California, San Diego and Rady Children's Hospital.

According to Eichenfield, it's generally established that it’s the itching that keeps people with eczema from getting enough sleep. However, Chang said that may not be the case.

Chang and colleagues discovered that patients with eczema, that had difficulty sleeping, had low levels of nocturnal melatonin. That intrigued Chang and inspired the new study.

"Melatonin is a natural human hormone with minimal adverse effects," Chang said, "so it seemed like a good choice for children."

The study was small and involved 48 children, about 22 months to 18 years old, who had eczema. The children received treatment with either an inactive placebo or a 3-milligram daily dose of melatonin at bedtime for four weeks. Thirty-eight participants then took the alternate treatment (melatonin or placebo) for another four weeks.

When the children took melatonin, the severity of eczema dipped slightly, possibly because melatonin's anti-inflammatory effect improved the skin condition, Chang said.

Also, kids taking melatonin fell asleep about 21 minutes sooner than kids taking the placebo, the findings showed.

Total nightly sleep rose by 10 minutes on average (from 380 to 390 minutes, or 6.5 hours total) in the melatonin group, while it fell by 20 minutes among those who took a placebo, according to the report.

The participants did not report any side effects. Melatonin supplements are inexpensive in the U.S.- typically under 9 cents a pill from one major supplier.

Eichenfield, who wasn't involved in the research, said the study appears to be well-designed. Melatonin hasn't been studied much as a sleep treatment for kids, he cautioned.

While Eichenfield said melatonin may turn out to be helpful, he said there are a broad set of other tools available to treat eczema and minimize its effect on children. He suggested tackling the skin condition first to try to mitigate the sleep issues.

Chang recommended that parents talk to their child's doctor before starting melatonin. As for adults, melatonin may help them, too. But more studies are needed, Chang said.

The study was published in a November online edition of the journal JAMA Pediatrics.

Source: Randy Dotinga, http://www.webmd.com/children/news/20151124/melatonin-might-help-sleepless-kids-with-eczema-study-finds

 

Your Child

The Eczema, Allergies and Asthma March

1:45

Eczema refers to a number of different skin conditions in which the skin becomes red and irritated and sometimes has small, fluid filled bumps that ooze.

The most common cause of eczema is atopic dermatitis (sometimes called infantile eczema), which affects older kids as well as infants.

Children with eczema may eventually get food allergies, hay fever, or asthma. But you can take steps to soothe the itch and possibly cut the risk of allergies.

While most experts don't think eczema is purely allergic, it's clearly connected to allergic conditions like food allergies, hay fever, and asthma.

·      Up to 80% of kids with eczema get hay fever or asthma later in childhood.

·       35% of adults with asthma or nasal allergies had eczema as kids.

·      If a mom has allergies, there's almost a 1 in 3 chance that her baby will have eczema.

·      37% of kids with moderate to severe eczema also have food allergies.

For some kids, eczema and allergies develop in a specific order, as they get older. It starts with eczema, then food allergies, then asthma, and then hay fever. It's called the allergic march.

But just because your child has eczema doesn't mean they'll get these other conditions. It just means there's a higher risk.

There are several things that can increase a child’s risk of being part of the allergic march.  Kids who get eczema at a young age may be more likely to have allergies or asthma later. Kids with worse eczema symptoms may be more likely to get allergies or asthma.

You can do some things that might lower your child's chances of worsening eczema, asthma, or allergies. The evidence isn't clear, so talk to your doctor or your child's pediatrician. Depending on the situation, the doctor might recommend:

Breastfeeding your baby: It might lower the risk of eczema, later allergies, or asthma.

Diet changes: If your baby has a high risk of allergic problems, some doctors recommend changes in diet. Breastfeeding for at least 4 months can help protect your child. “Hydrolyzed” formula might help protect formula-fed babies.

Other ways to keep your child's eczema under control include:

Get allergy testing. If you can pin the problem on a specific allergen, you can figure out ways to avoid it.

Use a moisturizer. Go for thick creams and ointments that stop the skin from drying out.

Keep fingernails short. Your child will do less damage to the skin from scratching.

Avoid irritants. Always use unscented soap and laundry detergent. Stay away from cigarette smoke.

Watch for problems. If your child's eczema seems to be getting worse -- or if they get allergy symptoms, like congestion or a runny nose -- see a doctor. The sooner you get treatment, the sooner your child will feel better.

In many cases, eczema goes into remission and symptoms may disappear altogether for months or even years.

For many kids, it begins to improve by the age of 5 or 6; others may have flare-ups throughout adolescence and early adulthood.

In some kids, the condition may improve but then restart as they enter puberty, when hormones, stress, and irritating skin products or cosmetics are introduced. Some people will have some degree of dermatitis into adulthood, with areas of itching and a dry, scaly appearance.

Eczema is not contagious, so there's no need to keep a baby or child who has it away from siblings, other kids, or anyone else.

Story sources; http://www.webmd.com/skin-problems-and-treatments/eczema/child-eczema-14/allergies?ecd=wnl_prg_050116&ctr=wnl-prg-050116_nsl-promo-4_title&mb=HJinmVxrQQBBWXaWABbkR%40HnVev1imbCiW2HnNaB9FE%3d

http://kidshealth.org/en/parents/eczema-atopic-dermatitis.html#

 

 

 

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!

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DR SUE'S DAILY DOSE

Why naps are so important for growing children.

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