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Your Baby

Special Baby Formulas Don’t Prevent Asthma, Allergies

2:00

Parents that have a baby at risk or allergies, asthma or type-1 Diabetes sometimes turn to hydrolyzed milk formulas in hopes of lowering their infant’s risk of developing these problems.

A new review of the data on hydrolyzed formulas finds that there is no evidence that they actually protect children from these types of autoimmune disorders.

"We found no consistent evidence to support a protective role for partially or extensively hydrolyzed formula," concluded a team led by Robert Boyle of Imperial College London in England.

"Our findings conflict with current international guidelines, in which hydrolyzed formula is widely recommended for young formula-fed infants with a family history of allergic disease," the study authors added.

In the study, Boyle's team looked at data from 37 studies that together included more than 19,000 participants and were conducted between 1946 and 2015.

The investigators found that infants who received hydrolyzed cow's milk formula did not have a lower risk of asthma, allergies (such as eczema, hay fever, food allergies) or type 1 diabetes compared to those who received human breast milk or a standard cow's milk formula.

The researchers also found no evidence to support an FDA-approved claim that a partially hydrolyzed formula could reduce the risk of the skin disorder eczema, or another conclusion that hydrolyzed formula could prevent an allergy to cow's milk.

Other experts in the United States said that the finding casts doubt on the usefulness of these kinds of specialized products.

"Allergies and autoimmune diseases [such as asthma, and type 1 diabetes] are on the rise and it would be nice if we did have a clear route to preventing them," said Dr. Ron Marino, associate chair of pediatrics at Winthrop-University Hospital in Mineola, N.Y.

"Unfortunately, despite U.S. Food and Drug Administration support [for hydrolyzed formula], the data are not compelling," he said.

Dr. Punita Ponda is assistant chief of allergy and immunology at Northwell Health in Great Neck, N.Y. She stressed that when it comes to infant feeding, breast milk is by far the healthiest option.

However, "current mainstream guidelines for infant formula do recommend that parents consider using hypoallergenic formula if a close family member -- like an older brother or sister -- has a food allergy," she said. That was based on prior studies supporting some kind of protective effect, Ponda said.

Protein hydrolysate formulas were first introduced in the 1940s for babies who could not tolerate the milk protein in cow’s milk.

Protein hydrolyzed formulas are formulas composed of proteins that are partially broken down or “hydrolyzed.” They are also called hydrolysates.

There are two broad categories of protein hydrolysates:

•       Partially hydrolyzed formulas (pHF)

•       Extensively hydrolyzed formulas (eHF)

Both partially and extensively hydrolyzed protein formulas are based on casein or whey, which are proteins found in milk.  

Hydrolyzed formulas have had the protein chains broken down into shorter and more easy-to -digest chains. The more extensively hydrolyzed the formula, the fewer potentially allergenic compounds remain.

Hydrolyzed formulas are also more expensive than regular cow’s milk formulas and often harder to find.

The researchers review was published March 08, 2016 in the BMJ.

Story sources: Robert Preidt, http://www.webmd.com/parenting/baby/news/20160308/special-infant-formulas-dont-shield-against-asthma-allergies-study

Victoria Groce, http://foodallergies.about.com/od/adultfoodallergies/p/hypoallergenic.htm

 

Your Baby

Updated Safety Guidelines for Infant Sleeping

2:00

Elaborate beddings and plush accessories may look stylish and cute in a newborn nursery however, pediatricians know that these things should never be part of a baby’s sleeping environment. Getting new parents to understand why this type of bedding can be dangerous for babies is one of the reasons that the American Academy of Pediatrics (AAP) has updated and issued new safety guidelines.

Nineteen evidence-based recommendations aimed at protecting infants up to 1 year of age are featured in SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, an AAP policy statement and technical report from the Task Force on Sudden Infant Death Syndrome.

Safe sleep recommendations include placing infants on their backs to sleep; using a firm sleep surface; room sharing without bed sharing; avoiding exposure to smoke, alcohol and illicit drugs; breastfeeding; routine immunization; and using a pacifier.

Every year, about 3,500 infants die from sleep-related deaths. Soon after the “Back to Sleep” campaign debuted in 1994, the SIDS rate declined, but it has leveled off in recent years. Ninety percent of cases occur before an infant turns 6 months of age, with peak incidence between 1 and 4 months.

Most parents know the importance of placing babies on their backs to sleep; the focus now is on the total sleep environment.

“I think the back-to-sleep message has gotten out loud and clear,” said Rachel Y. Moon, M.D., FAAP, lead author of the statements and chair of the task force. “When you ask parents, almost every parent knows — whether they are doing it or not is a different thing. We have been less successful at getting people to not sleep with their babies … and much less successful in getting the soft bedding away from babies.”

The dangers of bed-sharing and soft bedding are two problems that Moon says are often misunderstood.

“For the soft bedding, everybody thinks if it’s soft, then it can’t hurt the baby. But soft bedding is actually really a problem because it’s so soft they sink into it. People will often use pillows to ‘cushion’ the babies, and babies sink into them. …That’s very dangerous.”

It’s similar with bed-sharing, she said. “Some parents also think if baby is right next to them, they can tell if there is a problem … and protect the baby,” Moon noted.

A simple ABC formula can help remind new parents and caregivers of safe sleeping actions.

Michael H. Goldstein, M.D., FAAP, a neonatologist and task force member, lays out the “ABCs”:

 A for the baby sleeping alone

for back sleeping

C for sleeping in an uncluttered crib (or play-yard or bassinet)

“Outside of these, one of the biggest things I would really like to see people take away from the updated recommendations is that no matter what, babies should never sleep on a couch, especially with another person,” Dr. Goldstein said. Babies can get wedged between the adult and the cushions.

Other messages in the guidelines deal with sleeping with an infant, swaddling, breastfeeding and pacifiers.

Breastfeeding, along with the use of a pacifier after breastfeeding is established, also is a key recommendation. “We don’t know if people realize that (by breastfeeding) you reduce the risk of SIDS about 50%,” Dr. Goldstein said.

Parents also are advised to be vigilant about environments out of the home. A study in the November issue of Pediatrics found out-of-home settings are more likely to have certain risk factors for sleep-related deaths, including level placement for sleep and location in a stroller or car seat instead of a crib or bassinet

One of the most important milestones for parents and caregivers is when baby sleeps through the night However, it’s normal and appropriate for newborns to wake up a couple of times during the night, especially if breastfeeding, said Dr. Goldstein. Babies will eventually sleep through the night, but not till their little bodies are ready.

Below are the 2016 infant sleep recommendations for parents, caregivers, researchers, pediatricians and media outlets:

1. Place infants on their back to sleep for every sleep period until they are 1 year old. This position does not increase the risk of choking and aspiration.

2. Use a firm sleep surface.

3. Breastfeeding is recommended.

4. Infants should sleep in the parents’ room, close to the parents’ bed but on a separate surface designed for infants, ideally for the first year, but at least for the first six months.

5. Keep soft objects and loose bedding out of the infant’s sleep area.

6. Consider offering a pacifier at naptime and bedtime.

7. Avoid smoke exposures during pregnancy and after birth.

8. Avoid alcohol and illicit drug use during pregnancy and after birth.

9. Avoid overheating and head covering in infants.

10. Pregnant women should obtain regular prenatal care.

11. Infants should be immunized according to the recommended schedule.

12. Avoid using commercial devices that are inconsistent with safe sleep recommendations, such as wedges and positioners.

13. Don’t use home cardiorespiratory monitors as a strategy to reduce SIDS risk. 

14. Supervised tummy time while the infant is awake can help development and minimize positional Plagiocephal (flat head syndrome).

15. There is no evidence to recommend swaddling to reduce the risk of SIDS.

16. Health care professionals and staff in newborn nurseries and neonatal intensive care units as well as child-care providers should endorse and model recommendations to reduce SIDS risk.

17. Media and manufacturers should follow safe sleep guidelines in messaging and advertising.

18. Continue the Safe to Sleep campaign, focusing on ways to further reduce sleep-related deaths.

19. Research and surveillance should continue on all risk factors.

Parents and caregivers can find more information about the “Safe to Sleep” program at: http://www.healthychildcare.org/pdf/sidsparentsafesleep.pdf

Story source: Alyson Sulaski Wyckoff, http://www.aappublications.org/news/2016/10/24/SIDS102416

Your Baby

Recall: Otteroo Baby Floats Due to Drowning Risks

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Babies and young children can drown in less than 2 inches of water.  That’s why it is  vital that parents and caregivers never leave a baby or young child unattended while they are near or in water.

When bathing their infant, parents will sometimes attach a bath float to their child to help keep his or her head above water. While the float may offer some assistance, critics warn that the device can give parents a false sense of security that their child is protected from drowning.

Otteroo Corporation makes inflatable baby floats that are specifically designed for babies 8 weeks and up.

The company is recalling about 3000 units of their inflatable Baby Floats after receiving 54 reports of broken seems on the product. No injuries have been reported.

The Otteroo Inflatable Baby Float is an inflatable round ring made of clear and blue plastic material. It has two air chambers that fasten around a baby’s neck with a white buckle. The floats have a chin rest, two handles and two circular openings on the back of the ring to allow the device to expand as the child grows with age. There are three colorful balls that move freely around inside the ring.  The name “Otteroo” is imprinted on the top of the float in large, orange letters with an Otter logo.

Consumers should immediately stop using the recalled inflatable baby floats and contact the firm to receive a free replacement.

The floats were sold online at Otteroo.com and Amazon.com and Zulily.com from January 2014 through July 2014 for about $35.

Consumers can contact Otteroo Corporation at (415) 236-5388 from 9 a.m. to 5 p.m. PT Monday through Friday or online www.otteroo.com and click on “Safety” at the bottom of the page for more information.

According to their website, Otteroo is offering a free replacement for those who purchased the product manufactured in 2014 (NO: 002013001).

Sources: http://www.cpsc.gov/en/Recalls/Recall-Alerts/2015/Otteroo-Corp-Recalls-Inflatable-Baby-Floats/

http://otteroo.com/pages/safety-info

Your Baby

Antibiotics Not Effective for Mild Eczema in Kids

2:00

As many as 10 percent of all infants have some form of eczema, a condition that usually develops between the ages of 2 and 6 months, and almost always before the age of 5 years old. Kids with eczema usually develop itchy, dry, red skin with small bumps on their cheeks, forehead or scalp. The rash may spread to the arms and legs and the trunk, and red, crusted, or open lesions may appear on any area affected.

They also may have circular, slightly raised, itchy, and scaly rashes in the bends of the elbows, behind the knees, or on the backs of the wrists and ankles.

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.

Antibiotics are often prescribed as a treatment, but a new study says that they are not effective for milder cases in children.

"This is a good example of a common situation in medicine," said Dr. Michael Grosso. "A particular intervention 'makes sense,' becomes common practice -- and often becomes the so-called 'standard of care' -- only to be proved ineffective when the therapy is subjected to scientific investigation."

Eczema is an immunological condition affecting both children and adults.

Dr. Craig Osleeb explained, "Children with eczema have an overabundance of the bacteria normally found on skin." He is a pediatric allergist at Northern Westchester Hospital in Mount Kisco, N.Y.

"The excessive colonization of bacteria can exacerbate symptoms by causing infection and/or triggering inflammation," Osleeb said. So, "antibiotics have often been used to quell eczema exacerbations."

Doctors are concerned that, over time, bacteria can develop a resistance to antibiotics, opening the door for dangerous drug-resistant “superbug” infections. While once a very popular treatment, doctors are now leaning towards reducing the number of antibiotic prescriptions to treat certain cases.

The new study, led by Nick Francis of Cardiff University in Wales, included 113 children with non-severe, infected eczema who were randomly selected to join one of three groups.

The children received either an antibiotic pill plus a "dummy" placebo cream; a placebo pill and an antibiotic cream; or placebo pill plus placebo cream (the "control" group).

After watching outcomes for two weeks, four weeks and then three months, the British team found no significant differences between the three groups in terms of easing of eczema symptoms.

Researchers found that the children with non-severe eczema, given the antibiotics either in a pill or a cream, did not benefit from the treatment. The study authors added that such use might even promote antibiotic resistance or additional skin sensitization.

Francis and his team noted that the study focused only on kids with a milder form of eczema, so the results may not apply to children with more infected eczema.

Osleeb agreed. For children battling milder eczema outbreaks, "corticosteroid creams alone will suffice," he said, but "this study does not eliminate the potential role of antibiotics in more moderate to severe eczema exacerbations."

Diagnosing eczema can be challenging because each child has a unique combination of symptoms, which can vary in severity. Treatments can consist of topical corticosteroid creams, antihistamines and in some instances, ultraviolet light under the supervision of a dermatologist.

Some children will outgrow eczema and some may continue to have symptoms during their teens and into adulthood.

If you suspect your baby or young child may have eczema, have your child seen by your pediatrician for diagnosis and treatment options.

Story sources: Robert Preidt, https://consumer.healthday.com/diseases-and-conditions-information-37/eczema-news-618/skip-the-antibiotics-for-mild-eczema-in-kids-720482.html

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

Your Baby

Preventing Peanut Allergies in High-Risk Children

2:00

New research suggests that, under clinical supervision, children that are at a high risk for developing a peanut allergy can build a lasting tolerance to the legume.

Children that participated in the new study were fed peanuts for years as part of a supervised clinical trial. Now, the researchers are reporting that those youngsters maintained their tolerance for at least a year, even if they didn't keep eating peanuts.

"The therapy persisted, and after 12 months of avoidance there was no increase in the rates of peanut allergy. They maintained their ability to tolerate peanuts, even though they hadn't been eating it," said Dr. Sherry Farzan, an allergist with Northwell Health in Great Neck, N.Y. Farzan wasn't involved in the research.

This suggests that the immune system "learns" that peanut is not a threat to the body, and kids won't have to keep eating peanuts for the rest of their lives to maintain their tolerance, said Dr. Scott Sicherer. He's a pediatric allergy specialist at Mount Sinai Hospital in New York City. Sicherer also wasn't part of the current study.

This study is an extension of the groundbreaking LEAP (Learning Early about Peanut Allergy) clinical trial. Last year, that trial found that feeding peanuts to at-risk babies for 60 months reduced their risk of developing a peanut allergy. The study determined an infant's risk of peanut allergy using an allergy skin test.

Before the original LEAP study results, physicians told parents to avoid exposing their child to allergic foods until they were older and their immune system were more developed.

But the LEAP trial found that exposing at-risk kids to peanuts regularly beginning in infancy actually prevented peanut allergies by the time they reached age 5, Sicherer said. Eating peanuts lowered the rate of peanut allergy by 80 percent in the now-preschoolers, according to the study authors.

"For this high-risk group, waiting longer and longer to eat peanut isn't good," Sicherer said. "It's better to get it into your diet as soon as possible."

Both Farzan and Sicherer warned that this type of preventive strategy should only be given under a doctor’s supervision.

And, this prevention therapy is only for kids at risk of peanut allergy, not for kids who already have developed the allergy, Sicherer warned.

"If you have someone who already had a peanut allergy and gave them peanuts, then they'd get sick and maybe end up in an emergency room," he said.

After the initial study, researchers wanted to know if the children who were successful at building a tolerance to peanuts would have to eat them regularly for the rest of their lives.

To answer this question, the researchers followed more than 500 of the original 640 children for a one-year period of peanut avoidance. Half of this group included previous peanut consumers. The other half had always avoided peanuts.

 

After 12 months of peanut avoidance, only 5 percent of the original peanut consumers were found to be allergic, compared to 19 percent of the original peanut avoiders, the findings showed.

"This study offers reassurance that eating peanut-containing foods as part of a normal diet -- with occasional periods of time without peanut -- will be a safe practice for most children following successful tolerance therapy," said Dr. Gerald Nepom. He is director of the Immune Tolerance Network (ITN), the consortium behind the LEAP trial.

"The immune system appears to remember and sustain its tolerant state, even without continuous regular exposure to peanuts," he added in an ITN news release.

Farzan said there appears to be a "critical period" between 4 and 11 months where "we can push the immune system around a little."

Farzan and Sicherer both said that by the time kids reach age 5, the immune system appears to have accepted that peanuts aren't a danger to the body.

"After following this pattern, it may not be that important anymore, at least after age 5, to worry if someone isn't keeping up," Sicherer said. "It may not be necessary to keep up with such consistent ingestion."

According to the John Hopkins Bloomberg School of Public health, food allergies affect between 2 and 10 percent of U.S. children. Peanut allergy is considered the most fatal food allergy. 

The LEAP study, and now with the results from its extended research, may offer a new generation of children a chance at preventing this problematic allergy altogether.

Story source: HealthDay reporter Dennis Thompson, http://www.webmd.com/allergies/news/20160304/supervised-exposure-therapy-for-peanut-allergy-lasts-study-finds

 

Daily Dose

Mandatory Newborn Screenings

Newborn screenings vary state to state, however, this is currently under review by the federal governement.As you know, if you have had a baby, all babies undergo routine newborn screening for multiple metabolic disorders. The initial newborn screening test is performed on a heelstick blood sample in the first 24-48 hours after a baby’s birth and then the baby is typically re-screened after about 1-2 weeks as some of the metabolic  disorders are only detected after a baby has been on milk (breast or formula) for a while.

The use of newborn screening tests is not federally mandated, but varies from state to state.  In most cases states screen for somewhere between 25 – 30 tests routinely.  There is a push for these newborn screening tests to become universally  mandated  so that all states would be screening for the same diseases.  For instance, the state of Texas now screens for 29 diseases with the addition of screening for cystic fibrosis in December of 2009. There is an committee, the Secretary’s Advisory Committee for Heritable Disorders in Newborns and Children (ACHDNC) that reviews requests from individuals or organizations to nominate a heritable disorder to be considered by the ACHDNC for inclusion in the recommended uniform screening panel.  The advisory committee adopted a list of 29 recommended conditions for inclusion to the uniform screening panel in September of 2005. At the end of January of this year the panel recommended to add severe combined immunodeficiency (SCID) to the uniform newborn screening panel. This is the first addition since 2005. While the newborn screen looks at diseases  that you may know more about such as thyroid disease, adrenal insufficiency, sickle cell disease and PKU (the initial screening test developed in the 1960’s) there are other less known diseases that may be screened for.  There were several diseases that the committee considered for inclusion, but SCID was the only disease that was recommended for inclusion.  SCID affects somewhere  between 1 in 100,000 to 1 in 40,000 newborns. This group of disorders is characterized by the absence of an immune system which results in recurrent infections which may be life threatening if not treated in the first months of life. So, when you have a new baby, check to see which metabolic diseases your state is screening for.  It does seem incongruous to me that a baby born in Florida may not be screened for the same diseases as a baby born in New York or Nebraska. A universal test seems to make sense so that ALL babies are treated equally and parents are not confused as to which disease process their baby has been screened for.  A baby’s possible life threatening disease should not be screened differently based upon the state they live in! That's your daily dose for today.  We'll chat again soon.

Your Baby

Infant Ear Infections Declining

2:00

Ear infections in infants are very common and can be quite unsettling for parents. The good news is that ear infections among U.S. babies are declining according to a new study.

Researchers found that 46 percent of babies followed between 2008 and 2014 had a middle ear infection by the time they were 1 year old. While that percentage may seem high, it was lower when compared against U.S. studies from the 1980s and '90s, the researchers added. Back then, around 60 percent of babies had suffered an ear infection by their first birthday, the study authors said.

The decline is not surprising, according to lead researcher Dr. Tasnee Chonmaitree, a professor of pediatrics at the University of Texas Medical Branch, in Galveston.

"This is what we anticipated," she said.

That's in large part because of a vaccine that's been available in recent years: the pneumococcal conjugate vaccine, Chonmaitree said. The pneumococcal conjugate vaccine protects against several strains of pneumococcal bacteria, which can cause serious diseases like pneumonia, meningitis and bloodstream infections.

Those bacteria are also one of the major causes of children's middle ear infections, Chonmaitree said.

She added that flu shots, which are now recommended for children starting at 6 months, could be helping as well. Many times an ear infection will follow a viral infection such as the flu or a cold.

Vaccinations "could very well be one of the drivers" behind the decline in infant ear infections, agreed Dr. Joseph Bernstein, a pediatric otolaryngologist who wasn't involved in the study.

Other factors could be having a positive impact as well, such as rising rates of breast-feeding and a decrease in babies’ exposure to secondhand smoke.

"The data really do suggest that breast-feeding -- particularly exclusive breast-feeding in the first six months of life -- helps lower the risk of ear infections," said Bernstein, who is director of pediatric otolaryngology at the New York Eye and Ear Infirmary of Mount Sinai, in New York City.

There's also the fact that breast-fed babies are less likely to spend time drinking from a bottle while lying down, Bernstein noted. That position can make some infants more vulnerable to ear infections, he said.

The study findings were based on 367 babies followed during their first year of life. By the age of 3 months, 6 percent had been diagnosed with a middle ear infection; by the age of 12 months, that had risen 46 percent, researchers found.

Breast-fed babies had a lower ear infection risk, however. Those who'd been exclusively breast-fed for at least three months were 60 percent less likely to develop an ear infection in their first six months, the study showed.

But whether babies are breast-fed or not, they will benefit from routine vaccinations, Chonmaitree said. "Parents should make sure they're on schedule with the recommended vaccines," she said.

Parents can have a difficult time recognizing an ear infection in an infant or a child to young to tell them that their ear hurts.

Some symptoms to watch for are:

·      Tugging at the ear

·      Fever

·      Crying more than usual

·      Irritability

·      Child becomes more upset when lying down

·      Difficulty sleeping

·      Diminished appetite

·      Vomiting

·      Diarrhea

·      Pus or fluid draining from ear

Treatment for ear infections rarely requires medication, such as antibiotics, except when an infection is severe or in infants. 

According to the American Academy of Pediatrics (AAP), most children with middle ear infections get better without antibiotics, and doctors often recommend pain relievers -- like acetaminophen -- to start. But with babies, Bernstein said, antibiotics are often used right away.

The AAP recommends antibiotics for infants who are 6 months old or younger, and for older babies and toddlers who have moderate to severe ear pain.

The study was published online in the March edition of the journal Pediatrics.

Story source: Amy Norton, http://www.webmd.com/children/news/20160328/infant-ear-infections-becoming-less-common

Your Baby

Abusive Head Trauma in Babies, Toddlers Can Last a Lifetime

2:30

This is going to be a hard story to read, but don’t let that stop you. It’s difficult because it involves very young children who suffer head trauma because they are abused.   Sometimes, it’s an accident. Sometimes it’s because a parent or guardian loses control and angrily shakes an infant or toddler until brain damage occurs.  While you may never intentionally abuse your own child, you should know how to recognize the symptoms of an infant or toddler that has been shaken. That knowledge could save a child’s life or improve the quality of treatment they receive.

Half of children who experience a severe abusive head trauma before the age of 5 will die before they turn 21, according to a new study.

In addition, among those who survive severe injuries, quality of life will be cut in half, the study found.

What causes such terrible consequences? According to www.babycenter.com, when a caregiver shakes and injures a child, it's sometimes called shaken baby syndrome. Abusive head trauma (AHT) and shaken baby syndrome usually refer to the same thing.

When a child's head is shaken back and forth, his brain bumps against the skull, causing bruising, swelling, pressure, and bleeding in and around the brain. The impact often causes bleeding in the retina – the light-sensitive portion of the eye that transmits images to the brain.

A child with AHT may also have a damaged spinal cord or neck as well as bone fractures. The extent of the damage depends on how long and hard the child is shaken or how severe the blow to the head is. But in just seconds, a child can suffer severe, permanent damage or even death.

In the United States, "at least 4,500 children a year suffer preventable abusive head trauma," said lead researcher Ted Miller, of the Pacific Institute for Research and Evaluation, in Calverton, Md.

Among children with any abusive head trauma, including minor cases, one in three "will not survive to adulthood, and even the survivors will lose significant quality of life," Miller said.

For the study, the researchers surveyed parents, caregivers or pediatricians of 170 youngsters who survived an abusive head trauma to determine the victims' quality of life. The head traumas all occurred before the children were 5 years old. But, most -- about eight in 10 -- experienced the head trauma before they were 1 year old.

The majority  (71%) of the cases fell into the severe impact category. Moderate impact cases accounted for 13.5 percent and there were 16 percent that were listed as minor cases. 

Injuries caused by shaking a baby or toddler can be shocking. Almost one-quarter of children required a feeding tube, and 57 percent were blind or legally blind. Among the severe cases, 86 percent of the children lost their sight or needed corrective eye surgery, the report indicated.

"This article is a devastating reminder of how serious shaken baby syndrome is and how fragile these little ones are," said Linda Spears, vice president of policy and programs at Child Welfare League of America. She said children under 5 are much more likely to die due to abuse and neglect for several reasons.

"One is fragility of their little bodies, and another is that they have less ability to protect themselves," she said. "They're also less visible in the community because they rely on the people who abuse them. They're not in school yet and not seen in the community as much as older children."

Frustration is often the cause for shaking a baby. Parents can feel overwhelmed when their infant or toddler doesn’t stop crying. Potty training time is another trigger for some parents or guardians the study notes.

Parents of small children need a support system to help them through the rough times. Without one, things can get out of hand quickly.

"Shaken baby is one of the more devastating things that happen when people don't have what they need in terms of knowledge, skills, emotional maturity, concrete services and emotional support." Spears said.

She explained that "people feel incredibly inadequate in those moments, and if you have little support and little mentoring, frustration levels can get pretty high pretty quickly because parents feel upset and angry and need to feel like they can manage the situation."

The most common signs of abusive head trauma in an infant or young child are:

•       The child is not eating or is having difficulty feeding 

•       The child’s body is rigid; stiff, not flexible or feels firmly fixed.

•       The child’s eyes are glassy looking. They show no expression.

•       The child is unable to lift their head.

•       The child’s eyes are unable to focus on an object.

•       Vomiting

•       The child is lethargic.

•       The child seems constantly irritated.

In a second study, researchers tested the accuracy of a new screening method to identify which children's injuries were most likely caused by abuse.

By assessing four specific types of injuries to almost 300 children under 3 years old, the researchers determined that the method was approximately 96 percent accurate at identifying cases that were definitely caused by abusive head trauma.

Spears said providing education and support to parents, especially younger parents, is effective at preventing abusive head trauma and other forms of abuse, but it is a matter of identifying those families and getting them the support they need.

What should you do if you suspect a baby has been shaken in this way? Miller said you should report it to law enforcement or child protective services. Parents of children who may have been shaken, he said, should take their children to the emergency room, where immediate treatment may improve their long-term outcomes.

Both studies have been published in the journal Pediatrics. The newest study is in the online November issue.

Sources: Tara Haelle, http://consumer.healthday.com/head-and-neck-information-17/head-injury-news-344/abusive-head-trauma-in-babies-toddlers-can-have-lifelong-impact-693746.html

Karen Miles, http://www.babycenter.com/0_abusive-head-trauma-shaken-baby-syndrome_1501729.bc

Your Baby

Half of U.S. Parents Using Unsafe Bedding for Infants

2:00

Parents are getting better about using loose bedding and leaving soft objects in their baby’s bed, but about half of U.S. infants are still sleeping with potentially hazardous bedding according to a new study.

Blankets, quilts and pillows can obstruct an infant’s airway and pose a suffocation risk according to the American Academy of Pediatrics (AAP).  This type of bedding is a recognized risk factor for sudden infant death syndrome (SIDS).

The researchers investigated bedding use from 1993 to 2010 from the National Infant Sleep Position study.

They found that from 1993 to 2010, bedding use declined, but remained a common practice. The rate of bedding use averaged nearly 86 percent in 1993-1995, and declined to 55 percent in 2008-2010. Prevalence was highest for infants of teen mothers (83.5 percent) and lowest for infants born at term (55.6 percent). Researchers also found that bedding use was highest among infants who were sleeping in adult beds, placed to sleep on their sides, or shared a sleep surface.

AAP recommends that the best place for a baby to sleep is in the same room as his or her parents and always in a crib, not in the same bed. The crib should be free from toys, soft bedding, blankets, and pillows.

Other safe sleep practices are:

•       Place your baby on a firm mattress, covered by a fitted sheet that meets current safety standards. For more about crib safety standards, visit the Consumer Product Safety Commission’s Web site at http://www.cpsc.gov.

•       Place the crib in an area that is always smoke-free.

•       Don’t place babies to sleep on adult beds, chairs, sofas, waterbeds, pillows, or cushions.

•       Toys and other soft bedding, including fluffy blankets, comforters, pillows, stuffed animals, bumper pads, and wedges should not be placed in the crib with the baby. Loose bedding, such as sheets and blankets, should not be used as these items can impair the infant’s ability to breathe if they are close to his face. Sleep clothing, such as sleepers, sleep sacks, and wearable blankets are better alternatives to blankets.

•       Place babies to sleep on their backs to reduce the risk of SIDS. Side sleeping is not as safe as back sleeping and is not advised. Babies sleep comfortably on their backs, and no special equipment or extra money is needed.

•       “Tummy time” is playtime when infants are awake and placed on their tummies while someone is watching them. Have tummy time to allow babies to develop normally.

•       Remove mobiles when your baby is able to sit up.

Study authors conclude that while the numbers have improved significantly, infants are still being put to bed in an unsafe sleeping environment; about half still sleep with blankets, quilts, pillows, and other hazardous items.

It’s not unusual that many parents may not be aware of the dangers of blankets, pillows and quilts in a baby’s bed. Lots of people were raised with all these items in the bed, but that was also before scientists began to understand SIDS better and the possible causes. True, many babies did fine before these alerts and safety suggestions became more popular but a lot of children also died – we just didn’t know why.  Parents today are able to access better infant safety information than their own parents.

The study, “Trends in Infant Bedding Use: National Infant Sleep Position Study 1993-2010” was published in the January issue of the journal Pediatrics.

Source: http://www.healthychildren.org/English/News/Pages/Study-Shows-One-Half-of-US-Infants-Sleep-in-Potentially-Hazardous-Bedding.aspx

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