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Your Baby

Should Newborns Sleep in Yours or Their Own Room?

2:00

It’s an age-old question, should your newborn sleep in his or her own bed in the parents’ bedroom for a while or start their sleeping habits in their own room?

A new study suggests infants benefit from sleeping in their own room, but the American Academy of Pediatrics (AAP) says the dangers may offset the benefit.

Recent research from a hospital in Philadelphia says babies go to sleep earlier, take less time to fall asleep, get more total sleep over the course of 24 hours, and spend more time asleep at night when they don’t share a bedroom with their parents. Parents also report that they get more rest as well.

“There are a number of possible reasons that babies sleep better in their own room,” said lead study author Jodi Mindell, associate director of the Sleep Center at the Children’s Hospital of Philadelphia. 

“One main reason is that they are more likely to self-soothe to sleep,” Mindell said by email.

During the study, researchers found that parents who put babies to sleep in a separate room were less likely to feed infants to help them fall asleep at bedtime or when they awoke during the night.

When babies had their own rooms, parents also perceived bedtime to be less difficult.

The study focused on infants 6 to 12 months old. Researchers examined data from a questionnaire completed by parents of 6,236 infants in the U.S. and 3,798 babies in an international sample from Australia, Brazil, Canada, Great Britain and New Zealand. All participants were users of a publicly available smartphone app for baby sleep. The researchers noted that because of the use of the smartphone app, results might not be the same for a larger population of households.

The AAP recommends that newborns sleep in their own bed in their parents’ bedroom till the infant is at least 6 months of age to minimize the risk of sleep-related death. Ideally, babies should stay in their parents’ rooms at night for a full year, AAP advised 

The reason for the AAP recommendation is because babies sleeping in the same room as parents, but not the same bed, may have a lower risk of sudden infant death syndrome (SIDS).

The safest spot for infant sleep is on a firm surface such as a crib or bassinet without any soft bedding, bumpers or pillows, the guidelines stressed. 

“Pediatric providers have been struggling with what to tell parents since the release of the AAP recommendations,” Mindell said. “Once a baby is past the risk of SIDS, by 6 months of age, parents need to decide what works best for them and their family, which enables everyone in the family to get the sleep they need.”

SIDS deaths occur most often from birth to six months but can also happen in older babies that were the focus on the study, said Dr. Lori Feldman-Winter, a coauthor of the AAP guidelines and pediatrics researcher at Cooper Medical School of Rowan University in Camden, New Jersey. 

“If the only goal is to increase sleep, then the results may be compelling,” Feldman-Winter said in an email to Reuters Health. “However, since we don’t know the causes of SIDS and evidence supports room sharing as a method to decrease SIDS, giving up some sleep may be worth it.”

The study was published online in the journal Sleep Medicine.

Story source: https://www.reuters.com/article/us-sleep-infants-location/parents-find-older-babies-sleep-better-in-their-own-room-idUSKCN1BC5QI

 

Daily Dose

A Little TLC Goes A Long Way

Just what is TLC and how can it help your child feel better quicker?I can tell that I am aging!!  Not by the new “character lines” I see popping up (hate that), but rather by the way that language and jargon continues to change. I really have tried to stay up with new acronyms such as LOL, or POS, or even “keep it on the DL”.

But while we “mature” adults feel the need to keep up with the younger generation’s “language”, some of the older acronyms seem to be fading away.  I realized this today when I was seeing a young patient and his mother. The cute little 5 year old boy had one of those nasty winter time viruses with a fever and a cough. After finishing his exam and doing an influenza test on him (it was negative) I told the mom that the best way to treat his virus was with fever control and a little TLC.  She gave me this blank look and said, “is that a brand of cough syrup?”  I didn’t know whether to laugh or to cry. I thought that TLC was a universal acronym for all mothers (or maybe better put for parents) as even my own parents and grandparents would say, “you just need a little TLC”. For those of you who have read this far and still don’t know what I am talking about, TLC is the acronym for “tender loving care”.  What better way to treat your feverish, coughing, uncomfortable child, than with a little TLC. When my own children are sick, even now that they don’t all live at home, they still all want some TLC.  As much of a rule follower that I am, when your child is sick, the rules get broken for a while. That means that children get to sleep in their parent’s beds (I often moved after a few wild kicks and thrashing), but one parent remained with the feverish child sleeping next to mom or dad. There were all sorts of “forbidden fruits” given to a child who was sick, such as “slurpees”, ice cream and popsicles in bed, favorite foods all day long and even television without a  time limit. The homework might not get finished due to a fever and general “feel bads”, and the list of things to do just went away for a few days while a child was sick.  It was one of those lovely parenting moments when you could just “turn off the time” and snuggle with a sick child. In other words, lots of TLC. TLC has nursed many a child through numerous illnesses over the years.  I don’t think the directions for TLC have changed.  Just do anything that makes your child feel better. Games in bed, making cookies and jello to eat after an afternoon nap, and even getting to have a special TV tray to use while eating chicken noodle soup.  These “comfort foods” and pampering do make anyone who is sick feel a little bit better.  There are even studies to confirm this. So, remember TLC is not a new fancy cough syrup. It is the “tender loving care” a parent gives to a sick child. Some things never change with time and TLC is one of them.  Best of all, no need for a prescription or a copay! That’s your daily dose for today.  What’s your favorite TLC remedy for your kids? Comment below to share with all of us!

Daily Dose

Bump on Your Child's Leg?

1:15 to read

I recently saw a young adolescent patient who had noticed a “lump or bump” on her leg which she had noticed for some time and she had now wondered what it was. She said that she had initially thought she had bumped her leg,  but she had continued to watch it and noticed that it did not seem to be going away. So, after many months of watching it and wondering what it was she decided to come ask me.

On her exam she had a notable “bump” or mass on her lower leg, about the size of a half dollar. There was no surrounding bruising and the mass was non-tender. She told me it really did not bother her, and she was more concerned as she thought it was noticeable and a friend had asked her about the “bump”.  Other than cosmetic concerns, it did not cause any problem.

The most common reason for this bump is an osteochondroma, which is a benign bone tumor. The most common time to find this type of tumor is during periods of rapid growth during adolescence. They are usually found in the leg (femur, tibia) or the upper arm (humerus). 

So, I sent her for an x-ray which was compatible with the diagnosis of a benign osteochondroma. She then had a CT of the area which confirmed the diagnosis.  Most osteochondromas are solitary and the chance for malignant transformation is rare (less than 1%).  So, after discussing her case with a pediatric orthopedic surgeon it was decided to just watch it.  

She had mixed emotions about her diagnosis, as she was happy to know what caused the “bump” but was concerned that her friends would continue to ask her about it. Of course her parents were relieved to find out that it was benign and would likely never require any treatment.

We all decided to watch it for now…..as the tumor typically stops growing after an adolescent has completed their growth spurt and the growth plates of the bones are closed.  

Your Teen

Fewer Teens Having Sex, More Using Contraception

2:00

With the abundance of sexualized media directed at teens today, you might get the impression that they are constantly on the prowl to “hook up.” That’s not the case according to a new government study.

"The myth is that every kid in high school is having sex, and it's not true," noted Dr. Cora Breuner, a professor of pediatrics at Seattle Children's Hospital, who reviewed the findings. "It's less than half, and it's been less than half for more than 10 years," she said.

Sexual intercourse among teens has declined again after rates stabilized between 2002-2010, according to the National Center for Health Statistics report on teen sexual activity and contraceptive use released recently by the Centers for Disease Control and Prevention (CDC).

While the numbers aren’t exactly low enough to ease many parents’ minds, they are better than in previous years.

The study found that 42 percent of girls and 44 percent of boys - aged 15 to 19 - reported having sex at least once. That’s a huge decline from the peak of 1988 when 57 percent of teens between the ages of 15 and 19 reported having had sex.

And Breuner said that finding is nothing new. Going back to 2002, fewer than half of older teens told researchers that they are sexually active, federal data show.

Researchers also found that a higher percentage of teens having sex are involved in a relationship that is ongoing.

Three out of four girls participating in the study, said they were "going steady" with their first sexual partner, and a little more than half of the boys said the same. By comparison, only 2 percent of girls and 7 percent of boys said they lost their virginity to someone they just met.

"There's this myth that kids hook up quite a bit and have sex with someone they literally just met," Breuner said. "This dispels that myth, that our teenagers are having sex with people they don't know."

The statistics come from in-person interviews conducted with more than 4,000 teenagers across the United States between 2011 and 2015. Participation was voluntary and required parental permission, but responses were anonymous.

Today’s teens are more aware of and better educated about the dangers of sexually transmitted diseases such HIV and AIDS. Back in 1988, 51 percent of girls and 60 percent of boys between 15 and 19 said they were sexually active, but those numbers dropped to today's levels after word spread of a sexually transmitted disease that could kill, Breuner said.

Teens are also more concerned about the long-term consequences of pregnancy. Nine out of ten participants in the study said they use some form of birth control. Contraception is widely available now; particularly condoms and teens have better access to all forms of birth control than in decades before.  

At the same time, parents have become more at ease with talking about sex and making sure their teens engage in smart sex, Breuner added.

"Parents honestly to their credit were much more willing to talk about this with their teenagers and were more proactive in making sure they had access to contraceptives," she said.

The study was published in the June edition of the CDC’s National Health Statistics Report.

Story sources: Dennis Thompson, http://www.upi.com/Health_News/2017/06/22/Study-Most-US-teenagers-arent-having-sex/4041498137424/

Shamard Charles, M.D., http://www.nbcnews.com/health/kids-health/waiting-right-one-teens-having-sex-later-cdc-finds-n775236

 

 

Your Baby

Moms Getting Poor Advice on Baby’s Health Care

2:00

Moms are getting conflicting advice on infant and child care from family members, online searchers and even their family doctors a recent study found.

Oftentimes, that advice goes against the American Academy of Pediatrics (AAP) recommendations for topics such as breast-feeding, vaccines, pacifier use and infant-sleep, researchers say.

"In order for parents to make informed decisions about their baby's health and safety, it is important that they get information, and that the information is accurate," said the study's lead author, Dr. Staci Eisenberg, a pediatrician at Boston Medical Center.

"We know from prior studies that advice matters," Eisenberg said. Parents are more likely to follow the recommendations of medical professionals when they "receive appropriate advice from multiple sources, such as family and physicians," she added.

The researchers surveyed more than 1,000 U.S. mothers. Their children were between 2 months and 6 months old. Researchers asked the mothers what advice they had been given on a variety of topics, including vaccines, breastfeeding, pacifiers and infant sleep position and location.

Sources for information included medical professionals, family members, online searches and other media such as television shows. Mothers got the majority of their advice from doctors. However, some of that advice contradicted the recommendations from the AAP on these topics.

For example, as much as 15 percent of the advice mothers received from doctors on breast-feeding and on pacifiers didn't match recommendations. Similarly, 26 percent of advice about sleeping positions contradicted recommendations. And nearly 29 percent of mothers got misinformation on where babies should sleep, the study found.

"I don't think too many people will be shocked to learn that medical advice found online or on an episode of Dr. Oz might be very different from the recommendations of pediatric medical experts or even unsupported by legitimate evidence," said Dr. Clay Jones, a pediatrician specializing in newborn medicine at Newton-Wellesley Hospital in Massachusetts. He said inaccurate advice from some family members might not be surprising, too.

Mothers got advice from family members between 30 percent and 60 percent of the time, depending on the topic. More than 20 percent of the advice about breast-feeding from family members didn't match AAP recommendations.

Similarly, family advice related to pacifiers, where babies sleep and babies' sleep position went against the AAP recommendations two-thirds of the time, the study found.

"Families give inconsistent advice largely because they are not trained medical professionals and are basing their recommendations on personal anecdotal experience," Jones said.

Less than half of the mothers said they used media sources for advice except when it came to breastfeeding. Seventy percent reported their main source of advice on breastfeeding came from media sources; many of these sources were not consistent with AAP recommendations.

In addition, more than a quarter of the mothers who got advice about vaccines from the media received information that was not consistent with AAP recommendations.

"Mothers get inconsistent advice from the media, especially the Internet, because it is the Wild West with no regulation on content at all," Jones said.

The possible consequences of bad advice depend on the topic and the advice, Jones said.

"Not vaccinating your child against potentially life-threatening diseases like measles is an obvious example," he said. "Others may result in less risk of severe illness or injury but may still result in increased stress and anxiety, such as inappropriately demonizing the use of pacifiers while breast-feeding."

Mothers who look for information online should stick to sources such as the AAP, the American Academy of Family Physicians or the U.S. Centers for Disease Control and Prevention, Eisenberg suggested.

Even though some advice from doctors did not follow AAP recommendations entirely, Eisenberg and Jones agreed that doctors are the best source for mothers on the health and care of their children.

"While our findings suggest that there is room for improvement, we did find that health care providers were an important source of information, and the information was generally accurate," Eisenberg said. "But I would encourage parents to ask questions if they don't feel like their provider has been entirely clear, or if they have any questions about the recommendations."

The study was published in the July edition of the journal Pediatrics.

Source: Tara Haelle, http://www.webmd.com/parenting/baby/news/20150727/new-moms-often-get-poor-advice-on-baby-care-study

 

Your Child

FDA Warning: High Lead Levels in Herbal Remedy

2:00

The Food and Drug Administration is issuing a warning to parents and caregivers about high lead levels found in the herbal remedy, Balguti Kasaria Ayurvedic Medicine.

The herbal remedy is marketed for use in infants and children for various conditions such as rickets, cough and cold, worms, and teething. According to the product packaging, the product claims to help with digestion and bowel movement and improve the immune system.

The North Carolina Division of Public Health first reported high levels of lead after testing the product.

In addition, the Michigan Department of Health and Human Services notified the FDA that two children were found to have high levels of lead associated with the use of this product. The families of the children affected stated that they had the product mailed to them from India. At this time, the FDA has received one report of developmental delays in a child who was administered this product.   

Ayurvedic medicine is one of the world's oldest holistic healing systems. It was developed more than 3,000 years ago in India.

It’s based on the belief that health and wellness depend on a delicate balance between the mind, body, and spirit. Its main goal is to promote good health, not fight disease. But treatments may be geared toward specific health problems.

In the United States, it’s considered a form of complementary and alternative medicine (CAM).

Parents and caregivers should familiarize themselves with the symptoms of lead poisoning. High lead levels have also been found in toys, costume jewelry and other products that children use.

The symptoms are:

  • Developmental delay
  • Learning difficulties
  • Irritability
  • Loss of appetite
  • Weight loss
  • Sluggishness and fatigue
  • Abdominal pain
  • Vomiting
  • Constipation
  • Hearing loss
  • Seizures
  • Eating things, such as paint chips, that aren't food (pica)

Lead poisoning symptoms in newborns - Babies exposed to lead before birth might:

  • Be born prematurely
  • Have lower birth weight
  • Have slowed growth

The FDA is urging parents and caregivers to stop giving the product to children and to consult a healthcare professional. Balguti Kesaria is sold online and made by different companies, including Kesari Ayurvedic Pharmacy in India. The product has also been mailed or brought into the United States.

Story sources: Da Hee Han, PharmD, http://www.empr.com/safety-alerts-and-recalls/balguti-kesaria-ayurvedic-medicine-high-lead-levels/article/680132/

http://www.webmd.com/balance/guide/ayurvedic-treatments#1

http://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/dxc-20275054

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Teens and Alcohol

Teens & Alcohol: A Deadly Mix

Your Child

Teaching Kids About the Meaning of Memorial Day

2:00

For many kids, Memorial Day is just another three-day weekend celebrated with family bar-b-cues, a visit to the lake or pool, watching the latest action movie or any other of the numerous ways people spend the beginning of warm weather and a holiday. This year it falls on May 29th.

What is often lost in the celebrations is the meaning of Memorial Day and why it is an important reminder of sacrifice and service. Talking to your child about the history of Memorial Day and what it stands for can help them learn about the immeasurable cost of the freedoms they enjoy.

The preamble to Memorial Day was Decoration Day, established in 1868 – three years after the Civil War ended. The Grand Army of the Republic (GAR) — established Decoration Day as a time for the nation to decorate the graves of the war dead with flowers. Maj. Gen. John A. Logan declared that Decoration Day should be observed on May 30. It is believed that date was chosen because flowers would be in bloom all over the country.

The first large observance was held that year at Arlington National Cemetery, across the Potomac River from Washington, D.C.

Local ceremonies were also held across the northern and southern parts of the United States, honoring union and confederate soldiers.  It was not until after World War I, however, that the day was expanded to honor those who have died in all American wars.

In 1971, Memorial Day was declared a national holiday by an act of Congress, though it is still often called Decoration Day. It was then also placed on the last Monday in May.

In December 2000,  “The National Moment of Remembrance Act” was passed to “encourage the people of the United States to give something back to their country, which provides them so much freedom and opportunity” by coordinating commemorations in the United States of Memorial Day and the National Moment of Remembrance.

The National Moment of Remembrance asks all Americans to pause wherever they are at 3 p.m. local time on Memorial Day for a minute of silence to remember and honor those who have died in service to the nation.

Memorial Day doesn’t have to be only a day of remembrance for our veterans, but also a day to think about and celebrate the lives of family and friends that have been lost.

Most children learn why we celebrate Christmas and other religious holidays. They learn early about what the July 4th holiday is all about. Many a child’s first play is the re-enactment of the pilgrims and Native American Indians gathering to share food on Thanksgiving. But Memorial Day is sometimes given a vague description or is scrambled in commercials promoting holiday savings.

Enjoy this 3-day holiday break from the stress of school and work but also take a little time to talk about the meaning of Memorial Day with your child. And perhaps, stop for a moment of silence at 3:00 pm in remembrance of those who have lost their lives because of their service to our country.

Story source: https://www.va.gov/opa/speceven/memday/history.asp

 

 

Daily Dose

Hurricanes & Your Health

1:30 to read

The last week has been a tough one for Texans, and especially for those who live in Houston and along the Texas Gulf Coast.  Having my son, brother and mother all with houses in Houston, I have been watching the “Harvey” situation quite closely. Fortunately, my family is lucky enough not to have flood damage and they have not had to leave Houston.  But, too many other families have suffered flooding and have been forced to evacuate their homes and seek refuge in shelters not only in Houston, but in Dallas where I live as well. 

 

There are many families who are now living in very close quarters where they may be for sometime…as it will take weeks and months if not years to recover from this disaster and to rebuild the homes, schools, churches and businesses that have been either damaged or destroyed. 

 

The necessary relocation of families and children into shelters is also “a perfect storm” for the possibility of the spread of infectious disease. This is an important time in which managing the spread of illness and infection is paramount. What this means is that EVERYONE needs to be up to date on their immunizations to prevent the spread of vaccine preventable diseases. 

 

If you have ever “skipped” a vaccine by choice or missed a vaccine, now is the time to get your child’s vaccines updated. This is not only for those who have had to evacuate, but for everyone, as infectious diseases are spread outside of the shelters and as well.  We pediatricians are working in the shelters to try and make sure that everyone is vaccinated as they arrive, but there are those who are too young to be vaccinated and others who do not have their medical records to ensure accuracy of their vaccines. It is an arduous process.

 

But, for the public health system which will be stretched even more so during the flood recovery, vaccines are one of the most important ways to protect people. It only takes one person who might get mumps, measles or whooping cough to spread it to hundreds of others….all living in close proximity. These people will then also leave their shelter to go to school, church the store or even a temporary job where they may put others at risk, you never know if you might be exposed.

 

Lastly, it is really time to get those flu shots!!! The last thing we need is an early flu season with a large group of un-immunized people…and most doctors have already received shipments of flu vaccine.

 

Please please pray for these families who have lost so much and protect everyone by immunizing your children (and yourself).  

 

 

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