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Your Baby

Fish Oil During Pregnancy May Reduce Baby’s Asthma Risk

2:00

A Danish study’s results suggests pregnant women that take a fish oil supplement during the final 3 months of pregnancy may reduce their baby’s risk of developing asthma or persistent wheezing.

The study involved 736 pregnant women, in their third trimester. Half the women took a placebo containing olive oil and the other group was given 2.4 grams of fish oil. The women took the supplements until one week after birth.

Among children whose mothers took fish-oil capsules, 16.9 percent had asthma by age 3, compared with 23.7 percent whose mothers were given placebos. The difference, nearly 7 percentage points, translates to a risk reduction of about 31 percent.

In the study, the researchers noted that they are not ready to recommend that pregnant women routinely take fish oil. Although the results of the study were positive, several experts have noted that more research needs to be done before higher doses of fish oil supplements are recommended over eating more fish.

Researchers found no adverse effects in the mothers or babies, the doses were high, 2.4 grams per day is 15 to 20 times what most Americans consume from foods.

One in five young children are affected by asthma and wheezing disorders. In recent decades, the rate has more than doubled in Western countries. Previous research has shown that those conditions are more prevalent among babies whose mothers have low levels of fish oil in their bodies. The new large-scale test, reported in The New England Journal of Medicine, is the first to see if supplements can actually lower the risk.

Before doctors can make any recommendations, the study should be replicated, and fish oil should be tested earlier in pregnancy and at different doses, Dr. Hans Bisgaard, the leading author of the study, said in an email to the New York Times. He is a professor of pediatrics at the University of Copenhagen and the head of research at the Copenhagen Prospective Studies on Asthma in Childhood, an independent research unit.

Dr. Bisgaard said it was not possible to tell from the study whether pregnant women could benefit from simply eating more fish. Pregnant women are generally advised to limit their consumption of certain types of fish like swordfish and tuna because they contain mercury. But many other types are considered safe, especially smaller fish like sardines that are not at the top of the food chain and therefore not likely to accumulate mercury and other contaminants from eating other fish.

“It is possible that a lower dose would have sufficed," the Bisgaard team said.

The supplements didn't seem to affect the odds of a baby or toddler developing the skin condition eczema, or an allergy such as a reaction to milk or egg products, or a severe asthma attack.

An editorial in the same journal by an expert who was not part of the study praised the research, saying it was well designed and carefully performed. The author of that editorial, Dr. Christopher E. Ramsden, from the National Institutes of Health, said the findings would help doctors develop a “precision medicine” approach in which fish-oil treatment could be tailored to women who are most likely to benefit.

If the findings are confirmed in other populations, doctors could test to see who would mostly likely benefit from fish oil supplements. "The health care system is currently not geared for such," Bisgaard said. "But clearly this would be the future."

If you are considering taking fish oil supplements during pregnancy, be sure and check with your OB/GYN for a recommended dose.

All fish oils are not the same. Some brands of fish oil are of higher quality than others. A reputable fish oil manufacturer should be able to provide documentation of third-party lab results that show the purity levels of their fish oil, down to the particles per trillion level. Also, if the supplements smell or taste fishy, they shouldn’t. High quality fish oil supplements don’t. Avoid fish oils that have really strong or artificial flavors added to them because they are most likely trying to hide the fishy flavor of rancid oil.

Story sources: Denise Grady, http://www.nytimes.com/2016/12/28/health/fish-oil-asthma-pregnancy.html?WT.mc_id=SmartBriefs-Newsletter&WT.mc_ev=click&ad-keywords=smartbriefsnl

Gene Emery, http://www.reuters.com/article/us-health-asthma-fish-oil-idUSKBN14H1T3

http://americanpregnancy.org/pregnancy-health/omega-3-fish-oil/

 

Your Child

Study: Bedtime Routine Offers Kids Many Benefits

1:45

If your child doesn’t have a nightly bedtime routine, he or she is missing out on a tremendous amount of health and behavioral benefits according to a new study. And you’re not alone.

A multinational study consisting of over 10,000 mothers from 14 counties reported that less than 50 percent of their infants, toddlers and preschoolers had a regular bedtime routine every night.

Researchers determined that the participant’s children who did have a regular bedtime routine benefitted on many levels. The study found that children with a consistent bedtime routine had better sleep outcomes, including earlier bedtimes, shorter amount of time in bed before falling asleep, reduced night waking, and increased sleep duration. Children with a bedtime routine every night slept for an average of more than an hour longer per night than children who never had a bedtime routine. Institution of a regular bedtime routine also was associated with decreased sleep problems and daytime behavior problems, as perceived by mothers.


“Creating a bedtime routine for a child is a simple step that every family can do,” said principal investigator and lead author Jodi Mindell, PhD, professor of psychology at Saint Joseph’s University and associate director of the Sleep Center at Children’s Hospital of Philadelphia. “It can pay off to not only make bedtime easier, but also that a child is likely to sleep better throughout the entire night.”

According to the American Academy of Sleep Medicine, positive bedtime routines involve the institution of a set sequence of pleasurable and calming activities preceding a child’s bedtime. The goal is to establish a behavioral chain leading up to sleep onset. Activities may include giving your child a soothing bath, brushing teeth and reading a bedtime story.

“It’s important that parents create a consistent sleep schedule, relaxing bedtime routine and soothing sleep environment to help their child achieve healthy sleep,” said American Academy of Sleep Medicine President Dr. Timothy Morgenthaler.


Researchers found that consistency was an important factor in helping children sleep well

“For each additional night that a family is able to institute a bedtime routine, and the younger that the routine is started, the better their child is likely to sleep,” said Mindell. “It’s like other healthy practices:  Doing something just one day a week is good, doing it for three days a week is better, and doing it every day is best.”

Mothers participated in the study by completing a validated, online questionnaire that included specific questions about their child’s daytime and nighttime sleep patterns, bedtime routines and behavior. The questionnaire was translated into each language and back-translated to check for accuracy.

“The other surprising finding is that we found that this effect was universal,” said Mindell.  “It doesn’t matter if you are a parent of a young child in the United States, India, or China, having a bedtime routine makes a difference.”

Sleep deprivation is becoming an all too common problem with today’s children and adults. The earlier a good sleep routine can be established and practiced, the better for a child in the long run.

Study results are published in the May issue of the journal Sleep.

Source: http://www.healthcanal.com/disorders-conditions/sleep/63298-study-shows-that-children-sleep-better-when-they-have-a-nightly-bedtime-routine.html

Daily Dose

New Concussion Guidelines

1:30 to read

A really interesting study was published in Pediatrics online entitled “Benefits of Strict Rest After Acute Concussion”.  The guidelines for treating a concussion continue to be debated and that is what makes this study thought provoking.  

This was a “randomized controlled study”  which followed 88 patients between the ages of 11 and 22 years who had been diagnosed with a concussion.  45 of the patients were given instructions for 5 days of strict rest at home with no school, no work and no physical activity.  They were then allowed to have a “stepwise return to activity”.  The other 43 patients were told to “rest” for 1-2 days after which time they could  return to school also follow a “stepwise return to activity”.

Interestingly, there was no clinically significant difference in the  neurocognitive or balance outcomes between the two groups.  In fact the group that was “advised to rest for 5 days” reported more daily post concussive symptoms and slower resolution of symptoms than those who were told to rest for 1-2 days.  

This was a small study and does not mean that everyone should be treated the same way. In fact, when seeing a patient who has sustained a concussion each person seems to be a bit different.....as one could expect when discussing a “brain injury”.  No two brains are exactly alike...at least for the time being...who knows what will happen one day with genetics

In my own limited practice I have found that “very few” tweens and teens subscribe to the complete rest theory...that is no school, but also no TV, no computer and no videos or smart phones....WHAT??? No social media for 5 days?  You would have to put most of them on an isolated “post concussion island” to ensure they disconnect.  

The study authors also wondered if patients reported more symptoms after having strict rest recommended.  It seems plausible that I too might notice a few more symptoms when just sitting there wondering if my head hurts or if I seem to be more fatigued.

Subjective symptoms are always difficult to quantify...which makes treating a concussion more problematic.  I think erring on the conservative side and restricting “return to play” for a longer period seems to be of more importance than any other recommendation, including “5 days of strict rest”. In the meantime this is an interesting study....with more data to surely follow. 

 

Your Child

Doctors May Unknowingly Discourage HPV Vaccine for Preteens

2:00

The majority of physicians say that the HPV vaccine given to preteens, before they become sexually active, can help prevent infections with viruses that can cause cervical, penile and anal cancers as well as genital warts.

However, about 27 percent of doctors may inadvertently discourage parents from having their preteens vaccinated against human papillomavirus (HPV), according to a new study, because they don’t recommend the vaccine strongly enough.

Pediatricians and family physicians deliver the bulk of HPV vaccines. Some of these physicians do not offer the vaccines as strongly as they do when urging parents to vaccinate against meningococcal disease or to get tetanus, diphtheria, and pertussis booster shots, the study reported.

The study, which is based on a national online survey of 776 doctors, found a quarter did not strongly endorse the need for HPV vaccination with the parents of the 11- and 12-year-olds under their care.

Nearly 60 percent were more likely to recommend the vaccine for adolescents they thought were at higher risk of becoming infected — perhaps because the doctors knew or suspected they were sexually active — than for all 11- and 12-year-olds.

“You kind of get the sense that some [health care] providers see this as a somewhat uncomfortable situation,” said lead author Melissa Gilkey, a behavioral scientist in the department of population medicine at Harvard Medical School.

Many parents don’t like to think about the possibility of their child having sex, particularly when they are only 11 or 12 years old. The vaccine is actually meant to provide protection for when they are older. That’s why it is recommended before a child typically begins engaging in sexual activity. Studies have also shown preteens get the best immune response to the vaccines.

Evidence generated by one of Gilkey’s earlier studies suggests it’s not necessarily parents that are squeamish about the vaccination, but physicians that overestimate a parent’s response when the vaccination is urged. 

 “It’s not necessarily that physicians always are negative about it. But it’s kind of that HPV vaccine may get damned with faint praise, if you will,” Gilkey said. “Compared to the way that they recommend these other vaccines, parents may suspect that there’s something wrong with it.”

The aim of the research is to help figure out why HPV vaccination rates remain disappointingly low. The CDC reported that in 2014, 40 percent of adolescent girls and 22 percent of adolescent boys had received the recommended three doses of HPV vaccine. The agency says girls and boys should have all three doses by their 13th birthday.

According to the study, how the information is presented has an impact on how well it is received. Doctors who started conversations about the HPV vaccination by telling parents the vaccines protect against cancers and genital warts gave stronger recommendations than those who opened saying HPV viruses are sexually transmitted.

The study was published Thursday in Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

Although Gilkey declared no conflicts of interest, the senior author of the study, Noel Brewer of the University of North Carolina, has received research funding and speaker fees from companies that sell HPV vaccines.

Source: Helen Branswell, https://www.bostonglobe.com/lifestyle/health-wellness/2015/10/21/study-says-doctors-inadvertently-discourage-hpv-vaccines/LuJaMFoEupeOeYrrUOlYRN/story.html

 

 

 

 

 

Your Baby

Homemade or Commercial Baby Food- Which is Best?

1:45

A new study from the U.K. looked at homemade baby food versus commercial baby food bought in grocery stores. They both come up winners in some categories and losers in others.

The researchers wanted to assess how well homemade and commercially available readymade meals designed for infants and young children met age specific national dietary recommendations.

Once thought to be the ideal baby food, homemade meals turned out to be higher in calories and fat and more time-consuming to prepare, but less expensive and higher in nutrients and variety. Commercial baby food came in more convenient, lower in calories, total fats and salt but was more expensive and lacked variety. Sugar content was about the same in both foods.

Each option had upsides and downsides. For example, home-cooked food had higher nutritional content, but 50% of homemade meals also exceed calorie recommendations, and 37% exceeded the recommendations for calories from fat, reported a research team led by Sharon Carstairs, a PhD student at the University of Aberdeen in Scotland.

Only 7% of the commercial baby food evaluated exceeded calorie recommendations, and less than 1% exceeded recommendations for calories from fat, Carstairs and colleagues reported in Archives of Disease in Childhood.

Researchers compared the store-bought meals with 408 recipes for home-cooked infant meals obtained from best-selling published cookbooks. The investigators entered the recipe ingredients into dietary analysis software to calculate the nutritional composition of the recipes per 100 grams.

A chief limitation of the study was that it only analyzed the recipes for homemade meals and did not take into account how these meals might be prepared in "real life."

"Parents may use cookbooks prescriptively or only as guidance, and thus the nutritional content of home-cooked recipes can vary greatly, and this can be augmented further by natural variations in the nutritional composition of raw ingredients," Carstairs and colleagues noted.

In addition, "the authors may have overestimated the values for salt within home-cooked recipes as it was often cited as optional; these results should thus be considered with caution."

The study reassures parents that it is okay to give homemade food to babies being weaned from breast milk or formula, Lauri Wright, PhD, of the University of South Florida College of Public Health and a spokesperson for the Academy of Nutrition and Dietetics, told MedPage Today.

"This is an important study, because in the United States parents think they have to do the commercial foods. Parents are afraid their child will miss out on nutrients if they don't give the specialized baby food."

The greater variety offered by homemade food may result in healthier taste preferences later in life, Wright added. "We used to think that taste preference developed at age 4 or 5, but we now know that taste preferences develop with the introduction of these first solid foods."

The bottom line from this study is that both types of baby food are acceptable; each comes with its own pros and cons. Just like with any other meal, how your homemade baby food is prepared is the key to whether it’s going to be healthy or not for baby. Understanding the guidelines for nourishing infant food and knowing the nutritional values of the foods you use, can help you prepare a wholesome meal for baby. Commercial baby foods also offer convenience and lower calories and fats. A mix of both will probably suit most families very well.

Story source: Medpage Today staff, http://www.medpagetoday.com/pediatrics/generalpediatrics/59228

 

 

Your Child

Can Dogs Help Kids Be Less Anxious?

1:45

Scientific studies have already linked fewer allergies and asthma in kids that own dogs, now a new study says you can also add less anxiety to the list of benefits from man’s best friend.

Researchers say a new study shows kids who live in a home with a pet dog score far lower on clinical measures of anxiety.

Although the study was small, the results were not surprising. Researchers focused on 643 kids between 6 and 7. But the team at Bassett Medical Center in New York found that just 12 percent of children with pet dogs tested positive for clinical anxiety, compared to 21 percent of children without a dog.

"It may be that less anxious children have pet dogs or pet dogs make children less anxious," Dr. Anne Gadomski and colleagues wrote in the journal Preventing Chronic Disease.

Previous studies have also shown that adults benefit from owning a pet as well as kids. In fact, many health officials suggest that adults should consider getting a dog. Not only can they provide companionship but can encourage more exercise.

Gadomski acknowledged how special pets can be to a child by noting that, "Sometimes their first word is the name of their pet," she told NBC News. "There is a very strong bond between children and their pets."

What makes dogs such special pets for kids?  Godmski’s team said, "From a mental health standpoint, children aged 7 to 8 often ranked pets higher than humans as providers of comfort and self-esteem and as confidants," they wrote.

"Animal-assisted therapy with dogs affects children's mental health and developmental disorders by reducing anxiety and arousal or enhancing attachment," they added.

"Because dogs follow human communicative cues, they may be particularly effective agents for children's emotional development."

The researchers asked parents for specific details about what type of anxiety a child showed.

Pets seemed to help in several areas.

"Significant differences between groups were found for the separation anxiety component ('My child is afraid to be alone in the house') and social anxiety component ('My child is shy') favoring pet ownership," they wrote.

Most of the families in the study - 73 percent - had a pet of some kind. Most - 58 percent - had dogs. Families with pets may be more stable and may be more affluent, but the researchers suggest there's more to it than that.

"A pet dog can stimulate conversation, an ice-breaking effect that can alleviate social anxiety via a social catalyst effect," they wrote.

Other studies have also shown that playing or cuddling with a dog can release the bonding hormone oxytocin, and lower the stress hormone cortisol, they noted.

There’s already an abundance of research on dogs and families, which is one of the reasons Gadomski chose to look at the relationship between dogs and kids for this study.

However, she noted that cat lovers might also benefit from the same type of interaction.

If you’re interested in getting a dog as a pet for your family, there are several websites that offer a quiz to help families decide which breed may best be suited for them. Just search “best dog breeds for families.”

Shelters also have puppies and dogs that make wonderful pets.  Many of the older dogs are already house trained and socialized. Shelter staff can answer your questions about whether a particular dog that is up for adoption would be suitable for a family and small children.

Source: Maggie Fox, http://www.nbcnews.com/health/kids-health/heres-reason-get-puppy-kids-pets-have-less-anxiety-n469591

Image:http://www.popsugar.com/moms/Benefits-Dogs-Kids-36052085#photo-36052085

 

 

 

 

Your Baby

Infants That “Resettle” Sleep Better and Longer

2:00

Does this sound familiar?

You finally get your baby to fall asleep and shuffle off to bed yourself. Just as you’re drifting into a deep sleep (say about 45 minutes after you’ve laid down), you hear the cries of your little one. She’s awake and letting the world know it.

The dilemma becomes, do you get up and rock her back to sleep or let her “cry it out” and see if she’ll go back to sleep on her own?

According to a new study, infants who know how to “resettle” after waking up are more likely to sleep through the night.

When a baby “resettles” or self-settles, they have learned how to make themselves fall back asleep without the help of a parent or guardian. While many parents just can’t bear to listen to their baby cry, others find that with patience and a few changes to their baby’s sleep routine, resettling takes effect and their infant is able to fall back to sleep quicker and sleep longer without assistance.

For this study, British researchers made overnight infrared video recordings of just over 100 infants when they were 5 weeks and 3 months old.

The videos were analyzed to determine changes in sleep and waking during this age span, a time when parents hope their baby will start sleeping more at night, while crying less.  “Infants are capable of resettling themselves back to sleep by three months of age,” according to the study by Ian St James-Roberts and colleagues of the University of London. “Both autonomous resettling and prolonged sleeping are involved in ‘sleeping through the night’ at an early age.”

The “clearest developmental progression” between video recordings was an increase in length of sleeps: from a little over 2 hours at 5 weeks to 3.5 hours at 3 months. Only about 10% of infants slept continuously for 5 hours or more at 5 weeks, compared to 45% at 3 months.

At both ages, about one-fourth of the infants awoke and resettled themselves at least once during the night. These infants were able to get back to sleep with little to no crying or fussing.

“Self-resettling at 5 weeks predicted prolonged sleeping at 3 months,” the researchers write. Sixty-seven percent of infants who resettled in the first recording slept continuously for at least 5 hours in the second recording, compared to 38% who didn’t resettle.

The 3-month-old babies were more likely to suck on their fingers and hands than the 5 week old infants. Sucking seemed to be a self-regulatory strategy that helped them fall back to or maintain sleep.

When a baby wakes up and cries throughout the night, parents are the ones that end up exhausted. Letting your infant learn how to resettle make take a little extra effort at the beginning, but can reap the reward of more sleep in the long run.

Letting your baby learn how to resettle doesn’t mean they are not attended to when there is a need, such as when they need changing, hungry or are ill.

Babycenter.com has a good article on how to teach your baby to soothe him or herself to sleep. The link is provided below.

The video study was published in the June edition of the Journal of Developmental & Behavioral Pediatrics.

Sources: http://www.sleepreviewmag.com/article/babies-can-resettle-likely-sleep-night/

http://www.babycenter.com/404_how-do-i-teach-my-baby-to-soothe-himself-to-sleep_1272921.bc

 

 

Your Child

Another Study Finds No Vaccine –Autism Connection

2:00

A new study, using insurance records for nearly 96,000 U.S. children, found no link between the measles - mumps – rubella (MMR) vaccine and autism – even among children who are at an increased genetic risk.

Experts are hoping that this study, along with several other studies on the risks of autism and the MMR vaccine, will reassure parents that the vaccine is safe.

While the original 1998 study associating the vaccine with autism has been found fraudulent, many parents continue to worry that the vaccine could be a trigger for autism; particularly parents that already have a child with autism.

"Research has shown that parents of kids with autism spectrum disorders are more likely to delay vaccinating their younger children," said Dr. Bryan King, an autism researcher at the University of Washington, in Seattle.

"Basically, they wait until the developmental dust has settled, and it looks like their child will be unaffected (by autism)," said King, who wrote an editorial published with the study.

Health officials are concerned that children who do not receive the MMR vaccine are putting other children at risk for serious diseases. They point to the recent measles outbreaks as one example. So far this year, 162 people have been sickened across 16 states and Washington D.C. according to the U.S. Centers for Disease Control and Prevention (CDC).

Scientists are working hard to find out why there has been an increase in autism over the last decade.  It's known that genes make certain children more vulnerable to autism -- that's why kids with an affected older sibling are at higher-than-average risk. But environmental factors also have to play a role, experts believe.

Based on years of research, the MMR vaccine is not that trigger, according to health experts. "Every study that's looked at this, through every strategy they've used, has found no signal," King said.

According to King, it's natural for parents with a child who has autism to want to reduce their younger kids' risk.

"Everyone believes there have to be environmental factors contributing to the exponential rise we've seen in ASDs," he said. "But we don't understand what those factors are yet."

Researchers are finding clues, though. And more and more, they suspect that prenatal brain development is the critical period, King said.

The new findings are based on insurance records for nearly 96,000 U.S. children with an older brother or sister; 2 percent had an older sibling with an autism spectrum disorder.

Of the children with an affected sibling, 7 percent had an autism spectrum disorder themselves, compared to just under 1 percent of other kids. There was no evidence, though, that the MMR vaccination raised the risk of autism in either group of children, Jain said.

Among kids with an affected sibling, those who'd received one MMR dose by age 2 were actually one-quarter less likely to be diagnosed with an autism spectrum disorder, the study found. The odds were even lower among those who'd received two doses by age 5.

The study did not reveal any evidence that the MMR vaccine offered any protective influence over autism, only that it was not associated with an increase of risk for autism.

More studies are in the works to find the source of autism. Environmental factors are playing a key role in many of those studies as well as genetic links.

It’s understandable that parents would worry about vaccinations of any kind having a negative effect on their child, but more and more studies confirm that the MMR vaccine is one that parents can eliminate from their list of concerns.

This study was reported in the April 21 issue of the Journal of the American Medical Association.

Source: Amy Norton, http://consumer.healthday.com/cognitive-health-information-26/autism-news-51/another-study-finds-no-vaccine-autism-link-698635.html

Your Teen

Young Male Athletes, Parental Pressure and Doping

1:45

When 129 young male athletes, whose average age was 17, were asked what would make them consider “doping” as a way to boost their athletic ability – the majority said parental pressure.

A new study from the University of Kent in England asked the young male athletes about their attitudes on "doping" -- the use of prohibited drugs, such as steroids, hormones or stimulants, to increase athletic competence.

These substances, sometimes called performance-enhancing drugs, can potentially alter the human body and biological functions. However, they can be extremely harmful to a person's health, experts warn.

The study group was also asked about four different aspects of perfectionism. The areas were: parental pressure; self-striving for perfection; concerns about making mistakes; and pressure from coaches.

Only parental pressure was linked to positive feelings about doping among the athletes, the study authors found. Although the study was small, it did point out how important demanding expectations from parents can be to kids. 

Lead author of the study, Daniel Madigan, a Ph.D. student in the university's School of Sport and Exercise Sciences, said the findings suggest that parents need to recognize the consequences of putting too much pressure on young athletes in the family.

"The problem of pressure from parents watching their children play sports is widely known, with referees and sporting bodies highlighting the difficulties and taking steps to prevent it," Madigan said in a university news release.

"With the rise of so-called 'tiger' parenting-- where strict and demanding parents push their children to high levels of achievement -- this study reveals the price young athletes may choose to pay to meet their parents' expectations and dreams," Madigan added.

The researchers only focused on young men for this study but plan to investigate if the same result will occur with young female athletes, and if there are differences between athletes in team versus individual sports.

The study findings are scheduled for publication in the April print issue of the Journal of Sports Sciences.

Story source: Robert Preidt, http://teens.webmd.com/news/20160229/young-athletes-pressured-by-parents-may-resort-to-doping

 

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