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Your Child

New Guidelines for Tonsillectomies

Most children who get repeated throat infections probably don’t need surgery to remove their tonsils and would improve in time with careful monitoring, according to new clinical guidelines on tonsillectomies in children.

The new guidelines also suggest, however, that removal of the tonsils, or tonsillectomy, may improve problems tied to poor sleep, including bed-wetting, slow growth, hyperactive behavior, and poor school performance. In fact, sleep-disordered breathing -- a set or problems that range from snoring to obstructive sleep apnea - is now the most common reason for tonsil removal in kids younger than 15. “We used to think that only if you were an air traffic controller did it matter if you slept well or not, and now we know that’s not the case,” says Amelia F. Drake, MD, chief of the division of pediatric otolaryngology at the University of North Carolina School of Medicine in Chapel Hill. More than half a million tonsillectomies are performed each year on children in the U.S., making it the second most common surgery in this age group, just behind procedures to place tubes in the ears to relieve recurrent ear infections. Despite the fact that it is a mainstay of American medicine, experts have long disagreed about how useful or appropriate tonsillectomies may be. The new guidelines, published Monday by the American Academy of Otolaryngology - Head and Neck Surgery, are the first set of official recommendations on tonsillectomy published in the U.S. The guidelines aim to give doctors and parents more information about when tonsillectomy may be warranted and to help minimize the risks and pain of this procedure in young patients. “I thought they were very comprehensive,” says Drake, who reviewed the new recommendations but was not involved in drafting them. “This is an area where improvements and refinements can have a huge impact. This is medicine at its core.” New Criteria for Removing Tonsils The guidelines update a set of clinical indicators for tonsillectomies published in 2000 by the American Academy of Otolaryngology, which suggested that doctors could consider taking out the tonsils if a child had at least three cases of swollen and infected tonsils in a year. The new guideline, however, says that kids should have at least seven episodes of throat infection, such as tonsillitis or strep throat in a year, or at least five episodes each year for two years, or three episodes annually for three years, before they become candidates for surgery, and that those infections should be documented by a doctor, rather than just reported by parents. The idea, experts said, was to reserve surgery only for the most severely affected, because the surgery can rarely have serious complications including infections and serious bleeding. “Children who have fewer episodes really aren’t going to see a lot of benefit,” says Jack L. Paradise, MD, professor emeritus of pediatrics at the University of Pittsburgh School of Medicine. “There aren’t many kids, overall, who meet those stringent criteria,” Paradise says. What’s more, Paradise, and other experts stress, that even children who satisfy the guidelines shouldn’t get an automatic green light for surgery. “I’m not sure, if I had a child that met all the criteria, that I’d automatically subject the child to the consequences of that,” Paradise says, “Post-operatively, it’s a very painful procedure.” The tonsils are cone-shaped lumps of tissue embedded in the throat, and they are believed to play a role in how the body responds to infections, though experts aren’t exactly sure how. But in the early part of the 20th century, the tonsils were blamed as the “focus of infection” in the body, and doctors began taking them out as a way to promote good health. The operation became so common for example, that entire classrooms of youngsters would get their tonsils taken out at school. But by the 1970s, many experts were questioning how effective and appropriate it was to subject kids to a painful operation that could have rare but serious complications; all for what new research suggested were minimal improvements in the risk of sore throats. At the same time, however, doctors were starting to become more aware of the myriad problems tied to sleep disordered breathing in children, a spectrum of problems that can range from snoring to obstructive sleep apnea. And more tonsils began to be taken out as a way to open up the airway and improve sleep. Improvement in Care for Kids Having Surgery Several of the guidelines suggest ways doctors and parents can improve the care of children having tonsillectomies. One of the strongest recommendations is against the use of antibiotics just before or just after surgery. “They are commonly given, and there’s no evidence that antibiotics offer any benefit,” says study researcher Reginald F. Baugh, MD, professor and chief of otolaryngology at the University of Toledo Medical Center in Ohio. “You run the risk of allergic reactions and there are the harms of over-prescribing.” In drafting the statement that advises doctors to counsel parents about the importance of pain management in kids after surgery, Baugh says the panel that reviewed the evidence behind the guidelines was alarmed to learn that many parents don’t give medications to control pain after the procedure. “That was one thing we really learned, about the importance of telling parents about the need to give pain meds in these kids,” Baugh says.

Your Baby

New Guidelines To Help Prevent Peanut Allergies

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Peanut allergy is one of the most common food allergies. Even trace amounts can cause a severe reaction in a child that is allergic to the legume. Parents may be able to reduce the chance that their children will develop peanut allergies by introducing the food early on, as young as four to six months of age, experts now say.

The results of several studies on the positive benefits of introducing peanuts into a child’s diet, early in their life, are encouraging new recommendations from allergy experts.

“Guidance regarding when to introduce peanut into the diet of an infant is changing, based on new research that shows that early introduction around 4-6 months of life, after a few other foods have been introduced into the infant’s diet, is associated with a significantly reduced risk of such infants developing peanut allergy,” said Dr. Matthew Greenhawt, a pediatrician and co-director of the Food Challenge and Research Unit at Children’s Hospital Colorado in Aurora, Colorado, who coauthored the update.

“This is an amazing opportunity to help potentially reduce the number of cases of peanut allergy, but this can only be done with the cooperation of parents and healthcare providers,” Greenhawt told Reuters Health.

Research used for the restructured recommendations comes from the Learning Early about Peanut Allergy (LEAP) study. In that trial, infants at high risk for peanut allergies who were exposed to peanuts early were less likely to develop an allergy by the time they reached five years of age. The findings from that study were published last year in The New England Journal of Medicine.

The guidelines offer three approaches to introducing peanuts to infants- depending on their risk of allergy.

-       Infants with severe eczema, egg allergy or both are at high risk for peanut allergy. They should be exposed to peanuts as early as four to six months to reduce the risk of allergy. Beforehand, however, these infants should undergo a skin prick test. If the test yields no welt or a small welt of up to 2mm, parents can introduce peanuts at home. But if the test yields a welt of 3mm or larger, peanuts should be introduced in the doctor’s office - or not at all if the welt is large and an allergist recommends avoidance.

-       Infants with mild to moderate eczema who have already started solid foods should be exposed to peanuts at six months of age.

-       Infants without eczema or any food allergy are at low risk, and parents can introduce peanuts in an age-appropriate form at any time starting at age six months.

Giving an infant a whole peanut is not recommended because they can choke on them. However, there are ways to prepare peanuts that can be introduced safely.

Another coauthor of the new guidelines, Dr. Amal Assa’ad, a pediatrician and director of the FARE Food Allergy Center of Excellence at the Cincinnati Children’s Hospital Medical Center in Ohio, told Reuters Health, “Several appropriate forms of peanut-containing foods are creamy peanut butter that can be made softer or more liquefied by adding warm water and let it cool, or serving corn puffs containing peanut. For older infants, peanut butter can be added to apple sauce or other fruit purees.”

Parents should consult with an allergist or their pediatrician before giving their infant peanuts in any form.

While the news about early peanut allergy intervention has been noted by various medical, media and social networks, reliable strategies for how to determine who should and should not get the therapy and when to start it, have not been available. These new guidelines help answer those questions.

The updated guidelines will be published online in January on the National Institute of Allergy and Infectious Diseases website; in the meantime, the site provides the current 2010 guidelines on peanut and other food allergies.

Story source: Rob Goodler, http://www.reuters.com/article/us-health-allergies-peanuts-idUSKBN1361VW

 

Your Teen

Head Injury Linked To Violent Behavior

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A new study says that children who have suffered a head injury are more likely to get into a fight or take part in other types of violent behavior. Every parent knows that childhood often comes with bumps, bruises, cuts and falls. Sometimes those accidents include head injuries. A new study says that children who have suffered a head injury are more likely to get into a fight or take part in other types of violent behavior.

The connection between head injury and violence was particularly strong if the head injury had occurred within the past year, the authors of the study note in the journal Pediatrics. According to the U.S. Centers for Disease Control and Prevention, some 1.7 million Americans experience a traumatic brain injury every year, due to bumps, blows, jolts, or any injury that disrupts the brain's normal functioning. The study author, Dr. Sarah Stoddard with the University of Michigan in Ann Arbor, told Reuters Health that- with this type of research- it is difficult to figure out if brain injury is really the root of the aggression or if some other factor is the reason. Stoddard also notes that activities like drinking, drug use ,and a history of violence didn’t seem to explain the findings. Stoddard and a colleague analyzed several years' worth of data from 850 kids in high school and followed them until five years after they left school. All of the participants had a grade point average of 3 or lower, putting them at risk for dropping out. In the fifth year of the study, 88 of the young adults said they had suffered a head injury. Of those individuals, 43 percent said they had gotten into a fight, hurt someone, or taken part in some type of violence over the following year. That compared to 34 percent of those who didn't report a head injury. The findings suggest that the more recent a head injury is, the more likely a young adult is to be aggressive. According to Stoddard, "The brain does recover over time." Stoddard also adds that researchers should investigate the long-term effects of head injuries in young people, as well as preventive measures such as protective gear for sports and interventions that help kids with head injuries manage their behaviors before they lead to violence. A different study conducted by researchers at the Center for Injury Research and Policy Institute at Nationwide Children's Hospital, of young athletes 15-to-24 years old, reveals that sports are second only to motor vehicle crashes as the leading cause of injury to the brain. And concussions represent 10 percent of all high school athletic injuries. Previous studies have also shown that brain injuries can also cause changes in memory, reasoning, and emotions, including impulsivity and aggression. In studies with prisoners, researchers have found that those with a history of brain injuries are more likely to engage in violence. The study "does suggest there is a link between head injury and violence particularly early on," said Dr. Huw Williams, who has found the same relationship in prisoners, but was not involved in the new work. And if they believe their children experienced a brain injury in the past, they should also get expert advice on what to look for to make sure brain function doesn't deteriorate, he added. "It's important to monitor." Brain injury can range from mild to severe causing a short loss of consciousness and confusion to amnesia and coma. The American Academy of Pediatrics says that head injuries should be observed, and treatment should be sought if any of the following symptoms appear: •       A constant headache, particularly one that gets worse •       Slurred speech or confusion •       Dizziness that does not go away or happens repeatedly •       Extreme irritability or other abnormal behavior •       Vomiting more than 2 or 3 times •       Stumbling or difficulty walking •       Oozing blood or watery fluid from the nose or ears •       Difficulty waking up or excessive sleepiness •       Unequal size of the pupils (the dark center part of the eyes) •       Double vision or blurry vision •       Unusual paleness that lasts for more than an hour •       Convulsions (seizures) •       Difficulty recognizing familiar people •       Weakness of arms or legs •       Persistent ringing in the ears If your child does well through the observation period, there should be no long-lasting problems. Remember, most head injuries are mild. However, be sure to talk with your child's doctor about any concerns or questions you might have. The Center for Disease Control and Prevention’s website, www.cdc.gov/traumaticbraininjury also contains a free online training course on preventing sports-related brain injuries in young athletes.

Your Teen

HPV Vaccine, Proving Effective in Teenage Girls

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

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

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

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

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

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

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

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

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

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

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

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

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

The study was published in the online journal Pediatrics.

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

Your Child

Recess Is Important for Kids

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Add recess to reading, writing and arithmetic says a report from the American Academy of Pediatrics (AAP.)  The pediatricians believe that recess can be as important to a child’s overall development as standard classes and should never be denied, especially as a punishment.

"We consider it essentially the child's personal time and don't feel it should be taken away for academic or punitive reasons," said Dr. Robert Murray, who co-authored the new policy statement for the AAP.

According to the authors, recess is a “crucial and necessary component of a child’s development.”

Other reasons given for the importance of recess are that it helps students develop better communication skills, counteracts the time sitting in classrooms, and may foster skills such as cooperation and sharing - all good things.

The authors noted that previous research has found that children are able to pay closer attention and perform tasks better after a recess break.  A year ago, 14 studies were reviewed and researchers found that kids who get more exercise do better in school. Recess and sports related activities offer children the opportunity to exercise and burn off excess energy.  They also get a chance to recharge their brains and bodies.

Other organizations have recommended that children need recess as well. The American Heart Association and U.S. Centers for Disease Control and Prevention (CPSC) both call for schools to offer recess to kids.  You might think that recess in schools is a given, but in a 2011 survey of 1,800 elementary schools, researchers discovered that a third of the schools did not offer recess to their third-graders.  However, most schools do offer recess of between 15 and 30 minutes once or twice a day.

Is there a particular time of day that helps kids most?  Before lunch seems to be the consensus from government agencies, CPSC and the U.S. Department of Agriculture. Previous studies have found that children waste less food and behave better for the rest of the day when their recess is before their scheduled lunch, the pediatricians' statement notes.

They also agree that PE should not be substituted for recess. "Those are completely different things and they offer completely different outcomes," said Murray. "(Physical education teachers are) trying to teach motor skills and the ability of those children to use those skills in a bunch of different scenarios. Recess is a child's free time."

Free time means no structured activities by adults such as games. "I think it becomes structured to the point where you lose some of those developmental and social emotion benefits of free play," said Murray.

"This is a very important and overlooked time of day for the child and we should not lose sight of the fact that it has very important benefits," he added.

I remember recess fondly.  A group of friends would gather and run from one end of the schoolyard to the other at full gallop. The first one back would win the honor of becoming the “lead horse.” Yes, in our recess fantasy we were a heard of horses – whinnying and throwing our heads around (showing off our glorious manes.)

It was fun and exhilarating as we trotted around strutting our stuff.

Recess isn’t only important because it breaks up the monotony of sitting, studying and listening, it can also spark the imagination!

Source: http://news.yahoo.com/pediatricians-kids-recess-during-school-0547374

Your Teen

Studies: Smoking and Students

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Everyone knows that smoking is really bad for you. But, how do you help kids keep from starting the expensive and nasty habit in the first place? Peer pressure seems to help. And for young adults who are already smokers, what will it take to break the habit? Perhaps being able to breathe better is a key motivator.

Kids as young as 10 admit to sneaking a smoke every once in a while, while 17 percent of high-school students and 5.2 percent of middle-school students admit to being daily cigarette smokers. Many college students bring their habit with them when they enroll.

What helps kids keep from starting to smoke? A new study suggests that kids who are involved in team sports with teammates, who do not smoke, are less likely to start. 

Interestingly, the study showed that girls involved in sports with teammates who do smoke, are more likely to give it a try. Peer pressure seems to have more of an impact among girls.

"This result suggests that peers on athletic teams influence the smoking behavior of others even though there might be a protective effect overall of increased participation in athletics on smoking," study leader Kayo Fujimoto, who conducted the research while at the University of Southern California, said in a journal news release.

Researchers questioned 1,260 sixth through eighth graders about their smoking behavior. The children were middle class, lived in urban areas and ethnically diverse. The study, appearing Feb. 8 in Child Development, found that the more sports the kids played, the less likely they were to smoke.

The authors of the study believe that these findings may be helpful in improving anti-smoking campaigns aimed at children.

"Current guidelines recommend the use of peer leaders selected within the class to implement such programs," said Fujimoto. "The findings of this study suggest that peer-led interactive programs should be expanded to include sports teams as well."

Another recent study focused on college students who smoke.

Researchers at the University of Texas MD Anderson Cancer Center in Houston, studied 327 college students- ages 18 to 24 years old- who participated in a program to help motivate them to quit smoking. More than half the students smoked five to 10 cigarettes a day and had smoked for one to five years.

Participants who quit smoking for two weeks or more reported substantially fewer respiratory symptoms, especially coughing, than those who failed to kick the habit.

"That the benefit of stopping smoking starts in days to weeks -- not years or decades -- is important. Now health care providers can counsel young smokers that their breathing can feel better soon after they stop. This can help to motivate young adults to stop smoking before the severe damage is done," journal editor Dr. Harold Farber, an associate professor of pediatrics in the pulmonology section at Baylor College of Medicine in Houston, said in a journal news release.

Smoking has continued to decrease on college campuses, perhaps due to stricter smoking policies. Many colleges prohibit smoking anywhere on campus, and others do not allow smoking within a certain amount of feet from doorways. Cigarettes are expensive as well. Many college students are barely getting by with the increase costs in tuition. Something has to give, and cutting out cigarettes can save a pretty tidy sum. Also, smoking has lost a lot of its “cool” factor. Many students just find it annoying. 

Health professionals are always looking for ways to impress upon young people that smoking isn’t only a social nuisance, it can also become a serious long-term health problem.

Perhaps these studies can offer counselors, parents and friends, new discussion points in the battle to help kids avoid smoking or to help them quit. 

Sources: http://consumer.healthday.com/Article.asp?AID=66152 /  http://www.doctorslounge.com/index.php/news/hd/26596

Your Teen

What do Energy Drinks Actually Do to the Body?

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There’s been a lot of discussion over whether caffeine-spiked “Energy Drinks” are really safe for consumption, particularly for kids and young adults.  Although many manufacturers add the advisory statement “not recommended for children, pregnant or nursing women and persons sensitive to caffeine” on their label, it often goes ignored.

The Substance Abuse and Mental Health Services Administration reports that as these drinks have become more popular, the incidences of caffeine related overdoses and deaths have increased.

In one heartbreaking example, 14-year-old Anais Fournier died from cardiac arrest due to caffeine toxicity after consuming two 24- ounce cans of Monster energy drink a day apart.

While the Food and Drug Administration (FDA) has been investigating whether there is causal link to the drinks and health problems, Mayo Clinic researcher Anna Svatikova and her colleagues wanted more information about exactly what happens in your body after you consume one of the drinks.

She and her team recruited 25 volunteers. All were young adults age 18 or older, nonsmokers, free of known disease, and not taking medications. They were asked to drink a 16-ounce can of a Rockstar energy drink and a placebo -- with the same taste, texture, color and nutritional contents but without the caffeine and other stimulants -- within five minutes on two separate days.

The energy drink had the following stimulants: 240 mg of caffeine, 2,000 mg of taurine and extracts of guarana seed, ginseng root and milk thistle. All typical ingredients associated with energy drinks.

Researchers took numerous measurements first before they drank and 30 minutes after. With the placebo, there was very little change. With the energy drink, however, many of the changes were marked:

•       Systolic blood pressure (the top number) - 6.2 percent increase

•       Diastolic blood pressure (the bottom number) - 6.8 percent increase

•       Average blood pressure - 6.4 percent increase

•       Heart rate - none

•       Caffeine in blood - increase from undetectable to 3.4 micrograms/mL

•       Norepinephrine level (the stress hormone, which can give you the shakes when you have too much caffeine) in blood - increase from 150 pg/mL to 250 pg/ML

Writing in JAMA, the researchers said that these changes may predispose those who drink a single drink to increased cardiovascular risk.

This may explain why a number of those who died after consuming energy drinks appeared to have had heart attacks.

They also exposed the volunteers to two-minute physical, mental, and cold stressors after consuming the energy drinks to see how that might affect blood pressure and other body functions.

The physical stressor involved asking participants to squeeze on a handgrip; the mental one to complete a series of mathematical tasks as fast as possible; and the cold one immersing their one hand into ice water. Interestingly, there was no further change.

Another thing that is typically overlooked when people choose one of these drinks is the serving size. A 16-ounce can is two servings. A 24-ounce can has three servings. Caffeine and sugar content is often listed per serving. But honestly, how many people drink a third or half a can at a time? Besides caffeine, other stimulants are often added to energy drinks such as Ginseng and Guarana. Most people have no idea what they are, what they do and if they negatively interact with medications.

The American Beverage Association defends the drinks and said in a statement  that "there is nothing unique about the caffeine in mainstream energy drinks, which is about half that of a similar sized cup of coffeehouse coffee" and that drinking coffee would have produced similar effects.

“The safety of energy drinks has been established by scientific research as well as regulatory agencies around the globe. Just this year the European Food Safety Authority (EFSA) confirmed the safety of energy drinks and their ingredients after an extensive review," the organization said.

It’s up to parents to decide whether these drinks are beneficial to their family or if they should re-think purchasing one for themselves or their child. A family discussion about the pros and cons of energy drinks with pre-teens and teenagers could give the kids the information they need to make a good choice.

Source: Ariana Eunjung Cha, http://jama.jamanetwork.com/article.aspx?articleID=2469194

Your Baby

Fish Oil During Pregnancy May Reduce Baby’s Asthma Risk

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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 Baby

Infants That “Resettle” Sleep Better and Longer

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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

 

 

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DR SUE'S DAILY DOSE

Norovirus is going around.

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