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Your Baby

Chubby Baby = Obese Child?

2.00 to read

“Look at those cute little rolls of fat and chubby cheeks.” “It’s just baby-fat, he’ll grow out of it.” Common comments when people see a chubby baby. But, what was once thought of as a well-fed and healthy infant might prove to be just the opposite.

Researchers say they’ve found a way to determine if a rapid growing baby will become obese later in life. A new study says that if your baby has passed two key milestones, on a doctor’s growth chart by the age of two, then he or she has double the risk of being obese by the age of 5.  Rapid growers were also more likely to be obese at age 10, and infants whose chart numbers climbed that much during their first 6 months faced the greatest risks.

Children who grew more slowly were less likely to be obese by the same age.

That kind of rapid growth should be a red flag to doctors, and a sign to parents that babies might be overfed or spending too much time in strollers and not enough crawling around, said pediatrician Dr. Elsie Taveras, the study's lead author and an obesity researcher at Harvard Medical School.

Contrary to the idea that chubby babies are the picture of health, the study bolsters evidence that "bigger is not better" in infants, she said.

In an online article on healthland.time.com Dr. Michelle Lampl, director of Emory University's Center for the Study of Human Health, expressed concerns.

“It’s a bad idea that could backfire in the long run,” said Lampl.

"It reads like a very handy rule and sounds like it would be very useful _ and that's my concern," Lampl said. The guide would be easy to use to justify feeding infants less and to unfairly label them as fat. It could also prompt feeding patterns that could lead to obesity later, she said.

Lampl noted that many infants studied crossed at least two key points on growth charts; yet only 12 percent were obese at age 5 and slightly more at age 10. Nationally, about 10 percent of preschool-aged children are obese, versus about 19 percent of those aged 6 to 11.

Taveras said the rapid growth shown in the study should be used to raise awareness and not to put babies on a diet.

The study involved 45,000 infants and children younger than age 11 who had routine growth measurements during doctor checkups in the Boston area from 1980 through 2008.

Growth charts help pediatricians plot weight, length in babies and height in older kids in relation to other children their same age and sex. Pediatricians sometimes combine an infant's measures to calculate weight-for-length _ the equivalent of body-mass index, or BMI, a height-to-weight ratio used in older children and adults.

The charts are organized into percentiles. For example, infants at the 75th percentile for weight are heavier than 75 percent of their peers.

An infant whose weight-for-length jumped from the 19th percentile at 1 month to the 77th at 6 months crossed three major percentiles _ the 25th, 50th and 75th _ and would be at risk for obesity later in childhood, the authors said.

Larger infants were most at risk for obesity later on, but even smaller babies whose growth crossed at least two percentiles were at greater risk than those who grew more slowly.

About 40 percent of infants crossed at least two percentiles by age 6 months. An analysis of more than one-third of the study children found that 64 percent grew that rapidly by age 2.

Dr. Joanna Lewis, a pediatrician at Advocate Lutheran General Hospital in Park Ridge, Ill., said she supports the idea that infancy is not too young to start thinking about obesity.

Still, she emphasized that rapid growth in infancy doesn't mean babies are doomed to become obese. "It's not a life sentence," and there are steps parents can take to keep their babies at a healthy weight without restrictive diets, she said.

Lewis said many of her patients are large babies whose parents feed them juice or solid food despite guidelines recommending nothing but breast milk or formula in the first six months.

"The study reinforces what we try to tell parents already: Delay starting solids and don't put juice in a bottle," Lewis said.

Your Toddler

Proof That Reading to Your Child is Good for Them

1:45

Not only do small children love being read to but a new study confirms that it is actually good for them.

Brain scans taken of 19 preschoolers whose parents regularly read to them showed heightened activity in important areas of the brain. Experts have long theorized that reading to young children on a consistent basis has a positive impact on their brain development; researchers say this study provides hard evidence that it does.

 The study’s leader Dr. John Hutton, of Cincinnati Children's Hospital Medical Center,

 and his team used functional MRI scans to measure real-time brain activity in 19 children, aged 3 to 5 years, as they listened to stories and to sounds other than speech.

Parents were interviewed about "cognitive stimulation" at home, including how often they read to their children. Based on their responses, the number ranged from two nights a week to every night.

Overall, Hutton's team found, the more often children had story time at home, the more brain activity they showed while listening to stories in the research lab.

The impact was largely seen in the area of the brain that is used to obtain meaning from words. There was "particularly robust" activity, the researchers said, in areas where mental images are formed from what is heard.

"When children listen to stories, they have to put it all together in their mind's eye," Hutton explained.

Even though children's books have pictures, he added, that's different from watching all the action play out on a TV or computer screen.

When a child is listening to a story being read to them, they are engaging a different part of the brain than when they are passively sitting in front of a screen with images.

The American Academy of Pediatrics (AAP) advises parents to read to their children every day, starting at birth. That pre-kindergarten time is a critical time for brain development, Hutton said. Other research has found that children with poor reading skills in first grade usually do not "catch up" with their peers.

Hutton believes that a traditional story time provides a critical "back-and-forth" between parents and children.

"It's not just a nice thing to do with your child," he said. "It's important to their cognitive, social and emotional development."

Reading to your child can help him or her build a lifelong relationship with the written word. That skill will help them be able to navigate more easily in school, later on in business and can bring hours of personal pleasure through the stories of gifted writers.

Source: Amy Norton, http://consumer.healthday.com/cognitive-health-information-26/brain-health-news-80/brain-scans-show-why-reading-to-kids-is-good-for-them-701897.html

 

 

Your Child

2 Doses of Chickenpox Vaccine Almost 100 Percent Effective

2:00

Chickenpox is one of the most common childhood illnesses. It is a viral infection caused by the Varicella zoster virus and produces a painful, itchy rash with small, fluid-filled blisters.

It occurs most often in early spring and late winter and is highly contagious. Typically, chickenpox occurs in kids between 6 and 10 years of age.

A new study shows that among schoolchildren, two doses of the chickenpox vaccine is more effective than one.

Giving the first dose at age 1 and the second dose at ages 4 to 6 is nearly 100 percent effective in preventing the once common childhood disease, researchers have found.

"A second dose of varicella [chickenpox] vaccine provides school-aged children with better protection against the chickenpox virus, compared to one dose alone or no vaccination," said lead researcher Dana Perella, of the Philadelphia Department of Public Health.

Two doses of the vaccine protected against the moderate to severe chickenpox infections that can lead to complications and hospitalizations, she said.

Before routine chickenpox vaccination began in 1995, virtually all children were infected at some point, sometimes with serious complications. About 11,000 children were hospitalized each year for chickenpox, and 100 died annually from the disease, according to the CDC.

One-dose vaccination greatly reduced incidence of chickenpox, but outbreaks continued to be reported in schools where many kids had been vaccinated. That led the CDC in 2006 to recommend a second vaccine dose.

To evaluate effectiveness of the double- dose regimen, Perella and colleagues collected data on 125 children with chickenpox in Philadelphia and northern Los Angeles and compared them with 408 kids who had not had the disease.

They found that two doses of the vaccine was slightly more than 97 percent effective in protecting kids from chickenpox.

"With improved protection provided by two-dose varicella vaccination compared with one-dose only, continued decreases in the occurrence of chickenpox, including more severe infections and hospitalizations, are expected as more children routinely receive dose two between the ages of 4 and 6 years," Perella said.

For children with weakened immune systems that cannot take the vaccine, having their classmates and playmates protected by the vaccine helps protect them against the viral infection.

School vaccine requirements should include two-dose varicella vaccination, Perella said.

"In addition, 'catch-up' varicella vaccination is also important," she said. This applies to anyone over 6 who haven’t had a second vaccine dose, especially if they could be exposed to chickenpox or shingles - a painful condition in older people caused by reactivation of the chickenpox virus, she said.

Most healthy children who get chickenpox do not have serious complications from the illness. But there are cases when chickenpox has caused hospitalization, serious complications and even death.

A child may be at greater risk for complications if he or she:

·      Has a weakened immune system

·      Is under 1 year of age

·      Suffers from eczema

·      Takes a medication called salicylate

·      Was born prematurely

The report was published online March 14 and will appear in the April print issue of the journal Pediatrics.

Story sources: Steven Reinberg, http://www.webmd.com/children/news/20160314/two-dose-chickenpox-shot-gets-the-job-done-study-shows

http://www.parents.com/health/vaccines/chicken-pox/chickenpox-facts/

Your Child

Low Pollen Levels Can Trigger Asthma

2.00 to read

Asthma in children has been on the increase since the 80s and the current estimated number of American children with asthma is between 6 and 9 million. It is the leading cause of chronic illness in kids under 18 years old. If your child is sensitive to pollen, a new study suggests that even low levels can increase the chances of an asthma attack. . 

Yale and Brown University researchers tracked more than 400 children with asthma, as well as the daily pollen levels near each child's home, over the course of five years. Researchers found that there was a 37% increase in respiratory symptoms in children who were sensitive to pollen- even though pollen levels were very low- and they were taking daily medications to control their asthma.

“In some respects, it's common sense that if a child is asthmatic and allergic to pollen, when they're exposed to pollen, they would bear some risk of asthmatic symptoms," said lead author Curt DellaValle, of the Yale School of Forestry and Environmental Studies.

"The biggest thing, though, is seeing these effects even with the lowest levels of pollen," he told Reuters Health. "It leads us to believe that parents of these asthmatic children should be aware that even when pollen levels are low, their children will experience asthmatic symptoms."

The study also revealed data that surprised researchers. Pollen-sensitive kids that were part of the study had fewer symptoms when ragweed – a major irritant- was at high levels. DellaValle said it may mean that the children's parents reacted to high pollen reports and took extra precautions.

"It suggested that they modified their children's behavior by keeping them inside, in air conditioning or by using air filters," DellaValle said.

Here’s how the study worked:

DellaValle's team recruited 430 children with asthma between the ages of four and 12 in New York, Connecticut and Massachusetts between 2000 and 2003. Each kid's mother kept a calendar tracking her child's asthma symptoms and use of asthma medications. The researchers also tested the children's blood for sensitivity to pollens from trees, grass and weeds.

To get a better picture of realistic pollen exposures, every year during the Northeast's pollen season -- generally from late March to early October -- the researchers used a model to analyze the amount of pollen within 1.2 miles of each child's home. They also tracked daily and seasonal weather, foliage, when pollen seasons began and ended and peak pollen periods.

Among kids with sensitivities to particular types of pollen, even small amounts in the air could trigger asthma symptoms.

Children not on maintenance medication who were sensitive to grass pollen, for example, wheezed, coughed and had trouble breathing and other nighttime symptoms when they were exposed to more than two grains per cubic meter of grass pollen.

Kids on daily maintenance therapy and sensitive to weed pollen could have similar symptoms and a need for rescue medication at pollen levels above six to nine grains per cubic meter.

Among the kids sensitive to weed pollen, low-level exposures raised their risk of symptoms by 37 percent. That compared to a 23 percent rise in risk during the highest weed-pollen periods -- hinting that kids may have stayed indoors when pollen levels were known to be high, the researchers note.

Pollen levels were not tied to an increase in asthma symptoms in kids without allergies to specific pollens.

Parents with asthmatic children often follow pollen reports and adjust their children’s outdoor activity accordingly. This study shows that even low levels of pollen can affect a sensitive child’s breathing and general health.

Although there is no cure for asthma, it can be managed with proper prevention and treatment. There is often a genetic compound.

Asthma symptoms can be mild or severe, and many children’s symptoms become worse at night.

Symptoms may include:

- Frequent, intermittent coughing.

- A whistling or wheezing sound when exhaling.

- Shortness of breath.

- Chest congestion or tightness.

- Chest pain, particularly in younger children.

- Trouble sleeping caused by shortness of breath, coughing or wheezing.

- Bouts of coughing or wheezing that get worse with a respiratory infection, such as a cold or the flu.

- Delayed recovery or bronchitis after a respiratory infection.

- Trouble breathing that may limit play or exercise.

- Fatigue, which can be caused by poor sleep.

If your child experiences any of the above symptoms, make sure he or she is seen by a pediatrician or family doctor. 

 

 

Sources:

http://www.reuters.com/article/2011/12/01/us-pollen-levels-idUSTRE7B02HG...

http://www.mayoclinic.com

Your Teen

More Teens Fall Victim to Dating Violence

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The teenage years are supposed to be filled with laughter, fun and testing the boundaries of parental control. It’s also a time when many boys and girls will start dating. For some teens, the beginning of couple relationships is about as far away from fun as it could possibly be.

Some teenagers may think that teasing and name-calling are somehow linked with a fondness for someone, and that might have been true when they were six or seven years old. However, by the time a young girl or boy reaches their teenage years, that kind of behavior can take on a much different tone. What was once an awkward attempt at gaining someone’s attention can turn into physical and sexual abuse.

According to a new study from the Centers for Disease Control and Prevention (CDC) that is happening more than you might think.

Twenty-one percent of high school girls have been physically or sexually assaulted by someone they dated -- a figure twice as high as previously estimated.

Ten percent of high school boys also reported being physically or sexually assaulted by someone they had dated.

The authors of the new report noted that the CDC has changed the way it phrases its questions about teen dating violence, leading more students to report assaults.

Sadly, teens that have experienced dating violence are at risk for other serious problems as well. Research has shown that they are more than twice as likely to consider suicide. They are also more likely to get into fights, carry a weapon, use alcohol, marijuana or cocaine and to have sex with multiple partners. Not the kind of life any parent would want for their teenager or the one that they would truly want for themselves.  

Researchers don't know if any of these events causes the others. While it's possible that dating violence could cause thoughts of suicide, it's also possible that children who are depressed are more likely than others to fall into abusive relationships, says Adiaha Spinks-Franklin, a developmental and behavioral pediatrician at Texas Children's Hospital in Houston who was not involved in the study.

Assaults by romantic partners often aren't isolated events. Many teens reported being assaulted multiple times, according to the study, based on the CDC's Youth Behavior Risk Surveillance System using questionnaires answered by more than 13,000 high school students.

"If there is violence once, there is likely to be violence again," Spinks-Franklin says. "It has to be taken very seriously."

Spinks-Franklin says she has seen violence even among relationships between 10- and 11-year-olds.

"If a parent is concerned that a child is in an unhealthy relationship, they need to address it, but do it in a way that doesn't make the child shut down," she says. "They need to feel safe telling a parent."

Teens often hide the abuse from their parents, Spinks-Franklin says. Teens may not be able to confide in friends, either, because abusers sometimes isolate their victims from loved ones. Teens are sometimes more willing to talk to doctors, especially if their parents are not in the room.

Some schools have taken the lead in promoting awareness of and education on teen dating violence. Pediatricians can also discuss this important topic with their patients and parents. If time is limited, brochures in the waiting room can offer information and open the door for questions.

"This study makes it even more important for parents to ask lots of questions and get to know their teen's friends and significant others, and not ignore anything that makes them uncomfortable," says McCarthy, a pediatrician at Boston Children's Hospital. "They also shouldn't ignore any changes in their teen's behavior."

Dating violence may never be eliminated one hundred percent, but can be considerably lessoned when teens, families, organizations, and communities work together to implement effective prevention strategies.

One of the best strategies for prevention is for parents and teens to be able to communicate about serious topics without judgmental attitudes or closed-minded opinions. Your teen wants your help even if he or she doesn’t know how to ask. They'll appreciate you being there before and when they need you.

The new study was published in JAMA Pediatrics.

Sources: Liz Szabo, http://www.usatoday.com/story/news/2015/03/02/teen-dating-violence-study/24127121/

http://www.cdc.gov/violenceprevention/intimatepartnerviolence/teen_dating_violence.html

Your Child

Obesity Related Heart Disease Found in Children as Young as 8

2:00

All you have to do is look around, wherever children are gathered, to see that there are far too many kids that are overweight in this country.  And sadly, some of these children may already be developing heart disease according to a new study.

The study reports that obese children as young as 8 years of age, are beginning to show signs of heart abnormalities.

"It is both surprising and alarming to us that even the youngest obese children in our study who were 8 years old had evidence of heart disease," said study lead author Linyuan Jing, a postdoctoral fellow with Geisinger Health System in Danville, Pa.

"Ultimately, we hope that the effects we see in the hearts of these children are reversible," Jing added. "However, it is possible that there could be permanent damage."

Researchers conducted MRI scans of 40 children between 8 and 16 years old. Half of the participants were obese; the other half was of normal weight for their age and height.

They found that the obese children had an average of 27 percent more muscle mass in the left ventricle region their heart, and 12 percent thicker heart muscle overall. Both are considered indicators of heart disease, Jing said.

Among 40 percent of the obese children, scans showed thickened heart muscle had already translated into a reduced ability to pump blood. The children with this reduced heart capacity were considered to be at “high risk” for adult cardiac strain and heart disease.

"This should be further motivation for parents to help children lead a healthy lifestyle," Jing said.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, called the findings "alarming."

Some of the obese children in the study were struggling with health complications often associated with excess weight, including asthma, high blood pressure and depression, the researchers said. But none displayed customary warning signs of heart disease such as fatigue, dizziness or shortness of breath, Jing said.

The study did not include kids with diabetes or those that were too large to fit inside the MRI scanning machine. Jing noted that the study might actually underestimate how many children are suffering from heart related problems associated with obesity.

Jing said it’s up to parents to help their children maintain a healthy weight. They should buy healthy foods instead of cheap fast food and fruit juice, "which is high in sugar but low in fiber," she said.

She also recommended that parents limit TV, computer and video game time and encourage more physical outdoor activities.

Childhood obesity isn’t just an American problem; it’s a global problem as well.  The World Heart Federation says that one in 10 school-aged children worldwide are estimated to be overweight. However, in the USA, the number of overweight children has doubled and the number of overweight adolescents has tripled since 1980.

The researchers believe that schools can play a role in helping families understand the health problems associated with obesity.

“…Schools and communities need to do a better job at educating both the parents and children about the health risks of overweight and obesity," said Jing.

Fonarow agreed adding, "Substantially increased efforts are needed to prevent and treat childhood obesity."

The findings were presented at the annual meeting of the American Heart Association in Orlando, Fla.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Source: Alan Mozes, http://consumer.healthday.com/cardiovascular-health-information-20/misc-stroke-related-heart-news-360/obese-kids-as-young-as-8-show-heart-disease-signs-705099.html

 

 

 

Your Baby

No Link Found Between Induced Labor and Autism

1:30

In 2013, a study suggested there might be a link between induced labor using a medication such as oxytocin, and a higher risk of the baby developing autism.  New research out of Boston, Massachusetts says there is no connection between the two.

"These findings should provide reassurance to women who are about to give birth, that having their labor induced will not increase their child's risk of developing autism spectrum disorders," said senior researcher Dr. Brian Bateman. He's an anesthesiologist at Massachusetts General Hospital and Brigham and Women's Hospital in Boston.

Induced labor is sometimes needed when a mother’s labor stalls or the infant is endangered. Because of the former study, many women have had concerns about labor induction and the risk of autism.

Bateman's team of American and Swedish researchers, led by the Harvard T. H. Chan School of Public Health, decided to investigate the issue.

They used a database on all live births in Sweden from 1992 through 2005, and looked at child outcomes for more than 1 million births through 2013, to identify any children diagnosed with a neuropsychiatric condition.

They also identified all the children's brothers, sisters and cousins on their mother's side of the family. The health of the children's mothers was also taken into account.

Eleven percent of the inductions were due to health complications such as preeclampsia, diabetes or high blood pressure. Twenty-three percent were induced because of late deliveries (after 40 weeks of pregnancy).

Results showed that 2 percent of the babies in the study were later diagnosed with autism.

When just looking at unrelated children, the researchers did find a link between induced labor and a greater risk for an autism spectrum disorder. This association disappeared, however, once they also considered the women's other children who were not born from an induced labor.

"When we used close relatives, such as siblings or cousins, as the comparison group, we found no association between labor induction and autism risk," said study author Anna Sara Oberg, a research fellow in the department of epidemiology at the Harvard Chan School.

Explaining further, she said in a university news release, "many of the factors that could lead to both induction of labor and autism are completely or partially shared by siblings -- such as maternal characteristics or socioeconomic or genetic factors." Therefore, Oberg said, "previously observed associations could have been due to some of these familial factors, not the result of induction."

Other experts have agreed with the new study’s findings.

"Pregnant women have enough things to worry about," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York, in New Hyde Park, N.Y.

"If a woman's doctor recommends that labor be induced, the expectant mother should not worry about an increased risk of the child having an autism spectrum disorder," Adesman said.

If you have concerns about a connection between labor induction and autism, speak to your OB/GYN to learn more. 

The study was published in  in the July 25th online edition of JAMA Pediatrics.

Story source: Mary Elizabeth Dallas, https://consumer.healthday.com/cognitive-health-information-26/autism-news-51/induced-labor-won-t-raise-autism-risk-in-kids-study-suggests-713155.html

 

Your Child

Probiotics Reduce Diarrhea and Respiratory Infections

2.00 to read

A daily dose of probiotics can reduce the occurrences of diarrhea or respiratory tract infections in children who attend day care according to a new study.

Probiotics are live microorganisms that are similar to the natural and beneficial microorganisms found in the gut. They are often referred to as “good bacteria.”

In a study in Mexico, researchers tested 336 healthy children ages 6 months to 3 years who were attending day care centers. Half received a daily dose of Lactobacillus reuteri, a beneficial gut bacterium naturally present in many foods and in most people; the other half got an identical placebo.

The children were given probiotics or the placebo for 3 months and then followed for another 3 months without the supplements. During the study, 69 episodes of diarrhea were reported in the placebo group and 42 in the group receiving the probiotics. The placebo group had 204 respiratory tract infections, compared with 93 in those taking L. reuteri. And the placebo takers spent an average of 4.1 days on antibiotics, while the supplement users averaged 2.7 days. The differences persisted during the 12-week follow-up.

“What’s notable here is that they used a specific probiotic in a good design and they also did follow-up,” said Stephen S. Morse, an infectious disease specialist at Columbia University who was not involved in the study. “This strengthens the evidence for the value of probiotics, but we still have a lot to learn.”

The research group concluded that a daily administration of probiotics in healthy children in day care centers “had a significant effect in reducing episodes and duration of diarrhea and respiratory tract infection, with consequent cost savings for the communities”.

Probiotics have been added to many food and beverage products making it easier for parents to add them to their child’s diet.

The most common food is yogurt but some manufacturers have added probiotics to ice creams, granola bars, cereals, juices and yes…even pizza.

Some parents swear by probiotics saying that they have eased their children’s symptoms of colic, eczema and intestinal problems.

Antibiotics kill bad bacteria, but they can also kill the good bacteria and throw a child’s gut flora out of balance - leading to gastrointestinal distress. Previous studies have shown that adding supplements or foods containing probiotics to a child’s diet can have a positive affect on his or her bacterial balance.

The study was published in the journal Pediatrics and was supported by a grant from a manufacturer of probiotic supplements.

Sources: Nicholas Bakalar, http://well.blogs.nytimes.com/2014/03/17/probiotic-eases-ills-in-children/?_php=true&_type=blogs&_r=0

Nancy Gottesman, http://www.parents.com/toddlers-preschoolers/feeding/healthy-eating/probiotics-the-friendly-bacteria/

Your Teen

Inhaled Steroids to the Rescue

1.45 to read

A new study suggests that the combination of daily-inhaled steroids, with the bronchial dilator Albuterol when an asthma attack starts, may improve mildly persistent asthma in children.

Using inhaled steroids as a rescue medicine along with albuterol may help some children with mild persistent asthma avoid daily inhaled steroid therapy and one of its potential side effects, namely growth restriction, according to a new study. The new findings, which appear in the Lancet, apply only to children with mild persistent asthma that is under control. This step-down treatment is not recommended for children with moderate to severe asthma or uncontrolled mild asthma. Many children with asthma take one or two puffs of inhaled steroids such as beclomethasone, morning and evening to prevent an asthma attack. They also use a bronchial-dilator such as albuterol as a rescue medication to treat any breakthrough symptoms. Such symptom relief from albuterol doesn’t get at the underlying airway inflammation, which is why some people need daily-inhaled steroids. Steroids, inhaled daily, are still considered the gold standard to prevent asthma attacks but are not risk-free. Risks of daily-inhaled steroid therapy in children include possible restricted growth and problems with adherence. “The strategy is to give rescue therapy with inhaled corticosteroids every time you need Albuterol for relief of symptoms,” says study researcher Fernando D. Martinez, MD, the Swift-McNear Professor of Pediatrics and director of the Arizona Respiratory Center at the University of Arizona Tucson. For example, “you can use two puffs on Monday and another two puffs on Friday during one week, none during another week, and six puffs every day on another week, depending on how many symptoms you have,” he says in an email. The key is to know when you need help. “If the cold starts causing tightness and shortness of breath, the child will need more albuterol and thus will use more inhaled steroids,” he says. Colds can be an asthma trigger. “The number of inhaled steroid puffs is proportional to how many albuterol puffs are needed, and therefore, to how severe the symptoms are.” Always Discuss Medication Changes With a Doctor First “This is some important and landmark work,” says Harold J. Farber, MD, an associate professor of the pediatric pulmonary section at Baylor College of Medicine and Texas Children Hospital in Houston and author of Control Your Child's Asthma. “Starting the steroid, beclomethasone, along with albuterol at onset of symptoms gave almost as good of a benefit in prevention as daily inhaled steroid therapy,” he says. But “for it to work, you have to start it early at first sign of an attack,” he says. “If we wait for severe problems, it’s too little too late.” This advice is only good for “folks with mild asthma, not folks with moderate to severe asthma,” he says. “If you have moderate to severe asthma, the use of inhaled corticosteroid every day is better than as-needed use.” “Always talk with your doctor before making any changes to medication,” Farber says. “When used as a rescue modality, inhaled steroids (beclomethasone) do a reasonable job at controlling symptoms without the side effects of reduced growth,” says William Checkley, MD, assistant professor in the Division of Pulmonary and Critical Care of the Johns Hopkins School of Medicine in Baltimore. “This step-down approach reduces the need to do puffs twice a day.” But “there have to be more studies to support these findings,” he says. Checkley wrote an editorial accompanying the study.

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DR SUE'S DAILY DOSE

A few life lessons & fun with Elf on the Shelf!

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