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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.

Your Baby

Babies Can Tell the Difference and Sameness of Objects

1:45

How old are we when we begin to learn to tell when objects are alike or different?  Scientists involved in a new study say that with a little training, babies as young as seven months can discern whether objects are similar or not.

Previous studies have shown that toddlers have this ability, but researchers at Northwestern University, wanted to see if children could actually determine the difference at an even earlier age.  The scientists were the first to discover that infants can actually make this remarkable determination – long before they have the language skills to express abstract ideas.

“This suggests that a skill key to human intelligence is present very early in human development, and that language skills are not necessary for learning abstract relations,” said study author, Alissa Ferry, a brain development researcher.

To accomplish this, the scientists started out to see if seven--month-old infants could comprehend sameness and difference between two objects by showing them either two Elmo dolls or an Elmo doll and a toy camel until their observation time ran out.

They then had the infants look longer at pairs that were either the “same” or “different,” including test pairs composed of new items. The team saw infants who had learned the “same” relation looked longer at test pairs showing the “different” relation and vice versa. The team said this indicates the infants had figured out the abstract relation and recognized when the relation changed.

“We found that infants are capable of learning these relations,” Ferry said. “Additionally, infants exhibit the same patterns of learning as older children and adults — relational learning benefits from seeing multiple examples of the relation and is impeded when attention is drawn to the individual objects composing the relation.”

The researchers also believe that because the infants could learn the difference and the sameness of objects before they could speak, that this is a separate skill that humans need and develop early in their existence.

“The infants in our study were able to form an abstract same or different relation after seeing only 6-9 examples,” said study author Dedre Gentner, a professor of psychology at Northwestern. “It appears that relational learning is something that humans, even very young humans, are much better at than other primates.”

Source: Brett Smith, http://www.redorbit.com/news/health/1113398144/infants-can-compare-and-contrast-objects-study-052715/

 

 

Your Child

More PE in School Linked to Higher Math Scores

1:45

Students in the Washington D.C. school system who spent more time doing physical activity also increased their standardized math scores significantly, according to a new study American University study.

A law passed in 2010, requires D.C. students to adhere to certain requirements regarding nutrition and physical activity at school to receive federal funding. They are also obligated to report how they implement these programs.

“This finding demonstrates that students’ academic performance improves when there’s a balance between time spent on physical education and time spent on learning,” said Stacey Snelling, dean of American University’s School of Education.

The study divided the city’s elementary schools into four groups based on how much physical education they offered: the lower 25 percent, lower-middle 25 percent, upper-middle 25 percent and upper 25 percent.

The researchers then took the average DC CAS math proficiency score, from the 2012-2013 school year, for each of these four groups and found that schools offering more physical activity posted higher math scores.

The upper 25 percent had an average of 151 minutes of physical education and saw an average math proficiency rate of 56.66. The lower 25 percent had an average of 29 minutes of physical education per week and an average math proficiency rate of 47.53. Some of the findings also were published in the academic journal Appetite. 

Researchers graded each school on how it implemented various aspects of the legislation — including building school gardens, serving healthy lunches and offering ample physical education time — on a 33-point scale. They found that, despite socioeconomic differences, there were no significant variations in how schools performed on the 33-point-scale across the District’s eight wards.

There were certain limitations pointed out in the findings. Researchers said that the data is based on schools’ self-reporting – which can leave room for errors. Several schools have also closed and opened during the five –year study, yielding inconsistent data.

D. C. Council member Mary M. Cheh (D-Ward 3), who authored the original 2010 legislation, applauded the report’s findings, adding that although schools effectively provided more nutritious lunches, there is still more room for more physical ­activity.

“When children are fed and they are not hopping all around because their hungry, they’re better learners, and that’s translated throughout,” Cheh. “I was impressed with the findings.”

More schools across the country are taking a second look at adding back PE to students’ school week. Many schools have cancelled PE classes in order to use that time to prepare students for testing. As study after study comes in pointing out the benefits, including higher test scores, of children engaging in some sort of physical activity during the school day, school administrations are beginning take notice.

Source: Perry Stein, https://www.washingtonpost.com/news/education/wp/2016/02/09/is-more-physical-education-at-school-linked-to-higher-student-math-scores/

 

Daily Dose

Kids & Too Much TV

1:30 to read

Another recent study has just been released which confirms that children are getting close to 4 hours of background TV noise each day. While many parents are aware of the need to limit their children’s active screen time (which includes TV, video game, telephone texting and computer screens) to no more than 2 hours per day, background TV time may be equally important. The American Academy of Pediatrics also discourages any TV viewing for children under age 2 years. 

*The study from The University of Pennsylvania’s Annenberg School for Communication defines background TV as “TV that is on in the vicinity of the child that the child is not attending to”.  The research looked at TV exposure in 1,454 households with children aged 8 months-8 years. The study found that younger children and African-American kids were exposed to more background TV than other children.  Having background TV noise of any kind can disrupt mental tasks for all and may also interfere with language development in younger children. 

Those households that had the least background TV exposure were those that did not have a TV in the child’s room!! That doesn’t seem to be a surprising finding at all. Many parents leave the TV on in a child’s room to help them sleep, although there are numerous studies to show exactly the opposite effect, TV disrupts sleep. I now routinely ask every parent during their child’s check up if there is a TV in the child’s room. I also ask every older child the same question, and there are many teens who are not happy with me when I encourage their parents to take the TV out of the bedroom of their adolescent. There is just no need to have a TV in the bedroom of children of any age.  I have given up on this discussion with my college aged patients! 

While many parents are doing a good job of monitoring what their children are watching on TV, and how long they are watching, we may not be doing as well when it comes to background TV.  While older kids hear news stories or language that they needn’t be exposed to, a younger child’s language skills may be delayed due to background TV noise. 

So, the kitchen TV needn’t be on while you are making your children their breakfast before school or in the evening while eating dinner. Family dinner is one of the most important times of the day and conversation is the key. No one needs to try to talk over the TV, just turn it off! 

Lastly, keep reading those bedtime stories for children of all ages; this is key to language, and appropriate language at that. 

That’s your daily dose for today.  We’ll chat again tomorrow.

Your Teen

Schools Start Too Early, Teens Sleep Deprived

2:00

It’s a battle that is picking up steam, whether to start school a little later so teenagers can get the sleep they need or keeping schedules as they are for the sake of planning before and after school activities.

Research from the American Academy of Pediatrics (AAP) found that teenagers are biologically programmed to go to bed later than most adults and sleep later in the morning.

Last year, the AAP issued a set of guidelines recommending that school schedules are modified across the U.S. to start at 8.30 a.m. This way, children and teens would be able to meet the recommended sleep hours per night during school days.

Fewer than one in five middle and high schools in the United States start at 8:30 am or later, as recommended, according to data from the U.S. Centers for Disease Control and Prevention (CDC).

The same recommendations suggested that indeed, the biological rhythm of teenagers particularly is very different than that of adults. While they need 8 and a half to nine and a half hours of sleep per night, their circadian rhythm doesn’t allow them to go to sleep before midnight or a little after.

School nights are particularly difficult for adolescents because in order to get the rest they need, they have to go to bed earlier than their minds and bodies are set to fall asleep.

The CDC released a new study supporting the recommendations of the AAP. According to the findings, 83 percent of U.S. schools still start before 8:30 a.m. On average, the starting time was calculated at 8:03 a.m., based on data collected from 39,700 combined schools, middle schools, and high schools between 2011-2012.

Depriving teens of that sleep could wreak havoc on their academic performance, the CDC said in its Morbidity and Mortality Weekly Report.

"Getting enough sleep is important for students' health, safety, and academic performance," said Anne Wheaton, lead author and epidemiologist in CDC's Division of Population Health.

"Early school start times, however, are preventing many adolescents from getting the sleep they need."

The issue is driving a heated debate between supporters of later school start times and school administrators.

Safwan Badr, former president of the American Academy of Sleep Medicine stated:

“It makes absolutely no sense. You’re asking kids to learn math at a time their brains are not even awake”.

On the other hand, Daniel Domenech, the executive director of the School Superintendents Association stated with regards to changing school starting time:

“It’s a logistical nightmare. This has been going on forever, and kids have been graduation from school and going to college. It certainly doesn’t seem to have hurt them all these years”.

Some experts note that the long-term consequence of sleep deprivation is hurting our teens and has been for quite some time.

Judith Owens, the director of sleep medicine at Boston’s Children Hospital suggests that chronically sleep deprivation characterizes the majority of today’s teens. This results in increased risk of onset depression, substance abuse, unhealthy BMIs. Long-term effects of sleep deprivation result in type 2 diabetes or heart diseases.

There are things that parents can do to help their teens at least rest better if they can’t fall asleep earlier. The first and foremost agitator for sleep is viewing or being on a computer or smartphone right before bed.

Recent studies have shown that the use of any electronic device in the hour before bedtime was associated with an increased risk of taking longer than 60 minutes to fall asleep. In particular, the use of a computer, smartphone or MP3 player in the hour before bedtime was strongly linked with taking longer to fall asleep.

Make your teen’s bedroom a quiet place that can be a retreat at night from busy schedules and social media.

Your teen can take a hot bath or shower before bed to boost deep sleep. Then keep his or her room cool (about 68 F) to cool down the body. One study showed that sleep happens when the body cools. Wakefulness occurs when the body temperature warms up.

Aromatherapy helps some people fall off to sleep. Certain scents are shown to be relaxing such as orange blossom, marjoram, chamomile, and lavender. You can apply these oils before bed or put them on pillows, sheets or in potpourri. If candles are used, make sure they are put out before getting in bed. 

Having a regular schedule can help the body adjust. Going to bed at the same time each night can assist in adjusting the body’s circadian rhythm.  

More high schools are considering changing their schedules to a later start time, but currently most schools are keeping with the typical earlier schedules. You may not be able to convince the school board to start school at little later, but you can help your teen find what works for them at night to help them get the amount of sleep they need to function at their best.

Sources: Bonnie Gleason, http://www.trinitynewsdaily.com/chronically-sleep-deprived-teens-need-schools-starting-time-changed/3209/

http://www.ctvnews.ca/health/u-s-teens-start-school-too-early-need-more-sleep-study-1.2506322

http://teens.webmd.com/features/8-ezzz-sleep-tips-teens

 

 

 

Your Teen

Alcohol-Branded Clothing & Accessories Linked to Youth Alcohol Use

2:00

The T-shirts, handbags, backpacks, hats, jackets and sunglasses we wear and carry all say a little something about who we think we are or would like to be. Clothing with slogans and photos, accessories with name –brands or specific designs help express, at least a small way, how we connect with others and want others to connect with us.

From politics to religion to music and movies – we’re not likely to wear something that we philosophically disagree with. That’s pretty much true in all age groups.

So, what does it mean when teens proudly wear clothing and carry products with alcohol-brands up front and center?

According to a large review of different studies on the topic, teens that own caps, shirts, and other merchandise displaying alcohol logos are more likely to drink.

Australian researchers reviewed results from 13 studies looking at alcohol-branded merchandise and teen alcohol use. The research included more than 26,000 kids and teens, mostly from the United States.

Four studies looked specifically at young people who hadn't started drinking alcohol. Those who owned alcohol-branded merchandise were more likely to start drinking a year later, the researchers said.

While the study doesn’t prove causation (teens will drink if they own alcohol-branded items), it does show an association between the two activities.

"It is possible that owning the merchandise makes young people more likely to drink, or that young people who drink are more likely to want to own the merchandise, or a combination of these effects," explained study leader Sandra Jones. She's director of the Centre for Health and Social Research at Australian Catholic University in Melbourne.

Dr. Victor Strasburger, lead author of the American Academy of Pediatrics' Children, Adolescents, and Advertising policy statement, said, "The studies showed that this ownership contributes to onset of drinking, not the amount of drinking.”

“But we know that when teenagers begin drinking, they tend to binge drink, not use good judgment, and drive when drunk or intoxicated," he added.

Because of the study’s findings, Jones believes that promotional alcohol-branded products encourage drinking among adolescents.

"As they transition through adolescence, young people are developing their sense of identity," she said.

"The things that they wear, carry, and consume help to create and convey their desired identity. There is increasing evidence that brands facilitate this by allowing the young person to take on and project the desirable characteristics that are associated with that brand. These characteristics and brands then become a part of their sense of self, as well as the way that others see them," Jones said.

In addition to hats, caps and T-shirts, other examples of alcohol-related products include accessories, such as bags, backpacks, belts, lighters, sunglasses, wallets and key rings. Other promotional items include drinking glasses, utensils, cooler bags, bottle openers and coffee cups, the researchers said.

Depending on the study, ownership of such items ranged from 11 percent to 59 percent of the young participants. Ownership was higher among older children and males, the researchers said.

Most of the studies didn't find any gender differences. But two studies did find that the association between branded merchandise and drinking issues was actually stronger for girls.

Jones noted that company policies and regulations could help prevent the availability of such products for teens. She recommended restricting the sale of alcohol promotional products where the sale of alcohol is allowed, that alcohol-branded clothing not be made in children’s sizes and toys and gimmicks that appeal to children be discontinued.

Jones also noted that it’s not only up to businesses and government to regulate the availability of these products to kids, but parents as well.

"Many of these items are given away for free at promotional events or as gifts with purchase, and parents may hand them on to their children -- or allow others to do so -- without processing the fact that they are providing their child with extended exposure to an advertisement for an alcohol brand," she said.

Strasburger said the media are often irresponsible when it comes to alcohol. "They depict alcohol use as normative behavior, or a solution for complex problems, or show being drunk as funny," he said. "We spend something like $5 million on alcohol advertising every year, then we wonder why so many teenagers drink. It's not rocket science."

The findings were publised online in the April 1st edition of the journal Pediatrics. 

Story source: Don Rauf, http://consumer.healthday.com/kids-health-information-23/kids-and-alcohol-health-news-11/booze-branded-merchandise-may-spur-teen-drinking-709478.html

 

 

 

Your Child

Pre-teen Cholesterol Check-Up

1.45 to read

Do you know your child’s cholesterol level? Unless you have a family history of high cholesterol, getting your child’s checked probably hasn’t been high on your list of medical exams.

A panel of experts appointed by the National Heart, Lung and Blood Institute and endorsed by the American Academy of Pediatrics, are recommending that children be tested for high cholesterol by age eleven. They also recommend that children who are overweight, be screened every 2 years for diabetes.

Major medical groups already suggest children, with a family history of high cholesterol or diabetes, be screened early. Children without a family history of heart disease or diabetes have traditionally not been screened until their later years. Times have changed though and because of the childhood obesity epidemic many kids are developing heart disease and Type 2 diabetes at a much younger age.

Fats build up in the heart arteries in the first and second decade of life but usually don't start hardening the arteries until people are in their 20s and 30s, said one of the guideline panel members, Dr. Elaine Urbina, director of preventive cardiology at Cincinnati Children's Hospital Medical Center.

"If we screen at age 20, it may be already too late," she said. "To me it's not controversial at all. We should have been doing this for years."

An alarming statistic shows how destructive childhood obesity has become. Autopsy studies show that children already have signs of heart disease, long before they show symptoms. By the fourth grade, 10 percent to 13 percent of U.S. children have high cholesterol, defined as a score of 200 or more.

According to the National Cholesterol Education Program's Expert Panel on Blood Cholesterol in Children and Adolescents, the acceptable level for total cholesterol in kids 2 to 19 years old is less than 170 mg/dL. Their LDL cholesterol should be less than 110 mg/dL, HDL levels should be 35 mg/dL or greater, but preferably over 60, and triglycerides should be 150 mg/dL or less.

Doctors recommend screening between ages 9 and 11 because cholesterol dips during puberty and rises later. They also advise testing again later, between ages 17 and 21.

The rise in Type 2 diabetes, in children, has also increased in the last decade. It is hard to detect type 2 diabetes in children, because it can go undiagnosed for a long time; children may have no symptoms or mild symptoms; and because blood tests are needed for diagnosis. That’s why early screening is so important.

The guidelines also say doctors should:

  • Take yearly blood pressure measurements for children starting at age 3.
  • Start routine anti-smoking advice when kids are ages 5 to 9, and counsel parents of infants not to smoke in the home.
  • Review infants' family history of obesity and start tracking body mass index, or BMI, a measure of obesity, at age 2.

There has been some controversy over doctors using terms like overweight and obese when talking with parents and children about their weight. The panel suggests that these are medically correct terms and should be used so that parents and children understand the importance of the problem.

Children whose BMI is in the 85th to 95th percentile should be called overweight, not "at risk for overweight," and kids whose BMI is in the 95th percentile or higher should be called obese, not "overweight; even kids as young as age 2, the panel said.

"Some might feel that 'obese' is an unacceptable term for children and parents," so doctors should "use descriptive terminology that is appropriate for each child and family," the guidelines recommend.

They were released online by the journal Pediatrics.

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Can homemade products cure Hand-Foot-Mouth disease?

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