Thursday, December 11, 2008

Danger of heavy toilet seats to male toddlers

Doctors issue warning about the danger of heavy toilet seats to male toddlers

Keep the seat up or change it say urologists after increase in penis crush injuries

Doctors have expressed considerable concerns about the growing trend for heavy wooden and ornamental toilet seats after a number of male toddlers were admitted with crush injuries to their penises.

Writing in the December issue of BJU International, Dr Joe Philip and his colleagues at Leighton Hospital, Crewe, report on four boys under the age of four, who were admitted with injuries serious enough to require an overnight stay.

"As Christmas approaches many families will be visiting relatives and friends and their recently toilet trained toddlers will be keen to show how grown up they are by going to the toilet on their own" he says.

"It is important that parents check out the toilet seats in advance, not to mention the ones they have in their own homes, and accompany their children if necessary.

"A recent market research report has suggested that there has been a worldwide increase in the number of wooden and ceramic toilet seats sold. We would not be surprised to hear that other colleagues have noticed an increase in penis crush injuries as a result of this."

The four boys, aged from two to four, all attended as urological emergencies.

All had been recently toilet trained and they were using the toilet on their own. They had lifted the toilet seats, which had then fallen back down, crushing their penises.

Three had a build up of fluid in their foreskin, but were still able to pass urine, and the fourth had glanular tenderness.

Luckily there were no urethal injuries or bleeding and the symptoms settled down with pain relief. All the children were able to go home the next day.

The authors have come up with four key recommendations:

1. Parents should consider fitting toilet seats that fall slowly and with reduced momentum, markedly reducing the risk and degree of injury.

2. Heavier toilet seats could be banned in houses with male infants.

3. Households with male infants should consider leaving the toilet seat up after use, even though it contradicts the social norm of putting it down.

4. Parents could educate their toddlers to hold the toilet seat up with one hand when they pass urine and keep an eye on them until they are confident that they are able to do it unsupervised.

"As any parent knows, toilet training can be a difficult time with any toddler" concludes Dr Philip. "We are concerned that the growing trend of heavy toilet seats poses a risk not only to their health, but to their confidence."

Thursday, December 4, 2008

Vitamin E eases chronic inflammation?

Vitamin E shows possible promise in easing chronic inflammation

With up to half of a person’s body mass consisting of skeletal muscle, chronic inflammation of those muscles – which include those found in the limbs – can result in significant physical impairment.

According to University of Illinois kinesiology and community health professor Kimberly Huey, past research has demonstrated that the antioxidant properties of Vitamin E may be associated with reduced expression of certain pro-inflammatory cytokines, in vitro, in various types of cells. Cytokines are regulatory proteins that function as intercellular communicators that assist the immune system in generating a response.

To consider whether the administration of Vitamin E, in vivo, might have similar effects on skeletal and cardiac muscle, Huey and a team of Illinois researchers put Vitamin E to the test in mice. The team included study designer Rodney Johnson, a U. of I. professor of animal sciences, whose previous work has suggested a possible link, in mice, between short-term Vitamin E supplementation and reduced inflammation in the brain.

The study represents the first time researchers have looked at in vivo effects of Vitamin E administration on local inflammatory responses in skeletal and cardiac muscle.

In this study, the researchers investigated the effects of prior administration of Vitamin E in mice that were then injected with a low dose of E. coli lipopolysaccharide (LPS) to induce acute systemic inflammation. The effects were compared with those found in placebo control groups.

The research team examined the impact the Vitamin E or placebo treatment had on the mRNA and protein levels of three cytokines – interleukin (IL-6), tumor necrosis factor-alpha (TNF-alpha) and IL-1beta.

“The mice were administered Vitamin E for three days prior to giving them what amounts to a minor systemic bacterial infection,” Huey said. “One thing we did – in addition to (looking at) the cytokines – was to look, in the muscle, at the amount of oxidized proteins.

“Oxidation can be detrimental, and in muscle has been associated with reduced muscle strength,” Huey said.

Among the team’s major findings, in terms of function, Huey said, was that “there was a significant reduction in the amount of LPS-induced oxidized proteins with Vitamin E compared to placebo.”

“So that’s a good thing,” she said. “Potentially, if you reduce the oxidized proteins, that may correlate to increased muscle strength.”

Additionally, the researchers’ experiments yielded a significant decrease in two cytokines – IL-6 and IL-1beta – with Vitamin E, compared with the placebo.

That finding translates to somewhat mixed reviews.

“It’s hard to say functionally what those cytokine changes might mean,” Huey said. “IL-1beta is primarily a pro-inflammatory cytokine, so that could be a good thing – especially in terms of cardiac function.”

However, she said, “IL-6 can have both pro- or anti-inflammatory actions.” She said that the literature has yielded some evidence pointing to the detrimental effects of chronic increases in IL-6. But the effects of acute increases in IL-6 in skeletal muscles – which occur during exercise – may be another story.

“Whether there’s a difference between exercise-induced increases versus inflammation-induced increases in IL-6 is still highly debatable,” she said.

Nonetheless, Huey said, the larger take-home message of the study, published in the December issue of the journal Experimental Physiology, is that Vitamin E “may be beneficial in individuals with chronic inflammation, such as the elderly or patients with type II diabetes or chronic heart failure.”

While the Illinois research team’s work provides a foundation for future investigations that could ultimately have positive outcomes for people afflicted with chronic skeletal or cardiac muscle inflammation, Huey cautioned that it is still far too soon to speculate on results in humans.

“This is clearly an animal model so whether it would translate to humans still requires a lot more research,” she said. “Vitamin E is a supplement that is already approved, and these results may suggest an additional benefit of taking Vitamin E beyond what’s already been shown.”

Wednesday, November 26, 2008

Childhood constipation just as serious as asthma

According to new research conducted at Nationwide Children's Hospital, the burden of illness in children suffering from constipation, and the costs associated with this condition, are roughly of the same magnitude as those for asthma and attention deficit- hyperactivity disorder (ADHD).

These findings are a result of a study involving gastroenterologists and researchers at Nationwide Children's to estimate the health care utilization and cost for children with constipation in the United States. The study, available online at PubMed.gov, is slated for publication in The Journal of Pediatrics in early 2009.

Using a nationally representative survey, clinicians and researchers analyzed data of children under 18 years of age who were diagnosed with constipation or prescribed a laxative over two-consecutive years (2003 and 2004). Results showed that children with constipation used more health services than children without the condition, amounting to an additional cost of $3.9 billion each year for children with constipation. Despite this amplified cost impact and its prevalence during childhood, constipation has not received the amount of attention in public health campaigns that similarly occurring asthma and ADHD have.

"Despite being considered by many a relatively benign condition, childhood constipation has been shown to be associated with a significantly decreased quality of life," said the study's author, Carlo Di Lorenzo, MD, chief of Gastroenterology, Hepatology and Nutrition at Nationwide Children's and faculty member at The Ohio State University College of Medicine.

"The day-to-day struggle caused by constipation can often be emotionally devastating, and can also have an impact on the overall health and well-being of affected children and their families."

Researchers and clinicians hope that health care utilization and cost estimates revealed in this study can boost awareness of childhood constipation, awareness that could result in earlier treatment.

"In many cases, constipation in children can be prevented or corrected through dietary and behavioral changes," said Hayat Mousa, MD, a pediatric gastroenterologist at Nationwide Children's Hospital and a faculty member at The Ohio State University College of Medicine.

"Parents should talk to their children about their bathroom habits and make sure they are having a bowel movement at least every other day. For mild cases of constipation, prune or apple juice, high-fiber cereal, or over-the-counter softeners or laxatives made for children may help. If the problem persists, parents should seek the advice of a medical professional."

Wednesday, October 29, 2008

Braces for Your Teeth

Do you like the way your teeth look? No one has perfect teeth. Some people's teeth are crowded together. Other people have too much space between their teeth. Sometimes the upper teeth don't match the lower teeth when a person bites down. For some people the problem isn't so bad. But others may need braces to make their teeth straighter.

Braces are not just to make your smile look good. It's hard to brush crowded or crooked teeth. If your teeth don't get clean, they can get cavities and other problems.

There are special dentists who can tell if you need braces and can fit you with them if you do. They are called orthodontists.

How Do Braces Work?
Braces put pressure against the teeth. Most of the pressure comes from a metal wire that goes across the outside of the teeth. Very slowly this pressure makes the teeth move and become straight.

The orthodontist adjusts the wire just a little bit every few weeks. The small changes in the wire allow the braces to move the teeth slowly. This is important. If the braces make the teeth move too fast, it can cause the teeth to become loose.

Because the teeth only can be moved slowly, you'll need to wear braces for about two years. After that you'll need to wear a plastic retainer over your teeth. This will keep them in their new position until bones grow around the teeth to hold them in place permanently.

What Do Braces Look Like?
One wire goes across all of your top teeth and another goes across your bottom teeth. It is held in place by small pieces of metal or ceramic that are put on each tooth. These pieces can be clear or tooth-colored. But then the fun begins. The elastic ties that hold the wire to the pieces come in colors. You can get them to show your school spirit, support your favorite sports team, or celebrate an upcoming holiday. The ties can be changed when the orthodontist adjusts the wire.

How to Take Care of Your Teeth with Braces
When you have braces, you'll have to be very good about following the brushing and flossing instructions your orthodontist gives you.

You can't eat hard, sticky or gooey foods such as jawbreakers, peanuts, ice cubes, caramel, or taffy. Those kinds of foods can break or bend the wires or brackets or get caught in the braces and cause cavities.

If you think you need braces, talk to your mom and dad.

What to Do About the Flu

Every fall adults start talking about the flu. They say things like:

"I hope I don't get the flu."

"I sure got a bad case of the flu last year."

"Maybe I should get a flu shot."

What are they talking about?

What is the flu?

The flu they're talking about is caused by a very small germ called a virus. The flu can make you feel sick.

The virus moves from person to person when people cough or sneeze. It also can get on your hands if a sick person touches something like a doorknob and then you touch it.

In the United States people usually start getting the flu in the late fall.

Can you protect yourself from the flu?
Not always. But there are some things you can do.

Wash your hands often. Use soap and make the water as hot as you can stand. Wash long enough to sing the "Happy Birthday" song twice.

Try not to touch your eyes, nose or mouth. Those are the places that the flu virus, and other germs, can most easily enter your body.

Talk to your parents about getting a flu shot.

What happens if you get the flu?
You may feel just a little sick or very sick. Some or all of these things will happen:

Aches

Headache

Fever

Cough

Feeling really tired

Sore throat

Runny or stuffy nose

Upset stomach

Are there ways to feel better if you get the flu?
Yes. Get lots of rest. Drink fluids-juice, water. Ask your parents about taking a medicine for pain. But don't take aspirin when you have the flu. It can cause another problem that's even more serious than the flu.

Saturday, September 27, 2008

Fish Helps Infant Healt

Eating Fish While Pregnant, Longer Breastfeeding, Lead to Better Infant Development

Both higher fish consumption and longer breastfeeding are linked to better physical and cognitive development in infants, according to a study of mothers and infants from Denmark. Maternal fish consumption and longer breastfeeding were independently beneficial.

“These results, together with findings from other studies of women in the U.S. and the United Kingdom, provide additional evidence that moderate maternal fish intake during pregnancy does not harm child development and may on balance be beneficial,” said Assistant Professor Emily Oken, lead author of the study.

The study, which appeared in the September issue of the American Journal of Clinical Nutrition, was conducted by researchers from the Department of Ambulatory Care and Prevention of Harvard Medical School and Harvard Pilgrim Health Care and the Maternal Nutrition Group from the Department of Epidemiology at Statens Serum Institut in Copenhagen, Denmark. These findings provide further evidence that the omega-3 fatty acids found in fish and compounds in breast milk are beneficial to infant development.

The study team looked at 25,446 children born to mothers participating in the Danish Birth Cohort, a study that includes pregnant women enrolled from 1997-2002. Mothers were interviewed about child development markers at 6 and 18 months postpartum and asked about their breastfeeding at 6 months postpartum. Prenatal diet, including amounts and types of fish consumed weekly, was assessed by a detailed food frequency questionnaire administered when they were six months pregnant.

During the interviews mothers were asked about specific physical and cognitive developmental milestones such as whether the child at six months could hold up his/her head, sit with a straight back, sit unsupported, respond to sound or voices, imitate sounds, or crawl. At 18 months, they were asked about more advanced milestones such as whether the child could climb stairs, remove his/her socks, drink from a cup, write or draw, use word-like sounds and put words together, and whether they could walk unassisted.

The children whose mothers ate the most fish during pregnancy were more likely to have better motor and cognitive skills. For example, among mothers who ate the least fish, 5.7% of their children had the lowest developmental scores at 18 months, compared with only 3.7% of children whose mothers had the highest fish intake. Compared with women who ate the least fish, women with the highest fish intake (about 60 grams - 2 ounces - per day on average) had children 25% more likely to have higher developmental scores at 6 months and almost 30% more likely to have higher scores at 18 months.

Longer duration of breastfeeding was also associated with better infant development, especially at 18 months. Breastmilk also contains omega-3 fatty acids. The benefit of fish consumption was similar among infants breastfed for shorter or longer durations.

Women in the U.S. have been advised to limit their fish intake to two servings a week because some fish contains high traces of mercury, which has demonstrated toxic effects. Information regarding mercury levels was not available in this population, but most women consumed cod, plaice, salmon, herring, and mackerel, fish types that tend to have low mercury content. In this study, consumption of three or more weekly servings of fish was associated with higher development scores, so in this case the nutrient benefits of prenatal fish appeared to outweigh toxicant harm.

“In previous work in a population of U.S. women, we similarly found that higher prenatal fish consumption was associated with an overall benefit for child cognitive development, but that higher mercury levels attenuated this benefit,” says Dr. Oken. “Therefore, women should continue to eat fish - especially during pregnancy - but should choose fish types likely to be lower in mercury.” Information on mercury levels in commonly consumed fish is available at the U.S. Food and Drug Administration website (http://www.cfsan.fda.gov/~frf/sea-mehg.html.).



Fishy diet in early infancy cuts eczema risk

Early introduction of fish decreases the risk of eczema in infants

An infant diet that includes fish before the age of 9 months curbs the risk of developing eczema, indicates research published ahead of print in the Archives of Disease in Childhood.

The prevalence of atopic eczema and other allergic disease has risen sharply in developed countries in recent decades, say the authors. Environmental and dietary factors are thought to play a part.

The researchers quizzed the parents of 6 month old babies born in western Sweden in 2003 about their child's diet and any evidence of allergic eczema. They were quizzed again when the children reached the age of 12 months.

The children were all part of an ongoing health study, Infants of Western Sweden, which is tracking the long term health of almost 17000 babies.

Complete birth data and two sets of questionnaires were obtained for almost 5000 of the 8000 families contacted.

At six months, 13% of families said that their youngest child had already developed eczema. By the time the children had reached 12 months of age, one in five had the condition.

The average age at which first symptoms appeared was 4 months.

Genes had a significant impact. Children with a sibling or mother who had the condition were almost twice as likely to be affected by the age of 12 months.

But breast feeding, the age at which dairy products were introduced into the diet, and keeping a furry pet in the house had no impact on risk. Around one in five households had a pet.

However, the introduction of fish into the diet before the age of 9 months cut the risk of developing the disease by 25%. And a pet bird was also associated with a significant reduction in risk.



Variety of foods -- the key for child nutrition

New research shows that most children have a diet that contains enough essential vitamins and minerals

New research shows that most children have a diet that contains enough essential vitamins and minerals.

Analysis of the Government's own survey of children's diets and nutritional status has shown that the average child gets the recommended level of most vitamins and minerals, even though they consume more added sugars than recommended.

The study published online in the British Journal of Nutrition, looked at a nationally representative sample of children aged 4-18 years who took part in the National Diet and Nutrition Survey. It found that the average child consumed levels of vitamins and most minerals that met recommendations, and in many cases, comfortably exceeded them. These conclusions were based on records from 7-day weighed food diaries and were confirmed by biochemical measurements of blood samples.

'The children in this study were healthy British children' said Mrs. Sigrid Gibson, lead author on the study. 'Some children who are fussy eaters might get lesser amounts of nutrients from their limited range of food choices, and if they also eat a lot of added sugars they might be at risk'. But she added, 'the solution is to broaden their choice of foods – it does not appear that simply discouraging sugar consumption would have any real benefit'.

Mrs. Gibson is an independent nutrition consultant, with over 20 year's experience of working with the government, food industry and agencies such as the Food Standards Agency. She is the author of over 30 peer-reviewed scientific publications and is a regular contributor to nutrition journals. 'There is an over-emphasis on avoiding sugar at all costs rather than having a balanced diet' said Mrs. Gibson. 'Concerns that added sugars 'dilute' the diet and jeopardise essential nutrients are just not founded'.

The school food trust works to improve the quality of school lunches by providing information on the Government's food and nutrient standards. They recommend 10% of your energy intake should come from added sugars. The children in this study had on average 15% of their energy from added sugars and still had enough of most vitamins and minerals.

Exercise and Calcium

Osteoporosis: Calcium and exercise to strengthen the bones – do you get enough?

People who are physically active and get enough calcium can strengthen their bones - even in old age / New online calcium calculator


Cologne, 12 September 2008: A stumble, a fall - a broken bone: many older people are afraid of this happening. The German Institute for Quality and Efficiency in Health Care published information today about how you can protect yourself. Research shows that regular adequate intake of calcium and exercise can strengthen the bones. But many people do not know whether they are getting enough calcium in their diets. The Institute has developed a calculator at www.informedhealthonline.org that can help you estimate if you are getting enough calcium.

Regular intake of calcium protects the bones

Getting older does not necessarily mean that you will get osteoporosis. However, the risk of osteoporosis does rise as we get older, and people over 70 often have brittle bones. A fall does not only mean bruises then, but it is easier for a bone to break. There are several ways to protect and strengthen bones, even when you are already older.

One important way is to get enough calcium regularly. To stop our bones losing too much strength we need an increasing amount of calcium as we get older. The best way to get it is with a calcium-rich diet. "Older people in particular are often not getting enough calcium," according to the Institute's Director, Professor Peter Sawicki.

The World Health Organization (WHO) recommends a minimum daily intake of calcium of 1,300 mg for women after the menopause and men over the age of 65. The Institute developed an online calculator for its website with the help of the Robert Koch Institute in Berlin. The calculator helps you find out quickly and easily roughly how much calcium you are getting through your diet every day and whether that is enough.

If you cannot get enough calcium in your diet, then calcium supplements could help. Trials have shown that taking daily calcium supplements can help protect people who are at high risk of bone fracture. According to Professor Sawicki, "Even when you are already over 70, you can reduce your risk of bone fracture if you get enough calcium."

Exercise strengthens the bones and might help reduce the risk of falling

Some people believe that they can best protect themselves by not moving around too much and trying to avoid situations where they might have a chance of falling. But in reality being too immobile is one of the major risk factors for osteoporosis. If you spend a large part of the day sitting or lying down, your bones are more likely to become weak and brittle. Physical activity that involves carrying your weight can actually strengthen your bones. One of the easier ways to get exercise with a low risk of injury is brisk walking. According to the Institute, even in older age, walking is a simple way of getting enough exercise that people feel comfortable with - and it benefits more than the bones, as well.

Professor Sawicki said: "Injury is of course always possible when you exercise. But people who are more active strengthen their muscles and bones - and that can help them stay physically stable and secure. People may gain more confidence in their bodies and that might mean a lower risk of stumbling and falling."

Wednesday, August 13, 2008

Childhood dairy intake and adolescent bone health

Dairy is recognized as a key component of a healthy, balanced diet. However, until recently it was unclear how long-term dairy intake contributes to the many aspects of bone health in children, including bone density, bone mineral content, and bone area. A new study soon to be published in The Journal of Pediatrics investigates the effect of childhood dairy intake on adolescent bone health.

Dr. Lynn Moore and colleagues from Boston University School of Medicine analyzed data from the Framingham Children's Study in an effort to understand the relationship between childhood dairy intake and adolescent bone health. The researchers gathered information from 106 children, 3 to 5 years of age at the beginning of the study, over a 12-year period. The families enrolled in the study were given food diaries to complete for the child and were asked to record everything the child ate and drank for several days each year.

The researchers used these diaries, along with information from the United States Department of Agriculture, to calculate the children's average daily intake of dairy and other foods. At the end of the 12-year period, the authors assessed the bone health of the now adolescent study participants. They found that the adolescents who had consumed 2 or more servings of dairy per day as children had higher levels of bone mineral content and bone density. Even after adjusting for factors that affect normal bone development, including the child's growth, body size, and activity level, the authors found that these adolescents' average bone mineral content was 175 grams higher than the adolescents who had consumed less than 2 servings of dairy per day.

The researchers also evaluated the combined effects of dairy and other foods consumed by the study participants. According to Dr. Moore, "Children who consumed 2 or more servings of dairy and 4 ounces of meat or other nondairy protein had bone mineral contents over 300 grams higher than those children with lower intakes of both dairy and other proteins." The study highlights the importance of dairy intake throughout childhood, and Dr. Moore points out that "dairy is a key source of proteins, calcium, and other micronutrients including phosphorus and vitamin D." Parents can promote healthy bone development during adolescence by making dairy a regular part of their child's diet.

Monday, July 7, 2008

Improved care for children with ADHD

An innovative program is helping busy primary care physicians improve the care they provide for school-aged children with Attention-Deficit/Hyperactivity Disorder (ADHD), according to a study led by researchers at Cincinnati Children's Hospital Medical Center and published in the July edition of Pediatrics.

The study is the first to intervene with an entire community of primary care physicians and help them more accurately diagnose and effectively monitor treatment response of their patients with ADHD, said Jeff Epstein, Ph.D., director of the Center for ADHD at Cincinnati Children's and lead author of the study. Although community practitioners are the first point of contact for children with ADHD, the use of standardized evidence-based diagnosis and treatment guidelines established by the American Academy of Pediatrics (AAP) was infrequent at most of the participating pediatric practices before the study began.

The intervention consisted of an innovative training program developed by Cincinnati Children's on how to implement AAP diagnosis and treatment guidelines. The training focused on modifying office systems to accommodate the AAP guidelines, said Dr. Epstein. This included building in the use of parent and teacher ADHD rating scales into the evaluation and treatment monitoring process.

After 84 Cincinnati-area community physicians finished training and implemented AAP guidelines at their practices, the use of ADHD child assessment rating scales by parents and teachers soared from 55 percent and 52 respectively to nearly 100 percent, the research team reported. This led to more accurate diagnosis of prospective patients and fewer children being started on medication inappropriately. Systematic monitoring of patient medication response improved from a baseline of 9 percent to over 40 percent. For patients who were being monitored systematically, most had documentation of significant symptom reduction during their first several months of treatment

"An additional benefit of the intervention is it appears that as a result of participating in the intervention, physicians in the community are now better equipped to recommend alternatives to medication – such as behavioral therapy – engage families in setting treatment goals, and more effectively coordinate care with the child's school.," said Dr. Epstein.

ADHD is the most commonly diagnosed behavioral disorder in childhood, with prevalence rates among grade-schoolers children estimated at 3 to 8 percent. ADHD is characterized by developmentally inappropriate symptoms of inattention, hyperactivity and impulsivity. These symptoms produce significant impairment in school performance, social interactions with peers and family, daily self-management activities and self-esteem.

Although ADHD is classified as a mental disorder, the majority of children with ADHD are evaluated and treated by primary care physicians rather than by mental health specialists. The AAP has encouraged its members to become more knowledgeable about best-practice standards for ADHD diagnosis and management and in 2001 published an evidence-based guideline for pediatricians to follow.

"A significant problem, both locally and nationally, is that guidelines, once published, rarely find their way quickly into clinical usage," Dr. Epstein said. "A large part of the problem is that no means exists for systematically exposing physicians to the guidelines and teaching them how to adapt them for use in their busy practices. This was the case in the Cincinnati-area practices with the ADHD guidelines."

Taper Meds in Kids With Stable Asthma

Note to Pediatricians: Taper Meds in Kids With Stable Asthma; Hopkins Children's Study Shows Many Doctors Wouldn't

BAA study of how pediatricians prescribe asthma medications suggests that while most would readily increase a child's medication if needed, many are reluctant to taper off drug use when less might be best. A report on the study, led by Johns Hopkins Children's Center researchers, appears in the July issue of Pediatrics.

"Asthma medications can have serious, albeit infrequent, side effects, and while under-treatment is undeniably a big problem, not stepping down treatment when a child is doing well may be too," says lead investigator Sande Okelo, M.D., an asthma specialist at Hopkins Children's.

In the research, conducted among 310 pediatricians nationwide, 40 percent said they would not step down high-dose treatment even if a child's symptoms were well controlled and infrequent.

"If a child is doing well and her symptoms are well under control, why not take that chance and see if a smaller dose would do the trick?," says senior investigator Gregory Diette, M.D., M.H.S., a lung specialist at Hopkins.

Beyond side effects, Okelo says, a failure by pediatricians to taper off drugs may also lead parents to do so on their own by skipping doses or decreasing them.

"Past research shows that when parents are concerned about side effects and their child is doing well, they may take action without a doctor's approval," Okelo says.

For the study, the pediatricians were asked to devise treatment plans using different patient scenarios, describing various elements, including whether a child had been hospitalized recently, how bothersome and frequent a child's symptoms were, whether symptoms had recently intensified or lessened and whether the child had wheezing on a physical exam. Most doctors reported they would step up treatment in patients with: 1) recent hospitalizations 2) frequent symptoms 3) parents who said they were bothered by their child's symptoms 4) those who had wheezing on exam.

While current treatment guidelines focus on symptom frequency, nearly all pediatricians reported using multiple factors in their decision-making, including quality of life and how bothered parents were by their child's symptoms.

Okelo says pediatricians might greatly benefit from a step-by-step, "frontlines" tool that tells them how to specifically apply treatment guidelines and how to use different dimensions of the disease in their day-to-day practice.

Because asthma is an unstable disease and can change often and unpredictably, it is essential that children with asthma get regular follow-up exams every three to six months even in the absence of symptoms, researchers recommend.

Asthma is the most common pediatric chronic illness, affecting 6.5 million children in the United States, according to the Centers for Disease Control and Prevention.

Monday, June 2, 2008

Cold Medication Use in Young Children Dangerous

Cough and cold medication use in young children has been linked to a significant number of adverse effects and several deaths, leading the FDA to recommend against their use for children less than two years old. Despite these concerns about safety and efficacy, there has been little research on patterns of cough and cold medication use in very young children. Now, a new study from the Emergency Medicine Network (www.emnet-usa.org) led by Katherine O’Donnell, M.D. of Children’s Hospital Boston reveals important new statistics about medication use in children under the age of two.


According to the study, 1-in-3 children under the age of two with bronchiolitis (a lower respiratory tract infection associated with runny nose, cough, wheezing and/or difficulty breathing) had received over-the-counter cough and cold medicines in the week prior to visiting an emergency department.


This study identifies rates and predictors of cough and cold medication use prior to the manufacturer recall of and FDA recommendations against use of these medications in children younger than two years of age.


“After the recall and labeling changes, it will be important to monitor for potential ongoing use of these medicines in young children and observe if parents or physicians are turning to other therapies in place of these medications,” says O’Donnell.


Given these findings and the fact that non-concentrated cough and cold formulations remain available for over-the-counter use, the authors encourage physicians to counsel all parents of young children about these ineffective and potentially dangerous medications.


While the study did not identify a specific high-risk demographic group for targeted educational interventions, factors including daycare attendance, second-hand smoke exposure, recent antibiotic use and presence of wheezing were associated with increased use of cough and cold medications. Children less than a year old, as well as those with a history of hospitalization, were less likely to use these medications.

Improving Doctor-Child Communication

Study finds kids who use touch pad device are more likely to share critical info with doctor

Technology may be the key to identifying high-risk behaviors among adolescents. Injury risk, depressive symptoms and drug and alcohol use are the leading causes of adolescent morbidity and mortality; yet pediatricians often lack the time to screen for these behavioral concerns. That paradox of care is the motivation behind a new study, published in the June issue of Pediatrics, which found adolescents who participated in computerized screening with real-time results were more likely to be identified as having a problem by their pediatrician than adolescents whose screening results were delayed.

The study, conducted by researchers at the Center for Innovation in Pediatric Practices in The Research Institute at Nationwide Children’s Hospital, compared the results of 878 primary care patients, ages 11 to 20 years, who participated in a unique, computerized behavioral screening system between June 1, 2005 and February 20, 2006 called “Health eTouch.” Developed by researchers at Nationwide Children’s, Health eTouch is a Web application, presented to patients on secure wireless Web tablets with 10-inch touch screen displays. Questions vary based on the user’s age and reported behaviors and are drawn from existing publicly available validated measures.

Study participants took part in Health eTouch screening in the waiting rooms of the urban clinics they attended. These clinics were randomly assigned to have pediatricians either receive screening results just prior to face-to-face encounters with patients – “Immediate Results” condition – or two to three business days later – “Delayed Results” condition. When provided with the screening results, pediatricians were able to view a summary of patient responses to screening questions, as well as a list of flagged responses thought to be indicative of high-risk behaviors and an overall positive or negative rating for various behavioral concerns tested during the screening process.

After participating in Health eTouch, 59 percent of respondents screened positive for at least one of the following behavioral concerns: injury risk behaviors, significant depressive symptoms or substance use. Of those youths who screened positive and whose results were provided to pediatricians just prior to their consultation, 68 percent were identified as having a problem by their pediatrician, while only 52 percent of youths whose results were delayed were identified as having a problem by their pediatrician.

“Routine behavioral screening, although critical in identifying and addressing high-risk behaviors, often does not occur or is limited due to the time constraints and competing demands facing primary care physicians,” said Kelly Kelleher, MD, a principal investigator for the Center for Innovation in Pediatric Practices in The Research Institute at Nationwide Children’s and a faculty member at The Ohio State University College of Medicine. “Our research has found that recent advances in information technology, such as the Health eTouch system, and the immediate reporting of computerized screening results may help overcome barriers to behavioral screening.”

Direct data entry by youths in waiting rooms and automated scoring and printing programs minimize staff time necessary for screening, scoring, reporting and filing results. Also, past research has shown adults and adolescents are more willing to disclose sensitive information to a computer than to a clinician.

Low vitamin D levels common in children

Low vitamin D levels appear common in healthy children

Many healthy infants and toddlers may have low levels of vitamin D, and about one-third of those appear to have some evidence of reduced bone mineral content on X-rays, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Reports of a resurgence of vitamin D deficiency and rickets, the resulting bone-weakening disease, have emerged in several states, according to background information in the article. Vitamin D deficiency also appears to be high in other countries, including Greece, China, Canada and England.

Catherine M. Gordon, M.D., M.Sc., and colleagues at Children's Hospital Boston, studied 380 healthy children ages 8 months to 24 months who visited a primary care center for a physical examination between 2005 and 2007. Parents filled out a questionnaire regarding their nutritional intake and that of their children, and also reported on the use of vitamin D and other supplements, time spent outdoors, socioeconomic status and education level.

Among the 365 children for whom blood samples were available, 12.1 percent (44) had vitamin D deficiency, defined as 20 nanograms per milliliter of blood or less, and 40 percent (146) had levels below the accepted optimal level of 30 nanograms per milliliter. Breastfed infants who did not receive vitamin D and toddlers who drank less milk were at higher risk of deficiency (for each cup of milk toddlers drank per day, blood vitamin D level increased by 2.9 nanograms per milliliter).

Forty children of the 44 with vitamin D deficiency underwent X-rays of the wrist and knee. Thirteen (32.5 percent) had evidence of bone mineral loss, and three (7.5 percent) exhibited changes to their bones suggestive of rickets.

"Only one child had signs of rickets on physical examination," the authors write. "Thus, these infants and toddlers had a sub-clinical deficiency that could make detection of this issue particularly problematic in routine clinical practice, as a child's vitamin D status is not typically evaluated as part of routine care."

The data suggest that infants should receive vitamin D supplements while breastfeeding and raise the question of whether some children, including those with established risk factors for vitamin D deficiency, should receive regular measurements of blood vitamin D levels. "Given the potential benefits of vitamin D on bone and other tissues, and growing data supporting its immunomodulatory and antiproliferative effects, the current findings support recommendations advocating for vitamin D supplementation for all young children," they conclude.


Editorial: Additional Information Needed About Risks of Low Vitamin D Levels

"The results of this study suggest that a vitamin D level is not a good screening test for rickets in asymptomatic children; 92.5 percent of those with hypovitaminosis [low levels of] D, as defined by Gordon et al, had no evidence of rickets on radiograph [X-ray]," writes James A. Taylor, M.D., of the University of Washington, Seattle, in an accompanying editorial.

"Future research is needed to determine whether infants and toddlers with vitamin D levels of 20 nanograms per milliliter or lower are at significant short- or long-term risk for other bone disease or different conditions," Dr. Taylor writes. "Pending this research, the recommendations by Gordon et al that all young children should receive vitamin D supplementation and that children with risk factors should have periodic vitamin D levels obtained may be premature.

Drinking 100% juice OK

Drinking juice not associated with being overweight in children

Children who drink 100-percent juice are no more likely to be overweight and may have a better overall nutrient intake than children who do not drink juice, according to a report in the June issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Increasing numbers of Americans, including children, are overweight or obese, according to background information in the article. Food-consumption patterns may play a role in children's weight gain. Drinking juice has been associated with overweight and obesity in some studies but not in others.

Theresa A. Nicklas, Dr.P.H., of Baylor College of Medicine, Houston, and colleagues analyzed data from a group of 3,618 children age 2 to 11 who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2002. During in-home interviews, the children were weighed and measured, and they or their parents reported the types of foods and drinks they consumed.

On average, the children drank 4.1 fluid ounces of juice per day, which contributed an average of 58 calories to their diet. There was no association between drinking juice and being overweight. Children who drank juice had significantly higher intakes of calories, carbohydrates, vitamins C and B6, potassium, riboflavin, magnesium, iron and folate and significantly lower intakes of total fat, saturated fat, discretionary fat and added sugar.

Children who drank juice also ate more whole fruit than those who did not drink juice. "It is not clear why some children drink more fruit juice and what the association is with increased intake of fruit in these individuals," the authors write. "Taste and availability are two generally recognized factors in increased intake of fruit and vegetables; usual food intake, subjective norms, parenting style and visual benefits of eating fruit and vegetables are others."

Overall, children drank less juice than the daily maximum amounts recommended by the American Academy of Pediatrics—4 to 6 ounces for children 1 to 6 years old and 8 to 12 ounces for children and teens 7 to 18 years old. Children age 2 to 3 drank the most juice—an average of 6 ounces per day.

"One-hundred–percent juice consumption was associated with better nutrient intake than in the non-consumption group and was not associated with weight status or the likelihood of being overweight in children 2 to 11 years of age," the authors conclude.

Tuesday, May 27, 2008

Vitamin D Below Essential Levels for Children?

The current recommended daily allowance (RDA) of vitamin D for children is 200 International Units (IUs), but new research reveals that children may need and can safely take ten-times that amount. According to a recently accepted report in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM), this order-of-magnitude increase could improve the bone health of children worldwide and may have other long-term health benefits.

“Our research reveals that vitamin D, at doses equivalent to 2,000 IUs a day, is not only safe for adolescents, but it is actually necessary for achieving desirable vitamin D levels,” said Ghada El-Haff Fuleihan, M.D., of the American University of Beirut-Medical Center, Lebanon, and lead author of the study.

Vitamin D is an essential hormone for bone growth and development in children and promotes skeletal health in adults. Currently, the National Academy of Sciences’ Institute of Medicine recommends an adequate daily intake of 200 IUs of vitamin D for children. This is also the recommendation from the American Academy of Pediatrics. These levels, however, may not be adequate for bone growth and musculoskeletal health in children and adolescents.

“Data on appropriate vitamin D levels in the pediatric age group are lacking,” said Dr. Fuleihan. “This is a major obstacle to finding the right daily allowance to enhance musculoskeletal health.”

To help clarify these important guidelines, Fuleihan and his colleagues conducted both short- and long-term trials to gauge the safety of relatively high doses of vitamin D3 in children ages 10-17 years.

Vitamin D3 is one of the most common forms of vitamin D, and is easily converted to 25-OHD (25-hydroxyvitamin), which is the active form of vitamin D found in the blood.

For this placebo-controlled study, researchers gave children various doses of vitamin D at various intervals and measured the impact this had on serum levels of 25-OHD.

For the short-term study, 25 students (15 boys and 10 girls) received one-weekly, 14,000 IU doses of vitamin D for eight weeks. Serum levels of 25-OHD were then measured for an additional eight weeks. This portion of the test was conducted during the summer and early fall, when the highest natural levels of vitamin D are reached.

For the long-term, one-year study, 340 students (172 boys and 168 girls) received either a low dose of vitamin D (1,400 IUs each week) or a high dose (14,000 IUs each week).

Only children given the equivalent of 2,000 IUs a day of vitamin D increased 25-OHD levels from the mid-teens to the mid-thirties (ng/ml)—the level considered optimal for adults. None of the children in either trial showed any evidence for vitamin D intoxication.

Although many experts agree that a 25-OHD level of 30 ng/ml is desirable in adults, what constitutes an optimal D level for children and adolescents is more debatable. According to the researchers, due to rapid skeletal growth, children and adolescents are more likely to be vitamin D deficient, and are far less likely to reach vitamin D levels that doctors would consider toxic.

“Supplementation of children and adolescents with 2,000 IUs a day of vitamin D3 is well tolerated and safe,” said Dr. Fuleihan. “This is particularly relevant in light of the increasingly recognized health benefits of vitamin D for adults and children.”

Other researchers involved in the study include Joyce Maalouf, Mona Nabulsi, Reinhold Vieth, Samantha Kimball, Rola El-Rassi, and Ziyad Mahfoud.

The study “Short term and long term safety of weekly high dose vitamin D3 supplemetnation in school children” will be published in the July issue of JCEM.

Thursday, May 15, 2008

Too Much Water Raises Seizure Risk in Babies

It’s a recurrent summer-time scenario in the pediatric emergency room and doctors from Johns Hopkins Children’s are sounding the alarm on it: An otherwise healthy infant is brought in by panicked parents after suffering a seizure, which turns out to be caused by drinking too much water.

Pediatricians at Hopkins Children’s see at least three or four such cases every summer, and while the seizures are benign and have no lasting effect on a child’s health, they are quite dramatic and completely preventable, doctors say.

“Babies need extra fluids in the hot weather, but straight water is not one of them,” says pediatrician Allen Walker, M.D., head of the Emergency Department at Hopkins Children’s. “A parent’s natural instinct is to give the baby water to prevent dehydration, but too much water can disrupt the delicate balance in a baby’s body, leading to water intoxication. Before you know it, the baby is seizing.”

Too much water dilutes sodium in the blood and flushes it out of the body, thus altering brain activity, which can lead to a seizure. Infants under 1 year of age may be more prone to these types of seizures than older children because a young infant’s diet does not contain enough food sources to replenish the lost sodium. Also, an infant’s immature kidneys cannot flush out excess water fast enough, causing a dangerous buildup of water in the body.

Breast milk and formula are the best way to keep a child under 1 year of age who is not eating solid foods hydrated, Walker says, and straight water should be avoided. Over-diluted formula can lead to water intoxication as well. Electrolyte-enriched pediatric drinks are not recommended for routine hydration.
Symptoms of water intoxication in an infant include:

• changes in mental status, i.e., unusual irritability or drowsiness
• low body temperature, usually 97 degrees or less
• facial swelling or puffiness
• seizures

Though any infant who consumes too much water can suffer water intoxication, the risk is highest among children who are already dehydrated, typically after a bout with viral or bacterial infections that cause vomiting and diarrhea. Symptoms of dehydration in a young child include dry mouth, increased thirst, irritability and reduced sweating and urination. An easy way to spot dehydration is if a child has fewer than three wet diapers in 24 hours, Walker says.

In otherwise healthy infants, water intoxication is one of the leading triggers of seizures. The most common type of childhood seizures are febrile seizures, occurring in 2 to 5 percent of all children under 5 years of age, according to the American College of Emergency Physicians.

Cough medicines for under-2s despite warnings

tudy finds
More than 40 per cent of parents have used cough medicine for children younger than two – even though it is not recommended, nor proven effective for children in this age group, an Australia-first study has found.

The joint University of Melbourne and Royal Children’s Hospital study, surveyed 325 parents at hospital outpatient clinics, maternal child health centres and child care centres about their use of over-the-counter medication for children aged 0-24 months.

It is the first study in Australia examining the use of over-the-counter medications among parents of children in this age group.

University of Melbourne Nursing PhD researcher Misel (pronounced Michelle) Trajanovska will present data from her study at the National Medicines Symposium 2008 in Canberra tomorrow (Friday 16 May).

She found:

98 per cent had purchased an over-the-counter medication in the past year;
Paracetamol was the most commonly used drug (95.9 per cent);
47.3 per cent had given their children topical teething gels;
Almost half (42.8 per cent) had given their children cough and cold medicines containing anti-histamines;
Nearly all parents had used over the counter medications to combat pain and fever;
About seven per cent of parents had given their child over-the-counter medication to induce sleep or settle their child;
Two parents had given their children paracetamol because they were “cranky”.
Ms Trajanovska said the use of cough and cold medicines on children under two was of particular concern.

“Internationally there have been a number of reports of serious side effects among infants and children given over-the-counter cough medicines,’’ she said.

“There is also a lack of evidence that these medicines are even effective for treating coughs.

“The Therapeutic Goods Administration recommends that these medicines should not be used on children under two, and from September they will only be available to children under two on prescription.”

Ms Trajanovska said the survey results reinforced the need for continued education of parents about the safe use of over-the-counter medicines.

“Despite the widespread use of over-the-counter medicines for young children, they are not without risks such as side effects or poisoning,” she said.

Ms Trajanovska said that in Victoria 0-4 year olds had the highest poisoning admission rates. In emergency departments 16 per cent of these poisonings were due to paracetamol and 11 per cent were caused by cough and cold medicines.

Wednesday, May 7, 2008

Weight Gain Poses Risks to Pregnant Mothers, Babies

Women who gain more or less than recommended amounts of weight during pregnancy are likely to increase the risk of problems for both themselves and their child, according to a new report by the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center.

The report, which was supported by the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) in partnership with the American Dietetic Association, is based on a systematic review of 150 studies that assessed the short- and long-term effects of maternal weight gain on pregnancy, mothers, fetuses, and children. The studies were published in English between January 1990 and October 2007.

Among the report’s key findings is a strong association between high maternal weight gain and increased fetal growth and infant birth weight, which can contribute to complications during labor if a baby is too big, and can lead to long term health effects for the child. High maternal weight gain also is associated with cesarean delivery and weight retention by mothers after childbirth.

The review also confirmed that gaining too little weight during pregnancy can be a problem. Low maternal weight gain is associated with poor fetal growth, lower birth weight, and the chance of a baby being born prematurely.

The report was prompted by several trends, including an increase in the number of American women who are overweight and obese, as well as the number who gain more weight during pregnancy than amounts laid out in the Institute of Medicine’s 1990 recommendations for maternal weight gain. Public health officials also are concerned about an increase in pregnancy complications such as diabetes and cesarean delivery.

The Institute of Medicine is currently reviewing its pregnancy weight guidelines to see if they need to be revised; it expects to issue a report next summer.

“Unfortunately, the existing body of research on maternal weight gain is inadequate to permit a more comprehensive assessment,” said Meera Viswanathan, Ph.D., the study director and a senior research analyst at RTI International. “Most beneficial would be an analysis that considers the risks and potential benefits of various maternal weight-gain scenarios to all women – irrespective of age, race or ethnicity, or their body mass index before they became pregnant. But such an analysis is not possible at this time.”

Her research colleague at UNC, Anna Maria Siega-Riz, Ph.D., agreed.

“Despite the large body of research, clear clinical recommendations based on this systematic review will be challenging to formulate because of major shortcomings in this research,” said Siega-Riz, an associate professor in the UNC School of Public Health’s epidemiology and nutrition departments. “To fully understand the effects of maternal weight gain on short- and long-term health outcomes for both women and infants, future studies will need to adopt standard measures and consistent definitions of exposures and outcomes.”

The researchers said future studies will need to examine multiple outcomes within the same study population to explore fully the trade-offs between the risks and benefits to the mother and to the child.

Along with Viswanathan and Siega-Riz, the other authors of the report are Merry-K Moos, a research professor in the obstetrics and gynecology department in the UNC School of Medicine, and an adjunct professor in the schools of Nursing and Public Health; Andrea Deierlein, a research assistant and doctoral student in the nutrition department in the School of Public Health; Sunni Mumford, a doctoral student in the epidemiology department in the School of Public Health; Julie Knaack, program assistant in the maternal and child health department in the School of Public Health; Patricia Thieda, project coordinator at UNC’s Cecil G. Sheps Center for Health Services Research; and Linda J. Lux and Kathleen N. Lohr, Ph.D., from RTI International.

The report can be found on AHRQ’s Web site at: http://www.ahrq.gov/clinic/tp/admattp.htm.

Monday, May 5, 2008

1 in 10 children using cough, cold medications

1 in 10 children using cough, cold medications

Researchers from Boston University’s Slone Epidemiology Center have found that approximately one in ten U.S. children uses one or more cough and cold medications during a given week.

Pediatric cough and cold medications are widely marketed in the U.S. but surprisingly little is known about just how often they are used in children. This information is especially important in light of recent revelations that cough and cold medications are responsible for serious adverse events and even deaths among children.

To define the frequency and patterns of use, the researchers analyzed data between 1999 and 2006 from the Slone Survey, a national telephone survey of medication use in a representative sample of the U.S. population. The authors considered all oral medicines that are approved by the FDA to treat children’s coughs and colds.

The researchers found that in a given week, at least one cough and cold medication was used by 10.1 percent of U.S. children. In terms of active ingredients contained in these medications, exposure was highest to decongestants and antihistamines (6.3 percent each), followed by anti-cough ingredients (4.1 percent) and expectorants (1.5 percent).

Exposures to cough and cold medications was highest among 2 to 5 year olds, but was also high among children under 2 years of age.

Among all the products used, 64.2 percent contained more than one active ingredient. The most commonly used product types were single-ingredient antihistamines, antihistamine/decongestant combinations and antihistamine/decongestant/anti-cough combinations. The researchers also found the use of cough and cold medications declined from 12.3 percent in 1999-2000 to 8.4 percent in 2005-2006.

According to the researchers the especially common use of cough and cold medications among young children is noteworthy. “Given concerns about potential harmful effects and lack of evidence proving that these medications are effective in young children, the fact that one in ten U.S. children is using one of these medications is striking,” said lead author Louis Vernacchio, MD, MSc, an assistant professor of epidemiology and pediatrics at Boston University School of Medicine.

Fixing up 'this old house' = lead hazard

Ripping out and tearing down to create a divinely designed home, a la HGTV, is all the rage today – and the economic downturn may be leading more families to renovate rather than relocate. But a new study has found that parents need to be aware that all this interior renovation can put their children's health at risk due to exposure to lead.

The study conducted by researchers at Cincinnati Children’s Hospital Medical Center found that interior renovation of older housing is associated with a modest increase in children’s blood lead level (BLL) and associated long-term health risks. These findings will be presented by co-author Stephen Wilson, M.D., at the Pediatric Academic Society (PAS) annual meeting in Honolulu on May 3.

“Any person working on a home where children reside or visit frequently should know that their renovation work could cause lead hazards for the kids if the home was built before 1978, when the government banned lead-based paint in housing,” said Adam Spanier, M.D., Ph.D. M.P.H., the study’s lead author and director of the Pediatric Environmental Health and Lead Clinic at Cincinnati Children’s Hospital Medical Center.

The study of 249 children, all living in homes built before 1978, found that those who resided in houses where renovations had been done had higher blood lead levels than those in houses where no renovating had been done. Researchers used multivariable analysis to find that the kids who had lived through renovation projects had a 12 percent increase in mean BLL by age 2 compared with other children (p<0.01). The increase in BLL seemed related directly to the renovation work, given that if renovation took place within one month prior to measurement, 2-year-old children had a 1.6 micrograms per deciliter increase in average BLL and if the renovation was more recent (within a month before blood tests were done), compared to an average jump of 0.8 micrograms per deciliter in children whose houses had been renovated two to six months before measurement (p<0.01).

The researchers also noted an association between high lead concentration in the building’s existing paint and the child’s BLL. Specifically, for every 10 milligram per square centimeter increase in paint lead concentration, there was a 7.5 percent increase in average blood lead levels (p=0.02).

Some research studies have shown that children’s BLL below 7.5 is associated with intellectual impairment and affects brain development.

“Toxic agents such as lead could have long-term effects on children’s brain development even as early as when they are fetuses,” said Dr. Spanier. “If lead poisoning goes undetected and untreated in children, it has the potential to result in a number of neurodevelopmental issues, including ADHD and learning problems.”

During renovations, most children are exposed to lead paint dust that is disturbed by the work. If precautions are not taken, this lead paint dust may settle on surfaces and could be spread in the air inside the house through interior ventilation systems. Although the study looked at children between the ages of 6 to 24 months, Dr. Spanier cautioned that all young children, particularly those under 6 years, are considered most at risk.

”There are risks to renovating older homes, but there also are lots of ways parents can reduce the risk of lead exposure to their children,” Dr. Spanier said. “It’s also more cost effective to avoid the problem than to treat an already exposed child. Preventing exposure is the key.”

If parents are unsure about the paint or other lead hazards in their home, Dr. Spanier suggested they should call the National Lead Information Center, provided by ABVI Good Will, at 1-800-424-LEAD or visit the Environmental Protection Agency’s website at www.epa.gov/lead for more information on local labs that can test lead paint. If there are hazards professional abatement is the best option.

However, if abatement of the lead is not an option, there are a few precautions do-it-yourself rehabbers can take while renovating homes.

Attach a High Efficiency Particulate Air, or HEPA, vacuum to all power tools and use a HEPA vacuum to clean up the area
Use heavy plastic to cover doorways, windows, floors, and any furniture that can’t be removed from the renovated area and to dispose of all trash and debris
Block off and shut off air conditioning or heating vents in the work area
Close windows and doors in or near the work area
Mist paint before sanding or scraping
Keep everyone not working in the area out and, if possible, have the children stay at a friend or relatives while the work is being done
Use personal protective devices (masks, gloves, etc)
Seek training in lead safe work practices
Also, if parents hire a contractor to do their home renovations, it’s important to choose someone who has gone through lead safety training.

If parents who have done renovations are worried about their child’s lead levels or are concerned they may have been exposed to lead dust from building renovations, a pediatrician or family practitioner can order a lead test for the child. This will allow them to determine the child’s lead level and recommend treatment if needed. Several treatment options available, depending on the blood lead levels detected.

“Not having lead hazards in homes would be the goal, but for now, it is important to know lead’s health risks to children and what adults can do to avoid them,” said Dr. Spanier.

US parents don't know what to expect of infants

Nearly one-third of US parents don't know what to expect of infants

Lack of parenting savvy leads to unrealistic expectations, poorer interactions

Almost one-third of U.S. parents have a surprisingly low-level knowledge of typical infant development and unrealistic expectations for their child’s physical, social and emotional growth, according research from the University of Rochester. The new findings, which suggest that such false parenting assumptions can not only impair parent-child interactions, but also rob kids of much-needed cognitive stimulation, will be presented Sunday, May 4, at the Pediatric Academic Society meeting in Honolulu, Hawaii.

“There are numerous parenting books telling people what to expect when they’re pregnant,” said Heather Paradis, M.D., a pediatric fellow at the University of Rochester Medical Center. “But once a baby is born, an astonishing number of parents are not only unsure of what to anticipate as their child develops, but are also uncertain of when, how or how much they are to help their babies reach various milestones, such as talking, grabbing, discerning right from wrong, or even potty-training.”

Moms and dads often misinterpret behaviors – some parents expect too much of babies too soon and grow frustrated; others underestimate their child’s abilities, preventing them from learning on their own.

Using data from the Early Childhood Longitudinal Study’s Birth Cohort (ECLS-B), Paradis and her colleagues analyzed the average parenting knowledge of a nationally-representative sample of parents of more than 10,000 9-month-old babies. These parents first answered an 11-point survey designed to distinguish informed parents from less-informed parents (asking questions such as “Should a 1-year-old child be able to tell between right from wrong"” and “Should a 1-year-old child be ready to begin toilet-training"”). Those who scored 4 or fewer correct answers were considered to have low-level knowledge of typical infant development.

Paradis and colleagues then compared these knowledge scores to both scores from (1) a 73-point videotape analysis of the same families’ parent-child interactions while teaching a new task, and (2) from these parents’ self-reports of how often they engaged their child in enrichment activities (e.g. reading books, telling stories, or singing songs).

The analysis revealed that 31.2 percent of parents of infants had low-level knowledge of infant development, and that this low-level knowledge correlated with lower parental education level and income. Still, even when controlling for maternal age, education, income and mental state (e.g., depression), low-level knowledge of infant development still significantly and independently predicted parents being both less likely to enjoy healthy interactions with their infants during learning tasks and less likely to engage their children in regular enrichment activities

“This is a wake-up call for pediatricians,” Paradis said. “At office visits, we have a prime opportunity to intervene and help realign parents’ expectations for their infants, and in turn, promote healthy physical, social, and emotional development for these children. On the other hand, we still have more work cut out for us – additional research is needed to explore how these unrealistic expectations form in the first place.”

Children more vulnerable to harmful effects of lead

Contrary to prevailing assumptions, children are more vulnerable to the harmful effects of lead exposure at the age of 6 than they are in early childhood, according to a Cincinnati Children’s Hospital Medical Center study to be presented May 4 at the annual meeting of the Pediatric Academic Societies in Honolulu.

“Although we typically worry about protecting toddlers from lead exposure, our study shows that parents and pediatricians should be just as, if not more concerned about lead exposure in school-aged children,” says Richard Hornung, Dr.P.H., a researcher in the division of general and community pediatrics at Cincinnati Children’s and the study’s main author.

The researchers found that blood lead concentrations (BPb) at age 6, compared to those at younger ages, are more strongly associated with IQ and reduced volume of gray matter in the prefrontal cortex of the brain, which is involved in planning, complex thinking and moderating behavior.

Overall, the children’s average BPb levels peaked at 13.9 micrograms of lead per deciliter of blood at age 2, then declined to an average of 7.3 micrograms per deciliter by age 6. For children, however, with the same average blood lead levels through age 6, those who received more of their exposure at age 6 had substantially greater decrements in intellectual ability than those more heavily exposed at age 2.

“Lead toxicity is difficult to recognize in a clinical setting, but it can have devastating effects,” says Bruce Lanphear, M.D., director of the Cincinnati Children’s Environmental Health Center and the study’s senior author. “We found that children may be particularly vulnerable to lead exposure just as the child approaches school age, during a period of rapid cognitive development.

Because IQ tests were not administered to children older than 6, it is unknown whether older children are even more vulnerable to environmental lead exposure, according to Dr. Hornung.

Approximately 310,000 U.S. children age 1 to 5 years have blood lead levels greater than 10 micrograms per deciliter, the level at which the Centers for Disease Control and Prevention recommends public health actions be initiated. But research has consistently shown that blood lead levels considerably lower than 10 micrograms per deciliter are associated with adverse effects.

Federal and state regulatory standards have helped to minimize or eliminate the amount of lead in U.S. consumer products and occupational settings, according to the National Institute of Environmental Health Sciences (NIEHS). Today, the most common sources of lead exposure in the United States are lead-based paint in older homes, contaminated soil, household dust, drinking water, lead crystal and lead-glazed pottery.

While extreme lead exposure can cause a variety of neurological disorders, such as lack of muscular coordination, convulsions and coma, lower lead levels have been associated with measurable deficits in children’s mental development and behavioral problems. These include hyperactivity, or ADHD, lowered performance on intelligence tests, and deficits in fine motor function, hand-eye coordination and reaction time. Chronic lead exposure in adults can result in increased blood pressure, decreased fertility, cataracts, nerve disorders, muscle and joint pain as well as problems with memory or concentration.

Iron supplements harm infants who have enough

A new study suggests that extra iron for infants who don't need it might delay development -- results that fuel the debate over optimal iron supplement levels and could have huge implications for the baby formula and food industry.

"Our results for 25 years of research show problems with lack of iron. For us to find this result is a big deal, it's really unexpected," said Dr. Betsy Lozoff, University of Michigan research professor at the Center for Human Growth and Development, and the study's principal investigator.

U.S. infant formulas typically come fortified with 12 mg/L of iron to prevent iron-deficiency anemia. Europe generally uses a lower amount. In infants, iron-deficiency anemia is associated with poorer development, and during pregnancy it contributes to anemia in mothers, contributing to premature birth, low birth weight and other complications.

"I thought that behavior and development would be better with the 12 mg formula," said Lozoff, also professor of pediatrics in the U-M Department of Pediatrics and Communicable Diseases at the Medical School and C.S. Mott Children's Hospital

The U-M study of 494 Chilean children showed that those who received iron fortified formula in infancy at the 12 mg used in the U.S. lagged behind those who received low-iron formula in cognitive and visual-motor development by age 10 years. Lozoff stressed that most children who received the 12 mg formula did not show lower scores. But the 5 percent of the sample with the highest hemoglobin levels at 6 months showed the poorest outcome. Your body needs iron to make hemoglobin, a substance in red blood cells that enables them to carry oxygen. High hemoglobin generally indicates sufficient iron.

Adversely affected children scored 11 points lower in IQ and 12 points lower in visual-motor integration, on average; the average overall score on both tests was 100. A similar pattern was observed for spatial memory and other visual-motor measures.

Lozoff noted that not many infants in Chile had high hemoglobin levels at the time since there was no iron-fortification program for infants and that more than 5 percent of U.S. infants might have high hemoglobin levels in early infancy.

In this randomized study, healthy infants without iron-deficiency anemia were given formula with either 12 mg or 2.3 mg iron from 6 to 12 months and followed to 10 years. The next step is to test the participants again at age 16, Lozoff said, who says that no such study has been conducted in the United States or elsewhere.

Iron deficiency occurs because babies grow so quickly they often "grow out" of the amount of iron they are born with. Breast milk is thought to contain the iron a baby needs for 4-6 months, Lozoff said. Other important sources of iron for infants include iron-fortified infant formulas and cereals, iron drops and meat.

Infants are typically not tested for hemoglobin or iron levels before 9-12 months. It would be premature to recommend earlier testing or to avoid supplemental iron based on the study's results, Lozoff said. She expects parents to be concerned, but stressed that results must be reproduced in other studies.

"At this point there's no basis for changing practice, but it's really important that we have continued research on this issue," she said.

Children's physical activity in child care

Flip flops, mulch and no coat

First phase of NHLBI-sponsored study on children's physical activity in child care

At a time when over half of US children (aged 3-6) are in child care centers, and growing concern over childhood obesity has led physicians to focus on whether children are getting enough physical activity, a new study of outdoor physical activity at child care centers, conducted by researchers at Cincinnati Children’s Hospital Medical Center, has identified some surprising reasons why the kids may be staying inside. The study, will be presented May 5 at the annual meeting of the Pediatric Academic Societies in Honolulu, Hawaii.

“It’s things we never expected, from flip flops, mulch near the playground, children who come to child care without a coat on chilly days, to teachers talking or texting on cell phones while they were supposed to be supervising the children,” according to Kristen Copeland, M.D., lead author of the study which was funded by the National Heart, Lung and Blood Institute. She noted that because there are so many benefits of physical activity for children – from prevention of obesity, to better concentration and development of gross motor skills – it’s important to know what barriers to physical activity may exist at child-care centers.

“With so many American preschool-aged children in child care centers, and previous reports that the amount of physical activity children get varies widely across different centers, we wanted to explore what some of the barriers to physical activity at these centers might be,” said Dr. Copeland, a physician scientist and Assistant Professor of Pediatrics in the Division of General and Community Pediatrics at Cincinnati Children’s. According to the most recent statistics 74% of US children aged 3-6 years are in some form of non-parental child care. 56% percent of 3-6 year old children spend time in centers, including child care centers and preschools. Her team began by exploring child-care center staff members’ perceptions of barriers to children’s physical activity. They conducted focus groups with 49 staff members from 34 child-care centers in the Cincinnati area (including Montessori, Head Start and centers in the inner city and suburban areas) as the first of several studies on this subject.

“We found several previously unreported barriers that meant kids had to stay inside, including inappropriate footwear such as flip flops and inappropriate clothing for the weather,” said Dr. Copeland. In some child care centers, if one child in the group shows up without a coat on a chilly day, she noted, that means the whole group has to stay inside. Even more surprising to the researchers was the fact that the child-care staff members said some parents appear to intentionally keep their children’s coats (or send children without coats) so they’d have to stay inside, which staff attributed to parents’ concerns about the child getting injured or dirty, or a having a cold that may be exacerbated by cold weather.

Teachers said they also felt pressure from some parents who were more concerned with children spending time on cognitive skills, such as reading and writing, than on the gross motor and socio-emotional skills (such as kicking a ball or negotiating with another child for a turn on the slide) that are best learned on the playground.

Then there was the mulch factor. “The staff members who participated in the groups were really concerned about mulch in the play area,” said Dr. Copeland. “Many said that the kids eat the mulch, or use it as weapons, or it gets caught in their shoes. It also requires constant upkeep. It’s certainly not something that we had anticipated as an issue, but judging by the amount of and intensity of the discussions among child care teachers, it really is.”

Dr. Copeland said the child-care center staff recognized that they themselves could sometimes serve as a barrier to children’s physical activity. “We heard reports of teachers talking or texting on cell phones instead of interacting with the children while on the playground,” said Dr. Copeland. She continued, “We found that a staff member who doesn’t like going outside—maybe she’s not a cold-weather person, or she thinks it’s too much work to bundle up and unbundle the children on a cold day — could act as a gatekeeper to the playground.” In some cases, staff reported that their own issues with being overweight prevented them from encouraging children’s physical activity.

“This initial qualitative research has identified a number of issues that we will be exploring in subsequent studies,” noted Dr. Copeland. “Clearly this is a complex issue –But finding out what the barriers are is the first step in addressing the problem and getting more kids involved in more much-needed physical activity.”

Study links breastfeeding to increased intelligence

Prolonged and exclusive nursing improves children's cognitive development

The largest randomized study of breastfeeding ever conducted reports that breastfeeding raises children’s IQs and improves their academic performance, a McGill researcher and his team have found.

In an article titled, Breastfeeding and Child Cognitive Development, published in the current issue of the Archives of General Psychiatry, Dr. Michael Kramer reports the results from following the same group of 14,000 children for 6.5 years.

"Our study provides the strongest evidence to date that prolonged and exclusive breastfeeding makes kids smarter," said Kramer, a Professor of Pediatrics and of Epidemiology & Biostatistics in the McGill University Faculty of Medicine and lead investigator in the study.

Kramer and his colleagues evaluated the children in 31 Belarusian hospitals and clinics. Half the mothers were exposed to an intervention that encouraged prolonged and exclusive breastfeeding. The remaining half continued their usual maternity hospital and outpatient pediatric care and follow-up. This allowed the researchers to measure the effect of breastfeeding on the children’s cognitive development without the results being biased by differences in factors such as the mother’s intelligence or her way of interacting with her baby.

The children’s cognitive ability was assessed by IQ tests administered by the children’s pediatricians and by their teachers’ ratings of their academic performance in reading, writing, mathematics and other subjects. Both sets of measures were significantly higher in the group randomized to the breastfeeding promotion intervention.

"The effect of breastfeeding on brain development and intelligence has long been a popular and hotly debated topic,” says Dr. Kramer. "While most studies have been based on association, however, we can now make a causal inference between breastfeeding and intelligence – because of the randomized design of our study.”

Monday, April 28, 2008

Daycare cuts childhood leukemia risk by 30 percent

New analysis finds daycare attendance early in life cuts childhood leukemia risk by 30 percent

LONDON: Children who attend day care or play groups have about a 30% lower risk of developing the most common type of childhood leukaemia than those who do not, according to a new analysis of studies investigating the link.

The new research, to be presented Tuesday at the 2nd CHILDREN with LEUKAEMIA Causes and Prevention of Childhood Leukaemia Conference in London, is the first comprehensive analysis of studies investigating the association between social contact and childhood leukaemia.

“Combining the results from these studies together provided us with more confidence that the protective effect is real. Analysing the evidence in this way gives a more reliable answer to the question and a more precise estimate of the magnitude of the effect,” said the study’s leader, Dr. Patricia Buffler, professor of epidemiology at the School of Public Health of the University of California, Berkeley.

While the analysis does not reveal how intense social contact might ward off childhood leukaemia, it bolsters the theory that children exposed to common infections early in life gain protection from the disease. It is known that environments such as day care centres increase the chance of infections spreading. Some proponents of the theory believe that if the immune system is not challenged early in life and does not develop normally it may mount an inappropriate response to infections encountered later in childhood and that this could provoke the development of leukaemia.

Leukaemia is the most common cancer found in children in the industrialised world, affecting about one in 2,000 children. Incidence of the disease has been on the increase for decades. Acute lymphoblastic leukaemia, or ALL, the type of leukaemia the studies focused on, accounts for more than 80% of cases and most often occurs in children aged between 2 and 5 years. Scientists believe that for most types of childhood leukaemia to develop, there first must be a genetic mutation in the womb, followed by a second trigger during childhood that results in 1% of those children developing the disease. Infection – or the timing of infection - is one of the suspected triggers.

Buffler’s analysis included 14 published studies comprising a total of 6,108 children with leukaemia and 13,704 without the disease. Parents were asked about day care and playgroup attendance, as well as other forms of social interaction with other children. The studies varied in the timing, duration and extent of social contact investigated and in the age groups and types of leukaemia studied. Twelve of the studies found some indication of a protective effect of social interaction with other children, while two found no effect. No study found that social contact increased the risk of childhood leukaemia.

“Our analysis concluded that children who attended day care or play groups had about a 30% lower risk of developing leukaemia than those who did not. Combined results for studies of day care attendance specifically before the age of 1 or 2 showed a similarly reduced risk,” Buffler said.

The protective effect became even stronger when the researchers omitted from the analysis 5 studies in which the selection of healthy children for the comparison group relied on methods not considered optimal. In that analysis, children exposed to social contact were almost 40% less likely to go on to develop leukaemia than their counterparts.

In a separate report released at the conference on Tuesday by CHILDREN with LEUKAEMIA, scientists reviewed the evidence from studies that have investigated a link between infection and childhood leukaemia. They examined not only the idea that early life infections protect against the disease but also whether vaccination plays a role. In addition, they examined two other related areas of research: the role of infection during pregnancy and whether infection might be a factor influencing childhood leukaemia risk in situations where the population mix changes.

The report concluded that the evidence regarding whether infection during pregnancy or in situations of unusual patterns of population mixing influences the risk is inconclusive at present and that further research is necessary.

“On the question of whether infection early in life protects against leukaemia, the best evidence comes from studies of indirect measures of infection - which eliminates many of the problems common in trying to study infections directly - as well as from studies on immune system stimulation and on the genetics of immune responses,” said one of the report’s authors, Dr. Adrienne Morgan, staff scientist at CHILDREN with LEUKAEMIA.

“Putting our review together with the new analysis on social interaction, we can say pretty confidently that childcare, breastfeeding and vaccination are good things. This gives a steer to the biologists looking for what mechanisms might be at play,” she said.

Friday, April 11, 2008

Minimizing Childhood Stress

Stress overload can cause your child to be withdrawn, depressed, irritable and even suicidal. Stress is a part of everyday life for both you and your child. Some people love stress and are very productive under pressure. Others dread it and fall apart.

Strange as it may sound, stress is a necessary part of life. Without the stress of everyday things, life would get pretty boring. You and your child wouldn't have to deal with the everyday events that make you think, respond to problems and grow. Too little stress can be as bad as too much stress because constant boredom can make you feel sad and even depressed.

The key to the balancing act is stress management - so try these stress busters:
• Make sure your child eats right and gets plenty of exercise and rest
• Tell them to listen to music.
• Let them draw.
• Inspire your child to write.
• Encourage them to play with the dog.
• Allow them to talk it out. Don't force your child, but give them lots of opportunities.
• Discourage the use of tobacco, alcohol or drugs.
• Help them to replace negative thoughts with positive ones. Instead of saying, "I'm stupid," encourage your child to say, "we all make mistakes."
• Laugh together - rent a fun family film or go outdoors and have a snowball or water pistol fight.
• Encourage your school-ager or teen to start a hobby.
• Relax - lighten up their load. Does your child really need a half dozen after-school activities? Good old-fashioned play is a great stress buster.

Worried that your child may be stressed out already? If they have any of these signs, talk to your health care provider:
- Headaches, backaches, chest pain, stomachaches, indigestion, nausea or diarrhea.
- Rashes.
- Overeating or under eating.
- Sleep disturbances (too much sleep, restless sleep, difficulty falling asleep, difficulty staying asleep, waking up early).
- Twitching.
- Having trouble concentrating or with school work.
- Feeling anxious or worried.
- Feeling inadequate, frustrated, helpless or overwhelmed.
- Feeling bored or dissatisfied.
- Feeling pressured, tense, irritable, angry or hostile.
- Aggressive behavior.
- Substance abuse.
- Excessive or inappropriate crying.
- Avoiding others.

Arthritis Common in Children

Aches and pains are common in children and teens. Most of the time, they are fairly benign and dismissed as growing pains. However, musculoskeletal pains can signal several serious conditions, says Sangeeta Sule, M.D., pediatric rheumatologist at Johns Hopkins Children’s Center, including juvenile rheumatoid arthritis (JRA), the most common form of arthritis in children and teens. JRA and other rheumatologic conditions affect an estimated 294,000 American children, according to the Centers for Disease Control and Prevention.

As National Arthritis Month approaches in May, Sule and other experts at Hopkins Children’s invite coverage of the challenges in detecting and treating JRA, an autoimmune disease, in which the body mistakenly attacks its own tissues and organs, and related joint and muscle disorders in children.

“Children get arthritis, but since it’s rarely the first condition that comes to mind when a child complains of pains, substantial damage to the joints can occur before the correct diagnosis is made and treatment begins,” Sule notes.

Distinguishing harmless aches and pains from arthritis isn’t always easy. Often, JRA is a diagnosis of exclusion, and no specific test can confirm or rule it out. Several blood tests and imaging tests, such as X-rays, can help a doctor distinguish JRA from garden-variety pains.

For parents, Sule offers the following telltale signs, which should prompt a visit to the pediatrician:

• Limping
• Stiffness, swelling and redness of the joints
• Fatigue and malaise

In contrast, growing pains usually occur between the ages of 4 and 12 and cause:

• Deep aching and cramping pain in the thigh, shin or calf.
• Pain that occurs at night, often waking up the child. Growing pains are never present in the morning, which distinguishes them from rheumatic conditions, where the pain is more severe in the morning or constant throughout the day.
• Aches triggered by exercise the previous day.

Language Development Problems At Three Months

Impairments in Language Development
Can Be Detected in Infants as Young as Three Months

Speech Problems Could Be Corrected Before Child Learns to Talk

Uncover how the brains of infants distinguish differences in sounds and it may become possible to correct language problems even before children start to speak, sparing them the difficulties that come from struggling with language.
New studies conducted by Professor of Neuroscience April Benasich and her Infancy Studies Laboratory at Rutgers University in Newark are revealing new and exciting clues about how infant brains begin to acquire language and paving the way for correcting language difficulties at a time when the brain is most able to change.
Benasich and her lab were the first to determine that how efficiently a baby processes differences between rapidly occurring sounds is the best predictor of future language problems. Using methods developed by Benasich and her lab, it can be determined as early as three to six months whether a baby will struggle with language development.
Benasich’s research is now focused on uncovering in specific detail how the developing brain processes and distinguishes acoustic differences that arrive in rapid succession. The ability to differentiate those sounds, such as the difference between “ba” and “da,” is critically important because decoding language requires us to process tiny auditory differences occurring as quickly as 40 milliseconds. During the first months of life, the baby’s developing brain also is involved in constructing an acoustic map of the sounds of his or her native language. That map allows the baby to efficiently acquire language. Apparently, however, in some infants the process seems to go awry.
About 5 to 10 percent of all children beginning school are estimated to have language-learning impairments (LLI) leading to reading, speaking and comprehension problems, according to Benasich. In families with a history of LLI, 40 to 50 percent of children are likely to have a similar problem. Many of these children go on to develop dyslexia.
Using several novel methods, including dense array EEG/ERP recordings, Benasich and her lab are able to analyze EEG, ERPs and the proportion of gamma power in infant brains. The dense sensor array allows the researchers to gently measure a full range of brain activity. Those measurements are obtained by placing a soft bonnet of sensors, resembling a hairnet with lots of little sponges, on a baby’s head and then having the infant listen to different series of rapid tone sequences.
“We are finding that children who have difficulty processing rapid auditory input are not just showing a simple maturational lag, but are actually processing incoming acoustic information differently,” says Benasich.
Specifically, the research shows that babies who struggle with rapid auditory processing appear to be using different brain areas (as shown by neural patterns) and perhaps different analysis strategies to accomplish that task than children who do not have such difficulties. Included among their initial findings, the researchers have found less left hemisphere activity in the brains of children who struggle with rapid auditory processing as compared with matched control children. By pinpointing the exact differences in how the brain handles incoming acoustic information, it may become possible to guide the brains of babies at risk of developing language problems to work more efficiently before the children even begin to speak.
“We can predict with about 90 percent accuracy what a baby’s language capabilities will be just by their response to tones,” says Benasich. “Our hope now is that we will be able to gently
guide the brains of infants who are at the highest risk for language learning impairments to be more efficient processors so they can avoid the difficulties that result from struggling with language.”
To shed additional light on how inefficiencies in rapid auditory processing might be corrected, Benasich and her team have developed a Magnetic Resonance Imaging (MRI) protocol for scanning naturally sleeping healthy babies. This technique will allow better localization of active brain areas. To solve the challenge of imaging the brains of young children who typically are unable to lie still for extended periods in a scanner, Benasich’s team conducts the scans in the evening and asks the parents to go through their child’s normal bedtime routine, such as reading their infant a story, nursing them, rocking and snuggling. Once the child is asleep, headphones providing a steady stream of lullabies and an acoustic foam bonnet are placed on the baby’s head to reduce the sound of the MRI.
“Our goal is not only to develop training techniques to correct rapid auditory processing problems, but to identify the period during infant development when the brain is most “plastic,” or most able to change through learning,” explains Benasich.
The lab’s work is funded by several sources, including grants from the Solomon Center for Neurodevelopmental Research, the Don and Linda Carter Foundation, the National Institute of Child Health and Human Development, and a new $460,000 grant from the Ellison Medical Foundation.
For more information on the research being conducted by the Infancy Studies Laboratory at Rutgers University in Newark, please visit http://babylab.rutgers.edu.