The government on Thursday said it would adopt strict new limits on using chimpanzees in medical research, after a prestigious scientific group recommended that experiments with humans' closest relative be done only as a last resort.
joi, 15 decembrie 2011
Health Tip: Dealing With Hemorrhoids During Pregnancy
The government on Thursday said it would adopt strict new limits on using chimpanzees in medical research, after a prestigious scientific group recommended that experiments with humans' closest relative be done only as a last resort.
miercuri, 14 decembrie 2011
Kids' leukemia risk tied to dads' smoking
NEW YORK (Reuters Health) - Children whose fathers smoked have at least a 15 percent higher risk of developing the most common form of childhood cancer, a new Australian study finds.
"Paternal smoking seems to be real" as a risk factor, said Patricia Buffler, a professor at the University of California, Berkeley, who was not involved in the current analysis.
"The importance of tobacco exposure and children's cancers has been overlooked until recently," Buffler told Reuters Health. "So I think this paper is important" in adding to the growing body of evidence.
The research team, led by Dr. Elizabeth Milne at the Telethon Institute for Child Health Research in Australia, surveyed the families of nearly 400 children with acute lymphoblastic leukemia (ALL).
Although ALL is the most common childhood cancer, it is still rare, affecting about three to five children out of every 100,000, according to the National Cancer Institute. More than 1,000 kids die of the disease every year.
The survey asked about the smoking habits of both parents.
Milne and her colleagues compared these families to the families of more than 800 children of similar ages who did not have leukemia.
They found that the mothers' smoking behavior had no impact on the kids' risk of developing the cancer.
But kids whose fathers smoked at all around the time of their conception were 15 percent more likely to develop leukemia. Those whose dads smoked at least 20 cigarettes per day around that time were 44 percent more likely to be diagnosed with the cancer.
A 15 percent increase in the risk of ALL would increase the number of cases from six out of every 200,000 children to seven out of every 200,000.
Of the nine earlier reports that the researchers used in their comparison with the current study, six of them also found an increased risk.
The findings make sense, Buffler said. "Tobacco smoke is full of toxins," including carcinogens, she said, "so it's not unlikely that you'd have damage" in the cells that produce sperm.
"Sperm containing DNA (damage) can still reach and fertilize an ovum, which may lead to disease in the offspring," Milne wrote in an email to Reuters Health.
The study did not prove that DNA damage in the sperm caused by smoking is responsible for the children's increased risk of cancer.
"The causes of ALL are likely to be multifactorial, and our findings relate to just one of the possible contributing factors," said Milne.
She added that her results are not intended to be used to place blame or make parents feel guilty.
Several other environmental factors are also tied to a greater chance of developing childhood leukemia, including ionizing radiation such as x-rays and the mother's exposure to paint or pesticides while pregnant.
Milne said that many of the studies regarding these potential causes have been small, and not conclusive.
Buffler is leading an international consortium of researchers tracking thousands of cases of childhood leukemia to determine the influence of environmental, genetic and other biological factors on developing the disease.
SOURCE: http://bit.ly/snq3sL American Journal of Epidemiology, online December 5, 2011.
Kids' leukemia risk tied to dads' smoking
NEW YORK (Reuters Health) - Children whose fathers smoked have at least a 15 percent higher risk of developing the most common form of childhood cancer, a new Australian study finds.
"Paternal smoking seems to be real" as a risk factor, said Patricia Buffler, a professor at the University of California, Berkeley, who was not involved in the current analysis.
"The importance of tobacco exposure and children's cancers has been overlooked until recently," Buffler told Reuters Health. "So I think this paper is important" in adding to the growing body of evidence.
The research team, led by Dr. Elizabeth Milne at the Telethon Institute for Child Health Research in Australia, surveyed the families of nearly 400 children with acute lymphoblastic leukemia (ALL).
Although ALL is the most common childhood cancer, it is still rare, affecting about three to five children out of every 100,000, according to the National Cancer Institute. More than 1,000 kids die of the disease every year.
The survey asked about the smoking habits of both parents.
Milne and her colleagues compared these families to the families of more than 800 children of similar ages who did not have leukemia.
They found that the mothers' smoking behavior had no impact on the kids' risk of developing the cancer.
But kids whose fathers smoked at all around the time of their conception were 15 percent more likely to develop leukemia. Those whose dads smoked at least 20 cigarettes per day around that time were 44 percent more likely to be diagnosed with the cancer.
A 15 percent increase in the risk of ALL would increase the number of cases from six out of every 200,000 children to seven out of every 200,000.
Of the nine earlier reports that the researchers used in their comparison with the current study, six of them also found an increased risk.
The findings make sense, Buffler said. "Tobacco smoke is full of toxins," including carcinogens, she said, "so it's not unlikely that you'd have damage" in the cells that produce sperm.
"Sperm containing DNA (damage) can still reach and fertilize an ovum, which may lead to disease in the offspring," Milne wrote in an email to Reuters Health.
The study did not prove that DNA damage in the sperm caused by smoking is responsible for the children's increased risk of cancer.
"The causes of ALL are likely to be multifactorial, and our findings relate to just one of the possible contributing factors," said Milne.
She added that her results are not intended to be used to place blame or make parents feel guilty.
Several other environmental factors are also tied to a greater chance of developing childhood leukemia, including ionizing radiation such as x-rays and the mother's exposure to paint or pesticides while pregnant.
Milne said that many of the studies regarding these potential causes have been small, and not conclusive.
Buffler is leading an international consortium of researchers tracking thousands of cases of childhood leukemia to determine the influence of environmental, genetic and other biological factors on developing the disease.
SOURCE: http://bit.ly/snq3sL American Journal of Epidemiology, online December 5, 2011.
marți, 13 decembrie 2011
Many Toddlers Wind Up in ER After Accidental Overdose
TUESDAY, Dec. 13 (HealthDay News) -- Each year in the United States, one of every 150 two-year-olds visits an emergency room for treatment of an accidental medication overdose, a new government report shows.
Most of these cases occur when unsupervised children eat or drink medicines they find at home, according to the U.S. Centers for Disease Control and Prevention.
A new program to educate parents and caregivers about safe medication storage and what to do in an emergency was announced this week by the CDC and a coalition of partners. The "Up and Away and Out of Sight" program outlines measures parents can take to protect children.
"Parents may not be aware of the danger posed by leaving medications where young children can reach them. In recent years, the number of accidental overdoses in young children has increased by 20 percent," Dr. Dan Budnitz, director of CDC's Medication Safety Program, said in a CDC news release. "A few simple steps -- done every time -- can protect our children."
Any vitamin or medicine, even those you buy without a prescription, can cause harm if taken improperly, the CDC warned.
All medicines and vitamins should be stored in a place that's too high for children to reach or see. Always put medicines away after you use them. Never leave them out on a kitchen counter or a sick child's bedside, even if you have to give the medicine again in a few hours.
Make sure safety caps are locked after you use medicines. If it's a locking cap that turns, twist it until you hear a click.
Teach children about medicine safety. Never tell children that medicine is candy to get them to take it, the CDC stressed.
Ask visitors and houseguests to keep purses, bags or coats that have medicines in them up and away and out of sight when they are in your home.
Be prepared for emergencies. Program the poison control number (1-800-222-1222) into home and cellphones.
"Even with improvements to packaging, no medication package can be 100 percent childproof," Dr. Richard Dart, president of the American Association of Poison Control Centers, said in the news release. "Poison centers receive calls every day about young children getting into medicines without adult supervision; that's why we encourage all parents and caregivers to follow these simple steps to ensure their child's safety."
More information
The Nemours Foundation offers more tips on how to protect children from poisoning caused by medications and other substances.
Stress Early in Pregnancy Linked to Fewer Baby Boys
THURSDAY, Dec. 8 (HealthDay News) -- A stressful early pregnancy could lower a woman's odds for delivering a boy and raise her risk for premature delivery, a new study suggests.
The findings from an investigation of how the stress of a major 2005 earthquake affected pregnant women in Chile suggest that pregnancy can be impacted by exposure to stress itself rather than the factors that often accompany or cause stress, such as poverty, the researchers said.
The investigators analyzed the birth certificates of all the babies born in Chile between 2004 and 2006, which was more than 200,000 per year. The birth records provided information about the babies and their mothers, including how close the mothers lived to the epicenter of the magnitude 7.9 earthquake.
Reporting in the Dec. 8 issue of Human Reproduction, the study authors found that exposure to the earthquake during the third month of pregnancy reduced the ratio of male to female births.
"Generally, there are more male than female live births. The ratio of male to female births is approximately 51:49 -- in other words, out of every 100 births, 51 will be boys. Our findings indicate a 5.8 percent decline in this proportion, which would translate into a ratio of 45 male births per 100 births, so that there are now more female than male births. This is a significant change for this type of measure," Dr. Karine Kleinhaus, an assistant professor of psychiatry, obstetrics & gynecology, and environmental medicine at New York University, said in a journal news release.
This finding may be related to previous research, which has found that male fetuses tend to grow larger than females and need more resources from the mother, and therefore are more likely to miscarry in times of stress. In addition, male fetuses may be less robust than females and may be less capable of adapting their development to a stressful environment in the womb.
The study also revealed that women who experienced the earthquake during their second and third months of pregnancy had shorter pregnancies and were more likely to have premature babies.
Compared to women in parts of Chile unaffected by the earthquake, the pregnancies of women exposed to the earthquake in the second month of pregnancy were an average of 1.3 days shorter, and the pregnancies of those exposed to the earthquake in the third month of pregnancy were an average of about 2 days shorter, the findings showed.
More than nine in 100 women exposed to the earthquake in the third month of pregnancy had a premature baby, a 3.4 percent increase over the normal rate of about six in 100. The effect was most notable among baby girls -- close to a 4 percent increase in premature birth if the mother was exposed to the earthquake in the second month of pregnancy and a 3.8 percent increase if it occurred in the third month.
Earthquake exposure had no statistically significant effect on the risk of having a premature baby boy, the researchers noted.
More information
The March of Dimes has more about stress and pregnancy.
Steroids May Boost Survival for Very Preemie Babies
TUESDAY, Dec. 6 (HealthDay News) -- Giving steroids to pregnant women at risk for preterm birth as early as 23 weeks during their pregnancy may boost an infant's overall chance of survival and reduce the baby's risk of serious developmental issues, including brain injury, a new study says.
The study, published in the Dec. 7 issue of the Journal of the American Medical Association, is potentially significant, according to experts who are not affiliated with the study.
Current guidelines suggest administering prenatal steroids to women who are at risk for delivering between the 24th and 34th week of their pregnancy, but make no recommendations about what to do if women show signs of labor before week 24. Most "full-term" babies are born between 38 and 42 weeks. Steroids help the infants' lungs develop and this increases survival rates and lowers their risk of brain injury.
The new study provides some much-needed clarity for mothers and doctors of babies who are born at 23 weeks.
"When given as early as 23 weeks, prenatal or antenatal steroids reduce an infant's risk of death and important developmental issues," said study author Dr. Wally Carlo, director of the division of neonatology at the University of Alabama at Birmingham.
In the absence of clear guidelines, standard practice varies widely, he said. In the study, around 40 percent of women who showed signs of preterm labor at 23 weeks were not treated with steroids. "There is a huge potential to increase the use of prenatal steroids," he said. "Mothers need to know that there is a lot that physicians can do to improve the outcome for these babies."
The new study included about 10,500 infants born at 23 medical centers between January 1993 and January 2008 at 22 to 25 weeks. These babies weighed shy of 2 pounds at birth. The study compared infants who received prenatal steroids to those who had not. The researchers also performed neurologic exams on more than 4,900 of the surviving infants at 18 to 22 months after their original due dates.
When steroids were given to moms during their 22nd to 23rd week of pregnancy, infants' risk of death decreased by more than 33 percent, and their risk of neurodevelopmental delays dropped by more than 20 percent, the study showed. Such neurodevelopmental delays may include blindness, hearing impairment, cerebral palsy or severe delays in motor and cognitive issues. The treatment worked across many subgroups of women, Carlo said. "Even one dose may have important effects," he noted.
This suggests that prenatal steroids work just as well in babies born at 23 weeks as they do in those born at 26 weeks.
Dr. Burton Rochelson, chief of maternal-fetal medicine at the North Shore-Long Island Jewish Health System in Great Neck, N.Y., called the new study findings "important" and "a big deal." This study "provides pretty convincing evidence that we can give these steroids to infants between 22 and 23 weeks of pregnancy," he said. "If it looks like you are going to deliver even as early as 23 weeks, you should have a discussion with your doctor and be offered corticosteroids."
More information
Visit the March of Dimes to learn more about preterm birth.
A little reward might get kids to eat veggies
NEW YORK (Reuters Health) - If your preschooler turns her nose up at vegetables, giving her a small reward for taking even a taste might help, a new study suggests.
Researchers found that when parents gave their 3- and 4-year-olds a sticker each time they took a "tiny taste" of a disliked vegetable, it gradually changed the preschoolers' attitude.
After a couple weeks, kids rewarded with stickers were giving higher ratings to a vegetable they'd previously sworn off. On average, the vegetable moved up the scale from between 1 and 2 -- or somewhere between "yucky" and "just OK" -- to between 2 and 3 ("just OK" and "yummy").
The children were also willing to eat more of the vegetable in taste tests in the lab.
Verbal praise, on the other hand, did not work so well, the study found.
The bottom line for parents? It might not hurt to try the sticker approach, according to Jane Wardle, a researcher at University College London in the UK who worked on the study.
"We would recommend that parents consider using small non-food rewards, given daily for tasting tiny pieces of the food -- smaller than half a little finger nail," Wardle told Reuters Health in an email.
It might seem obvious that a reward could entice young children to eat their veggies. But the idea is actually controversial, Wardle and her colleagues note in their report in the American Journal of Clinical Nutrition.
That's because some studies have suggested that rewards can backfire, Wardle explained. In most of those studies, rewards caused kids to lose interest in foods they already liked.
In the latest study, the researchers focused on vegetables that their preschool group had little taste for.
They randomly assigned 173 families to one of three groups. In one, parents used stickers to reward their child each time he took a tiny sample of a disliked vegetable (either carrots, celery, cucumber, red pepper, cabbage or sugar snap peas).
A second group of parents used praise as a reward (as in, "Brilliant, you're a great vegetable taster!") The third group served as a "control," where parents used to no special veggie-promoting tactics.
Parents in the reward groups offered their child a taste of the "target" vegetable every day for 12 days.
Soon afterward, children in the sticker group were giving higher ratings to their previously disliked vegetable. And in the research lab, they were willing to eat more as well: from an average of 5 grams at the study's start, to about 10 grams after the 12-day experiment.
The turnaround also seemed to last, Wardle's team found. Preschoolers in the sticker group were still willing to eat more of the once-shunned veggie three months later.
Verbal praise, on the other hand, seemed ineffective.
It's possible, the researchers say, that parents' words seemed "insincere" to their little ones. Or the preschool set may just really like stickers. Whatever the reason, Wardle suggested that parents give the sticker reward a shot. (Children in this study, she noted, were also given a special sheet where they could place their well-earned rewards.)
And it's unlikely you would have to bribe your children with stickers until they are 18. This research, according to Wardle, suggests that about 10 days is typically enough to change young children's attitudes.
SOURCE: http://bit.ly/tvqPoN American Journal of Clinical Nutrition, December 7, 2011.
If Parents Drink and Drive, Their Kids May Too: Study
One is a healthy first-grader, the other an honors college student majoring in psychology. Once the tiniest babies ever born, both girls are thriving, despite long odds when they entered the world weighing less than a pound.
Health Tip: How to Ease Leg Cramps During Pregnancy
One is a healthy first-grader, the other an honors college student majoring in psychology. Once the tiniest babies ever born, both girls are thriving, despite long odds when they entered the world weighing less than a pound.
Chavez launches cash giveaway for poor Venezuela kids
CARACAS (Reuters) - President Hugo Chavez launched on Monday a program to provide $100 a month to poor Venezuelan children in the latest of a plethora of social "missions" that have underpinned his popularity.
Chavez, who seeks re-election in 2012, says such measures show the tangible benefit of socialist rule in the South American OPEC member nation. But critics argue it is a pre-election ploy masking broader economic failure.
"Thank God, the Bolivarian Revolution arrived in time and is stopping poverty and misery," Chavez said at a meeting with low-income pregnant women to announce the initiative. He styles his government after independence hero Simon Bolivar.
Under the Great Sons of Venezuela Mission, low-income households will be able to claim 430 bolivars ($100) per month from the government for each child up to a maximum of three. Disabled dependents will qualify for 600 bolivars.
Chavez supporters say the latest social project -- adding to a dozen such missions covering everything from healthcare to low-cost housing -- prove how Venezuela's oil wealth is being properly distributed for the benefit of the poor.
They contrast that with the reduction of social benefits amid economic hard times in Europe and the United States.
Although wary of criticizing a benefit for children being announced just before Christmas, opponents say the latest project is a typical populist tactic to maximize votes for Chavez in next October's presidential election.
They argue the giveaway is just a plaster on the ailing economy and the poor would benefit more from better employment prospects, lower inflation, less corruption and more efficient use of Venezuela's unprecedented oil revenues.
"EACH CHILD LIKE JESUS"
Some say the measure will encourage teenage pregnancies.
"What madness," Chavez said of the criticism. "The problem is not the child but the phenomenon of poverty and misery.
"Those children who are coming, they are a blessing. Each one of you is like the Virgin Mary and each child is like a Jesus who is reborn. Mary was very poor and Joseph did not have a minimum salary," he quipped, referring to another much-vaunted pillar of the government's social policies.
Chavez faces a strong challenge from a newly united opposition coalition but remains Venezuela's most popular politician with an approval rating above 50 percent.
His "missions" have guaranteed him strong support in Venezuela's urban slums and poor rural areas. They have also exacted a heavy toll on the finances of state oil company PDVSA, which is short of funds for investment.
Government officials sometimes stoke fear among the population by saying opponents would reverse Chavez's flagship social policies like free clinics staffed by Cuban medics in the Mision Barrio Adentro (Inside the Slum Mission).
Yet the leading opposition candidate, center-left state governor Henrique Capriles Radonski, has praised the best of Chavez's social policies and said he would be "mad" to overturn them.
Poverty levels have fallen among Venezuela's 29 million people during Chavez's 13-year-rule, according to U.N. figures, but there is debate over the data and to what extent the government has been responsible for the improvement.
"Given the oil bonanza Venezuela is in, the results should have been much, much better," Radonski said recently.
Venezuela's oil barrel has averaged more than $100 this year, allowing the government to splash money liberally on social projects and build up a pre-election war-chest.
At Monday's event in a Caracas maternity hospital, women peppered Chavez with requests for housing and improvements to refugee shelters, in a sign both of Venezuela's deep social needs and his highly personalized style of government. (Additional reporting by Eyanir Chinea; Editing by Marianna Parraga and Bill Trott)
Birth Defects Seem Rare in Kids of Childhood Cancer Survivors
MONDAY, Dec. 12 (HealthDay News) -- Children of parents who survived childhood cancer are unlikely to suffer from birth defects, finds a new study that should allay some concerns about long-term effects of treatment.
It appears that DNA damage done by chemotherapy and radiation of the reproductive organs doesn't increase the risk that children will inherit those damaged genes, researchers say.
"We found that DNA damage from radiation and chemotherapy with alkylating agents are not associated with the risk of genetic birth defects in the offspring," said lead researcher Lisa Signorello, an associate professor of medicine at Vanderbilt University in Nashville.
"This is really reassuring," she said. "This is one less thing for childhood cancer survivors to worry about." The prevalence of birth defects among the children of cancer survivors is similar to that of the general population, added Signorello, who's also a senior epidemiologist at the International Epidemiology Institute in Rockville, Md.
While life-saving in many cases, radiotherapy and chemotherapy with alkylating agents, such as busulfan, cyclophosphamide and dacarbazine, can damage DNA.
Signorello noted that childhood cancer survivors have a higher rate of infertility and a greater risk of having miscarriage, preterm birth and low birth-weight infants.
Although cancer treatment can cause DNA damage to the sperm and eggs, "it may be that these damages get filtered out," she said.
Genetic-based birth defects are rare, accounting for about 3 percent of births. Although earlier research found little or no increased risk for birth defects among the children of cancer survivors, the studies were small in size and lacked detailed data about radiation and chemotherapy, such as radiation doses to the testes and ovaries, the researchers noted.
The report was published in the Dec. 12 issue of the Journal of Clinical Oncology.
For the study, Signorello and colleagues collected data on more than 20,000 children who had survived cancer. The data were taken from the 1970 and 1986 Childhood Cancer Survivor Study. Fifty-seven percent of them had been treated for leukemia or lymphoma.
The researchers also looked at the health of nearly 4,700 children of these survivors.
Of the parents treated for cancer, 63 percent had radiation therapy and 44 percent of men and 50 percent of women had chemotherapy.
Among their children, 2.7 percent had at least one birth defect such as Down syndrome, achondroplasia (dwarfism), or cleft lip.
Three percent of the mothers exposed to radiation or treated with alkylating chemotherapy had a child with a genetic birth defect, compared with 3.5 percent of mothers who survived cancer, but weren't exposed to these treatments, the researchers found.
Only 1.9 percent of children of the cancer-surviving fathers had these birth defects, compared with 1.7 percent of children of fathers who did not have chemotherapy or radiation, they said.
"This is very encouraging, because there has been a worry," said Dr. Michael Katz, senior vice president for research and global programs at the March of Dimes.
Dr. Jeanette Falck Winther, a senior researcher at the Institute of Cancer Epidemiology at the Danish Cancer Society in Copenhagen and co-author of an accompanying journal editorial, said the study findings should address some of the reproductive concerns of childhood cancer survivors, geneticists and pediatric oncologists.
"Our hope is that this reassuring information will be used by the physicians in counseling childhood cancer survivors who desire and are able to have children," she said.
More information
For more information on childhood cancer, visit the American Cancer Society.
Adult Sickle Cell Drug May Benefit Kids, Too
SUNDAY, Dec. 11 (HealthDay News) -- A drug called hydroxyurea that's approved for use in adults with severe sickle cell anemia can also help young children with the disease, new research suggests.
Children with sickle cell anemia younger than 4 years old who took the medication had fewer emergency department visits for pain crises, hospital admissions, illnesses with fever and need for transfusions, the study found.
"Hydroxyurea may be an option for all children with sickle cell anemia. If you're the parent of a child with sickle cell anemia, talk with your child's doctor about whether it might be right for your child," said study lead author Dr. Zora Rogers, a professor of pediatrics at the University of Texas Southwestern Medical Center, Dallas.
"We don't see a difference in toxicity; we don't see a big difference in growth," said Rogers, who's also clinical director of the bone marrow failure and general hematology program at Children's Medical Center in Dallas. "Hydroxyurea is not causing any obvious harm. We'll need to follow the children through adolescence, but right now the oldest is 9."
Rogers was scheduled to present the study's findings Sunday at the annual meeting of the American Society of Hematology in San Diego.
In sickle cell anemia, red blood cells become rigid and develop a crescent, or sickle, shape, often leading to pain, infection, organ damage, and even stroke. Hydroxyurea makes it less likely that red blood cells will bend abnormally, according to the U.S. National Institutes of Health. People taking the drug must get monthly blood counts to verify they're on the most effective dose, Rogers said.
The new study followed up on one done with babies and toddlers with sickle cell anemia. In that earlier study, nearly 200 babies between 9 and 18 months old were randomly selected to receive treatment with either hydroxyurea or a placebo. The study, called Baby Hug, found that children on hydroxyurea had fewer pain crises, acute chest syndrome events, blood transfusions and hospital admissions.
Parents of the 176 children who completed at least 18 months of the Baby Hug study were offered a chance to participate in the current follow-up study, sponsored by the U.S. National Heart, Lung, and Blood Institute. One hundred and sixty-three children continued in the study.
All the children had the chance to take hydroxyurea in the follow-up study. One hundred and thirty three parents chose the drug.
Researchers have seen each child every six months, and now have 36 months of follow-up data. Rogers said the researchers have almost 500 patient-years of follow-up information.
As with the initial study, the follow-up study saw fewer ER visits for pain crises, transfusions and hospital admissions. For each 100 patient-years, the study found 28.8 emergency room visits for pain crises for those children on hydroxyurea, compared to 53.6 for those on a placebo. For transfusions, there were 18.3 per 100 patient-years for kids on the medication, versus 35.9 for those on a placebo. There were 72.9 hospital admissions per 100 patient-years for those receiving treatment, and 131.7 for those taking a placebo.
The follow-up also found fewer illnesses with fever -- 28.5 per 100 patient years for kids on the drug and 61.5 for children not taking the drug.
"The benefits outweigh the risks for hydroxyurea when administered under supervision," said Dr. Lakshmanan Krishnamurti, director of hematology and hemoglobinopathy at Children's Hospital of Pittsburgh. "This study [offers] a ray of hope and shows us a way to move forward. I hope it leads to change in how physicians think about patients with sickle cell disease. Families can undertake medications and they will come for monitoring."
"We know what 30 years of sickle cell does to a body," Krishnamurti added. "This study shifts the paradigm from chronic palliation to an attempt to give the medication that now has a demonstrated track record of efficacy before damage is done."
A second study, also to be presented Sunday at the meeting, looked at the potential for a side effect from hydroxyurea called genotoxicity. A drug with genotoxic effects has the potential to damage DNA. Some laboratory tests had suggested that this could be possible with hydroxyurea.
Researchers from the Baylor College of Medicine in Houston and elsewhere looked for evidence of DNA damage in the babies and toddlers enrolled in the Baby Hug study. They found no significant differences in signs indicating DNA damage between kids on the drug and kids on a placebo, suggesting that any potential for genotoxicity is low.
Research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
More information
To learn more about hydroxyurea, visit the U.S. National Library of Medicine.
Headaches common in kids months after brain injury
NEW YORK (Reuters Health) - Kids who have a concussion or other traumatic brain injury are more likely to develop headaches for up to a year afterward than children who have had a bodily injury, according to a new study.
While not entirely surprising, the results point to a difficult long-term problem for kids and their parents because adequate treatments are lacking, researchers say.
"It's an issue because they may have problems with sleep, and the headaches can make it harder to concentrate," said lead author Dr. Heidi Blume at Seattle Children's Research Institute.
More than half a million children go to the hospital each year for brain injury.
Blume and her colleagues tracked more than 400 children who had come into the emergency room with a brain injury -- 402 kids had a mild injury and 60 kids had a moderate or severe injury.
Oftentimes the damage was caused by rough play in sports, falls and car accidents.
Blume's team compared these head-injury cases to kids who had come into the emergency room with an arm injury.
Parents and children kept a diary of any headaches the kids reported for a year.
After three months, 43 out of every 100 kids who experienced a mild brain injury complained of headaches.
Among kids with moderate or severe brain injuries, 37 out of every 100 complained of headaches.
In comparison, 26 out of every 100 kids who had an arm injury reported having headaches three months later.
Blume said headaches can have a big impact on kids' lives, affecting their performance in school and forcing them to drop out of sports, band or other activities that could potentially trigger headaches.
It's unclear why the children with mild brain injury were more likely to have headaches than those who suffered more severe damage.
"That is a conundrum that we don't fully understand, but it's been noted before" in research on adults, said Karen Barlow at Alberta Children's Hospital in Calgary, Canada.
"There might be something about the moderate and severe traumatic brain injuries that interfere with the mechanisms of sensing pain," Barlow speculated, "but we haven't gotten to the bottom of that."
The researchers did not determine whether kids who suffered a brain injury were also more likely to have had headaches before the injury than the kids who had an arm injury.
They did find that the risk for having headaches after a head injury was especially pronounced among girls.
Girls who had a mild brain injury were more than twice as likely to have headaches as girls who had an arm injury, whereas boys had nearly similar rates of headaches regardless of the type of injury.
"I'm not surprised about this because it's what I see in clinic," Blume told Reuters Health.
The study, published in the journal Pediatrics, did not determine why there was a difference between the sexes.
Girls might be more likely to report headaches, Blume said, "but I don't think it can all be chalked up to a difference in reporting. I think there's something else going on."
Women and girls are more likely to suffer migraines than men and boys, which could be due to hormone levels, and perhaps hormones might also play a role with headaches after brain injury too.
The greater chance of having headaches among girls could also reflect changes in the way boys' and girls' brains develop, Blume said.
The challenge for any child suffering headaches after a brain injury is that there are few ways to treat them.
"Right now we have no studies to guide the treatment of post-traumatic headaches in children," said Barlow, who was not involved in the new study.
Rest and hydration are usually offered, but Barlow said there's only anecdotal evidence backing them up.
Fortunately, it appears that 12 months after a brain injury, the headaches seem to go back to the levels seen among kids who have had an arm injury.
SOURCE: http://bit.ly/t5t2IV Pediatrics, online December 5, 2011.
Health Tip: Keep the Sport in Kids' Sports
One is a healthy first-grader, the other an honors college student majoring in psychology. Once the tiniest babies ever born, both girls are thriving, despite long odds when they entered the world weighing less than a pound.
Michelle Duggar Loses 20th Baby; Miscarriage Resources for Parents
Michelle and Jim Bob Duggar, quiverfull parents of TLC's "19 and Counting" lost their 20th child. A 19-week ultrasound detected no heartbeat and the Duggars have opted to let the miscarriage occur naturally, says People magazine. Here are stillborn-infant and miscarriage information for parents.
Parent miscarriage guilt
Medicine Net says 60 percent to 70 percent of pregnancies end in miscarriage. Most occur before 13 weeks and many before the mother knows she has conceived. Despite the commonness of miscarriage, it is one of the most guilt-producing events in parenting, ABC News Medical Unit reports. Parents tend to blame themselves for neonatal loss, though few miscarriages are caused by something either parent was responsible for. The main reasons for miscarriage: caused by chromosomal abnormalities, collagen vascular disease, diabetes, hormone problems, infections and uterine abnormalities. Smoking, alcohol and drug use (including non-steroidal anti-inflammatory drugs) are also linked. Women with a past history of miscarriages are more prone to further problems. Parents may fault themselves for things like sexual intercourse, exercise and work; Medicine Net says that in a healthy pregnancy, those things do not cause miscarriage.
Parent choices about miscarriage
After miscarriage, the mother's body may not immediately expel the fetus. Net Doctor says parents have three options at this point. They may decide to wait for the baby to be born naturally, as the Duggars are doing. However, in a miscarriage, the mother's body doesn't produce pregnancy hormones needed for birth. Doctors may give labor-inducing stimulants. Kids Health says doctors may also recommend evacuating the fetus more quickly, especially if the baby has been dead for some time. They may perform a D&C (dilation and curettage) or scraping of the uterine wall. A D&E (dilation and extraction) uses a suction to remove the fetal matter.
Parent choices about baby's remains
After miscarriage, parents may have to decide what to do with the fetal remains. Parent choices about dealing with the body, may depends upon how their state's abortion laws are written, Pregnancy Loss says. Before the age of viability, about 20-24 weeks, the fetus's body may be deemed biological waste and treated as any other surgically-removed body part. Parents may not be given fetal remains, depending upon where they live. After the age of viability, the fetus is considered a person. The remains must be dealt with a human body would be: cremation or burial. However, in some states, if the fetus was surgically removed, with D&E or D&C, the remains may still not be surrendered to the parents. Before age of viability, states may offer three options: disposal, donation to science and burial/cremation (with some kind of funeral). The Duggar have chosen this option.
Grief support for parents
GriefSpeaks says parents need to acknowledge their loss and connect with others. The website lists several major neonatal loss support groups, like AMEND (Aiding Mothers and Fathers Experiencing Neonatal Death).
Marilisa Kinney Sachteleben writes about parenting from 23 years raising four children and 25 years teaching K-8, special needs, adult education and homeschool.
Chavez launches cash giveaway for poor Venezuela kids
CARACAS (Reuters) - President Hugo Chavez launched on Monday a program to provide $100 a month to poor Venezuelan children in the latest of a plethora of social "missions" that have underpinned his popularity.
Chavez, who seeks re-election in 2012, says such measures show the tangible benefit of socialist rule in the South American OPEC member nation. But critics argue it is a pre-election ploy masking broader economic failure.
"Thank God, the Bolivarian Revolution arrived in time and is stopping poverty and misery," Chavez said at a meeting with low-income pregnant women to announce the initiative. He styles his government after independence hero Simon Bolivar.
Under the Great Sons of Venezuela Mission, low-income households will be able to claim 430 bolivars ($100) per month from the government for each child up to a maximum of three. Disabled dependents will qualify for 600 bolivars.
Chavez supporters say the latest social project -- adding to a dozen such missions covering everything from healthcare to low-cost housing -- prove how Venezuela's oil wealth is being properly distributed for the benefit of the poor.
They contrast that with the reduction of social benefits amid economic hard times in Europe and the United States.
Although wary of criticizing a benefit for children being announced just before Christmas, opponents say the latest project is a typical populist tactic to maximize votes for Chavez in next October's presidential election.
They argue the giveaway is just a plaster on the ailing economy and the poor would benefit more from better employment prospects, lower inflation, less corruption and more efficient use of Venezuela's unprecedented oil revenues.
"EACH CHILD LIKE JESUS"
Some say the measure will encourage teenage pregnancies.
"What madness," Chavez said of the criticism. "The problem is not the child but the phenomenon of poverty and misery.
"Those children who are coming, they are a blessing. Each one of you is like the Virgin Mary and each child is like a Jesus who is reborn. Mary was very poor and Joseph did not have a minimum salary," he quipped, referring to another much-vaunted pillar of the government's social policies.
Chavez faces a strong challenge from a newly united opposition coalition but remains Venezuela's most popular politician with an approval rating above 50 percent.
His "missions" have guaranteed him strong support in Venezuela's urban slums and poor rural areas. They have also exacted a heavy toll on the finances of state oil company PDVSA, which is short of funds for investment.
Government officials sometimes stoke fear among the population by saying opponents would reverse Chavez's flagship social policies like free clinics staffed by Cuban medics in the Mision Barrio Adentro (Inside the Slum Mission).
Yet the leading opposition candidate, center-left state governor Henrique Capriles Radonski, has praised the best of Chavez's social policies and said he would be "mad" to overturn them.
Poverty levels have fallen among Venezuela's 29 million people during Chavez's 13-year-rule, according to U.N. figures, but there is debate over the data and to what extent the government has been responsible for the improvement.
"Given the oil bonanza Venezuela is in, the results should have been much, much better," Radonski said recently.
Venezuela's oil barrel has averaged more than $100 this year, allowing the government to splash money liberally on social projects and build up a pre-election war-chest.
At Monday's event in a Caracas maternity hospital, women peppered Chavez with requests for housing and improvements to refugee shelters, in a sign both of Venezuela's deep social needs and his highly personalized style of government. (Additional reporting by Eyanir Chinea; Editing by Marianna Parraga and Bill Trott)
Babies learn whom to trust at early age: study
One is a healthy first-grader, the other an honors college student majoring in psychology. Once the tiniest babies ever born, both girls are thriving, despite long odds when they entered the world weighing less than a pound.
Schools, Parents, Lawmakers Take on Childhood Obesity
School lunch programs have been targeted, but lawmakers have been reluctant to enforce stricter nutrition standards, claiming they are too expensive, says News 14 Carolina. A recent Pediatrics study found although weight problems begin at home, they get worse at school. Louisiana State University is waging war on obesity on both fronts, Associated Press says. Here are details about childhood obesity and home-school health cooperatives for parents.
Poverty and obesity
The Centers for Disease Control and Prevention reports that one of seven kids from poor families are obese. Low-income parents often have to rely on cheap, non-nutritious foods. They have less access to fresh foods. Low-income children also more eat free school breakfast and lunch, so school nutrition is essential for addressing the childhood obesity epidemic.
New directions for school nutrition
School Nutrition Association News is exploring ways to get less-expensive, healthier foods into student meals. It recommends parents follow the guidelines at home. The focus is decreasing meat and adding more protein alternatives. It is also looking for ways to increase fiber in the diet.
Louisiana childhood obesity initiatives
The Pediatrics study concluded parents and schools need be on the same page if childhood obesity is to get under control. LSU is going into the community to teach parents ways to end the fast food and junk food reliance. LSU's AgCenter plans to host Family Nutrition Nights that focus on hands-on activities. The News Star says that beginning in January, LSU and the Children's Coalition in Northeast Louisiana will do a "Traveling Kitchen" series in which parents learn basic cooking skills and easy, healthy recipes. Nutrition programs will focus on weight management tools like proper portion sizes, healthy snacking, the need for breakfast and counting calories in beverages. LSU will also do a series on exercise awareness for parents and schools.
Marilisa Kinney Sachteleben writes about parenting from 23 years raising four children and 25 years teaching K-8, special needs, adult education and home-school.
Steroids help very young babies survive: study
Babies born as early as 23 weeks showed better survival rates and less brain damage if their mothers were given steroids in the days preceding their birth, a US study said Tuesday.
The research in the December 7 issue of the Journal of the American Medical Association suggests that preterm babies may benefit sooner than thought from the boost in lung power and organ growth they get from exposure to steroids.
Until now, little was known about the efficacy of giving a pregnant woman steroids for a fetus less than 24 weeks old, and some were worried it could raise the risk of infection in the mother.
Current guidelines, published in 1995, recommend a two-shot regimen for mothers who go into preterm labor when the fetus is between 24 and 34 weeks of age. A normal full-term pregnancy is between 37 and 42 weeks.
However, even though premature babies exposed to steroids were twice as likely to survive as those who were not, the researchers cautioned that overall survival still remained relatively low, at 36 percent.
To determine if steroids could help the youngest babies survive after being born on the edge of viability, doctor Waldemar Carlo of the University of Alabama at Birmingham and colleagues looked back at records between 1993 and 2009 at 23 academic perinatal centers in the United States.
Data included babies born between 401 grams (14.1 ounces) and 1,000 grams (35.3 ounces) at 22 to 25 weeks' gestation.
Among babies born at 23 weeks who were exposed to steroids, 83 percent either died or had brain development problems by age 18-22 months. Ninety percent of those who weren't given steroids either died or showed brain damage.
The same advantages were not seen at a statistically significant level in babies aged 22 weeks who were exposed to steroids.
The improvements were more pronounced in babies aged 24 weeks, 68 percent of whom died or had brain damage after getting steroids compared to 80.3 percent who did not.
Concerns about potential infection in pregnant mothers, whose immune systems would dip after being given the steroids, were unfounded, he said.
"The results of the study showed that mortality was decreased by more than 33 percent and neurodevelopmental impairment was decreased by more than 20 percent," Carlo said.
"We also found that using the antenatal corticosteroids did not increase the infection rate for the mothers."
Carlo and colleagues urged further research and said doctors should consider giving preterm mothers steroids starting at "23 weeks' gestation and later if the infant will be given intensive care because this therapy is associated with reduced mortality and morbidity."
Vitamin D Levels Tied to Diabetes Risk in Obese Kids
TUESDAY, Dec. 6 (HealthDay News) -- Low levels of vitamin D are much more common in obese children than in those who aren't obese and are associated with insulin resistance, a risk factor for type 2 diabetes, researchers have found.
The study included 411 obese children and 87 children who weren't overweight. Researchers measured the children's vitamin D levels, blood sugar levels, serum insulin, body mass index and blood pressure.
The children were also asked about their daily consumption of soda, juice, milk, fruits and vegetables, and whether or not they routinely skipped breakfast.
The findings are slated for publication in the January issue of the Journal of Clinical Endocrinology & Metabolism.
"Our study found that obese children with lower vitamin D levels had higher degrees of insulin resistance," lead author Dr. Micah Olson, of the University of Texas Southwestern Medical Center in Dallas, said in a news release from the Endocrine Society. "Although our study cannot prove causation, it does suggest that low vitamin D levels may play a role in the development of type 2 diabetes."
Obese kids who had poor dietary habits, such as skipping breakfast and drinking lots of soda and juice, also tended to have lower vitamin D levels, the study found.
Future research should look at whether making sure obese kids get adequate vitamin D could also help with insulin resistance, Olson added.
Past studies have linked low vitamin D levels with cardiovascular disease and type 2 diabetes. It's not fully known how obesity and associated conditions are related to vitamin D deficiency.
More information
The U.S. Centers for Disease Control and Prevention has more about childhood overweight and obesity.
Working Moms Happier, Healthier Than Stay-at-Home Peers: Study
TUESDAY, Dec. 13 (HealthDay News) -- Working mothers have better health and fewer symptoms of depression than stay-at-home moms, a new study indicates.
The researchers also found that mothers with part-time jobs can balance work and nurturing their children better than those with full-time jobs.
For the study, published in the December issue of the Journal of Family Psychology, researchers analyzed data collected from over 1,300 mothers in the United States who were interviewed shortly after their child's birth and underwent further interviews and observation over more than 10 years of follow-up.
The women were enrolled in the U.S. National Institute of Child Health and Human Development Study of Early Child Care and Youth Development.
Mothers who worked either full-time or part-time reported better overall health and fewer symptoms of depression than stay-at-home moms, according to the researchers at the University of North Carolina at Greensboro.
Mothers with part-time jobs were just as involved in their child's school as stay-at-home moms, and more involved than mothers with full-time jobs, the investigators found. The study authors also noted that mothers with part-time jobs appeared more sensitive with their preschool children and provided more learning opportunities for toddlers than stay-at-home moms and mothers with full-time jobs.
The researchers pointed out that cost-conscious employers often hire part-time workers because they typically don't receive the same amount of benefits, such as health insurance, training and career advancement.
"Since part-time work seems to contribute to the strength and well-being of families, it would be beneficial to employers if they provide fringe benefits, at least proportionally, to part-time employees as well as offer them career ladders through training and promotion," study co-author Marion O'Brien, a professor of human development and family studies, said in a news release from the American Psychological Association.
More information
The American Academy of Pediatrics has more about working mothers.
Blink Patterns May Be a Window Into Autistic Mind
MONDAY, Dec. 12 (HealthDay News) -- Toddlers with autism show different blink patterns than other children, a finding that researchers say may provide a clue to the way people with autism process what they see.
Blinking is largely an involuntary process that helps keep the eyes hydrated and protected. During that split second that your eyes are closed, you are temporarily blinded. And throughout a typical day, adults spend about 44 minutes with their eyes closed.
The current study got started when Sarah Shultz, a graduate student at the Yale Child Study Center, noticed that kids blink less often when watching videos. She and her colleagues wondered: Would kids with autism, who have impairments in social communications, including reading facial expressions and interacting with others, show the same blink timing?
In the study, researchers had 93 typically developing children and children with an autism spectrum disorder, all aged 2, watch short videos of two children in a wagon who get into an argument over whether the wagon door should be open or shut. Using eye-tracking technology, the researchers tracked when and how often the kids blinked.
Researchers found that both the kids with autism and typically developing kids blinked less during the video.
However, typical kids blinked less during the emotional exchange between the kids, while the autistic kids blinked less when there were moving parts, such as the wagon door being slammed.
"We have a new way of understanding not just what people are looking at but how engaged they are with what they're looking at," said senior study author Warren Jones, director of research at the Marcus Autism Center and an assistant professor in the department of pediatrics at Emory University School of Medicine in Atlanta.
"The more engaged you are, the less likely you are to blink," Jones said. "That's what we saw with those 2-year-olds. We were stunned to see typically developing 2-year-old kids would not blink when something emotionally exciting or charged was happening in the movie. What we saw in 2-year-olds with autism was they were more likely not to blink while looking at physical objects in motion."
When you blink, you "lose" a bit of information, Jones added. Therefore, not blinking is a sign that kids find that information most important, engaging or relevant.
The study is published in this week's online issue of the Proceedings of the National Academy of Sciences.
Prior research has found that kids with autism pay less attention to social cues and social information, Jones said. "What these new findings and new measure really gives us is an opportunity to look at in more detail how kids with autism are engaging in whatever it is they are looking at," he said.
Rebecca Landa, director of the Center for Autism & Related Disorders at Kennedy Krieger Institute in Baltimore, said the study uses a "novel" technique to examine how kids with autism process information and respond to things they see.
"The more evidence that we have about the nature of the information that children with autism are either delayed in deciphering -- in this case, through visual pathways -- or that they have certain preferences or biases for, the more informed we can be in the development of interventions," Landa said. "That's why this is important. We try to take ever more precise steps into understanding what children with autism understand and how they extract information from the world around them."
The study also found that typically developing kids "inhibited" their blinking sooner than the kids with autism, suggesting that they're better able to anticipate what might unfold between the two children on screen.
"There's a growing body of information that young children with autism are not paying attention to or extracting information from social sequences in the same way as typical kids," Landa said, noting that treatments that break down such information into smaller bits, as well as making sure kids with autism are repeatedly exposed to such situations, may help them start to comprehend the emotional aspects of social interactions.
Geraldine Dawson, chief science officer for Autism Speaks, said it's well-established that unlike typical kids, young children with autism pay more attention to objects than people. "However, this is the first study to my knowledge that has used blinking to assess how engaged a child is with what he or she is viewing," Dawson said.
The results suggest that blinking could be used as a way of measuring whether therapies designed to help a child with autism increase their emotional engagement are working, she said.
"If a child is not visually engaged with the social world, this can affect the development of neural systems that underlie social behavior which rely on social stimulation for development," she added. "The hope is that, as a result of therapy, the young child with autism will show higher levels of attention and engagement with the social world and this will open up opportunities for learning."
More information
The U.S. National Institute of Mental Health has more on autism.
'Love Hormone' May Buffer Kids From Mom's Depression
FRIDAY, Dec. 9 (HealthDay News) -- Children born to mothers with postpartum depression are at increased risk for mental health problems, but a hormone called oxytocin may reduce the risk, according to a new study.
Oxytocin, which is produced naturally in the body and has been associated with feelings of love and trust, may help protect kids from the negative effects of maternal depression, the researchers found. A synthetic version of the hormone is available as medication.
In the study, Israeli researchers looked at 155 mother-child pairs. By the time they were 6 years old, 60 percent of children born to mothers who were consistently depressed for the first year after giving birth had mental health problems, mainly anxiety and conduct disorders.
Among the 6-year-old children whose mothers did not have postpartum depression, only 15 percent had mental health problems, the investigators noted.
The study also found that children born to mothers with extended postpartum depression were less verbal and had lower levels of playfulness and creativity, less engagement with their mothers, diminished social involvement, and less empathy for the pain and distress of others.
These children and their mothers also had disordered functioning of the oxytocin system, as shown by lower levels of oxytocin in their saliva and a variant on the oxytocin receptor gene that increases the risk of depression, according to study leader Ruth Feldman, a professor in the psychology department and the Gonda Brain Sciences Center at Bar-Ilan University, and colleagues.
Among the children born to depressed mothers, the 40 percent who did not have mental disorders by age 6 had normal functioning of the oxytocin system and normal levels of oxytocin in their saliva.
The study was slated for presentation Thursday at the annual meeting of the American College of Neuropsychopharmacology, in Hawaii.
"We found the functioning of the oxytocin system helps to safeguard some children against the effects of chronic maternal depression," Feldman said in a college news release. "This study could lead to potential treatment options for postpartum depression and methods to help children develop stronger oxytocin systems."
Because this study was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.
More information
The Nemours Foundation has more about postpartum depression.
Kids won't eat veggies? Try rewards, a study says
(Reuters) - If your preschoolers turn up their noses at carrots or celery, a small reward like a sticker for taking even a taste may help get them to eat previously shunned foods, a U.K. study said.
Though it might seem obvious that a reward could tempt young children to eat their vegetables, the idea is actually controversial, researchers wrote in the American Journal of Clinical Nutrition.
That's because some studies have shown that rewards can backfire and cause children to lose interest in foods they already liked, said Jane Wardle, a researcher at University College London who worked on the study.
Verbal praise, such as "Brilliant! You're a great vegetable taster," did not work as well.
"We would recommend that parents consider using small non-food rewards, given daily for tasting tiny pieces of the food -- smaller than half a little finger nail," Wardle said in an email.
The study found that when parents gave their three- and four-year-olds a sticker each time they took a "tiny taste" of a disliked vegetable, it gradually changed the children's attitudes.
Over a couple of weeks, children rewarded this way were giving higher ratings to vegetables, with the foods moving up the scale from between 1 and 2 -- somewhere between "yucky" and "just okay" -- to between 2 and 3, or "just okay" and "yummy."
The children were also willing to eat more of the vegetables -- either carrots, celery, cucumber, red pepper, cabbage or sugar snap peas -- in laboratory taste tests, the study said.
Researchers randomly assigned 173 families to one of three groups. In one, parents used stickers to reward their child each time they took a tiny sample of a disliked vegetable.
A second group of parents used verbal praise. The third group, where parents used no special veggie-promoting tactics, served as a "control."
Parents in the reward groups offered their child a taste of the "target" vegetable every day for 12 days.
Soon after, children in the sticker group were giving higher ratings to the vegetables -- and were willing to eat more in the research lab, going from an average of 5 grams at the start to about 10 grams after the 12-day experience.
The turnaround also seemed to last, with preschoolers in the sticker group still willing to eat more of the once-shunned veggie three months later.
Why didn't the verbal praise work? Wardle said the parents' words may have seemed "insincere" to their children. SOURCE: http://bit.ly/tvqPoN
(Reporting from New York by Amy Norton at Reuters Health; editing by Elaine Lies)
Preemies Among World's Smallest Surviving Newborns Beating Odds
Two women who hold records for being the smallest surviving newborns are now doing fine and have developed normally, despite being born months premature and weighing about as much as a smart phone after birth, according to doctors where both babies were born.
Madeline Mann is now 20 and a college student. When she was born in 1989, at nearly 27 weeks, she was the world's smallest surviving infant at 9.9 oz. In 2004, Rumaisa Rahman, a twin, weighed just 9.2 oz when she was born at nearly 26 weeks and became the world's smallest surviving newborn. She still holds that record today.
In a follow-up study published in the journal Pediatrics, doctors at Loyola described the girls' progress since their birth. Both Madeline and Rumaisa developed normal motor and speech abilities and so far, have no chronic health problems. They are also both much smaller than peers their age.
In addition to being born extremely early, both babies were very low birth weight for their gestational ages. Normally, an 18-week-old fetus is around the weight they were when they were born. Although they are doing well, llead author Dr. Jonathan Muraskas, professor of neonatal-perinatal medicine at Loyola University Medical Center, stressed that despite their successes, Madeline and Rumaisa are very atypical of babies born that early and at weights that low.
"The normal outcomes that are somewhat of a miracle," said Muraskas. "We don't want the public to look at these two and have false expectations about outcomes."
"The vast majority of extremely pre-term infants who are also growth-restricted as these two were don't survive and those that do have major handicaps as well as ongoing health issues," said Dr. Deborah Campbell, director of neonatology at the Children's Hospital at Montefiore in the Bronx, N.Y.
Dominic Francis, a two-year-old from Cincinnati, is living with some of these health issues. Though he wasn't born as early as Madeline or Rumaisa, he was only 29 weeks old and weighed a little more than two pounds at birth.
He developed cerebral palsy after he was born, and now has trouble walking and communicating.
"He's a funny kid and he's a great kid, but in terms of mobility, he can't sit up on his own and he can't crawl," said his mother, Laura.
Because of a problem in his brain, he also had trouble making eye contact for about the first year. His brain, his mother explained, was "overwhelmed."
While she's happy to hear about rare cases like Madeline and Rumaisa, Francis also wants people to know they are the exception.
"The more common stories are the kids like my son who now face a lifetime of health and medical issues. I understand why the happy story gets the press, but the reality is that families of preemies have an uphill battle starting at birth," she said.
The chances of survival increase and the risk of complications decreases at higher gestational age, but children can have some problems associated with prematurity.
Zach Reisfeld is now 21, but was born at only 30 weeks old. Babies born at that age have a 95 percent chance of survival and less than a 5 percent chance of serious complications, according to Muraskas. Reisfeld works full-time at an electronics store and considers himself as normal as anyone else his age.
But he did struggle with some effects of his premature birth, including a sensory processing disorder that caused him to be hypersensitive to certain things touching him. Some data suggest this hypersensitivity is associated with prematurity.
"When I was a lot younger, I would have sensitivity to stuff," he said. "Like feeling the tag of a shirt against the back of my neck drove me nuts. My mom would notice all these holes in my shirts because I ripped off the tags."
He also has asthma, which Muraskas explained is more common in tiny babies who were on ventilators and oxygen after their birth. In addition, Reisfeld said he was diagnosed with attention-deficit hyperactivity disorder, which studies have shown premature infants are at higher risk for developing.
"Females do better than males, and giving mothers steroids before they deliver a baby can accelerate the maturation of babies' lungs and brains in utero, which leads to better outcomes," said Muraskas.
Current recommendations are for mothers to receive steroids, which help the lungs develop, before pre-term birth when a fetus is between 24 and 34 weeks of age.
The fact that both babies were older than 25 weeks also played a role in their successful outcomes, he also said.
"The single best predictor for outcome as far as how well the brain is working is maternal educational attainment," said Dr. F. Sessions Cole, director of the division of newborn medicine at Washington University of St. Louis Children's Hospital.
While the study did not give any details on the mothers' backgrounds and the families did not want to be interviewed, Campbell said it's obvious these women were able to receive excellent perinatal care.
"If we're talking in terms of developmental outcome over time, parental education is synonymous with environment, meaning they're better able to provide good resources and access to care," she said.
Muraskas and his colleagues wrote that a baby born older than 25 weeks old must be resuscitated because at that age, the baby is considered viable. Resuscitation is "obligatory on the ethical grounds of the 'best interests' of the newborn," they wrote.
The Supreme Court generally considers a fetus viable at around 24 weeks of age or when doctors make the determination of viability, which Cole explained sometimes dictates institutional policy on keeping certain premature newborns alive.
"Some institutions, in the interest of trying to put structure around these decisions, decide, regardless of the likelihood of survival, if a baby is born 16 weeks early or in that range, that baby would be given full life support regardless of parents' opinions," he said.
But he added that it may be better for these complex and delicate decisions to be made by the parents and health professionals involved on a case by case basis.
Advances in technology have made it possible for smaller babies to survive, wrote the authors. When a baby is near the age of questionable viability, they also say gender, gestational age and the use of steroids before birth should be considered as contributors to the ability to survive and do well.
And while the pressures of dealing with the health issues that often plague premature infants can be overwhelming, Francis wants other parents to know there is plenty of support out there.
"It's important for them to know they are not alone. There's help out there."
Also Read
Most Doctors Don't Tell Parents Kids Are Overweight
TUESDAY, Dec. 6 (HealthDay News) -- Less than one-quarter of American parents with an overweight child remember ever being told by a health care professional that this was the case, a new study says.
"Parents might be more motivated to follow healthy eating and activity advice if they knew their children were overweight, but very few parents of overweight children say they have ever heard that from their doctor," lead author Dr. Eliana Perrin, an associate professor in the University of North Carolina at Chapel Hill School of Medicine and a pediatrician at North Carolina Children's Hospital, said in a university news release.
"As health care providers, it's our job to screen for overweight and obesity and communicate those screening results in sensitive ways, and we are clearly either not doing it or not doing it in a way that families can hear or remember. While we've done better in recent years, clearly there's more work to be done," she added.
Perrin and colleagues analyzed federal government data collected on nearly 5,000 overweight children aged 2 to 15 between 1999 to 2008. During that time, 22 percent of parents said a doctor or other health care professional told them their child was overweight.
This percentage did increase from 19.4 percent in 1999 to 23.4 percent in 2004 and 29.1 percent in by 2008.
Among parents with obese children, only 58 percent recalled a doctor telling them that their child was obese.
The study appeared online Dec. 5 in the journal Archives of Pediatrics & Adolescent Medicine.
"We need to figure out two things: How much does communication of weight status influence parents' behaviors? And, if hearing that their children are overweight is as big a wake-up call to changing lifestyle as we know from some other small studies, we need to figure out where this communication is breaking down so we can do better in the future," Perrin said.
More information
The Nemours Foundation has more about overweight and obesity in children.
Gallbladder and appendix surgery safe in pregnancy
NEW YORK (Reuters Health) - Pregnant women are at no greater risk of developing an infection or other complication after having their gallbladder or appendix removed than their non-pregnant counterparts, researchers report in a new study.
"Often surgery is necessary in pregnancy and, in fact, it probably promotes not only the health of the woman, but her pregnancy as well," said Dr. Jeffrey Ecker, an obstetrician at Massachusetts General Hospital, who was not involved in this study.
There had been some concern that pregnancy could pose an additional risk during surgery, said Dr. Elisabeth Erekson, a professor at Yale School of Medicine and the lead author of the study.
But many of the reports of the past didn't compare the outcomes in pregnant women to similar women who were not pregnant.
Erekson and her colleagues collected data on nearly 1,300 moms-to-be and more than 51,000 similarly aged women who weren't pregnant. Their information came from a database designed to track how well people fare after surgery.
Among more than 800 pregnant women who had their appendix removed, about four out of every 100 landed up with a complication within a month of the surgery.
This included an infection, an embolism, death, heart attack, or a return to the operating room.
Of the 19,000 non-pregnant women who also had an appendectomy, three out of every 100 had a complication.
The difference was most likely due to chance, the researchers concluded.
About two out of every 100 women who had their gallbladder removed experienced a problem after the surgery, but the rate was the same regardless of whether or not they were pregnant.
Erekson told Reuters Health that the results are reassuring for pregnant women in need of surgery.
"The good news is there is not an increased risk to her. If she has appendicitis, it is a good idea to proceed with the surgery" if her doctor advises it, Erekson said.
DON'T DELAY BECAUSE OF PREGNANCY
Ecker said that the study backs up what obstetricians would usually recommend for their patients: necessary, emergent surgeries, such as for appendicitis or a broken leg, should not be delayed because of pregnancy.
He added that it's still wise to push off elective procedures until after the pregnancy is over.
In some cases, such as for gallbladder removal to treat inflammation, it's a tough call. Ecker told Reuters Health that the inflammation might not necessarily be an emergency, but it could be a good idea to remove the gallbladder before it gets worse.
"For those in-between cases it requires a careful conversation," said Ecker, who is also vice chair of the American College of Obstetrics and Gynecology's committee on Obstetric Practice. "But one of the things that don't need to be focused on in that conversation is, 'Is it worse from the perspective of my health because I'm pregnant?'"
The study, published in the medical journal Obstetrics and Gynecology, did not determine whether surgery posed additional risks to the health of the fetus.
Erekson said that earlier reports "tend to support that the fetus does well under anesthesia."
Ecker said he'd like to see larger studies that track the outcomes of babies whose mothers had surgery while pregnant.
SOURCE: http://bit.ly/tuW9VU, Obstetrics and Gynecology, December, 2011.
Many Kids Seen in ER Have High Blood Pressure
WEDNESDAY, Dec. 7 (HealthDay News) -- More than half of children admitted to the pediatric emergency department at Shands Jacksonville Medical Center in Florida have high blood pressure, a new study says.
Researchers said they're not entirely sure what to make of the findings. Kids' blood pressure may go up temporarily because they're scared or upset, said study co-author Dr. Phyllis Hendry, an associate professor in the department of emergency medicine at the University of Florida College of Medicine-Jacksonville, in a university news release.
But high blood pressure in children can be a sign of kidney or other health problems. Doctors need to carefully evaluate blood pressure readings and possibly conduct further tests to determine if there is a serious problem, Hendry said.
Parents should also follow up with their pediatrician to make sure the child's blood pressure returns to normal after they go home.
Researchers analyzed the medical charts of nearly 1,000 patients 18 years and younger admitted to Shands -- an urban hospital -- over 13 months in 2007 and 2008. They expected about 100 patients to have elevated blood pressure upon arrival at the emergency department, but more than 500 did so. More than 20 percent of the children had severely elevated blood pressure levels.
The researchers also found that high blood pressure was recognized on the medical record in just a small percentage of cases.
"In adult emergency patients, we are very focused on blood pressure, and abnormal values are clearly defined," Hendry said in the news release. "In children, it's easy to dismiss a high value because often they are anxious, crying or in pain. There are a number of things that can affect blood pressure."
She noted that 5 percent of American youth have high blood pressure today, compared with 1 percent in the 1970s and 1980s, and that emergency departments can play a larger role in flagging potential blood pressure issues.
The study was recently published in the journal Pediatric Emergency Care.
More information
The Nemours Foundation has more about high blood pressure in children.
Working Moms Happier, Healthier Than Stay-at-Home Peers: Study
TUESDAY, Dec. 13 (HealthDay News) -- Working mothers have better health and fewer symptoms of depression than stay-at-home moms, a new study indicates.
The researchers also found that mothers with part-time jobs can balance work and nurturing their children better than those with full-time jobs.
For the study, published in the December issue of the Journal of Family Psychology, researchers analyzed data collected from over 1,300 mothers in the United States who were interviewed shortly after their child's birth and underwent further interviews and observation over more than 10 years of follow-up.
The women were enrolled in the U.S. National Institute of Child Health and Human Development Study of Early Child Care and Youth Development.
Mothers who worked either full-time or part-time reported better overall health and fewer symptoms of depression than stay-at-home moms, according to the researchers at the University of North Carolina at Greensboro.
Mothers with part-time jobs were just as involved in their child's school as stay-at-home moms, and more involved than mothers with full-time jobs, the investigators found. The study authors also noted that mothers with part-time jobs appeared more sensitive with their preschool children and provided more learning opportunities for toddlers than stay-at-home moms and mothers with full-time jobs.
The researchers pointed out that cost-conscious employers often hire part-time workers because they typically don't receive the same amount of benefits, such as health insurance, training and career advancement.
"Since part-time work seems to contribute to the strength and well-being of families, it would be beneficial to employers if they provide fringe benefits, at least proportionally, to part-time employees as well as offer them career ladders through training and promotion," study co-author Marion O'Brien, a professor of human development and family studies, said in a news release from the American Psychological Association.
More information
The American Academy of Pediatrics has more about working mothers.
A little reward might get kids to eat veggies
NEW YORK (Reuters Health) - If your preschooler turns her nose up at vegetables, giving her a small reward for taking even a taste might help, a new study suggests.
Researchers found that when parents gave their 3- and 4-year-olds a sticker each time they took a "tiny taste" of a disliked vegetable, it gradually changed the preschoolers' attitude.
After a couple weeks, kids rewarded with stickers were giving higher ratings to a vegetable they'd previously sworn off. On average, the vegetable moved up the scale from between 1 and 2 -- or somewhere between "yucky" and "just OK" -- to between 2 and 3 ("just OK" and "yummy").
The children were also willing to eat more of the vegetable in taste tests in the lab.
Verbal praise, on the other hand, did not work so well, the study found.
The bottom line for parents? It might not hurt to try the sticker approach, according to Jane Wardle, a researcher at University College London in the UK who worked on the study.
"We would recommend that parents consider using small non-food rewards, given daily for tasting tiny pieces of the food -- smaller than half a little finger nail," Wardle told Reuters Health in an email.
It might seem obvious that a reward could entice young children to eat their veggies. But the idea is actually controversial, Wardle and her colleagues note in their report in the American Journal of Clinical Nutrition.
That's because some studies have suggested that rewards can backfire, Wardle explained. In most of those studies, rewards caused kids to lose interest in foods they already liked.
In the latest study, the researchers focused on vegetables that their preschool group had little taste for.
They randomly assigned 173 families to one of three groups. In one, parents used stickers to reward their child each time he took a tiny sample of a disliked vegetable (either carrots, celery, cucumber, red pepper, cabbage or sugar snap peas).
A second group of parents used praise as a reward (as in, "Brilliant, you're a great vegetable taster!") The third group served as a "control," where parents used to no special veggie-promoting tactics.
Parents in the reward groups offered their child a taste of the "target" vegetable every day for 12 days.
Soon afterward, children in the sticker group were giving higher ratings to their previously disliked vegetable. And in the research lab, they were willing to eat more as well: from an average of 5 grams at the study's start, to about 10 grams after the 12-day experiment.
The turnaround also seemed to last, Wardle's team found. Preschoolers in the sticker group were still willing to eat more of the once-shunned veggie three months later.
Verbal praise, on the other hand, seemed ineffective.
It's possible, the researchers say, that parents' words seemed "insincere" to their little ones. Or the preschool set may just really like stickers. Whatever the reason, Wardle suggested that parents give the sticker reward a shot. (Children in this study, she noted, were also given a special sheet where they could place their well-earned rewards.)
And it's unlikely you would have to bribe your children with stickers until they are 18. This research, according to Wardle, suggests that about 10 days is typically enough to change young children's attitudes.
SOURCE: http://bit.ly/tvqPoN American Journal of Clinical Nutrition, December 7, 2011.
Blink Patterns May Be a Window Into Autistic Mind
MONDAY, Dec. 12 (HealthDay News) -- Toddlers with autism show different blink patterns than other children, a finding that researchers say may provide a clue to the way people with autism process what they see.
Blinking is largely an involuntary process that helps keep the eyes hydrated and protected. During that split second that your eyes are closed, you are temporarily blinded. And throughout a typical day, adults spend about 44 minutes with their eyes closed.
The current study got started when Sarah Shultz, a graduate student at the Yale Child Study Center, noticed that kids blink less often when watching videos. She and her colleagues wondered: Would kids with autism, who have impairments in social communications, including reading facial expressions and interacting with others, show the same blink timing?
In the study, researchers had 93 typically developing children and children with an autism spectrum disorder, all aged 2, watch short videos of two children in a wagon who get into an argument over whether the wagon door should be open or shut. Using eye-tracking technology, the researchers tracked when and how often the kids blinked.
Researchers found that both the kids with autism and typically developing kids blinked less during the video.
However, typical kids blinked less during the emotional exchange between the kids, while the autistic kids blinked less when there were moving parts, such as the wagon door being slammed.
"We have a new way of understanding not just what people are looking at but how engaged they are with what they're looking at," said senior study author Warren Jones, director of research at the Marcus Autism Center and an assistant professor in the department of pediatrics at Emory University School of Medicine in Atlanta.
"The more engaged you are, the less likely you are to blink," Jones said. "That's what we saw with those 2-year-olds. We were stunned to see typically developing 2-year-old kids would not blink when something emotionally exciting or charged was happening in the movie. What we saw in 2-year-olds with autism was they were more likely not to blink while looking at physical objects in motion."
When you blink, you "lose" a bit of information, Jones added. Therefore, not blinking is a sign that kids find that information most important, engaging or relevant.
The study is published in this week's online issue of the Proceedings of the National Academy of Sciences.
Prior research has found that kids with autism pay less attention to social cues and social information, Jones said. "What these new findings and new measure really gives us is an opportunity to look at in more detail how kids with autism are engaging in whatever it is they are looking at," he said.
Rebecca Landa, director of the Center for Autism & Related Disorders at Kennedy Krieger Institute in Baltimore, said the study uses a "novel" technique to examine how kids with autism process information and respond to things they see.
"The more evidence that we have about the nature of the information that children with autism are either delayed in deciphering -- in this case, through visual pathways -- or that they have certain preferences or biases for, the more informed we can be in the development of interventions," Landa said. "That's why this is important. We try to take ever more precise steps into understanding what children with autism understand and how they extract information from the world around them."
The study also found that typically developing kids "inhibited" their blinking sooner than the kids with autism, suggesting that they're better able to anticipate what might unfold between the two children on screen.
"There's a growing body of information that young children with autism are not paying attention to or extracting information from social sequences in the same way as typical kids," Landa said, noting that treatments that break down such information into smaller bits, as well as making sure kids with autism are repeatedly exposed to such situations, may help them start to comprehend the emotional aspects of social interactions.
Geraldine Dawson, chief science officer for Autism Speaks, said it's well-established that unlike typical kids, young children with autism pay more attention to objects than people. "However, this is the first study to my knowledge that has used blinking to assess how engaged a child is with what he or she is viewing," Dawson said.
The results suggest that blinking could be used as a way of measuring whether therapies designed to help a child with autism increase their emotional engagement are working, she said.
"If a child is not visually engaged with the social world, this can affect the development of neural systems that underlie social behavior which rely on social stimulation for development," she added. "The hope is that, as a result of therapy, the young child with autism will show higher levels of attention and engagement with the social world and this will open up opportunities for learning."
More information
The U.S. National Institute of Mental Health has more on autism.
Birth Defects Seem Rare in Kids of Childhood Cancer Survivors
MONDAY, Dec. 12 (HealthDay News) -- Children of parents who survived childhood cancer are unlikely to suffer from birth defects, finds a new study that should allay some concerns about long-term effects of treatment.
It appears that DNA damage done by chemotherapy and radiation of the reproductive organs doesn't increase the risk that children will inherit those damaged genes, researchers say.
"We found that DNA damage from radiation and chemotherapy with alkylating agents are not associated with the risk of genetic birth defects in the offspring," said lead researcher Lisa Signorello, an associate professor of medicine at Vanderbilt University in Nashville.
"This is really reassuring," she said. "This is one less thing for childhood cancer survivors to worry about." The prevalence of birth defects among the children of cancer survivors is similar to that of the general population, added Signorello, who's also a senior epidemiologist at the International Epidemiology Institute in Rockville, Md.
While life-saving in many cases, radiotherapy and chemotherapy with alkylating agents, such as busulfan, cyclophosphamide and dacarbazine, can damage DNA.
Signorello noted that childhood cancer survivors have a higher rate of infertility and a greater risk of having miscarriage, preterm birth and low birth-weight infants.
Although cancer treatment can cause DNA damage to the sperm and eggs, "it may be that these damages get filtered out," she said.
Genetic-based birth defects are rare, accounting for about 3 percent of births. Although earlier research found little or no increased risk for birth defects among the children of cancer survivors, the studies were small in size and lacked detailed data about radiation and chemotherapy, such as radiation doses to the testes and ovaries, the researchers noted.
The report was published in the Dec. 12 issue of the Journal of Clinical Oncology.
For the study, Signorello and colleagues collected data on more than 20,000 children who had survived cancer. The data were taken from the 1970 and 1986 Childhood Cancer Survivor Study. Fifty-seven percent of them had been treated for leukemia or lymphoma.
The researchers also looked at the health of nearly 4,700 children of these survivors.
Of the parents treated for cancer, 63 percent had radiation therapy and 44 percent of men and 50 percent of women had chemotherapy.
Among their children, 2.7 percent had at least one birth defect such as Down syndrome, achondroplasia (dwarfism), or cleft lip.
Three percent of the mothers exposed to radiation or treated with alkylating chemotherapy had a child with a genetic birth defect, compared with 3.5 percent of mothers who survived cancer, but weren't exposed to these treatments, the researchers found.
Only 1.9 percent of children of the cancer-surviving fathers had these birth defects, compared with 1.7 percent of children of fathers who did not have chemotherapy or radiation, they said.
"This is very encouraging, because there has been a worry," said Dr. Michael Katz, senior vice president for research and global programs at the March of Dimes.
Dr. Jeanette Falck Winther, a senior researcher at the Institute of Cancer Epidemiology at the Danish Cancer Society in Copenhagen and co-author of an accompanying journal editorial, said the study findings should address some of the reproductive concerns of childhood cancer survivors, geneticists and pediatric oncologists.
"Our hope is that this reassuring information will be used by the physicians in counseling childhood cancer survivors who desire and are able to have children," she said.
More information
For more information on childhood cancer, visit the American Cancer Society.
Many Toddlers Wind Up in ER After Accidental Overdose
TUESDAY, Dec. 13 (HealthDay News) -- Each year in the United States, one of every 150 two-year-olds visits an emergency room for treatment of an accidental medication overdose, a new government report shows.
Most of these cases occur when unsupervised children eat or drink medicines they find at home, according to the U.S. Centers for Disease Control and Prevention.
A new program to educate parents and caregivers about safe medication storage and what to do in an emergency was announced this week by the CDC and a coalition of partners. The "Up and Away and Out of Sight" program outlines measures parents can take to protect children.
"Parents may not be aware of the danger posed by leaving medications where young children can reach them. In recent years, the number of accidental overdoses in young children has increased by 20 percent," Dr. Dan Budnitz, director of CDC's Medication Safety Program, said in a CDC news release. "A few simple steps -- done every time -- can protect our children."
Any vitamin or medicine, even those you buy without a prescription, can cause harm if taken improperly, the CDC warned.
All medicines and vitamins should be stored in a place that's too high for children to reach or see. Always put medicines away after you use them. Never leave them out on a kitchen counter or a sick child's bedside, even if you have to give the medicine again in a few hours.
Make sure safety caps are locked after you use medicines. If it's a locking cap that turns, twist it until you hear a click.
Teach children about medicine safety. Never tell children that medicine is candy to get them to take it, the CDC stressed.
Ask visitors and houseguests to keep purses, bags or coats that have medicines in them up and away and out of sight when they are in your home.
Be prepared for emergencies. Program the poison control number (1-800-222-1222) into home and cellphones.
"Even with improvements to packaging, no medication package can be 100 percent childproof," Dr. Richard Dart, president of the American Association of Poison Control Centers, said in the news release. "Poison centers receive calls every day about young children getting into medicines without adult supervision; that's why we encourage all parents and caregivers to follow these simple steps to ensure their child's safety."
More information
The Nemours Foundation offers more tips on how to protect children from poisoning caused by medications and other substances.
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