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There are many transitions in a baby’s life that can cause stress for parents, especially first-time parents. One of these is the transition from an exclusively liquid diet (breast milk or formula) to one that also incorporates solids. With my first son, the concept of feeding him solids in addition to breast milk blew my mind. First of all, I had no idea what to cook for a baby. Second, I was afraid he might choke on these new solid foods. And third, I just couldn’t get my head around putting anything but milk into his wee mouth… What would happen?
To say I was a little paranoid is an understatement. After all, I am the mother that wanted to park outside the ER the first time I gave my son a peanut, so we’d be in the right place in case he had an allergic reaction. (I still don’t think this plan is totally crazy, by the way.) But these parental worries are why education is so important and the reason we must surround ourselves with people and sources that we trust. These sources of information can help us navigate each new stage, give us confidence that we are doing things in the best way for our family, and ease the worry that can cause us to miss out on the joys of these milestone moments.
The transition from a liquid to solid diet has been in the news a lot lately due to a recent study, conducted by the Centers for Disease Control and Prevention (CDC), that found a large number of mothers were not following the American Academy of Pediatrics’ (AAP) guidelines on introducing solid foods. The AAP currently recommends introducing solids when your child is 6 months old and exclusively breastfeeding (or using formula when breastfeeding is not possible) up until that point. This is important because introducing solids too early is associated with obesity, celiac disease, diabetes, and eczema and may pose a choking risk if the child is not able to properly hold up his head. I also want to dispel the myth that eating more solid foods will dramatically help a child sleep through the night. Sleeping through the night is possible even on an exclusively liquid diet and is a learned ability, rather than a result of being overly “full.”
While it can sometimes be hard to fight your own poor habits or pass on advice from overly helpful family members and friends, it is important to remember that breakthroughs in science and research help us improve our parenting know-how over time to make present and future generations healthier than the last. With the AAP’s research about the implications of introducing solids too early—combined with the potential choking hazard and the fact that introducing solids early won’t help him learn to sleep through the night—it just doesn’t make sense not to follow these guidelines. Your child has a lifetime of chewing ahead of him, so there’s no need to start him on solids until your baby reaches the current AAP recommendation of 6 months and shows signs of readiness. Instead, enjoy the months of not having to whip up some pureed squash and having it hurled at you as your wee one tries to navigate a spoon while they last!
This guest post comes from our advisor Ari Brown, M.D., a pediatrician in Austin, Texas, the co-author of several books including Baby 411, and a spokesperson for the American Academy of Pediatrics.
This week, the respected Institute of Medicine (IOM) issued a report addressing the current childhood immunization schedule. After a thorough review of the scientific literature, the IOM found no major safety concerns with the recommended schedule. Specifically, they cited no relationship of vaccines to autism, attention deficit disorder, or learning disabilities.
Regardless of the landmark report, social media is busy chattering that the U.S. Vaccine Injury Compensation Program recently gave two children with autism monetary awards for their health conditions. As a pediatrician, does it change my opinion about vaccine safety? No. Let me explain why. (Warning: It’s kind of boring, but worth reading about!)
The Centers for Disease Control (CDC) and Food and Drug Administration (FDA) closely monitor vaccines through the Vaccine Adverse Event Reporting System (VAERS). Anyone (doctors, patients’ families, lawyers) may submit a VAERS form if a health issue arises at anytime after vaccination. Obviously, these reports do not prove that a vaccine causes a particular illness. The CDC and FDA review each report to see if there is a pattern of illness after vaccination. VAERS data is available to the public here. Independent of the federal government, six U.S. academic medical centers also evaluate for vaccine side effects. Additionally, the Vaccine Safety Datalink, a database maintained by several managed care groups across the country, monitors potential vaccine safety issues. Bottom line: There are several mechanisms in place to ensure that immunizations are safe.
However, like any medication, no vaccine is 100 percent effective or 100 percent risk-free. Rare, serious reactions can occur with vaccination. And if it happens, it’s devastating. But we take this small risk for the tremendous benefit of protection to ourselves and to others. As such, the U.S. Department of Health and Human Services created the Vaccine Injury Compensation Program (VICP) in 1988 to compensate those who potentially suffered a vaccine reaction. Those specific disorders are here.
At VICP, lawyers reviews patients’ records and determine whether to award monetary compensation. Yes, you read that correctly—attorneys are making the call here—not doctors, scientists, or vaccinologists. While the decisions from the “vaccine court” do not prove anything scientifically, VICP acts compassionately and does a reasonable job.
Since 1988, 100 million American babies have been born (99 percent of whom have received vaccines) and millions of older children and adults have also been vaccinated. With this huge number of vaccinated Americans, there have been less than 15,000 VICP claims filed. VICP has awarded compensation to 20 percent of those claimants. About one-third of all claims sought compensation for autism, and most claims occurred during the height of vaccine safety concerns in 2002-2004. VICP reviewed these claims collectively and found no substantial evidence linking vaccines and autism to provide compensation.
So then: What’s the story with the kids with autism who received financial compensation? Well, the children’s medical records are not publicly available so it is impossible to know, but they did not receive the awards for autism.
With a severe flu season and twenty children who have died, it’s important to look at the big picture. Most people get shots and endure nothing more than a sore arm.
With the scrutiny given to vaccines, we would know if there was a significant problem. As a pediatrician and a mom, I vaccinated my own kids to protect them. I wouldn’t do anything differently for yours.
1. In a presentation by one of our advisors, Wendy Sue Swanson, M.D., a pediatrician at Seattle Children’s Hospital and author of the must-be-bookmarked blog Seattle Mama Doc, Dr. Swanson noted that that more and more parents are confusing experience for expertise. Though she didn’t single out this person, you can consider Jenny McCarthy a perfect example: Her experience with her son’s autism is clearly being confused by some as having an expertise in autism.
2. Another doctor spoke about the importance of a pediatrician getting a family history from patients. It’s not easy, since lots of families don’t necessarily know their health history. In fact, one study showed that only 1/3 of people have ever tried to gather and organize their family’s health history. Have you? It’s most helpful for docs to have info on three generations: yours, your parents’, and your grandparents’ (and, of course, your partner’s parents and grandparents).
3. Along those lines, it’s really important to let your pediatrician know if anyone in your family (or your partner’s family) has died suddenly, or if there’s a new family history of cancer. Your child’s doctor can use this information to consider recommending certain health screenings, either now or down the line.
4. Firearm safety was a big focus at this year’s meeting. Did you know that when you look at the rate of deaths in children up to age 14 in 23 high-income countries, 87%of them occur in the United States?
5. The AAP’s position has not changed: The safest home for a child is one without guns. The next-best option is a home where guns are stored safely (as in locked up), unloaded and separate from the ammunition.
6. Pediatricians are noticing a disturbing trend in the country, where they may find themselves limited by the kinds of information they can share with patients. One example is asking parents whether they have a gun in their home–and then talking to them about gun safety. You may remember the controversial Florida law that passed in 2011 restricting pediatricians from having this conversation. The law was determined to be unconstitutional and was overturned, but Florida’s governor is appealing it.
7. Sexual abuse was the subject of a crowded session. One doctor shared this stat: When a child decides to share that she has been abused, she’s more likely to tell a peer than anyone else. (Abused children tell their peers 53% of the time; an adult relative 32% of the time; a non-related adult 10% of the time, and school personnel 3% of the time. 2% of kids tell someone who falls into an “other” category.) This means, said the expert, that there’s an “underground railroad” of kids who know about other kids being abused. She made a point that we didn’t address in our recent story about sexual abuse: We have to teach our children that if a friend tells them that he’s been abused, they should try and help this friend tell an adult who can do something about it.
8. Several sessions dealt with trauma and post-traumatic stress disorder (PTSD)–more than I can remember from past conferences. It’s encouraging to know that 70% of those children who experience trauma have no lasting symptoms. Of the 30% who do have lasting symptoms, though, half recover, and half have a chronic form of PTSD. So it’s important to make sure a child who has suffered a trauma–whether that’s abuse, a car accident, witnessing a violent episode, among other examples–gets help.
9. For everyone with a child who has a food allergy, or diabetes, or asthma, or a similar chronic disease: Emergency medical bracelets are always a good idea, especially if your child goes to a day care center or school. Your child’s usual caregiver or teacher may be very well aware of his condition and how to manage or treat it, but new caregivers or substitute teachers can definitely benefit from the info.
10. Last week, a report came out noting that three major health organizations around the world recommend that kids under 6 get three hours a day of physical activity instead of the one hour that’s currently suggested by groups like the AAP. For those of us who have a child younger than 6, this can feel daunting. (And by younger than 6 we’re not talking about, say, newborns–this guideline is meant for kids who are awake at least 12 hours each day.) But a professor who gave an interesting talk called “The Reluctant Athlete: How To Get the Sedentary Child Off the Sofa” put it into context. The one-hour recommendation is for “moderate to vigorous” activity–and that’s just hard for a young child to pull off–so changing it to three hours gives kids more time to be active. It works out to about 15 minutes per hour, which seems doable.
Back-to-School Supplies Contain Toxic Chemicals, Report
According to a new consumer report, children’s back-to -school supplies have chemicals that have been linked to asthma and birth defects. (via Medical Daily)
Obese Youth Have Significantly Higher Risk of Gallstones
Children who are overweight or obese face an increased risk for gallstones, according to a Kaiser Permanente study published in the Journal of Pediatric Gastroenterology & Nutrition. (via Science Daily)
AAP Issues New Guidelines for Kids’ Snoring
A new set of practice guidelines released Monday by the American Academy of Pediatrics (AAP) may help parents and pediatricians uncover things that go snore in the night. (via ABC News)
Benefits of circumcision outweigh risks, US pediatrics group says
The American Academy of Pediatrics has issued new guidelines saying the health benefits of infant circumcision outweigh the risks of the surgery, but the influential physician’s group has fallen short of a universal recommendation of the procedure for all infants, saying that parents should make the final call. (via Reuters)
Parents, coaches, and health educators can benefit from this DVD as kids become interested in and take more part in sports. Serious problems can occur if the body isn’t used to new exercise routines, so this 2-hour DVD offers easy step-by-step guidelines on how kids can strength train safely and prevent sports injuries.
Kids can also develop strength, endurance, balance, and flexibility without enrolling in expensive gym program, and learn the proper way to stretch before and recover after workouts. Flashcards within the DVD also offer instructions on how to exercise for specific sports at all player levels (beginner, intermediate, advanced). A related mobile app will be available in the near future.
Editor’s Note: This guest post is written by Ari Brown, M.D., FAAP, a Parents advisor and pediatrician in Austin, TX. She is the co-author of the best-sellling “411” parenting book series including Expecting 411: Clear Answers and Smart Advice for your Pregnancy, Baby 411, and Toddler 411. Here, she shares her new role as champion for the world-wide Shot@Life initiative.
As a pediatrician, and a spokesperson for the American Academy of Pediatrics, I’ve been involved in children’s health initiatives in the U.S. for a long time. But this year, I’m going global! I’m excited to be a part of a new movement to help kids and I want to share it with you!
On April 26, 2012, the United Nations Foundation will roll out a new grassroots program cleverly titled, Shot@Life. The message: every child—no matter where they live—deserves a shot at leading a healthy, productive life.
American parents don’t usually have to worry about losing their children to diseases like measles, pneumonia, or even the worst case of diarrhea. That’s because most of our kids have access to and are able to receive life-saving vaccines. Unfortunately, 1 in 5 children worldwide don’t have that opportunity for protection. In fact, 1.7 million children will die this year from these diseases that are rare in the U.S., thanks to vaccination. Unfortunately, a child dies every 20 seconds.
I know, I know. We have so many economic issues at home, it is hard to think about the plight of children on the other side of the world. But honestly, protection against diseases there helps all of our kids. Germs don’t need a passport. They don’t have to take their shoes off in security or go through special body scanners to get on a plane to our hometowns. So, our own children will benefit from protecting children in other countries.
Screen Time Higher Than Ever for Children
Children under 8 are spending more time than ever in front of screens, and an “app gap” is emerging between children in affluent and low-income households, a new study found.
Kids Behaving Badly? Blame It on Mom
All little kids can be aggressive, but those who remain explosive by the time they enter kindergarten have their mothers to blame, according to new research published Wednesday in the journal Child Development.
Soda-Drinking Teens More Violent
A study finds that teens who drank more than five cans of non-diet soda per day were significantly more likely to report behaving violently towards others, and more likely to report having carried a gun or knife in the past year, researchers said.
Using Beads to Get Pregnant — or Prevent It
A new study in the October issue of the Journal of Family Planning & Reproductive Health Care finds that a fertility-awareness-based method of family planning developed by researchers from the Institute for Reproductive Health at Georgetown University Medical Center (GUMC) actually works so well for those women who have a pretty regular menstrual cycle that they continued to use it successfully for years.
If you have a baby younger than 1 year of age, chances are that he or she is sleeping in a way that goes against the latest recommendations from the American Academy of Pediatrics (AAP). At the AAP’s national conference in Boston, which wraps up today, the Academy released their revised policy statement on safe sleeping and SIDS prevention.
Until babies are 1 year old, they should:
Be put to sleep on their back. Always, always, always. At some point, your baby will be able to roll from her back to her front and from her front to her back—and at that point, you can leave her in whatever position she ends up.
Sleep in the same room as—but not the same bed as—their parents. To keep a baby in your room until age 1 may seem… let’s say… difficult, but “these recommendations are most important in the first few months,” says pediatrician Rachel Moon, M.D, lead author of the new guidelines and chair of the AAP SIDS task force. Bedsharing is not recommended at any age, even if you’re using an actual cosleeping device that attaches to the side of your bed. “No bedsharing can be classified as safe,” says Dr. Moon, who adds that babies under 3 months are at a “very, very high risk” of suffocation.
Use a pacifier as often as possible. Pacifiers are associated with a decreased risk of SIDS, perhaps because it may position the tongue in a way that helps keep the airways open, Dr. Moon says. Pacifiers also tend to arouse babies as they sleep (I’ll say! Who else has experienced that sinking feeling every time their newborn’s pacifier popped out of her mouth and woke her up?!), and when babies are able to be easily woken, their risk of SIDS goes down.
Be breastfed. Lots of research backs up the positive connection between nursing and SIDS risk reduction.
Be fully immunized. There may be a protective effect here, too; evidence points to a 50 percent decrease in the risk of SIDS.
Not have anything in their cribs (or bassinets or Pack & Plays) except a tight-fitting sheet. No bumpers—not even the mesh kind. (Chicago now bans the sale of bumpers.) No stuffed animals. No pillows. No blankets. Nothing between the mattress and the sheet to make the surface softer. (“Soft does not equal safe,” says Dr. Moon. “Soft is bad.”) No elevating the head of the crib mattress by propping pillows underneath it, either, because babies can slide down to the bottom of the crib and end up in a position that obstructs their airway, or get wedged between the mattress and the side of the crib.
Not sleep in a car seat, stroller, swing, or sling for more than 60-90 minutes, and even then only under close supervision. Nothing but a crib, bassinet, or Pack & Play is recommended for extended periods of sleep. If your baby falls asleep in one of those other places, Dr. Moon recommends moving him as soon as is practical. Otherwise, they run the risk of sliding or slumping down and boosting the chance of suffocation.
Not sleep with the help of any products marketed as reducing the risk of SIDS. This goes for wedges, positioners, and home apnea monitors. “Parents believe that if a product is sold, it must be safe. They don’t always understand that these items don’t have to be tested or proven to work in order to be in stores,” says Dr. Moon.
She made an important point about why some parents don’t follow safe sleep recommendations. “Everybody thinks their baby is the exception to the rule,” she explains. “They’ll say ‘My baby has reflux.’ ‘My baby was premature.’ ‘My baby’s not a good sleeper.’” But she sees more than her share of infant deaths—at least one per month in her hometown of Washington, D.C. “We have to get the message out.”