Monday, December 2nd, 2013
A growing number of the smallest premature babies are surviving and, in many cases, thriving–but medical issues commonly persist long after birth. More from NBC News:
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Alexis [Clarke] was born after she’d been in the womb just over 25 weeks; a typical pregnancy lasts 40 weeks. Babies born before 37 weeks are considered premature, but with medical and technological advances, it’s no longer unusual for very preterm babies to survive. The key, in general, is a steroid for mothers and a drug for their babies.
Alexis’ journey has been marked by ups and downs. Just as her parents thought she was ready to be discharged in time for Thanksgiving, one of her doctors told them she needed emergency eye surgery. Then a small cough raised concerns that she’d contracted whooping cough, prompting her to be put into isolation (tests came back clear). But an MRI of her brain delivered the good news that her development seems to be proceeding normally.
Baby Alexis is hardly the tiniest preemie born, but her journey from neonatal intensive care to home is typical of other extremely premature babies. In 2011, less than 1 percent of live births in the U.S. were considered “extremely preterm,” delivered before 28 weeks. That represents more than 28,000 babies. Meanwhile, the total number of premature births in the U.S declined last year to 450,000, or 11.5 percent, the lowest preterm birth rate in 15 years.
“In the past six years we’ve had babies survive that we didn’t think could survive,” Dr. Krishelle Marc-Aurele, one of Alexis’ doctors, told NBC San Diego.
Some hospitals are divided on treating babies born in the “gray zone,” between 23 and 25 weeks. In the U.S, up to 90 percent of neonatal units resuscitate babies born as soon as 23 weeks. Younger than that and most doctors believe a baby is not viable. “The lower level of viability is inching down,” said Dr. John Muraskas, who resuscitated the smallest surviving baby on record, Rumaisa Rahman, born in 2004 weighing 9.2 ounces.
Muraskas, a professor of pediatrics and neonatal/perinatal medicine at Loyola University Medical Center, said the key treatments began in the 1990s and have made all the difference.
Now doctors routinely give moms on the brink of delivering too soon two doses of steroids to help the baby or babies’ lungs mature quicker and strengthen the blood vessels in the brain. That reduces the risk of a premature infant developing a brain bleed.
Once born, preemies receive surfactant, a drug administered through a breathing tube into their lungs that makes them stronger and less stiff, and able to breathe independently sooner.
Wednesday, November 27th, 2013
The American family is more diverse than ever–even compared to the changing landscape of the past few years with a rise in same-sex marriages, adoptions, and trans-racial families–according to researchers who follow census data on family structure. More from The New York Times:
“This churning, this turnover in our intimate partnerships is creating complex families on a scale we’ve not seen before,” said Andrew J. Cherlin, a professor of public policy at Johns Hopkins University. “It’s a mistake to think this is the endpoint of enormous change. We are still very much in the midst of it.”
Yet for all the restless shape-shifting of the American family, researchers who comb through census, survey and historical data and conduct field studies of ordinary home life have identified a number of key emerging themes.
Families, they say, are becoming more socially egalitarian over all, even as economic disparities widen. Families are more ethnically, racially, religiously and stylistically diverse than half a generation ago — than even half a year ago.
In increasing numbers, blacks marry whites, atheists marry Baptists, men marry men and women women, Democrats marry Republicans and start talk shows. Good friends join forces as part of the “voluntary kin” movement, sharing medical directives, wills, even adopting one another legally.
Single people live alone and proudly consider themselves families of one — more generous and civic-minded than so-called “greedy marrieds.”
“There are really good studies showing that single people are more likely than married couples to be in touch with friends, neighbors, siblings and parents,” said Bella DePaulo, author of “Singled Out” and a visiting professor of psychology at the University of California, Santa Barbara.
But that doesn’t mean they’ll be single forever. “There are not just more types of families and living arrangements than there used to be,” said Stephanie Coontz, author of the coming book “Intimate Revolutions,” and a social historian at Evergreen State College in Olympia, Wash. “Most people will move through several different types over the course of their lives.”
At the same time, the old-fashioned family plan of stably married parents residing with their children remains a source of considerable power in America — but one that is increasingly seen as out of reach to all but the educated elite.
“We’re seeing a class divide not only between the haves and the have-nots, but between the I do’s and the I do nots,” Dr. Coontz said. Those who are enjoying the perks of a good marriage “wouldn’t stand for any other kind,” she said, while those who would benefit most from marital stability “are the ones least likely to have the resources to sustain it.”
Image: Multi-colored picket fence, via Shutterstock
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Tuesday, November 26th, 2013
Children who spend a lot of time watching television or playing with smartphones or tablets are more likely to gain weight than kids who have less screen time, according to a new study. The new research is the latest in a long string of findings that link weight issues with screen time. More from Reuters:
Many parents believe their children are getting a reasonable amount of recreational screen time, Mark Tremblay said. But most U.S. and Canadian kids exceed the recommended two-hour maximum per day.
“We don’t pay attention to the fact that it’s half an hour here, half an hour there, an hour here, an hour there,” Tremblay told Reuters Health. He is the director of Healthy Active Living and Obesity Research at the Children’s Hospital of Eastern Ontario Research Institute in Ottawa, Canada, and wasn’t involved in the new study.
Researchers used data from a long-term study of kids who took surveys every other year. The surveys included questions about their height and weight as well as how much time they spent watching TV and DVDs and playing computer and videogames.
Kids were between ages nine and 16 when the study started.
Out of about 4,300 girls in the study, 17 percent were overweight or obese. Twenty-four percent of the 3,500 boys were also above a healthy weight.
From one survey to the next, each one-hour increase in children’s daily TV watching was tied to an increase of about 0.1 points on a body mass index (BMI) scale, which measures weight in relation to height. That’s a difference of approximately half a pound per extra hour of TV.
Increases in total screen time between survey periods were linked with similar but smaller changes in BMI.
“The weight of the evidence is pretty strong that television viewing is related to unhealthy changes in weight among youth,” Jennifer Falbe said.
But, she told Reuters Health, “It’s important for parents to be aware of all the potentially obesogenic screens that they should really be limiting in their children’s lives.” Increases in DVD and video watching were tied to weight gain among girls, in particular.
Falbe led the study while at the Harvard School of Public Health in Boston. She is now at the University of California, Berkeley School of Public Health.
Image: Kids watching TV, via Shutterstock
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Tuesday, November 19th, 2013
Amid reports that a growing number of kids are showing up at emergency rooms with gastritis, an irritation of the stomach lining, health officials are warning parents that super spicy foods including chips and crackers may not be safe for kids. More from ABC News:
Dr. Martha Rivera, a pediatrician at White Memorial Medical Center in Los Angeles, said she sees between five and six cases of children with gastritis daily.
“We have a population who loves to eat the hot spicy, not real foods, and they come in with these real complaints,” Rivera told KABC-TV.
Dr. Robert Glatter, an emergency room physician at Lenox Hill Hospital in New York, said he believes that the flavoring coating the chips and snacks is what might be causing the stomach pH to change, rather than just the spiciness of the snacks. For example, he said he hasn’t had a lot of people coming in doubled over from eating too much spicy salsa.
“In the past, I had not seen any problems with snack food until spicy flavoring became more popular,” said Glatter.
Glatter said it wasn’t just the high fat or high salt content that the kids or adolescents crave but the actual burn of the spicy flavoring.
“It’s almost like a food addiction. They seek out the burn,” said Glatter. “It’s a little thrill-seeking. ‘It’s like how much can I tolerate?’ and I’ve seen a number of children who eat four or five bags and come in screaming in pain.”
Image: Spicy snacks, via Shutterstock
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Monday, November 18th, 2013
Boys are slightly more likely than girls to be born prematurely, a new international study on newborn health has found. Additionally, boys don’t tend to fare as well as girls world-wide. More from The Associated Press:
“This is a double whammy for boys,” said Dr. Joy Lawn of the London School of Hygiene & Tropical Medicine, who led the team of researchers. “It’s a pattern that happens all over the world.”
The gender difference isn’t large: About 55 percent of preterm births in 2010 were male, the report found. Nor is it clear exactly why it happens.
The finding comes from a series of international studies being published Friday that examine newborn health and prematurity. About 15 million babies worldwide are born too soon, most of them in Africa and parts of Asia where survival is difficult for fragile newborns. Globally, about 1 million babies die as a direct result of preterm birth and another million die of conditions for which prematurity is an added risk, the researchers calculated.
Friday’s report offers some of the first estimates of how many preemie survivors go on to suffer certain disabilities, and found that where these babies are born, and how early, determines their risk.
Overall, Lawn said about 7 percent of survivors have two of the most burdensome disabilities: neurologic-developmental impairment ranging from learning disabilities to cerebral palsy, and vision loss.
But the biggest risk is to the youngest preemies, those born before 28 weeks gestation. Worldwide, 52 percent of them are estimated to have some degree of neurodevelopmental impairment, the report found.
Moreover, the risk of impairment in middle-income countries is double that of wealthy countries like the U.S.
For example, China is saving more preemies’ lives but at the cost of their vision, Lawn said.
Middle-income countries are missing out on a lesson the U.S. learned the hard way several decades ago, that giving these tiny babies too much oxygen can trigger a potentially blinding condition called retinopathy of prematurity.
“Disability is not something that’s inevitable. It’s preventable,” she said, calling for improved quality of care including eye checks to prevent or reduce vision loss.
The March of Dimes reported this month that 11.5 percent of U.S. births now are preterm. That rate is inching down, thanks mostly to fewer babies being born just a few weeks early as standards for elective deliveries have tightened, but it still is higher than in similar countries.
Image: Newborn baby, via Shutterstock
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