Wednesday, January 30th, 2013
The American Academy of Pediatrics has, for the first time, issued guidelines for managing weight-related diabetes in children. The move is attributed to the rise in childhood obesity in America. The two major recommendations are that pediatricians should screen every child for diabetes, and take care to distinguish between type 1 and type 2 diabetes. More from Time.com:
Children have long been diagnosed with Type 1 diabetes, in which the body fails to make enough insulin-producing cells to process glucose in the blood, but doctors are now seeing an increasing number of children with type 2 diabetes, in which fat cells that enlarge with weight gain thwart the body’s ability to break down sugars. Up to a third of cases being diagnosed in kids these days are Type 2, which generally develops later in life, generally after age 40. “We’re seeing it much more than we did before,” says Dr. Janet Silverstein, co-author of the new American Academy of Pediatrics guidelines on diabetes and professor of pediatrics at the University of Florida. “Many pediatricians were never trained in managing Type 2 because it just wasn’t a disease we used to see. It was a disease of adulthood. But as we’re seeing more obesity in kids, we’re seeing adult diseases in childhood.”
The guidelines, which are the first of their kind for kids between the ages of 10 and 18, were developed in collaboration with the American Diabetes Association, the Pediatric Endocrine Society, the American Academy of Family Physicians and the Academy of Nutrition and Dietetics.
They emphasize the importance of distinguishing between type 1 and type 2 to determine an appropriate treatment plan. Children with type 2 don’t necessarily need insulin. They may initially be treated with medication that increases their sensitivity to insulin. And they should be encouraged to move: doctors should advise them to exercise at least an hour a day and limit screen time that’s not related to schoolwork to under two hours a day.
Image: Candy, via Shutterstock
Thursday, January 10th, 2013
Fussy infants are more likely to be put in front of a television in a parent’s attempt to calm and occupy them, a new study published in the journal Pediatrics has found. The finding is despite the American Academy of Pediatrics’ recommendation that children not be shown television until age 2. More from Time.com:
In the study, published in the journal Pediatrics, the researchers analyzed data from 217 African-American mother and infant pairs from the Infant Care and Risk of Obesity Study. At 3, 6, 9, 12, and 18 months after birth, the infants’ mothers reported on their babies’ temperament—how fussy or complacent they were—as well as their own TV viewing habits, including how long the TV was on during the day and how often they fed their babies while watching TV. Overall, mothers spent a significant amount of time watching television, and reported that they spent quite a bit of time feeding their infants in front of the TV as well. Infants just 3 months old were exposed to an average of nearly three hours of TV or videos daily, and nearly 40% of the youngsters were exposed to three hours of TV every day by the time they were a year old.
More active and fussier infants were more likely to spend extended periods of time in front of the TV. The exposure was also higher among obese mothers, especially those with the fussier kids, leading the researchers to suggest that the television may serve as an easy entertainment strategy.
The scientists were also able to find some factors that contribute to fewer hours in front of the screen, however. Moms with a high school diploma or any additional education were less likely to have TVs in their infants’ room, and less likely to keep the television on during meals.
“In the last decade or so there has been a lot of attention paid to parenting style and care giving. One component has to do with feeding and focus placed on the feeding environment,” says Margaret E. Bentley, Associate Dean of Global Health at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health and the principal investigator of the study. “Half of the time, infants are being fed with the television on, which is a feeding strategy we do not recommend.”
Eating in front of the television can lead to unhealthy dining habits that linger into childhood and adulthood, Bentley and her colleagues say, since mothers feeding infants while watching TV might be distracted and not as alert to subtle cues babies send when they feel full, which can lead to overfeeding.
Image: Baby watching television, via Shutterstock
Tuesday, September 25th, 2012
The American Academy of Pediatrics has updated a 1999 recommendation concerning trampolines, now warning children to stay away from them at home and at playgrounds. Nearly 100,000 emergency room visits can be attributed each year to trampoline-related injuries, the group said, and new “safety features” on many trampolines can give families a false sense of security. Reuters has more:
“As best we can tell, the addition of safety nets and padding has actually not changed the injuries we have seen,” said Dr. Susannah Briskin, a sports medicine specialist who helped draft the new statement.
It’s estimated that the number of trampoline injuries nationwide has been dropping – from 111,851 cases treated at ERs in 2004, to 97,908 in 2009. But that doesn’t necessarily mean the devices have become any less dangerous, Briskin told Reuters Health.
“Even though there has been a decrease in injuries,” she said, “I caution people against taking that too literally because the number of trampolines has also decreased.”
The actual risk of hurting yourself if you step onto a trampoline is not clear, Briskin added, because there are no good data on national exposure. The rate of hospitalization due to the injuries is about three percent.
Mark Publicover, founder and president of JumpSport Inc, a trampoline manufacturer in San Jose, California, scoffed at the AAP’s recommendations.
He said he invented a safety net that encircles the trampoline and cuts the number of injuries by half. And, he added, if parents ban trampolines, their children might start climbing trees, using swings or skateboards, for instance.
“If you look at all those activities, a safety-enclosed trampoline is safer by hours of use,” Publicover told Reuters Health. “When they say, ‘Don’t use trampolines with a safety enclosure,’ they are going to increase the number of injuries.”
Image: Kids on trampoline, via Shutterstock
Monday, August 27th, 2012
The American Academy of Pediatrics has revised its policy on circumcision, saying the benefits of the procedure mean parents should get access to it, and insurance companies should pay for it.
But the academy stopped short of recommending circumcision for all baby boys, saying it’s up to parents to decide, the Associated Press reports.
The new policy follows recent studies showing that circumcision reduces chances of infection with HIV and other sexually spread diseases, urinary tract infections and penis cancer.
Insurance coverage of circumcision varies, and Medicaid won’t pay for it in some states. Rates of circumcision in the United States have dropped in recent years, although about half of all U.S. baby boys still undergo the procedure. From the AP:
[The new policy] comes amid ongoing debate over whether circumcision is medically necessary or a cosmetic procedure that critics say amounts to genital mutilation. Activists favoring a circumcision ban made headway in putting it to a vote last year in San Francisco but a judge later knocked the measure off the city ballot, ruling that regulating medical procedures is up to the state, not city officials.
In Germany, Jewish and Muslim leaders have protested a regional court ruling in June that said circumcision amounts to bodily harm.
Meantime, a recent study projected that declining U.S. circumcision rates could add more than $4 billion in health care costs in coming years because of increased illness and infections.
Image: Newborn baby boy via Shutterstock.
Monday, July 9th, 2012
Mothers who breastfeed their children beyond infancy have been in the news recently, especially in the wake of a controversial Time magazine cover story about “attachment parenting.” Now, a New York production is reportedly planning a reality television show that will tell the stories of these moms. The New York Post reports:
“I didn’t set out to nurse a 3-year-old,” said Jessica Cary of Park Slope, whose daughter Olive continues to breastfeed. “But two years came and went. Now breastfeeding and mothering are so intertwined for me.”
Government agencies don’t track breastfeeding past 12 months, and many pediatricians assume it has stopped by the child’s first birthday. So there’s no way to know how many of the 28 percent of New York babies who breastfeed up to age 1 keep on going.
Long-term breastfeeding moms often cite the World Health Organization, which encourages nursing until at least age 2. Neither WHO nor the American Academy of Pediatrics sets an upper limit on breastfeeding’s duration
“Experienced pediatricians realize that the benefits of breastfeeding don’t just magically disappear after one year,” said Karen McGratty, a lactation consultant in Midwood who is nursing her 3-year-old son.
Most mothers of breastfeeding preschoolers let the child take the lead in weaning.
“At this point I don’t offer nursing, only give it to her when she requests it,” said Cary. That leads to a gradual reduction on the child’s own timetable.
Image: Nursing mother, via Shutterstock.