Monday, August 12th, 2013
Toddlers who watch an extra hour of television daily–”extra” meaning an hour more than the two-hour maximum for children two or older recommended by the American Academy of Pediatrics–may suffer consequences when they enter kindergarten. The effects of the extra TV time, according to a new study by researchers by the University of Montreal, include diminished vocabulary and math skills, attention and concentration issues, physical prowess, and likelihood of victimization or bullying by classmates. ScienceDaily.com has more:
“This is the first time ever that a stringently controlled associational birth cohort study has looked at and found a relationship between too much toddler screen time and kindergarten risks for poor motor skills and psychosocial difficulties, like victimization by classmates,” [Professor Linda] Pagani said. “These findings suggest the need for better parental awareness and compliance with existing viewing recommendations put forth by the American Academy of Pediatrics. The AAP discourages watching television during infancy and recommends not more than two hours per day beyond age 2. It seems that every extra hour beyond that has a remarkably negative influence.”
Pagani conducted the study to discover the effect of television viewing prior to kindergarten. He said, “Much of the research on school readiness has focused on how kindergarten characteristics predict later success. Kindergarten entry characteristics predict long-term psycho-social adjustment and economic characteristics like income and academic attainment. Being innovative, my focus has been to examine what predicts kindergarten entry characteristics. Adding further originality, I also wanted to focus on neglected yet crucial aspects of school readiness such as motor skills, which predict later physical activity and reading skills, likelihood of being “picked-on,” which predict social difficulties, and skills at linked to doing what you are supposed to be doing when having been given instructions, which are in turn linked to attention systems that are regulated by the brain’s frontal lobe development.”
991 girls and 1006 boys in Quebec whose parents reported their television viewing behaviour as part of the Quebec Longitudinal Study of Child Development.
Pagani noted that the standard deviation is a commonly used statistic tool that tells us what is within a normal range compared to the average. One standard deviation from the average daily amount of television viewed by the toddlers in this sample (105 minutes) is 72 minutes. Some of the children who participated in the study were two or even three standard deviations away from the average, and their kindergarten indicators were correspondingly worse than those who were one standard deviation away.
This study only looks at the most common form of screen time, which is in the home. However, it may be an underestimate because many child care settings use television as an activity during care giving.
Image: Boys watching TV, via Shutterstock
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Wednesday, July 31st, 2013
Children who were breastfed for much of their infancy may be rewarded with higher scores on intelligence tests at ages 3 and 7, according to a new study conducted by researchers at Boston Children’s Hospital. More from Reuters:
Researchers found that for each extra month women reported breastfeeding, their children performed slightly better on those exams – though not on tests of motor skills and memory.
“Given the size of the benefit, I think this should be helpful for women who are trying to make decisions about how long to breastfeed… because there are many factors that go into that decision,” said Dr. Mandy Belfort, who led the study at Boston Children’s Hospital.
“You have to weigh that against the time that it takes, maybe the time that it takes away from work and your other family duties.”
She said the findings support recommendations from the American Academy of Pediatrics and other groups for exclusive breastfeeding up to six months of age, followed by a mix of breastfeeding and solid foods.
For their study, Belfort and her colleagues tracked 1,312 Massachusetts women who were recruited while pregnant in 1999 to 2002 and their babies.
Mothers reported if they had ever breastfed, and if so how old their child was when they stopped. The researchers then gave both women and their children standardized intelligence tests.
On language tests given at age three, children in the study scored an average of 103.7. Once the women’s intelligence and other family factors including income were taken into account, the researchers found that each extra month of breastfeeding was tied to a 0.21-point improvement on the exam.
Children who were fed only breast milk for six months scored an average of three points higher on the language test than those who were never breastfed, Belfort and her colleagues write in JAMA Pediatrics.
For intelligence tests that included reading and writing given at age seven, average scores were 112.5 and each extra month of breastfeeding was linked to a 0.35-point improvement.
Those tests take 10 to 20 minutes to complete, and 100 is considered an average score across all children.
Belfort said a parent or teacher probably wouldn’t notice a difference of a few points on a child’s intelligence test.
“I think the importance is more on the level of the whole population or society,” she told Reuters Health.
Image: Breastfeeding newborn, via Shutterstock
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Thursday, July 25th, 2013
A growing number of retail stores are offering pediatric care services, examining kids with minor health issues and saving parents a trip to the doctor’s office. A new study published in the journal JAMA Pediatrics is taking a closer look at whether these retail clinics are as effective as they are convenient. More from Time.com:
Researchers from Washington University School of Medicine, St. Louis report that even families with well-established relationships with a pediatrician take advantage of pediatric retail clinics to take care of their children’s minor health issues, even if they are staffed with non-pediatric health care personnel.
Why? The researchers surveyed 1,484 parents from 19 Midwestern pediatric practices who said that they took their kids to the clinics out of convenience; 74% of the parents said they first considered going to their pediatrician, but 37% decided on the retail clinic because it had hours that conformed better with their schedules.
In a corresponding editorial, Dr. Edward Schor of the Lucille Packard Foundation for Children’s Health in Palo Alto, California wrote that such decisions may become more commonplace: “Retail-based clinics reflect systemic changes occurring within the health care industry to which pediatric practices must adapt.” Retail clinics, which are typically run by nurse practitioners and physician assistants, are not only convenient, but cost patients about 30% to 40% less than office practices. Most of these clinics are located in retail pharmacy stores, while others are operated by hospitals or doctors’ groups.
The lower cost and increased convenience of the clinics are putting pediatricians on the defensive, and the American Academy of Pediatrics (AAP) formally opposes them as an appropriate venue for care of infants and children. AAP officials question the quality of care patients receive, stemming from the fact that children may see different practitioners at each visit.
Image: Mother and child at pharmacy, via Shutterstock
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Wednesday, May 15th, 2013
In a move that is drawing a variety of opinions from people on every side of the debate over gun violence, the American Academy of Pediatrics appealed to Congress this month to pass legislation that includes an assault weapon ban, mandatory background checks and waiting periods before all firearm purchases, a ban on high-capacity magazines, handgun regulations and requirements for safe firearm storage under federal law. NBC News has more:
“I think we can be honest brokers,” says Dr. Lolita McDavid, medical director for child advocacy and protection at University Hospitals, part of Case Western Reserve University’s school of medicine in Cleveland.
“We have to have a collectively louder voice,” Dr. Danielle Laraque, who chairs the pediatrics department at Maimonides Infants and Children’s Hospital in Brooklyn, told a meeting of the Pediatric Academic Societies in Washington, D.C., earlier this month. “What we need is a call to action, to really look at how we can change public policy that is not often affected by data.”
They don’t always get a friendly reception. Just two weeks before the doctors arrived, Congress had scuttled what gun-control advocates had considered a modest bill to expand background checks for gun sales.
Congress had already dropped a wider measure pushed by President Barack Obama and Vice President Joe Biden after the December shootings of 20 schoolchildren and six adults in Newtown, Conn.
Image: Gun trigger, via Shutterstock
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Tuesday, April 30th, 2013
New guidelines from the American Academy of Pediatrics (AAP) urge doctors to distinguish between gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) when diagnosing infants who suffer from the very common complaint of reflux. The guidelines follow a study published earlier this month in the journal Pediatrics, which concluded that high rates of GERD may be resulting in over-medicated infants.
More on the AAP’s new recommendations:
Making the appropriate diagnosis will identify patients who can be treated with lifestyle changes alone or those who require more intensive therapies, according to Jenifer Lightdale, MD, MPH, of Boston Children’s Hospital, David Gremse, MD, of the University of South Alabama Health System in Mobile, and colleagues from the AAP section on gastroenterology, hepatology, and nutrition.
Among patients with either condition, lifestyle changes — such as modifying maternal diets in breastfeeding mothers or avoiding spicy foods in older children — are recommended as a first-line therapy, while more intensive treatments are recommended for those with intractable symptoms or life-threatening GERD-related complications, they wrote online in Pediatrics.
GER is common to more than two-thirds of infants who are otherwise healthy and “is considered a normal physiologic process that occurs several times a day in healthy infants, children, and adults,” they wrote.
The condition is “generally associated with transient relaxations of the lower esophageal sphincter independent of swallowing, which permits gastric contents to enter the esophagus,” they explained.
While GER is short lived and can cause few to no symptoms in healthy adults, GERD is characterized by mucosal injury on upper endoscopy and can result in vomiting, poor weight gain, dysphagia, abdominal or substernal/retrosternal pain, and esophagitis.
Symptoms of GERD can also include cough, laryngitis, and, in infants, wheezing, as well as dental erosion, pharyngitis, sinusitis, and recurrent otitis media.
Image: Upset infant, via Shutterstock
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