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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Tuesday, April 16th, 2013
Listening to live music, whether strummed on a guitar or hummed by a parent, is soothing and healthy for babies who are born prematurely, a new study has shown. The New York Times has more:
Beth Israel Medical Center in New York City led the research, conducted in 11 hospitals, which found that live music can be beneficial to premature babies. In the study, music therapists helped parents transform their favorite tunes into lullabies.
The researchers concluded that live music, played or sung, helped to slow infants’ heartbeats, calm their breathing, improve sucking behaviors important for feeding, aid sleep and promote states of quiet alertness. Doctors and researchers say that by reducing stress and stabilizing vital signs, music can allow infants to devote more energy to normal development.
And while the effects may be subtle, small improvements can be significant. Premature births have increased since 1990, to nearly 500,000 a year, one of every nine children born in the United States.
The study, published Monday in the journal Pediatrics, adds to growing research on music and preterm babies. Some hospitals find music as effective as, and safer than, sedating infants before procedures like heart sonograms and brain monitoring. Some neonatologists say babies receiving music therapy leave hospitals sooner, which can aid development and family bonding and save money.
Image: Mother rocking baby, via Shutterstock
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Tuesday, March 5th, 2013
In a medical first, doctors have used a treatment that appears to have cured a baby born with HIV, raising hopes that babies born with the AIDS-causing virus may be facing far more hopeful futures. The New York Times reports:
The baby, born in rural Mississippi, was treated aggressively with antiretroviral drugs starting around 30 hours after birth, something that is not usually done. If further study shows this works in other babies, it will almost certainly change the way newborns of infected mothers are treated all over the world. The United Nations estimates that 330,000 babies were newly infected in 2011, the most recent year for which there is data, and that more than 3 million children globally are living with H.I.V.
If the report is confirmed, the child born in Mississippi would be only the second well-documented case of a cure in the world, giving a boost to research aimed at a cure, something that only a few years ago was thought to be virtually impossible.
The first person cured was Timothy Brown, known as the “Berlin patient,’’ a middle-aged man with leukemia who received a bone-marrow transplant from a donor genetically resistant to H.I.V. infection.
“For pediatrics, this is our Timothy Brown,’’ said Dr. Deborah Persaud, associate professor at the Johns Hopkins Children’s Center and lead author of the report on the baby. “It’s proof of principle that we can cure H.I.V. infection if we can replicate this case.’’
Dr. Persaud and other researchers spoke in advance of a presentation of the findings on Monday at the Conference on Retroviruses and Opportunistic Infections in Atlanta.
Some outside experts, who have not yet heard all the details, said they needed convincing that the baby had truly been infected. If not, this would be a case of prevention, something already done for babies born to infected mothers.
“The one uncertainty is really definitive evidence that the child was indeed infected,” said Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital.
Image: Smiling doctor, via Shutterstock
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Wednesday, August 22nd, 2012
Babies who are given antibiotics before six months of age are at greater risk of being overweight children, a new study has found. Yahoo News reports:
“We typically consider obesity an epidemic grounded in unhealthy diet and exercise, yet increasingly studies suggest it’s more complicated,” said co-author Leonardo Trasande of the New York University School of Medicine.
“Microbes in our intestines may play critical roles in how we absorb calories, and exposure to antibiotics, especially early in life, may kill off healthy bacteria that influence how we absorb nutrients into our bodies, and would otherwise keep us lean.”
The study adds to a growing body of research warning of the potential dangers of antibiotics, especially for children.
Preliminary studies have linked changes in the trillions of microbial cells in our bodies to obesity, inflammatory bowel disease, asthma and other conditions. However, direct causal proof has not yet been found.
This was the first study analyzing the relationship between antibiotic use and body mass starting in infancy.
Image: Cute baby, via Shutterstock
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Thursday, April 5th, 2012
Six-month-old British baby Olivia Norton is being called “a medical miracle” for surviving after being born with virtually no blood. Parentdish.co.uk reports:
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The six-month-old little girl was born completely white because she had such a low count of haemoglobin – the chemical which carries oxygen in red blood cells – that it could not officially be classed as ‘blood’.
She was given less than two hours to live but survived thanks to emergency transfusions which transformed her into a glowing healthy pink colour.
Olivia’s mum Louise Bearman, 31, a barrister’s clerk, told of her shock at giving birth to a ‘ghost white’ baby whose condition was so rare she will now feature in medical text books.