Tuesday, May 7th, 2013
Teenagers with asthma have better oversight of their care from parents and doctors than young adults in their early 20s, so teens’ care is more consistent, a new study published in the journal Pediatrics has found. More from Boston.com:
Parents of teens with asthma can remind them to take medications, fill their prescriptions, and make appointments with pediatricians who probably know the child well. But a few years later, when the young adult has left home for college or to live independently, that oversight is gone — and their care can suffer.
Twenty-nine percent of young adults with asthma received treatment at an emergency room during the previous year, compared with 19 percent of younger teenagers with the condition, according to an analysis of national survey data collected between 1999 and 2009. Losing health insurance coverage is a major — but not the only — factor in this declining care, the study found.
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The research, led by Dr. Kao-Ping Chua of Harvard Medical School and Boston Children’s Hospital, suggests that many young people wait for a medical crisis rather than seeking preventive care from primary care doctors they may not know well.
Image: Teenager using inhaler, via Shutterstock
Thursday, April 4th, 2013
Doctors are increasingly making the diagnosis of “GERD,” or gastroesophageal reflux disease, in infants, and the label may be prompting parents to medicate for infant issues that pediatricians would otherwise regard as normal, such as crying and spitting up.
A new report published in the journal Pediatrics argues that the use of the disease label is leading to the growing use of medication. “Labeling an otherwise healthy infant as having a “disease” increased parents’ interest in medicating their infant when they were told that medications are ineffective,” the article concludes. “These findings suggest that use of disease labels may promote overtreatment by causing people to believe that ineffective medications are both useful and necessary.”
Previous research has already established the growing number of medical interventions for GERD. One 2010 study by the Food and Drug Administration found that the prescription rate for a particular class of acid blockers increased 11-fold in the years between 2002 and 2009 for babies under age 1.
The new study, which was conducted as a survey of parents in a general pediatric clinic, attributes the rise to the use of the disease label GERD. From the survey’s abstract, “Parents who received a GERD diagnosis were interested in medicating their infant, even when they were told that the medications are likely ineffective. However, parents not given a disease label were interested in medication only when medication effectiveness was not discussed (and hence likely assumed).”
Image: Crying newborn baby, via Shutterstock
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Tuesday, March 26th, 2013
The American Academy of Pediatrics recommends that babies be fed only formula or breast milk until they are 6 months old, but more than 90 percent of mothers are offering solid food to their babies earlier than that, with 40 percent offering solids before 4 months, according to a new study by the Centers for Disease Control and Prevention. The CDC survey, which was published in the journal Pediatrics, said the findings are “worrisome” in that babies may be at increased risk for developing chronic diseases, such as diabetes, obesity, eczema, and celiac disease. More from NBC News:
The mothers who volunteered for the CDC study filled out food diaries and questionnaires designed to ferret out their opinions on why and when solid foods should be offered.
Among the moms offering solid foods to infants younger than 4 months, the most commonly cited reasons for doing so included: “My baby was old enough;” “My baby seemed hungry;” “I wanted to feed my baby something in addition to breast milk or formula,” “My baby wanted the food I ate;” “A doctor or other health care professional said my baby should begin eating solid food;” and “It would help my baby sleep longer at night,” researchers reported.
What’s more, moms who fed their babies formula were far more likely to start solids too early versus those who exclusively breast-fed (53 percent versus 24 percent), the study showed.
One food expert unaffiliated with the CDC study suggested that some health-care providers may simply be unfamiliar with current baby-feeding recommendations.
“I think this is worrisome,” said Ann Condon-Meyers, a pediatric dietician at the University of Pittsburgh Medical Center and Children’s Hospital of Pittsburgh. “I think it may show that word isn’t getting out that … it is 6 months before solid foods should be offered.”
Image: Baby being fed, via Shutterstock
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Wednesday, February 20th, 2013
A new study published in the journal Pediatrics has found that children who watch quality, educational programs on television are better-behaved than those kids who watch television of varying moral and educational value. The new research will be welcome news to parents who struggle to minimize their kids’ screen time despite recommendations from the American Academy of Pediatrics and other groups. More from Time.com:
“There is no question kids watch too much television at all ages,” says Dr. Dimitri Christakis, lead author and director of the Center for Child Health, Behavior and Development
at Seattle Children’s Research Institute. “Part of the message is not just about turning off the television but about changing the channel.”
Kids are sponges who absorb their surroundings; it’s how they learn to develop the proper behaviors and responses to social situations. And they are not only parroting their parents and other family members, but mimicking behaviors they see on television or in movies as well. So Christakis, who has conducted extensive research on the effects of screen time on child development, explored ways to influence what shows children watch so that they’re more apt to imitate quality conduct. “We’ve known for decades that kids imitate what they see on TV,” he says. “They imitate good behaviors and they imitate bad behaviors.”
In the study, he and his colleagues tracked 617 families with kids between the ages of 3 and 5. Half of the families agreed to go on a media “diet” and swap programming with more aggressive and violent content for educational, prosocial shows that encourage sharing, kindness and respect, like Dora the Explorer, which teaches how to resolve conflicts, and Sesame Street, which models tolerance for diversity. The other families did not change their children’s viewing choices.
To help parents in the first group to choose appropriate shows, they received a program guide that highlighted prosocial content and learned how to block out violent programming. (The parents were so delighted with the guidance that many asked to continue receiving program guides even after the study ended.) They were also urged to watch alongside their kids. The researchers tracked what the children watched and also measured their behavior with standard tests of aggressiveness and sharing responses six months and a year into the study.
At both testing periods, the children in the first group watched less aggressive programming than they did at the beginning of the study compared with children in the control group. Both groups of kids upped their screen time a bit, but the first group saw more quality programs while the control group spent even more time watching violent shows.
Six months after the study began, the children who increased their prosocial viewing acted less aggressively and showed more sharing and respectful behaviors compared with the control group. They were more apt to compromise and cooperate than children who didn’t change their viewing content, and the effects persisted for the entire year that the study lasted. “There is a connection between what children watch, not just in terms of violence but in terms of improved behavior,” says Christakis, who is also a professor of pediatrics at the University of Washington.
Who got the biggest boost in behavior? Low-income boys. “They derived the greatest benefit, which is interesting because they are most at risk of being victims and perpetrators of aggression,” he says.
Image: Child watching TV, via Shutterstock
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Wednesday, January 16th, 2013
Parents who offer their children complementary and alternative medical therapies including acupuncture, herbal supplements, and chiropractic care, are not necessarily forthcoming about those practices with their pediatricians, a new study published in the journal Pediatrics has found. Sharing more information with pediatricians would, however, benefit children, parents, and doctors alike, as CNN reports:
The most commonly used CAM therapies included massage, faith healing, chiropractic and aromatherapy, while the most popular products to treat conditions ranging from cancer to asthma and inflammatory bowel disease were vitamins and minerals, herbal remedies and homeopathic medicines.
“Whether we’re looking at the general population or at children’s hospitals, it seems that complementary medicine use is extremely common,” says Dr. Sunita Vohra, lead author of the study and a pediatrician who is chair of the section on integrated medicine for the American Academy of Pediatrics.
In the United States, a recent survey found that one in nine children had used alternative therapies to treat a health condition.
Vohra says parents’ own beliefs about and reliance on CAM therapies is a major factor behind its use in children, as is parents’ desire to provide their children with every possible health option.
“For most parents, their number one priority is the health of their children so they’re interested in exploring all options to promote their children’s health,” says Vohra. “Many parents consider all products that are available and seek out not only conventional health care but also complementary health care.”
With CAM being used by so many children, however, she and her colleagues say it’s time for pediatricians to do a better job of discussing the safety and efficacy of the therapies with parents.
“Given the rates of use, we would like to encourage all health care providers to ask about complementary therapies and we encourage all parents to tell,” says Vohra. “In many cases, it’s not discussed because parents think doctors won’t support them, but it’s far better to have an open discussion.”
Such discussions can avoid potentially harmful interactions between conventional medicines and herbal remedies, for example, or other incompatibilities that can worsen, rather than improve, symptoms. In the study, parents reported 80 adverse effects, most of which were described as minor.
Most parents, says Vohra, will deny that their children are taking alternative therapies, even if they are — and not because they want to intentionally deceive their doctors.
“They don’t think of herbs as medicine,” says Vohra. “So doctors should ask parents, ‘What are all the therapies, including complementary medicines, that your child is taking?’”
Image: Acupuncture, via Shutterstock
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