Sick children, especially those with some dehydration from flu or other illnesses, risk significant kidney injury if given drugs such as ibuprofen and naproxen, Indiana University School of Medicine researchers said Friday.
In an article published online Jan. 25 by the Journal of Pediatrics, Jason Misurac, M.D., and colleagues from IU and Butler University reported that nearly 3 percent of cases of pediatric acute kidney injury over a decade could be traced directly to having taken the common nonsteroidal anti-inflammatory drugs, or NSAIDs.
Although relatively few in terms of percentage of total kidney damage cases, the children with problems associated with NSAIDs included four young patients who needed dialysis, and at least seven who may have suffered permanent kidney damage, the researchers said.
“These cases, including some in which patients’ kidney function will need to be monitored for years, as well as the cost of treatment, are quite significant, especially when you consider that alternatives are available and acute kidney injury from NSAIDs is avoidable,” Dr. Misurac, a fellow in pediatric nephrology, said.
Although such drugs have been linked to kidney damage in small, anecdotal reports, the study reported Thursday is believed to be the first large-scale study of the incidence and impact of acute kidney injury caused by NSAIDs.
The research team evaluated medical records at Riley Hospital for Children at IU Health in Indianapolis from January 1999 through June 2010 and found 1,015 cases in which patients had been treated for acute kidney injury from any cause.
After excluding cases in which the acute kidney injuries could possibly be explained by other factors, such as diseases affecting kidney function, the researchers found 27 cases, or 2.7 percent, in which the only factors were the administration of NSAIDs. In nearly all cases, the NSAIDs were administered before the children were admitted to the hospital. Because many of the 1,015 cases involved multiple potential causes of acute kidney injury, the researchers said the 27 cases are likely an underestimate of the number of cases in which NSAIDs contributed to the kidney damage.
Among the researchers’ findings:
- Most of the children had been treated with recommended dosages.
- All of the children under the age of 5 needed to undergo dialysis temporarily, were more likely than the older children to be placed in an intensive care unit and needed longer hospital stays.
- The average cost for hospital and kidney specialist fees in the 27 cases was nearly $13,500, and the costs were much higher for younger children. At least $375,000 was spent on the NSAID-associated kidney injury cases at Riley Hospital over the study period, the researchers said, but billing data for other specialists were not available in the database, suggesting that the actual costs were likely much higher.
NSAIDs affect kidney function by restricting blood flow to the blood-filtering components of the kidneys, which suggests the risks from the drugs are greater among children who are dehydrated due to the effects of their illness, such as vomiting or diarrhea, Dr. Misurac said.
Fever is normal during an infection and not in itself dangerous, he noted, so “one alternative to NSAIDs would be acetaminophen, but another alternative would be no medication at all, at least for a while, to let the body fight the infection.”
In addition to Dr. Misurac, authors of the paper are Sharon P. Andreoli, M.D., Jeffrey D. Leiser, M.D., Ph.D., Corina Nailescu, M.D., and Amy C. Wilson, M.D., of the IU School of Medicine, and Chad A. Knoderer, Pharm.D., of the Butler University College of Pharmacy and Health Sciences.
Courtesy of Eurekalert.org.
Doctors have long believed that disabling autistic disorders last a lifetime, but a new study has found that some children who exhibit signature symptoms of the disorder recover completely.
The study, posted online on Wednesday by the Journal of Child Psychology and Psychiatry, is the largest to date of such extraordinary cases and is likely to alter the way that scientists and parents think and talk about autism, experts said.
Researchers on Wednesday cautioned against false hope. The findings suggest that the so-called autism spectrum contains a small but significant group who make big improvements in behavioral therapy for unknown, perhaps biological reasons, but that most children show much smaller gains. Doctors have no way to predict which children will do well.
Researchers have long known that between 1 and 20 percent of children given an autism diagnosis no longer qualify for one a few years or more later. They have suspected that in most cases the diagnosis was mistaken; the rate of autism diagnosis has ballooned over the past two decades, and some research suggests that it has been loosely applied.
The new study should put some of that skepticism to rest.
“This is the first solid science to address this question of possible recovery, and I think it has big implications,” said Sally Ozonoff of the MIND Institute at the University of California, Davis, who was not involved in the research. “I know many of us as would rather have had our tooth pulled than use the word ‘recover,’ it was so unscientific. Now we can use it, though I think we need to stress that it’s rare.”
She and other experts said the findings strongly supported the value of early diagnosis and treatment.
In the study, a team led by Deborah Fein of the University of Connecticut at Storrs recruited 34 people who had been diagnosed before the age of 5 and no longer had any symptoms. They ranged in age from 8 to 21 years old and early in their development were in the higher-than-average range of the autism spectrum. The team conducted extensive testing of its own, including interviews with parents in some cases, to gauge current social and communication skills.
The debate over whether recovery is possible has simmered for decades and peaked in 1987, when the pioneering autism researcher O. Ivar Lovaas reported that 47 percent of children with the diagnosis showed full recovery after undergoing a therapy he had devised. This therapy, a behavioral approach in which increments of learned skills garner small rewards, is the basis for the most effective approach used today; still, many were skeptical and questioned his definition of recovery.
Dr. Fein and her team used standardized, widely used measures and found no differences between the group of 34 formerly diagnosed people and a group of 34 matched control subjects who had never had a diagnosis.
“They no longer qualified for the diagnosis,” said Dr. Fein, whose co-authors include researchers from Queens University in Kingston, Ontario; Children’s Hospital of Philadelphia; the Institute of Living in Hartford; and the Child Mind Institute in New York. “I want to stress to parents that it’s a minority of kids who are able to do this, and no one should think they somehow missed the boat if they don’t get this outcome.”
On measures of social and communication skills, the recovered group scored significantly better than 44 peers who had a diagnosis of high-functioning autism or Asperger’s syndrome.
Dr. Fein emphasized the importance of behavioral therapy. “These people did not just grow out of their autism,” she said. “I have been treating children for 40 years and never seen improvements like this unless therapists and parents put in years of work.”
The team plans further research to learn more about those who are able to recover. No one knows which ingredients or therapies are most effective, if any, or if there are patterns of behavior or biological markers that predict such success.
“Some children who do well become quite independent as adults but have significant anxiety and depression and are sometimes suicidal,” said Dr. Fred Volkmar, the director of the Child Study Center at the Yale University School of Medicine. There are no studies of this group, he said.
That, because of the new study, is about to change.
Courtesy of The New York Times
A new study finds that diapers, both disposable and cloth, impede walking in babies.
It’s a given that most babies wear diapers, in western cultures anyway. But diapers may trap more than waste—they may also confine a baby’s ability to walk.
Scientists compared the walking gaits of 60 babies who were either naked, wore a thin disposable diaper or a thick cloth diaper. Half the babies were 13-month old novice walkers and the other half 19-month old experienced walkers.
When the 30 13-month olds walked naked only 10 fell, but while wearing the cloth diaper 21 of them fell, and while wearing the disposable 17 of them fell. Among the 19-month olds only 4 fell while naked or wearing disposables, while 8 fell when wearing cloth diapers. But both age groups took wider and shorter steps while wearing diapers as opposed to walking naked. The research is in the journal Developmental Science. [Whitney G. Cole, Jesse M. Lingeman and Karen E. Adolph, Go naked: diapers affect infant walking]
Because the effects were immediate, this study cannot predict if wearing diapers has a long-term impact. Nonetheless the researchers believe walking naked would speed up walking development. But then we are left with the issue of covering the entire house in plastic and relying heavily on the child’s ability to communicate his or her elimination intentions.
Courtesy of Huffington Post
A new study confirms that giving H1N1 flu vaccines to pregnant women during the 2009 swine flu pandemic was safe for them and their babies, and likely reduced the risk of miscarriage and stillbirth.
Norwegian researchers launched the study because of concerns over the safety of vaccines, especially the new vaccine to combat pandemic flu. Thirty women in Norway reported miscarriages after receiving the H1N1 shot, according to the study, published today in The New England Journal of Medicine.
Those fears weren’t borne out by the data, however, when researchers looked at the larger picture: 117,347 pregnancies in Norway from 2009 through 2010. More than half of all pregnant women in Norway received the H1N1 shot — a fact that doctors can accurately calculate because of that country’s national health system.
In fact, the vaccines offered substantial benefits, says co-author Camilla Stoltenberg, from the Norwegian Institute of Public Health.
Vaccinated pregnant women were 70% less likely to develop H1N1 flu than unvaccinated women, the study says.
Developing H1N1 flu was extremely dangerous: Pregnant women who contracted the flu were nearly twice as likely to experience miscarriage or stillbirth, the study says.
Unvaccinated women were 25% more likely to miscarry or have a stillbirth, although this finding could have been due to chance, due to the relatively low rate of fetal death. There were about five miscarriages or stillbirths for every 1,000 live births in Norway during this period.
The findings, which are supported by previous research demonstrating the safety of flu vaccines during pregnancy, come at an opportune time, amid an early and severe flu season, says Siobhan Dolan, an obstetrician-gynecologist at Montefiore Medical Center in New York and a medical adviser to the March of Dimes.
“There has been this misconception that getting a flu shot, or a vaccine in general, is risky during pregnancy,” Dolan says. “But it’s the flu that poses the greatest risk, not the shot,” says Dolan, who was not involved in the new study.
The Centers for Disease Control and Prevention recommends an annual flu shot for everyone over 6 months old, including pregnant women.
Women can be vaccinated safely any time during pregnancy, Dolan says.
Studies also show that getting vaccinated against flu during pregnancy protects the baby for the first few months of life, when it is too young to be vaccinated, Stoltenberg says. Newborns are especially vulnerable to complications from influenza, because of their immature immune systems and small airways.
The Norwegian study — supported by the Norwegian Institute of Public Health and the U.S. National Institutes of Health — involved a slightly different H1N1 vaccine from that used in the USA, says Gregory Poland, a professor and vaccine researcher at the Mayo Clinic in Minnesota. Norwegians added an adjuvant to their vaccine, which is intended to produce a stronger immune response.
H1N1 flu vaccines in the USA did not contain adjuvants, due to concerns by some consumers about their safety, says Poland, who was not involved in the new study.
Pregnant women face increased risks from the flu for many reasons, Dolan says. Their immune systems are weaker than usual, and their lung capacity is less, for example.
The greatest risk from a flu vaccine is Guillain-Barre syndrome, Poland notes, which may occur in an additional one in every 1 million people if they get the vaccine.
Guillain-Barre is a condition in which the body’s immune systems attack its nerves, often after infection with a respiratory bug or stomach flu. Although acute cases are an emergency, most people recover completely, according to the Mayo Clinic.
Poland notes that anecdotes about adverse reactions from vaccines can be misleading. When women miscarry after getting a vaccine, it’s most likely a coincidence, although it may not feel that way to a woman who has just lost a pregnancy.
“Thousands of miscarriages are going to occur within a week of when we give influenza vaccines, but that is a coincidence,” Poland says.
What consumers don’t see, he says, are the ravages of influenza that doctors treat every day.
“We plead with patients to get the vaccine, because we see what is going to happen,” Poland says. “In our hospital right now, we have 80 people critically ill from the flu in the hospital and intensive-care unit.”
Poland adds, “The risks from influenza vaccine are so small that they can’t be reliably measured. The risks of flu to mother and baby are very real.”
Courtesy of USA Today
Hailed as one of today’s most gifted pop troubadours, multi-Grammy award-winning and multi-platinum recording artist Jason Mraz has made no secret of his admiration for children’s television visionary Fred Rogers, even performing the theme from the beloved Mister Rogers’ Neighborhood at some of his concerts and using a quote from Rogers within his album artwork. On February 14, Mraz will help bring Rogers’ timely message of love and acceptance to a new generation of preschoolers and families from coast to coast with the national premiere of “You are Special,” an all-new episode of the animated hit Daniel Tiger’s Neighborhood on PBS KIDS (check local listings). The world-renowned musician sings the opening and closing tunes – “It’s a Beautiful Day in the Neighborhood” and “It’s Such a Good Feeling” – two classic songs penned and originally performed by Rogers himself.
“Given Jason’s strong connection to Fred Rogers, we couldn’t think of a more perfect person to be our ‘neighbor’ and sing two of Fred’s most well-known and best-loved songs,” said Angela C. Santomero, Co-Executive Producer of Daniel Tiger’s Neighborhood. “Fred knew that music is very important in connecting with young viewers and we believe he would have been very happy to know of Jason’s ‘visit’ to the Neighborhood of Make-Believe.”
One of the hallmarks of the standout series is its innovative use of irresistible musical strategies that reinforce every show’s theme that get preschoolers and parents singing along and using them in their daily lives. The Daniel Tiger’s Neighborhood Valentine’s Day episode features two endearing stories that reinforce the important theme, “It’s you I like.” The songs that Mraz recorded for the new episode bookend the two tales that make up the half-hour episode. In You Are Special Daniel and his friends are having a show at school to celebrate each of their talents. O the Owl struggles with wanting to be exactly like his friends, until they remind him, “I like you just the way you are,” and O figures out what he can do that makes him special! And, in Daniel is Special, Daniel and his dad take a nature walk together through the neighborhood. When, Daniel sees a few of his friends, he suddenly worries that there’s nothing special about him. But Dad reminds Daniel, “I like you just the way you are,” and Daniel learns that we all have things that make us special. For Daniel, it’s his powerful imagination.
Toddlers who have more developed language skills are less likely to throw temper tantrums by the time they begin preschool, according to a new study.
This is likely because they are better able to talk about their frustrations, according to researchers, from Pennsylvania State University.
They followed 120 predominately white children from the ages of 18 months to 4 years and measured their language skills and their ability to cope with frustration.
In one test, for example, the children’s ability to control their anger was observed as they had to wait eight minutes before opening a gift while their mothers completed a questionnaire.
Strategies used by the children in this situation included seeking support (“Mom, are you done yet?” or “I wonder what it is”) and distracting themselves from the gift by doing things such as counting out loud or making up a story.
The researchers found that children who had better language skills as toddlers and whose language developed more quickly expressed less anger at age 4 than those whose language skills weren’t as good when they were toddlers.
Children whose language developed more quickly were more likely to calmly seek their mother’s support while waiting at age 3. This, in turn, predicted less anger at age 4, according to the study, which was published Dec. 20 in the journal Child Development.
“Better language skills may help children verbalize rather than use emotions to convey needs and use their imaginations to occupy themselves while enduring a frustrating wait,” study author Pamela Cole, a professor of psychology and human development and family studies, said in a journal news release.
Courtesy of HealthDay News
Flu vaccination rates among U.S. children were lower than expected over a recent five-year period, a new study reports.
The findings were released in the midst of the current flu season, with 47 states now reporting widespread illness, according to the U.S. Centers for Disease Control and Prevention. Health officials recommend that all children 6 months and older get the flu vaccine.
For the new study, Wake Forest Baptist Medical Center researchers reviewed data on more than 8,000 children younger than 5 in three counties in Ohio, New York and Tennessee between 2004 and 2009, and found that less than 45 percent of them received a flu shot.
“Our research showed that one in six children under age 5 who went to an emergency department or clinic with fever and respiratory symptoms during the peak flu seasons had the flu,” study author Dr. Katherine Poehling, an associate professor of pediatrics and epidemiology, said in a Wake Forest news release.
“Many of those illnesses could have been prevented by vaccination, the best known protection against the flu,” she added.
Children younger than 6 months of age had the highest hospitalization rates with flu, the study authors noted.
“Parents should include a yearly flu shot to protect themselves and their children,” Poehling said in the news release. “The best way to protect infants too young to receive the influenza vaccine is for pregnant women, the infant’s family members and contacts to get the shot, too,” she added.
The study was published in the online edition of the February issue of the journal Pediatrics.
Content published by Health Day News
The U.S. Centers for Disease Prevention and Control has more about children, the flu and the flu vaccine.
ALBANY, N.Y. — Baby food used to have an image as stable — and bland — as a jar of strained peas. And its target market was limited to, well… babies.
Old-school glass jars of applesauce are still around, but these days they share shelf space in the baby food aisle with curious (and often organic) combinations like zucchini, banana and amaranth (it’s a grain) packed in brightly colored pouches intended to be squished and slurped by consumers with little — and not so little — hands.
“What we try to do is engage them, stimulate all of their senses,” says Paul Lindley, founder of Ella’s Kitchen baby food, a pioneer in the use of pouch-style packaging. “Not just their taste sense, not just putting a spoon in their mouth or a pouch into their mouth … but to try to stimulate all their other senses.”
Welcome to the world of premium baby foods, part of a $1.5 billion industry that’s no longer just about babies. Babies don’t generally care much about food packaging. But toddlers, older children and convenience-driven parents do.
Pouches have allowed baby food makers to broaden the appeal of their products beyond the traditional baby food years. Maureen Putman, chief marketing officer for the Hain Celestial Group, maker of organic brand Earth’s Best, says pouches have helped fuel 11 percent growth at Earth’s Best even as the U.S. birth rate declines.
“It’s allowing us to age up. Where moms may have stopped baby food at 9 to 12 months, the pouches have really helped extend the shelf life of baby food,” she says. “We see growth for a long time to come.”
Parents like Lindsey Carl, of Clarksville, Tenn., make the case, saying pouches are a less messy way to feed her 22-month-old daughter and 10-month-old son simultaneously. “They don’t require a spoon, which makes on-the-go easy,” she says. “You don’t have to worry about bringing a spoon: ‘Where do I wash the spoon? Where do I put the spoon?’”
And the premium baby food world is an increasingly crowded one, with other major players including Plum Organics, Sprout, the organic baby food company founded by Food Network star Tyler Florence, and even long established baby food maker Gerber.
“We’re excited about pouches and we’re the No. 1 in the segment and we want to continue to grow it,” said Aileen Stocks, Gerber’s head of integrated marketing.
Obviously, the premium trend also is about what’s in the pouches. And increasingly it’s organic. While organic accounts for only about 4 percent of total U.S. food sales, organic baby food represents a more impressive 21 percent of that category, says Putman.
Gerber, with more than half the market, also is No. 1 in pouch sales, with about a 30 percent share, Stocks said. She said while organic pouches are driving growth in premium products, Gerber’s product line runs from infants to preschool and they are focusing on growth and innovation in all the segments.
“Pouches obviously, it’s an exciting story because you’re seeing a lot of it in the aisles right now,” she said. “But it’s really just one part of the whole story as far as the child’s nutrition.”
Putman says the popularity of organics is a sign that parents are concerned about what they’re feeding their babies. But there could be other reasons, too. The creative new mixes available — such as Plum’s sweet potato, mango and millet, and Sprout’s pasta with lentil Bolognese — might speak to Mom and Dad’s inner foodie.
Premium baby foods also bridge the gap between the parents who feed out of jars and those who prefer a make-it-from-scratch approach, creating a middle ground both sides of that parenting debate are more comfortable with.
Florence sees Sprout as a way to expose more young eaters to a wider variety of more flavorful foods. His own “Aha!” moment came when a friend’s toddler was spitting up old fashioned jar food. Florence steamed and pureed carrots, and the boy licked the bowl clean.
“If you’re feeding a child just sort of green gruel out of a jar and they’re spitting it up all over their shirt, they’re saying, ‘Listen, I don’t like this stuff,’” said Florence.
Organic pouches can run $1.69 for 4 ounces, compared to 99 cents for some jarred food. Still, Meagan Call of Cleveland, Ohio, says she can get them on sale for about $1. Call sees pouches as a healthy alternative to sugar-heavy juice boxes for her 18-month-old son.
“They’re more like smoothies,” Call said. “That’s what I see it as. I’m giving him smoothies and smoothies are fairly healthy as long as you don’t overdo it.”
Not everyone is cooing over pouches, though.
One common criticism is that in some cases a pouch will read something like “spinach and apples,” giving an impression of a vegetable-rich meal even if the ingredient label lists more apples than spinach. More pointedly, some critics claim that parents tend to over-rely on pouches.
Dina Rose, a sociologist who writes the “It’s Not About Nutrition” blog, said while pouches can be a beneficial “bridge” to fresh fruits and vegetables, they are no substitute.
“It lulls people into thinking that they’ve done their fruit-and-vegetable job. So they’re done,” Rose said. “And it gets them out of what they think of as the struggle to get their kids to eat fruits and vegetables.”
—Copyright 2013 Associated Press
Photo courtesy of PlumOrganics.com
Although doctors say babies should not watch television, some mothers may use the tube as a way to calm fussy infants, a new study suggests.
The results show that infants who were perceived as more active — for example, they squirmed a lot — or fussier by their mothers were exposed to more TV each day compared with infants who were seen as less active or less fussy.
Infants were especially likely to watch more TV if their mothers were obese or did not graduate from high school. Both factors are associated with more TV viewing.
Previous studies have found that infants with tempers are at greater risk for obesity later in childhood, and the new study offers a possible reason why. “Mothers use the TV to soothe and/or entertain them,” the researchers wrote in the Jan. 7 issue of the journal Pediatrics.
Excess TV viewing early in life is a concern because the habit has been linked to weight problems and developmental delays in preschool kids, the researchers said. In addition, the TV viewing habits of young children appear to continue into later childhood and the teen years.
The study included only low-income black mothers, and their infants watched more TV on average than infants enrolled in previous studies, so the results may not be true of the population as a whole, the researchers said.
The findings suggest that one way to reduce TV exposure early in life is to give parents alternative strategies to help them calm fussy infants, said the researchers, from the University of North Carolina at Chapel Hill.
The American Academy of Pediatrics discourages TV watching in children younger than 2, citing evidence that it does not provide an educational benefit, and may have adverse health effects.
The new study included 217 black mothers and their infants living in North Carolina. The mothers were visited in their homes when their children were 3 months old, and both the moms and babies were followed until the children were 18 months of age.
Mothers were asked how many hours their child spent in front of the TV when it was turned on. They also answered a questionnaire that gauged each baby’s level of fussiness, activity level and duration of crying.
Infants as young as 3 months watched an average of 2.6 hours of TV a day. By age 1, nearly 40 percent of the babies were watching more than three hours of television a day, the researchers said.
Three-month-olds who watched more than three hours of TV daily had higher fussiness scores compared with those who watched less than one hour a day.
Among fussy infants with obese mothers, 37 percent watched more than three hours of TV a day, compared with 19 percent of infants who weren’t as fussy and had normal weight mothers.
It’s important to note the study only found an association between TV viewing and fussiness. Because many infants in the study were already watching more than two hours of TV at age 3 months, more research is needed to tease out whether parents really do use TV to calm fussy infants, or whether infants fuss because they watch too much TV, the researchers said.
Article courtesy of Huffington Post
A new study, said to be the first of its kind, reveals that babies begin learning the distinctive sounds of their native language while in utero.
Researchers from Pacific Lutheran University in Washington State have found that infants show interest in the vowels of their native language only hours after being born.
“These little ones had been listening to their mother’s voice in the womb, and particularly her vowels for ten weeks,” explains coauthor Patricia Kuhl. “The mother has first dibs on influencing the child’s brain.”
“The fact that the infants can learn the vowels in utero means they are putting some pretty sophisticated brain centers to work, even before birth,” she adds. “We can’t waste early curiosity.”
The findings, announced Wednesday, are set to be published in a future edition of the journal Acta Paediatrica.
Babycentre.uk advises moms-to-be to talk and sing to their baby bump, which will help bonding, and after birth, your newborn will pay more attention to your voice than others.