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Parenting

AAP Says Lice Shouldn’t Keep Kids Out of School

1:30

Typically, when a student has head lice or nits (the eggs of head lice), the school requires that he or she go home and not return until the lice are gone. The American Academy of Pediatrics (AAP) recently proposed new guidelines that say, "No healthy child should be excluded from school or allowed to miss school time because of head lice or nits."

The AAP says that while head lice may be annoying and cause itching, they don’t actually make people sick or spread disease. Many people believe that the insects are easily spread, but experts say that direct head-to-head contact is required.

The AAP notes that most doctors who care for children agree that school policies requiring children to be free from nits before returning to school should be abandoned.

The AAP also reported that screening kids at school for head lice does not reduce the occurrence in classrooms over time. However, pediatricians advise parents to check their children’s heads for lice and school nurses may check children who are showing symptoms such as repeated head scratching.

To treat lice, the AAP recommends parents start with over-the-counter medications that contain 1 percent permethrin or pyrethrins (types of insect-killing chemicals).

Parents should carefully follow the treatment instructions, and when using permethrin or pyrethrin products, should apply the treatment at least twice (about 9 days apart).

Because these medications do not kill 100 percent of the lice eggs, the treatments should be followed by manual removal of the eggs, the guidelines say. This can be a tedious process, but fine-tooth combs called "nit-combs" can make the process easier.

Some head lice have become resistant to OTC treatment, these cases may benefit from prescription medications such as spinosad or topical ivermectin.

Once a person is diagnosed with head lice, everyone in the family should be checked for the condition. Lice are usually transmitted by direct contact, so it's less likely that people will get lice from touching household items, but it is still wise to clean all hair-care items and bedding used by the person who had lice, the guidelines say.

Children should be taught not to share items such as combs, brushes and hats, although such precautions may not prevent all cases of head lice, they can reduce the risk of transmission.

Source: Rachel Rettner, http://www.livescience.com/50629-head-lice-recommendations.html

Parenting

Laughing Gas to Ease Labor Pains?

2:00

Like many Americans, you may think laughing gas (Nitrous Oxide) is something that is only used in a dentist’s office to ease the fear of dental work.  But if you live outside the U.S., you’re more likely to associate the pain reducing gas with childbirth.

A recent U.S. survey based on interviews with a representative sample of nearly 1,600 women who gave birth in American hospitals in 2005, showed that only about 1% of American women used nitrous oxide for pain relief during labor, as compared to 69 % of British women and 70% of New Zealanders.

However, U.S. doctors say that these figures may already be starting to shift in favor of using laughing gas in the delivery room.

Laughing gas used to be given to women during delivery quite often - but was replaced in the 1930s by the epidural for controlling pain. Today in the delivery room, epidurals are used almost exclusively for medically- induced pain relief.

In 2011, the Food and Drug Administration approved new laughing gas equipment to be used in American delivery rooms, and this resulted in a resurgence of use in America.

"Maybe 10 years ago, less than five or 10 hospitals used it [for women in labor]," Dr. William Camann, director of obstetric anesthetics at Brigham and Women's Hospital, told ABC News. "Now, probably several hundred. It’s really exploded. Many more hospitals are expressing interest."

Why should a woman consider using laughing gas during labor?  There are actually quite a few pros.

Laughing gas is regarded as a less extreme pain relief option during labor, when compared to the traditional epidural. It’s recommended for women who opt for a natural delivery but simply need a bit of help along the way.

"It's a relatively mild pain reliever that causes immediate feelings of relaxation and helps relieve anxiety," Camman explained. "It makes you better able to cope with whatever pain you’re having."

According to an article published in the journal Birth, “Although nitrous oxide provides much less complete pain relief than an epidural, it is enough for many women. It is eliminated through the lungs rather than the liver, and so does not accumulate in the mother’s or baby’s body. Unlike opioids, it does not depress respiration.”  

Another advantage is the cost. Nitrous oxide is a lot less expensive than an epidural. The average cost for a woman choosing laughing gas during labor may be less than a $100, compared to an epidural, which may run as high as $3,000 according to some experts.

One of the biggest complaints for women who undergo an epidural is the numbness they experience far after labor. It can take sometimes hours for women to regain complete sensation in the lower half of their body, but with laughing gas the effects wear off nearly as soon as inhalation ceases.

There are cons associated with laughing gas as well. It doesn’t completely alleviate the pain and many women feel it just isn’t strong enough. It can also cause some disorientation and a change in awareness.

Laughing gas is also known to have side effects such as nausea, dizziness, and drowsiness. Although these are not experienced by all women who use the gas for pain relief, for those that do, it can blemish the birthing experience.

Ultimately, the choice whether or not to use laughing gas is completely up to the mom’s comfort level. She can also opt to have an epidural if she finds she does not like the effects of the gas or feels that it is not providing enough relief from the pain. Unfortunately, at this point many hospitals in America do not even offer laughing gas as an option, but perhaps due to this recent surge in popularity more delivery rooms will become stocked with the pain relief option in time. 

Having gone through the birthing experience myself, I vote for as many safe pain-relieving options as possible!

Sources: Dana Dovey, http://www.medicaldaily.com/laughing-gas-pain-relief-when-giving-birth-becoming-popular-option-among-new-moms-319180

Judith P. Rooks, CNM, MPH, MS http://onlinelibrary.wiley.com/doi/10.1111/j.1523-536X.2006.00150.x/full

Parenting

Norovirus Prevention: Tips for Swimming in Untreated Waters

2:00

With summer around the corner, lots of families will be headed to the lake for picnics, fishing and swimming. And not to rain on anyone’s parade, but every parent should be aware that the Norovirus loves untreated waters just as much as you and the kids do.

What is Norovirus? Noroviruses are a group of viruses that cause inflammation of the stomach and large intestine lining. They are the leading cause of gastroenteritis in the U.S.; In other words, severe vomiting and diarrhea.

Noroviruses are the same viruses that give you food poisoning – but they can also be active in waters that are untreated with chlorine such as lakes and ponds.

A norovirus outbreak in July 2014 was linked to a lake near Portland Oregon, and sickened 70 people. Those who swam in the lake were 2.3 times more likely to develop vomiting or diarrhea than those who visited the park but didn’t go in the water. More than half of those who got ill were children between 4–10 years old.

Experts believe the outbreak began after a swimmer infected with norovirus had diarrhea or vomited in the water and other swimmers swallowed the contaminated water. To prevent other people from getting sick, park officials closed the lake to swimmers for 10 days.

“Children are prime targets for norovirus and other germs that can live in lakes and swimming pools because they’re so much more likely to get the water in their mouths,” said Michael Beach, Ph.D, CDC’s associate director for healthy water. “Keeping germs out of the water in the first place is key to keeping everyone healthy and helping to keep the places we swim open all summer.”

Swimmers can help protect themselves, their families and friends by following a few easy and effective steps: 

Keep the pee, poop, sweat, and dirt out of the water!

•       Don’t swim if you have diarrhea or have been vomiting

•       Shower before you get in the water

•       Don’t pee or poop in the water

•       Don’t swallow lake or pool water

Every hour—everyone out!

•       Take kids on bathroom breaks

•       Check diapers, and change them in a bathroom or diaper-changing area–to keep germs away from the water.

Noroviruses, like other viruses, don't respond to antibiotics, which are designed to kill bacteria. No antiviral drug can treat noroviruses, but in healthy people the illness should go away on its own within a couple of days.

Children and the elderly are most susceptible to dehydration. Children should be given an oral rehydration solution (such as Pedialyte) to replace lost fluids and electrolytes. Avoid giving your child sugary drinks, which can make diarrhea worse, as well as caffeinated beverages, which can dehydrate them further.

Norovirus is very contagious and can be spread through contaminated food, water, or surfaces.

Summer is a time when families have more opportunities to have fun and spend time together. You can help make sure your picnic or day at the lake doesn’t include the side effects from a norovirus by adhering to the health safety prevention tips listed above.

Sources: http://www.physiciansbriefing.com/Article.asp?AID=699479

http://www.cdc.gov/media/releases/2015/a0514-norovirus-from-swimming.html

http://www.webmd.com/children/norovirus-symptoms-and-treatment

Parenting

Energy Drinks and Hyperactivity in Kids

2:00

A new study suggests that energy drinks may contribute to hyperactivity and inattention in middle-school students.

Researchers looked at 1,600 students in an urban school district in Connecticut where the average age was 12 years old. They found that children who drank energy drinks were 66 percent more likely to be at risk for hyperactivity and inattention symptoms, according to the study in the current issue of the journal Academic Pediatrics.

Not only did the drinks contain caffeine, a central nervous system stimulant, but were also packed with sugar. The study also took into account other sugar-sweetened drinks consumed by the students.

"As the total number of sugar-sweetened beverages increased, so too did risk for hyperactivity and inattention symptoms among our middle-school students. Importantly, it appears that energy drinks are driving this association," study leader Jeannette Ickovics, a professor in the School of Public Health, said in a Yale news release.

"Our results support the American Academy of Pediatrics recommendation that parents should limit consumption of sweetened beverages and that children should not consume any energy drinks," she added.

The students in this study drank an average of two sugary drinks a day. The number of daily sugary drinks ranged from none to as many as seven or more such drinks. Some sugar-sweetened beverages and energy drinks contain up to 40 grams of sugar each. Depending on how old they are, children should only have about 21 to 33 grams of sugar a day, according to the researchers.

On an average, boys tended to drink more energy drinks than girls.

Along with the hyperactivity and inattention in school, researchers were concerned about the risk of obesity for children that consume these types of drinks.

Lots of kids and even some parents confuse sports drinks and energy drinks – thinking that they are the same thing. They are not.

Energy drinks contain substances not found in sports drinks that act as stimulants, such as caffeine, guarana and taurine. Caffeine – by far the most popular stimulant – has been linked to a number of harmful health effects in children, including effects on the developing neurologic and cardiovascular systems.

As soda sales slip, energy drinks have increased nearly 7 percent creating a $9.7 billion dollar industry according to Bloomberg. Concerns have been raised that some energy drink manufacturers are marketing energy drinks directly at kids.

The American Academy of Pediatricians (AAP) that deals specifically with children’s health issues, has emphatically stated that energy drinks are never appropriate for children or adolescents.

Sources: Robert Preidt, http://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/energy-drinks-tied-to-low-attention-and-hyper-behavior-in-middle-schoolers-study-696275.html

http://www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Kids-Should-Not-Consume-Energy-Drinks,-and-Rarely-Need-Sports-Drinks,-Says-AAP.aspx

Parenting

Any Benefits From Eating Your Own Placenta?

2:00

Here’s a medical study I never thought I’d read –“Are there health benefits associated with eating your own placenta after giving birth”?

Well…no, according to a research team from Northwestern University in Chicago. In fact, there may be a few health risks associated with ingesting placenta.

As I read the study’s findings, I began to wonder; who thought this was a good idea in the first place?

It turns out that throughout history there have been some cultures in which women ate the placenta after giving birth. It’s called placentophagy.

Some animals are known to also eat their afterbirth.

Apparently its’ also become the thing among a few celebrity mothers. While some believe that fresh placenta provides the most benefits, others elect to make a smoothie or have it dried, processed and made into pills.

However, the question still remains – is there any real benefit from eating placenta whether it’s raw, processed, made into a smoothie or pill, grilled or baked?

Scientists from Northwestern University pored over accumulated research that has been done on the topic.  The bottom line is that they could not find any evidence that there are any health benefits to placentophagy and that there may be unknown risks to mothers and their infants.

"Our sense is that women choosing placentophagy, who may otherwise be very careful about what they are putting into their bodies during pregnancy and nursing, are willing to ingest something without evidence of its benefits and, more importantly, of its potential risks to themselves and their nursing infants," study lead author and psychologist Cynthia Coyle said in a Northwestern news release.

In the study, Coyle's team reviewed data from 10 published studies. They found no data to support that eating the placenta -- either raw, cooked or in pill form -- protects against postpartum depression, reduces pain after childbirth, increases a woman's energy, helps with lactation, improves mother-child bonding, replenishes iron in the body, or improves skin elasticity. All touted as reasons many of the celebrity moms chose to give it a try.

The researchers also said that there are no studies examining the risks associated with eating the placenta, which acts as a filter to absorb and protect fetuses from toxins and pollutants.

Coyle noted that "there are no regulations as to how the placenta is stored and prepared, and the dosing is inconsistent. Women really don't know what they are ingesting."

If placentophagy appeals to you, be sure and check with your hospital or birthing center first. Many hospitals dispose of the placenta as bio-hazardous waste along with the other medical waste that occurs during birth (needles, blood, gloves etc.). You’ll most likely have to make arrangements ahead of time or find a more accommodating provider.

Source: Robert Preidt, http://www.webmd.com/baby/news/20150604/new-moms-gain-no-benefit-from-eating-placenta-studies-show

Parenting

Backyard Chickens and Salmonella Bacteria

1:45

Chicken coops are springing up in backyards around the country. People are into raising chickens for fresh eggs and some are even developing close bonds with their feathered producers.  Unfortunately, many of the new chicken owners don’t have any experience with safely handling and keeping fowl.

While fresh eggs from the backyard may make breakfast more satisfying, there’s also a downside to raising chickens; salmonella bacteria.

The Centers for Disease Control and Prevention (CDC) says eight ongoing outbreaks of salmonella are linked to backyard chickens. These outbreaks have sickened 611 people, including 195 children under the age of 5, across 45 states since Jan. 4. Because most cases go unreported, the actual number of illnesses may be as high as 10,000, according to the CDC.

“Direct contact with chicks, chickens, ducklings, ducks, geese, and turkeys or contact with their environment can make people sick with salmonella infections,” says Megin Nichols, DVM, a veterinarian with the CDC. “Poultry can have salmonella in their droppings and on their feathers, feet, and beak, even though they appear healthy and clean.”

Salmonella can make you very ill. Symptoms include diarrhea, stomach cramps and fever. If you’re basically healthy, you’ll most likely get better without treatment.  However, children under the age of 5, adults over 65, people with chronic illnesses, people with weakened immune systems, and pregnant women have a higher risk of severe salmonella infections.

Experts say salmonella cases are increasing. The CDC says the 2016 outbreaks "involve the largest number of sick people linked to live poultry that we've seen."

The CDC is trying to pinpoint what types of contact caused the most illnesses in the recent outbreaks. In the past, baby chicks have been the source. Keeping baby chicks in the house, snuggling them, and kissing them are no-nos.

Experts say since you can’t be sure that your flock does not harbor salmonella, you should treat it as if it does.

Salmonella is part of chicken and other live poultry’s gut bacteria.  They shed it in droppings as well as onto their feathers and feet. It’s going to be anywhere you keep your birds.

Washing your hands is one of the top ways experts suggest to protect yourself.

After you handle live poultry, feed live poultry, or touch its backyard coop or living space, wash your hands vigorously for 20 seconds or more with soap and water, then dry them with a clean towel. Have an alcohol-based hand sanitizer handy in case you can’t get to a sink right away, says Elizabeth Scott, PhD, co-director of the Center for Hygiene and Health at Simmons College in Boston.

“If possible, wash your hands outdoors, not at the kitchen sink,” Scott says. “You do not want to be rinsing salmonella off your hands and into the kitchen sink, and you don’t want to use the kitchen sponge or dishrag either. The salmonella can proliferate in both.”

You should also clean any feeding dishes or other equipment outside. Do not bring them indoors.

Experts also offer these tips to prevent infection:

Wear proper clothes: Pick out clothing and a pair of boots or shoes that you will wear only when tending your flock, advises Scott, who grew up on a farm. Keep it outside. After cleaning your coop, separately wash the clothes you wore in your machine’s hot water cycle. (Wash yourself as well! A hot shower will do the trick.)

Set barriers: Chickens and other live poultry belong in the yard, not in the house, and especially not in the kitchen or any room where you store, prepare, and serve food, Scott says.

Says Nichols: “The poultry have their area, you have your area, and you keep it that way. That will definitely help prevent infection.”

Supervise your children: Children under the age of 5 should not have any direct contact with live poultry, Nichols says. Their immune systems cannot protect them enough from infection. Also, they are much more likely to put their fingers in their mouths.

Keep a close eye on older children to be sure that they don’t put their fingers in their mouths and that they wash their hands thoroughly after handling poultry.

No kissing: Don’t let a baby chick’s cuteness fool you into thinking it’s free of disease, Scott warns. “It’s better not to kiss them.”

Handle eggs properly: When you collect your flock’s eggs, which you should do at least once a day, rinse them in water that’s warmer than the eggs themselves. The warm water causes the shell to expand slightly, which helps push dirt out of pores on the shell. Don’t let them sit in the water. Use a detergent made for egg washing if your eggs are dirty. Dry them and store large side up in the refrigerator.

When you’re ready to eat, make sure to cook your eggs thoroughly. “The salmonella bacteria are actually in the yolk,” Scott says. “That’s why we shouldn’t eat raw or undercooked eggs.”

Story source: Matt McMillen, http://www.webmd.com/food-recipes/food-poisoning/20160719/backyard-chicken-salmonella

Parenting

Flour with Added Folic Acid Is Reducing Birth Defects

2:00

Folic acid is a B vitamin that is known to help prevent certain types of birth defects in newborns. In January 1998, the FDA added a requirement that folic acid be added to breads, cereals, and other products that use enriched flour. These fortified foods include most enriched breads, flours, corn meals, rice, noodles, macaroni, and other grain products.

Since then, a new report shows that serious birth defects have fallen 35 percent. While that is certainly wonderful news, a 2014 study found that as many as 25 percent of American women are still not receiving even the minimum amount of recommended folic acid from either their diet or through supplements.

Women who don't get enough folic acid have an elevated risk of giving birth to a child with conditions called neural tube defects, the best known of which is spina bifida, which often causes paralysis.

Health experts began recommending that women of childbearing age take folic acid in 1992 because studies showed that taking 400 micrograms a day could reduce spina bifida and related birth defects by up to 70%.

Doctors now recommend that women who are considering having children start taking folic acid before trying to get pregnant. Since some pregnancies are not necessarily planned, many doctors recommend that women of childbearing age take a daily multivitamin that contains folic acid.

The benefits of folic acid have been researched for quite some time and since food producers began adding folic acid to grains, that simple step has prevented more than 1,300 babies a year from being born with spina bifida or related conditions, according to a report from the Centers for Disease Control and Prevention.

Authors of the new study found that Hispanic women are more likely to have a baby with spina bifida or a similar birth defect.

That's partly because the "masa harina" corn flour used in tortillas and other Hispanic foods isn't fortified with folic acid, the study says. The March of Dimes has petitioned the FDA to require that folic acid be added to corn flour. Adding folic acid to corn flour would prevent another 40 cases of spina bifida or related conditions each year, the report says.

"Even with fortification, there will be some women that do not get the recommended amount of folic acid every day," says Candice Burns Hoffmann, of the CDC's National Centers for Birth Defects and Developmental Disabilities. "We still have more work to do."

If you’re considering having a baby, talk to your doctor before becoming pregnant about the benefits of folic acid and how much you may need.

Sources: Liz Szabo, http://www.usatoday.com/story/news/nation/2015/01/15/folic-acid-birth-defects/21784019/

http://www.spinabifidaassociation.org

Parenting

Breast Feeding

1:30 to read

I recently read an editorial in The New York Times entitled “Overselling Breast Feeding”. It was written by Courtney Jung who is a professor of political science at the University of Toronto.  It was quite interesting to me as she stated “the moral fervor surrounding breast feeding continues unabated, with a steady stream of advocacy and education campaigns”.  The WHO (World Health Organization) developed “ten steps to successful breast feeding” in hopes of increasing breast feeding initiation and duration around the world. Hospitals have been designated “Baby-Friendly”  (aren’t they all supposed to be?)  if they adhere to these steps as well. But the United States has done well with breast feeding rates as 79% of mothers initiate breast feeding.

Most, if not all of the new mothers I make rounds on are proponents of breast feeding. They have read the books, gone to classes and are determined to be successful at breast feeding. But, in my experience over the last several years, I have actually seen more and more new mothers becoming over-wrought and wary of breast feeding fueled by the “rules” that they are being required to follow. With that being said, having someone “tell you that you must breast feed your baby in the first hour after birth”, and that “your baby must remain in your room 24 hours a day“, and that they “may not have a pacifier”, “and should “breast feed on demand” is actually anxiety promoting and leaves many a new mother exhausted and tearful within a day or two of having a baby. 

While breast feeding is “natural” it also requires some practice and the only practice is really “on the job” training.  Some babies just latch on quickly and are pros immediately, but not all babies will become proficient at breast feeding in the first day or two. The mothers are told to “let the baby nurse on demand” and some mothers have had their babies at the breast for hours on end and are exhausted, with sore and bleeding nipples. I have walked in to too many hospital rooms with a mother in tears and a fretful baby, and a “helpless” new father.  Some feel as if “they are failures” as mothers before they even are discharged, and at the same time are having serious doubts about continuing to breast feed.  They are sure that their baby will catch serious illnesses and have a lower IQ if they don’t breast feed, but how can they maintain this constant breast feeding and no sleep and never put a pacifier in their baby’s mouth??? Is there only one way to be successful at breast feeding?

I loved breast feeding but it was a long time ago and we were instructed by caring nurses “to just go home and put the baby to the breast every 2-3 hours”. While that may not have been the best education has the pendulum swung too far?  Will giving the baby one bottle when a mother is having postpartum anxiety and sleeplessness really harm the baby?  Should a mother have to sign an order allowing her baby to have a pacifier??   While guidelines for breast feeding are helpful should they be so rigid that a mother “gives up” on breast-feeding because she can’t follow 10 steps in the first 24-48 hours?   

The New York Times article was quite interesting and I had to agree with many of the author’s  points. Supporting a woman’s choice to breast feed is admirable and “policy changes promoting maternity leave, and flexibility” are definitely needed to encourage women to continue to breast feed. But as she states “is all of this breast feeding advocacy crossing the line?”   A mother should choose to breast feed because she wants to, and that does not mean if her baby does not breast feed in the first hour that she will never bond with her baby or be successful at breast feeding.  Some woman are unable to breast feed for a multitude of reasons and that decision should not label her as a “bad mother”.  Again, breast feeding, like a woman’s breast, is not “one size fits all”. 

 

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DR SUE'S DAILY DOSE

Norovirus is going around and is very contagious.

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