Your Baby

Longer Breast-Feeding Time, Less Childhood Obesity

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A new study looks at the duration of breast-feeding and babies who are high risk for obesity, as they get older. Researchers found that the longer mothers breast –fed these higher risk babies, the less likely the babies were to become overweight later.

"Breast-feeding for longer durations appears to have a protective effect against the early signs of overweight and obesity," said lead researcher Stacy Carling, a doctoral candidate in nutrition at Cornell University, in Ithaca, N.Y.

Carling and her colleagues followed 595 children from birth to the age of 2. They tracked the children's weight and length over this time, and compared individual children's growth trajectories to how long the children breast-fed.

Which children are considered at high risk for extra weight gain? Researchers found that babies whose mothers were overweight or obese, mothers with lower education levels and mothers who smoked during pregnancy were more likely to have overweight children. Almost 59 percent of the children at risk for being overweight had mothers with one or more of these characteristics, compared to about 43 percent of the children not at risk for excessive weight gain.

Higher-risk babies who breast-fed for less than two months were more than twice as likely to gain extra weight than those who breast-fed for at least four months.

Although the study didn’t prove that longer breast-feeding actually reduced risk for obesity, it did provide several reasons why the link between the two may exist.

"Breast-feeding an infant may allow proper development of hunger and satiety signals, as well as help prevent some of the behaviors that lead to overweight and obesity," Carling said.

"Breast-feeding, especially on demand, versus on schedule, allows an infant to feed when he or she is hungry, thereby fostering an early development of appetite control," she said. "When a baby breast-feeds, she can control how much milk she gets and how often, naturally responding to internal signals of hunger and satiation."

The study did not include information on whether the babies were exclusively breast-fed or how often they were getting milk at the breast versus from a bottle, but the time required to reduce obesity risk was not long.

"The difference of two months of breast-feeding may be enough to reap some benefit," Carling said.

There are many reasons mothers choose to breast-feed for shorter periods, and some mothers are not able to breast-feed at all. For mothers that choose to breast-feed, Carling believes they need to be supported on many levels.

"Ultimately, increasing breast-feeding rates in the United States means increasing knowledge and support at a variety of levels from institutional to interpersonal," Carling said. "Our study recognizes the benefit of longer duration breast-feeding in a specific population and, hopefully, this and other studies will lead to more customized breast-feeding promotion in those populations at higher risk for overweight and obesity."

The findings were published in the January print issue of Pediatrics, and funded by the U.S. National Institutes of Health. The authors reported no conflicts of interest.

Source: Tara Haelle, http://consumer.healthday.com/women-s-health-information-34/breast-feeding-news-82/breast-feeding-for-longer-may-protect-infants-at-risk-for-obesity-694218.html

Your Baby

Baby’s Delicate Skin

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A baby’s skin is delicate and prone to a variety of irritations. 

Probably the most common skin problem babies suffer from is diaper rash. Most rashes occur because either the diaper is too tight or wet for too long. Some babies are more sensitive to a particular brand of diapers. If you’re changing your baby’s diaper quickly after it’s wet and using a mild detergent, try another brand of diapers and see if that helps. Treat diaper rash by keeping the diaper area open to the air as long as possible, changing diapers as soon as they are wet, wash the area with a clean warm cloth and apply zinc oxide cream.

Another skin problem is often referred to as “baby acne”. It’s not really acne that teens and adults get, but looks similar. Tiny pus filled spots on the baby’s nose and cheeks may be more related to yeast than oil production. These tiny pimples usually clear up within a few weeks by themselves so there’s no need to apply lotions.

Eczema is an itchy, red rash that may or may not occur in response to a trigger. Children who come from families with a history of asthma, allergies or atopic dermatitis often will have eczema as a baby. Eczema may occur on baby's face as a weepy rash. Over time it becomes thick, dry, and scaly. You may also see eczema on the elbow, chest, arms, or behind the knees. To treat it, identify and avoid any triggers. Use gentle soaps and detergents and apply moderate amounts of moisturizers. More severe eczema should be treated with prescription.

Sometimes parents will notice that their newborn’s skin is peeling or very dry. Not to worry, this often happens when babies are born a little later than their due date. The underlying skin is healthy, soft and moist. If your baby’s dry skin persists, you should have your pediatrician take a look.

Sweating because a baby is overheated can cause prickly heat rash. It usually appears on the neck, diaper area, armpits, and skin folds. A cool, dry environment and loose-fitting clothes are all you need to treat prickly heat rash -- which can even be brought on in winter when baby is over-bundled.

Yeast infections often appear after your baby has had a round of antibiotics, and show up differently depending on where they are on your baby's skin. Thrush appears on the tongue and mouth, and looks like dried milk, while a yeast diaper rash is bright red, often with small red pimples at the rash edges. Talk to your pediatrician: Thrush is treated with an anti-yeast liquid medicine, while an anti-fungal cream is used for a yeast diaper rash.

Sunburn is a painful reminder that baby’s skin needs extra protection under the piercing rays of the sun.  You can use baby sunscreen on infants at any age. Hats and umbrellas are also good for babies. But for the best protection from sunburn, keep your infant out of direct sunlight during the first six months of life. For severe sunburn, take your infant to the pediatrician or hospital for treatment.

Instead of soothing or protecting a baby’s skin, some baby skin products can actually be the cause of skin irritation. Avoid products that contain dyes, fragrances, phthalates and parabens.

Most baby skin rashes and problems aren't serious, but a few may be signs of infection -- and need close attention. If baby's skin has small, red-purplish dots, if there are yellow fluid-filled bumps (pustules), or if baby has a fever or lethargy, see your pediatrician for medical treatment right away.

Source: Hansa D. Bhargava, MD http://www.webmd.com/parenting/baby/ss/slideshow-baby-skin-care

Your Baby

Can Formula Help Breast-Feeding Moms?

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Many a new mother has struggled with whether to breast-feed or give her newborn formula. A recent study, published in the journal Pediatrics,  says the best approach might be both.  In fact, the study suggests that giving newborns a little bit of formula may actually help new mothers, who choose to breast-feed, continue feeding longer.

The lead author of the study, Dr. Valerie Flaherman, an assistant professor of pediatrics and epidemiology and biostatistics at UCSF, and her team followed 40 newborns that had lost at least 5 percent of their birth weight by the time they were 36 hours old. The American Academy of Pediatrics (AAP) notes that it is normal for babies to lose weight during their first days as they become accustomed to feeding. However, if infants drop 10 percent of their birth weight, pediatricians become concerned that babies will be at risk for other heath problems.

For the small trial, Flaherman and her colleagues assigned half the babies a couple days of birth to receive two teaspoons of formula after each breast-feeding, via a syringe so as not to encourage “nipple confusion,” a condition in which a baby has trouble transitioning between breast and bottle. Mothers were instructed to discontinue the formula supplementation once their milk supply appeared, which generally takes two to five days. The other were exclusively breast-fed unless the doctor ordered formula.

When the babies were one week of age, 10% of the moms in the formula group were still using formula in some way as part of their feeding strategy compared with 47% of the group originally assigned to breast-feed but who added formula. And when the babies were three months old, 79% of the formula-group moms were exclusively breast-feeding, significantly more than the 42% of moms in the group originally instructed to breast-feed.

Flaherman suspects that adding a little formula early in the feeding process, then withdrawing it, helped moms feel more secure that their babies were getting enough to eat. That may have also given them the confidence to continue breast-feeding until it was exclusively how their babies were fed. 

“Using that little bit of formula earlier really seems to have had a big effect on whether babies are getting formula at one week,” Flaherman says. “We wanted to try to find an early intervention we could do with these babies and moms to help them continue breast-feeding. I was surprised the effect was this big.”

The AAP recommends that moms breast-feed for 6 months at a minimum. In the United States however, most new mothers start by breast-feeding their infants but only 40 percent continue to 6 months. 20 percent make it to one year.

Some breast-feeding experts take issue with the study’s findings. They worry that the results may undermine the public-heath messages that breast milk alone is best for babies.

“This study goes against everything that’s been published for several years now from very reliable clinicians and researchers about the potential hazards of supplementing exclusively breast-feeding babies with formula,” says Dr. Kathleen Marinelli, an associate professor of pediatrics at the University of Connecticut School of Medicine and the chair-elect of the U.S. Breastfeeding Committee. “They’re flying in the face of years of research here and doing so rather glibly, stating that this is the new way to look at things.”

Tanya Lieberman, a lactation consultant who writes about scientific research for breast-feeding advocacy organization Best for Babes, says she’s “a little confused” by the results. “We know what works to increase breast-feeding exclusivity and duration and we’ve known it for 20 years. That includes no supplementation unless medically necessary.”

Lieberman believes the findings may have been affected by the attitude of the women who were open to the idea of adding formula to their breast-feeding routine.

She believes it’s possible that the mothers may have misunderstood how much milk newborns need.  “Babies don’t need large volumes of milk in the first few days,” she says. “They are fine until their mother’s milk comes in.”

Flaherman, on the other hand, says the study’s results are not necessarily applicable to all babies. "This isn’t something we think all people should do,” she says. “It is just a potential tool for moms to consider using if they think it might be helpful.”

She also says that the ultimate goal of the study was to find a way to help more mothers breast-feed, and to do so for as long as possible to help their babies. “It’s kind of crazy that only 20% of people reach the recommended duration of breast-feeding,” says Flaherman. “Different approaches to supporting breast-feeding may work better for different people.”

If you’re interested in the idea of adding formula to your breast-feeding routine, it’s a good idea to talk with your pediatrician first. If you’re having trouble adjusting to breast-feeding, there are experts your doctor or pediatrician can recommend that can answer any questions you have.  You may just decide that adding a little formula in the beginning is helpful as you and your baby adjust to breast-feeding and a new life together.

Source: Bonnie Rochman, http://healthland.time.com/2013/05/13/can-giving-newborns-formula-increase-breast-feeding-rates/#ixzz2TKJaxygx

Your Baby

Controversial Time Magazine Cover

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You’ve probably either seen or heard about the current Time magazine cover with the photograph of a mother breastfeeding her 3 year-old son.  It’s definitely stirring up a lot of debate.  Some people think the photo is inappropriate. Some are “grossed out.” Other folks are wondering how the child will deal with the sudden- and thanks to the Internet- eternal notoriety. Then there’s the debate over breast milk versus formula.

Most of the comments I have read are by women with the occasional man wondering if years of breastfeeding are ruining the mother’s breast. Images certainly can spur a myriad of reactions.

The actual article that the photo is supposed to represent is about attachment parenting. Attachment parenting has come into vogue through the writings of Dr. Bill Sears and his wife Martha. Their book, The Baby Book, was published in 1992, and promotes extended breast-feeding, co-sleeping and “baby wearing,” in which infants are physically attached to their parents by slings. But a lot of people are having a hard time getting pass the cover to read the article.

Another debate the photo has inspired is "how old is too old" for a child to breastfeed?

Personally I think that’s a parent’s choice. I’ve known mothers who breastfed till their child was 3, others who breastfed from 6 months to a year, and others who didn’t breastfeed at all. All the children are doing well.

Breastfeeding is the natural way to feed your baby. Not every mom can or wants to breastfeed her child, but there are plenty of good reasons to give it a try.

Breast milk contains all the vitamins and nutrients your baby needs in the first six months of life, and it is easily digested. Also, breast milk contains antibodies that help protect infants from a wide variety of infectious diseases, including diarrhea. Studies suggest that breastfed babies are less likely to develop certain medical problems, including diabetes, high cholesterol, asthma, and allergies. Breastfeeding may also decrease the chances that the child will become overweight or obese.

Those are all very good reasons for mothers to breastfeed their children.

There are times however, when breastfeeding isn’t recommended. Sometimes a mother's health can interfere with her ability to breastfeed. For example, a mother undergoing chemotherapy for cancer, or a mom who is infected with human immunodeficiency virus (HIV, the virus that causes AIDS) should not breastfeed.

If you have a medical condition or take any medications on a regular basis, you should check with your doctor before breastfeeding. Mothers with inverted nipples can have a difficult time breastfeeding.

How long should you breastfeed? The American Academy of Pediatrics (AAP) recommends that breastfeeding continue for at least 12 months, and thereafter for as long as mother and baby desire. The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond.

Is the Time magazine cover making a positive or negative statement about breastfeeding, or is it just a clever way to get publicity and sell magazines? I think we know the answer to that.

Sources: http://kidshealth.org/parent/growth/feeding/feednewborn.html

http://www.cdc.gov/breastfeeding/faq/index.htm

Your Baby

Sad Dads May Lead to Crying Infants

New research out of the Netherlands shows that a crying, colicky your-baby can be just as much the result of dad's state of mind as mom's.New research out of the Netherlands shows that a crying, colicky your-baby can be just as much the result of dad’s state of mind as mom’s. Past studies have found that depression among mothers can be related to excessive crying or colic, a common problem with newborns, but the researchers said that little was known about whether fathers' emotions and behavior also have an effect.

"Up to now, almost all attention went to the prenatal effects of maternal depression on child development, leading to the development of detection and treatment programs that focused on mental well-being of mothers," said lead researcher Dr. Mijke P. van den Berg, a psychiatrist at the Erasmus Medical Center in Rotterdam. "This study showed the importance of taking paternal factors and well-being during pregnancy into account, next to maternal," she said. Her report is published in the July 2009 issue of Pediatrics. To see how parental depression was related to excessive crying, researchers gathered data on symptoms of depression among parents of 4,426 infants who were two months old. Excessive crying was defined as crying for more than three hours a day on more than three days in the past week. Overall, just 2.5 percent of the infants in the study fit the excessive crying criteria. But, the researchers found a 30 percent higher risk for depression among parents whose infant cried excessively. "This finding could not be attributed to co-existing depressive symptoms of the mother, which is already known to be a risk factor for excessive infant crying," van den Berg said. It could be related to genetics, a depressed father or, indirectly, through factors such as marital, family or economic stress, she said. In fact, a dad with symptoms of depression was twice as likely to have an infant who cried excessively as was a dad who was not depressed, the study found. "Fathers do matter, so take care for the mental well-being of fathers during pregnancy," van den Berg said.

Your Baby

Diapers and Baby’s Walking Ability

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Just about all western babies wear diapers. I’m pretty sure we all know that, but what you may not know is that the bigger the diaper the more difficult it may be for baby to walk.

Scientists compared the gait of 60 babies who wore either a thin diaper, a thicker cloth diaper or no diaper at all. Half of the babies were 19 month-old more experienced walkers, and half were 13 month-old beginners.

When the 13 month-olds walked naked only 10 fell, but when they wore cloth diapers – 21 fell. When the babies wore the thinner disposable diapers, 17 fell.

The more experienced walkers, the 19 month-olds, were able to maneuver better. Among the babies who went naked or wore the thinner disposable diapers only four fell. Once they switched to the fuller cloth diapers, 8 fell. Both of the age groups took wider and shorter steps when wearing diapers as opposed to walking naked.

The study cannot predict if wearing diapers has any long-term impact, but it does suggests that giving baby a break from diaper wearing might speed up walking development.

Of course, that leaves a rather big problem… what to do about the mess that your baby makes when left to wander the house au naturel. By the way, fresh air on the hiney is also good to cut back on diaper rash, so if you’re inclined to give it a try – you might wait till after your baby has a bowel movement or has urinated and then let him or her walk a bit without a diaper.

I remember when my child was between one and two years old and learning to walk – it was an exercise in futility trying to keep clothes on her because she loved toddling around naked. She rarely had diaper rash and learned to walk pretty quickly. Of course, diapers are necessary and she wore her fair share, but when we had some time to relax and hang out together – off the diapers came. While I kept a close eye on her in case an “accident” should occur (actually there were only a few), she smiled, giggled and toddled around butt-naked while exploring her home.

The research was published in the journal of Developmental Science in September of 2012.

Source: Christie Nicholson,  http://www.scientificamerican.com/podcast/episode.cfm?id=diapers-hinder-walking-in-babies-13-01-23

Your Baby

Preemies: Sugar Water May Relieve Pain

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Premature infants have a fight on their hands from the moment they are born. Part of the battle includes painful medical procedures that are needed to help a preemie survive.

A new study suggests that something as common as a few drops of sugar-water along with comforting and reassuring holding can ease their pain.

The study took place in three NICUs in Swiss hospitals. Preemies were given either sugar water, held tightly, or given both when they had heel sticks to draw blood during their first two weeks in neonatal intensive care units. The babies who got both sugar and an embrace called facilitated tucking suffered the least, compared to babies who got just sugar or who were just held. 

The results are the latest in many studies that have shown that it is possible to relieve pain, even in the very young and fragile. Most preemies aren't good candidates for the pain relieving drugs used in older children and adults. So it's been a huge relief to parents to know that treatments without drugs can work.

Sugar water has been recommended since the late 1990s as the go-to intervention, and multiple studies have proven that it helps the most, even for babies who are in the NICU for months.

Giving sugar water during painful procedures is recommended by an international group of clinicians. Forms of touch usually give less relief than sugar. Using a pacifier with sugar helps best, according to a 2011 review of 44 studies by the Cochrane Collaboration. But not all preemies can manage a pacifier. Other effective ways to reduce pain are kangaroo care, in which a parent holds the baby against their chest skin while the procedure is performed, followed by swaddling or facilitated tucking. With facilitated tucking, the baby is held firmly so he or she can't flail arms and legs.

Given the results of the study, Denise Harrison, an assistant professor at the University of Ottawa School of Nursing, and who studies pain relief in preemies, believes it's time for all preemies to be given sugar with every painful procedure, as well as pacifiers and touch. But many preemies still aren't getting that simple help, she says.

"Parents should be aware of what they can do," Harrison says. That includes asking that their child be given sugar water, and holding their child as much as possible. "We're getting better at letting parents hold their babies, but we need to take that much more to the next step, and get parents to hold their babies for much longer periods."

Harrison also says that the benefits of sugar for pain relief are so clear that it was unethical of this new study to withhold it from the 24 babies who were only given facilitated tucking, especially since giving sucrose is the standard of care in the NICUs where the babies were treated. Giving the children small "rescue" doses of sucrose after the facilitated tucking would have let the scientists do their work while still letting the babies get the best standard of care, she says.

Source: http://www.npr.org/blogs/health/2012/01/09/144910916/a-little-sugar-and-...

Your Baby

Daydreaming Newborns?

Babies are born with an important collection of fully formed brain networks, including one linked to introspection, a new study shows.Ever wonder what’s going on in that tiny little newborn’s brain? According to a new study, he or she could be daydreaming about the future.

Babies are born with an important collection of fully formed brain networks, including one linked to introspection, a new study shows. The findings challenge previous ideas about early-stage brain development and activity. Scientists at the MRC Clinical Sciences Center at Imperial College London used functional MRI to examine the brains of 70 babies born at between 29 and 43 weeks. The scans showed that full-term babies have adult-equivalent resting state networks. These are connected systems of neurons that are always active, even when a person is not focusing on a particular task or is asleep. One fully formed resting state network identified in babies is called the default mode network, which is believed to be involved in introspection and daydreaming. Previous research had indicated this network was incomplete at birth and developed during early childhood. "Some researchers have said that the default mode network is responsible for introspection -- retrieving autobiographical memories and envisioning the future, etc. The fact that we found it in newborn babies suggests that either being a fetus is a lot more fun than any of us can remember -- lying there happily introspecting and thinking about the future -- or that this theory is mistaken," lead author David Edwards said in a news release from Imperial College London. "Our study shows that babies' brains are more fully formed than we thought. More generally, we sometimes expect to be able to explain the activity we can see on brain scans in terms of someone thinking or doing some task. However, most of the brain is probably engaged in activities of which we are completely unaware, and it is this complex background activity that we are detecting," Edwards said. The findings were released online Nov. 1 in advance of publication in an upcoming print issue of the Proceedings of the National Academy of Sciences. This hyperawareness comes with several benefits. For starters, it allows young children to figure out the world at an incredibly fast pace. Although babies are born utterly helpless, within a few years they've mastered everything from language - a toddler learns 10 new words every day - to complex motor skills such as walking. According to this new view of the baby brain, many of the mental traits that used to seem like developmental shortcomings, such as infants' inability to focus their attention, are actually crucial assets in the learning process. In fact, in some situations it might actually be better for adults to regress into a newborn state of mind. While maturity has its perks, it can also inhibit creativity and lead people to fixate on the wrong facts. When we need to sort through a lot of seemingly irrelevant information or create something completely new, thinking like a baby is our best option. "We've had this very misleading view of babies," says Alison Gopnik, a psychologist at the University of California, Berkeley, and author of the forthcoming book, "The Philosophical Baby." "The baby brain is perfectly designed for what it needs to do, which is learn about the world. There are times when having a fully developed brain can almost seem like an impediment." Gopnik argues that, in many respects, babies are more conscious than adults. She compares the experience of being a baby with that of watching a riveting movie, or being a tourist in a foreign city, where even the most mundane activities seem new and exciting. "For a baby, every day is like going to Paris for the first time," Gopnik says. "Just go for a walk with a 2-year-old. You'll quickly realize that they're seeing things you don't even notice."

Your Baby

Protect Your Child Against Whooping Cough

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Pertussis, often called whooping cough, is a common disease that peaks every 3 to 5 years. Because the disease is highly infectious, once an outbreak starts it can spread rapidly.  Before a vaccine was available, pertussis killed 5,000 to 10,000 people in the U.S. every year. Currently, documented cases are on the increase and Texas could see the highest number of recorded cases in 50 years.

The Texas Department of State Health Services has issued a health alert. Officials are urging people to make sure that their vaccinations and their children’s vaccination are up-to-date.

Whooping cough mainly affects infants younger than 6 months and kids 11-18 whose immunity has started to fade from earlier vaccinations.

The first symptoms are similar to those of the common cold. Children may experience a runny nose, sneezing, a mild cough and a low- grade fever. After about 1 to 2 weeks the dry cough evolves into a much harsher coughing spell that can last more than a minute. A child can turn red or purple from coughing so hard and may make the characteristic whooping sound when breathing in. Some children may actually vomit. Between coughing spells the child may look and feel okay.

Sometimes infants don’t cough or whoop like older kids do, but look as if they are gasping for air. Their face can turn red and they may actually stop breathing for a few seconds during a bad session.

The bacteria that causes pertussis is spread from person to person through tiny drops of fluid from an infected person's nose or mouth. These may become airborne when the person sneezes, coughs, or laughs. Adults and children become infected by inhaling the drops or getting the drops on their hands and then touching their mouths or noses. The time that someone is most contagious is during the earliest stages after the cough begins and continues for up to about 2 weeks.

Prevention begins with the pertussis vaccine. It’s part of the DTaP immunization that includes diphtheria, tetanus and acellular pertussis. The immunizations are routinely given in 5 doses before the child’s sixth birthday. The AAP recommends that kids ages 11 to 12 get a booster shot of the new combination vaccine, Tdap, to boost their immunity. Young adults entering college should also make sure that they are up-to-date on their pertussis vaccination. Crowded classrooms and dorms are the perfect breeding ground for contagious diseases. 

Infants younger than 2 months cannot be vaccinated. To help protect those babies the Centers for Disease Control and Prevention (CDC) recommends that pregnant women receive the pertussis vaccine between 27 and 36 weeks of gestation.

The name “whooping cough” sounds a little comical, but if you’ve ever witnessed a child in the throws of a pertussis coughing attack, it’s anything but funny. This disease can be fatal for little ones, so make sure you’re child is current on all of his or her DTap vaccinations and Tdap booster shots. If you are pregnant you can help protect your infant by getting the pertussis vaccination while you are carrying.

Research shows that adults and children who are not vaccinated are 8 times more likely to get whooping cough. Those that have received the vaccine may still get the disease but it tends to be less severe and doesn’t last quite as long.

Many of the cases in Texas are concentrated in the Fort Worth and Arlington area.  Statewide there have been 2 deaths, both were infants that were too young to recieve the vaccine. 

If your child has been diagnosed with whooping cough and is being treated at home, seek immediate medical care if he or she has difficulty breathing or shows signs of dehydration.

Sources: Gordon Dickson, http://www.star-telegram.com/2013/09/03/5130886/whooping-cough-outbreak-could.html

http://kidshealth.org/parent/infections/bacterial_viral/whooping_cough.html#

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