Your Child

Antibiotics Often Prescribed When Not Needed

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By now, most parents understand that antibiotics are not effective for viral infections, only for illnesses caused by bacteria.

However, that hasn’t deterred many physicians from over-prescribing antibiotics for children with ear and throat infections.

More than 11 million antibiotic prescriptions written each year for children and teens may be unnecessary, according to researchers from University of Washington and Seattle Children's Hospital. This excess antibiotic use not only fails to eradicate children's viral illnesses, researchers said, but also supports the dangerous evolution of bacteria toward antibiotic resistance.

"I think it's well-known that we prescribers overprescribe antibiotics, and our intent was to put a number on how often we're doing that," said study author Dr. Matthew Kronman, an assistant professor of infectious diseases at Seattle Children's Hospital.

"But as we found out, there's really been no change in this [situation] over the last decade," added Kronman. "And we don't have easily available tools in the real-world setting to discriminate between infections caused by bacteria or viruses."

 Doctors have limited resources when it comes to differentiating between bacterial or viral infections. Physicians can use the rapid step test to determine if the streptococcus bacteria is the cause of a child’s sore throat, but that is about it for immediate diagnostic tools.

Most colds are virus related and one of the first symptoms will be a sore or scratchy throat. It will typically go away after the first day or so and other cold symptoms will continue. Strep throat is often more severe and persistent.

A virus often causes ear infection as well. Many doctors treat ear infections as though they are bacterial to be on the safe side and avoid serious middle ear infections.

To determine antibiotic prescribing rates, Kronman and his colleagues analyzed a group of English-language studies published between 2000 and 2011 and data on children 18 and younger who were examined in outpatient clinics.

Based on the prevalence of bacteria in ear and throat infections and the introduction of a pneumococcal vaccine that prevents many bacterial infections, the researchers estimated that about 27 percent of U.S. children with infections of the ear, sinus area, throat or upper respiratory tract had illnesses caused by bacteria.

But antibiotics were prescribed for nearly 57 percent of doctors' visits for these infections, the study found.

Kronan hopes that the study’s results will encourage the development of more diagnostic tools and will spur doctors to think more critically about prescribing antibiotics unless clearly needed.

Previous research has shown that parents often pressure their doctor to prescribe an antibiotic to treat their child’s ear or sore throat symptoms. However, when parents are given other suggestions on how to alleviate the symptoms they have been much more receptive than when their doctor just flat out says he won’t prescribe antibiotics.

Many physicians and researchers are concerned that the amount of antibiotics being prescribed these days is setting us all up for future problems when dealing with bacterial infections. Bacteria are adaptable and mutate over time becoming less responsive to antibiotics. When possible, it’s much healthier in the long run to treat your child’s symptoms with simpler therapies. Ask your physican ways you can make your little one more comfortable until the symptoms pass. 

The study was published online in the journal Pediatrics.

Source: Maureen Salamon, http://consumer.healthday.com/infectious-disease-information-21/antibiotics-news-30/antibiotics-prescribed-twice-as-often-as-needed-in-children-study-says-691686.html

Your Child

Caregiving Tasks Are Too Much for Young Children

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It’s not uncommon for children of aging parents to feel overwhelmed by the responsibilities of caregiving. Studies have shown that the “sandwich generation” – adults trying to raise a family while caring for their parents – is just about stretched to their limits dealing with stress and economic struggles.

While adults may be having a hard time figuring out how to juggle all the demands on their time and resources, a new study looks at the impact on children who have had to take on a similar role as a caregiver.

An astounding 1.3 million American children and teens are caring for family members with physical or mental illness or substance abuse problems, and these children are at risk for poor health and school failure themselves according to the study.

This "hidden population" of young caregivers suffers physical and emotional stress due to their caregiving duties, wrote study author Dr. Julia Belkowitz, an assistant professor of pediatrics at the University of Miami Miller School of Medicine.

For this study, Belkowitz and her team studied youth caregivers in Palm Beach County, Florida.

Interestingly, the group of children mirrored the adult population of caregivers, with more females carrying the load than males. The average age was 12 years old, with 63 percent being girls and 37 percent boys.

When surveyed, the children reported that they spent an average of two hours each school day and four hours each weekend day doing caregiver tasks at home. Their family members said the children spent less than that amount of time caregiving. They estimated the children spent 1.5 hours a day on weekdays and 2.75 hours a day on weekends doing caregiver tasks.

The children’s tasks included helping family members with getting around, eating, dressing, bathing, using the toilet, and continence care. The youth caregivers also kept the family members company and offered emotional support, gave medications, translated during medical visits, handled medical equipment at home, cleaned the house and did grocery shopping.

"This study is an important step toward raising awareness about the issue of caregiving youth," Belkowitz said.

She and her colleagues worked on the study with the American Association of Caregiving Youth (AACY).

"Today in the U.S., there are many more than the 1.3 million children identified in 2005 who face the challenges of juggling adult-sized responsibilities of caring for ill, injured, aging or disabled family members while trying to keep up at school," Connie Siskowski, founder and president of AACY, said in the news release.

For many families, asking young children to help with caregiving may seem like the only option. This is particularly true for single parent families with no relatives nearby or two parent families that each have demanding or time consuming jobs. However, young caregivers pay a high price when asked to take over adult responsibilities. They may take extra time off from school, feel tired or overly stressed and not take the time to be with friends in an environment where they can just be kids or teens.

Parents needing caregiver help should look to other resources for assistance. While a parent might be reluctant to ask for help – fearing that certain services might try to interfere - it might be the only way to make life easier for you and your family.

The website www.aacy.org offers this advice: “If you want advice that is guaranteed to be private, use an anonymous telephone helpline or search for advice on the internet. Remember, most services and organizations that help people will only consider breaking confidentiality if they think it is the only way to keep someone safe. The Data Protection Act says that they must keep your personal information private unless you give them permission to share it or there is a very good reason for sharing it, such as keeping someone safe from harm.

If you have a disability, illness or substance misuse problem, you may be able to get an assessment of your needs from a social worker. An assessment is not a test of whether you are a good parent or not, it is a way of finding out what you and your family need to stay well. During an assessment, a social worker or sometimes a health worker will talk to you in private about your health problem and what help you need.”

This study was presented recently at an American Academy of Pediatrics meeting in San Diego. Research presented at meetings should be viewed as preliminary until published in a peer-reviewed journal.

Sources: Robert Preidt, http://consumer.healthday.com/senior-citizen-information-31/caregiving-news-728/young-caregivers-at-risk-for-failing-in-school-study-shows-692430.html

http://www.aacy.org

Your Child

Vaccine Proves Effective Against “Superbugs”

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A new study takes a deeper look at the benefits of the pneumococcal vaccine for children. The vaccine helps children avoid the suffering and danger of ear infections, meningitis and pneumonia.

The vaccine was first used in children in 2010. In this study, researchers found that not only are vaccinated children experiencing fewer infections, but they may also be protected from antibiotic-resistant “superbugs.”

Since the vaccine has been in use, it has been associated with a 62 percent reduction of drug-resistant infections of bacterial pneumonia, meningitis and bloodstream infections for children under 5.

"The vaccine is an important tool against antibiotic resistance," said lead researcher Sara Tomczyk, an epidemic intelligence service officer in the Respiratory Diseases Branch of the U.S. Centers for Disease Control and Prevention.

"Along with appropriate antibiotic use, it is part of the solution to protecting ourselves against the growing threat of antibiotic resistance," she added.

As more and more adults and children overuse antibiotics, antibiotic-resistant bacteria become especially worrisome. Traditional drugs used to treat infections begin to have little effect on the bacteria. These “superbugs” can produce uncontrollable infection that can lead to death.

The good news is that the pneumococcal vaccine may have lessened the danger. According to Tomczyk, more than 4,400 cases of antibiotic-resistant, invasive pneumococcal disease were prevented between 2010 and 2013.

"Not only does this vaccine prevent pneumococcal infection, which means fewer antibiotics are prescribed, but it also prevents antibiotic-resistant infections," she added.

Although we’re not at 100 percent compliance, 85 percent of U.S. children are receiving the vaccine. Pneumococcal conjugate vaccine is given in four doses, at 2, 4 and 6 months of age and at 12 through 15 months.

Tomczyk said the vaccine has been so effective that the U.S. government's Healthy People 2020 goal of reducing bacteria-resistant pneumococcal disease from 9.3 to 6 cases per 100,000 children was achieved nine years early and has since dropped to 3.5 cases per 100,000.

The vaccine is not only recommended for children, but adults as well. One dose is recommended for all adults 65 and older, followed by a dose of the pneumococcal polysaccharide vaccine six to 12 months later.

There are more than 90 types of pneumococcal bacteria. The pneumococcal conjugate vaccine protects against 13 of the most common severe pneumococcal infections among children, while the pneumococcal polysaccharide vaccine protects against 23 types of pneumococcal bacteria, including those most likely to cause serious disease, which is why both are recommended for older adults.

Dr. Adriana Cadilla, a pediatrician at Miami Children's Hospital, said, "It's wonderful news that we have proof that the vaccine works as well as it does."

It has clearly reduced antibiotic-resistant pneumococcal disease, she added. "It seems to be doing a great job. It is something parents should make sure their children have."

The pneumococcal vaccine is currently recommended for all children age 5 and younger. Pneumococcal bacteria can cause ear infections, pneumonia and meningitis. It is the most common vaccine-preventable bacterial cause of death, the researchers noted.

Source: Steven Reinberg, http://www.webmd.com/children/vaccines/news/20141010/common-childhood-vaccine-cuts-superbug-infection-study?

Your Child

Reducing the Spread of Enterovirus-D68 in Children

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While the first case of Ebola in the U.S. has captured the headlines, another virus that is actually having an impact on our kids, is picking up steam across the country.

43 states and the District of Columbia have reported over 500 confirmed cases of Enterovirus-D68 (EV-D68).

The virus was first isolated in1962 in California and had been considered a rather rare virus with only small pockets of cases reported regularly to the CDC since 1987. However, this year the number of cases is increasing rapidly

There has been one confirmed death from the virus: a four year-old boy from New Jersey. Four other deaths have been linked to EV-D68, but it’s still unclear whether the children actually died from the virus or whether there was an underlying condition that caused their death.

One thing the experts agree on is that the number of cases this year is higher and more severe than in other years. Health officials are also trying to determine if the virus is associated with cases of muscle weakness or paralysis that have struck 10 children in the Denver area. Similar cases have been reported in Massachusetts, Michigan and Missouri.

Infants, children and teenagers are the most likely to become infected with the enterovirus. It’s spread like any other virus; an infected person sneezes, coughs or touches a surface.

Doctors want parents to know that children with asthma or breathing problems are at risk for the more severe symptoms from EV-D68.

"Children with pre-existing lung conditions, such as asthma, appear to be at the greatest risk for severe symptoms from this virus. Most EV-D68 infected children recover without serious illness," Dr. Albert Rizzo, senior medical advisor at the American Lung Association, said in a news release.

Most children will recover from EV-D68 just as they would from any other cold-related virus, but there are symptoms- that if present- need immediate attention.

"It is important for parents to understand that children with this infection who have asthma or a history of wheezing episodes are at higher risk for increased symptoms of shortness of breath and wheezing and are more likely to need specific treatment to address this problem. This means quick contact with their pediatrician or family doctor and even a trip to the emergency room, or a call to 911 is appropriate if respiratory distress is present," Rizzo advised.

At this time there is no vaccine for EV-D68, but there are actions that adults and children can take to help prevent infection. They are:

·      Washing hands often with soap and water, for 20 seconds each time.

·      Not touching your eyes, nose and mouth with unwashed hands.

·      Avoiding contact such as kissing, hugging or sharing eating utensils or cups and glasses with people who are sick.

·      Disinfecting frequently touched surfaces such as toys and doorknobs, especially if someone is sick.

You can also check with your child’s school or daycare center about what actions are being taken to help prevent the spread of colds and viruses.

Earlier in the virus season, there was not as much concern about EV-D68 in the medical community because it was considered a rare virus that would likely be contained, just like in past years. However, this year is proving to be different than expected and doctors are now warning parents to keep a closer eye on their children’s symptoms if they are sick, especially if any breathing difficulties arise. It’s much better to get checked out as far as this virus is concerned.

Source: Robert Preidt, http://consumer.healthday.com/respiratory-and-allergy-information-2/asthma-news-47/experts-give-advice-on-respiratory-virus-that-has-struck-kids-across-the-u-s-692372.html

http://www.cdc.gov/non-polio-enterovirus/about/EV-D68.html

Your Child

Parents Beware! Ads for Concussion Supplements

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Dietary supplement companies are tuned into the concerns parents have about their children and sports related concussions. They often promise that their supplements provide faster brain healing and less time spent away from sport activities.

The U.S. Food and Drug Administration warns that dietary supplements that claim to prevent, treat or cure concussions are untested, unproven and possibly dangerous.

The agency said in a news release that companies attempting to exploit parents’ increasing concerns about concussions often sell their products on the Internet and in stores.

The products are also being marketed on social media sites.

One common misleading claim is that these dietary supplements promote faster brain healing after a concussion. Even if some of these products don't contain harmful ingredients, the claim itself can be dangerous, explained Gary Coody, National Health Fraud Coordinator at the FDA.

"We're very concerned that false assurances of faster recovery will convince athletes of all ages, coaches and even parents that someone suffering from a concussion is ready to resume activities before they are really ready," he said in the news release.

"Also, watch for claims that these products can prevent or lessen the severity of concussions or [traumatic brain injuries]," he added.

Many concussions occur during the time that kids are playing fall sports. Right now is the prime marketing time for these types of products and the FDA wants parents to be aware that replacing medical advice with supplements could lead to serious health problems for their children.

Head injuries require proper diagnosis, treatment and monitoring by a medical professional, the FDA stressed. There is mounting evidence that if concussion patients resume playing sports too soon, they're at increased risk for another concussion.

If a child is on the field and playing too soon after a concussion, repeat concussions are more likely to occur. Repeat concussions can lead to severe problems such as brain swelling, permanent brain damage, long-term disability and death.

"There is simply no scientific evidence to support the use of any dietary supplement for the prevention of concussions or the reduction of post-concussion symptoms that would allow athletes to return to play sooner," Charlotte Christin, acting director of the FDA's division of dietary supplement programs, said in the news release.

Many of the dietary supplements boast omega-3 fatty acids from fish oils and spices, such as turmeric, as their “secret weapon”. While these products may be beneficial for some heath concerns, the FDA wants parents to know that they are not helpful as far as concussions are concerned.

Two companies making false claims about their products changed their websites and labeling after the FDA sent them warning letters in 2012. The FDA issued a warning letter in 2013 to a third company that was doing the same.

"As we continue to work on this problem, we can't guarantee you won't see a claim about [traumatic brain injuries]," Coody said. "But we can promise you this: There is no dietary supplement that has been shown to prevent or treat them. If someone tells you otherwise, walk away."

Source: http://consumer.healthday.com/cognitive-health-information-26/concussions-news-733/concussion-products-fda-release-691109.html

Your Child

Water Safety Tips

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It’s not quite summer yet, but families are already enjoying time spent in pools and lakes. Every year when water activties increase we hear the sad news of someone's loved one drowning. There are safegueards people can take to make swimming and playing in the water safer and it's always appropriate to review them once again as the season begins. 

The American Academy of Pediatrics (AAP) has created a list of precautions to help keep children safe when they are playing near or in water.

Do swimming lessons for children 4 and under help prevent drowning?

Some parents believe that starting their toddler (or infant) with swimming lessons will give them an advantage if they somehow find themselves in water over their head. The AAP used to not recommend swimming lessons for children one to three years of age because there was little evidence that lessons prevented drowning or resulted in better swim skills. There was also concern that parents or guardians would become less vigilant about supervising a child who had learned some swimming skills.

However, small studies have shown that children who develop swimming skills at this age are less likely to drown. The studies don’t define what type of lessons work best, so the AAP is not recommending mandatory swim lessons for all children ages 1 to 4 at this time. Instead, the new guidance recommends that parents should decide whether to enroll an individual child in swim lessons based on the child’s frequency of exposure to water, emotional development, physical abilities, and certain health conditions related to pool water infections and pool chemicals.

The AAP does not recommend formal swimming lessons for children under the age of one.

If you do enroll your child in swimming lessons, make sure that pool safety guidelines set by the YMCA are used.

The AAP recommends these 12 safety rules for parents, guardians and children when they are around water:

  1. Be aware of small bodies of water your child might encounter, such as bathtubs, fishponds, ditches, fountains, rain barrels, creeks, watering cans—even the bucket you use when you wash the car. Empty containers of water when you’re done using them. Children are drawn to places and things like these and need constant supervision to be sure they don’t fall in.
  2. An adult, preferably one who knows CPR, should always be near and watch children who are swimming, even in a shallow toddler’s pool. The adult should be within arm’s length, providing “touch supervision” whenever infants, toddlers, or young children are in or around water. Empty and put away inflatable pools after each play session.
  3. Enforce safety rules: No running near the pool and no pushing others underwater.
  4. Don’t allow your child to use inflatable toys or mattresses in place of a life jacket. These toys may deflate suddenly, or your child may slip off them into water that is too deep for him or her.
  5. Be sure the deep and shallow ends of any pool your child swims in are clearly marked. Never allow a child to dive into the shallow end.
  6. Backyard swimming pools, (including large, inflatable above-ground pools), should be completely surrounded with at least a 4-foot (1.2 meters) high fence that completely separates the pool from the house. The fence should have a self-closing and self-latching gate that opens away from the pool, with the latch at least 54 inches high. Check the gate frequently to be sure it is in good working order. Keep the gate closed and locked at all times. Be sure your child cannot manipulate the lock or climb the fence. No opening under the fence or between uprights should be more than 4 inches (10 cm) wide. Keep toys out of the pool area when not in use so that children are not tempted to try to get through the fence.
  7. If your pool has a cover, remove it completely before swimming. Also, never allow your child to walk on the pool cover; water may have accumulated on it, making it as dangerous as the pool itself. Your child also could fall through and become trapped underneath. Do not use a pool cover in place of a four-sided fence because it is not likely to be used appropriately and consistently.
  8. Keep a safety ring with a rope beside the pool at all times. If possible, have a phone in the pool area with emergency numbers clearly marked.
  9. Spas and hot tubs are dangerous for young children, who can easily drown or become overheated in them. Don’t allow young children to use these facilities.
  10. Your child should always wear a life jacket when he swims or rides in a boat. A life jacket fits properly if you can’t lift it off over your child’s head after he’s been fastened into it. For the child under age five, it also should have a flotation collar to keep the head upright and the face out of the water.
  11. Adults should not drink alcohol when they are swimming or boating. It presents a danger for them as well as for any children they might be supervising. According to the Centers for Disease Control and Prevention, 70% of boating fatalities are alcohol related.
  12. Be sure to eliminate distractions while children are in the water. Talking on the phone, working on the computer, and other tasks need to wait until children are out of the water. 

Drowning ranks fifth among the leading causes of unintentional injury death in the United States. About one in five people who die from drowning are children 14 and younger. For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.

These statistics are not meant to scare you into not allowing your child to enjoy the benefits and fun of swimming. Swimming is great exercise and really enjoyable, particularly on a hot summer day. It’s also a great family activity. These stats are to remind you that extra precautions and serious attention needs to be given when children are around water, so that fun doesn’t turn into tragedy.

Source: http://www.healthychildren.org/English/safety-prevention/at-play/Pages/Water-Safety-And-Young-Children.aspx

http://www.cdc.gov/homeandrecreationalsafety/water-safety/waterinjuries-factsheet.html

Your Child

Preschoolers and Depression

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Should preschoolers be screened for depression? A new study says that children ages 3 to 5 years old can definitely suffer from depression, but screening may not help because there is no recognized treatment for kids that age.

The research team from Washington University in St. Louis, found that not only are some preschoolers experiencing depression, but those that do are two and a half times more likely to continue to have bouts of the disorder in elementary and middle school.

They also added that recognizing depression in young children could help make treatment more effective later. 

"It's the same old bad news about depression; it is a chronic and recurrent disorder," child psychiatrist Dr. Joan Luby, who directs the university's Early Emotional Development Program, said in a university news release.

"But the good news is that if we can identify depression early, perhaps we have a window of opportunity to treat it more effectively," Luby said. That could "potentially change the trajectory of the illness so that it is less likely to be chronic and recurring," she added.

The study involved 246 preschool children, ranging from ages 3 to 5 years old. The team evaluated the children for depression and other psychiatric conditions over time.

The children and their caregivers participated in six yearly assessments as well as four semiannual assessments. Specifically, the caregivers were asked about their child's sadness, irritability, guilt, sleep and appetite, as well as reduced enjoyment in activities or playtime.

The researchers also evaluated interactions between the caregivers and their children through a two-way mirror. This was done to determine if part of the reason why children had ongoing symptoms of depression was because they lacked nurturing by their parents.

When the study began, 74 children were diagnosed with depression. Six years later, 79 of the children met the criteria for clinical depression, including about half of the 74 kids originally diagnosed.

On the other hand, just 24 percent of the remaining 172 children that were not diagnosed with depression, went on to develop depression later.

The study also noted that the children at highest risk for depression were school-age youngsters whose mothers had suffered from depression.

Mothers appeared to play a very important role in the child’s development. Being diagnosed with a conduct disorder while in preschool also boosted a child's risk for depression later on in elementary or middle school. However, this risk was reduced if children had a lot of support from their mother, the researchers noted.

The big-take-away from the study was that the risk for depression was greatest for the kids who were diagnosed with the condition while they were in preschool, Luby’s team reported.

"Preschool depression predicted school-age depression over and above any of the other well-established risk factors," Luby said. "Those children appear to be on a trajectory for depression that's independent of other psychosocial variables."

The researchers believe that preschoolers as young as 3 years old should be regularly screened for depression. But they also understand why that can be a problem since there are no effective treatments for young children, they noted.

"The reason it hasn't yet become a huge call to action is because we don't yet have any proven, effective treatments for depressed preschoolers," Luby explained. "Pediatricians don't usually want to screen for a condition if they can't then refer patients to someone who can help."

If you suspect your preschooler may be depressed, or would like to know the symptoms of child depression, talk with your pediatrician or family doctor to learn more about it. If you have a family history of depression, mention this to your pediatrician or family doctor so they can help you keep an eye on any symptoms that may begin to pop-up with your little one.

Source: Mary Elizabeth Dallas, http://consumer.healthday.com/mental-health-information-25/depression-news-176/preschoolers-can-suffer-depression-too-690255.html

Your Child

Study: Obesity May Be Set By Age 5

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A new study says that children who are overweight at the age of five are four times more likely to be obese by age fourteen than five-year-olds who are at a healthy weight.

The new data came from the Early Childhood Longitudinal Study conducted by the U.S. National Center for Education Statistics. The study involved 8000 children whose height and weight were tracked seven times between 1998, when they were in kindergarten, to 2007.

Overall, 27 percent of kids in the study were overweight or obese when they started school and that ratio increased to 38 percent by eighth grade.

"Half of childhood obesity occurred among children who had become overweight during the preschool years," researchers led by Solveig Cunningham of Emory University in Atlanta wrote.

"If we're just focused on improving weight when kids are adolescents, it may not have as much of an impact as focusing on the preschool-age years," Cunningham told Reuters Health. The study "doesn't tell us what to do about it, but it helps tell us when we need to think creatively about what to do."

Research has shown that the rate of childhood obesity rose from about 4 percent in the early 1960s to more than 15 percent by 2000. Most of that research was done in adolescents.

"However, since many of the processes leading to obesity start early in life, data with respect to incidence before adolescence are needed," the researchers noted in the New England Journal of Medicine.

Interestingly, the obesity rate rose rapidly between first and third grade, from 13 percent to almost 19 percent. Between fifth and eighth grades, the rate didn’t increase significantly.

About 32 percent of kids who were overweight when they entered kindergarten had become obese by age 14. That compared to 8 percent of normal-weight kindergarteners.

Not all of the healthy weight five-years-old, continued to maintain a normal weight by the time they were teens, "Half of obese eighth graders do start out at normal weight," Cunningham said.

Other studies have said a child’s chances of becoming overweight or obese may start as early as babyhood.

While roughly 11 percent of babies born weighing 8.8 pounds or less were obese by kindergarten, the rate was almost 23 percent for those born weighing more. By eighth grade, about 20 percent of children born with low or normal weights were obese and just over 31 percent of children with high birth weights were obese.

Experts say that the best thing that parents can do is to feed their kids in a healthy way from birth throughout their childhood. And of course, be a good example of someone who has a sensible relationship with food and lives a healthy lifestyle.

Source: Gene Emery, http://www.reuters.com/article/2014/01/29/us-overweight-idUSBREA0S23V20140129

Your Child

Severe Obesity On the Rise in U.S. Kids

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In February of this year, the Journal of the American Medical Association (JAMA) published the results of a study that looked at whether the obesity rate in U.S. children was increasing, decreasing or holding steady. They found encouraging news that the obesity in preschoolers was on the decline and the percentage of obesity in older children was not increasing. That seemed to be very good news indeed.

However, a new study using the same data as the previous study-only extending the years investigated-has more sobering results. Extreme obesity among U.S. kids is on the rise.

"We found that the number of extremely obese kids seems to be increasing," said lead researcher Asheley Cockrell Skinner, an assistant professor of pediatrics at the University of North Carolina. "This is particularly true for school-age girls and teenage boys."

For the new report, published online in the journal JAMA Pediatrics, Skinner and a colleague used the same National Health and Nutrition Examination Survey data as the CDC researchers, but extended their research from 1999 to 2012.

"When extending the data out to 14 years, we see there isn't really a decline. We need to be cautious about reports that say obesity is declining and assume things are better." Skinner noted.

Categories of obesity are based on a child's height and weight in relation to their peers. A 10-year-old boy who is 4 feet, 6 inches tall and weighs 95 pounds is considered obese, according to Dr. David Katz, director of the Yale University Prevention Research Center. At 130 pounds, that boy would be severely obese.

"This paper will come as a sobering reality check for any who believed the recent headlines about childhood obesity rates plummeting," he said.

Severe obesity in children is rising, he said, adding that this is a critical piece of information.

"Severe obesity is much more likely to induce serious chronic disease and steal years from life," Katz said. "It calls out for clinical interventions, up to and including weight-loss surgery."

For the new study, Skinner's team examined data on nearly 26,700 children ages 2 to 19 years old. For the years 2011-12, they found 32 percent of America's children were overweight and 17 percent were obese. Among obese kids, 8 percent were severely obese, the researchers said.

When specific categories of obesity were examined, more bad news emerged. Among girls, the researchers found obesity rates jumped from 14.5 percent in 1999-2000 to 17.4 percent by 2011-12. And severe obesity among girls climbed from 0.9 percent in 1999-2000 to 2.3 percent by 2011-12.

In boys, obesity rose from 14.6 percent in 1999-2000 to 17.2 percent by 2011-12, while severe obesity grew from 1 percent to 2 percent.

A second study published in JAMA Pediatrics, analyzed the additional costs associated with childhood obesity. The report suggested that, over the course of a lifetime, higher medical costs with severely obese children increased about $19,000 per person. A child in the normal weight range, who becomes overweight or obese in adulthood, could expect an extra increase of about $12,900 per person for medical costs.

"To put these findings in perspective, multiplying the lifetime medical cost estimate of $19,000 times the number of obese 10-year-olds today generates a total direct medical cost of obesity of roughly $14 billion for this age alone," wrote Eric Andrew Finklestein, PhD, from the Duke Global Health Institute at Duke University, and colleagues.

Authors who conducted the study on the rise of severe obesity in kids noted that more research is needed to determine which public health programs, if any, are helpful in preventing obesity.

Obesity in children is linked to a number of medical conditions such as high cholesterol, high blood pressure, early heart disease, diabetes, bone problems and skin conditions such as heat rash, fungal infections and acne. According to the CDC, obese children tend to become obese adults and are more risk for heart disease, type 2 diabetes, stroke, several types of cancer and osteoporosis.

Weight is a touchy subject in our culture. Nobody likes the word obese. But medically speaking, it’s a reality that too many of our children are overweight, obese and severely obese. Parents are the key in helping their children get their weight under control. It doesn’t mean that every child has to be skinny or even what is considered normal weight for his or her height and age. But they should be close to a healthy weight.  Children without a medical condition ought to be able to run, skip, walk and play without being exhausted or gasping for air after a few minutes. 

If you are unsure whether your child is at a normal weight, underweight, overweight or possibly obese, talk to your family doctor or pediatrician. Calculating the body-mass-index (BMI) for children is different than for adults. Your child’s doctor should be able to help you determine your child’s BMI and recommend a nutritional diet and exercise plan for your child and family.

Sources: http://health.usnews.com/health-news/articles/2014/04/07/more-us-children-severely-obese-study-says

Salynn Boyles, http://www.medpagetoday.com/Endocrinology/Obesity/45150

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DR SUE'S DAILY DOSE

Facts not fear when it comes to Ebola.