Pediatrics

• Breastfeeding
• Child-Adolescent Nutrition and Overweight
• Diagnosis, Imaging, Screening
• Diseases and Conditions
• General Information
• Guidelines
• Internet Sites
• Immunization
• Infant Nutrition
• Risk Factors
• Risk Reduction
• SIDS (Sudden Infant Death Syndrome)
• Treatment

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REVIEW our Selected Pediatric Articles in 2007. Stay informed and updated!

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Breastfeeding

NIH – Breastfeeding (Medical Encyclopedia) “Recommendations: Choosing how and what to feed your baby is a personal decision that deserves careful and thorough consideration. Breast milk is the natural nutritional source for infants less than one year of age. Most health care professionals (including the American Academy of Pediatricians and the National Association of Pediatric Nurse Associates and Practitioners) recommend breastfeeding for your baby's first year. Breast milk is the best source of nutrition for the first 6 months of life. It contains appropriate amounts of carbohydrate, protein, and fat, and provides digestive enzymes, minerals, vitamins, and hormones that infants require. Breast milk also contains antibodies from the mother that can help the baby resist infections. Experts agree that breastfeeding your baby for any length of time, regardless of how short, is of benefit to you and your baby. You can provide your baby with breast milk directly by breastfeeding or by feeding your baby breast milk from a bottle. ... ADVANTAGES OF BREASTFEEDING Research shows that breastfed babies may have less frequent: • Ear infections • Stomach or intestinal infections • Low iron levels in the blood (iron-deficiency anemia) • Skin diseases (infantile eczema) • Infant allergies Breastfed babies may have less risk of developing: • Digestive problems such as constipation or diarrhea • Obesity or becoming overweight • High blood pressure • Diabetes • Tooth decay”

NIH – Breastfeeding “What are the benefits of breastfeeding? Breastfeeding offers many benefits to the baby: Breast milk provides the right balance of nutrients to help an infant grow into a strong and healthy toddler. Breastfed infants, and those who are fed expressed breast milk, have fewer deaths during the first year and experience fewer illnesses than babies fed formula. Some of the nutrients in breast milk also help protect an infant against some common childhood illnesses and infections, such as diarrhea, middle ear infections, and certain lung infections. Some recent NICHD-supported research also suggests that breast milk contains important fatty acids (building blocks) that help an infant's brain develop. Two specific fatty acids, known as DHA and AA, may help increase infants’ cognitive skills. Many types of infant formulas available in the United States are fortified with DHA and AA, and all formula available for preterm infants is fortified with these fatty acids.”

NHS - Breast-feeding (Video)

Highlighted Articles

Breastfeeding and Child Cognitive Development (Arch Gen Psychiatry. 2008) “Conclusion These results, based on the largest randomized trial ever conducted in the area of human lactation, provide strong evidence that prolonged and exclusive breastfeeding improves children's cognitive development.”

Advances in our understanding of the biology of human milk and its effects on the offspring. (J Nutr. 2007) "The most important short-term immunological benefit of breast-feeding is the protection against infectious diseases. There is also some evidence of lower prevalence of inflammatory bowel diseases, childhood cancers, and type I diabetes in breast-fed infants, suggesting that breast-feeding influences the development of the infant's own immune system. One of the most consistent findings of breast-feeding is a positive effect on later intelligence tests with a few test points advantage for breast-fed infants."

Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations? (Am J Clin Nutr. 2007) "That review concluded that infants exclusively breastfed for 6 mo experienced less morbidity from gastrointestinal infection and showed no deficits in growth but that large randomized trials are required to rule out small adverse effects on growth and the development of iron deficiency in susceptible infants. Others have raised concerns that the evidence is insufficient to confidently recommend exclusive breastfeeding for 6 mo for infants in developed countries, that breast milk may not meet the full energy requirements of the average infant at 6 mo of age, and that estimates of the proportion of exclusively breastfed infants at risk of specific nutritional deficiencies are not available. Additionally, virtually no data are available to form evidence-based recommendations for the introduction of solids in formula-fed infants. Given increasing evidence that early nutrition and growth have effects on both short- and longer-term health, it is vital that this issue be investigated in high-quality randomized studies."

Immunization

NIH - Immunizations - general overview (Medical Encyclopedia) “IMMUNIZING CHILDREN: Babies get so many shots these days! Many parents are concerned that the sheer number of vaccines might overwhelm, weaken, or use up a baby's immature immune system. But a baby's immune system is built to make antibodies to as many as 10,000 foreign proteins. If a baby were to receive all 11 available vaccines at once, this would engage only a tiny fraction of the immune system. … IMMUNIZATION SCHEDULE The recommended immunization schedule is updated at least every 12 months by organizations such as the American Academy of Pediatrics. Consult your primary care provider about specific immunizations for you or your child. The current recommendations are available on the Centers for Disease Control and Prevention (CDC) website at www.cdc.gov/vaccines. At every doctor visit, ask about the next recommended immunizations.”

NIH - Childhood Immunization “Vaccines help make you immune to serious diseases without getting sick first. Without a vaccine, you must actually get a disease in order to become immune to the germ that causes it. Vaccines work best when they are given at certain ages. For example, children don't receive measles vaccine until they are at least one year old. If it is given earlier it might not work as well.”

CDC - Recommended Immunization Schedules for Persons Aged 0--18 Years --- United States, 2008

CDC - Immunization Schedules (USA)

Childhood Vaccines: What They Are and Why Your Child Needs Them “Are there any reasons my child should not be vaccinated? In some special situations, children shouldn't be vaccinated. For example, some vaccines shouldn't be given to children who have certain types of cancer or certain diseases, or who are taking drugs that lower the body's ability to resist infection. The MMR vaccine shouldn't be given to children who have a serious allergy to eggs. If your child has had a serious reaction to the first shot in a series of shots, your family doctor will probably talk with you about the pros and cons of giving him or her the rest of the shots in the series. Talk to your doctor if you have any questions about whether your child should receive a vaccine.”

CDC - Common Questions Parents Ask about Infant Immunizations

NHS – Childhood immunisations (UK) “Childhood immunisation prevents a large variety of diseases. These include: Tetanus. An infection found in the soil that causes severe muscle contractions and breathing difficulties. Polio (short for poliomyelitis). A virus that first attacks the gut (bowel) but then travels to the nervous system. Polio can cause paralysis (when you can't move your limbs) in one or more parts of your body. Pneumococcal infections. These can affect anyone, but young children are at an increased risk of developing serious complications such as meningitis. Diphtheria. A highly contagious disease caused by a bacterium called Corynebacterium diphtheriae. It causes a serious throat and chest infection. Meningitis C. Caused by the meningococcus group c bacterium. In rare cases it can lead to blood poisoning and serious types of meningitis. Hib (full name is haemophilus influenzae type b). A bacterium that can cause pneumonia and meningitis. Whooping cough (pertussis) - causes prolonged coughing that can be very distressing. In children, complications can include brain damage. Measles. Caused by the measles virus and can result in a serious fever and rash. In severe cases, measles can be fatal. Mumps. Caused by the mumps virus. Mumps usually leads to inflammation and swelling of the salivary glands (the glands located just below the ears). In severe cases this can cause deafness. Rubella (also know as German measles). Caused by the rubella virus and can lead to a mild illness and rash. In later life rubella can be serious to an unborn child as it can potentially lead to several birth defects. Other immunisations Some children may require additional immunisations that are not part of the childhood immunisation programme. Your GP will be able to advise you if your child requires any further immunisations. These may include immunisations if your child has a chronic condition.”

Highlighted Article

Thimerosal exposure in infants and neurodevelopmental disorders: An assessment of computerized medical records in the Vaccine Safety Datalink. (J Neurol Sci. 2008) “Routine childhood vaccination should be continued to help reduce the morbidity and mortality associated with infectious diseases, but efforts should be undertaken to remove Hg from vaccines.”

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Pediatrics

Risk Factors

NEWS:

Baby Products Study Raises Safety Concerns “Babies don't usually need special lotions and powders, and water alone or shampoo in very small amounts is generally enough to clean infant hair, Sathyanarayana said. Concerned parents can seek products labeled "phthalate-free," or check labels for common phthalates, including DEP and DEHP. But the chemicals often don't appear on product labels. That's because retail products aren't required to list individual ingredients of fragrances, which are a common phthalate source.”

California Sues Baby Furniture Manufacturers: Dangerous levels of formaldehyde in cribs, changing tables, state charges “California Attorney General Edmund G. Brown Jr. has sued five baby furniture manufacturers for failing to warn consumers about the dangerous levels of formaldehyde gas emitted by their products, including cribs and changing tables. “We’re suing these companies because parents deserve to know if there’s a dangerous chemical in products for children,” Brown said. “Over the past two years, we’ve brought other actions to ensure the safety of children’s products, such as lead in toys and phthalates in baby bibs. "Increasingly, the wood and other materials in consumer products are produced globally, and the lack of tough safeguards and strict enforcement can lead to dangerous levels of exposure,” Brown added.“

Canada Takes Steps to Ban Most Plastic Baby Bottles“The Canadian government moved Friday to ban polycarbonate infant bottles, the most popular variety on the market, after it officially declared one of their chemical ingredients toxic.”

CDC: Watch Out for Pool Parasites

China child-killing virus may be yet to peak: WHO “An outbreak of a virus that has killed dozens of children across China may be yet to reach its peak, but will not threaten Beijing's Olympic Games in August, the World Health Organisation (WHO) said on Monday. Health authorities in China have been battling to contain EV71, an intestinal virus that has killed 22 children in Fuyang, a city in China's eastern Anhui province, and caused at least two deaths in southern Guangdong province. EV71 has also been traced in outbreaks of hand, foot and mouth disease (HFMD) in Hunan, Jiangsu and Zhejiang provinces that have infected thousands of children across China. HFMD is a common disease in children and infants and outbreaks regularly occur in China without deaths. But HFMD caused by EV71 can cause viral meningitis and deaths, according to the U.S. National Centre for Infectious Diseases. At least two other children have died of HFMD, but authorities have not confirmed any link to the EV71 virus.“

Chronic lead poisoning from urban soils“"These national numbers for chronic lead poisoning are staggering but the percentage of affected children in older urban areas is much much higher than in rural areas or newer cities. The blowing soil and dust young children ingest contains large amount of lead from lead paint and leaded gasoline deposited decades ago, and from industrial contamination. In Indianapolis, we found high levels of soil contamination. Many older urban centers, have lead poisoning rates that are 5 to10 times the national average." said Filippelli, who is a biogeochemist studying environmental contamination of heavy metals and its effects on children's health. Going into neighborhoods where yards are dirt rather than grass-covered and spraying clean water with high power shower systems when tests show that soil moisture is low (usually mid-July to mid-September in Indianapolis, for example), would significantly decrease the chronic lead poisoning in children, according to Filippelli. Since contaminated dirt blows from one property to another, this cannot be done on a house by house basis but must be carried out on a regional basis. … Young children, especially those who crawl, put objects in their mouth, eat dirt, or are exposed to blowing dirt, and can consume a significant amount of lead. Children's developing digestive systems are very susceptible to lead poisoning. To a child's body, lead looks like calcium because they both have same ionic charge and size. As their neurons develop, the nervous system tries to use lead in place of calcium and the child's neural systems fail to form correctly. This impairs neural function leading to irreversibly decreased IQ and increased attention deficient issues.“

Cold Meds Send 7,000 Kids To ERs Each Year “Cough and cold medicines send about 7,000 children to hospital emergency rooms each year, the U.S. government said Monday in its first national estimate of the problem. About two-thirds of the cases were children who took the medicines unsupervised. However, about one-quarter involved cases in which parents gave the proper dosage and an allergic reaction or some other problem developed, the study by the U.S. Centers for Disease Control and Prevention reported.”

Congressional Leaders Send Message to Mattel “More than 50 members of a Congress have sent a strong message this week to toymaker Mattel: "Stop selling toxic toys." ”

Crowded Cribs Linked to Baby Deaths “To reduce risk of suffocation and sudden infant death syndrome, parents should place babies on their back in a crib that meets current safety standards, the agency said. Among other incidents of death in cribs, babies became trapped when the mattress was ill-fitting, CPSC said. Old, broken and modified cribs should not be used, and parents should never allow a gap larger than two fingers at any point between the sides of the crib and mattress, the agency advised. The agency said there were 36 deaths over the same period relating to baby baths and bath seats. All occurred when caregivers left the baby unattended. In many instances, babies slipped out of bath seats, fell out of baby seats or tipped forward or sideways into the water. At no time, even for a few seconds, should babies be left unattended in the tub, Vallese said. Deaths involving playpens also were high, with many resulting from the use of soft bedding. “

Dangers Of Cod Liver Oil

Energy drinks not for children

Group: Soft Plastic Toys Are Health Risk “A consumer watchdog group is urging parents to avoid buying soft plastic toys this holiday season because of a risk that the toys may contain toxic chemicals. Toys containing the chemicals, called phthalates, can no longer be manufactured or imported after February 2009, according to a product safety law that passed Congress over the summer. But the group says the Consumer Product Safety Commission is allowing the toy industry to circumvent the law. The agency wrote a letter last week telling manufacturers they can still sell their existing stocks of phthalate-containing toys even after the ban takes effect in February.“

Kids want a hamster? Ask your doctor first “Young children are vulnerable because of developing immune systems plus they often put their hands in their mouths. That means families with children younger than 5 should avoid owning "nontraditional" pets. Also, kids that young should avoid contact with these animals in petting zoos or other public places, according to the report from the American Academy of Pediatrics. The report appears in the October edition of the group's medical journal, Pediatrics. "Many parents clearly don't understand the risks from various infections" these animals often carry, said Dr. Larry Pickering, the report's lead author and an infectious disease specialist at the federal Centers for Disease Control and Prevention.”

Lack Of Vitamin D Causes Weight Gain And Stunts Growth In Girls

Low Zinc Levels Linked to Febrile Seizures in Children

Melamine Found in Walgreens Chocolate Bars “Melamine has surfaced in samples of chocolate bars that were sold with teddy bears at Walgreens drug stores nationwide. The national pharmacy chain is now recalling 173 of those products — approximately 9-inch high Dressy Teddy Bears that come with 4-oz. chocolate bars--because of the contamination.”

Most Caregivers Of Young Children Lack Basic Knowledge Of Potentially Toxic Household Products

News Review From Harvard Medical School -- Baby Products May Leach Chemicals

Nigeria Doctors on Alert After Drug Kills 25 Infants “Nigeria's drug administration agency warned doctors across the country on Wednesday to be on the lookout for symptoms of toxic poisoning in babies after contaminated teething syrup killed at least 25 infants. The National Agency for Food, Drug Administration and Control (NAFDAC) said tests had shown traces of the chemical diethylene glycol, a poisonous substance normally used in engine coolant, in the widely-sold "My Pikin" baby teething mixture.“

Parents Warned Camphor Can Be Toxic to Children

Pesticides may be hidden danger to child IQ “Household pesticides may cause some of the intellectual development problems in children previously associated with lead, an Australian toxicologist says. In a commentary available online in the journal Science of the Total Environment, Professor Brian Gulson says there is no question lead has a detrimental effect on children's intellectual development. But the Macquarie University researcher says several studies have shown similar effects in children exposed to low levels of organophosphate pesticides. “

Pet Turtles Cause Salmonella Outbreak: Small Pet Turtles Are a Health Risk, Especially to Young Kids, Says CDC “The CDC today blamed small pet turtles for infecting at least 44 people in five states with salmonella bacteria. Salmonella infection usually causes diarrhea, which may be bloody. Serious complications and death can also occur but are rarer. Those cases, which happened since May 2007, mostly affected young kids who played with or cared for the turtles. No deaths have been linked to the salmonella outbreak. Cases were reported in California, North Carolina, Ohio, South Carolina, and Wisconsin. "These turtles are a risk to the public and especially to young children," states the CDC's Morbidity and Mortality Weekly Report. This isn't the first time that the CDC has warned the public that turtles (and other reptiles) can carry salmonella bacteria. But 80% of the patients in the current outbreak didn't know that. “

Secondhand Smoke Exposure in Infants May Increase Later Risk for Serious Infections “A previous study found that passive smoking during pregnancy and childhood can damage pulmonary function in children, with a greater effect noted for maternal smoking during pregnancy. • In the current study, SHS exposure within 3 meters increased the risk for all hospitalizations, hospitalizations related to any infection, and hospitalizations related to unintentional injuries. SHS within 3 meters was not significantly associated with the risk for hospitalization for respiratory tract infection. “

Secondhand Smoke Hikes Tots' Risk of Heart Disease “Secondhand smoke causes signs of cardiovascular damage in children, especially the very youngest, new research contends. The findings, which focused on children from 2 to 14 years old, showed that environmental tobacco exposure (second-hand smoke) caused increased markers of inflammation and signs of vascular injury, suggesting an increased risk of heart disease. The youngest children appeared to be more affected than teens.“

Sedentary High School Girls Are At Significant Risk For Future Osteoporosis “"Most important and alarming is that 30 percent of the non athletes versus 16 percent of athletes were found to have low bone mineral density putting them at greater risk for developing osteoporosis earlier in life," says Dr. Hoch.”

Smokers' Homes More Likely to House Hungry Kids “Children who live with adult smokers are more likely to be underfed and undernourished, a new study finds. The same is true for adult members of smoking households, but children feel the impact the most, said study author Dr. Michael Weitzman, chairman of pediatrics at New York University School of Medicine. "We know that there are long-term consequences of food insecurity for children. They are more likely to do poorly in school, to have iron deficiency and anemia, and to have behavioral and social problems," Weitzman said. "Food insecurity" is a concept that was developed by the U.S. Department of Agriculture in the 1990s to study malnutrition in developed countries such as the United States. "It is a standardized scale measuring how many times a household cannot give children the food they want, how many meals they skip, how often they go to bed hungry," Weitzman said.”

Smoke-exposed kids show nicotine dependence signs “Children who have never had a single puff of a cigarette may report symptoms of nicotine dependence if they've been exposed to secondhand tobacco smoke, Canadian researchers report. "I think it's very compelling," co-investigator Dr. Jennifer O'Loughlin of the Universite de Montreal in Quebec told Reuters Health. "It's just one more link in the chain that parents shouldn't be smoking in front of their kids." Previous research has shown that children exposed to environmental tobacco smoke at home or in the family car have nicotine and markers of nicotine metabolism in their urine, blood and hair, O'Loughlin and her team note in their report, published in the current issue of the journal Addictive Behaviors. One investigation showed that non-smoking children with higher concentrations of one of these markers, cotinine, in their saliva were more likely to become smokers 2 years later.”

Study Children and Cellphones, U.S. Experts Advise “"Although it is unknown whether children are more susceptible to RF exposure, they may be at increased risk because of their developing organ and tissue systems," it added. "Additionally, Specific Absorption Rates for children are likely to be higher than for adults, because exposure wavelength is closer to the whole-body resonance frequency for shorter individuals." The report also notes that children today will experience a longer period of RF field exposure from mobile phones than adults, because they will most likely start using them at an early age. Researchers should also analyze the different types of antennas for the amount of RF energy they deliver to different parts of the body.“

Study: Chemical Released More Quickly With Boiling Liquids; Risk to People Not Clear “Pouring boiling liquid into reusable water bottles or baby bottles made of polycarbonate plastic causes a much faster release of the estrogen-mimicking chemical bisphenol A, new research shows. University of Cincinnati researchers reported that exposure to boiling water caused polycarbonate drinking bottles to release bisphenol A (BPA) up to 55 times more rapidly than exposure to cool or temperate water.“

Third-hand Smoke: Another Reason To Quit Smoking “"When you smoke – anyplace – toxic particulate matter from tobacco smoke gets into your hair and clothing," says lead study author, Jonathan Winickoff, MD, MPH, assistant director of the MGHfC Center for Child and Adolescent Health Policy. "When you come into contact with your baby, even if you're not smoking at the time, she comes in contact with those toxins. And if you breastfeed, the toxins will transfer to your baby in your breastmilk." “

Toddlers Affected Most By Secondhand Smoke Exposure At Home, Study Shows “"Toddlers in the homes of smokers not only had higher levels of nicotine, but also had higher levels of markers for cardiovascular disease in the blood," said John Bauer, Ph.D., senior author of the study and director of the Center for Cardiovascular Medicine at Nationwide Children's Hospital and Research Institute in Columbus, Ohio. "The dose of smoke is greater in toddlers than adolescents who are able to move in and out of the home. Toddlers are like a fish in a fishbowl. They are exposed at a higher dose. And it appears that toddlers also are more susceptible to the cardiovascular effects of smoke." “

Toys in Doctors’ Offices Are Germ Hotbeds “Bring your child's toys with you when visiting the pediatrician. That's the advice of University of Virginia germ hunters who found evidence of cold viruses on one in five toys tested in waiting rooms. The commercially available germ-killing wipes that are commonly used to clean the toys are "only modestly effective," says researcher Diane Pappas, MD.”

Torn ACLs, Other Big Injuries Hit Little Athletes

Vitamin D Deficiency May Be Common in Infants and Toddlers

ARTICLES:

JOURNAL ARTICLES:

Association of Black Carbon with Cognition among Children in a Prospective Birth Cohort Study (American Journal of Epidemiology 2008) “It is well documented that air pollution is associated with a number of adverse respiratory and cardiovascular health effects (1–3). Many of these effects seem to be more strongly associated with particles from traffic (1), which are rich in elemental carbon and are the principal source of ultrafine particle exposure. However, the possible neurodegenerative effect of air pollution remains largely unexplored. The potential effect of translocation of particles from the lung to other organs has been documented. Researchers have shown that ultrafine and fine particles can be translocated from the lungs when they penetrate pulmonary tissue and enter the capillaries, reaching other organs (i.e., liver, spleen, kidneys, heart, brain) through circulation (4). … In this prospective urban birth cohort study, long-term concentration of black carbon particles from mobile sources was associated with decreases in cognitive test scores, even after adjustment for socioeconomic status, birth weight, tobacco smoke exposure, and blood lead level. Although our linear regression-based analyses do not establish causation, only associations, a number of features strengthen our findings. Decreases in cognitive functioning were seen in verbal and nonverbal intelligence constructs as well as memory constructs”

Baby Care Products: Possible Sources of Infant Phthalate Exposure (PEDIATRICS 2008) “CONCLUSIONS. Phthalate exposure is widespread and variable in infants. Infant exposure to lotion, powder, and shampoo were significantly associated with increased urinary concentrations of monoethyl phthalate, monomethyl phthalate, and monoisobutyl phthalate, and associations increased with the number of products used. This association was strongest in young infants, who may be more vulnerable to developmental and reproductive toxicity of phthalates given their immature metabolic system capability and increased dosage per unit body surface area.”

Blood Lead Concentrations < 10 mug/dL and Child Intelligence at 6 Years of Age. (Environ Health Perspect. 2008) “CONCLUSIONS: Evidence from this cohort indicates that children's intellectual functioning at 6 years of age is impaired by blood lead concentrations well below 10 mug/dL, the Centers for Disease Control and Prevention definition of an elevated blood lead level.”

Children's response to air pollutants. (J Toxicol Environ Health A. 2008)

Determinants of vitamin K status in humans. (Vitam Horm. 2008) “Infants are at the greatest risk of vitamin K deficiency because of a poor maternal-fetal transfer across the placenta and low vitamin K concentrations in breast milk. During adulthood, there may be subtle age-related changes in vitamin K status but these are inconsistent and may be primarily related to dietary intake and lifestyle differences among different age groups. However, there is some suggestion that absence of estrogen among postmenopausal women may be a determinant of vitamin K, status.”

Developmental impacts of heavy metals and undernutrition. (Basic Clin Pharmacol Toxicol. 2008) “In prior analyses, after adjusting for social factors, well-water arsenic and manganese were both significantly associated with poorer developmental scores at age 10; associations for water arsenic at 6 years were significant, but attenuated. Negative associations with metal exposures held up in newer analyses, and stunting was significantly associated with lower intellectual functioning in analyses considering either metal. There were no significant stunting-by-metal interactions. Developmental risks often co-occur. Millions in South Asia are exposed to naturally occurring arsenic and manganese through household wells. Stunting affects more than 25% of young children in developing countries. The combined neurocognitive loss from both risks, although rarely jointly studied, represents a substantial loss of global potential.”

Dietary Intake and Its Contribution to Longitudinal Organophosphorus Pesticide Exposure in Urban/Suburban Children (EHP 2008)

Exposure to maternal smoking in the first year of life interferes in breast-feeding protective effect against the onset of respiratory allergy from birth to 5 yr. (Pediatr Allergy Immunol. 2008) “This study proposes a confounding effect of maternal smoking on this protection, exposed by a higher risk for present allergic symptoms until the age of 5 yr, in children exclusively breast-fed for 6 months or more, when their mothers smoked.”

Fatal and non-fatal food injuries among children (aged 0-14 years). (Int J Pediatr Otorhinolaryngol. 2008)

Fetal and neonatal responses following maternal exposure to mobile phones. (Saudi Med J. 2008)

Hypovitaminosis D Among Healthy Children in the United States (Arch Pediatr Adolesc Med. 2008)

Identification of mold and dampness-associated respiratory morbidity in 2 schools: comparison of questionnaire survey responses to national data. (J Sch Health. 2008) “Results: Employees from both schools had excess work-related throat and lower respiratory symptoms, as well as eye, nasal, sinus, and wheezing symptoms. School B employees also had excess physician-diagnosed asthma and work-related fatigue, headache, and skin irritation. Employees in sections of the school buildings that were categorized as having greater dampness and mold contamination had more frequent upper and lower respiratory symptoms than employees working in other building sections.”

Is pacifier use a risk factor for acute otitis media? A dynamic cohort study. (Fam Pract. 2008) “CONCLUSION: Pacifier use appears to be a risk factor for recurrent AOM. Parents should be informed about the possible negative effects of using a pacifier once their child has been diagnosed with AOM to avoid recurrent episodes.”

Neonatal Antibiotic Treatment Is a Risk Factor for Early Wheezing (PEDIATRICS 2008) “CONCLUSIONS. Treatment with antibiotics in the neonatal period was an independent risk factor for wheezing that was treated with inhaled corticosteroids at 12 months of age. These results indirectly support the hypothesis that an alteration in the intestinal flora can increase the risk of subsequent wheezing.”

Norovirus Outbreak in an Elementary School --- District of Columbia, February 2007 (MMWR 2008) “DCDOH recommended two preinvestigation interventions, which were implemented the same evening (February 8): 1) more thorough handwashing and 2) bleach cleaning of all shared environmental surfaces with a diluted (1:50 concentration) household bleach solution. This report summarizes the subsequent investigation of the outbreak, which suggested that noncleaned computer equipment (i.e., keyboards and mice) and person-to-person contact resulted in illness. To decrease disease transmission during gastroenteritis outbreaks, public health officials should emphasize good handwashing practices, exclusion of ill persons, and thorough environmental disinfection, including fomites that are shared but not commonly cleaned. … On February 15, DCDOH recommended the following additional interventions: 1) clean computer equipment (e.g., mice and keyboards) and other shared surfaces that were overlooked during the February 8 cleaning with a 1:50 concentration household bleach solution, and 2) exclude ill persons from school for at least 72 hours after resolution of illness because of continued fecal shedding of infectious virus (1).”

Outdoor Swimming Pools and the Risks of Asthma and Allergies during Adolescence. (Eur Respir J. 2008) “Odds for asthma were significantly increased among adolescents with total serum IgE above 25 kIU.l(-1), on average by one to two units for each 100 hours-increase in pool attendance. Use of residential outdoor pools was also associated with higher risks of elevated exhaled nitric oxide and sensitization to cat or house-dust mite allergens.Outdoor chlorinated pools attendance is associated with higher risks of asthma, airways inflammation and some respiratory allergies.”

Paternal smoking, genetic polymorphisms in CYP1A1 and childhood leukemia risk. (Leuk Res. 2008) “Our results suggest that paternal smoking is a risk factor for childhood leukemia and the effect may be modified by CYP1A1 genotype.”

Polychlorinated biphenyls, organochlorine pesticides and neurodevelopment. (Curr Opin Pediatr. 2008) “SUMMARY: Exposures to polychlorinated biphenyls, dichlorodiphenyl trichloroethane/dichlorodiphenyl dichloroethene and hexachlorobenzene are likely detrimental to neurodevelopment. Effective control of exposure is complicated by variable exposure sources and variable contaminant levels in food, particularly fish, for which it is important to balance the risk of contaminants with nutritional benefits.”

Prenatal Exposure to Maternal Infections and Epilepsy in Childhood: A Population-Based Cohort Study (PEDIATRICS 2008) “CONCLUSIONS. Prenatal exposure to some maternal infections was associated with an increased risk for epilepsy in childhood.”

Prevalence of Vitamin D Deficiency Among Healthy Infants and Toddlers (Arch Pediatr Adolesc Med. 2008) “Conclusions Suboptimal vitamin D status is common among otherwise healthy young children. Predictors of vitamin D status vary in infants vs toddlers, information that is important to consider in the care of these young patients. One-third of vitamin D–deficient participants exhibited demineralization, highlighting the deleterious skeletal effects of this condition.”

Unexpected Infant Deaths Associated With Use of Cough and Cold Medications (PEDIATRICS 2008) “CONCLUSIONS. Review of these infants' deaths raises concern about the role of the over-the-counter cough and cold medications in these deaths. These findings support the recommendation that such medications not be given to infants. In addition, these findings suggest that warnings on these medications "to consult a clinician" before use are not being followed by parents. Educational campaigns to decrease the use of over-the-counter cough and cold medications in infants need to be increased.”

Very low lead exposures and children's neurodevelopment. (Current Opinion in Pediatrics 2008) “Summary: No level of lead exposure appears to be 'safe' and even the current 'low' levels of exposure in children are associated with neurodevelopmental deficits. Primary prevention of exposure provides the best hope of mitigating the impact of this preventable disease.”

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