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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

Immunization

NEWS:

1 in 4 U.S. Toddlers Improperly Vaccinated: They either miss shots or get them at the wrong time, CDC study finds

Changes in the 2008 Immunization Schedule

Childhood and Adolescent Immunization Schedules Revised

Childhood Vaccine Linked to Convulsions “Children suffered higher rates of fever-related convulsions when they got a Merck & Co. combination vaccine instead of two separate shots, according to a new study presented Wednesday. The results prompted a federal advisory panel on vaccines to water down their preference for the combo vaccine ProQuad, which protects against measles, mumps and rubella as well as chickenpox. “

Delaying DPT Vaccination May Reduce Incidence of Childhood Asthma

Guidelines Issued on Pertussis, Tetanus, Diphtheria Prevention in Pregnant Women and Newborns

Health Groups Release 2008 Immunization Schedules

How Independent Are Vaccine Defenders? “The vaccine industry gives millions to the Academy of Pediatrics for conferences, grants, medical education classes and even helped build their headquarters. The totals are kept secret, but public documents reveal bits and pieces.”

Immunization Schedule for Children and Teens Updated

Influenza Guidelines Updated “The main new recommendation from the ACIP involves influenza vaccination for children. The previous recommendation called for routine vaccination of children from 6 months through 59 months of age. The new recommendation calls for routine vaccination of children from 6 months to 18 years of age. Vaccination of this age group should begin in 2008 to 2009, with a goal of wider vaccination during the 2009 to 2010 influenza season. • Routine vaccination of children between the ages of 6 and 59 months should continue to be a primary focus of influenza prevention because these children are at higher risk for complications of influenza. • Children between the ages of 6 months and 8 years should receive 2 doses of influenza vaccine, separated by at least 4 weeks, if they have not been vaccinated against influenza during previous influenza seasons. If a child was previously vaccinated but received only 1 dose of vaccine, 2 doses are still required. “

Kids' combination vaccines cut number of required shots “The Food and Drug Administration in June approved a pair of vaccines that provide as many as five childhood immunizations in one shot. The Advisory Committee on Immunization Practices followed up on this action by recommending that the vaccines be incorporated into the regular immunization schedule.”

Mumps Vaccine Good, Not Perfect

Needle-Length Guidelines for Thigh and Shoulder Vaccinations May Need Revision “Because of substantial risk for overpenetration of the intramuscular layer when using current recommendations for vaccination needle lengths, a revision of these needle-length guidelines for thigh and shoulder injections may be needed, according to the results of a study reported in the August 11 issue of Pediatrics. "The US Centers for Disease Control and Prevention [CDC] has needle-length recommendations for intramuscular vaccinations in the thigh and shoulder on the basis of the age of the child," write William C. Lippert, BA, from Tulane University in New Orleans, Louisiana, and Eric J. Wall, MD, from Cincinnati Children's Hospital Medical Center in Ohio. "Underpenetration of the intramuscular layer with short needles has been documented; however, few studies have focused on the risk for overpenetration of the intramuscular level with needles that are too long. The purpose of this study was to determine the optimal needle length for intramuscular vaccination of children of various ages and sizes at the shoulder and thigh levels by using MRI [magnetic resonance imaging] and computed tomography [CT] scan measurements." Potential dangers of needle overpenetration from the intramuscular level to the bone or periosteum may include pain and/or damage to the bone or periosteum and detachment of the needle from the syringe.”

Public Health Risk Seen as Parents Reject Vaccines“Children who are not vaccinated are unnecessarily susceptible to serious illnesses, they say, but also present a danger to children who have had their shots — the measles vaccine, for instance, is only 95 percent effective — and to those children too young to receive certain vaccines. Measles, almost wholly eradicated in the United States through vaccines, can cause pneumonia and brain swelling, which in rare cases can lead to death. The measles outbreak here alarmed public health officials, sickened babies and sent one child to the hospital. Every state allows medical exemptions, and most permit exemptions based on religious practices. But an increasing number of the vaccine skeptics belong to a different group — those who object to the inoculations because of their personal beliefs, often related to an unproven notion that vaccines are linked to autism and other disorders.“

Routine Vaccination With Quadrivalent Meningococcal Conjugate Vaccine Not Recommended for Certain Children

U.S. measles cases at highest point since 1996 “The increase in measles cases seen this year "was not the result of a greater number of imported cases, but was the result of greater viral transmission after importation into the United States, leading to a greater number of importation-associated cases," the report concludes. "These importation-associated cases have occurred largely among school-aged children who were eligible for vaccination but whose parents chose not to have them vaccinated." “

Vaccine-wary parents spark public health worry “Skeptical of government mandates and leery of feared links to disorders from asthma to autism, parents say they’re exercising their rights to protect their kids from risk. But health officials say there’s no question that the risk of vaccination is far outweighed by the benefits of inoculation, and that those who don’t immunize endanger not only their own kids, but also the collective resistance that keeps everyone else safe, too. “When more than 10 percent of a community opts out of vaccinations, it leaves the entire community at risk because germs have a greater chance of causing an epidemic,” said Dr. Ari Brown, an Austin, Texas, pediatrician who represents the American Academy of Pediatrics. Scientists worry that vaccine resisters increasingly are breaching "herd immunity," the necessary level of protection that keeps disease from spreading. When enough people in a community are immune to a disease, they provide a buffer that keeps germs from infecting those too vulnerable for vaccination, or those for whom a vaccine doesn't work or wears off. “

ARTICLES:

CDC - School is Starting ? Make Sure Your Young Child is Fully Vaccinated

Childhood Immunization (Vaccination) Schedule

Guiding Principles for Development of ACIP Recommendations for Vaccination During Pregnancy and Breastfeeding

How to Stop the Hurt -- Sucrose Prior to Infant Vaccinations: A Best Evidence Review

Prevention of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants. Recommendations of the Advisory Committee on Immunization Practices (ACIP). (2008)

Vaccine Safety

Vaccines schedule for children

JOURNAL ARTICLES:

Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants (MMWR 2008)

Recommended Childhood and Adolescent Immunization Schedules—United States, 2009 Committee on Infectious Diseases (Pediatrics 2008)

Syncope After Vaccination --- United States, January 2005--July 2007 (MMWR 2008)

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.”

Updated recommendation from the Advisory Committee on Immunization Practices (ACIP) for use of 7-valent pneumococcal conjugate vaccine (PCV7) in children aged 24-59 months who are not completely vaccinated. (MMWR Morb Mortal Wkly Rep. 2008)

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