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Pediatrics
Treatment is updated with the most recent articles listed on top. 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.” 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.” CONTINUE YOUR INFOMEDSEARCH RESEARCH with our previous InfoMedLinks. Start with InfoMedLinks 2007.
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PediatricsInfant NutritionNEWS:Calls for national infant formula recall spread “While proclaiming that the very low concentrations detected of melamine and a similar compound called cyanuric acid pose no health danger to infants, the FDA has maintained it is unable to identify any exposure level of melamine in infant formula "that does not raise public health concerns." Further complicating the situation was inaccurate data that FDA released to The Associated Press, which was first to disclose the formulas' brand names and other details in an investigative report Tuesday. A spreadsheet the AP obtained from the FDA under a Freedom of Information Act request stated that Mead Johnson's Infant Formula Powder, Enfamil LIPIL with Iron contained traces of melamine. On Wednesday, FDA spokeswoman Judy Leon said that spreadsheet contained an error — that the FDA had incorrectly switched the names of the Mead Johnson product with Nestle's Good Start Supreme Infant Formula with Iron. That meant, Leon said, that the Nestle's Good Start had melamine while Mead Johnson's Enfamil had traces of cyanuric acid. The FDA said last month that the toxicity of cyanuric acid is under study, but that in the meantime it is "prudent" to assume that its potency is equal to that of melamine. Problems with melamine-spiked formula surfaced this fall in China, where unscrupulous manufacturers intentionally dumped it into watered-down milk to falsely elevate protein levels. The concentrations in China were as much as 2,500 parts per million — about 10,000 times greater than what the FDA found in the U.S. “ China tainted milk scandal widens “The scandal of tainted dairy products in China has widened, with liquid milk now found to be contaminated. Inspectors found that 10% of liquid milk taken from three dairies was tainted with melamine. The scandal first came to light in milk powder that killed four infants and sickened more than 6,000 others. Suppliers are believed to have added melamine, a banned chemical normally used in plastics, to diluted milk to make it appear higher in protein. “ FAQ: Melamine in U.S. Baby Formula “Which brands of U.S. baby formula contain melamine? According to the Associated Press, FDA tests detected trace amounts of melamine in Mead Johnson's Infant Formula Powder, Enfamil LIPIL with Iron. Melamine levels in the product were very low: about 0.14 parts per million. The deliberately contaminated baby formula in China contained over 250 parts per million of melamine -- at least two thousand times higher than the U.S. contamination. The AP report also said the FDA detected cyanuric acid in tests of Nestle's Good Start Supreme Infant Formula with Iron, at about 0.25 parts per million -- again, some thousand-fold less than in Chinese formula. In addition, the AP report said that while the FDA tests came up negative, Similac maker Abbott Laboratories said some company tests did find traces of melamine, at concentrations below 0.05 parts per million. These three manufacturers -- Mead Johnson, Nestle, and Abbott -- make more than 90% of the baby formula sold in the U.S.” FDA finds traces of melamine in US infant formula “Traces of the industrial chemical melamine have been detected in samples of top-selling U.S. infant formula, but federal regulators insist the products are safe. The Food and Drug Administration said last month it was unable to identify any melamine exposure level as safe for infants, but a top official said it would be a "dangerous overreaction" for parents to stop feeding infant formula to babies who depend on it. "The levels that we are detecting are extremely low," said Dr. Stephen Sundlof, director of the FDA's Center for Food Safety and Applied Nutrition. "They should not be changing the diet. If they've been feeding a particular product, they should continue to feed that product. That's in the best interest of the baby." Melamine is the chemical found in Chinese infant formula — in far larger concentrations — that has been blamed for killing at least three babies and making at least 50,000 others ill.“ FDA Issues Health Information Advisory on Infant Formula Infant iron deficiency may hinder emotional growth “Iron deficiency during the first year of life appears to adversely impact the social and emotional development of infants, and the presence or absence of anemia does not alter the impact, study findings suggest.” Iron Supplements Harmful to Infants? “Researchers at the University of Michigan studied 494 children from Chile and found those given iron fortified formula as infants were less developed in their cognitive and visual-motor skills by age 10 than those who received low-iron formula.” Kids Health QA: Overfeeding Baby Low-Fat Milk OK for Some Toddlers “For babies ready to graduate from breast milk or formula to cow's milk, the longstanding recommendation has been that they receive whole milk, instead of reduced-fat or fat-free milk. But new guidelines from the American Academy of Pediatrics (AAP) now advise parents of toddlers who are overweight or obese, or those who have a family history of obesity, high cholesterol or cardiovascular disease, to switch to reduced-fat milk between 1 and 2 years of age. The new guidelines — from the clinical report Lipid Screening and Cardiovascular Health in Childhood in the July issue of Pediatrics — are part of a long list of new recommendations aimed at keeping children's cholesterol levels down to protect their long-term heart health.“ Overweight problems seen even in infants “In a study reported in the journal Pediatrics, overweight infants were at increased risk for developmental delays and possibly breathing problems, such as asthma. Moreover, in most cases, parents were unaware of their child's weight problem. "Although the consequences of infant and childhood excess body weight may seem to manifest in later years, this perception is inaccurate," Dr. Ron Shaoul, from Bnai Zion Medical Center in Haifa, Israel, and colleagues warn. "Our findings indicate a need to intervene during these critical years by adopting proper eating habits and active lifestyles," they add. “ Second infant death in China milk scandal Some Melamine in Infant Formula is OK, FDA Says: Agency reverses course after declaring chemical unsafe “The FDA's Stephen Sundlof, head of the food safety division, says the agency draws a distinction between food products containing trace amounts of melamine and products containing trace amounts of cyanuric acid, a melamine by-product. Separately, he says, trace amounts of the chemicals cause no harm. However, when the two chemicals are combined they cause crystals that can lead to kidney damage. No amounts of the two chemicals together, he said, will be allowed in infant formula.” ARTICLES:Babies and solid foods: What to serve when JOURNAL ARTICLES:Age at first introduction of cow milk products and other food products in relation to infant atopic manifestations in the first 2 years of life: the KOALA Birth Cohort Study. (Pediatrics. 2008) “RESULTS: More delay in introduction of cow milk products was associated with a higher risk for eczema. In addition, a delayed introduction of other food products was associated with an increased risk for atopy development at the age of 2 years. Exclusion of infants with early symptoms of eczema and recurrent wheeze (to avoid reverse causation) did not essentially change our results. DISCUSSION: Delaying the introduction of cow milk or other food products may not be favorable in preventing the development of atopy.” Effects of soy protein-based formula in full-term infants Longchain polyunsaturated fatty acid supplementation in infants born at term. (Cochrane Database Syst Rev. 2008) Newborn vitamin a supplementation reduced infant mortality in rural Bangladesh. (Pediatrics. 2008) Powdered infant formula as a source of Salmonella infection in infants. (Clin Infect Dis. 2008) Timing of Solid Food Introduction in Relation to Eczema, Asthma, Allergic Rhinitis, and Food and Inhalant Sensitization at the Age of 6 Years: Results From the Prospective Birth Cohort Study LISA (PEDIATRICS 2008) “CONCLUSIONS. This study found no evidence supporting a delayed introduction of solids beyond 4 or 6 months for the prevention of asthma, allergic rhinitis, and food or inhalant sensitization at the age of 6 years. For eczema, the results were conflicting, and a protective effect of a delayed introduction of solids cannot be excluded. Positive associations between late introduction of solids and food sensitization have to be interpreted with caution. A true protective effect of a delayed introduction of solids on food sensitization seems unlikely.” |
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