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Pediatrics
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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 2009.
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NotesThe 2007 Treatment Guidelines section will contain the 2007 published guidelines. To view Guidelines from previous years, view year 2006 Treatment Guidelines and 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section). |
PediatricsDaily Treatment ReportCognitive Therapy-CBT-PsychotherapyDevice TherapyDrug Side-Effects and InteractionsFDA says Tessalon liquid cough capsules pose risk for young children Previous Antimicrobial Exposure Is Associated With Drug-Resistant Urinary Tract Infections in Children. (Pediatrics. 2010) “Conclusions: Recent antimicrobial exposure is associated with antimicrobial-resistant UTIs among pediatric outpatients, and the magnitude of this association decreases with time since exposure. Judicious antimicrobial prescribers should consider this association when selecting empiric antimicrobial agents for a new UTI and should use strategies to reduce unnecessary antimicrobial use to avoid development of resistant bacteria .” DrugsConfusing Labeling Found on Many Nonprescription Kids' Meds ExerciseYoga Found To Be Beneficial For Childhood Cancer Patients And Their Parents General InformationEarly Treatment Decisions Crucial for Teens with Treatment-resistant Depression Psychopharmacology of Pediatric Bipolar Disorder (Expert Rev Neurother. 2010) Diagnosis and Treatment of Acute Otitis Media in Children Reviewed Study: Antibiotics have little impact on child ear infections “The study found that 80 out of 100 otherwise healthy children would recover from an acute ear infection within a few days if given medication only to relieve pain or fevers. If all 100 were given antibiotics instead, 92 would be better in the same period, said Dr. Tumaini Coker, the study's lead author. "But we would also expect three to 10 kids to develop rash and five to 10 to develop diarrhea," said Coker, a pediatrician at Mattel Children's Hospital at the University of California-Los Angeles. Coker noted that the increased number of children in the study who benefited from treatment with antibiotics was similar to the number that could be expected to get side effects from the antibiotic treatment. "Clinicians and parents need to know the benefits and side effects on how to manage their child's ear infection," Coker said. … Of the three basic types of ear infections, acute otitis media may benefit from antibiotics because it is often caused by a bacteria. But it also can be caused by a virus, which won't respond to antibiotics. Another type of ear infection, otitis media with effusion, causes a buildup of fluid in the middle ear. That is also caused by a viral infection, against which antibiotics are ineffective. But antibiotics usually work for the third type, otitis externa, or "swimmer's ear." “ Half of Teens Treated for Depression Will Relapse: Study “Although almost all teens who were treated for major depression initially recovered, about half ended up suffering a relapse within five years, a new study found. And those recurrences were more likely to strike girls than boys, the researchers found.” Tonsillectomy Study Finds Best Way to Avoid Complications Benzyl Alcohol Lotion 5% Suffocates Head Lice “Benzyl alcohol lotion 5% (BAL 5%), a non-neurotoxic topical treatment that kills head lice by suffocating them, is safe and effective in children as young as 6 months and is the first non-neurotoxic compound to win approval by the US Food and Drug Administration (FDA), investigators report in a study published online February 23 in Pediatric Dermatology. "Prescription and ...FDA approved over-the-counter (OTC) pediculicides contain neurotoxic pesticides as active ingredients, resulting in potential toxicity and other problems," write Terri L. Meinking, PhD, from Global Health Associates of Miami, Miami, Florida, and colleagues. "This leaves practitioners, parents and patients hoping for a safe, nonneurotoxic cure." “ Adenoidectomy for recurrent or chronic nasal symptoms in children. (Cochrane Database Syst Rev. 2010) Adenoidectomy for otitis media in children. (Cochrane Database Syst Rev. 2010) Interventions for acute otitis externa. (Cochrane Database Syst Rev. 2010) Honey for acute cough in children. (Cochrane Database Syst Rev. 2010) “AUTHORS' CONCLUSIONS: We found insufficient evidence to advise for or against the use of honey for acute cough in children.” Diagnosis and Management of Red Eye in Primary Care Reviewed Ear Infections: New Thinking on What to Do “Ear infections often clear up on their own. But another pediatric otolaryngologist, Dr. Richard Rosenfeld, stressed that "observation is different than no treatment." Rosenfeld is chairman of otolaryngology at Long Island College Hospital and the State University of New York Downstate Medical Center and a consultant for the American Academy of Pediatrics on the ear infection guidelines. When recommending observation before medication, he said, doctors might send parents home with a "safety net" prescription, one to have on hand in case the situation worsens. Parents should ask the doctor for specifics on the timeline for observation, which typically ranges from one to three days. And while watching and waiting, the focus would be on pain relief. But observation isn't advised for all kids, even if they're healthy and 2 years or older, Tunkel said. For instance, a child with a fever of 102 or more would typically be treated. "We don't want to withhold antibiotics from kids," he said.” GuidelinesImmunotherapy
Internet SitesTreatment Information Drug-Food-Supplement Information DrugDigest (drug interactions) FDA - Drug Interactions: What You Should Know NIH - Botanical Dietary Supplements: Background Information NIH - Drug, Supplements, and Herbal Information NIH - Herbal Supplements: Consider Safety, Too NIH - Vitamin and Mineral Supplement Fact Sheets Nutrition
OtherOther Treatments Experimental Radiotherapy
Supplements-Vitamins-CAMHigher Intake of Fish, EPA, and DHA Linked to Less Depression in Teenage Boys Zinc supplements for preventing otitis media. (Cochrane Database Syst Rev. 2010) SurgerySurgery "should be last resort for obese children" “In a review of studies on the obesity epidemic, scientists from Britain and the United States said lifestyle changes such as better diet and more exercise should always be the first option, and treatment with drugs should be used rarely. Bariatric surgery, or weight-loss surgery, such as operations to apply gastric bands to limit the stomach size of severely overweight people, should be a last resort, they said.” Laparoscopic Adjustable Gastric Banding in Severely Obese Adolescents (JAMA 2010) “Conclusions Among obese adolescent participants, use of gastric banding compared with lifestyle intervention resulted in a greater percentage achieving a loss of 50% of excess weight, corrected for age. There were associated benefits to health and quality of life.” Transplantation
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