Children’s Health

Flu Can Kill Even Healthy Children, Study Finds

Children, even those without severe medical conditions, can die from the flu in as little as three days after symptoms appear, U.S. health officials warn.

Between 2004 and 2012, flu complications killed 830 children in the United States, many of whom were otherwise healthy, according to the U.S. Centers for Disease Control and Prevention.

Most striking is that 35 percent of these children died before being hospitalized or within the first three days of developing symptoms, according to the report published online Oct. 28 in Pediatrics.

“We found these influenza-related deaths can occur in children with and without medical conditions and in children of all ages, and that very few of these children have been vaccinated,” said lead author Dr. Karen Wong, a CDC medical epidemiologist.

Researchers who reviewed those deaths found that only 22 percent with a high-risk medical condition and just 9 percent without a significant medical condition had been vaccinated.

Wong doesn’t know why so many children die so fast. “About a third of these children die within the first three days of their first reported symptoms,” she said.

One expert wasn’t surprised that many otherwise healthy children who died did so before being admitted to the hospital.

“First, parents don’t realize that flu can be fatal,” said Dr. Marcelo Laufer, a pediatric infectious diseases specialist at Miami Children’s Hospital.

Second, parents of children with chronic diseases “know the system better, so they come earlier than healthy patients,” he said.

Because flu can progress so quickly, prevention is really the best strategy, Wong said. “And that’s why we recommend every child 6 months or older get vaccinated every year,” she said.

Because an infant under 6 months of age can’t be given flu vaccine, Wong said it is vital that pregnant women get a flu shot to help protect their newborn, and that everyone likely to be near the baby also be vaccinated so they can’t pass flu to the infant.

Wong said children who get the flu need to be watched carefully. She recommends getting in touch with the child’s doctor when symptoms start.

“That’s especially true for kids with high-risk medical conditions and for very young children,” she explained. “These children are at especially high risk for flu complications.”

Laufer, however, said a phone call to the doctor isn’t enough. “It’s very difficult for a pediatrician on the other side of the phone to understand how sick the child really is,” he said.

Parents should take their child to the doctor or emergency department if they’re sicker than what one would expect with a common cold, he said.

“Parents should realize that influenza is much more than sniffles,” Laufer added. “A kid with influenza is a kid who is very sick, is a kid who is lethargic, has decreased appetite, is not drinking as much and not urinating as much in addition to other flu symptoms,” he said.

Wong added that early antiviral treatment is recommended for high-risk children who develop symptoms of influenza. “That’s another thing they can talk to their health care provider about,” Wong added.

Antiviral drugs include Tamiflu, Relenza, Symmetrel and Flumadine.

In the study, Wong’s group found that of the 794 children whose medical history was known, 43 percent had no medical condition that put them at high risk of dying from flu.

As for children with high-risk medical conditions who died, 33 percent had neurological conditions such as cerebral palsy or seizure disorder, and 12 percent had a genetic condition that put them at risk for flu complications.

Asthma, lung disease, heart disease and cancer can also increase a child’s odds of dying from flu, the researchers noted.

Each year in the United States, flu causes an estimated 54,000 to 430,000 hospitalizations and 3,000 to 49,000 deaths, with infection rates highest among children, according to the CDC.

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7 Healthy Habits to Pass on to Your Kids

Turn everyday situations into opportunities to teach your children about healthy living

7 Healthy Habits to Pass on to Your Kids Intro

With 1 in 3 children and teens considered overweight or obese in the United States, it’s time to do something, and doctors agree that parents need to take the lead when it comes to educating children about staying healthy: Up to 90% of doctors agree that weight is the most important health topic for parents to discuss with their children, even more than safe sex, cigarette smoking, drug use, and alcohol consumption, according to the 2011 Raising Fit Kids survey by WebMD and Sanford Health. In addition to having an open dialogue, it’s important to lead by example. “Kids definitely take on the behaviors of their parents,” says Susan Bartell, PhD, a parenting and child psychologist in New York. To set your child on the right path, turn everyday activities like dinnertime, playtime, or grocery shopping into real-life lessons on health, nutrition, and fitness. Here’s how.

Leave Some Food on the Plate

In an attempt to make sure they don’t miss out on any nutrients, many parents ask kids to clean their plates, making them more likely to overeat later in life, says Sarah Krieger, RD, spokesperson for the American Dietetic Association and director of the Fit 4 All Kids program at All Children’s Hospital in St. Petersburg, FL. If your kids say they’re not hungry, wrap up their plates, says Krieger, but make them stay at the table until the rest of the family finishes (to avoid a situation in which they choose playtime over full tummy). And if they’re hungry later, warm up the plate of food instead of offering a snack.

Recognize the Difference between Hunger and Boredom

Even if you had to tape a stop sign on your fridge to get there, you learned to give yourself time to decide if you’re hungry or just need to pick up a hobby. Children shouldn’t have free access to the snack drawer, says Krieger, and should ask parents for permission to have a snack. “The first thing parents should offer is a piece of fruit and a reminder of the time for the next meal,” she says. If children are actually hungry, they’ll take the fruit. If they’re bored, they’ll wait until dinner.

 

Don’t Use Food as a Reward

Congratulating yourself with a sweet treat after a day of healthy eating is a little bit nuts. Rewards should help you work toward your goal—not against it, says Bronco. And making dessert—or anything edible—the pot of gold at the end of the eating rainbow could affect your child’s food preferences. One study published in the European Journal of Clinical Nutrition found that children who were rewarded with stickers for eating sweet red peppers consumed fewer pieces of the vegetable and had greater dislike for it than children who were told only that they could eat as much as they wanted. In other words, there’s a chance you could turn your child off broccoli if eating it puts him on the fast track to a brownie. If an after-dinner treat is standard in your household, downplay dessert by serving sweet, in-season fruit and small cookies only a few times a week, say Krieger.

Avoid Distracted Eating

Multitasking while you munch can lead to unwanted extra pounds. Distracted eaters—like those who surf the web or watch TV—have a hard time recalling what they eat, are less likely to feel satiated, and more likely to consume extra calories throughout the day, according to a study published in the American Journal of Clinical Nutrition. Good advice for adults and youngsters alike: Eat only when sitting at the table. No iPods, cell phones, or gaming systems allowed—just food and family. This helps encourage mindful eating, says Michael Bronco, a personal trainer and owner of Bronco’s Gym in Madison, NJ.

Stick to the List When You Go Grocery Shopping

Experts agree that shopping with a list helps you avoid fattening impulse buys and guarantees you have all the ingredients you need to make healthy meals. Get the kiddos involved in the grocery shopping by helping you compile the list, says Bronco. Make columns for proteins, fruits, vegetables, and whole grains, and ask your children to make recommendations for foods they’d like to eat that fit each category. It’s a great way to learn about the food groups and get familiar with the healthy options that fill them. It also doesn’t hurt that your kids get the sense that they “chose” the peas rather than feeling like victims of the vegetables on their plates.

Read Food Labels

Sneaky sugars and sodium can transform a seemingly harmless item into a diet disaster—that’s why reading nutrition labels is crucial to healthy grocery shopping. Turn a trip to the market into a nutritional scavenger hunt by asking reading-age children to find cereals with less than 8 g of sugar, canned soup with less than 300 mg of sodium, or a loaf of bread that clearly states it’s 100% whole grain. They’ll learn how to navigate a nutrition panel and be too busy to complain that the sleeve of cookies they wanted didn’t make it into the cart.

Find a Workout You Enjoy

Let’s face it, if you hate the gym you’re not going to go—and the same goes for your kids and soccer practice. “The adults who are most successful with their workouts found something they really love doing,” says Bronco. “It’s worth it to find an activity that your kid really loves, and if it becomes not so fun anymore, try something else. I think if you get too strict about sticking with one sport and it becomes a chore, you run the risk of turning your child off fitness completely.” When people are having fun, they stop worrying about how many calories they’re burning.

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Hearing loss: Is your child Falling behind?

The most vital period for hearing development in a child’s life occurs in the first two years. Children who receive no auditory stimulation during this critical period will face difficulties learning to speak. The brain’s ability to learn to process sound and develop spoken language decreases after this critical period until about age seven, when learning language becomes much more difficult. Children’s development of speech and language varies individually. There are, however, milestones for speech and language development that can serve as a guideline for normal development.

Typical Signs of Hearing Loss Are:

  • Child does not react to loud sounds
  • Child is unable to detect where a sound is coming from
  • Child may start to babble, but soon stops
  • Babbling does not develop into understandable speech
  • Child does not react to voices, especially when he or she is not being held
  • Child does not follow commands or misunderstands directions
  • Child may start acting frustrated

Hearing Tests

A variety of different methods are available to test your child’s hearing. The audiologist will choose a method that is best suited for your child’s age. Usually, hearing tests performed on newborns and babies use objective measuring methods to assess the baby’s hearing and do not require the active participation of the baby. All these tests are quick, simple and painless and are performed while the baby is asleep. Parents can stay with the baby while the hearing test is being carried out.

In Otoacoustic Emission (OAE) screening, the function of the hair cells in the cochlea is checked. A tiny earpiece is placed into the baby’s ears emitting clicking sounds. When the cochlea receives these sounds, it produces an echo that the screening equipment picks up. A similar screening method, the Auditory Brainstem Response (ABR), measures brain waves in response to auditory stimuli (usually a clicking sound). Older children can participate more actively in audiometry tests. The child indicates when he or she hears a sound (pure-tone audiometry) or understands speech (speech audiometry).

Early Intervention

Newborns are already able to recognize their mother’s voice. During the first few months, infants learn to understand a variety of sounds around them. They can very quickly distinguish between human speech and other environmental sounds. The first two years are especially important for language acquisition. Children with hearing loss cannot easily develop these abilities later on.

Early intervention means acting without delay to treat your child’s hearing loss. If your child has an irreversible hearing loss that cannot be otherwise remedied, it is vital to get hearing instruments as soon as possible. It is also very important to assess how well the hearing instrument(s) work(s) for the child. If hearing aids are not going to be enough to help the child to develop spoken language, it is crucial to determine this as quickly as possible so that other alternatives can be evaluated while the child is still in the critical language learning phase.

The younger a child’s age when receiving a hearing device, the easier it will be for him/her to learn to hear and speak. A baby’s brain is better able to process new information than that of older children, and when children are provided with a hearing device at a very young age, they often develop spoken language quickly and can “catch up” with other children born with normal hearing.

Is My Child a Candidate for a CI?

If you and your audiologist or speech-language professional consider a cochlear implant to be the best solution for your child, the next step is to contact an ENT clinic with a cochlear implant program. A list of cochlear implant centers is available from MED-EL. Your local team of CI specialists will work with you to determine whether your child is a candidate for cochlear implantation.

Basic candidacy criteria for implantation include:

  • Your child has a profound sensorineural hearing loss in both ears.
  • Your child receives little or no benefit from hearing aids.
  • There are no medical reasons your child cannot undergo surgery.
  • Your child has access to appropriate education and rehabilitation follow-up.
  • You and your child are highly motivated to participate in required rehabilitation programs.

Please note: not every child with a profound hearing loss is a candidate for cochlear implantation. Here are some reasons why:

  • If your child can receive a significant benefit from hearing aids, they are likely the better solution.
  • If your child’s hearing loss comes from somewhere other than the inner ear, a cochlear malformation, or the absence of the hearing nerve, an alternative solution might be more effective.
  • To gain the greatest hearing benefit from a CI, it is important for children to have full support from their family and to participate in rehabilitation programs. If a family cannot commit to participation in a rehabilitation program, other options besides a CI may need to be considered.

Advantages of Early Cochlear Implantation

Your child may benefit from a cochlear implant regardless of his or her age, but for children who became deaf before learning to speak success is more likely if treatment begins early. This is because they receive auditory information at a time when the brain is really ready to learn language. As previously mentioned, if children with a profound hearing impairment are implanted early enough, their hearing and speech can develop much like a normal hearing child’s. Spoken language appears to emerge almost naturally.

For children who have had hearing experience and have lost their hearing later, a similar rule applies: the shorter the time period of deafness, the more likely they will benefit from the cochlear implant. Children are being implanted younger and younger because of improved surgical procedures and research proving better results with children implanted at very young ages.

On the Way to Success

It is important to remember that the cochlear implant is a technical tool for your child’s hearing. Success with the implant depends on many factors. Age of implantation is only one factor influencing the benefit a child will receive from a cochlear implant. A rich communication environment, effective audio processor programming, motivation, rehabilitation and realistic expectations are all important factors contributing to a child’s overall success.

Source: www.sciencedaily.com

 

Could Your Child Have Sleep Apnea?

This sleep disorder can cause serious health problems for kids.

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder affecting more than 18 million adults and 2% to 3% of children of all ages, even newborns, according to the National Sleep Foundation. It seems to run in families, and kids who have enlarged tonsils and/or adenoids (lymph nodes in the throat behind the nose) have a higher risk of developing OSA.

Other factors include being obese, having a small jaw or midface, or a larger-than-usual tongue, being exposed to tobacco smoke, and having less muscle tone (such as in children with Down syndrome, cerebral palsy, and/or neuromuscular disorders), explains Dennis Rosen, MD, associate medical director of the Center for Pediatric Sleep Disorders at Boston Children’s Hospital.

Treating Children’s Sleep Apnea

Sleep apnea, derived from the Greek word for “without breath,” is a serious condition. Breathing temporarily pauses during sleep for more than 10 seconds in adults and longer than two breath cycles in children, and this can happen up to 70 times an hour. Oxygen levels in the blood plummet, and the body responds as if choking.

Sometimes young children outgrow OSA as their throats get larger and airways stiffen, says Rosen. Those with large tonsils and adenoids may need surgery (adenotonsillectomy), which typically cures 80% to 90% of children, says Rosen

Symptoms of Sleep Apnea

Think your child might have obstructive sleep apnea? Look for these symptoms, Rosen says.

  • Loud snoring, often with gasping, choking, and snorts
  • Long pauses in breathing while sleeping (longer than two breath cycles)
  • Excessive sweating at night because of the strain of trying to breathe
  • Waking up with headaches and daytime sleepiness, irritability, hyperactivity, and difficulty concentrating

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A baby born with HIV remains free after taking Pills

A 3-year-old girl born in Mississippi with HIV acquired from her mother during pregnancy remains free of detectable virus at least 18 months after she stopped taking antiviral pills.

New results on this child, published online by the New England Journal of Medicine, appear to green-light a study in the advanced planning stages in which researchers around the world will try to replicate her successful treatment in other infected newborns.

And it means that the Mississippi girl still can be considered possibly or even probably cured of HIV infection — only the second person in the world with that lucky distinction. The first is Timothy Ray Brown, a 47-year-old American man apparently cured by a bone marrow transplant he received in Berlin a half-dozen years ago.

This new report addresses many of the questions raised earlier this year when disclosure of the Mississippi child’s case was called apossible game-changer in the long search for an HIV cure.

“There was some very healthy skepticism,” Dr. Katherine Luzuriaga, a professor at the University of Massachusetts in Worcester, tells Shots. She’s part of the team that has been exhaustively testing the toddler’s blood and considering every possible explanation for her apparently HIV-free state.

Luzuriaga is confident the latest tests prove that the child was truly infected with HIV at the time of her birth — not merely carrying remnants of free-floating virus or infected blood cells transferred before birth from her mother, as some skeptics wondered.

The UMass researcher says there’s no way the child’s mother could have contributed enough of her own blood plasma to the newborn to account for the high levels of HIV detected in the child’s blood shortly after birth.

Similarly, Luzuriaga says, new calculations show that the mother “would have had to transfer a huge number of [HIV-infected] white blood cells to the baby in order for us to get the [viral] signal that we got early on.”

Clinching the question as far as the researchers are concerned is the infant’s response to anti-HIV drugs that she began receiving shortly after birth. The remarkable earliness of her treatment is a crucial feature that makes this child different from almost any other.

“There’s a very characteristic clearance curve of viruses once we start babies on treatment,” Luzuriaga says. “The decay of viruses we see in this baby is exactly what we saw in early treatment trials from 20 years ago when we initiated anti-retroviral therapy and shut off viral replication. That’s a very different decay curve than you would expect if it were just free virus transferred to the baby.”

It might be helpful to recap the unusual, if not unique, features of the Mississippi case.

Her mother did not receive prenatal care, so she was not identified as HIV-infected before delivery. If she had been, she would have received drugs that are highly effective in preventing mother-to-child transmission of the virus.

While the mother was in labor, she got HIV testing, as is routine for women without prenatal care. When that came up positive, Dr. Hannah Gay, a pediatrician at the University of Mississippi Medical Center in Jackson, was ready to test the newborn for infection and start anti-retroviral medicines within 30 hours of birth.

The treatment quickly cleared the virus from the baby’s blood. Normally such children would stay on antiviral drugs for a lifetime. But in this case the mother – whose life circumstances were reportedly chaotic – stopped giving the child the medication between 15 and 18 months after birth.

Gay and her colleagues caught up to the child when she was 23 months old and were astonished to discover she was apparently still virus-free despite being off treatment. Five rounds of state-of-the-art testing — at UMass, Johns Hopkins, federal research labs and the University of California San Diego — failed to reveal any trace of the virus in her blood.

That led to last spring’s report and widely reported hope that the child had been cured of HIV.

But Dr. Scott Hammer, an HIV researcher at Columbia University in New York, is not quite convinced. “Is the child cured of HIV infection? The best answer at this moment is a definitive ‘maybe,’ ” Hammer writes in a New England Journal editorial that accompanied the report.

The reason is that a couple of tests done when the child was about 2 years old found indications that her system may contain pieces of RNA or DNA from HIV. This hints that some of the nucleic acid building blocks of the virus are hanging around within her blood cells.

There’s no evidence these “proviral” remnants are capable of assembling themselves into whole viruses that can make copies of themselves. But researchers are concerned about that possibility and how it might be headed off.

“The question is whether those viral nucleic acids have the ability at some point to replicate and allow a rebound of the virus,” Luzuriaga acknowledges. “That’s why it’s important to continue to test the baby over time.” She says that means years.

But for now, the signs from the Mississippi child’s case are encouraging enough to have generated an ambitious global human experiment that Luzuriaga says is in final planning stages.

Women who present in labor without having had prenatal care will be tested for HIV and, if positive, their infants will be intensively treated within a couple of days of birth, as the Mississippi child was. Then they’ll be followed with the most sensitive tests to determine if the virus has been eradicated.

If certain criteria are met, researchers plan to decide whether it would be safe to discontinue HIV treatment deliberately and follow the children closely to see if the virus returns. (If it did, treatment would be restarted.)

If the experiment succeeds, it would be a huge advance in the prevention of childhood HIV and AIDS in many parts of the world. More than 9 out of 10 the world’s 3.4 million HIV-infected childrenlive in sub-Saharan Africa, where many women deliver without having had prenatal care or HIV treatment. Around 900 children are newly infected every day.

Meanwhile, researchers pursuing an HIV cure will convene next month in San Francisco to consider various strategies — for adults as well as children. One other recent glimmer of hope was provided this summer by Boston researchers who reported that two HIV-infected men with lymphoma remain virus-free without treatment for several months after stopping antiviral treatment.

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Every child should get free vitamins to stave off rickets

Every child in the country should be given free vitamins by the NHS in order to stave off the return of rickets, the Chief Medical Officer for England has said.

Experts said the changes should be introduced because too many children were being denied vital nutrients by poor diets, while getting too little sunshine because they spend too much time indoors on computers and gaming consoles.

In other cases, parents have become so worried about skin cancer that they smother children in too much sunscreen when they do go outside, inadvertently increasing their risk of rickets, which is caused by vitamin D deficiency, doctors said.

The bone-deforming disease – which was rife in the Victorian era – had been virtually wiped out, but has returned and risen five-fold in the past 15 years, figures show.

Prof Dame Sally Davies, has asked the National Institute for Health and Care Excellence (Nice) to examine whether to introduce free vitamins for all under-fives, but she said she believed it would be cost-effective, and was now necessary to reverse the “appalling” return of the disease.

As well as causing brittle bones, bow legs and other deformities, deficiencies of vitamin D can be fatal, causing a type of heart failure.

Estimates suggest that 40 per cent of children have levels of the vitamin below recommended thresholds, because of a combination of poor diets and lack of exposure to sunshine.

Currently, parents are advised that under-fives should have daily vitamin drops, but they are only given free to deprived families as part of Healthy Start programs.

NICE will examine whether all children between six months and the age of five should receive the vitamins A, C and D via drops or tablets.

Prof Davies said: “We know that many children, not just in vulnerable groups have vitamin deficiencies. We are seeing again rickets.. it is appalling.”

She said a scheme in Birmingham to offer free vitamin D supplements to all children has halved the number of cases of rickets and other vitamin D deficiency problems in the area.

Between 1998 and 2011, the number of cases of rickets admitted to hospital each year increased more than five-fold, from 147 to 762, official figures show.

Doctors said the disease had returned because today’s children spend far more time indoors on their computers than previous generations, instead of playing outside with friends, often eating poorer diets.

Messages to protect children from skin cancer meant some parents were smothering on too much sunscreen, so that their offspring did not absorb enough vitamin D.

Dr Sarah Jarvis, a GP in inner city London, said she has seen increasing cases in recent years: “Children just don’t spend as much time outside as they did in the past, and parents who have taken note of messages to protect children against skin cancer are sometimes too extreme with the sunscreen, so that children don’t get any exposure.”

Doctors said children were less likely to be given cod liver oil, a good source of vitamin D, which was often given to previous generations, and sometimes rejected the types of food such as oily fish which contain it.

The best source of vitamin D, which is essential for keeping bones and teeth healthy, is sun on the skin but it also occurs in some foods, such as oily fish and eggs, and is added to some items such as fat spreads and breakfast cereals.

Vitamin A, found in dairy, fortified fat spreads, carrots, sweet potatoes, swede, mangoes and dark green vegetables such as spinach, cabbage and broccoli is essential for strengthening the immune system, vision and maintaining healthy skin. Vitamin C, which boosts the immune system and helps the body absorb iron, can be found in many fruits and some vegetables.

Dr Tim Cheetham, a consultant pediatrician at Royal Victoria Infirmary in Newcastle, said: “There are combinations of reasons – diet and also ethnic background play a part, because dark skin absorbs less vitamin D, but certainly reduced exposure to sunlight is one of the reasons why we are seeing increasing cases.”

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Elevated Carcinogen Levels In 87 %Of California Daycare Centers

Nearly nine out of every 10 day care centers analyzed in a new University of California, Berkeley survey contained elevated levels of formaldehyde or other types of contaminants.

The study, which was funded by the California Air Resources Board (CARB) and is the first detailed analysis of environmental contaminants and exposures for California day care centers, looked at 40 child care facilities in Alameda and Monterey counties, UC Berkeley Media Relations official Sarah Yang reported Thursday.

It discovered that 35 of them (87.5%) had chemicals and other pollutants that exceeded state health guidelines, including formaldehyde levels above California’s safe-exposure guidelines of 9 micrograms per cubic meters over an eight hour period.

Formaldehyde is listed as a carcinogen under the state’s Safe Drinking Water and Toxic Enforcement Act of 1986 and is also a known respiratory irritant, Yang said. It is “commonly found in the glues used in pressboard furniture and laminated wood,” as well as “in many paint, clothing and cosmetic products” and in emissions originating from “combustion sources such as wood burning and gas stoves,” she added.

“Children are more vulnerable to the health effects of environmental contaminants, and many small children spend as much as 10 hours per day, five days a week, in child care centers,” Asa Bradman, lead author of the study and the associate director of the UC Berkeley Center for Environmental Research and Children´s Health (CERCH), said. “We wanted to establish the baseline levels of environmental exposures in these early child care settings, and to provide information that could be used for any necessary policy changes.”

The 40 facilities studied by UC Berkeley and the CARB serviced more than 1,700 children in both rural and urban areas, Yang explained. Bradman and colleagues collected dust samples from both the air and the floor while the children were in attendance at the centers, and tested those samples for a variety of chemicals and other substances, including fine particulates that can be inhaled into a person’s lungs.

“These findings show that cleaning and sanitizing products impact air quality in child care settings,” Victoria Leonard, who was not involved in the research but works as a scientist at the UC San Francisco Institute for Health and Aging and the head of an initiative to promote healthier product choices in child care, told Yang. ”Given that many young children have asthma or other respiratory problems, this study offers strong evidence to select safer cleaning products that have less volatile chemicals.”

“In some centers, levels of ultrafine particles increased by up to a thousandfold when cooking appliances were turned on,” Yang explained. “And since formaldehyde can also be emitted from gas stoves, the study authors advised using a range hood and fan when cooking to reduce particle and formaldehyde levels.”

Other substances detected by the investigators included phthalates (found in plastics), flame retardants, pesticides and perfluorinated compounds (found in Teflon and stain resistant carpets), she added.

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Overweight children should watch less television

Parents of overweight children should be told to reduce the amount of time they spend watching television and playing computer games, according to new official guidance for health workers.

Children over 12 whose weight is a concern should be encouraged to keep a diary of how much time they spend in front of the television or playing computer games each day, the health watchdog said.

Parents of younger children should carefully monitor their behavior in the same way, according to official guidance issued by the National Institute for Health and Care Excellence (Nice).

Doing so could help parents and children form a plan to reduce their TV viewing at certain times and replace hours spent in front of a screen with a more active pastime.

The advice is one of a broad range of recommendations issued by Nice on Wednesday with the intention of tackling the “obesity time bomb” among British children.

The guidance is aimed at health workers and other professionals who provide “lifestyle weight management services” for children, but identifies families as the key to tackling the problem.

It includes advice on identifying parents who are in denial about their child’s weight, amid concerns that efforts to help children lose weight are in some cases “undermined” by family members.

Similar guidance last week recommended the use of lifestyle weight management services, which are focused on helping people develop healthy eating and exercise habits, for adults but warned doctors not to “blame” patients for being fat.

Figures from 2011 suggest that about 30 per cent of boys and girls aged two to 10 were overweight or obese, including about 23 per cent of children aged four to five and 34 per cent aged 10 to 11.

Professor Mike Kelly, director of the Centre for Public Health at Nice, said: “Obesity in children and young people is a serious and growing concern”.

The programs will “support parents to identify changes that can be done at home to tackle obesity – and maintained over the long-term”, he added.

“Many of them are things we should all be doing anyway, including healthy eating, getting the whole family to be more active and reducing the amount of time spent watching TV and playing computer games.”

The guidance says parents and children should be told how obesity can cause serious health problems such as type 2 diabetes in later life, and to ask about their attitudes towards diet and exercise and the amount of time they spend being sedentary.

Program organizers should highlight the importance of all family members following advice on eating healthily and being physically active, even if they are not themselves overweight, it says.

It calls for “positive parenting skills training”, such as help in understanding nutritional information from food labels, or finding ways to incorporate more activity into their children’s daily life such as walking or cycling.

Tam Fry, spokesman for the National Obesity Forum, said the advice was “spot on” but said persuading local authorities to follow the guidance could be “a different kettle of fish”.

“They have been handed a poisoned chalice of dealing with it by Westminster without the funding required for the job,” he said.

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Bottle feeding linked to stomach obstruction in infants

New research says that bottle feeding appears to increase the risk of babies developing hypertrophic pyloric stenosis, a form of stomach obstruction characterized by severe and frequent projectile vomiting and most common among infants in their first 2 months of life.

Surgery, called pyloromyotomy, may be needed to clear the hypertrophic pyloric stenosis (HPS), which occurs when the smooth muscle layer of the pylorus (the “gateway” between the stomach and small intestines) thickens.

Dr. Jarod P. McAteer from Seattle Children’s Hospital and colleagues say in the study that although this is a fairly common condition – it occurs in approximately 2 in 1,000 births – the cause remains unknown.

This study, published in JAMA Pediatrics, sets out to establish if bottle feeding during early infancy increases the risk of developing HPS, and if so, how the risk is modified by other factors.

Bottle feeding ‘may play a role in HPS’

The researchers found that the incidence of HPS decreased from 14 per 10,000 births in 2003 to 9 per 10,000 births in 2009. They note that the popularity of breastfeeding also increased during that time from 80% in 2003 to 94% in 2009.

The study revealed that bottle-fed infants were more likely to develop HPS, compared with controls (19.5% vs. 9.1%). The odds of an infant developing HPS also increased if they were male, and when mothers were 35 years and older and multiparous (having given birth more than once before.).

In an accompanying editorial, Dr. Douglas C. Barnhart from the Primary Children’s Hospital, Salt Lake City, writes:

“While the data seem convincing that bottle feeding increases the risk, the reason is not clear.”  

“Further understanding of the pathogenesis of hypertrophic pyloric stenosis will come from both basic research and more detailed epidemiologic studies,” Barnhart concludes.

Dr. McAteer and his colleagues agree, adding:

“Further studies are warranted to validate these findings and to look more closely at the speculative mechanisms, including possible hormonal effects, underlying the bottle feeding-HPS association.”

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Poor coping skills linked to kids’ lower quality of life

Kids who dwell on or “catastrophize” chronic stomach pain is likely having lower quality of life than kids with a better attitude.

 However, the study showed that parents can help their children learn to cope, Fox News reported.

Study co-author Claudia Calvano of the University of Potsdam in Germany said that if the kids think, ‘My pain will not stop,’ then this can lead to further impairment and increase psychological strain.

The researchers looked at two types of stomach pain, organic pain- the kind for which doctors can identify a medical cause, and another type was functional pain- with no clear source.

They examined data on 170 kids and teenagers ages 8 to 18 and found that poor coping skills, and not gender, economic status, or type of abdominal pain, was directly tied to lower quality of life scores.

Calvano said that it is very important that a parent acknowledge the pain and not deny it, but he or she then needs to introduce the child to healthy coping strategies.

The researchers also suggested that cognitive behavioral therapy (CBT) is a way to better handle the pain

Source: medindia.com