The boys and I read two extra books last night — we almost skipped it altogether as it was late and we were beat from a long day and yada, yada, yada…you know the drill. But reviewing this data changed me, yet again. I knew some of the value of reading to young children before I had kids because of my experiences being a teacher and my training in pediatrics but the refreshers provided this week only compound my interest in screaming the value of reading from the rooftops.
It’s NEVER too early to start reading to your baby. Reading aloud before bed is always the right thing to do.
This week The Clinton Foundation with Too Small To Fail, The American Academy of Pediatrics, Reach Out And Read, and Scholastic got serious about ensuring our country takes reading seriously right out of the gate. For the first time ever the groups have come together to proclaim that parents should start reading to children “as early as you can” after birth. The new policy and partnership emphasizes the need for early reading to all infants and children while also emphasizing the necessity that all pediatricians promote this healthy habit at birth and through all preschool doctor visits. Profound health disparities currently exist for US children and book time. I suspect the numbers will surprise you.
It’s a no-brainer to most parents I talk with that reading books enhances development, literacy, and school readiness. What may surprise you is that reading has also been found to enhance the relationship between a child and parent. Reading books (or even the newspaper) to your infant from day one can have profound effects on how they live, how they talk, and how they learn — the impact extends well into adulthood. From the very beginning, though, some children are missing out. Children from low-income families hear fewer words in early childhood and know fewer words by 3 years of age creating the “word gap” early in their lives. The more words a child hears during early, critical times for language development, the more they’ll know. And although reading books can be a great resource to introduce an expansive, enriched vocabulary, less than 1/2 of children are read aloud to in this country every day.
All families face issues of limited time, limited parental understanding of the key role of reading aloud, and competition for the child’s interest and attention from other sources of entertainment ~ The American Academy of Pediatrics Council on Communications And Media ( 2011)
A new policy statement from The American Academy of Pediatrics finds that many women, including up to 1/3 of pregnant women, may have low levels of iodine putting them at risk for iodine deficiency. The reason for the deficiency is the changing food source. Over the last 20-30 years our major source of salt has shifted away from table salt (supplemented with iodine) to salt from processed foods, sea salt or gourmet salts that have no supplemental iodine. This is especially important for breastfeeding and pregnant women as iodine is essential for thyroid function that supports fetal and newborn brain development.
This policy statement was news to me. I had no idea that the salt used to make most processed foods lacked iodine, that the majority of prenatal vitamins didn’t provide iodine, and the number of women who may have a deficiency. I’m not alone; when I polled my Mama Doc Facebook community most moms & many doctors also commented this was a newsflash. Here’s more:
Iodine Deficiencies– Shifting Sources Salt
WHY ARE WE DEFICIENT? Most processed foods made are with salt that is not iodized. Since we get most of our salt from those foods we’re taking in less iodine than we used to.
TABLE SALT INTAKE: Table salt is iodized, many gourmet salts are not. Consider ensuring that when cooking in your home (ie putting salt in the pasta water or salting the veggies) you use iodized table salt so your intake of iodine goes back up. REMEMBER: this doesn’t mean you should eat MORE salt, just swap in the table salt for the fancy salts when you can.
WHY DO WE NEED IODINE? We need iodine for thyroid hormone synthesis as thyroid is essential in brain development and metabolism. The policy reminds us that even mild iodine deficincy can affect fetal and early childhood neurocognitive development stating, “adequate thyroid hormone production is critical in pregnant women and neonates because thyroid hormone is required for brain development in children.” The recommendations from AAP spelled out:
Constipation is really no fun for anyone. No fun for baby or child, no fun for the parent who cleans the clogged toilet, no fun for the sister or brother who waits while someone works on solving the problem in the room next door. In general, constipation is a frustrating, sometimes embarrassing, and often chronic problem for young children. Here are a few ideas to get rid of the no-fun part and ways to protect your children, support them positively, and avoid dangers that can rarely come from over-the-counter (OTC) medications.
Before you reach for OTC medications, consider what is normal and what is not normal when it comes to poop. I usually break this down for children (and parents) in visual terms. I talk about things you find outside.
In general, poop in the toilet can look like a pond,a snake, a log, or a pebble. When it comes to poop, we’re always looking for snakes. It seems to me that framed this way, school age children can do a better job knowing if they’re constipated or not. We’re looking for Snakes in the Lake, people! Frame it this way with your child and perhaps they will be more likely to get a glimpse of what they produce in the toilet?
In my experience, parents worry a lot about hard infant or toddler poop in the diaper but constipation sneaks up on many families to school-aged children. After children are toilet trained and wiping themselves (around age 4 or 5) many parents no longer gaze in the toilet bowl. Long gone are the days of staring at every diaper as parents lose track of the daily poops, how often they poop, and how a child feels when pooping. But first, some definitions: Read full post »
New 2014 recommendations are out for improving our prevention efforts for children. Parents can help ensure children get what they deserve at check ups. The updates to recommendations for wellness check-up are written to guide physicians but parents are a key voice in ensuring it all happens!
Updated 2014 Recommendations For Check-Ups
Some relevant changes to prevention/screening for children:
Infants: All infants need a pulse oximetry screen at or after 1 day of life to screen for heart defects. The test is non-invasive (just requires a technician, nurse, or doctor put an oxygen probe on their arms and legs). More information on the test here. Ideal time for testing is between 24 and 48 hours of life. If your baby is born at home or outside the hospital, go in to see pediatrician for the screen on day 1 or 2! Toddlers should be screened for iron deficiency risk at 15 and 30 months of age.
Teens: All teens need an annual check-up (a complete check-up will provide some time alone with doctor and nurse; mom or dad will be asked to leave for at least part of the visit). All teens need HIV screening test at age 16-18 (or sooner) and girls get their first pap smear at age 21.
“Children appear to be less at risk for developing peanut or tree nut allergies if their mothers are not allergic and ate more nuts during pregnancy,” according to a study published today in JAMA Pediatrics. And although this doesn’t mean that you need to run out for the peanut brittle the minute you’re pregnant, it may mean we can reassure pregnant women that if they have no allergies themselves, what they eat during pregnancy should contain nuts, among other things.
As you’ve likely heard, children with peanut allergies have more than tripled in the United States this last 15 years. Food allergies affect 1 in 13 children in the United States and up to 40% of children have had a life-threatening or severe reaction. Any family with a food-allergic child will tell you this is a BIG deal.
The rapid rise of food allergies is incompletely understood, but more and more research suggests that waiting to introduce “high allergy” foods (traditionally thought of as peanut, egg, or shellfish for example) may have actually caused more allergies than prevented them. As this was being discovered this last decade or so, flip-flopping recommendations on what to eat ourselves when pregnant and what to feed our babies have left many of us confused.
New recommendations really encourage introduction of a variety of foods, including nuts, eggs, shellfish, wheat, and soy within the first year of life. The theory is that early introduction of the components of these foods allow a child’s developing body to create a tolerance to them, thus potentially avoiding any allergy or reaction to them later on. Read full post »
I got in a heated discussion with a researcher last week. We were chatting about strategies to improve challenges with overweight and obesity. He mentioned it was media controls (automatic locks on devices) that would change children’s habits regrading screen time in the home — he just didn’t want to leave it up to parents anymore. As I understood his perspective, left to chance it’s unlikely parents will avoid screens when it comes at the cost of convenience. I mentioned to him that my young children watched very little television, that in fact, “They’d never turned the television on themselves.” He looked at me sideways, he called my bluff. I told him again they literally had zero access to TV or other screens on their own.
I’ve carried this conversation with the researcher with me since. Not only because of how it rubbed me the wrong way but how his presumptions are based in new realities. It was easier, even just 7 years ago, to rear our children screen-free. I mean, the iPhone didn’t exist when my 7 year-old was born. It’s far more difficult to moderate screen use now that the majority of parents have smart phones in their pockets, laptops in the kitchen, and tablets near the couch. Three quarters of young children now live in homes with mobile devices (like my children). Those of us who avoid or limit screens have created huge work-arounds in our world.
Earlier this year Common Sense Media published their Zero To Eight report detailing young children’s media use. The report is worth a glance as the stats are fairly mind-blowing. A snaphot shows us:
3/4 of young children live in homes with mobile devices, some 38% of infants and toddlers have now used a mobile device.
1/3 of children have a television in their bedroom (16% of infants have one) and the likelihood that one ends up there increases with age. For children between 5 and 8 years of age, nearly 1/2 (45%) have a TV where they sleep. Most noteworthy for me: the main reason parents report that a child has a TV in the bedroom is to, “Free up other TVs so family members can watch their own shows.”
Over 1/3 of families say the television is on “most or all of the time” in their home.
63% of children have played a game on a smartphone or mobile device with 17% of parents reporting their children (0-8 years) use a mobile device every single day.
New research out today confirms that buying breast milk on the Internet via milk-sharing sites may not be safe. Although breast milk purchased from online sites may be free or as cheap as $1-$2 an ounce, it may carry significant risk for babies. Clearly the benefits of breast milk are vast; pediatricians and health experts recommend exclusive breast feeding until 6 months of age. However, simply put, breast milk obtained from unknown (or known) individuals online may carry contamination from medications/drugs excreted in the breast milk, bacterial, or viral contamination. If a mother isn’t able to provide enough breast milk for her newborn or infant, parents must know that milk from online sellers can be contaminated at the time of collection and/or during transport, dangerous especially for babies born prematurely. If buying human breast milk parents should look for a certified milk bank.
Back in 2010 the FDA spoke out against the practice of buying breast milk online, warning parents of potential risks due to bacteria or viral contamination, exposure to chemicals, medications, and drugs. The research out today confirmed these hesitations: nearly 3/4 of the breast milk obtained by researchers online had bacterial contamination and 20% of the samples tested positive for a virus called CMV.
It should be noted that breast milk bacteria (or virus) counts aren’t deterministic for infection, meaning that just having bacteria in a breast milk sample doesn’t mean a baby will get sick from it. How old a baby is, the amount of bacteria in the sample, and the immune status of an infant all also play a part. However, there are reports of premature babies and babies with immune dysfunction becoming seriously ill from donated unpasteurized breast milk so caution is necessary.
To be very clear the breast milk obtained and studied in the new research was NOT from a milk bank. Human Milk Banking of North America (HMBANA) breast milk banks screen donors for infections (like HIV) and pasteurize the breast milk to ensure improved safety protection. The trouble for many families unable to make enough breast milk with using these banks can be very costly secondary to the handling, screening, and pasteurization. Milk can be several dollars an ounce! Read full post »
Unthinkable really, leaving a child in a car and forgetting about them. But it happens more than a dozen times every single year here in the US. On average, over 30 children die from the consequences of heat stroke after being left or trapped in a hot car.
Children are particularly vulnerable to heat stroke because their bodies heat up 5 times faster than adults. The reason for their quicker warming stems from a child’s inferior ability to cool themselves (sweat) and their high surface-area-to-mass ratios.
A car heats up rapidly on a hot day. For example, if it’s 80 degrees outside your car can heat up to 123 degrees in an hour. Heatstroke can happen when it’s only 60-70 degrees outside and we all know from experience that in just 10 minutes, your car can rise 20 degrees in temperature.
Most people instantly feel that they could never forget their sleeping children in their car on the way to work. Read this incredible 2009 award-winning Washington Post article if you’re in doubt. Gene Weingarten chronicles the experience of a man on trial for murder after forgetting his child in the car. He weaves in details about the science of distraction. It’s a haunting and terribly difficult article to read but it’s wholly instructive: this could happen to any of us.
We have to create reminders and habits that prevent the possible mistakes of leaving an infant or child in a hot car (see below).
Parents may leave children in a car that can overheat by accident after forgetting to drop them at school in the morning. Mr Weingarten writes: Read full post »
Some new data published in the American Journal of Managed Care finds increased value in preventative well baby and toddler check-ups. Not because it keeps pediatricians busy, but really because it potentially can save suffering and hospitalizations for young children that would otherwise hopefully not occur.
A study published this month evaluated over 20,000 babies and toddlers in the Group Health network. They reviewed medical charts to study both rates of hospitalizations and rates that families showed up for their well baby check-ups. They specifically evaluated rates of hospitalizations for what they call, “ambulatory-care sensitive hospitalizations,” in which access to routine care could potentially avoid an illness developing that would require a child to be admitted to the hospital for treatment. Here’s more and how you can find low cost medical or dental clinics for yourself or your child and get help applying for health insurance:
Like so many controversial parenting topics, discussing home births brings out dynamic opinions. These controversial topics unfortunately often tease us apart from one another. This week, the American Academy of Pediatrics (AAP) issued a policy statement on home births that will hopefully help inform. In general, the policy statement identified data confirming it’s safer to have birth in a hospital, but outlined ways to decrease risks for moms and families, midwives, and doulas that want to partner with moms to have their babies at home, as safely as possible.
Home births only occur in about 1% of births here in the United States although interest in increasing. Distance from the hospital matters~ if it takes more than 20 minutes to get into a hospital from home, risk of complications including infant mortality are higher. Data shows that home births carry at 2-3 fold higher risk for infant death when compared to hospital births.
The AAP states home births should only be considered if no maternal health problems, if it’s a term baby (after 37 weeks and before 41 weeks gestation), labor started at home spontaneously or as an outpatient, and it’s a single pregnancy that isn’t breech. Having had a previous C-section makes a home birth a no-no in their mind.
The AAP recommends having at least 2 people attending the birth with at least one person at the birth who’s sole job is to care for and tend to the baby after the birth. They outline that the baby’s caregiver needs to know how and why to resuscitate a newborn. The team caring for mom and baby need access to consultation with obstetricians and pediatricians and a well-planned way to access the hospital or medical team easily if needed.
The AAP says, “Every newborn infant deserves health care that adheres to the standards highlighted in this statement.” Care described includes warming the baby and initial transitions, glucose monitoring, infection monitoring, feeding assessment, jaundice checks, vitamin K shot, Hepatitis B shot, eye infection prevention, hearing screen, newborn blood screen, and follow-up care plans.
I believe we each have the right to make health care decisions that are best for our families. We also must have access to un-biased information on safety. Every single health decision we make is a process where we weigh risks against benefits. Home birth versus hospital birth is no exception.
My disclaimers: I had 2 hospital births which required all sorts of intervention and intensive care—2 C-sections, a bedside resuscitation for my newborn, and a short NICU stay for one of my sons. I would never have wanted to have a home birth after my training in pediatrics. That being said, there were aspects of the hospital care that really upset me. I didn’t have a birth plan, per se. I wanted this: a healthy baby and to survive the delivery without complication. I got both, thank goodness, but it wasn’t perfect. The beginning of motherhood was a challenge for me both times around and in part, I’ve always looked back feeling I should have been a stronger mom in the hospital… Read full post »
Seattle Children’s provides healthcare for the special needs of children regardless of race, color, creed, national origin, religion, sex (gender), sexual orientation or disability. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.