New York urges new mothers to breastfeed babies

New York City Mayor Michael Bloomberg and state officials are pushing initiatives aimed at encouraging new mothers to breastfeed their babies, drawing criticism from some parents who say officials are interfering with their health choices.

State health commissioners announced on Tuesday that letters highlighting the importance of breastfeeding were being sent to hospitals, reminding them of regulations limiting unnecessary formula feedings for breastfed newborns.

The state initiative coincides with Bloomberg's call for hospitals to lock away their baby formula and have nurses encourage new mothers to breastfeed.

Under the mayor's plan, slated to start September 3, the city will keep a record of the number of bottles that hospitals stock and use. Formula would be signed out like medication.

The pro-breastfeeding campaign has drawn the ire of some women who argue it stigmatizes infant formula and interferes with a mother's choice of what to feed her child.

A number of the city's other health initiatives -- including cracking down on large-sized sodas and banning smoking in public places -- have attracted similar criticism from those who accuse the mayor of creating a "nanny" state.

"I breastfed both of my kids and it took me a good three weeks before I figured it out," said Rene Syler, who wrote about the issue on her website Goodenoughmother.com. "I can't imagine what it must be like to be in the hospital with someone sort of standing over your shoulder and lecturing you every time you ask for a bottle to feed your crying baby."

Under current regulations, hospitals are only allowed to provide formula to infants who have an indicated medical reason and a doctor's order for the supplemental feedings, the state health department said in a statement.

Still, only 39.7 percent of newborn infants in New York are exclusively breastfed -- well below the federal government goal of 70 percent, the state health department said. Roughly half of breastfed infants received supplemental formula in the hospital.

"We recognize that there are women that won't be able to breastfeed or chose to not breastfeed for a variety of reasons and that is a choice they should be able to make," said Dr. Barbara Wallace, the state health department's director of chronic disease prevention.

The state health department said the benefits of breastfeeding included fewer episodes of acute respiratory illnesses, inner-ear infections and gastroenteritis.

Mothers who do not breastfeed are at increased risk for postpartum bleeding and anemia, and have higher rates of breast cancer later in life, the health department statement said.

(Editing by Paul Thomasch and Lisa Shumaker)

Source : New York Reuter

Shots Should Be on College Kids' Back-to-School List

Immunizations aren't just for young children -- college students need them, too.

That's the message an expert has for parents who will be seeing children off to college this month.

"Children who are preparing for their freshman year in a dormitory are at increased risk for bacterial meningitis," Dr. Peter Wenger, associate professor at the University of Medicine and Dentistry of New Jersey, said in a university news release.

Bacterial meningitis causes swelling of the brain and spinal cord. The potentially deadly condition affects up to 2,600 otherwise healthy people in the United States each year, and teenagers and young adults are in the high-risk category.

All first-year college students should receive the meningitis vaccine, the U.S. Centers for Disease Control and Prevention recommends. The vaccine provides three to five years of protection. New Jersey, Pennsylvania and seven other states require all incoming students living on college campuses either to be vaccinated or to sign a waiver saying they choose not to receive the vaccine, according to the news release.

Wenger said the college students also should consider these other vaccines:

• Human papillomavirus, which protects against viruses that cause cervical cancer, anal cancer and genital warts.
• Tetanus, diphtheria and pertussis, which is given as a one-time dose to teens and adults. Pertussis is also called whooping cough.
• Hepatitis A, which protects against a virus that attacks the liver.
• Annual flu vaccination and any vaccines that weren't received when the college student was an infant, such as varicella (chicken pox).

If college-bound children don't have time to get vaccinated at their doctor's office, they can visit the college's office of student health.

Source : news.yahoo.com

Scientists ID New Gene Linked to Vision Loss in Infants

A new gene associated with a rare form of blindness from birth has been identified by researchers.

According to the report published online July 29 in the journal Nature Genetics, mutations in the NMNAT1 gene are linked to Leber congenital amaurosis (LCA), an inherited retinal degenerative disease that causes reduced vision in infants. Signs of vision loss are apparent in the first few months of life.

LCA is a common reason for enrolling children in schools for the blind.

This finding is a step forward in developing sight-saving gene therapy for patients with LCA, according to the researchers at the Massachusetts Eye and Ear Infirmary, the Children's Hospital of Philadelphia, Loyola University Chicago Health Sciences Division, and their colleagues.

"The immediate benefit of this discovery is that affected patients with mutations in this new LCA gene now know the cause of their condition," study co-senior author Dr. Eric Pierce, director of the Ocular Genomics Institute at Massachusetts Eye and Ear, said in an infirmary news release.

"Scientists now have another piece to the puzzle as to why some children are born with LCA and decreased vision. The long-term goal of our research is to develop therapies to limit or prevent vision loss from these disorders," Pierce said.

NMNAT1 is the 18th identified LCA gene and is located in a region known to harbor another LCA gene.

Leber congenital amaurosis occurs in about three of 100,000 newborns, and is one of the most common causes of blindness in children, according to the U.S. National Library of Medicine.

Source : news.yahoo.com

Mental Abuse of Kids Leaves Lifelong Scars

Constantly belittling, threatening or ignoring children can be as damaging to their mental health as physical or sexual abuse, according to a new report from a pediatricians' group.

But, with no bruises to spot, pediatricians, teachers and family members may have trouble recognizing these and other forms of psychological abuse. Not only are there no obvious physical scars, there is no universally agreed-upon definition of what constitutes psychological maltreatment of children, and a fine line can exist between not-so-great parenting and outright abuse, experts say.

"The main message for child health clinicians and people working with children is that psychological maltreatment is just as harmful as other types of maltreatment," said report co-author Dr. Harriet MacMillan, a professor in the departments of psychiatry, behavioral neurosciences and pediatrics at McMaster University in Ontario, Canada.

"We know that exposure to other types of maltreatment like physical and sexual abuse can be associated with a broad range of types of impairment in physical and mental health, and cognitive and social development," she said. "Similarly, we see these types of impairments associated with psychological maltreatment."

The American Academy of Pediatrics' report is published online July 30 and in the August print issue of Pediatrics.

Estimating the prevalence of the problem is difficult, in part because of the lack of a universally accepted definition of psychological abuse, MacMillan said. Studies in Britain and the United States estimate that 8 percent to 9 percent of women and 4 percent of men report severe psychological abuse during childhood.

Psychological maltreatment of children can take many forms. It can include chronically belittling, humiliating or ridiculing a child for showing normal emotions. There is also neglect, such as leaving an infant alone in a crib all day, except for feeding or changing.

Other forms of psychological maltreatment can include withholding love and warmth from a child, putting children in dangerous or chaotic situations, having rigid or unrealistic expectations accompanied by threats if not met, or confining a child and restricting social interactions. Limiting a child's access to necessary health care for reasons other than affordability is another example, according to the report.

Sometimes, but not always, psychological abuse goes hand in hand with physical abuse.

"I once had a child who talked about being hit by his dad," MacMillan said. "The child said that the dad says things about me that make me feel badly, worse than the hitting."

One of the keys to spotting abuse is the pervasiveness of it, experts say. A single bad parenting day probably isn't abuse. But near-constant ridicule, telling a child he or she is unloved and unwanted, is abuse, MacMillan said.

Similarly, there is "suboptimal" parenting -- in other words, no one is going to nominate these moms or dads for parent of the year vs. parenting that is so damaging it rises to the level of abuse.

Telling the two apart can be difficult, experts say.

"Psychological abuse is so insidious, and is not as easily recognized by the victim or other family members," said Alec Miller, chief of child and adolescent psychology at Montefiore Medical Center, in New York City.

"If you see someone getting beaten, we all know it's against the law," Miller said. "It's demarcated as illegal and very unhealthy. Some of these other things are a little more slippery. If there is no bruising physically, it's harder to be convinced there is abuse."

Research shows the effects of psychological abuse and neglect can be profound and long-lasting, ranging from problems with brain development and a failure to grow properly, to problems with behavior and relating to others.

Some parents who are psychologically abusive aren't even aware that their words and actions are harming their child, experts said.

For example, consider parents going through a very difficult divorce. "The child is subjected to major conflict between the parents and told all sorts of things about the other parent and made to choose an allegiance," MacMillan said. "These sorts of things can be psychologically abusive to a child."

Suspected cases of psychological should be reported to child protective services, the authors say. They also urge pediatricians to look for signs of emotional maltreatment in their patients.

Source : news.yahoo.com

Experts Offer Tips to Cut Kids' Screen Time During Summer

Lots of parents would like to avoid having their kids spend the summer watching television or playing video games.

According to the Alliance for a Healthier Generation, reducing the amount of time spent in front of a computer or TV can boost health and happiness, prompting families to do more physical activity and get creative in finding other ways to spend their time.

The nonprofit organization, which was formed to combat childhood obesity, offered tips to cut down on screen time:

• Schedule screen time. Decide in advance what shows will be watched, what video games will be played or how much Internet time is allowed.
• Keep track. Have children write down the amount of time they spend in front of the TV or a computer screen. If they realize they are spending more time in front of a screen than they thought, they may be motivated to change their habits.
• Be positive. Set goals for reducing screen time and offer rewards for reaching them.
• Do something else. Go outside, join a club, play a sport, get a hobby.
• Designate screen-free time. Don't turn on the TV first thing in the morning. Turn off the TV during dinner. Instead, eat outside or have a family talk. Remove electronics from bedrooms.
• Put electronics away. Try storing all electronics in one room for an entire day and not touching them, or cover screens to help you forget about them.
• Read instead. Take the kids to the library. Allow children to stay up 15 minutes past their bedtime as a reward for reading.

Source : news.yahoo.com

More Drug Trials Needed for Conditions Affecting Kids: Review

A new review finds that while children account for almost 60 percent of those with five common medical conditions, only 12 percent of clinical trials of drugs for those conditions examined their effects on pediatric patients.

Yet, the review authors noted, previous research has shown that off-label drugs, where the medicine has only been approved for adult use by the U.S. Food and Drug Administration, make up as much as 79 percent of the medications given to children in hospitals and up to 56 percent of drugs prescribed for kids in doctors' offices.

"We think this contrast is striking, and speaks to the under-representation of research on kids," said review author Dr. Florence Bourgeois, an assistant professor of pediatrics at Boston Children's Hospital and Harvard Medical School in Boston. "Understandably, whenever we see an adverse event the concern is, 'Could these drugs really be dangerous?' and we are left wondering."

The results were released online July 23 in advance of publication in the August print issue of the journal Pediatrics.

The FDA requires that clinical trials demonstrate a drug's safety and effectiveness for a condition before it approves the drug to treat that condition, but many drugs are only tested in adults. As a result, physicians are often left to rely on trial-and-error to decide how to use drugs off-label in children, the review noted. Bourgeois and her team found that, while just over 21 percent of people in high-income countries who are afflicted by conditions such as depression, asthma, migraines, schizophrenia and bipolar disorder are children and adolescents, less than 10 percent of clinical trials studying these conditions included patients under the age of 18.

The gap was even wider for developing countries, where children and adolescents bear nearly 62 percent of the disease burden for conditions such as malaria, diarrhea, HIV and depression, but only about 12 percent of clinical trials of treatments for these diseases include pediatric patients.

A number of professional organizations, including the Institute of Medicine, the American Academy of Pediatrics and the Royal College of Paediatrics and Child Health in England, have all published statements on the importance of evaluating medical treatments for children using randomized, controlled trials. A randomized, controlled trial, in which study participants are randomly chosen to either receive a treatment or not, is the gold standard for medical research.

"In some instances, it may be fine to extrapolate adult [dosing] information and scale down, but the way drugs are metabolized and excreted from the body is different in children," Bourgeois said. "Children might metabolize faster and need a greater dose than one might think just in terms of scaling down."

Children are also a special patient group because their bodies are still developing, and leaving them out of clinical trials means the possible effects of drugs on their growth go unaddressed, said review co-author Dr. Kenneth Mandl, an associate professor of pediatrics at Boston Children's Hospital.

In addition, some drugs taken by adults work the opposite way in kids, explained Albert Wertheimer, a professor of pharmacoeconomics at Temple University in Philadelphia.

"Drugs for [attention-deficit disorder] are stimulants that people take to stay up for a test, but when used in kids, they settle them down," Wertheimer noted.

For the review, Bourgeois and her colleagues reviewed all the clinical trials that were registered at ClinicalTrials.gov, the largest repository of clinical trials conducted around the world, between 2006 and 2011 for major pediatric conditions.

One reason for the lack of pediatric clinical trials could be who pays for them: The current study found that, while half of funding for trials on adults came from industry sources such as drug makers, the major source of funding for trials on kids was nonprofit groups.

Although the lack of industry funding of children's drug trials could be viewed as a good thing because industry backing has been shown to introduce biases, "it's tricky because there are limited resources when it comes to nonprofits, so it would limit the amount you can do," Bourgeois explained.

Pharmaceutical companies make a "conscious decision" to exclude children from trials of their drugs because it is more difficult and expensive to recruit children and get parental consent, and they have a higher rate of dropping out of trials, Wertheimer said.

On top of that, the payoff is higher for adults, Mandl said. "There are even larger markets of adult chronic conditions that are in the sweet spot for profitability of blockbuster drugs."

In an effort to spur drug research in kids, the U.S. government has been offering financial incentives to drug companies that carry out pediatric studies for more than a decade.

But, Bourgeois thinks that more is needed. "It should be a combination of financial incentives and some requirements around what drugs need to be tested in children," she explained.

And, in high-income countries, the drugs to treat mental illness should require the most research. "It's really neuropsychiatric conditions that have overtaken physical impairments," Bourgeois explained. "Children might be deprived of effective treatments if clinicians are not willing to use drugs off-label in them."

Wertheimer agreed that greater requirements for pediatric clinical trials might be in order.

"For any drug that has a high probability of being used in children, it wouldn't be a bad idea to mandate that the drug be tested in some population of children," said Wertheimer, who added that drugs such as antibiotics would likely have a large market in children.

In the meantime, the pace of research in children is at least picking up, even if the rate has not been increasing as much as it has for adults, Bourgeois noted.

Source : news.yahoo.com

More Than a Third of Babies Unintended

More Than a Third of Babies Unintended

July 24, 2012 -- More than one-third of births in the U.S. are the result of an unplanned pregnancy, according to a CDC study.

Despite a decrease in unplanned pregnancies among white women, researchers say the number of unintended births has remained steady at about 37% of all births since 1982.

"The growing proportion of births to unmarried women, most of which were unintended, has kept the overall proportion of unintended births approximately constant," write researcher William Mosher, PhD, of the National Center for Health Statistics at the CDC, and colleagues.

The study is published in the National Health Statistics Reports. It shows that unmarried women accounted for 41% of all births in 2009, up from 18% in 1980.

Researchers say major differences also persist in the number of unplanned pregnancies according to:

• age
• race
• income
• education

"Unintended births occur disproportionately among non-Hispanic black women, unmarried women, and women with less income and education," they write. "For example, the proportion of all births that were unwanted or mistimed by two years or more was 7% for college graduates compared with 35% for women who did not complete high school."

Unplanned Pregnancy Statistics

The study shows that never-married women and Hispanic women now account for a growing number of births.

Researchers say the percentage of births that were intended among white women who had ever been married has increased during recent years. But these women now represent a much smaller share of overall births. In 1981, they accounted for 66% of all births. But in 2006-2010 this number decreased to 43%.

The study also showed that 60% of women who experienced an unplanned pregnancy in 1998-2002 were not using contraception.

More than a third of those who did not use contraception (36%) said they did not think they could get pregnant.

"Underestimating the risk of pregnancy is the most common reason for not using contraception that leads to unintended pregnancy," write the researchers. "There was no significant variation in the percentage of women who gave this reason by age, marital status, or income. However, Hispanic women were more likely than others to say they did not think they could get pregnant (49%, compared with 35% of white women and 25% of black women)."

Researchers say the most recent unplanned pregnancy statistics from 2006-2010 highlight persistent differences according to the mother's age, ethnicity, and marital status.

During this period:

• Nearly 4 out of 5 teen births were the result of an unplanned pregnancy.
• Half of births to young women aged 20-24 were intended compared with 75% of births among women aged 25-44.
• About 77% of births to women who were married at the time of birth were intended compared with 49% of births to women who were living with their partner and 33% of births among single women.
• More than two-thirds of births to white women were intended compared with 57% among Hispanic women and 47% among African-American women.

Source : webmd.com