User login
A decent proposal
Guys, if you haven’t proposed to your beloved yet, don’t bother planning anything romantic. Just text her, “Will u marry me?” along with a link to Amazon’s jewelry section. Because unless you’re prepared to rent a stadium, hire a 50-piece band to play your own original composition, and arrange a pyrotechnics display that would put Metallica to shame, there’s no way your efforts can compare to Kanye West’s proposal to Kim Kardashian (and don’t think your girlfriend doesn’t know that). The couple’s infant daughter North was not in attendance, as it was past her bedtime. Kanye was thinking of North’s safety, however, when he bought the engagement diamond: The rock is far too large to fit in a baby’s mouth.
Spare rods?
When it’s running slow, admit it, you sometimes smack your computer. Our IT consultant says that’s why he has to keep replacing my keyboard, but it just feels so good, you know? According to two companion studies in this month’s Pediatrics, spanking children makes about that much sense, and it doesn’t feel nearly as good, perhaps because computers rarely cry.
Most parents say they spank in order to gets their children to behave, although it’s possible some of them simply suffer sudden, uncontrolled arm movements. Both of the new studies demonstrated that spanking actually worsens children’s behavior in the long term, and one also showed a strong correlation with poor receptive language skills at age 9 years. Essentially, spanking kids is like punishing your car by driving it without oil.
The glaring difference between the studies, aside from their focus on different age groups (under age 2 in one, ages 3-5 years in the other), is that the one with the toddlers found that only white children suffer behavioral effects from spanking. The logical conclusion of this finding would of course be that we provide racially specific counseling to parents of toddlers, suggesting for example that biracial children only be spanked on one buttock. The study of preschoolers failed to find racial differences in the harm attributable to spanking, presumably because, before they ran the statistics, the investigators remembered to whack their computers.
Culture club
Is it just me, or are there some things you still just shouldn’t buy online? I get all these e-mail offers for Viagra, which, even if I had, you know, pulmonary hypertension, I still probably wouldn’t be ordering from some Internet operation in Chechnya. So was anyone surprised to see the article in Pediatrics this week with what has to be the least suspenseful headline ever: “Microbial Contamination of Human Milk Purchased via the Internet”?
The authors ordered 101 different human milk samples online and had them delivered to a rented mailbox in Ohio. (“Breast-milk again, huh? You guys sure do seem to get a lot of that stuff!”) They then checked the bacterial content of this milk, finding that nearly three-quarters of the samples were colonized with high counts of bacteria, including E. coli, Staphylococcus, and Salmonella. I don’t think that’s what they mean when they say, “probiotics.”
The authors suggest that mothers who require supplemental breast milk for their babies work with lactation consultants and approved milk banks instead of buying the milk from strangers all over the country online and waiting for it to arrive at an anonymous mailbox in Ohio. The authors do not comment on whether they gave the sellers of contaminated milk poor reviews on eBay.
You want fries with that?
You know what constitutes a First World problem? Picky eaters. You think there are kids in Southern Sudan going, “I don’t like hummus, I only want chicken nuggets!”? But apparently in England as in America, there are kids who refuse to taste vegetables and insist on eating only macaroni and cheese or bangers and mash or whatever it is picky British toddlers survive on. Now, however, researchers in England have hit upon a solution: the Tiny Tastes program. And no, it does not involve sending children to live in Southern Sudan.
Investigators publishing in the Journal of the Academy of Nutrition and Dietetics challenged 196 little picky eaters to try small bites of vegetables in return for rewards. The program involved a video-training program, a booklet, and stickers to give to cooperative kids (because we know food rewards are about as useful as whacking a computer). Compared with kids in the control group, children who got stickers became virtual Peter Rabbits, with 141 enjoying vegetables at the end of the experiment, up from 39 at the beginning. Future research will focus on how many vegetables children will eat in return for Kim Kardashian’s engagement ring.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Guys, if you haven’t proposed to your beloved yet, don’t bother planning anything romantic. Just text her, “Will u marry me?” along with a link to Amazon’s jewelry section. Because unless you’re prepared to rent a stadium, hire a 50-piece band to play your own original composition, and arrange a pyrotechnics display that would put Metallica to shame, there’s no way your efforts can compare to Kanye West’s proposal to Kim Kardashian (and don’t think your girlfriend doesn’t know that). The couple’s infant daughter North was not in attendance, as it was past her bedtime. Kanye was thinking of North’s safety, however, when he bought the engagement diamond: The rock is far too large to fit in a baby’s mouth.
Spare rods?
When it’s running slow, admit it, you sometimes smack your computer. Our IT consultant says that’s why he has to keep replacing my keyboard, but it just feels so good, you know? According to two companion studies in this month’s Pediatrics, spanking children makes about that much sense, and it doesn’t feel nearly as good, perhaps because computers rarely cry.
Most parents say they spank in order to gets their children to behave, although it’s possible some of them simply suffer sudden, uncontrolled arm movements. Both of the new studies demonstrated that spanking actually worsens children’s behavior in the long term, and one also showed a strong correlation with poor receptive language skills at age 9 years. Essentially, spanking kids is like punishing your car by driving it without oil.
The glaring difference between the studies, aside from their focus on different age groups (under age 2 in one, ages 3-5 years in the other), is that the one with the toddlers found that only white children suffer behavioral effects from spanking. The logical conclusion of this finding would of course be that we provide racially specific counseling to parents of toddlers, suggesting for example that biracial children only be spanked on one buttock. The study of preschoolers failed to find racial differences in the harm attributable to spanking, presumably because, before they ran the statistics, the investigators remembered to whack their computers.
Culture club
Is it just me, or are there some things you still just shouldn’t buy online? I get all these e-mail offers for Viagra, which, even if I had, you know, pulmonary hypertension, I still probably wouldn’t be ordering from some Internet operation in Chechnya. So was anyone surprised to see the article in Pediatrics this week with what has to be the least suspenseful headline ever: “Microbial Contamination of Human Milk Purchased via the Internet”?
The authors ordered 101 different human milk samples online and had them delivered to a rented mailbox in Ohio. (“Breast-milk again, huh? You guys sure do seem to get a lot of that stuff!”) They then checked the bacterial content of this milk, finding that nearly three-quarters of the samples were colonized with high counts of bacteria, including E. coli, Staphylococcus, and Salmonella. I don’t think that’s what they mean when they say, “probiotics.”
The authors suggest that mothers who require supplemental breast milk for their babies work with lactation consultants and approved milk banks instead of buying the milk from strangers all over the country online and waiting for it to arrive at an anonymous mailbox in Ohio. The authors do not comment on whether they gave the sellers of contaminated milk poor reviews on eBay.
You want fries with that?
You know what constitutes a First World problem? Picky eaters. You think there are kids in Southern Sudan going, “I don’t like hummus, I only want chicken nuggets!”? But apparently in England as in America, there are kids who refuse to taste vegetables and insist on eating only macaroni and cheese or bangers and mash or whatever it is picky British toddlers survive on. Now, however, researchers in England have hit upon a solution: the Tiny Tastes program. And no, it does not involve sending children to live in Southern Sudan.
Investigators publishing in the Journal of the Academy of Nutrition and Dietetics challenged 196 little picky eaters to try small bites of vegetables in return for rewards. The program involved a video-training program, a booklet, and stickers to give to cooperative kids (because we know food rewards are about as useful as whacking a computer). Compared with kids in the control group, children who got stickers became virtual Peter Rabbits, with 141 enjoying vegetables at the end of the experiment, up from 39 at the beginning. Future research will focus on how many vegetables children will eat in return for Kim Kardashian’s engagement ring.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Guys, if you haven’t proposed to your beloved yet, don’t bother planning anything romantic. Just text her, “Will u marry me?” along with a link to Amazon’s jewelry section. Because unless you’re prepared to rent a stadium, hire a 50-piece band to play your own original composition, and arrange a pyrotechnics display that would put Metallica to shame, there’s no way your efforts can compare to Kanye West’s proposal to Kim Kardashian (and don’t think your girlfriend doesn’t know that). The couple’s infant daughter North was not in attendance, as it was past her bedtime. Kanye was thinking of North’s safety, however, when he bought the engagement diamond: The rock is far too large to fit in a baby’s mouth.
Spare rods?
When it’s running slow, admit it, you sometimes smack your computer. Our IT consultant says that’s why he has to keep replacing my keyboard, but it just feels so good, you know? According to two companion studies in this month’s Pediatrics, spanking children makes about that much sense, and it doesn’t feel nearly as good, perhaps because computers rarely cry.
Most parents say they spank in order to gets their children to behave, although it’s possible some of them simply suffer sudden, uncontrolled arm movements. Both of the new studies demonstrated that spanking actually worsens children’s behavior in the long term, and one also showed a strong correlation with poor receptive language skills at age 9 years. Essentially, spanking kids is like punishing your car by driving it without oil.
The glaring difference between the studies, aside from their focus on different age groups (under age 2 in one, ages 3-5 years in the other), is that the one with the toddlers found that only white children suffer behavioral effects from spanking. The logical conclusion of this finding would of course be that we provide racially specific counseling to parents of toddlers, suggesting for example that biracial children only be spanked on one buttock. The study of preschoolers failed to find racial differences in the harm attributable to spanking, presumably because, before they ran the statistics, the investigators remembered to whack their computers.
Culture club
Is it just me, or are there some things you still just shouldn’t buy online? I get all these e-mail offers for Viagra, which, even if I had, you know, pulmonary hypertension, I still probably wouldn’t be ordering from some Internet operation in Chechnya. So was anyone surprised to see the article in Pediatrics this week with what has to be the least suspenseful headline ever: “Microbial Contamination of Human Milk Purchased via the Internet”?
The authors ordered 101 different human milk samples online and had them delivered to a rented mailbox in Ohio. (“Breast-milk again, huh? You guys sure do seem to get a lot of that stuff!”) They then checked the bacterial content of this milk, finding that nearly three-quarters of the samples were colonized with high counts of bacteria, including E. coli, Staphylococcus, and Salmonella. I don’t think that’s what they mean when they say, “probiotics.”
The authors suggest that mothers who require supplemental breast milk for their babies work with lactation consultants and approved milk banks instead of buying the milk from strangers all over the country online and waiting for it to arrive at an anonymous mailbox in Ohio. The authors do not comment on whether they gave the sellers of contaminated milk poor reviews on eBay.
You want fries with that?
You know what constitutes a First World problem? Picky eaters. You think there are kids in Southern Sudan going, “I don’t like hummus, I only want chicken nuggets!”? But apparently in England as in America, there are kids who refuse to taste vegetables and insist on eating only macaroni and cheese or bangers and mash or whatever it is picky British toddlers survive on. Now, however, researchers in England have hit upon a solution: the Tiny Tastes program. And no, it does not involve sending children to live in Southern Sudan.
Investigators publishing in the Journal of the Academy of Nutrition and Dietetics challenged 196 little picky eaters to try small bites of vegetables in return for rewards. The program involved a video-training program, a booklet, and stickers to give to cooperative kids (because we know food rewards are about as useful as whacking a computer). Compared with kids in the control group, children who got stickers became virtual Peter Rabbits, with 141 enjoying vegetables at the end of the experiment, up from 39 at the beginning. Future research will focus on how many vegetables children will eat in return for Kim Kardashian’s engagement ring.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Fantasy I Land
Is anything quite so unsettling as waiting for people who should be responsible adults to stop fighting and arrive at a consensus, especially when so much is hanging in the balance? I mean, how long is it going to take Focus Features to pick an actor to play the hot young billionaire-sadist Christian Grey? According to an article in Variety, the problem is that all the really sexy leading men in Hollywood are...my age. That’s right, George Clooney, Robert Downey Jr., Will Smith, Hugh Jackman, Johnny Depp, Brad Pitt, Vin Diesel, all of them are 45 to 50 years old. I know because we all work out together.
My own theory has less to do with the movie business than with the varied nature of human sexuality. Since 2011, E.L. James’s Fifty Shades... books have sold more than 70 million copies worldwide, with many a dog-eared volume being passed among friends over cosmopolitans. That means there have to be, like, 140 million different and intensely vivid ideas of what Christian Grey looks like. No matter who gets picked for the role, 139 million readers will be tweeting that he’s all wrong. When the producers finally do settle on an actor, 139,999,999 boyfriends and husbands will be going, “But I thought you said I was your Christian Grey!” And one dude is going to be like, “Yesss!”
Carpe diem
Is it too early to start compiling the pre-New Year’s list of fads from 2013 that are officially over? Can we compost kale? Can we give gluten sensitivity back to people who actually have celiac disease? And is it now finally time to send alternative vaccine schedules wherever it is Psy went? And, if there’s room, can we also send Miley Cyrus?
As if the professional humiliation of Andrew Wakefield and unprecedented outbreaks of measles and whooping cough were not already sending a message, a new study in JAMA Pediatrics should give serious pause to parents who delay vaccinating their children against measles because they think it’s safer. As it turns out, late measles vaccination nearly doubles the risk of febrile seizures, compared with timely immunization. That, and it leaves children unprotected from measles. That second one should be self-evident, but, well, you know.
Lead author Dr. Ali Rowhani-Rahbar of the University of Washington, Seattle, lives at the epicenter of vaccine resistance in the United States, but he reached out nationally to include more than 850,000 children in his study (take that, alpha error!). He found that giving kids fevers at the time of life when they’re most likely to have febrile seizures (16-24 months) made them more likely to have febrile seizures. I know, right? Will these results finally stop a few of our colleagues from flogging their pseudoscientific books on talk shows and social media? I’m guessing that if actual epidemics of measles and pertussis didn’t do it, then Dr. Rowhani-Rahbar will still have plenty of subjects for his next study.
Lights out
There has been much hand-wringing about the overuse of prescription stimulants to treat attention-deficit/ hyperactivity disorder (ADHD), partly because the side effects of these stimulants include hand-wringing. The search for alternative cures for childhood behavior problems has led from fish oil to gluten- and dairy-free diets, but could it be possible that one solution is as simple as a light switch? New data from the U.K. suggest that just putting kids to bed at the same time every night can substantially improve their behavior, and it doesn’t leave a fishy aftertaste.
We’ve known that sleep deprivation and conditions like obstructive sleep apnea can detract from children’s behavior and academic performance, but a trio of authors from the Department of Epidemiology and Public Health, University College London, wondered if irregular circadian rhythms would have the same effect independent of actual hours of sleep. Their study of more than 10,000 7-year-olds demonstrated not only a correlation between irregular bedtimes and behavioral problems, but they showed something much more important: Kids whose bedtimes became more regular improved their behavior. Fellow parents of whiny children who don’t want to go to bed, I say to you, “Booyah!”
Of course, before we start treating behavior problems with nothing more than an alarm clock, we must acknowledge some limitations of the study. Perhaps the most glaring is that irregular bedtimes are likely a good proxy for all sorts of limit-setting issues in families, as well as for a generally chaotic household. But don’t think for a minute I’m letting my kids know about that. Every night at 8:30, their lights are out, and if they complain they can’t sleep, I’m just going to threaten to read this study aloud to them. Good night!
Just say no
Does anyone remember the early days of the DARE (Drug Abuse Resistance Education) program, when police officers would stand in front of your class and tell you dope is for dopes? It launched when I was in high school, and I had friends who would only attend the lectures stoned. It took years of research and a major shift in the program’s content before it became nominally effective at its goals of reducing youth drug use and gang violence. Could the new crop of bullying-prevention programs be the DARE of our age? Why, yes, they could.
Or they could be worse. According to a study of bullying-prevention programs in the Journal of Criminology, students are more likely to be bullied at schools with prevention programs than at those without them. Lead author Seokjin Jeong suggests that perhaps the programs provide a script for budding bullies to follow so that they don’t have to be creative. With all the attention given to bullying right now, I’m optimistic that we’ll eventually figure out how to intervene in a way that doesn’t just serve as an instructional video for jerks. One day our children will grow up in a world where the only sadists are handsome billionaires, and we can all agree what he looks like.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Is anything quite so unsettling as waiting for people who should be responsible adults to stop fighting and arrive at a consensus, especially when so much is hanging in the balance? I mean, how long is it going to take Focus Features to pick an actor to play the hot young billionaire-sadist Christian Grey? According to an article in Variety, the problem is that all the really sexy leading men in Hollywood are...my age. That’s right, George Clooney, Robert Downey Jr., Will Smith, Hugh Jackman, Johnny Depp, Brad Pitt, Vin Diesel, all of them are 45 to 50 years old. I know because we all work out together.
My own theory has less to do with the movie business than with the varied nature of human sexuality. Since 2011, E.L. James’s Fifty Shades... books have sold more than 70 million copies worldwide, with many a dog-eared volume being passed among friends over cosmopolitans. That means there have to be, like, 140 million different and intensely vivid ideas of what Christian Grey looks like. No matter who gets picked for the role, 139 million readers will be tweeting that he’s all wrong. When the producers finally do settle on an actor, 139,999,999 boyfriends and husbands will be going, “But I thought you said I was your Christian Grey!” And one dude is going to be like, “Yesss!”
Carpe diem
Is it too early to start compiling the pre-New Year’s list of fads from 2013 that are officially over? Can we compost kale? Can we give gluten sensitivity back to people who actually have celiac disease? And is it now finally time to send alternative vaccine schedules wherever it is Psy went? And, if there’s room, can we also send Miley Cyrus?
As if the professional humiliation of Andrew Wakefield and unprecedented outbreaks of measles and whooping cough were not already sending a message, a new study in JAMA Pediatrics should give serious pause to parents who delay vaccinating their children against measles because they think it’s safer. As it turns out, late measles vaccination nearly doubles the risk of febrile seizures, compared with timely immunization. That, and it leaves children unprotected from measles. That second one should be self-evident, but, well, you know.
Lead author Dr. Ali Rowhani-Rahbar of the University of Washington, Seattle, lives at the epicenter of vaccine resistance in the United States, but he reached out nationally to include more than 850,000 children in his study (take that, alpha error!). He found that giving kids fevers at the time of life when they’re most likely to have febrile seizures (16-24 months) made them more likely to have febrile seizures. I know, right? Will these results finally stop a few of our colleagues from flogging their pseudoscientific books on talk shows and social media? I’m guessing that if actual epidemics of measles and pertussis didn’t do it, then Dr. Rowhani-Rahbar will still have plenty of subjects for his next study.
Lights out
There has been much hand-wringing about the overuse of prescription stimulants to treat attention-deficit/ hyperactivity disorder (ADHD), partly because the side effects of these stimulants include hand-wringing. The search for alternative cures for childhood behavior problems has led from fish oil to gluten- and dairy-free diets, but could it be possible that one solution is as simple as a light switch? New data from the U.K. suggest that just putting kids to bed at the same time every night can substantially improve their behavior, and it doesn’t leave a fishy aftertaste.
We’ve known that sleep deprivation and conditions like obstructive sleep apnea can detract from children’s behavior and academic performance, but a trio of authors from the Department of Epidemiology and Public Health, University College London, wondered if irregular circadian rhythms would have the same effect independent of actual hours of sleep. Their study of more than 10,000 7-year-olds demonstrated not only a correlation between irregular bedtimes and behavioral problems, but they showed something much more important: Kids whose bedtimes became more regular improved their behavior. Fellow parents of whiny children who don’t want to go to bed, I say to you, “Booyah!”
Of course, before we start treating behavior problems with nothing more than an alarm clock, we must acknowledge some limitations of the study. Perhaps the most glaring is that irregular bedtimes are likely a good proxy for all sorts of limit-setting issues in families, as well as for a generally chaotic household. But don’t think for a minute I’m letting my kids know about that. Every night at 8:30, their lights are out, and if they complain they can’t sleep, I’m just going to threaten to read this study aloud to them. Good night!
Just say no
Does anyone remember the early days of the DARE (Drug Abuse Resistance Education) program, when police officers would stand in front of your class and tell you dope is for dopes? It launched when I was in high school, and I had friends who would only attend the lectures stoned. It took years of research and a major shift in the program’s content before it became nominally effective at its goals of reducing youth drug use and gang violence. Could the new crop of bullying-prevention programs be the DARE of our age? Why, yes, they could.
Or they could be worse. According to a study of bullying-prevention programs in the Journal of Criminology, students are more likely to be bullied at schools with prevention programs than at those without them. Lead author Seokjin Jeong suggests that perhaps the programs provide a script for budding bullies to follow so that they don’t have to be creative. With all the attention given to bullying right now, I’m optimistic that we’ll eventually figure out how to intervene in a way that doesn’t just serve as an instructional video for jerks. One day our children will grow up in a world where the only sadists are handsome billionaires, and we can all agree what he looks like.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Is anything quite so unsettling as waiting for people who should be responsible adults to stop fighting and arrive at a consensus, especially when so much is hanging in the balance? I mean, how long is it going to take Focus Features to pick an actor to play the hot young billionaire-sadist Christian Grey? According to an article in Variety, the problem is that all the really sexy leading men in Hollywood are...my age. That’s right, George Clooney, Robert Downey Jr., Will Smith, Hugh Jackman, Johnny Depp, Brad Pitt, Vin Diesel, all of them are 45 to 50 years old. I know because we all work out together.
My own theory has less to do with the movie business than with the varied nature of human sexuality. Since 2011, E.L. James’s Fifty Shades... books have sold more than 70 million copies worldwide, with many a dog-eared volume being passed among friends over cosmopolitans. That means there have to be, like, 140 million different and intensely vivid ideas of what Christian Grey looks like. No matter who gets picked for the role, 139 million readers will be tweeting that he’s all wrong. When the producers finally do settle on an actor, 139,999,999 boyfriends and husbands will be going, “But I thought you said I was your Christian Grey!” And one dude is going to be like, “Yesss!”
Carpe diem
Is it too early to start compiling the pre-New Year’s list of fads from 2013 that are officially over? Can we compost kale? Can we give gluten sensitivity back to people who actually have celiac disease? And is it now finally time to send alternative vaccine schedules wherever it is Psy went? And, if there’s room, can we also send Miley Cyrus?
As if the professional humiliation of Andrew Wakefield and unprecedented outbreaks of measles and whooping cough were not already sending a message, a new study in JAMA Pediatrics should give serious pause to parents who delay vaccinating their children against measles because they think it’s safer. As it turns out, late measles vaccination nearly doubles the risk of febrile seizures, compared with timely immunization. That, and it leaves children unprotected from measles. That second one should be self-evident, but, well, you know.
Lead author Dr. Ali Rowhani-Rahbar of the University of Washington, Seattle, lives at the epicenter of vaccine resistance in the United States, but he reached out nationally to include more than 850,000 children in his study (take that, alpha error!). He found that giving kids fevers at the time of life when they’re most likely to have febrile seizures (16-24 months) made them more likely to have febrile seizures. I know, right? Will these results finally stop a few of our colleagues from flogging their pseudoscientific books on talk shows and social media? I’m guessing that if actual epidemics of measles and pertussis didn’t do it, then Dr. Rowhani-Rahbar will still have plenty of subjects for his next study.
Lights out
There has been much hand-wringing about the overuse of prescription stimulants to treat attention-deficit/ hyperactivity disorder (ADHD), partly because the side effects of these stimulants include hand-wringing. The search for alternative cures for childhood behavior problems has led from fish oil to gluten- and dairy-free diets, but could it be possible that one solution is as simple as a light switch? New data from the U.K. suggest that just putting kids to bed at the same time every night can substantially improve their behavior, and it doesn’t leave a fishy aftertaste.
We’ve known that sleep deprivation and conditions like obstructive sleep apnea can detract from children’s behavior and academic performance, but a trio of authors from the Department of Epidemiology and Public Health, University College London, wondered if irregular circadian rhythms would have the same effect independent of actual hours of sleep. Their study of more than 10,000 7-year-olds demonstrated not only a correlation between irregular bedtimes and behavioral problems, but they showed something much more important: Kids whose bedtimes became more regular improved their behavior. Fellow parents of whiny children who don’t want to go to bed, I say to you, “Booyah!”
Of course, before we start treating behavior problems with nothing more than an alarm clock, we must acknowledge some limitations of the study. Perhaps the most glaring is that irregular bedtimes are likely a good proxy for all sorts of limit-setting issues in families, as well as for a generally chaotic household. But don’t think for a minute I’m letting my kids know about that. Every night at 8:30, their lights are out, and if they complain they can’t sleep, I’m just going to threaten to read this study aloud to them. Good night!
Just say no
Does anyone remember the early days of the DARE (Drug Abuse Resistance Education) program, when police officers would stand in front of your class and tell you dope is for dopes? It launched when I was in high school, and I had friends who would only attend the lectures stoned. It took years of research and a major shift in the program’s content before it became nominally effective at its goals of reducing youth drug use and gang violence. Could the new crop of bullying-prevention programs be the DARE of our age? Why, yes, they could.
Or they could be worse. According to a study of bullying-prevention programs in the Journal of Criminology, students are more likely to be bullied at schools with prevention programs than at those without them. Lead author Seokjin Jeong suggests that perhaps the programs provide a script for budding bullies to follow so that they don’t have to be creative. With all the attention given to bullying right now, I’m optimistic that we’ll eventually figure out how to intervene in a way that doesn’t just serve as an instructional video for jerks. One day our children will grow up in a world where the only sadists are handsome billionaires, and we can all agree what he looks like.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
What can I help you with?
It seems like there’s only one story in the news this week, and I’m sick of it dominating everything. That’s right, actress Susan Bennett has been revealed as the voice behind Siri. Bennett got her start in the business as the avatar of the very first automated teller machine, a gig that gave her ample opportunity to get used to users screaming at her in frustration. Then she graduated to Delta Airlines’ phone tree. Is it any wonder she sounds so...touchy?
Got game
When I was a kid, Olympic star Bruce Jenner’s picture was on the box of Wheaties, and I ate them, hoping to be just like Bruce. Eventually, it worked: I got divorced. But what about today’s kids, hoping to grow up like LeBron James, Peyton Manning, and Serena Williams? According to a new study in Pediatrics, the more they consume the products endorsed by these sports stars, the more they’ll resemble athletes -- specifically, sumo wrestlers.
The study, originated at Yale’s Rudd Center for Food Policy and Obesity, asked a question so simple no has ever thought of it before: How do you measure an athlete’s impact on the American diet? The authors created an index that multiplied the top 100 athletes’ food endorsement contracts by the nutritional index of the products they were selling to generate a sort of a hall of fame of the NFL (National Fatness Leaders).
In their version of an All-Star Game, Kraft’s 2009 Double Stuf Oreos campaign won the title by simultaneously drafting Shaquille O’Neal, Serena and Venus Williams, Peyton and Eli Manning, and, for good measure, Apolo Ohno. The authors suggest a parallel with cigarette advertisements that featured athletes until public disapproval led to a voluntary ban on these ads in 1964. They suggest that shame over junk food endorsements might lead either the food industry or the athletes themselves to reconsider their contracts. I share the authors’ aspirations, but my guess is that this one is going to be a long game. A lot will have to change before these sports stars Just Don’t Do It.
Over easy
Do you get as furious as I do when someone says (usually while holding a cigarette), “Well, anything can kill you”? Yeah, okay, you win. Carrots can get lodged in windpipes. Too much air can be bad if it’s, say, a tornado. But that doesn’t change the fact that some things are a lot safer than others. We can now add to that list flu vaccines, even for patients with serious egg allergies.
Over the last few years, our colleagues at the American Academy of Allergy, Asthma, and Immunology (AAAAI: The Academy With More A’s Than Yours) have been edging gradually closer to declaring that it’s okay for patients with egg allergies to receive flu vaccine. First it was, “Just don’t give it.” Then it was, “Okay, but only in an ICU setting and through a central line.” Then it was, “Give 10% of the dose first, and have epinephrine at the bedside.” Now, finally, they’re like, “Yeah, just give it. After all, it's much safer than carrots.”
Of the 4,000 egg-allergic recipients of the vaccine studied in a variety of trials, not a one had a serious complication from the immunization, including those with severe egg-protein allergies. So let it rain flu shots, people! Because if there’s one thing more dangerous than air, it’s influenza. That and junk food, but only LeBron James can block junk food.
Baby got back
In this day of electronic everything, I have to wonder how it is my kids’ backpacks are just as heavy as mine was when I was their age? I know what I had in mine: 10-pound history texts, three-ring binders that could hold the entire text of the World Book Encyclopedia, the entire text of the World Book Encyclopedia (1982 Edition). But with my kids getting their homework and even some of their textbooks online, how is it they are still lugging backpacks that would overwhelm a Sherpa? And won’t it cause them lifelong back pain?
Apparently not. Portuguese researchers publishing in the International Journal of Human Factors and Ergonomics have shifted the blame for students’ back pain from the long-maligned backpack to where it really belongs: the desk. Back pain, neck pain, and headache correlated strongly with the distance from students’ elbows to their desktops and not with the weight of their book bags. The effect was worse for girls than for boys. Researchers did not report the findings I would have been most interested in: What is the effect on back pain of leaning forward to use a geometry compass to carve “AC/DC” into the upper left-hand corner of the desktop? Of course I could always ask Siri...yeah, never mind.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
It seems like there’s only one story in the news this week, and I’m sick of it dominating everything. That’s right, actress Susan Bennett has been revealed as the voice behind Siri. Bennett got her start in the business as the avatar of the very first automated teller machine, a gig that gave her ample opportunity to get used to users screaming at her in frustration. Then she graduated to Delta Airlines’ phone tree. Is it any wonder she sounds so...touchy?
Got game
When I was a kid, Olympic star Bruce Jenner’s picture was on the box of Wheaties, and I ate them, hoping to be just like Bruce. Eventually, it worked: I got divorced. But what about today’s kids, hoping to grow up like LeBron James, Peyton Manning, and Serena Williams? According to a new study in Pediatrics, the more they consume the products endorsed by these sports stars, the more they’ll resemble athletes -- specifically, sumo wrestlers.
The study, originated at Yale’s Rudd Center for Food Policy and Obesity, asked a question so simple no has ever thought of it before: How do you measure an athlete’s impact on the American diet? The authors created an index that multiplied the top 100 athletes’ food endorsement contracts by the nutritional index of the products they were selling to generate a sort of a hall of fame of the NFL (National Fatness Leaders).
In their version of an All-Star Game, Kraft’s 2009 Double Stuf Oreos campaign won the title by simultaneously drafting Shaquille O’Neal, Serena and Venus Williams, Peyton and Eli Manning, and, for good measure, Apolo Ohno. The authors suggest a parallel with cigarette advertisements that featured athletes until public disapproval led to a voluntary ban on these ads in 1964. They suggest that shame over junk food endorsements might lead either the food industry or the athletes themselves to reconsider their contracts. I share the authors’ aspirations, but my guess is that this one is going to be a long game. A lot will have to change before these sports stars Just Don’t Do It.
Over easy
Do you get as furious as I do when someone says (usually while holding a cigarette), “Well, anything can kill you”? Yeah, okay, you win. Carrots can get lodged in windpipes. Too much air can be bad if it’s, say, a tornado. But that doesn’t change the fact that some things are a lot safer than others. We can now add to that list flu vaccines, even for patients with serious egg allergies.
Over the last few years, our colleagues at the American Academy of Allergy, Asthma, and Immunology (AAAAI: The Academy With More A’s Than Yours) have been edging gradually closer to declaring that it’s okay for patients with egg allergies to receive flu vaccine. First it was, “Just don’t give it.” Then it was, “Okay, but only in an ICU setting and through a central line.” Then it was, “Give 10% of the dose first, and have epinephrine at the bedside.” Now, finally, they’re like, “Yeah, just give it. After all, it's much safer than carrots.”
Of the 4,000 egg-allergic recipients of the vaccine studied in a variety of trials, not a one had a serious complication from the immunization, including those with severe egg-protein allergies. So let it rain flu shots, people! Because if there’s one thing more dangerous than air, it’s influenza. That and junk food, but only LeBron James can block junk food.
Baby got back
In this day of electronic everything, I have to wonder how it is my kids’ backpacks are just as heavy as mine was when I was their age? I know what I had in mine: 10-pound history texts, three-ring binders that could hold the entire text of the World Book Encyclopedia, the entire text of the World Book Encyclopedia (1982 Edition). But with my kids getting their homework and even some of their textbooks online, how is it they are still lugging backpacks that would overwhelm a Sherpa? And won’t it cause them lifelong back pain?
Apparently not. Portuguese researchers publishing in the International Journal of Human Factors and Ergonomics have shifted the blame for students’ back pain from the long-maligned backpack to where it really belongs: the desk. Back pain, neck pain, and headache correlated strongly with the distance from students’ elbows to their desktops and not with the weight of their book bags. The effect was worse for girls than for boys. Researchers did not report the findings I would have been most interested in: What is the effect on back pain of leaning forward to use a geometry compass to carve “AC/DC” into the upper left-hand corner of the desktop? Of course I could always ask Siri...yeah, never mind.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
It seems like there’s only one story in the news this week, and I’m sick of it dominating everything. That’s right, actress Susan Bennett has been revealed as the voice behind Siri. Bennett got her start in the business as the avatar of the very first automated teller machine, a gig that gave her ample opportunity to get used to users screaming at her in frustration. Then she graduated to Delta Airlines’ phone tree. Is it any wonder she sounds so...touchy?
Got game
When I was a kid, Olympic star Bruce Jenner’s picture was on the box of Wheaties, and I ate them, hoping to be just like Bruce. Eventually, it worked: I got divorced. But what about today’s kids, hoping to grow up like LeBron James, Peyton Manning, and Serena Williams? According to a new study in Pediatrics, the more they consume the products endorsed by these sports stars, the more they’ll resemble athletes -- specifically, sumo wrestlers.
The study, originated at Yale’s Rudd Center for Food Policy and Obesity, asked a question so simple no has ever thought of it before: How do you measure an athlete’s impact on the American diet? The authors created an index that multiplied the top 100 athletes’ food endorsement contracts by the nutritional index of the products they were selling to generate a sort of a hall of fame of the NFL (National Fatness Leaders).
In their version of an All-Star Game, Kraft’s 2009 Double Stuf Oreos campaign won the title by simultaneously drafting Shaquille O’Neal, Serena and Venus Williams, Peyton and Eli Manning, and, for good measure, Apolo Ohno. The authors suggest a parallel with cigarette advertisements that featured athletes until public disapproval led to a voluntary ban on these ads in 1964. They suggest that shame over junk food endorsements might lead either the food industry or the athletes themselves to reconsider their contracts. I share the authors’ aspirations, but my guess is that this one is going to be a long game. A lot will have to change before these sports stars Just Don’t Do It.
Over easy
Do you get as furious as I do when someone says (usually while holding a cigarette), “Well, anything can kill you”? Yeah, okay, you win. Carrots can get lodged in windpipes. Too much air can be bad if it’s, say, a tornado. But that doesn’t change the fact that some things are a lot safer than others. We can now add to that list flu vaccines, even for patients with serious egg allergies.
Over the last few years, our colleagues at the American Academy of Allergy, Asthma, and Immunology (AAAAI: The Academy With More A’s Than Yours) have been edging gradually closer to declaring that it’s okay for patients with egg allergies to receive flu vaccine. First it was, “Just don’t give it.” Then it was, “Okay, but only in an ICU setting and through a central line.” Then it was, “Give 10% of the dose first, and have epinephrine at the bedside.” Now, finally, they’re like, “Yeah, just give it. After all, it's much safer than carrots.”
Of the 4,000 egg-allergic recipients of the vaccine studied in a variety of trials, not a one had a serious complication from the immunization, including those with severe egg-protein allergies. So let it rain flu shots, people! Because if there’s one thing more dangerous than air, it’s influenza. That and junk food, but only LeBron James can block junk food.
Baby got back
In this day of electronic everything, I have to wonder how it is my kids’ backpacks are just as heavy as mine was when I was their age? I know what I had in mine: 10-pound history texts, three-ring binders that could hold the entire text of the World Book Encyclopedia, the entire text of the World Book Encyclopedia (1982 Edition). But with my kids getting their homework and even some of their textbooks online, how is it they are still lugging backpacks that would overwhelm a Sherpa? And won’t it cause them lifelong back pain?
Apparently not. Portuguese researchers publishing in the International Journal of Human Factors and Ergonomics have shifted the blame for students’ back pain from the long-maligned backpack to where it really belongs: the desk. Back pain, neck pain, and headache correlated strongly with the distance from students’ elbows to their desktops and not with the weight of their book bags. The effect was worse for girls than for boys. Researchers did not report the findings I would have been most interested in: What is the effect on back pain of leaning forward to use a geometry compass to carve “AC/DC” into the upper left-hand corner of the desktop? Of course I could always ask Siri...yeah, never mind.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Bingeing Bad
Am I the only one out there who feels like a total loser for not following AMC’s Breaking Bad? Honestly, with five kids, a busy pediatric practice, and a blog to write, I haven’t found the time to watch a television series start to finish since Sex and the City wrapped. (Don’t judge.) I’m still saving up vacation hours to binge-watch The Wire, and after that I’m planning to feign a back injury to catch up on Mad Men.
Based on all the buzz, I’ve decided I definitely need to watch Breaking Bad all the way through. But do me a favor, though, okay? No spoilers! All I know now is that it’s about a high school teacher who goes bald and wears yellow jumpsuits. That, and it’s even funnier than Malcolm in the Middle. I can’t wait!
Catchy!
Scientists must get a little frustrated when they work their whole careers to prove something, and then people who really don’t know anything go, “Yeah, I don’t believe you.” Evolution, global warming, gravity, there’s always someone out there who’s done some research on the Internet that says it’s all a big hoax. But the thing about the laws of nature is, they don’t care if you believe in them.
Which brings us to the great California whooping cough epidemic of 2010, when more than 9,000 people contracted pertussis, more than in any year since 1947. It doesn’t take a PhD to tell you that the rise in pertussis just might be related to a vaccine refusal rate that jumped from 0.77% to 2.33% in the preceding decade. No, it takes 4 PhDs, 1 MD, and 5 MPHs, led by Jessica E. Atwell, MPH, at the Department of International Health at John Hopkins Bloomberg School of Public Health, Baltimore.
To prove their point, they asked a question that’s simple, provided you have a powerful computer and a small army of statisticians: Did children living in school districts with higher rates of non-medical vaccine exemptions suffer more whooping cough than would be predicted based on the known properties of pertussis outbreaks? After all, it’s not like those 2.33% of people not vaccinating their children were evenly spread throughout the state; some schools reported that 84% of their students were not vaccinated.
Spoiler alert: It was Kristin Shepard who shot JR Ewing! Oh yeah, and children who attended schools with lower vaccination rates were 2.5 times more likely to get whooping cough. Science: It’s not just good, it’s good for you.
Eternal flame retardant
Is there anything about polybrominated diphenyl ethers (PBDEs) that doesn’t sound like they would be perfectly healthy for pregnant mothers? These chemicals, used as fire retardants until they were phased out nationwide in 2005, turned out to cause brain damage in fetuses and thyroid disease in children and adults, which is a shame, because they were pretty good at delaying fires. And while 2005 seems like a long time ago -- Hannah Montana hadn’t even aired its first episode and “twerking” was considered a spelling error -- it’s a short time in the life of the crumbling, PBDE-infused upholstery foam.
Researchers in California figured it was time to check pregnant women’s bloodstreams and see how much levels of PBDEs had fallen, since that state was early to adopt job-killing environmental regulations against the chemicals. They were concerned, since the first testing period in 2008 and 2009 demonstrated women in the state to still have the highest blood levels of PBDE reported anywhere in the world. The good news? By the 2011-2012 testing period, levels had already fallen by around 2/3. The bad news? Pregnant women in California are now at their highest risk in decades of spontaneous combustion.
Breaking worse
If watching Breaking Bad makes you wonder who exactly thinks, “Methamphetamine? Sure, I’ll give it a go!”, then you’ll be even more confounded by the newest drug to hit American shores, “Krokodil.” This homemade concoction of codeine, iodine, paint thinner, and gasoline is just as benign as it sounds, earning its street name in Russia, where users first watched their skin turn green and crack.
Users of krokodil (or desomorphine) almost inevitably die, but first they suffer festering abscesses, rotting mandibles, and blood poisoning, all for a high that’s shorter than heroin’s. I know life sometimes imitates art, but I much prefer to think that it only happens with Sex and the City.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Am I the only one out there who feels like a total loser for not following AMC’s Breaking Bad? Honestly, with five kids, a busy pediatric practice, and a blog to write, I haven’t found the time to watch a television series start to finish since Sex and the City wrapped. (Don’t judge.) I’m still saving up vacation hours to binge-watch The Wire, and after that I’m planning to feign a back injury to catch up on Mad Men.
Based on all the buzz, I’ve decided I definitely need to watch Breaking Bad all the way through. But do me a favor, though, okay? No spoilers! All I know now is that it’s about a high school teacher who goes bald and wears yellow jumpsuits. That, and it’s even funnier than Malcolm in the Middle. I can’t wait!
Catchy!
Scientists must get a little frustrated when they work their whole careers to prove something, and then people who really don’t know anything go, “Yeah, I don’t believe you.” Evolution, global warming, gravity, there’s always someone out there who’s done some research on the Internet that says it’s all a big hoax. But the thing about the laws of nature is, they don’t care if you believe in them.
Which brings us to the great California whooping cough epidemic of 2010, when more than 9,000 people contracted pertussis, more than in any year since 1947. It doesn’t take a PhD to tell you that the rise in pertussis just might be related to a vaccine refusal rate that jumped from 0.77% to 2.33% in the preceding decade. No, it takes 4 PhDs, 1 MD, and 5 MPHs, led by Jessica E. Atwell, MPH, at the Department of International Health at John Hopkins Bloomberg School of Public Health, Baltimore.
To prove their point, they asked a question that’s simple, provided you have a powerful computer and a small army of statisticians: Did children living in school districts with higher rates of non-medical vaccine exemptions suffer more whooping cough than would be predicted based on the known properties of pertussis outbreaks? After all, it’s not like those 2.33% of people not vaccinating their children were evenly spread throughout the state; some schools reported that 84% of their students were not vaccinated.
Spoiler alert: It was Kristin Shepard who shot JR Ewing! Oh yeah, and children who attended schools with lower vaccination rates were 2.5 times more likely to get whooping cough. Science: It’s not just good, it’s good for you.
Eternal flame retardant
Is there anything about polybrominated diphenyl ethers (PBDEs) that doesn’t sound like they would be perfectly healthy for pregnant mothers? These chemicals, used as fire retardants until they were phased out nationwide in 2005, turned out to cause brain damage in fetuses and thyroid disease in children and adults, which is a shame, because they were pretty good at delaying fires. And while 2005 seems like a long time ago -- Hannah Montana hadn’t even aired its first episode and “twerking” was considered a spelling error -- it’s a short time in the life of the crumbling, PBDE-infused upholstery foam.
Researchers in California figured it was time to check pregnant women’s bloodstreams and see how much levels of PBDEs had fallen, since that state was early to adopt job-killing environmental regulations against the chemicals. They were concerned, since the first testing period in 2008 and 2009 demonstrated women in the state to still have the highest blood levels of PBDE reported anywhere in the world. The good news? By the 2011-2012 testing period, levels had already fallen by around 2/3. The bad news? Pregnant women in California are now at their highest risk in decades of spontaneous combustion.
Breaking worse
If watching Breaking Bad makes you wonder who exactly thinks, “Methamphetamine? Sure, I’ll give it a go!”, then you’ll be even more confounded by the newest drug to hit American shores, “Krokodil.” This homemade concoction of codeine, iodine, paint thinner, and gasoline is just as benign as it sounds, earning its street name in Russia, where users first watched their skin turn green and crack.
Users of krokodil (or desomorphine) almost inevitably die, but first they suffer festering abscesses, rotting mandibles, and blood poisoning, all for a high that’s shorter than heroin’s. I know life sometimes imitates art, but I much prefer to think that it only happens with Sex and the City.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Am I the only one out there who feels like a total loser for not following AMC’s Breaking Bad? Honestly, with five kids, a busy pediatric practice, and a blog to write, I haven’t found the time to watch a television series start to finish since Sex and the City wrapped. (Don’t judge.) I’m still saving up vacation hours to binge-watch The Wire, and after that I’m planning to feign a back injury to catch up on Mad Men.
Based on all the buzz, I’ve decided I definitely need to watch Breaking Bad all the way through. But do me a favor, though, okay? No spoilers! All I know now is that it’s about a high school teacher who goes bald and wears yellow jumpsuits. That, and it’s even funnier than Malcolm in the Middle. I can’t wait!
Catchy!
Scientists must get a little frustrated when they work their whole careers to prove something, and then people who really don’t know anything go, “Yeah, I don’t believe you.” Evolution, global warming, gravity, there’s always someone out there who’s done some research on the Internet that says it’s all a big hoax. But the thing about the laws of nature is, they don’t care if you believe in them.
Which brings us to the great California whooping cough epidemic of 2010, when more than 9,000 people contracted pertussis, more than in any year since 1947. It doesn’t take a PhD to tell you that the rise in pertussis just might be related to a vaccine refusal rate that jumped from 0.77% to 2.33% in the preceding decade. No, it takes 4 PhDs, 1 MD, and 5 MPHs, led by Jessica E. Atwell, MPH, at the Department of International Health at John Hopkins Bloomberg School of Public Health, Baltimore.
To prove their point, they asked a question that’s simple, provided you have a powerful computer and a small army of statisticians: Did children living in school districts with higher rates of non-medical vaccine exemptions suffer more whooping cough than would be predicted based on the known properties of pertussis outbreaks? After all, it’s not like those 2.33% of people not vaccinating their children were evenly spread throughout the state; some schools reported that 84% of their students were not vaccinated.
Spoiler alert: It was Kristin Shepard who shot JR Ewing! Oh yeah, and children who attended schools with lower vaccination rates were 2.5 times more likely to get whooping cough. Science: It’s not just good, it’s good for you.
Eternal flame retardant
Is there anything about polybrominated diphenyl ethers (PBDEs) that doesn’t sound like they would be perfectly healthy for pregnant mothers? These chemicals, used as fire retardants until they were phased out nationwide in 2005, turned out to cause brain damage in fetuses and thyroid disease in children and adults, which is a shame, because they were pretty good at delaying fires. And while 2005 seems like a long time ago -- Hannah Montana hadn’t even aired its first episode and “twerking” was considered a spelling error -- it’s a short time in the life of the crumbling, PBDE-infused upholstery foam.
Researchers in California figured it was time to check pregnant women’s bloodstreams and see how much levels of PBDEs had fallen, since that state was early to adopt job-killing environmental regulations against the chemicals. They were concerned, since the first testing period in 2008 and 2009 demonstrated women in the state to still have the highest blood levels of PBDE reported anywhere in the world. The good news? By the 2011-2012 testing period, levels had already fallen by around 2/3. The bad news? Pregnant women in California are now at their highest risk in decades of spontaneous combustion.
Breaking worse
If watching Breaking Bad makes you wonder who exactly thinks, “Methamphetamine? Sure, I’ll give it a go!”, then you’ll be even more confounded by the newest drug to hit American shores, “Krokodil.” This homemade concoction of codeine, iodine, paint thinner, and gasoline is just as benign as it sounds, earning its street name in Russia, where users first watched their skin turn green and crack.
Users of krokodil (or desomorphine) almost inevitably die, but first they suffer festering abscesses, rotting mandibles, and blood poisoning, all for a high that’s shorter than heroin’s. I know life sometimes imitates art, but I much prefer to think that it only happens with Sex and the City.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Royal blues
F. Scott Fitzgerald wrote that the very rich are different from you and me, but how, exactly? Well, consider Queen Elizabeth II, who just had a new portrait of her great grandson Prince George installed in the sitting room of her Scottish Highlands estate. I mean, who has a portrait painted of a 1-month-old infant? Not pediatricians. We know that at 4 weeks, babies are still all splotchy.
More to the point, who has a room just for sitting? That’s how I’ll know I’ve finally made it in life -- I’ll sit down. In a room. Where that’s all you do. With a portrait of a newborn. Don’t worry, when the time comes, you’re all invited to take a load off; pull up a throne!
Blanket policy
Don’t you hate it when you get news and you’re not sure whether to be happy or upset? Like this week my daughter proudly told me she made the second-highest grade in her class on a math test? Which was 75? Pediatricians all over are struggling with how to feel over a new report in JAMA Pediatrics suggesting a new way to help mothers nurse their infants longer: co-sleeping. I know, right? “Yay! Wait a minute. Boo! But then again, yay?”
Dr. Fern Hauck and his team from the University of Virginia polled around 1,800 nursing mothers of infants from age 2 weeks to age 12 months, checking in with them a total of seven times and asking them a bunch of questions about supplemental feeds and when, whether, and why they stopped breastfeeding. Half of women who shared their beds with their babies continued to nurse for a full year, as recommended by the American Academy of Pediatrics. In contrast, breastfeeding rates were under 50% at 7 months of age among women who never slept with their infants, as recommended by the American Academy of Pediatrics.
Co-sleeping puts infants at dramatically increased risk of sudden infant death syndrome (SIDS). Breastfeeding significantly lowers infants’ risks of SIDS. Co-sleeping appears to encourage breastfeeding, but we can’t encourage co-sleeping, and, well, I need a nap. What we have here, of course, is a golden opportunity for a grant application: Someone with a slave army of graduate students needs to meta-analyze the various risk factors of co-sleeping and formula-feeding and churn out a statistical model that helps pediatricians know when to nod approvingly and when to roll our eyes and embark on some earnest counseling. Wake me up when you’re done.
Brace yourself
Practicing evidence-based medicine constantly makes me feel like the hard-boiled fictional detective Philip Marlowe. Just when I think I’m as cynical as I can get, someone tells me something that makes me feel as innocent as a newborn (if not as splotchy). Now a new study in the New England Journal of Medicine purports to show for the first time ever that back braces can slow the progression of scoliosis. You mean we didn’t know that already? I assumed this was a confirmed fact back in 1984 based on my repeated viewings of Sixteen Candles. Did we really make poor Joan Cusack suffer for pure clinical conjecture?
Apparently so, but not any more. Those confined to back braces since their invention in 1948 will be happy to learn that they did not wear them in vain. As it turns out, the study was stopped early when it became clear that 72% of brace-wearers were able to avoid invasive back surgery, compared with only 48% of those randomized to watchful waiting. Furthermore, there was a dose-related effect; the more hours each day subjects wore their braces, the better their chances of staving off surgery. Perhaps for the first time ever, one of my strongly held beliefs is confirmed by evidence!
Of course, we’re nowhere near done. Some back brace patients still go one to surgery, and no one knows how to tell which ones. I only hope that when we figure it out someone will let me in on it. In the meantime I’ll just continue stumbling blindly through life, at least until I get that sitting room.
Measure for measure
Some things are a lot better in theory than in execution, like, say, binge drinking. A new study from England suggests that these things should include physician pay-for-performance plans. The problem, as you may have suspected, is that there is almost no correlation between evidence-based measures of quality of care and patients’ satisfaction with the care they receive. This fact should be obvious to anyone who has ever spent twenty minutes explaining to a parent why green snot does not always warrant an antibiotic prescription.
Since patient satisfaction is often counted among the measures of physician performance, I’m very worried. To the extent that “good” medical practice corresponded to patient happiness, access to appointments and to preferred providers were the most influential measures. This means, of course, that the least popular doctors were the most popular, until they became too popular, making them unpopular. Fortunately for me, we’re still entrenched in a system in which physician pay depends solely on sheer volume, influenced neither by clinical quality nor by patient satisfaction. And that is why, if I ever want that sitting room, there’s no time to sit.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
F. Scott Fitzgerald wrote that the very rich are different from you and me, but how, exactly? Well, consider Queen Elizabeth II, who just had a new portrait of her great grandson Prince George installed in the sitting room of her Scottish Highlands estate. I mean, who has a portrait painted of a 1-month-old infant? Not pediatricians. We know that at 4 weeks, babies are still all splotchy.
More to the point, who has a room just for sitting? That’s how I’ll know I’ve finally made it in life -- I’ll sit down. In a room. Where that’s all you do. With a portrait of a newborn. Don’t worry, when the time comes, you’re all invited to take a load off; pull up a throne!
Blanket policy
Don’t you hate it when you get news and you’re not sure whether to be happy or upset? Like this week my daughter proudly told me she made the second-highest grade in her class on a math test? Which was 75? Pediatricians all over are struggling with how to feel over a new report in JAMA Pediatrics suggesting a new way to help mothers nurse their infants longer: co-sleeping. I know, right? “Yay! Wait a minute. Boo! But then again, yay?”
Dr. Fern Hauck and his team from the University of Virginia polled around 1,800 nursing mothers of infants from age 2 weeks to age 12 months, checking in with them a total of seven times and asking them a bunch of questions about supplemental feeds and when, whether, and why they stopped breastfeeding. Half of women who shared their beds with their babies continued to nurse for a full year, as recommended by the American Academy of Pediatrics. In contrast, breastfeeding rates were under 50% at 7 months of age among women who never slept with their infants, as recommended by the American Academy of Pediatrics.
Co-sleeping puts infants at dramatically increased risk of sudden infant death syndrome (SIDS). Breastfeeding significantly lowers infants’ risks of SIDS. Co-sleeping appears to encourage breastfeeding, but we can’t encourage co-sleeping, and, well, I need a nap. What we have here, of course, is a golden opportunity for a grant application: Someone with a slave army of graduate students needs to meta-analyze the various risk factors of co-sleeping and formula-feeding and churn out a statistical model that helps pediatricians know when to nod approvingly and when to roll our eyes and embark on some earnest counseling. Wake me up when you’re done.
Brace yourself
Practicing evidence-based medicine constantly makes me feel like the hard-boiled fictional detective Philip Marlowe. Just when I think I’m as cynical as I can get, someone tells me something that makes me feel as innocent as a newborn (if not as splotchy). Now a new study in the New England Journal of Medicine purports to show for the first time ever that back braces can slow the progression of scoliosis. You mean we didn’t know that already? I assumed this was a confirmed fact back in 1984 based on my repeated viewings of Sixteen Candles. Did we really make poor Joan Cusack suffer for pure clinical conjecture?
Apparently so, but not any more. Those confined to back braces since their invention in 1948 will be happy to learn that they did not wear them in vain. As it turns out, the study was stopped early when it became clear that 72% of brace-wearers were able to avoid invasive back surgery, compared with only 48% of those randomized to watchful waiting. Furthermore, there was a dose-related effect; the more hours each day subjects wore their braces, the better their chances of staving off surgery. Perhaps for the first time ever, one of my strongly held beliefs is confirmed by evidence!
Of course, we’re nowhere near done. Some back brace patients still go one to surgery, and no one knows how to tell which ones. I only hope that when we figure it out someone will let me in on it. In the meantime I’ll just continue stumbling blindly through life, at least until I get that sitting room.
Measure for measure
Some things are a lot better in theory than in execution, like, say, binge drinking. A new study from England suggests that these things should include physician pay-for-performance plans. The problem, as you may have suspected, is that there is almost no correlation between evidence-based measures of quality of care and patients’ satisfaction with the care they receive. This fact should be obvious to anyone who has ever spent twenty minutes explaining to a parent why green snot does not always warrant an antibiotic prescription.
Since patient satisfaction is often counted among the measures of physician performance, I’m very worried. To the extent that “good” medical practice corresponded to patient happiness, access to appointments and to preferred providers were the most influential measures. This means, of course, that the least popular doctors were the most popular, until they became too popular, making them unpopular. Fortunately for me, we’re still entrenched in a system in which physician pay depends solely on sheer volume, influenced neither by clinical quality nor by patient satisfaction. And that is why, if I ever want that sitting room, there’s no time to sit.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
F. Scott Fitzgerald wrote that the very rich are different from you and me, but how, exactly? Well, consider Queen Elizabeth II, who just had a new portrait of her great grandson Prince George installed in the sitting room of her Scottish Highlands estate. I mean, who has a portrait painted of a 1-month-old infant? Not pediatricians. We know that at 4 weeks, babies are still all splotchy.
More to the point, who has a room just for sitting? That’s how I’ll know I’ve finally made it in life -- I’ll sit down. In a room. Where that’s all you do. With a portrait of a newborn. Don’t worry, when the time comes, you’re all invited to take a load off; pull up a throne!
Blanket policy
Don’t you hate it when you get news and you’re not sure whether to be happy or upset? Like this week my daughter proudly told me she made the second-highest grade in her class on a math test? Which was 75? Pediatricians all over are struggling with how to feel over a new report in JAMA Pediatrics suggesting a new way to help mothers nurse their infants longer: co-sleeping. I know, right? “Yay! Wait a minute. Boo! But then again, yay?”
Dr. Fern Hauck and his team from the University of Virginia polled around 1,800 nursing mothers of infants from age 2 weeks to age 12 months, checking in with them a total of seven times and asking them a bunch of questions about supplemental feeds and when, whether, and why they stopped breastfeeding. Half of women who shared their beds with their babies continued to nurse for a full year, as recommended by the American Academy of Pediatrics. In contrast, breastfeeding rates were under 50% at 7 months of age among women who never slept with their infants, as recommended by the American Academy of Pediatrics.
Co-sleeping puts infants at dramatically increased risk of sudden infant death syndrome (SIDS). Breastfeeding significantly lowers infants’ risks of SIDS. Co-sleeping appears to encourage breastfeeding, but we can’t encourage co-sleeping, and, well, I need a nap. What we have here, of course, is a golden opportunity for a grant application: Someone with a slave army of graduate students needs to meta-analyze the various risk factors of co-sleeping and formula-feeding and churn out a statistical model that helps pediatricians know when to nod approvingly and when to roll our eyes and embark on some earnest counseling. Wake me up when you’re done.
Brace yourself
Practicing evidence-based medicine constantly makes me feel like the hard-boiled fictional detective Philip Marlowe. Just when I think I’m as cynical as I can get, someone tells me something that makes me feel as innocent as a newborn (if not as splotchy). Now a new study in the New England Journal of Medicine purports to show for the first time ever that back braces can slow the progression of scoliosis. You mean we didn’t know that already? I assumed this was a confirmed fact back in 1984 based on my repeated viewings of Sixteen Candles. Did we really make poor Joan Cusack suffer for pure clinical conjecture?
Apparently so, but not any more. Those confined to back braces since their invention in 1948 will be happy to learn that they did not wear them in vain. As it turns out, the study was stopped early when it became clear that 72% of brace-wearers were able to avoid invasive back surgery, compared with only 48% of those randomized to watchful waiting. Furthermore, there was a dose-related effect; the more hours each day subjects wore their braces, the better their chances of staving off surgery. Perhaps for the first time ever, one of my strongly held beliefs is confirmed by evidence!
Of course, we’re nowhere near done. Some back brace patients still go one to surgery, and no one knows how to tell which ones. I only hope that when we figure it out someone will let me in on it. In the meantime I’ll just continue stumbling blindly through life, at least until I get that sitting room.
Measure for measure
Some things are a lot better in theory than in execution, like, say, binge drinking. A new study from England suggests that these things should include physician pay-for-performance plans. The problem, as you may have suspected, is that there is almost no correlation between evidence-based measures of quality of care and patients’ satisfaction with the care they receive. This fact should be obvious to anyone who has ever spent twenty minutes explaining to a parent why green snot does not always warrant an antibiotic prescription.
Since patient satisfaction is often counted among the measures of physician performance, I’m very worried. To the extent that “good” medical practice corresponded to patient happiness, access to appointments and to preferred providers were the most influential measures. This means, of course, that the least popular doctors were the most popular, until they became too popular, making them unpopular. Fortunately for me, we’re still entrenched in a system in which physician pay depends solely on sheer volume, influenced neither by clinical quality nor by patient satisfaction. And that is why, if I ever want that sitting room, there’s no time to sit.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Legends of the Fall
Think for a moment: what’s the worst thing that can happen at your wedding? Getting stood up? A drunken brawl? An outbreak of Norovirus? You’re not using your imagination. Right: Brad Pitt shows up (unless you’re Angelina Jolie, in which case congratulations and thanks for reading my blog, I’m a huge admirer of your work).
This is precisely the nightmare that confronted groom Daniel Lingwood, 41, who inadvertently booked the same Buckinghamshire hotel as the Sexiest Man Alive for his nuptials to 28-year-old Abi. When Daniel spotted the actor across the lobby, did he react like any sensible Not-Brad-Pitt Brit and create a diversion by chucking a sterling tray of crumpets in front of a pack of foxhounds while singing “God Save the Queen”? No, he did not. He rushed to grab his betrothed and introduced her to Mr. Pitt, posing for a photo that was then digitally shared with the whole world. To do this with, say, Steve Buscemi is one thing, but Brad Pitt? The first rule of Brad Pitt is we do not take photos with Brad Pitt.
Without restraint
We pediatricians know parents lie to us every day, right? No one really smokes outside all the time. Their kids do not take 400 units of vitamin D every day. And that bike helmet? It’s in the garage under a big pile of outlet covers, stair gates, and vitamin bottles. So when we read this week that a new survey from Safe Kids Worldwide finds that 1 in 4 parents think it’s okay to leave their children unrestrained in the car as long as it’s a short trip or they’re driving at night, are you surprised?
Yes, you are! You’re surprised not because many parents who say they properly restrain their children end the sentence with an inaudible asterisk (*just not on short trips or overnight drives, doc). No, you’re surprised because the people who don’t think car seats are a big deal are the same ones who would pay huge premiums to send their kids to an exclusive preschool, assuming they survive to that age. According to the survey, non-bucklers were much more likely to have household incomes over $100,000, to hold graduate degrees, and to way overpay for a tall skinny mocha latte, no whip.
These are, in other words, the same privileged people who delay or forgo their kids’ immunizations. Kate Carr, president and CEO of Safe Kids Worldwide, said, "We haven't done a focus group yet that would ask, Do they think their car is safer? Do they think they're a safer driver?" As far as I can tell, they think that money itself has magical powers to fight disease and protect children in crashes, just as it improves the flavor of coffee (seriously, roll up a $100 bill sometime and use it to stir in your Turbinado sugar - you can taste the difference). I propose a new public service campaign with arty black-and-white posters displayed at yoga studios, wine tastings, and cupcake boutiques all over the country: “Yes, your child, too, can die, so buckle up every time, and hey, while you’re at it, immunize!”
The little things
Psychologists tell us that happy people tend to take pleasure in even the smallest of victories. By that measure, pediatricians should be giddy at the first large-scale study showing that teens in the United States are actually following our advice when it comes to healthy lifestyles. The gains are tiny! Are you smiling yet?
The authors, from the National Institute of Child Health and Human Development, polled tens of thousands of 6th-to-10th-graders around the country in 2002, 2006, and 2010, to see how their obesity-related behaviors were changing. In every behavior they studied, they discovered encouraging trends, presuming these trends continue in a linear fashion for the next 160 years. Kids in the survey improved over the decade in time spent in physical activity, daily consumption of fruits and vegetables, eating breakfast regularly, avoiding sugar-sweetened beverages and snacks, and limiting television and computer use. The authors fail to report whether teens also cleaned up their rooms, helped more old ladies cross the street, and decreased their greenhouse gas emissions.
What did not change appreciably over time was kids’ average body mass index measurements, but even this can be framed as a victory when contrasted with prior trends demonstrating that by 2050 American kids would weigh more than the average rhinoceros. Personally, I’m satisfied enough with these results to move on to more pressing anticipatory guidance. Since helping others also increases happiness, I’m going to ask each teen to find one affluent young parent to lecture about using car seats.
The nuclear option
In a world where it seems like we’re finding something new to fear every day, isn’t it nice to learn that something is safer than we thought? Researchers publishing in the British Journal of Cancer now bring us a study of around 10,000 children followed from 1962 to 2007, finding that their risks of childhood leukemia were in no way related to their home’s proximity to a nuclear reactor. Children with two heads were counted as 1.5 individuals, and kids who glowed were interviewed at a distance of 100 meters, using a megaphone. Children whose genetic mutations gave them an uncanny resemblance to Brad Pitt were interviewed and then reminded never to be photographed at a stranger’s wedding party unless the groom shared the same rare disorder.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Think for a moment: what’s the worst thing that can happen at your wedding? Getting stood up? A drunken brawl? An outbreak of Norovirus? You’re not using your imagination. Right: Brad Pitt shows up (unless you’re Angelina Jolie, in which case congratulations and thanks for reading my blog, I’m a huge admirer of your work).
This is precisely the nightmare that confronted groom Daniel Lingwood, 41, who inadvertently booked the same Buckinghamshire hotel as the Sexiest Man Alive for his nuptials to 28-year-old Abi. When Daniel spotted the actor across the lobby, did he react like any sensible Not-Brad-Pitt Brit and create a diversion by chucking a sterling tray of crumpets in front of a pack of foxhounds while singing “God Save the Queen”? No, he did not. He rushed to grab his betrothed and introduced her to Mr. Pitt, posing for a photo that was then digitally shared with the whole world. To do this with, say, Steve Buscemi is one thing, but Brad Pitt? The first rule of Brad Pitt is we do not take photos with Brad Pitt.
Without restraint
We pediatricians know parents lie to us every day, right? No one really smokes outside all the time. Their kids do not take 400 units of vitamin D every day. And that bike helmet? It’s in the garage under a big pile of outlet covers, stair gates, and vitamin bottles. So when we read this week that a new survey from Safe Kids Worldwide finds that 1 in 4 parents think it’s okay to leave their children unrestrained in the car as long as it’s a short trip or they’re driving at night, are you surprised?
Yes, you are! You’re surprised not because many parents who say they properly restrain their children end the sentence with an inaudible asterisk (*just not on short trips or overnight drives, doc). No, you’re surprised because the people who don’t think car seats are a big deal are the same ones who would pay huge premiums to send their kids to an exclusive preschool, assuming they survive to that age. According to the survey, non-bucklers were much more likely to have household incomes over $100,000, to hold graduate degrees, and to way overpay for a tall skinny mocha latte, no whip.
These are, in other words, the same privileged people who delay or forgo their kids’ immunizations. Kate Carr, president and CEO of Safe Kids Worldwide, said, "We haven't done a focus group yet that would ask, Do they think their car is safer? Do they think they're a safer driver?" As far as I can tell, they think that money itself has magical powers to fight disease and protect children in crashes, just as it improves the flavor of coffee (seriously, roll up a $100 bill sometime and use it to stir in your Turbinado sugar - you can taste the difference). I propose a new public service campaign with arty black-and-white posters displayed at yoga studios, wine tastings, and cupcake boutiques all over the country: “Yes, your child, too, can die, so buckle up every time, and hey, while you’re at it, immunize!”
The little things
Psychologists tell us that happy people tend to take pleasure in even the smallest of victories. By that measure, pediatricians should be giddy at the first large-scale study showing that teens in the United States are actually following our advice when it comes to healthy lifestyles. The gains are tiny! Are you smiling yet?
The authors, from the National Institute of Child Health and Human Development, polled tens of thousands of 6th-to-10th-graders around the country in 2002, 2006, and 2010, to see how their obesity-related behaviors were changing. In every behavior they studied, they discovered encouraging trends, presuming these trends continue in a linear fashion for the next 160 years. Kids in the survey improved over the decade in time spent in physical activity, daily consumption of fruits and vegetables, eating breakfast regularly, avoiding sugar-sweetened beverages and snacks, and limiting television and computer use. The authors fail to report whether teens also cleaned up their rooms, helped more old ladies cross the street, and decreased their greenhouse gas emissions.
What did not change appreciably over time was kids’ average body mass index measurements, but even this can be framed as a victory when contrasted with prior trends demonstrating that by 2050 American kids would weigh more than the average rhinoceros. Personally, I’m satisfied enough with these results to move on to more pressing anticipatory guidance. Since helping others also increases happiness, I’m going to ask each teen to find one affluent young parent to lecture about using car seats.
The nuclear option
In a world where it seems like we’re finding something new to fear every day, isn’t it nice to learn that something is safer than we thought? Researchers publishing in the British Journal of Cancer now bring us a study of around 10,000 children followed from 1962 to 2007, finding that their risks of childhood leukemia were in no way related to their home’s proximity to a nuclear reactor. Children with two heads were counted as 1.5 individuals, and kids who glowed were interviewed at a distance of 100 meters, using a megaphone. Children whose genetic mutations gave them an uncanny resemblance to Brad Pitt were interviewed and then reminded never to be photographed at a stranger’s wedding party unless the groom shared the same rare disorder.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Think for a moment: what’s the worst thing that can happen at your wedding? Getting stood up? A drunken brawl? An outbreak of Norovirus? You’re not using your imagination. Right: Brad Pitt shows up (unless you’re Angelina Jolie, in which case congratulations and thanks for reading my blog, I’m a huge admirer of your work).
This is precisely the nightmare that confronted groom Daniel Lingwood, 41, who inadvertently booked the same Buckinghamshire hotel as the Sexiest Man Alive for his nuptials to 28-year-old Abi. When Daniel spotted the actor across the lobby, did he react like any sensible Not-Brad-Pitt Brit and create a diversion by chucking a sterling tray of crumpets in front of a pack of foxhounds while singing “God Save the Queen”? No, he did not. He rushed to grab his betrothed and introduced her to Mr. Pitt, posing for a photo that was then digitally shared with the whole world. To do this with, say, Steve Buscemi is one thing, but Brad Pitt? The first rule of Brad Pitt is we do not take photos with Brad Pitt.
Without restraint
We pediatricians know parents lie to us every day, right? No one really smokes outside all the time. Their kids do not take 400 units of vitamin D every day. And that bike helmet? It’s in the garage under a big pile of outlet covers, stair gates, and vitamin bottles. So when we read this week that a new survey from Safe Kids Worldwide finds that 1 in 4 parents think it’s okay to leave their children unrestrained in the car as long as it’s a short trip or they’re driving at night, are you surprised?
Yes, you are! You’re surprised not because many parents who say they properly restrain their children end the sentence with an inaudible asterisk (*just not on short trips or overnight drives, doc). No, you’re surprised because the people who don’t think car seats are a big deal are the same ones who would pay huge premiums to send their kids to an exclusive preschool, assuming they survive to that age. According to the survey, non-bucklers were much more likely to have household incomes over $100,000, to hold graduate degrees, and to way overpay for a tall skinny mocha latte, no whip.
These are, in other words, the same privileged people who delay or forgo their kids’ immunizations. Kate Carr, president and CEO of Safe Kids Worldwide, said, "We haven't done a focus group yet that would ask, Do they think their car is safer? Do they think they're a safer driver?" As far as I can tell, they think that money itself has magical powers to fight disease and protect children in crashes, just as it improves the flavor of coffee (seriously, roll up a $100 bill sometime and use it to stir in your Turbinado sugar - you can taste the difference). I propose a new public service campaign with arty black-and-white posters displayed at yoga studios, wine tastings, and cupcake boutiques all over the country: “Yes, your child, too, can die, so buckle up every time, and hey, while you’re at it, immunize!”
The little things
Psychologists tell us that happy people tend to take pleasure in even the smallest of victories. By that measure, pediatricians should be giddy at the first large-scale study showing that teens in the United States are actually following our advice when it comes to healthy lifestyles. The gains are tiny! Are you smiling yet?
The authors, from the National Institute of Child Health and Human Development, polled tens of thousands of 6th-to-10th-graders around the country in 2002, 2006, and 2010, to see how their obesity-related behaviors were changing. In every behavior they studied, they discovered encouraging trends, presuming these trends continue in a linear fashion for the next 160 years. Kids in the survey improved over the decade in time spent in physical activity, daily consumption of fruits and vegetables, eating breakfast regularly, avoiding sugar-sweetened beverages and snacks, and limiting television and computer use. The authors fail to report whether teens also cleaned up their rooms, helped more old ladies cross the street, and decreased their greenhouse gas emissions.
What did not change appreciably over time was kids’ average body mass index measurements, but even this can be framed as a victory when contrasted with prior trends demonstrating that by 2050 American kids would weigh more than the average rhinoceros. Personally, I’m satisfied enough with these results to move on to more pressing anticipatory guidance. Since helping others also increases happiness, I’m going to ask each teen to find one affluent young parent to lecture about using car seats.
The nuclear option
In a world where it seems like we’re finding something new to fear every day, isn’t it nice to learn that something is safer than we thought? Researchers publishing in the British Journal of Cancer now bring us a study of around 10,000 children followed from 1962 to 2007, finding that their risks of childhood leukemia were in no way related to their home’s proximity to a nuclear reactor. Children with two heads were counted as 1.5 individuals, and kids who glowed were interviewed at a distance of 100 meters, using a megaphone. Children whose genetic mutations gave them an uncanny resemblance to Brad Pitt were interviewed and then reminded never to be photographed at a stranger’s wedding party unless the groom shared the same rare disorder.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Expendable
If you have kids, then you’ve certainly heard of the Chuck Norris meme. People all over the Internet try to top each other with the most outrageous claims for the aging action movie star and six-time karate world champion: “When Google has a question, they Norris it." "Guns carry Chuck Norris for protection." "Chuck Norris: His tears cure cancer. Too bad he’s never cried.”
Let’s try to create our own: Chuck Norris advises the President on Syrian foreign policy. Oh, wait, too late. Chuck Norris already made that one up himself. Seriously, if you see Chuck Norris, don’t tell him I made fun of him. If he’s already heard, say I’m not home. I’ve moved in with the Honey Badger.
Wait for it...
Can I be honest, just with you? It annoys the fool out of me when parents say they want to delay their children’s vaccines. I especially relish it when, using their extensive backgrounds in immunology and infectious diseases, they hand me some schedule where we give one vaccine every time a full moon falls on a date in Fibonacci’s sequence. Why, I wonder, should we limit such caution to vaccines? Shouldn’t we hold off on using car seats until kids’ skeletal systems are mature enough to handle them, around age 18?
Now a coalition of researchers from Kaiser Permanente publishing in JAMA Pediatrics tell us that children whose pertussis vaccines are delayed are more likely to get whooping cough. How did we come to live in a world where this is even a legitimate research topic, much less a headline? Additional studies will examine the relationships between not eating and starvation, water and drowning, and walking with your eyes closed and tripping over stuff.
In a case-control study, investigators found that children aged 3 to 36 months who missed three doses of pertussis vaccine were 18 times more likely than were vaccinated children to contract the disease. Those who missed four doses were 28 more times likely to fall ill. In 2012, the United States saw 41,000 reported cases of pertussis and 18 deaths, mostly in infants, the highest numbers since 1959. Maybe we need a new public service campaign. How about, “Get your kids vaccinated against whooping cough. Unless they’re Chuck Norris.”
Peas porridge cold
Some days I have to ask myself, “Am I cynical enough?” I know what you’re thinking: “You? Really?” Really. Take baby food for example. I figured it was, you know, good for babies. Because if it weren’t better than nursing, wouldn’t we just tell mothers to nurse until their kids are old enough to grill their own steaks? Thanks to Dr. Charlotte Wright of the University of Glasgow, Scotland, and her team for pulling the scales from my eyes in this months’ Archives of Diseases in Childhood.
Her team evaluated the nutritional content and label suggestions of 462 first foods on the shelves in Great Britain, including powdered foods, breakfast cereals, finger foods, and little pots of stuff that looked like even the dog might not try it. The first thing they noted was that most foods were marketed for infants 4 months and older, in contradiction to feeding guidelines in place in both the U.S. and the U.K., but hey, since when did babies read guidelines?
Next they found that the nutritional content of the foods was no better than breast milk and that they were overwhelmingly sweet. They also discovered little to recommend these foods when it came to protein and iron content, even in the pasty goo that, according the label, was once meat. The authors suggested that homemade infant foods provide much better nutrition than do commercial brands. Of course, that leaves it to you to grill the steak and grind it up...unless your infant is Chuck Norris.
In therapy
We all know what kids are supposed to learn in high school health class: that if you text during the videos, you risk missing the gross parts. But what if, in the first 15 weeks of school, they could participate in a program that would leave them with better social behaviors, higher grades, lower levels of depression, less alcohol use, and healthier weights? I don’t know about where you live, but here in North Carolina, we’d cut the funding.
A new study of 800 high school students who participated in the COPE program (for Creating Opportunities for Personal Empowerment) demonstrated that teaching kids cognitive-behavioral therapy techniques could have all of the above beneficial effects. Lead author Bernadette Melnyk, Ph.D., dean of the Ohio State University College of Nursing, said, "This program dropped scores of severely depressed teens almost in half. Less than 25% of adolescents who have mental health problems get any help, and here we have an intervention that addresses that suffering and also can prevent or reduce obesity." She added, “As we refine the program, we fully expect our graduates to be able to defeat Chuck Norris...in a foreign policy debate.”
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
If you have kids, then you’ve certainly heard of the Chuck Norris meme. People all over the Internet try to top each other with the most outrageous claims for the aging action movie star and six-time karate world champion: “When Google has a question, they Norris it." "Guns carry Chuck Norris for protection." "Chuck Norris: His tears cure cancer. Too bad he’s never cried.”
Let’s try to create our own: Chuck Norris advises the President on Syrian foreign policy. Oh, wait, too late. Chuck Norris already made that one up himself. Seriously, if you see Chuck Norris, don’t tell him I made fun of him. If he’s already heard, say I’m not home. I’ve moved in with the Honey Badger.
Wait for it...
Can I be honest, just with you? It annoys the fool out of me when parents say they want to delay their children’s vaccines. I especially relish it when, using their extensive backgrounds in immunology and infectious diseases, they hand me some schedule where we give one vaccine every time a full moon falls on a date in Fibonacci’s sequence. Why, I wonder, should we limit such caution to vaccines? Shouldn’t we hold off on using car seats until kids’ skeletal systems are mature enough to handle them, around age 18?
Now a coalition of researchers from Kaiser Permanente publishing in JAMA Pediatrics tell us that children whose pertussis vaccines are delayed are more likely to get whooping cough. How did we come to live in a world where this is even a legitimate research topic, much less a headline? Additional studies will examine the relationships between not eating and starvation, water and drowning, and walking with your eyes closed and tripping over stuff.
In a case-control study, investigators found that children aged 3 to 36 months who missed three doses of pertussis vaccine were 18 times more likely than were vaccinated children to contract the disease. Those who missed four doses were 28 more times likely to fall ill. In 2012, the United States saw 41,000 reported cases of pertussis and 18 deaths, mostly in infants, the highest numbers since 1959. Maybe we need a new public service campaign. How about, “Get your kids vaccinated against whooping cough. Unless they’re Chuck Norris.”
Peas porridge cold
Some days I have to ask myself, “Am I cynical enough?” I know what you’re thinking: “You? Really?” Really. Take baby food for example. I figured it was, you know, good for babies. Because if it weren’t better than nursing, wouldn’t we just tell mothers to nurse until their kids are old enough to grill their own steaks? Thanks to Dr. Charlotte Wright of the University of Glasgow, Scotland, and her team for pulling the scales from my eyes in this months’ Archives of Diseases in Childhood.
Her team evaluated the nutritional content and label suggestions of 462 first foods on the shelves in Great Britain, including powdered foods, breakfast cereals, finger foods, and little pots of stuff that looked like even the dog might not try it. The first thing they noted was that most foods were marketed for infants 4 months and older, in contradiction to feeding guidelines in place in both the U.S. and the U.K., but hey, since when did babies read guidelines?
Next they found that the nutritional content of the foods was no better than breast milk and that they were overwhelmingly sweet. They also discovered little to recommend these foods when it came to protein and iron content, even in the pasty goo that, according the label, was once meat. The authors suggested that homemade infant foods provide much better nutrition than do commercial brands. Of course, that leaves it to you to grill the steak and grind it up...unless your infant is Chuck Norris.
In therapy
We all know what kids are supposed to learn in high school health class: that if you text during the videos, you risk missing the gross parts. But what if, in the first 15 weeks of school, they could participate in a program that would leave them with better social behaviors, higher grades, lower levels of depression, less alcohol use, and healthier weights? I don’t know about where you live, but here in North Carolina, we’d cut the funding.
A new study of 800 high school students who participated in the COPE program (for Creating Opportunities for Personal Empowerment) demonstrated that teaching kids cognitive-behavioral therapy techniques could have all of the above beneficial effects. Lead author Bernadette Melnyk, Ph.D., dean of the Ohio State University College of Nursing, said, "This program dropped scores of severely depressed teens almost in half. Less than 25% of adolescents who have mental health problems get any help, and here we have an intervention that addresses that suffering and also can prevent or reduce obesity." She added, “As we refine the program, we fully expect our graduates to be able to defeat Chuck Norris...in a foreign policy debate.”
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
If you have kids, then you’ve certainly heard of the Chuck Norris meme. People all over the Internet try to top each other with the most outrageous claims for the aging action movie star and six-time karate world champion: “When Google has a question, they Norris it." "Guns carry Chuck Norris for protection." "Chuck Norris: His tears cure cancer. Too bad he’s never cried.”
Let’s try to create our own: Chuck Norris advises the President on Syrian foreign policy. Oh, wait, too late. Chuck Norris already made that one up himself. Seriously, if you see Chuck Norris, don’t tell him I made fun of him. If he’s already heard, say I’m not home. I’ve moved in with the Honey Badger.
Wait for it...
Can I be honest, just with you? It annoys the fool out of me when parents say they want to delay their children’s vaccines. I especially relish it when, using their extensive backgrounds in immunology and infectious diseases, they hand me some schedule where we give one vaccine every time a full moon falls on a date in Fibonacci’s sequence. Why, I wonder, should we limit such caution to vaccines? Shouldn’t we hold off on using car seats until kids’ skeletal systems are mature enough to handle them, around age 18?
Now a coalition of researchers from Kaiser Permanente publishing in JAMA Pediatrics tell us that children whose pertussis vaccines are delayed are more likely to get whooping cough. How did we come to live in a world where this is even a legitimate research topic, much less a headline? Additional studies will examine the relationships between not eating and starvation, water and drowning, and walking with your eyes closed and tripping over stuff.
In a case-control study, investigators found that children aged 3 to 36 months who missed three doses of pertussis vaccine were 18 times more likely than were vaccinated children to contract the disease. Those who missed four doses were 28 more times likely to fall ill. In 2012, the United States saw 41,000 reported cases of pertussis and 18 deaths, mostly in infants, the highest numbers since 1959. Maybe we need a new public service campaign. How about, “Get your kids vaccinated against whooping cough. Unless they’re Chuck Norris.”
Peas porridge cold
Some days I have to ask myself, “Am I cynical enough?” I know what you’re thinking: “You? Really?” Really. Take baby food for example. I figured it was, you know, good for babies. Because if it weren’t better than nursing, wouldn’t we just tell mothers to nurse until their kids are old enough to grill their own steaks? Thanks to Dr. Charlotte Wright of the University of Glasgow, Scotland, and her team for pulling the scales from my eyes in this months’ Archives of Diseases in Childhood.
Her team evaluated the nutritional content and label suggestions of 462 first foods on the shelves in Great Britain, including powdered foods, breakfast cereals, finger foods, and little pots of stuff that looked like even the dog might not try it. The first thing they noted was that most foods were marketed for infants 4 months and older, in contradiction to feeding guidelines in place in both the U.S. and the U.K., but hey, since when did babies read guidelines?
Next they found that the nutritional content of the foods was no better than breast milk and that they were overwhelmingly sweet. They also discovered little to recommend these foods when it came to protein and iron content, even in the pasty goo that, according the label, was once meat. The authors suggested that homemade infant foods provide much better nutrition than do commercial brands. Of course, that leaves it to you to grill the steak and grind it up...unless your infant is Chuck Norris.
In therapy
We all know what kids are supposed to learn in high school health class: that if you text during the videos, you risk missing the gross parts. But what if, in the first 15 weeks of school, they could participate in a program that would leave them with better social behaviors, higher grades, lower levels of depression, less alcohol use, and healthier weights? I don’t know about where you live, but here in North Carolina, we’d cut the funding.
A new study of 800 high school students who participated in the COPE program (for Creating Opportunities for Personal Empowerment) demonstrated that teaching kids cognitive-behavioral therapy techniques could have all of the above beneficial effects. Lead author Bernadette Melnyk, Ph.D., dean of the Ohio State University College of Nursing, said, "This program dropped scores of severely depressed teens almost in half. Less than 25% of adolescents who have mental health problems get any help, and here we have an intervention that addresses that suffering and also can prevent or reduce obesity." She added, “As we refine the program, we fully expect our graduates to be able to defeat Chuck Norris...in a foreign policy debate.”
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
The XY factor
Do you remember the days when dads didn’t change diapers? Yeah, neither do I. But, as acerbic X Factor judge Simon Cowell prepares for fatherhood at age 53, he has made it clear that changing any diapers at all will not make the cut. I suspect he’s worried that his newborn will be just as critical as he is: “No, stop. Just stop. I mean it. That’s enough. You call that wiping? There was a moment there when I shut my eyes, and I thought you were actually trying to sand my bum. You have absolutely no talent for this. Just call one of those boys to take over -- what are their names? Niall? Liam? Zayne? Is Zayne even a real name? Oh, look, I just peed on your V-neck!”
Urine trouble
I’ve often daydreamed of authoring an evidence-based guideline, just because I think they’re so cool! Then I see an article like the one in this month’s Pediatrics about urine testing in kids treated for urinary tract infections (UTIs), and I realize I may as well skip the whole guideline-development step and go straight to beating my head against a rock. The entire article is worth a read, at least if you’re not given to bouts of depression, but let me sum it up: The more important it is that a child get a urinalysis or urine culture before being treated with antibiotics for a UTI, the less likely that child is to get any urine study at all. Now, where’s my rock?
The authors examined records of 28,678 children who were prescribed antibiotics for more than 5 years, for a total of 40,603 UTIs. Overall, 80% of cases saw at least some sort of testing, which seems pretty good, until you look at who wasn’t tested. Boys, for example, were less likely to be tested than girls, because, you know, anatomically normal boys get bladder infections all the time. Children under age 2 years also had fewer tests, which makes sense since you can usually rely on them to give you a good history and physical exam, and pretty much nothing else causes fever and fussiness in toddlers. Kids recently discharged from the hospital were also less likely to be tested, since, resistance, schmesistance!
I know I’m being sort of a downer about these findings, especially as we live in a world where antibiotic-resistant organisms are not causing an epidemic of hospitalizations, and where unnecessary invasive testing, irradiation, and specialty referrals have no health or financial consequences. Oh, wait, that was part of my daydream. Okay, people, what will it be, granite or schist?
Prize fighter
Dr. James Sargent and his team at Dartmouth’s Geisel School of Medicine have made a major leap forward in their efforts to improve fast food marketing in the United States. Publishing in PLoS One (the journal for people who can’t spell “PLUS”), researchers analyzed advertisements designed to promote unhealthy meals to kids and adults, and they noticed a glaring omission. While 70% of advertisements airing on networks such as Nickelodeon and Cartoon Network focused on free toys, campaigns targeted to adults emphasized flavor, portion size, and cost, with only 1% of ads featuring some sort of giveaway. Do I smell fries? Or is that the scent...of opportunity?
You see where this is going, right? I mean, one cheap slab of salt and fat between two buns is pretty much the same as the next, but what if it came in a cardboard box printed with images of underwear models, cool cars/vacation rentals, and sports trivia/celebrity gossip (“Will that be the man’s meal, or the lady’s?”)? Inside would be freebies of interest to adults: nose hair trimmers, deodorant samples, vodka... There could even be movie tie-ins. Would The Lone Ranger have fared so poorly if some fast food chain had given away free neckerchiefs with a large burger?
My guess is that Dr. Sargent and his team are already all over this. I bet they’re days away from opening a new fast food chain to feature the Geisel Green-Eggs-and-Hamburger, the Filet-of-One-Fish-Two-Fish, and the large, medium, or super-sized Hop-On Pop. I’ll have mine with the free pair of Fox-In Socks, please.
Baby talk
Minna Huotilainen and her colleagues published a paper last week in the Proceedings of the National Academy of Sciences demonstrating that fetuses can learn the words their parents say while still in utero. Dammit!
I mean “darnit!” Oh well, it’s way too late now. While previous work had suggested that language learning begins before birth, the new study actually monitored electrical activity in the brain to show that words newborns had heard in utero produced the sorts of responses associated with familiarity. I have no idea what expectant father might benefit from this information... Simon?
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Do you remember the days when dads didn’t change diapers? Yeah, neither do I. But, as acerbic X Factor judge Simon Cowell prepares for fatherhood at age 53, he has made it clear that changing any diapers at all will not make the cut. I suspect he’s worried that his newborn will be just as critical as he is: “No, stop. Just stop. I mean it. That’s enough. You call that wiping? There was a moment there when I shut my eyes, and I thought you were actually trying to sand my bum. You have absolutely no talent for this. Just call one of those boys to take over -- what are their names? Niall? Liam? Zayne? Is Zayne even a real name? Oh, look, I just peed on your V-neck!”
Urine trouble
I’ve often daydreamed of authoring an evidence-based guideline, just because I think they’re so cool! Then I see an article like the one in this month’s Pediatrics about urine testing in kids treated for urinary tract infections (UTIs), and I realize I may as well skip the whole guideline-development step and go straight to beating my head against a rock. The entire article is worth a read, at least if you’re not given to bouts of depression, but let me sum it up: The more important it is that a child get a urinalysis or urine culture before being treated with antibiotics for a UTI, the less likely that child is to get any urine study at all. Now, where’s my rock?
The authors examined records of 28,678 children who were prescribed antibiotics for more than 5 years, for a total of 40,603 UTIs. Overall, 80% of cases saw at least some sort of testing, which seems pretty good, until you look at who wasn’t tested. Boys, for example, were less likely to be tested than girls, because, you know, anatomically normal boys get bladder infections all the time. Children under age 2 years also had fewer tests, which makes sense since you can usually rely on them to give you a good history and physical exam, and pretty much nothing else causes fever and fussiness in toddlers. Kids recently discharged from the hospital were also less likely to be tested, since, resistance, schmesistance!
I know I’m being sort of a downer about these findings, especially as we live in a world where antibiotic-resistant organisms are not causing an epidemic of hospitalizations, and where unnecessary invasive testing, irradiation, and specialty referrals have no health or financial consequences. Oh, wait, that was part of my daydream. Okay, people, what will it be, granite or schist?
Prize fighter
Dr. James Sargent and his team at Dartmouth’s Geisel School of Medicine have made a major leap forward in their efforts to improve fast food marketing in the United States. Publishing in PLoS One (the journal for people who can’t spell “PLUS”), researchers analyzed advertisements designed to promote unhealthy meals to kids and adults, and they noticed a glaring omission. While 70% of advertisements airing on networks such as Nickelodeon and Cartoon Network focused on free toys, campaigns targeted to adults emphasized flavor, portion size, and cost, with only 1% of ads featuring some sort of giveaway. Do I smell fries? Or is that the scent...of opportunity?
You see where this is going, right? I mean, one cheap slab of salt and fat between two buns is pretty much the same as the next, but what if it came in a cardboard box printed with images of underwear models, cool cars/vacation rentals, and sports trivia/celebrity gossip (“Will that be the man’s meal, or the lady’s?”)? Inside would be freebies of interest to adults: nose hair trimmers, deodorant samples, vodka... There could even be movie tie-ins. Would The Lone Ranger have fared so poorly if some fast food chain had given away free neckerchiefs with a large burger?
My guess is that Dr. Sargent and his team are already all over this. I bet they’re days away from opening a new fast food chain to feature the Geisel Green-Eggs-and-Hamburger, the Filet-of-One-Fish-Two-Fish, and the large, medium, or super-sized Hop-On Pop. I’ll have mine with the free pair of Fox-In Socks, please.
Baby talk
Minna Huotilainen and her colleagues published a paper last week in the Proceedings of the National Academy of Sciences demonstrating that fetuses can learn the words their parents say while still in utero. Dammit!
I mean “darnit!” Oh well, it’s way too late now. While previous work had suggested that language learning begins before birth, the new study actually monitored electrical activity in the brain to show that words newborns had heard in utero produced the sorts of responses associated with familiarity. I have no idea what expectant father might benefit from this information... Simon?
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Do you remember the days when dads didn’t change diapers? Yeah, neither do I. But, as acerbic X Factor judge Simon Cowell prepares for fatherhood at age 53, he has made it clear that changing any diapers at all will not make the cut. I suspect he’s worried that his newborn will be just as critical as he is: “No, stop. Just stop. I mean it. That’s enough. You call that wiping? There was a moment there when I shut my eyes, and I thought you were actually trying to sand my bum. You have absolutely no talent for this. Just call one of those boys to take over -- what are their names? Niall? Liam? Zayne? Is Zayne even a real name? Oh, look, I just peed on your V-neck!”
Urine trouble
I’ve often daydreamed of authoring an evidence-based guideline, just because I think they’re so cool! Then I see an article like the one in this month’s Pediatrics about urine testing in kids treated for urinary tract infections (UTIs), and I realize I may as well skip the whole guideline-development step and go straight to beating my head against a rock. The entire article is worth a read, at least if you’re not given to bouts of depression, but let me sum it up: The more important it is that a child get a urinalysis or urine culture before being treated with antibiotics for a UTI, the less likely that child is to get any urine study at all. Now, where’s my rock?
The authors examined records of 28,678 children who were prescribed antibiotics for more than 5 years, for a total of 40,603 UTIs. Overall, 80% of cases saw at least some sort of testing, which seems pretty good, until you look at who wasn’t tested. Boys, for example, were less likely to be tested than girls, because, you know, anatomically normal boys get bladder infections all the time. Children under age 2 years also had fewer tests, which makes sense since you can usually rely on them to give you a good history and physical exam, and pretty much nothing else causes fever and fussiness in toddlers. Kids recently discharged from the hospital were also less likely to be tested, since, resistance, schmesistance!
I know I’m being sort of a downer about these findings, especially as we live in a world where antibiotic-resistant organisms are not causing an epidemic of hospitalizations, and where unnecessary invasive testing, irradiation, and specialty referrals have no health or financial consequences. Oh, wait, that was part of my daydream. Okay, people, what will it be, granite or schist?
Prize fighter
Dr. James Sargent and his team at Dartmouth’s Geisel School of Medicine have made a major leap forward in their efforts to improve fast food marketing in the United States. Publishing in PLoS One (the journal for people who can’t spell “PLUS”), researchers analyzed advertisements designed to promote unhealthy meals to kids and adults, and they noticed a glaring omission. While 70% of advertisements airing on networks such as Nickelodeon and Cartoon Network focused on free toys, campaigns targeted to adults emphasized flavor, portion size, and cost, with only 1% of ads featuring some sort of giveaway. Do I smell fries? Or is that the scent...of opportunity?
You see where this is going, right? I mean, one cheap slab of salt and fat between two buns is pretty much the same as the next, but what if it came in a cardboard box printed with images of underwear models, cool cars/vacation rentals, and sports trivia/celebrity gossip (“Will that be the man’s meal, or the lady’s?”)? Inside would be freebies of interest to adults: nose hair trimmers, deodorant samples, vodka... There could even be movie tie-ins. Would The Lone Ranger have fared so poorly if some fast food chain had given away free neckerchiefs with a large burger?
My guess is that Dr. Sargent and his team are already all over this. I bet they’re days away from opening a new fast food chain to feature the Geisel Green-Eggs-and-Hamburger, the Filet-of-One-Fish-Two-Fish, and the large, medium, or super-sized Hop-On Pop. I’ll have mine with the free pair of Fox-In Socks, please.
Baby talk
Minna Huotilainen and her colleagues published a paper last week in the Proceedings of the National Academy of Sciences demonstrating that fetuses can learn the words their parents say while still in utero. Dammit!
I mean “darnit!” Oh well, it’s way too late now. While previous work had suggested that language learning begins before birth, the new study actually monitored electrical activity in the brain to show that words newborns had heard in utero produced the sorts of responses associated with familiarity. I have no idea what expectant father might benefit from this information... Simon?
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Shutterbug
I’ve always thought that the only places pediatrics and celebrity gossip intersect are here at “Needles” and in the office of Dr. Harvey Karp. A new cause célèbre, however, may resonate with pediatricians, even if it doesn’t get us any autographs. Halle Berry and Jennifer Garner continue their campaign to strengthen California’s laws against harassing children based on their parents’ professions.
These laws originated to protect abortion providers’ kids from being followed and threatened, but it turns out they work pretty well on paparazzi, too. Apparently young, green ambush photographers are assigned to stalk famous people’s children until they get brave enough to take on Kanye West. Personally, I wouldn’t mind having my five kids photographed everywhere they go in public. At some point, perhaps someone would get a shot where not one of the them is picking their nose.
Yo Baby
Don’t you hate it when you get all excited about something, and then on further inspection, it’s just hype, kind of like World War Z? That’s how I felt when I read that allergists had collected evidence that giving babies probiotics prenatally might reduce their risk of allergic disease. All I could think was, “How in the heck did they get fetuses to eat yogurt?”
Sadly, they didn’t. It turns out that the moms ate the yogurt, or, more accurately, various refined probiotics such as Lactobacillus acidophilus and Bifidobacterium lactis, which don’t sound nearly as tasty as Yoplait. And here is where I get confused. I see how exposing newborns and babies to friendly gut bacteria might drive the ratio of type 1 and type 2 of T-helper cells toward a less-allergenic profile (okay, I don’t really, but it sounds cool). I need an immunologist, however, to explain why feeding these bacteria to the mother should have an effect on the infant (start right after the part where some maternal antibodies cross the placenta).
Further disappointment awaits in this meta-analysis of 25 studies. While supplementation seemed to lower kids’ IgE levels, theoretically making them less prone to allergic disease, it failed to protect subjects against asthma, the only clinically relevant endpoint tested. And L. acidophilus seemed to make things worse, not better, despite being really tasty in yogurt. Finally...wait for it...the authors suggest more research is needed. Fetuses and their mothers hope that new investigations will focus on chocolate.
Ban du soleil
Public health officials must sometimes feel like they’re talking to a wall. When it comes to messaging about tanning beds and melanoma, it’s like, “Blah, blah, blah, I can’t hear you! I’m wearing tiny sunglasses!” A discouraging new analysis of data from the 2011 Youth Risk Behavior Survey found that nearly 30% of non-Hispanic white female high school students reported artificial tanning in the past year, with 16.7% being serial offenders (10 or more instances). Death from skin cancer? Schmeath from schmin schmancer! (Even Yiddish scholars have a hard time with that one.)
Of course, we all know that tanning at a young age raises the risk of melanoma by 59%-75% or, put another way, by 1.8% for every single tanning session. We also know that one place kids won’t hear those data are from employees of tanning salons. Here in North Carolina, our legislature offered a bill to ban minors from using tanning beds, and the industry sent a lobbyist to suggest that maybe all those skin cancer deaths were just a coincidence, easily offset by the benefits of all that rejuvenating vitamin D (the bill did not pass).
Adolescents, in the meantime, are apt to adopt the time-honored teen-think trope, “Ya gotta die of something, so you may as well go with toasty brown skin.” But before dermatologists get so disheartened they drink sunscreen, we also have some information on how to get through to these teens. Those who are reminded that tanning will make them into wrinkly middle-age people covered in liver spots are less likely to bake themselves. I think that, rather than legislating against tanning beds for teens, we should simply insist that before they tan, they tour a retirement community for nudists.
Perfect harmony
Some readers (ahem) might be old enough to remember a famous soft drink commercial from 1971 that channeled the hippie spirit of the era by featuring a multiethnic commune of singers holding soda bottles and crooning about achieving world peace by sharing carbonated corn syrup. Now, however, it appears that soda consumption actually promotes interpersonal aggression and violence, at least among children. Can’t we just buy they world a reliable source of clean water?
Researchers publishing in the Journal of Pediatrics strengthened the association between excess soda consumption and aggression, withdrawal, and attention problems among at-risk children. Kids who drank four or more soft drinks a day were more likely to destroy others’ belongings, get into fights, and attack people, even after researchers adjusted for maternal depression, intimate partner violence, and paternal incarceration. The effect didn’t quite reach statistical significance, but I’d venture a guess that consuming 1.4 liters of soda a day is a decent proxy for all sorts of family dysfunction, so whether it’s the caffeine, the fructose, or the simple fact that there’s no regression analysis that perfectly captures parental neglect, I’d buy the results, if not the soda. In the meantime, if you’re a paparazzo and you see some celebrity’s kid holding a 2-liter soda bottle, back away slowly and go look for Kanye West.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I’ve always thought that the only places pediatrics and celebrity gossip intersect are here at “Needles” and in the office of Dr. Harvey Karp. A new cause célèbre, however, may resonate with pediatricians, even if it doesn’t get us any autographs. Halle Berry and Jennifer Garner continue their campaign to strengthen California’s laws against harassing children based on their parents’ professions.
These laws originated to protect abortion providers’ kids from being followed and threatened, but it turns out they work pretty well on paparazzi, too. Apparently young, green ambush photographers are assigned to stalk famous people’s children until they get brave enough to take on Kanye West. Personally, I wouldn’t mind having my five kids photographed everywhere they go in public. At some point, perhaps someone would get a shot where not one of the them is picking their nose.
Yo Baby
Don’t you hate it when you get all excited about something, and then on further inspection, it’s just hype, kind of like World War Z? That’s how I felt when I read that allergists had collected evidence that giving babies probiotics prenatally might reduce their risk of allergic disease. All I could think was, “How in the heck did they get fetuses to eat yogurt?”
Sadly, they didn’t. It turns out that the moms ate the yogurt, or, more accurately, various refined probiotics such as Lactobacillus acidophilus and Bifidobacterium lactis, which don’t sound nearly as tasty as Yoplait. And here is where I get confused. I see how exposing newborns and babies to friendly gut bacteria might drive the ratio of type 1 and type 2 of T-helper cells toward a less-allergenic profile (okay, I don’t really, but it sounds cool). I need an immunologist, however, to explain why feeding these bacteria to the mother should have an effect on the infant (start right after the part where some maternal antibodies cross the placenta).
Further disappointment awaits in this meta-analysis of 25 studies. While supplementation seemed to lower kids’ IgE levels, theoretically making them less prone to allergic disease, it failed to protect subjects against asthma, the only clinically relevant endpoint tested. And L. acidophilus seemed to make things worse, not better, despite being really tasty in yogurt. Finally...wait for it...the authors suggest more research is needed. Fetuses and their mothers hope that new investigations will focus on chocolate.
Ban du soleil
Public health officials must sometimes feel like they’re talking to a wall. When it comes to messaging about tanning beds and melanoma, it’s like, “Blah, blah, blah, I can’t hear you! I’m wearing tiny sunglasses!” A discouraging new analysis of data from the 2011 Youth Risk Behavior Survey found that nearly 30% of non-Hispanic white female high school students reported artificial tanning in the past year, with 16.7% being serial offenders (10 or more instances). Death from skin cancer? Schmeath from schmin schmancer! (Even Yiddish scholars have a hard time with that one.)
Of course, we all know that tanning at a young age raises the risk of melanoma by 59%-75% or, put another way, by 1.8% for every single tanning session. We also know that one place kids won’t hear those data are from employees of tanning salons. Here in North Carolina, our legislature offered a bill to ban minors from using tanning beds, and the industry sent a lobbyist to suggest that maybe all those skin cancer deaths were just a coincidence, easily offset by the benefits of all that rejuvenating vitamin D (the bill did not pass).
Adolescents, in the meantime, are apt to adopt the time-honored teen-think trope, “Ya gotta die of something, so you may as well go with toasty brown skin.” But before dermatologists get so disheartened they drink sunscreen, we also have some information on how to get through to these teens. Those who are reminded that tanning will make them into wrinkly middle-age people covered in liver spots are less likely to bake themselves. I think that, rather than legislating against tanning beds for teens, we should simply insist that before they tan, they tour a retirement community for nudists.
Perfect harmony
Some readers (ahem) might be old enough to remember a famous soft drink commercial from 1971 that channeled the hippie spirit of the era by featuring a multiethnic commune of singers holding soda bottles and crooning about achieving world peace by sharing carbonated corn syrup. Now, however, it appears that soda consumption actually promotes interpersonal aggression and violence, at least among children. Can’t we just buy they world a reliable source of clean water?
Researchers publishing in the Journal of Pediatrics strengthened the association between excess soda consumption and aggression, withdrawal, and attention problems among at-risk children. Kids who drank four or more soft drinks a day were more likely to destroy others’ belongings, get into fights, and attack people, even after researchers adjusted for maternal depression, intimate partner violence, and paternal incarceration. The effect didn’t quite reach statistical significance, but I’d venture a guess that consuming 1.4 liters of soda a day is a decent proxy for all sorts of family dysfunction, so whether it’s the caffeine, the fructose, or the simple fact that there’s no regression analysis that perfectly captures parental neglect, I’d buy the results, if not the soda. In the meantime, if you’re a paparazzo and you see some celebrity’s kid holding a 2-liter soda bottle, back away slowly and go look for Kanye West.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
I’ve always thought that the only places pediatrics and celebrity gossip intersect are here at “Needles” and in the office of Dr. Harvey Karp. A new cause célèbre, however, may resonate with pediatricians, even if it doesn’t get us any autographs. Halle Berry and Jennifer Garner continue their campaign to strengthen California’s laws against harassing children based on their parents’ professions.
These laws originated to protect abortion providers’ kids from being followed and threatened, but it turns out they work pretty well on paparazzi, too. Apparently young, green ambush photographers are assigned to stalk famous people’s children until they get brave enough to take on Kanye West. Personally, I wouldn’t mind having my five kids photographed everywhere they go in public. At some point, perhaps someone would get a shot where not one of the them is picking their nose.
Yo Baby
Don’t you hate it when you get all excited about something, and then on further inspection, it’s just hype, kind of like World War Z? That’s how I felt when I read that allergists had collected evidence that giving babies probiotics prenatally might reduce their risk of allergic disease. All I could think was, “How in the heck did they get fetuses to eat yogurt?”
Sadly, they didn’t. It turns out that the moms ate the yogurt, or, more accurately, various refined probiotics such as Lactobacillus acidophilus and Bifidobacterium lactis, which don’t sound nearly as tasty as Yoplait. And here is where I get confused. I see how exposing newborns and babies to friendly gut bacteria might drive the ratio of type 1 and type 2 of T-helper cells toward a less-allergenic profile (okay, I don’t really, but it sounds cool). I need an immunologist, however, to explain why feeding these bacteria to the mother should have an effect on the infant (start right after the part where some maternal antibodies cross the placenta).
Further disappointment awaits in this meta-analysis of 25 studies. While supplementation seemed to lower kids’ IgE levels, theoretically making them less prone to allergic disease, it failed to protect subjects against asthma, the only clinically relevant endpoint tested. And L. acidophilus seemed to make things worse, not better, despite being really tasty in yogurt. Finally...wait for it...the authors suggest more research is needed. Fetuses and their mothers hope that new investigations will focus on chocolate.
Ban du soleil
Public health officials must sometimes feel like they’re talking to a wall. When it comes to messaging about tanning beds and melanoma, it’s like, “Blah, blah, blah, I can’t hear you! I’m wearing tiny sunglasses!” A discouraging new analysis of data from the 2011 Youth Risk Behavior Survey found that nearly 30% of non-Hispanic white female high school students reported artificial tanning in the past year, with 16.7% being serial offenders (10 or more instances). Death from skin cancer? Schmeath from schmin schmancer! (Even Yiddish scholars have a hard time with that one.)
Of course, we all know that tanning at a young age raises the risk of melanoma by 59%-75% or, put another way, by 1.8% for every single tanning session. We also know that one place kids won’t hear those data are from employees of tanning salons. Here in North Carolina, our legislature offered a bill to ban minors from using tanning beds, and the industry sent a lobbyist to suggest that maybe all those skin cancer deaths were just a coincidence, easily offset by the benefits of all that rejuvenating vitamin D (the bill did not pass).
Adolescents, in the meantime, are apt to adopt the time-honored teen-think trope, “Ya gotta die of something, so you may as well go with toasty brown skin.” But before dermatologists get so disheartened they drink sunscreen, we also have some information on how to get through to these teens. Those who are reminded that tanning will make them into wrinkly middle-age people covered in liver spots are less likely to bake themselves. I think that, rather than legislating against tanning beds for teens, we should simply insist that before they tan, they tour a retirement community for nudists.
Perfect harmony
Some readers (ahem) might be old enough to remember a famous soft drink commercial from 1971 that channeled the hippie spirit of the era by featuring a multiethnic commune of singers holding soda bottles and crooning about achieving world peace by sharing carbonated corn syrup. Now, however, it appears that soda consumption actually promotes interpersonal aggression and violence, at least among children. Can’t we just buy they world a reliable source of clean water?
Researchers publishing in the Journal of Pediatrics strengthened the association between excess soda consumption and aggression, withdrawal, and attention problems among at-risk children. Kids who drank four or more soft drinks a day were more likely to destroy others’ belongings, get into fights, and attack people, even after researchers adjusted for maternal depression, intimate partner violence, and paternal incarceration. The effect didn’t quite reach statistical significance, but I’d venture a guess that consuming 1.4 liters of soda a day is a decent proxy for all sorts of family dysfunction, so whether it’s the caffeine, the fructose, or the simple fact that there’s no regression analysis that perfectly captures parental neglect, I’d buy the results, if not the soda. In the meantime, if you’re a paparazzo and you see some celebrity’s kid holding a 2-liter soda bottle, back away slowly and go look for Kanye West.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television, and Internet outlets.
Great expectations
Do you get annoyed when the grocery store tabloids are not adequately entertaining? I have, like, 3 minutes to stand in line looking at headlines and wondering if I should pick up a paper and try to turn the pages so gently that the cashier doesn’t insist I buy it; I don’t have time for old news! So I was relieved to hear Jennifer Aniston finally put to rest the rumors that she’s pregnant, rumors that have graced the cover of The Globe every week since 1994.
The 44-year-old actress explained to radio hosts in Australia that the most recent media frenzy over her “baby bump” resulted from her putting on “just a couple of pounds” before appearing in a sleek dress at the premiere of her new movie, We’re the Millers. At 45, I think it’s time I come clean about the appearance of my own midriff in certain items of clothing: I am pregnant.
To B or not to B
No one stays #1 forever, just ask Tiger Woods. This rule holds even in the tiny world of bacteria, where Escherichia coli has usurped Group B streptococcus as the reigning cause of newborn sepsis. After a career spent in constant vigilance against Group B strep, I know I should be celebrating, but for some reason, I just want to listen to Coldplay.
Dr. Rianna Evans told a crowd at the Pediatric Hospital Medicine 2013 meeting that surveillance of blood cultures from febrile infants reported by six different medical centers conducted between 2006 and 2012 demonstrated a pronounced trend toward E. coli as the dominant organism. She attributed the change in part to the introduction of universal Group B strep prophylaxis in pregnant mothers and to the use of new vaccines, adding, “but honestly, I just think Group B strep got overconfident.” In a further insult to Group B strep, Dr. Evans suggested treating febrile infants empirically with only a third-generation cephalosporin, leaving ampicillin, “in the dustbin of history, like Madonna.”
Reached for comment, Group B strep responded, “I’d be lying if I said it hasn’t been a rough time recently. I’ve been struggling offensively. Maybe I didn’t bring my “A” game, but if I had I wouldn’t be true to myself; I’d be strep viridans.”
Out of date
My 13-year-old daughter has informed me that she’s “dating” a classmate, and I have to admit, I’m like, what does that even mean? It’s not like they can go to the mall or a movie together; I’d have to drive them, and I’m pretty sure I haven’t. As best I understand it means they text each other in class and announce to all their friends that they’re an item until, a week later, they’re not.
Now, Dr. Pamela Orpinas of the University of Georgia College of Public Health has helped me understand what it means. It means they’ll both drop out of school and abuse drugs and alcohol. What her publication in the Journal of Research on Adolescence does not explain is how to make it stop.
Dr. Orpinas’s group followed 624 Georgia students from 6th through 12th grade, finding that those who dated earlier had poorer academic skills and a substantially higher risk for dropping out and abusing substances, compared with those who dated later. I now understand how I made Honor Roll all those years: no one would go out with me until I was 29. And a half.
Baby Heisenberg
Even the name “Campaign for a Commercial-Free Childhood (CCFC),” seems like a lost cause, doesn’t it? Do these people live in this country? How exactly do they intend to make childhood commercial free without moving the entire pediatric population of the U.S. deep into the Amazon rain forest for 18 years? And yet, if you tilt at enough windmills, every now and then you bring one home for dinner (I have no idea how to prepare windmill, but I’m not that quixotic). Recently, CCFC brought a mouse to its knees, compelling Disney to offer refunds to millions of parents who bought Baby Einstein videos under the impression that they would make their children smarter.
Now the folks at CCFC have turned their sights on the fast-growing world of mobile apps, rife with misleading or unproven claims about promoting children’s learning and development.In a new complaint filed with the Federal Communications Commission, CCFC alleges that Fisher-Price’s “Laugh & Learn” mobile apps may compel young users to laugh, but the learning piece remains completely untested, and therefore is deceptive. It’s too early to know the outcome of this complaint, but CCFC has a point in that screen time may actually distract toddlers from the sorts of real-world interactions proven to help them learn. But the folks at Fisher-Price have a secret defense: Unlike cartoon mice, Fisher-Price people don’t have knees! I honestly can’t tell whether they have baby bumps.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets.
Do you get annoyed when the grocery store tabloids are not adequately entertaining? I have, like, 3 minutes to stand in line looking at headlines and wondering if I should pick up a paper and try to turn the pages so gently that the cashier doesn’t insist I buy it; I don’t have time for old news! So I was relieved to hear Jennifer Aniston finally put to rest the rumors that she’s pregnant, rumors that have graced the cover of The Globe every week since 1994.
The 44-year-old actress explained to radio hosts in Australia that the most recent media frenzy over her “baby bump” resulted from her putting on “just a couple of pounds” before appearing in a sleek dress at the premiere of her new movie, We’re the Millers. At 45, I think it’s time I come clean about the appearance of my own midriff in certain items of clothing: I am pregnant.
To B or not to B
No one stays #1 forever, just ask Tiger Woods. This rule holds even in the tiny world of bacteria, where Escherichia coli has usurped Group B streptococcus as the reigning cause of newborn sepsis. After a career spent in constant vigilance against Group B strep, I know I should be celebrating, but for some reason, I just want to listen to Coldplay.
Dr. Rianna Evans told a crowd at the Pediatric Hospital Medicine 2013 meeting that surveillance of blood cultures from febrile infants reported by six different medical centers conducted between 2006 and 2012 demonstrated a pronounced trend toward E. coli as the dominant organism. She attributed the change in part to the introduction of universal Group B strep prophylaxis in pregnant mothers and to the use of new vaccines, adding, “but honestly, I just think Group B strep got overconfident.” In a further insult to Group B strep, Dr. Evans suggested treating febrile infants empirically with only a third-generation cephalosporin, leaving ampicillin, “in the dustbin of history, like Madonna.”
Reached for comment, Group B strep responded, “I’d be lying if I said it hasn’t been a rough time recently. I’ve been struggling offensively. Maybe I didn’t bring my “A” game, but if I had I wouldn’t be true to myself; I’d be strep viridans.”
Out of date
My 13-year-old daughter has informed me that she’s “dating” a classmate, and I have to admit, I’m like, what does that even mean? It’s not like they can go to the mall or a movie together; I’d have to drive them, and I’m pretty sure I haven’t. As best I understand it means they text each other in class and announce to all their friends that they’re an item until, a week later, they’re not.
Now, Dr. Pamela Orpinas of the University of Georgia College of Public Health has helped me understand what it means. It means they’ll both drop out of school and abuse drugs and alcohol. What her publication in the Journal of Research on Adolescence does not explain is how to make it stop.
Dr. Orpinas’s group followed 624 Georgia students from 6th through 12th grade, finding that those who dated earlier had poorer academic skills and a substantially higher risk for dropping out and abusing substances, compared with those who dated later. I now understand how I made Honor Roll all those years: no one would go out with me until I was 29. And a half.
Baby Heisenberg
Even the name “Campaign for a Commercial-Free Childhood (CCFC),” seems like a lost cause, doesn’t it? Do these people live in this country? How exactly do they intend to make childhood commercial free without moving the entire pediatric population of the U.S. deep into the Amazon rain forest for 18 years? And yet, if you tilt at enough windmills, every now and then you bring one home for dinner (I have no idea how to prepare windmill, but I’m not that quixotic). Recently, CCFC brought a mouse to its knees, compelling Disney to offer refunds to millions of parents who bought Baby Einstein videos under the impression that they would make their children smarter.
Now the folks at CCFC have turned their sights on the fast-growing world of mobile apps, rife with misleading or unproven claims about promoting children’s learning and development.In a new complaint filed with the Federal Communications Commission, CCFC alleges that Fisher-Price’s “Laugh & Learn” mobile apps may compel young users to laugh, but the learning piece remains completely untested, and therefore is deceptive. It’s too early to know the outcome of this complaint, but CCFC has a point in that screen time may actually distract toddlers from the sorts of real-world interactions proven to help them learn. But the folks at Fisher-Price have a secret defense: Unlike cartoon mice, Fisher-Price people don’t have knees! I honestly can’t tell whether they have baby bumps.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets.
Do you get annoyed when the grocery store tabloids are not adequately entertaining? I have, like, 3 minutes to stand in line looking at headlines and wondering if I should pick up a paper and try to turn the pages so gently that the cashier doesn’t insist I buy it; I don’t have time for old news! So I was relieved to hear Jennifer Aniston finally put to rest the rumors that she’s pregnant, rumors that have graced the cover of The Globe every week since 1994.
The 44-year-old actress explained to radio hosts in Australia that the most recent media frenzy over her “baby bump” resulted from her putting on “just a couple of pounds” before appearing in a sleek dress at the premiere of her new movie, We’re the Millers. At 45, I think it’s time I come clean about the appearance of my own midriff in certain items of clothing: I am pregnant.
To B or not to B
No one stays #1 forever, just ask Tiger Woods. This rule holds even in the tiny world of bacteria, where Escherichia coli has usurped Group B streptococcus as the reigning cause of newborn sepsis. After a career spent in constant vigilance against Group B strep, I know I should be celebrating, but for some reason, I just want to listen to Coldplay.
Dr. Rianna Evans told a crowd at the Pediatric Hospital Medicine 2013 meeting that surveillance of blood cultures from febrile infants reported by six different medical centers conducted between 2006 and 2012 demonstrated a pronounced trend toward E. coli as the dominant organism. She attributed the change in part to the introduction of universal Group B strep prophylaxis in pregnant mothers and to the use of new vaccines, adding, “but honestly, I just think Group B strep got overconfident.” In a further insult to Group B strep, Dr. Evans suggested treating febrile infants empirically with only a third-generation cephalosporin, leaving ampicillin, “in the dustbin of history, like Madonna.”
Reached for comment, Group B strep responded, “I’d be lying if I said it hasn’t been a rough time recently. I’ve been struggling offensively. Maybe I didn’t bring my “A” game, but if I had I wouldn’t be true to myself; I’d be strep viridans.”
Out of date
My 13-year-old daughter has informed me that she’s “dating” a classmate, and I have to admit, I’m like, what does that even mean? It’s not like they can go to the mall or a movie together; I’d have to drive them, and I’m pretty sure I haven’t. As best I understand it means they text each other in class and announce to all their friends that they’re an item until, a week later, they’re not.
Now, Dr. Pamela Orpinas of the University of Georgia College of Public Health has helped me understand what it means. It means they’ll both drop out of school and abuse drugs and alcohol. What her publication in the Journal of Research on Adolescence does not explain is how to make it stop.
Dr. Orpinas’s group followed 624 Georgia students from 6th through 12th grade, finding that those who dated earlier had poorer academic skills and a substantially higher risk for dropping out and abusing substances, compared with those who dated later. I now understand how I made Honor Roll all those years: no one would go out with me until I was 29. And a half.
Baby Heisenberg
Even the name “Campaign for a Commercial-Free Childhood (CCFC),” seems like a lost cause, doesn’t it? Do these people live in this country? How exactly do they intend to make childhood commercial free without moving the entire pediatric population of the U.S. deep into the Amazon rain forest for 18 years? And yet, if you tilt at enough windmills, every now and then you bring one home for dinner (I have no idea how to prepare windmill, but I’m not that quixotic). Recently, CCFC brought a mouse to its knees, compelling Disney to offer refunds to millions of parents who bought Baby Einstein videos under the impression that they would make their children smarter.
Now the folks at CCFC have turned their sights on the fast-growing world of mobile apps, rife with misleading or unproven claims about promoting children’s learning and development.In a new complaint filed with the Federal Communications Commission, CCFC alleges that Fisher-Price’s “Laugh & Learn” mobile apps may compel young users to laugh, but the learning piece remains completely untested, and therefore is deceptive. It’s too early to know the outcome of this complaint, but CCFC has a point in that screen time may actually distract toddlers from the sorts of real-world interactions proven to help them learn. But the folks at Fisher-Price have a secret defense: Unlike cartoon mice, Fisher-Price people don’t have knees! I honestly can’t tell whether they have baby bumps.
David L. Hill, M.D., FAAP is the author of Dad to Dad: Parenting Like a Pro (AAP Publishing, 2012). He is also vice president of Cape Fear Pediatrics in Wilmington, N.C., and adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He serves as Program Director for the AAP Council on Communications and Media and as an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets.