Dr. David Hill

I know schools are overburdened already, but I still think they need to add a class on all that stuff you’re just supposed to know. Where else should kids learn that the Nigerian finance minister will never randomly pick them as someone to be trusted with tens of millions of dollars hidden in a Swiss bank account? Where is it written that central air conditioners have filters and that if you don’t change them every few months your heat pump will explode in a giant ball of burning money?

iStockphoto

And who tells you that neither kitchen grease nor wet wipes are to be flushed down the drain? Because wider knowledge of that last one would have saved Londoners 6 weeks of sewer work while technicians remove a 15-ton “fatberg” composed mainly of those two substances from under the city’s streets. I was just lucky to have a mother to show me how to pour food grease into an empty can for disposal in the garbage and a father to teach me that baby wipes are to be placed in the trash until the smell is so overwhelming that someone else empties it.

Drinking problem

I have a declaration of scientific principle that some may find controversial, but I don’t care: sugar-sweetened beverages (SSBs) are over. Done. Write them off, pour them down the drain, never speak of them again, and under no circumstances apply for a grant to study whether they contribute to obesity. They do, okay? Case closed. Let’s toast with our glasses of ice water and move on to the next pressing question: Why do artificially sweetened beverages also appear to contribute to obesity?

The final nail in the cask of sugar-sweetened beverages may well be a study in Pediatrics clearing up some ambiguity about the age at which SSB consumption causes obesity. Previously, the beverage industry had funded two studies demonstrating that SSBs did not contribute to obesity in children aged 2-5 years, although controversy remained as to why these children would be immune to the excess empty calories, with some researchers favoring unicorn magic while others suggested the intervention of elves.

The real problem may have been flawed study design, which these most recent authors overcame by assessing “SSB consumption and body mass index Z scores among 9,600 children followed in the Early Childhood Longitudinal Survey—Birth Cohort, using linear and logistic regression and adjusting for race/ethnicity, socioeconomic status, mother’s BMI, and television viewing.” Booyah! Their findings? SSBs contribute to obesity starting at about age 2 years. Now maybe we can finally dedicate some research dollars to figuring out whether vaccines cause autism.

Culture club

Don’t you love it when you don’t have to do something you thought you did, like take out the trash can full of diaper wipes? The story arc of pediatrics in our age seems to be the ever-forward march away from intervention and toward anticipatory guidance. When I was growing up, I had to give a urine and blood sample at every annual physical. In 10 more years, a wellness exam is going to consist of Skyping a parent and talking for 30 minutes about avoiding sugar-sweetened beverages.

The latest step away from intervention involves uncomplicated skin and soft tissue infections (SSTIs). Back in the old blood-and-urine days, admissions for these infections were rare and the organisms were interesting, so blood cultures were part of the routine work-up. Now, however, we’re in the future, and our children have been turned into replicant pod slaves by our methicillin-resistant Staphylococcus aureus (MRSA) overlords. A new publication confirms what you already suspected: We admit a child for an SSTI every other encounter, the blood cultures are always negative, and the wound cultures invariably grow some flavor of MRSA.

While these results may not apply to complicated SSTIs such as those from surgical or traumatic wound infection or infected ulcers or burns, the authors suggest sparing thousands of children unnecessary blood cultures that do nothing but prolong their hospitalizations by a day. With the money we save, we might even be able to buy up the nation’s supply of SSBs and pour them into the sewers to break up those baby-wipe fatbergs before they evolve into intelligent beings even more frightening than MRSA.

Soap what?

Have you heard of the meme “first-world problems?” Even my own kids realize that sometimes their complaints are, well, a little self-indulgent: “Dad, you bought the wrong kind of tofu-chicken nuggets...again!” But even this budding self-awareness occasionally needs a bump from actual reality. This week’s context comes from researchers at the London School of Hygiene and Tropical Medicine, who analyzed 14 studies of water, sanitation, and soap availability in low- and middle-income countries. Their findings? Having clean water and soap is enough to bump children’s height growth by 0.5 cm at age 5.

Soap. And water. That’s what I’m going to bring the kids next time the Apple TV won’t connect to Netflix. Brainstorm! Might children in developing countries be able to clean their hands just as well with our sugar-sweetened beverages? Y’all make sure the people at the Gates Foundation know it was my idea first.

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 know schools are overburdened already, but I still think they need to add a class on all that stuff you’re just supposed to know. Where else should kids learn that the Nigerian finance minister will never randomly pick them as someone to be trusted with tens of millions of dollars hidden in a Swiss bank account? Where is it written that central air conditioners have filters and that if you don’t change them every few months your heat pump will explode in a giant ball of burning money?

iStockphoto

And who tells you that neither kitchen grease nor wet wipes are to be flushed down the drain? Because wider knowledge of that last one would have saved Londoners 6 weeks of sewer work while technicians remove a 15-ton “fatberg” composed mainly of those two substances from under the city’s streets. I was just lucky to have a mother to show me how to pour food grease into an empty can for disposal in the garbage and a father to teach me that baby wipes are to be placed in the trash until the smell is so overwhelming that someone else empties it.

Drinking problem

I have a declaration of scientific principle that some may find controversial, but I don’t care: sugar-sweetened beverages (SSBs) are over. Done. Write them off, pour them down the drain, never speak of them again, and under no circumstances apply for a grant to study whether they contribute to obesity. They do, okay? Case closed. Let’s toast with our glasses of ice water and move on to the next pressing question: Why do artificially sweetened beverages also appear to contribute to obesity?

The final nail in the cask of sugar-sweetened beverages may well be a study in Pediatrics clearing up some ambiguity about the age at which SSB consumption causes obesity. Previously, the beverage industry had funded two studies demonstrating that SSBs did not contribute to obesity in children aged 2-5 years, although controversy remained as to why these children would be immune to the excess empty calories, with some researchers favoring unicorn magic while others suggested the intervention of elves.

The real problem may have been flawed study design, which these most recent authors overcame by assessing “SSB consumption and body mass index Z scores among 9,600 children followed in the Early Childhood Longitudinal Survey—Birth Cohort, using linear and logistic regression and adjusting for race/ethnicity, socioeconomic status, mother’s BMI, and television viewing.” Booyah! Their findings? SSBs contribute to obesity starting at about age 2 years. Now maybe we can finally dedicate some research dollars to figuring out whether vaccines cause autism.

Culture club

Don’t you love it when you don’t have to do something you thought you did, like take out the trash can full of diaper wipes? The story arc of pediatrics in our age seems to be the ever-forward march away from intervention and toward anticipatory guidance. When I was growing up, I had to give a urine and blood sample at every annual physical. In 10 more years, a wellness exam is going to consist of Skyping a parent and talking for 30 minutes about avoiding sugar-sweetened beverages.

The latest step away from intervention involves uncomplicated skin and soft tissue infections (SSTIs). Back in the old blood-and-urine days, admissions for these infections were rare and the organisms were interesting, so blood cultures were part of the routine work-up. Now, however, we’re in the future, and our children have been turned into replicant pod slaves by our methicillin-resistant Staphylococcus aureus (MRSA) overlords. A new publication confirms what you already suspected: We admit a child for an SSTI every other encounter, the blood cultures are always negative, and the wound cultures invariably grow some flavor of MRSA.

While these results may not apply to complicated SSTIs such as those from surgical or traumatic wound infection or infected ulcers or burns, the authors suggest sparing thousands of children unnecessary blood cultures that do nothing but prolong their hospitalizations by a day. With the money we save, we might even be able to buy up the nation’s supply of SSBs and pour them into the sewers to break up those baby-wipe fatbergs before they evolve into intelligent beings even more frightening than MRSA.

Soap what?

Have you heard of the meme “first-world problems?” Even my own kids realize that sometimes their complaints are, well, a little self-indulgent: “Dad, you bought the wrong kind of tofu-chicken nuggets...again!” But even this budding self-awareness occasionally needs a bump from actual reality. This week’s context comes from researchers at the London School of Hygiene and Tropical Medicine, who analyzed 14 studies of water, sanitation, and soap availability in low- and middle-income countries. Their findings? Having clean water and soap is enough to bump children’s height growth by 0.5 cm at age 5.

Soap. And water. That’s what I’m going to bring the kids next time the Apple TV won’t connect to Netflix. Brainstorm! Might children in developing countries be able to clean their hands just as well with our sugar-sweetened beverages? Y’all make sure the people at the Gates Foundation know it was my idea first.

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 know schools are overburdened already, but I still think they need to add a class on all that stuff you’re just supposed to know. Where else should kids learn that the Nigerian finance minister will never randomly pick them as someone to be trusted with tens of millions of dollars hidden in a Swiss bank account? Where is it written that central air conditioners have filters and that if you don’t change them every few months your heat pump will explode in a giant ball of burning money?

iStockphoto

And who tells you that neither kitchen grease nor wet wipes are to be flushed down the drain? Because wider knowledge of that last one would have saved Londoners 6 weeks of sewer work while technicians remove a 15-ton “fatberg” composed mainly of those two substances from under the city’s streets. I was just lucky to have a mother to show me how to pour food grease into an empty can for disposal in the garbage and a father to teach me that baby wipes are to be placed in the trash until the smell is so overwhelming that someone else empties it.

Drinking problem

I have a declaration of scientific principle that some may find controversial, but I don’t care: sugar-sweetened beverages (SSBs) are over. Done. Write them off, pour them down the drain, never speak of them again, and under no circumstances apply for a grant to study whether they contribute to obesity. They do, okay? Case closed. Let’s toast with our glasses of ice water and move on to the next pressing question: Why do artificially sweetened beverages also appear to contribute to obesity?

The final nail in the cask of sugar-sweetened beverages may well be a study in Pediatrics clearing up some ambiguity about the age at which SSB consumption causes obesity. Previously, the beverage industry had funded two studies demonstrating that SSBs did not contribute to obesity in children aged 2-5 years, although controversy remained as to why these children would be immune to the excess empty calories, with some researchers favoring unicorn magic while others suggested the intervention of elves.

The real problem may have been flawed study design, which these most recent authors overcame by assessing “SSB consumption and body mass index Z scores among 9,600 children followed in the Early Childhood Longitudinal Survey—Birth Cohort, using linear and logistic regression and adjusting for race/ethnicity, socioeconomic status, mother’s BMI, and television viewing.” Booyah! Their findings? SSBs contribute to obesity starting at about age 2 years. Now maybe we can finally dedicate some research dollars to figuring out whether vaccines cause autism.

Culture club

Don’t you love it when you don’t have to do something you thought you did, like take out the trash can full of diaper wipes? The story arc of pediatrics in our age seems to be the ever-forward march away from intervention and toward anticipatory guidance. When I was growing up, I had to give a urine and blood sample at every annual physical. In 10 more years, a wellness exam is going to consist of Skyping a parent and talking for 30 minutes about avoiding sugar-sweetened beverages.

The latest step away from intervention involves uncomplicated skin and soft tissue infections (SSTIs). Back in the old blood-and-urine days, admissions for these infections were rare and the organisms were interesting, so blood cultures were part of the routine work-up. Now, however, we’re in the future, and our children have been turned into replicant pod slaves by our methicillin-resistant Staphylococcus aureus (MRSA) overlords. A new publication confirms what you already suspected: We admit a child for an SSTI every other encounter, the blood cultures are always negative, and the wound cultures invariably grow some flavor of MRSA.

While these results may not apply to complicated SSTIs such as those from surgical or traumatic wound infection or infected ulcers or burns, the authors suggest sparing thousands of children unnecessary blood cultures that do nothing but prolong their hospitalizations by a day. With the money we save, we might even be able to buy up the nation’s supply of SSBs and pour them into the sewers to break up those baby-wipe fatbergs before they evolve into intelligent beings even more frightening than MRSA.

Soap what?

Have you heard of the meme “first-world problems?” Even my own kids realize that sometimes their complaints are, well, a little self-indulgent: “Dad, you bought the wrong kind of tofu-chicken nuggets...again!” But even this budding self-awareness occasionally needs a bump from actual reality. This week’s context comes from researchers at the London School of Hygiene and Tropical Medicine, who analyzed 14 studies of water, sanitation, and soap availability in low- and middle-income countries. Their findings? Having clean water and soap is enough to bump children’s height growth by 0.5 cm at age 5.

Soap. And water. That’s what I’m going to bring the kids next time the Apple TV won’t connect to Netflix. Brainstorm! Might children in developing countries be able to clean their hands just as well with our sugar-sweetened beverages? Y’all make sure the people at the Gates Foundation know it was my idea first.

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.

Quick, finish the following sentence: “What the world needs now is...” If you said “love, sweet love” you are either an idealist or a Burt Bacharach fan. If you said, “peace, love, and understanding,” you, like I, often confuse Burt Bacharach and Elvis Costello. And if you said The Smurfs 2, you are an executive at Columbia Pictures. Absolutely no one else would give that answer.

iStockphoto iStockphoto iStockphoto iStockphoto

Meh

You notice how sometimes, when people finally get something they really, really wanted, they don’t seem all that excited? If anticipation were worth anything, my 13-year-old daughter would still run to me every morning, give me a crushing hug, and thank me for that My Little Pony. But no, Rainbow is pastured, along with Pasture, in a box in the attic, and now my daughter is begging me to fix the cracked screen on her iPhone, which she’ll probably barely appreciate when she’s 30.

But say you had something really big, like a way to prevent a common cancer. Don’t you think people would remain excited about it? Apparently not, if the cancer is cervical and the way is a vaccine as opposed to what people were expecting, a flying unicorn. The Centers for Disease Control and Prevention just published a report stating that, after years of growth, use of vaccines against human papillomavirus has stalled out at around 53%-54%, dooming thousands to avoidable deaths in coming years from cervical and oropharyngeal malignancies.

Parents who declined the vaccine for their daughters gave five main reasons when surveyed: vaccine not needed (19.1%), vaccine not recommended (14.2%), vaccine safety concerns (13.1%), lack of knowledge about the vaccine or the disease (12.6%), and daughter is not sexually active (10.1%). Researchers conducting the study suffered an increased rate of concussions from repeatedly smacking their heads against the cinder-block walls of the CDC. Upon recovery, they issued a recommendation that physicians redouble their efforts at educating parents about HPV vaccine and that the CDC administration consider using softer materials in future wall construction.

Brain food

Rarely in life do we get the satisfaction of having something we hoped would be true turn out to actually be true. I get a little smug remembering how, when other kids would taunt me in third grade, I’d shout through my tears, “One day, many years from now, I’ll have a lovely wife, talented children, and high job satisfaction, so there!” Come to think of it, there may have been a reason I was picked on...

Now breastfeeding advocates can point to actual evidence that prolonged nursing increases kids’ IQs, a claim that’s been floated before but backed by the sort of highly questionable data usually reserved for political pundits. The new study out of Boston correlated duration of breastfeeding with measures of intelligence in 1,312 infants, finding that continued nursing for the first 12 months of life accounted for a 4-point bump in IQ at age 7 years.

Researchers were quick to point out that no single study is definitive, and they added that 4 IQ points are not so many that most people would notice. One anonymous academic explained, “It’s not so much the difference between inventing Apple and working at GameStop. It’s more like the difference between Despicable Me 2 and The Smurfs 2.”

Falling behind

As wealth disparities continue to worsen in the U.S., pediatric researchers are thinking, “You know what we’re gonna need more of? Measures of childhood poverty.” So much attention has been paid to the 17 million American children living with food insecurity, that we’ve totally ignored the other side of the equation, but not anymore. Now researchers publishing in Pediatrics have validated a new measure of early childhood economic stress: diaper need.

It turns out that around 30% of mothers cannot afford adequate diapers for their children and that, as you might imagine, this situation contributes to family stress. It also turns out that some communities offer resources to help these mothers, which, like, who knew? I’ll be looking for these resources for patients in my own city, since, according to the tagline of this week’s major animated release, “Smurf happens.”

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.

Quick, finish the following sentence: “What the world needs now is...” If you said “love, sweet love” you are either an idealist or a Burt Bacharach fan. If you said, “peace, love, and understanding,” you, like I, often confuse Burt Bacharach and Elvis Costello. And if you said The Smurfs 2, you are an executive at Columbia Pictures. Absolutely no one else would give that answer.

iStockphoto iStockphoto iStockphoto iStockphoto

Meh

You notice how sometimes, when people finally get something they really, really wanted, they don’t seem all that excited? If anticipation were worth anything, my 13-year-old daughter would still run to me every morning, give me a crushing hug, and thank me for that My Little Pony. But no, Rainbow is pastured, along with Pasture, in a box in the attic, and now my daughter is begging me to fix the cracked screen on her iPhone, which she’ll probably barely appreciate when she’s 30.

But say you had something really big, like a way to prevent a common cancer. Don’t you think people would remain excited about it? Apparently not, if the cancer is cervical and the way is a vaccine as opposed to what people were expecting, a flying unicorn. The Centers for Disease Control and Prevention just published a report stating that, after years of growth, use of vaccines against human papillomavirus has stalled out at around 53%-54%, dooming thousands to avoidable deaths in coming years from cervical and oropharyngeal malignancies.

Parents who declined the vaccine for their daughters gave five main reasons when surveyed: vaccine not needed (19.1%), vaccine not recommended (14.2%), vaccine safety concerns (13.1%), lack of knowledge about the vaccine or the disease (12.6%), and daughter is not sexually active (10.1%). Researchers conducting the study suffered an increased rate of concussions from repeatedly smacking their heads against the cinder-block walls of the CDC. Upon recovery, they issued a recommendation that physicians redouble their efforts at educating parents about HPV vaccine and that the CDC administration consider using softer materials in future wall construction.

Brain food

Rarely in life do we get the satisfaction of having something we hoped would be true turn out to actually be true. I get a little smug remembering how, when other kids would taunt me in third grade, I’d shout through my tears, “One day, many years from now, I’ll have a lovely wife, talented children, and high job satisfaction, so there!” Come to think of it, there may have been a reason I was picked on...

Now breastfeeding advocates can point to actual evidence that prolonged nursing increases kids’ IQs, a claim that’s been floated before but backed by the sort of highly questionable data usually reserved for political pundits. The new study out of Boston correlated duration of breastfeeding with measures of intelligence in 1,312 infants, finding that continued nursing for the first 12 months of life accounted for a 4-point bump in IQ at age 7 years.

Researchers were quick to point out that no single study is definitive, and they added that 4 IQ points are not so many that most people would notice. One anonymous academic explained, “It’s not so much the difference between inventing Apple and working at GameStop. It’s more like the difference between Despicable Me 2 and The Smurfs 2.”

Falling behind

As wealth disparities continue to worsen in the U.S., pediatric researchers are thinking, “You know what we’re gonna need more of? Measures of childhood poverty.” So much attention has been paid to the 17 million American children living with food insecurity, that we’ve totally ignored the other side of the equation, but not anymore. Now researchers publishing in Pediatrics have validated a new measure of early childhood economic stress: diaper need.

It turns out that around 30% of mothers cannot afford adequate diapers for their children and that, as you might imagine, this situation contributes to family stress. It also turns out that some communities offer resources to help these mothers, which, like, who knew? I’ll be looking for these resources for patients in my own city, since, according to the tagline of this week’s major animated release, “Smurf happens.”

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.

Quick, finish the following sentence: “What the world needs now is...” If you said “love, sweet love” you are either an idealist or a Burt Bacharach fan. If you said, “peace, love, and understanding,” you, like I, often confuse Burt Bacharach and Elvis Costello. And if you said The Smurfs 2, you are an executive at Columbia Pictures. Absolutely no one else would give that answer.

iStockphoto iStockphoto iStockphoto iStockphoto

Meh

You notice how sometimes, when people finally get something they really, really wanted, they don’t seem all that excited? If anticipation were worth anything, my 13-year-old daughter would still run to me every morning, give me a crushing hug, and thank me for that My Little Pony. But no, Rainbow is pastured, along with Pasture, in a box in the attic, and now my daughter is begging me to fix the cracked screen on her iPhone, which she’ll probably barely appreciate when she’s 30.

But say you had something really big, like a way to prevent a common cancer. Don’t you think people would remain excited about it? Apparently not, if the cancer is cervical and the way is a vaccine as opposed to what people were expecting, a flying unicorn. The Centers for Disease Control and Prevention just published a report stating that, after years of growth, use of vaccines against human papillomavirus has stalled out at around 53%-54%, dooming thousands to avoidable deaths in coming years from cervical and oropharyngeal malignancies.

Parents who declined the vaccine for their daughters gave five main reasons when surveyed: vaccine not needed (19.1%), vaccine not recommended (14.2%), vaccine safety concerns (13.1%), lack of knowledge about the vaccine or the disease (12.6%), and daughter is not sexually active (10.1%). Researchers conducting the study suffered an increased rate of concussions from repeatedly smacking their heads against the cinder-block walls of the CDC. Upon recovery, they issued a recommendation that physicians redouble their efforts at educating parents about HPV vaccine and that the CDC administration consider using softer materials in future wall construction.

Brain food

Rarely in life do we get the satisfaction of having something we hoped would be true turn out to actually be true. I get a little smug remembering how, when other kids would taunt me in third grade, I’d shout through my tears, “One day, many years from now, I’ll have a lovely wife, talented children, and high job satisfaction, so there!” Come to think of it, there may have been a reason I was picked on...

Now breastfeeding advocates can point to actual evidence that prolonged nursing increases kids’ IQs, a claim that’s been floated before but backed by the sort of highly questionable data usually reserved for political pundits. The new study out of Boston correlated duration of breastfeeding with measures of intelligence in 1,312 infants, finding that continued nursing for the first 12 months of life accounted for a 4-point bump in IQ at age 7 years.

Researchers were quick to point out that no single study is definitive, and they added that 4 IQ points are not so many that most people would notice. One anonymous academic explained, “It’s not so much the difference between inventing Apple and working at GameStop. It’s more like the difference between Despicable Me 2 and The Smurfs 2.”

Falling behind

As wealth disparities continue to worsen in the U.S., pediatric researchers are thinking, “You know what we’re gonna need more of? Measures of childhood poverty.” So much attention has been paid to the 17 million American children living with food insecurity, that we’ve totally ignored the other side of the equation, but not anymore. Now researchers publishing in Pediatrics have validated a new measure of early childhood economic stress: diaper need.

It turns out that around 30% of mothers cannot afford adequate diapers for their children and that, as you might imagine, this situation contributes to family stress. It also turns out that some communities offer resources to help these mothers, which, like, who knew? I’ll be looking for these resources for patients in my own city, since, according to the tagline of this week’s major animated release, “Smurf happens.”

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 thing about celebrities is that we feel like we know them, but really almost none of us do. We can laugh at famous people, comfortable in the knowledge that, except for that rare oh-my-gosh-that’s-really-him moment in a hotel lobby, we’ll never see them, and if we do, only one of us will show a flash of recognition.

And yet, the characters celebrities portray can seem almost as real to us as people we actually know. Maybe that’s why the death of actor Cory Monteith last week left our family with a sense of pain and loss much deeper than we’d expect to feel for a stranger. Thankfully, Geraldo Rivera chose that moment in popular culture to post a seminude “selfie” on Twitter. Thanks, Geraldo, we needed that.

iStockphoto

Boyz to mantra

In a world with so many acronyms, it’s always a challenge to come up with a good one. My guess is that once someone thought up the name “Youth Empowerment Seminar,” they felt a lot of pressure to make it something good. Ironically, it appears from a new study in the Journal of Adolescent Health that teenage participants in YES are better than their peers are at saying “no,” at least maybe.

YES is described by the researchers as a biopsychosocial workshop for adolescents that teaches skills of stress management, emotion regulation, conflict resolution, and attentional focus. In short, the message is not, “Just say no to drugs.” It’s “Meditate. Then just say no to drugs.” High school students who learned yoga, mindfulness, and relaxation techniques during gym class ended up reporting significantly less impulsive behavior than did their less mindful peers. When they did do stupid stuff, they were fully present in the experience.

The implications for preventing all sorts of tragically thoughtless teen behavior are profound. Meditation and yoga could beat the heck out of traditional scare tactics (nonviolently, of course) in preventing teen pregnancy, juvenile delinquency, and drug use. If only the YES program had reached Geraldo Rivera...

Hard knock life

Compared with the folks at YES, think how the designers must have wracked their brains to come up with a concussion test called “ImPACT” (Immediate Post-Concussion Assessment and Cognitive Testing). The lower-case “m” is a dead giveaway. ImPACT is a popular computer-based tool designed to identify athletes with head injuries that should keep them out of play. The idea is to test youths when they’re well and then again after any suspicious incident. The problem is that a bad night’s sleep may be just as damaging to cognitive function as a concussion, if not as painful.

Researchers presenting to the American Orthopaedic Society for Sports Medicine compared baseline scores of youths who reported getting under 7 hours of sleep with those of their better-slept peers and found significantly diminished performance in reaction time, verbal memory, and visual memory, but not in visual-motor (processing) speed. These results have led me to institute a new program for my own kids, called SLEEP, for Slumber Lengthening Enlightens Every Person. I know, it could be better, but cut me a break; I was up early.

Blowing it

What’s the difference between learning to make a blow gun from a video on the Internet and learning it from your dad, a Yanomami tribal elder? In both cases, you’re probably sitting around in your underwear, but the guys on YouTube don’t teach you not to inhale the dart. According to a new article in Pediatrics, whichever teens were still breathing after the Cinnamon Challenge are now crafting homemade blow guns and inhaling the darts when they forget to take a deep breath before bringing the guns to their mouths.

The slender metal projectiles, designed to travel down tubes at high speed, do exactly that, lodging in the lower airway, where they can be retrieved only by a rigid bronchoscope or a very small Pygmy. What’s worse, the kids are so embarrassed about the mechanism of injury that they tend to delay reporting the problem to their parents. I’d say that’s reason enough to enroll every teen in America in a Youth Empowerment Seminar, or in my new program GROW (Geraldo Rivera Obviously Was drunk). I know. Let me sleep on it.

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 thing about celebrities is that we feel like we know them, but really almost none of us do. We can laugh at famous people, comfortable in the knowledge that, except for that rare oh-my-gosh-that’s-really-him moment in a hotel lobby, we’ll never see them, and if we do, only one of us will show a flash of recognition.

And yet, the characters celebrities portray can seem almost as real to us as people we actually know. Maybe that’s why the death of actor Cory Monteith last week left our family with a sense of pain and loss much deeper than we’d expect to feel for a stranger. Thankfully, Geraldo Rivera chose that moment in popular culture to post a seminude “selfie” on Twitter. Thanks, Geraldo, we needed that.

iStockphoto

Boyz to mantra

In a world with so many acronyms, it’s always a challenge to come up with a good one. My guess is that once someone thought up the name “Youth Empowerment Seminar,” they felt a lot of pressure to make it something good. Ironically, it appears from a new study in the Journal of Adolescent Health that teenage participants in YES are better than their peers are at saying “no,” at least maybe.

YES is described by the researchers as a biopsychosocial workshop for adolescents that teaches skills of stress management, emotion regulation, conflict resolution, and attentional focus. In short, the message is not, “Just say no to drugs.” It’s “Meditate. Then just say no to drugs.” High school students who learned yoga, mindfulness, and relaxation techniques during gym class ended up reporting significantly less impulsive behavior than did their less mindful peers. When they did do stupid stuff, they were fully present in the experience.

The implications for preventing all sorts of tragically thoughtless teen behavior are profound. Meditation and yoga could beat the heck out of traditional scare tactics (nonviolently, of course) in preventing teen pregnancy, juvenile delinquency, and drug use. If only the YES program had reached Geraldo Rivera...

Hard knock life

Compared with the folks at YES, think how the designers must have wracked their brains to come up with a concussion test called “ImPACT” (Immediate Post-Concussion Assessment and Cognitive Testing). The lower-case “m” is a dead giveaway. ImPACT is a popular computer-based tool designed to identify athletes with head injuries that should keep them out of play. The idea is to test youths when they’re well and then again after any suspicious incident. The problem is that a bad night’s sleep may be just as damaging to cognitive function as a concussion, if not as painful.

Researchers presenting to the American Orthopaedic Society for Sports Medicine compared baseline scores of youths who reported getting under 7 hours of sleep with those of their better-slept peers and found significantly diminished performance in reaction time, verbal memory, and visual memory, but not in visual-motor (processing) speed. These results have led me to institute a new program for my own kids, called SLEEP, for Slumber Lengthening Enlightens Every Person. I know, it could be better, but cut me a break; I was up early.

Blowing it

What’s the difference between learning to make a blow gun from a video on the Internet and learning it from your dad, a Yanomami tribal elder? In both cases, you’re probably sitting around in your underwear, but the guys on YouTube don’t teach you not to inhale the dart. According to a new article in Pediatrics, whichever teens were still breathing after the Cinnamon Challenge are now crafting homemade blow guns and inhaling the darts when they forget to take a deep breath before bringing the guns to their mouths.

The slender metal projectiles, designed to travel down tubes at high speed, do exactly that, lodging in the lower airway, where they can be retrieved only by a rigid bronchoscope or a very small Pygmy. What’s worse, the kids are so embarrassed about the mechanism of injury that they tend to delay reporting the problem to their parents. I’d say that’s reason enough to enroll every teen in America in a Youth Empowerment Seminar, or in my new program GROW (Geraldo Rivera Obviously Was drunk). I know. Let me sleep on it.

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 thing about celebrities is that we feel like we know them, but really almost none of us do. We can laugh at famous people, comfortable in the knowledge that, except for that rare oh-my-gosh-that’s-really-him moment in a hotel lobby, we’ll never see them, and if we do, only one of us will show a flash of recognition.

And yet, the characters celebrities portray can seem almost as real to us as people we actually know. Maybe that’s why the death of actor Cory Monteith last week left our family with a sense of pain and loss much deeper than we’d expect to feel for a stranger. Thankfully, Geraldo Rivera chose that moment in popular culture to post a seminude “selfie” on Twitter. Thanks, Geraldo, we needed that.

iStockphoto

Boyz to mantra

In a world with so many acronyms, it’s always a challenge to come up with a good one. My guess is that once someone thought up the name “Youth Empowerment Seminar,” they felt a lot of pressure to make it something good. Ironically, it appears from a new study in the Journal of Adolescent Health that teenage participants in YES are better than their peers are at saying “no,” at least maybe.

YES is described by the researchers as a biopsychosocial workshop for adolescents that teaches skills of stress management, emotion regulation, conflict resolution, and attentional focus. In short, the message is not, “Just say no to drugs.” It’s “Meditate. Then just say no to drugs.” High school students who learned yoga, mindfulness, and relaxation techniques during gym class ended up reporting significantly less impulsive behavior than did their less mindful peers. When they did do stupid stuff, they were fully present in the experience.

The implications for preventing all sorts of tragically thoughtless teen behavior are profound. Meditation and yoga could beat the heck out of traditional scare tactics (nonviolently, of course) in preventing teen pregnancy, juvenile delinquency, and drug use. If only the YES program had reached Geraldo Rivera...

Hard knock life

Compared with the folks at YES, think how the designers must have wracked their brains to come up with a concussion test called “ImPACT” (Immediate Post-Concussion Assessment and Cognitive Testing). The lower-case “m” is a dead giveaway. ImPACT is a popular computer-based tool designed to identify athletes with head injuries that should keep them out of play. The idea is to test youths when they’re well and then again after any suspicious incident. The problem is that a bad night’s sleep may be just as damaging to cognitive function as a concussion, if not as painful.

Researchers presenting to the American Orthopaedic Society for Sports Medicine compared baseline scores of youths who reported getting under 7 hours of sleep with those of their better-slept peers and found significantly diminished performance in reaction time, verbal memory, and visual memory, but not in visual-motor (processing) speed. These results have led me to institute a new program for my own kids, called SLEEP, for Slumber Lengthening Enlightens Every Person. I know, it could be better, but cut me a break; I was up early.

Blowing it

What’s the difference between learning to make a blow gun from a video on the Internet and learning it from your dad, a Yanomami tribal elder? In both cases, you’re probably sitting around in your underwear, but the guys on YouTube don’t teach you not to inhale the dart. According to a new article in Pediatrics, whichever teens were still breathing after the Cinnamon Challenge are now crafting homemade blow guns and inhaling the darts when they forget to take a deep breath before bringing the guns to their mouths.

The slender metal projectiles, designed to travel down tubes at high speed, do exactly that, lodging in the lower airway, where they can be retrieved only by a rigid bronchoscope or a very small Pygmy. What’s worse, the kids are so embarrassed about the mechanism of injury that they tend to delay reporting the problem to their parents. I’d say that’s reason enough to enroll every teen in America in a Youth Empowerment Seminar, or in my new program GROW (Geraldo Rivera Obviously Was drunk). I know. Let me sleep on it.

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’s not often the pediatric community goes all a-twitter about personnel changes on daytime TV, but ABC just announced that Elisabeth Hasselbeck’s replacement on The View will be Jenny McCarthy, and doctors seem more worked up than Ann Curry fans at a Matt Lauer mall appearance. Apparently, some in the pediatric community fail to appreciate Ms. McCarthy’s groundbreaking work as 1994’s Playboy Playmate of the Year or her dramatic tour de force in Scream 3. No, many of my colleagues seem unable to overlook McCarthy’s antivaccine advocacy, blaming her in part for the estimated 1,170 deaths from vaccine-preventable diseases in the U.S. since she began her crusade in 2007.

Personally, I’m thrilled. For one thing, I love McCarthy’s “Green Our Vaccines,” campaign, agreeing that the common immunization colors of clear, white, and milky are passé and hard to accessorize. I also admire McCarthy for her unwavering loyalty to (former) Dr. Andrew Wakefield who, since being disgraced by evidence that he falsified the data in his discredited article linking autism to measles vaccine, needs a friend. And I am ready to defend McCarthy from those who say she wears glasses just to give the impression that she may be intelligent. Are these not are the same people who say she’s blind to the overwhelming evidence proving that vaccines do not cause autism? Make up your minds! I do still wish The View had given a little more consideration to another well-spoken, glasses-wearing celebrity, Dr. Paul Offit.

iStockphoto

Down the tubes

You might think that the most common surgery performed on children, accounting for nearly 670,000 pediatric procedures a year, would be governed by some sort of evidence-based guidelines. And you’d be right, provided you had that thought very, very recently. Because July 1st marked the release of the first-ever tympanostomy tube guidelines from the American Academy of Otolaryngology-Head and Neck Surgery. The good news: If doctors were to actually follow these guidelines, we could eliminate unnecessary ear surgeries, just as we’ve already done with the overuse of antibiotics!

Pinning down what tympanostomy tubes are good for has been harder than you’d think. The evidence for tubes improving speech delays is more ambiguous than Johnny Depp’s wardrobe choices. And the tubes themselves can cause complications that can reduce both patients’ hearing and their parents’ HSA balances.

Of the twelve recommendations, the most popular is bound to be the one allowing children with tubes to swim without using ear plugs. I anticipate at least a 30% reduction in kids screaming at our community pool; I’ll collect data this weekend. The most controversial recommendation is bound to be the one against placing tubes just because a child has had a lot of ear infections. Some people just prefer action to inaction -- it will take time to convince parents and some doctors that this is yet another of those situations where it’s better to make like Congress, and do nothing.

Brother, can you spare a rod?

In a world where it seems there are fewer and fewer things people can agree upon, I think it’s still safe to say most Americans have a generally unfavorable opinion of child abuse. But that consensus dissolves when we try to define the word “abuse.” Not only has the U.S. not joined the 33 other countries that have outlawed physical punishment of children, we still have school systems in my state that endorse paddling, giving some North Carolina children a better shot at winning foreign political asylum than Edward Snowden.

We already know that severe child abuse results in lifelong health consequences, including early mortality, chronic pain, and psychiatric disease, but a group of Canadian researchers wondered if the same outcomes would hold for children who were merely pushed, grabbed, shoved, or slapped on a regular basis. Sure, some people would say this is also child abuse, but where I live we call it “a visit to Walmart.”

Not surprisingly, adults who recalled these sorts of childhood punishments suffered more heart disease, arthritis, obesity, and other physical conditions. The authors admit that convincing parents to embrace less physical methods of discipline may pose special challenges, and I’d have to say my own experience in practice makes me pessimistic, but we can still hope for a day when “getting physical” means nothing more torturous than being made to listen to an Olivia Newton John song.

Finnish talking

In case you thought you were wasting your breath counseling families on healthy diet, researchers in Finland have good news for you: You’re wasting your breath on other stuff. Based on their new study in Diabetes Care, your words can indeed help improve adolescents’ diets and their insulin sensitivity, so long as you start the counseling during infancy and continue it for 20 years. Better yet, researchers suggest that you consider moving in with your patients’ families and cooking some of their meals, or at least dropping by unannounced and cleaning out their pantries from time to time.

This study just goes to show that the right kind of talk really can save lives, which brings me back to daytime TV. How does this strike you: “Live! With Kelly Ripa and Paul Offit!”? Now that’s a show I would view.

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’s not often the pediatric community goes all a-twitter about personnel changes on daytime TV, but ABC just announced that Elisabeth Hasselbeck’s replacement on The View will be Jenny McCarthy, and doctors seem more worked up than Ann Curry fans at a Matt Lauer mall appearance. Apparently, some in the pediatric community fail to appreciate Ms. McCarthy’s groundbreaking work as 1994’s Playboy Playmate of the Year or her dramatic tour de force in Scream 3. No, many of my colleagues seem unable to overlook McCarthy’s antivaccine advocacy, blaming her in part for the estimated 1,170 deaths from vaccine-preventable diseases in the U.S. since she began her crusade in 2007.

Personally, I’m thrilled. For one thing, I love McCarthy’s “Green Our Vaccines,” campaign, agreeing that the common immunization colors of clear, white, and milky are passé and hard to accessorize. I also admire McCarthy for her unwavering loyalty to (former) Dr. Andrew Wakefield who, since being disgraced by evidence that he falsified the data in his discredited article linking autism to measles vaccine, needs a friend. And I am ready to defend McCarthy from those who say she wears glasses just to give the impression that she may be intelligent. Are these not are the same people who say she’s blind to the overwhelming evidence proving that vaccines do not cause autism? Make up your minds! I do still wish The View had given a little more consideration to another well-spoken, glasses-wearing celebrity, Dr. Paul Offit.

iStockphoto

Down the tubes

You might think that the most common surgery performed on children, accounting for nearly 670,000 pediatric procedures a year, would be governed by some sort of evidence-based guidelines. And you’d be right, provided you had that thought very, very recently. Because July 1st marked the release of the first-ever tympanostomy tube guidelines from the American Academy of Otolaryngology-Head and Neck Surgery. The good news: If doctors were to actually follow these guidelines, we could eliminate unnecessary ear surgeries, just as we’ve already done with the overuse of antibiotics!

Pinning down what tympanostomy tubes are good for has been harder than you’d think. The evidence for tubes improving speech delays is more ambiguous than Johnny Depp’s wardrobe choices. And the tubes themselves can cause complications that can reduce both patients’ hearing and their parents’ HSA balances.

Of the twelve recommendations, the most popular is bound to be the one allowing children with tubes to swim without using ear plugs. I anticipate at least a 30% reduction in kids screaming at our community pool; I’ll collect data this weekend. The most controversial recommendation is bound to be the one against placing tubes just because a child has had a lot of ear infections. Some people just prefer action to inaction -- it will take time to convince parents and some doctors that this is yet another of those situations where it’s better to make like Congress, and do nothing.

Brother, can you spare a rod?

In a world where it seems there are fewer and fewer things people can agree upon, I think it’s still safe to say most Americans have a generally unfavorable opinion of child abuse. But that consensus dissolves when we try to define the word “abuse.” Not only has the U.S. not joined the 33 other countries that have outlawed physical punishment of children, we still have school systems in my state that endorse paddling, giving some North Carolina children a better shot at winning foreign political asylum than Edward Snowden.

We already know that severe child abuse results in lifelong health consequences, including early mortality, chronic pain, and psychiatric disease, but a group of Canadian researchers wondered if the same outcomes would hold for children who were merely pushed, grabbed, shoved, or slapped on a regular basis. Sure, some people would say this is also child abuse, but where I live we call it “a visit to Walmart.”

Not surprisingly, adults who recalled these sorts of childhood punishments suffered more heart disease, arthritis, obesity, and other physical conditions. The authors admit that convincing parents to embrace less physical methods of discipline may pose special challenges, and I’d have to say my own experience in practice makes me pessimistic, but we can still hope for a day when “getting physical” means nothing more torturous than being made to listen to an Olivia Newton John song.

Finnish talking

In case you thought you were wasting your breath counseling families on healthy diet, researchers in Finland have good news for you: You’re wasting your breath on other stuff. Based on their new study in Diabetes Care, your words can indeed help improve adolescents’ diets and their insulin sensitivity, so long as you start the counseling during infancy and continue it for 20 years. Better yet, researchers suggest that you consider moving in with your patients’ families and cooking some of their meals, or at least dropping by unannounced and cleaning out their pantries from time to time.

This study just goes to show that the right kind of talk really can save lives, which brings me back to daytime TV. How does this strike you: “Live! With Kelly Ripa and Paul Offit!”? Now that’s a show I would view.

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’s not often the pediatric community goes all a-twitter about personnel changes on daytime TV, but ABC just announced that Elisabeth Hasselbeck’s replacement on The View will be Jenny McCarthy, and doctors seem more worked up than Ann Curry fans at a Matt Lauer mall appearance. Apparently, some in the pediatric community fail to appreciate Ms. McCarthy’s groundbreaking work as 1994’s Playboy Playmate of the Year or her dramatic tour de force in Scream 3. No, many of my colleagues seem unable to overlook McCarthy’s antivaccine advocacy, blaming her in part for the estimated 1,170 deaths from vaccine-preventable diseases in the U.S. since she began her crusade in 2007.

Personally, I’m thrilled. For one thing, I love McCarthy’s “Green Our Vaccines,” campaign, agreeing that the common immunization colors of clear, white, and milky are passé and hard to accessorize. I also admire McCarthy for her unwavering loyalty to (former) Dr. Andrew Wakefield who, since being disgraced by evidence that he falsified the data in his discredited article linking autism to measles vaccine, needs a friend. And I am ready to defend McCarthy from those who say she wears glasses just to give the impression that she may be intelligent. Are these not are the same people who say she’s blind to the overwhelming evidence proving that vaccines do not cause autism? Make up your minds! I do still wish The View had given a little more consideration to another well-spoken, glasses-wearing celebrity, Dr. Paul Offit.

iStockphoto

Down the tubes

You might think that the most common surgery performed on children, accounting for nearly 670,000 pediatric procedures a year, would be governed by some sort of evidence-based guidelines. And you’d be right, provided you had that thought very, very recently. Because July 1st marked the release of the first-ever tympanostomy tube guidelines from the American Academy of Otolaryngology-Head and Neck Surgery. The good news: If doctors were to actually follow these guidelines, we could eliminate unnecessary ear surgeries, just as we’ve already done with the overuse of antibiotics!

Pinning down what tympanostomy tubes are good for has been harder than you’d think. The evidence for tubes improving speech delays is more ambiguous than Johnny Depp’s wardrobe choices. And the tubes themselves can cause complications that can reduce both patients’ hearing and their parents’ HSA balances.

Of the twelve recommendations, the most popular is bound to be the one allowing children with tubes to swim without using ear plugs. I anticipate at least a 30% reduction in kids screaming at our community pool; I’ll collect data this weekend. The most controversial recommendation is bound to be the one against placing tubes just because a child has had a lot of ear infections. Some people just prefer action to inaction -- it will take time to convince parents and some doctors that this is yet another of those situations where it’s better to make like Congress, and do nothing.

Brother, can you spare a rod?

In a world where it seems there are fewer and fewer things people can agree upon, I think it’s still safe to say most Americans have a generally unfavorable opinion of child abuse. But that consensus dissolves when we try to define the word “abuse.” Not only has the U.S. not joined the 33 other countries that have outlawed physical punishment of children, we still have school systems in my state that endorse paddling, giving some North Carolina children a better shot at winning foreign political asylum than Edward Snowden.

We already know that severe child abuse results in lifelong health consequences, including early mortality, chronic pain, and psychiatric disease, but a group of Canadian researchers wondered if the same outcomes would hold for children who were merely pushed, grabbed, shoved, or slapped on a regular basis. Sure, some people would say this is also child abuse, but where I live we call it “a visit to Walmart.”

Not surprisingly, adults who recalled these sorts of childhood punishments suffered more heart disease, arthritis, obesity, and other physical conditions. The authors admit that convincing parents to embrace less physical methods of discipline may pose special challenges, and I’d have to say my own experience in practice makes me pessimistic, but we can still hope for a day when “getting physical” means nothing more torturous than being made to listen to an Olivia Newton John song.

Finnish talking

In case you thought you were wasting your breath counseling families on healthy diet, researchers in Finland have good news for you: You’re wasting your breath on other stuff. Based on their new study in Diabetes Care, your words can indeed help improve adolescents’ diets and their insulin sensitivity, so long as you start the counseling during infancy and continue it for 20 years. Better yet, researchers suggest that you consider moving in with your patients’ families and cooking some of their meals, or at least dropping by unannounced and cleaning out their pantries from time to time.

This study just goes to show that the right kind of talk really can save lives, which brings me back to daytime TV. How does this strike you: “Live! With Kelly Ripa and Paul Offit!”? Now that’s a show I would view.

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.

Who says Americans are no longer competitive? A quick glance at reality television proves we’re the best of the best at sorting through trash, dressing in drag, and running around in the jungle without clothes, all skills critical for success in today’s economy. Now the hardest fought competition in America has a winner. The Center for Science in the Public Interest (CSPI) has declared the country’s unhealthiest fast food meal, and it is...dramatic music and lighting...drawn-out, pointless pause...fish.

In a world that includes a glazed donut breakfast sandwich, bacon-filled tater tots, and a six-slices-of-bacon-and-cheese burger, Long John Silvers’ Big Catch managed to swim away with the prize, thanks not so much to its measly 1,320 kcal as to the 33 grams of trans fats and 3,700 mg of sodium distributed among fried fish, hush puppies, and onion rings in an orgy of artery-clogging crispiness. Honestly, this kind of spoils pirates for me. From now on, when I hear one of them say “Arrr,” I’m gonna be thinking, “There goes his left coronary.”

Jupiterimages

Misty

I have spent so much of my life in humid places that I don’t even notice any more. Transplants around me will be complaining that their hair’s a mess or that small ferns are growing from their ears, and I’m all like, “But it’s only 94% humidity. That’s a dry heat!” Now, however, it appears all this dampness does something more than make starching laundry as futile as moving a cat off your keyboard: It causes asthma.

That, at least, was the upshot of a new analysis from the International Study of Asthma and Allergies in Childhood, a comprehensive survey of 46,000 children in 20 countries, some of whom live in damp houses. It turns out that the dampness itself, not the associated mold, dust mites, or bad tempers, causes much of the increased asthma risk.

Obviously, these findings pose some issues for people who live, well, anywhere I’ve ever lived. I suggest that, for the good of public health, we all move to one of the dry parts of the country, as soon as the temperatures there fall below 110° F. Since I already have asthma, I may as well stay put. Y’all come visit sometime, and I’ll cut you a fresh slice of air.

Before its time

Sometimes I try to introduce my children to my favorite things a little too soon. My 2-year-old daughter was not really ready to appreciate Slayer. Or escargot. And yet, we all keep making the same mistake, as is evidenced by a new study  in the Journal of Adolescent Health demonstrating that 37% of 8-year-olds had already sipped alcohol. By age 12.5 years, the fraction increased to 67%, with 13% achieving the rank of Certified Sommelier.

The findings wouldn’t be such a big deal had these researchers and others not previously found that kids who started drinking earlier were also more likely to report problem behaviors like binge drinking later on. The idea that we attribute, like all bad ideas, to the French, is that earlier exposure to alcohol would demystify it and keep kids from abusing it. Simple logic should have told us that were this true, there would be no alcoholics in France, which would mean their wines would be lousy, which they’re not, so we shouldn’t waste them on 8-year-olds. In retrospect, it seems obvious, no? Now that she’s 13, I wonder if my daughter would enjoy Ulysses?

Moving on up

Lawmakers in my state have moved aggressively to cut off the traditional paths of social mobility: slashing early-childhood education, defunding public schools, and crafting a regressive new tax structure. The British have already experimented with some of these ideas, and now it’s the Brits who’ve discovered the work-around: breast milk.

According to data from the Own Register General’s Social Class database (doesn’t just reading that make you want a crumpet?), breastfeeding increased children’s odds of upward social mobility by more than 25%, while protecting babies from downward social drift later in life. The effect appeared due in part to the increased IQ attributable to breastfeeding and in part from improved stress responses, which lent nursed babies more emotional resilience. Doing a quick back-of-the-napkin calculation, I figure newborns born into poverty in North Carolina should all be able to attend Harvard provided they consume...let’s see here...24 gallons of breast milk a day. For those who can’t, well, there’s always a career in reality television. Or piracy.

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.

Who says Americans are no longer competitive? A quick glance at reality television proves we’re the best of the best at sorting through trash, dressing in drag, and running around in the jungle without clothes, all skills critical for success in today’s economy. Now the hardest fought competition in America has a winner. The Center for Science in the Public Interest (CSPI) has declared the country’s unhealthiest fast food meal, and it is...dramatic music and lighting...drawn-out, pointless pause...fish.

In a world that includes a glazed donut breakfast sandwich, bacon-filled tater tots, and a six-slices-of-bacon-and-cheese burger, Long John Silvers’ Big Catch managed to swim away with the prize, thanks not so much to its measly 1,320 kcal as to the 33 grams of trans fats and 3,700 mg of sodium distributed among fried fish, hush puppies, and onion rings in an orgy of artery-clogging crispiness. Honestly, this kind of spoils pirates for me. From now on, when I hear one of them say “Arrr,” I’m gonna be thinking, “There goes his left coronary.”

Jupiterimages

Misty

I have spent so much of my life in humid places that I don’t even notice any more. Transplants around me will be complaining that their hair’s a mess or that small ferns are growing from their ears, and I’m all like, “But it’s only 94% humidity. That’s a dry heat!” Now, however, it appears all this dampness does something more than make starching laundry as futile as moving a cat off your keyboard: It causes asthma.

That, at least, was the upshot of a new analysis from the International Study of Asthma and Allergies in Childhood, a comprehensive survey of 46,000 children in 20 countries, some of whom live in damp houses. It turns out that the dampness itself, not the associated mold, dust mites, or bad tempers, causes much of the increased asthma risk.

Obviously, these findings pose some issues for people who live, well, anywhere I’ve ever lived. I suggest that, for the good of public health, we all move to one of the dry parts of the country, as soon as the temperatures there fall below 110° F. Since I already have asthma, I may as well stay put. Y’all come visit sometime, and I’ll cut you a fresh slice of air.

Before its time

Sometimes I try to introduce my children to my favorite things a little too soon. My 2-year-old daughter was not really ready to appreciate Slayer. Or escargot. And yet, we all keep making the same mistake, as is evidenced by a new study  in the Journal of Adolescent Health demonstrating that 37% of 8-year-olds had already sipped alcohol. By age 12.5 years, the fraction increased to 67%, with 13% achieving the rank of Certified Sommelier.

The findings wouldn’t be such a big deal had these researchers and others not previously found that kids who started drinking earlier were also more likely to report problem behaviors like binge drinking later on. The idea that we attribute, like all bad ideas, to the French, is that earlier exposure to alcohol would demystify it and keep kids from abusing it. Simple logic should have told us that were this true, there would be no alcoholics in France, which would mean their wines would be lousy, which they’re not, so we shouldn’t waste them on 8-year-olds. In retrospect, it seems obvious, no? Now that she’s 13, I wonder if my daughter would enjoy Ulysses?

Moving on up

Lawmakers in my state have moved aggressively to cut off the traditional paths of social mobility: slashing early-childhood education, defunding public schools, and crafting a regressive new tax structure. The British have already experimented with some of these ideas, and now it’s the Brits who’ve discovered the work-around: breast milk.

According to data from the Own Register General’s Social Class database (doesn’t just reading that make you want a crumpet?), breastfeeding increased children’s odds of upward social mobility by more than 25%, while protecting babies from downward social drift later in life. The effect appeared due in part to the increased IQ attributable to breastfeeding and in part from improved stress responses, which lent nursed babies more emotional resilience. Doing a quick back-of-the-napkin calculation, I figure newborns born into poverty in North Carolina should all be able to attend Harvard provided they consume...let’s see here...24 gallons of breast milk a day. For those who can’t, well, there’s always a career in reality television. Or piracy.

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.

Who says Americans are no longer competitive? A quick glance at reality television proves we’re the best of the best at sorting through trash, dressing in drag, and running around in the jungle without clothes, all skills critical for success in today’s economy. Now the hardest fought competition in America has a winner. The Center for Science in the Public Interest (CSPI) has declared the country’s unhealthiest fast food meal, and it is...dramatic music and lighting...drawn-out, pointless pause...fish.

In a world that includes a glazed donut breakfast sandwich, bacon-filled tater tots, and a six-slices-of-bacon-and-cheese burger, Long John Silvers’ Big Catch managed to swim away with the prize, thanks not so much to its measly 1,320 kcal as to the 33 grams of trans fats and 3,700 mg of sodium distributed among fried fish, hush puppies, and onion rings in an orgy of artery-clogging crispiness. Honestly, this kind of spoils pirates for me. From now on, when I hear one of them say “Arrr,” I’m gonna be thinking, “There goes his left coronary.”

Jupiterimages

Misty

I have spent so much of my life in humid places that I don’t even notice any more. Transplants around me will be complaining that their hair’s a mess or that small ferns are growing from their ears, and I’m all like, “But it’s only 94% humidity. That’s a dry heat!” Now, however, it appears all this dampness does something more than make starching laundry as futile as moving a cat off your keyboard: It causes asthma.

That, at least, was the upshot of a new analysis from the International Study of Asthma and Allergies in Childhood, a comprehensive survey of 46,000 children in 20 countries, some of whom live in damp houses. It turns out that the dampness itself, not the associated mold, dust mites, or bad tempers, causes much of the increased asthma risk.

Obviously, these findings pose some issues for people who live, well, anywhere I’ve ever lived. I suggest that, for the good of public health, we all move to one of the dry parts of the country, as soon as the temperatures there fall below 110° F. Since I already have asthma, I may as well stay put. Y’all come visit sometime, and I’ll cut you a fresh slice of air.

Before its time

Sometimes I try to introduce my children to my favorite things a little too soon. My 2-year-old daughter was not really ready to appreciate Slayer. Or escargot. And yet, we all keep making the same mistake, as is evidenced by a new study  in the Journal of Adolescent Health demonstrating that 37% of 8-year-olds had already sipped alcohol. By age 12.5 years, the fraction increased to 67%, with 13% achieving the rank of Certified Sommelier.

The findings wouldn’t be such a big deal had these researchers and others not previously found that kids who started drinking earlier were also more likely to report problem behaviors like binge drinking later on. The idea that we attribute, like all bad ideas, to the French, is that earlier exposure to alcohol would demystify it and keep kids from abusing it. Simple logic should have told us that were this true, there would be no alcoholics in France, which would mean their wines would be lousy, which they’re not, so we shouldn’t waste them on 8-year-olds. In retrospect, it seems obvious, no? Now that she’s 13, I wonder if my daughter would enjoy Ulysses?

Moving on up

Lawmakers in my state have moved aggressively to cut off the traditional paths of social mobility: slashing early-childhood education, defunding public schools, and crafting a regressive new tax structure. The British have already experimented with some of these ideas, and now it’s the Brits who’ve discovered the work-around: breast milk.

According to data from the Own Register General’s Social Class database (doesn’t just reading that make you want a crumpet?), breastfeeding increased children’s odds of upward social mobility by more than 25%, while protecting babies from downward social drift later in life. The effect appeared due in part to the increased IQ attributable to breastfeeding and in part from improved stress responses, which lent nursed babies more emotional resilience. Doing a quick back-of-the-napkin calculation, I figure newborns born into poverty in North Carolina should all be able to attend Harvard provided they consume...let’s see here...24 gallons of breast milk a day. For those who can’t, well, there’s always a career in reality television. Or piracy.

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.

Does any good deed in this country go unpunished by a lawsuit? Two McDonald’s restaurants are giving up trying to cater to the Muslim population of Dearborn, Michigan, by serving food prepared according to Islamic code, apparently in response to a suit alleging that much of what had been advertised as “halal” was no such thing. Rumor has it the litigants became suspicious when they saw a preview menu featuring the Halal McRib. Unnamed sources report that, chastened by the experience, the fast food chain has also shelved plans to roll out the McKosher Bacon Double Cheeseburger.

Cat nip

Why can’t we use the Hollywood press to get doctors all on the same page? Kim Kardashian names her child North West, and everyone knows before the ink is dry on the birth certificate. But for years we’ve known head CTs are about as likely to cause brain tumors as to diagnose them in otherwise normal kids with headaches, and apparently the word is still not out. My vote for Kardashian’s next child’s name is “Don’t CT Normal Kids’ Brains West.” What? It’s no worse than “North.”

Researchers publishing in Pediatrics examined insurance claims for nearly 16,000 children aged 3-17 years who saw doctors at least twice for headaches, finding that over a quarter of them underwent at least one CT scan. Scan rates varied by medical specialty: The doctors most likely to order a head CT were the ones least likely to own a reflex hammer. The longer a child had been suffering from headache, the less likely he was to get a CT, which makes sense only in a world where brain masses start big, then shrink, like celebrities’ reputations.

The researchers expressed disappointment that, since the American Academy of Neurology, American Academy of Pediatrics, and American College of Radiology released headache guidelines in 2002 explaining that head CTs should not be performed on children without other neurologic symptoms or findings, there has been essentially no change in how most doctors practice. A pessimist would say evidence-based medicine doesn’t stand a chance against doctors' fear of lawsuits. I prefer to believe that we’re hoping that if we just subject enough children to enough ionizing radiation, at least one of them will develop superpowers.

Running on fumes

I keep trying to tell my kids that when they argue, they can both be right. Just because my daughter interrupted my son while he was trying to tell a story at dinner does not necessarily mean that he does not always leave his wet towels on the floor. This is more and more the shape of the debate over the causes of autism. Is it genetic? Does it result from having older parents? Is it caused by environmental toxins? Yes, yes, and yes; now finish your peas and get a shower before bed.

This week’s big autism news was picked up from the side of the road, literally. In the first comprehensive nationwide study, researchers from the Harvard School of Public Health (perhaps you’ve heard of it?) demonstrated that autism rates correlated directly and strongly with mothers’ exposure to air pollution, specifically diesel exhaust and airborne mercury. Researchers could not pinpoint exactly which pollutant was to blame, since it’s hard to find one without the other, but suffice to say if you’re pregnant and live next door to a cement kiln, you might consider renting a cabin in the woods for 9 months.

These findings finally help me understand why legislators in my state are pushing so hard to simultaneously weaken environmental regulations and access to health care. The only way giving more children lifelong debilitating medical conditions pays off is if we don’t cover their medical expenses. And I just thought they were wrong!

Heavy-lidded

Sometimes a story that makes some people laugh makes other people wince. My guess is that about half of the folks who read this next one will laugh and the other half will wince. See which half you’re in: Emergency departments are seeing more crush injuries from toilet seats falling on penises. If you winced and laughed, give yourself a point for whichever came first.

A team publishing in the British Journal of Urology International tracked the number of U.S. emergency department visits attributed to penile injuries from falling toilet lids between 2002 and 2010. The total number of injuries, for those of you who are keenly interested, was 13,175, reflecting an increase of around 100 injuries per year over the study period. Most of the victims were toddlers working on toilet training, many of whom presumably suffered a setback. Some were adults, which raises the question, “How...?”

The authors point out that toilet lid technology exists that could essentially eliminate these injuries, but these slow-lowering hinges are expensive. There is, of course, an all-American solution to the problem: Someone needs to sue.

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.

Does any good deed in this country go unpunished by a lawsuit? Two McDonald’s restaurants are giving up trying to cater to the Muslim population of Dearborn, Michigan, by serving food prepared according to Islamic code, apparently in response to a suit alleging that much of what had been advertised as “halal” was no such thing. Rumor has it the litigants became suspicious when they saw a preview menu featuring the Halal McRib. Unnamed sources report that, chastened by the experience, the fast food chain has also shelved plans to roll out the McKosher Bacon Double Cheeseburger.

Cat nip

Why can’t we use the Hollywood press to get doctors all on the same page? Kim Kardashian names her child North West, and everyone knows before the ink is dry on the birth certificate. But for years we’ve known head CTs are about as likely to cause brain tumors as to diagnose them in otherwise normal kids with headaches, and apparently the word is still not out. My vote for Kardashian’s next child’s name is “Don’t CT Normal Kids’ Brains West.” What? It’s no worse than “North.”

Researchers publishing in Pediatrics examined insurance claims for nearly 16,000 children aged 3-17 years who saw doctors at least twice for headaches, finding that over a quarter of them underwent at least one CT scan. Scan rates varied by medical specialty: The doctors most likely to order a head CT were the ones least likely to own a reflex hammer. The longer a child had been suffering from headache, the less likely he was to get a CT, which makes sense only in a world where brain masses start big, then shrink, like celebrities’ reputations.

The researchers expressed disappointment that, since the American Academy of Neurology, American Academy of Pediatrics, and American College of Radiology released headache guidelines in 2002 explaining that head CTs should not be performed on children without other neurologic symptoms or findings, there has been essentially no change in how most doctors practice. A pessimist would say evidence-based medicine doesn’t stand a chance against doctors' fear of lawsuits. I prefer to believe that we’re hoping that if we just subject enough children to enough ionizing radiation, at least one of them will develop superpowers.

Running on fumes

I keep trying to tell my kids that when they argue, they can both be right. Just because my daughter interrupted my son while he was trying to tell a story at dinner does not necessarily mean that he does not always leave his wet towels on the floor. This is more and more the shape of the debate over the causes of autism. Is it genetic? Does it result from having older parents? Is it caused by environmental toxins? Yes, yes, and yes; now finish your peas and get a shower before bed.

This week’s big autism news was picked up from the side of the road, literally. In the first comprehensive nationwide study, researchers from the Harvard School of Public Health (perhaps you’ve heard of it?) demonstrated that autism rates correlated directly and strongly with mothers’ exposure to air pollution, specifically diesel exhaust and airborne mercury. Researchers could not pinpoint exactly which pollutant was to blame, since it’s hard to find one without the other, but suffice to say if you’re pregnant and live next door to a cement kiln, you might consider renting a cabin in the woods for 9 months.

These findings finally help me understand why legislators in my state are pushing so hard to simultaneously weaken environmental regulations and access to health care. The only way giving more children lifelong debilitating medical conditions pays off is if we don’t cover their medical expenses. And I just thought they were wrong!

Heavy-lidded

Sometimes a story that makes some people laugh makes other people wince. My guess is that about half of the folks who read this next one will laugh and the other half will wince. See which half you’re in: Emergency departments are seeing more crush injuries from toilet seats falling on penises. If you winced and laughed, give yourself a point for whichever came first.

A team publishing in the British Journal of Urology International tracked the number of U.S. emergency department visits attributed to penile injuries from falling toilet lids between 2002 and 2010. The total number of injuries, for those of you who are keenly interested, was 13,175, reflecting an increase of around 100 injuries per year over the study period. Most of the victims were toddlers working on toilet training, many of whom presumably suffered a setback. Some were adults, which raises the question, “How...?”

The authors point out that toilet lid technology exists that could essentially eliminate these injuries, but these slow-lowering hinges are expensive. There is, of course, an all-American solution to the problem: Someone needs to sue.

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.

Does any good deed in this country go unpunished by a lawsuit? Two McDonald’s restaurants are giving up trying to cater to the Muslim population of Dearborn, Michigan, by serving food prepared according to Islamic code, apparently in response to a suit alleging that much of what had been advertised as “halal” was no such thing. Rumor has it the litigants became suspicious when they saw a preview menu featuring the Halal McRib. Unnamed sources report that, chastened by the experience, the fast food chain has also shelved plans to roll out the McKosher Bacon Double Cheeseburger.

Cat nip

Why can’t we use the Hollywood press to get doctors all on the same page? Kim Kardashian names her child North West, and everyone knows before the ink is dry on the birth certificate. But for years we’ve known head CTs are about as likely to cause brain tumors as to diagnose them in otherwise normal kids with headaches, and apparently the word is still not out. My vote for Kardashian’s next child’s name is “Don’t CT Normal Kids’ Brains West.” What? It’s no worse than “North.”

Researchers publishing in Pediatrics examined insurance claims for nearly 16,000 children aged 3-17 years who saw doctors at least twice for headaches, finding that over a quarter of them underwent at least one CT scan. Scan rates varied by medical specialty: The doctors most likely to order a head CT were the ones least likely to own a reflex hammer. The longer a child had been suffering from headache, the less likely he was to get a CT, which makes sense only in a world where brain masses start big, then shrink, like celebrities’ reputations.

The researchers expressed disappointment that, since the American Academy of Neurology, American Academy of Pediatrics, and American College of Radiology released headache guidelines in 2002 explaining that head CTs should not be performed on children without other neurologic symptoms or findings, there has been essentially no change in how most doctors practice. A pessimist would say evidence-based medicine doesn’t stand a chance against doctors' fear of lawsuits. I prefer to believe that we’re hoping that if we just subject enough children to enough ionizing radiation, at least one of them will develop superpowers.

Running on fumes

I keep trying to tell my kids that when they argue, they can both be right. Just because my daughter interrupted my son while he was trying to tell a story at dinner does not necessarily mean that he does not always leave his wet towels on the floor. This is more and more the shape of the debate over the causes of autism. Is it genetic? Does it result from having older parents? Is it caused by environmental toxins? Yes, yes, and yes; now finish your peas and get a shower before bed.

This week’s big autism news was picked up from the side of the road, literally. In the first comprehensive nationwide study, researchers from the Harvard School of Public Health (perhaps you’ve heard of it?) demonstrated that autism rates correlated directly and strongly with mothers’ exposure to air pollution, specifically diesel exhaust and airborne mercury. Researchers could not pinpoint exactly which pollutant was to blame, since it’s hard to find one without the other, but suffice to say if you’re pregnant and live next door to a cement kiln, you might consider renting a cabin in the woods for 9 months.

These findings finally help me understand why legislators in my state are pushing so hard to simultaneously weaken environmental regulations and access to health care. The only way giving more children lifelong debilitating medical conditions pays off is if we don’t cover their medical expenses. And I just thought they were wrong!

Heavy-lidded

Sometimes a story that makes some people laugh makes other people wince. My guess is that about half of the folks who read this next one will laugh and the other half will wince. See which half you’re in: Emergency departments are seeing more crush injuries from toilet seats falling on penises. If you winced and laughed, give yourself a point for whichever came first.

A team publishing in the British Journal of Urology International tracked the number of U.S. emergency department visits attributed to penile injuries from falling toilet lids between 2002 and 2010. The total number of injuries, for those of you who are keenly interested, was 13,175, reflecting an increase of around 100 injuries per year over the study period. Most of the victims were toddlers working on toilet training, many of whom presumably suffered a setback. Some were adults, which raises the question, “How...?”

The authors point out that toilet lid technology exists that could essentially eliminate these injuries, but these slow-lowering hinges are expensive. There is, of course, an all-American solution to the problem: Someone needs to sue.

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.

We can all exhale now, because Kim Kardashian and Kanye West have had their baby, a girl. The sex was not a surprise, since Kim announced it during the premier of season 8  of Keeping Up With the Kardashians (Eight seasons already? Golly, it seems like 12!). “Like, who doesn't want a girl? They're the best!” she said, adding quietly, “except for boys. They’re also the best. And hermaphrodites, because if girls are the best and boys are the best, then well, you know..." Updates have been lacking as to the size and health of the newborn, who is 5 weeks premature, but I suspect the couple is just waiting to file a report until they complete the peer-review process at People: Neonatology.

Photodisc

Thin kin 

Have you heard the maxim, “What doesn’t kill you makes you scarred for life?” Neither have I, probably because it’s not all that catchy. And yet, as we learn more about the long-term health effects of childhood trauma, it seems to apply. Now we hear that children who are bullied by their siblings suffer just as much if not more psychological trauma than do those who are victimized by their peers. And all along I had hoped it was character building.

To me, the biggest surprise in the randomized telephone survey of 3,599 families was that only 32% of children interviewed reported being assaulted, insulted, or intimidated by a sibling in the past year. In my household of five children, I feel lucky if they spend 32% of the time being pleasant to each other. The researchers, led by Corinna Jenkins Tucker, Ph.D., of the department of family studies at the University of New Hampshire in Durham, asked things like whether a child’s sibling had taken away their property or intentionally broken or ruined something the responder owned, a question that could not  possibly have been thought up by an only child.

The team also asked about participants’ experiences of nonsibling assault, property victimization, psychological victimization, child maltreatment, sexual victimization, school and Internet victimization, and witnessing family and community violence, all just to make sure that siblings didn’t get wrongly blamed for psychological damage. (They just didn’t want to hear, “But I swear, it wasn’t me!”) The results were compelling, causing me to lay down some new rules around our house, specifically that none of the kids may speak, touch each other, take each other’s stuff, or make eye contact until the youngest is old enough to pay for his own mental health coverage.

Unlike

Do you especially hate those people on Facebook who seem to want to put all their friends to some moral test? “I know only some of you will be brave enough to do this, but if you really think world hunger is bad, you’ll repost this picture of a sad puppy.” There are few moral absolutes, but I think 99% of us can agree that certain things are undesirable, for example, dog-fighting, slavery, and child abuse. (If you disagree, please don’t Friend me on Facebook.) The question is, short of reposting someone’s picture in social media, what can we really do about it?

I can’t speak to dogs or slavery, but when it comes to doctors trying to detect and prevent child abuse, it seems we can’t do as much we’d hoped, at least according to a new analysis from the U.S. Preventive Services Task Force. More specifically, the study looks at interventions for children who do not yet show signs of child abuse -- if the USPSTF started evaluating treatments rather than screening tools, it would be called the Cochrane Collaborative and would have to adopt a pretentious British accent.

So far, no question, exam finding, or counseling has proven effective at detecting and preventing child abuse, but while the literature review was comprehensive, they’ve only begun to evaluate leaked documents from the National Security Agency. If the NSA can thwart dozens of terrorist attacks as they claim, perhaps they know how to stop kids from being terrorized in their own homes? Of course, the USPSTF also hasn’t tested the power of the sad puppy photo...

Using some restraint

Do you ever think you’re speaking clearly only to find that you must have been mumbling? According to my kids I always swallow my words when I try to say, “Turn off the TV.” This sort of phenomenon might explain why, in a new review of car safety from the Journal of the Academy of Orthopedic Surgeons, only 42%  of parents with 4- to 6-year-old children were following recommendations for appropriate car restraints for their children. A mere 46% of parents of children  in this age group reported ever hearing that their kids should be properly restrained.

These statistics are only disturbing if you oppose child injury and death, which any of my Facebook friends can tell you I do. I think, however, that I have a solution that would get the booster seat message out to 99% of the population and also buff the image of at least one borderline celebrity. When Kim Kardashian finally releases the first photos of her baby to the public, the infant should be wearing a stylish designer onesie emblazoned with the words, “Keep all children in booster seats until they are 8 years of age or 58 inches tall.” How jealous would that make Beyoncé?!

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.

We can all exhale now, because Kim Kardashian and Kanye West have had their baby, a girl. The sex was not a surprise, since Kim announced it during the premier of season 8  of Keeping Up With the Kardashians (Eight seasons already? Golly, it seems like 12!). “Like, who doesn't want a girl? They're the best!” she said, adding quietly, “except for boys. They’re also the best. And hermaphrodites, because if girls are the best and boys are the best, then well, you know..." Updates have been lacking as to the size and health of the newborn, who is 5 weeks premature, but I suspect the couple is just waiting to file a report until they complete the peer-review process at People: Neonatology.

Photodisc

Thin kin 

Have you heard the maxim, “What doesn’t kill you makes you scarred for life?” Neither have I, probably because it’s not all that catchy. And yet, as we learn more about the long-term health effects of childhood trauma, it seems to apply. Now we hear that children who are bullied by their siblings suffer just as much if not more psychological trauma than do those who are victimized by their peers. And all along I had hoped it was character building.

To me, the biggest surprise in the randomized telephone survey of 3,599 families was that only 32% of children interviewed reported being assaulted, insulted, or intimidated by a sibling in the past year. In my household of five children, I feel lucky if they spend 32% of the time being pleasant to each other. The researchers, led by Corinna Jenkins Tucker, Ph.D., of the department of family studies at the University of New Hampshire in Durham, asked things like whether a child’s sibling had taken away their property or intentionally broken or ruined something the responder owned, a question that could not  possibly have been thought up by an only child.

The team also asked about participants’ experiences of nonsibling assault, property victimization, psychological victimization, child maltreatment, sexual victimization, school and Internet victimization, and witnessing family and community violence, all just to make sure that siblings didn’t get wrongly blamed for psychological damage. (They just didn’t want to hear, “But I swear, it wasn’t me!”) The results were compelling, causing me to lay down some new rules around our house, specifically that none of the kids may speak, touch each other, take each other’s stuff, or make eye contact until the youngest is old enough to pay for his own mental health coverage.

Unlike

Do you especially hate those people on Facebook who seem to want to put all their friends to some moral test? “I know only some of you will be brave enough to do this, but if you really think world hunger is bad, you’ll repost this picture of a sad puppy.” There are few moral absolutes, but I think 99% of us can agree that certain things are undesirable, for example, dog-fighting, slavery, and child abuse. (If you disagree, please don’t Friend me on Facebook.) The question is, short of reposting someone’s picture in social media, what can we really do about it?

I can’t speak to dogs or slavery, but when it comes to doctors trying to detect and prevent child abuse, it seems we can’t do as much we’d hoped, at least according to a new analysis from the U.S. Preventive Services Task Force. More specifically, the study looks at interventions for children who do not yet show signs of child abuse -- if the USPSTF started evaluating treatments rather than screening tools, it would be called the Cochrane Collaborative and would have to adopt a pretentious British accent.

So far, no question, exam finding, or counseling has proven effective at detecting and preventing child abuse, but while the literature review was comprehensive, they’ve only begun to evaluate leaked documents from the National Security Agency. If the NSA can thwart dozens of terrorist attacks as they claim, perhaps they know how to stop kids from being terrorized in their own homes? Of course, the USPSTF also hasn’t tested the power of the sad puppy photo...

Using some restraint

Do you ever think you’re speaking clearly only to find that you must have been mumbling? According to my kids I always swallow my words when I try to say, “Turn off the TV.” This sort of phenomenon might explain why, in a new review of car safety from the Journal of the Academy of Orthopedic Surgeons, only 42%  of parents with 4- to 6-year-old children were following recommendations for appropriate car restraints for their children. A mere 46% of parents of children  in this age group reported ever hearing that their kids should be properly restrained.

These statistics are only disturbing if you oppose child injury and death, which any of my Facebook friends can tell you I do. I think, however, that I have a solution that would get the booster seat message out to 99% of the population and also buff the image of at least one borderline celebrity. When Kim Kardashian finally releases the first photos of her baby to the public, the infant should be wearing a stylish designer onesie emblazoned with the words, “Keep all children in booster seats until they are 8 years of age or 58 inches tall.” How jealous would that make Beyoncé?!

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.

We can all exhale now, because Kim Kardashian and Kanye West have had their baby, a girl. The sex was not a surprise, since Kim announced it during the premier of season 8  of Keeping Up With the Kardashians (Eight seasons already? Golly, it seems like 12!). “Like, who doesn't want a girl? They're the best!” she said, adding quietly, “except for boys. They’re also the best. And hermaphrodites, because if girls are the best and boys are the best, then well, you know..." Updates have been lacking as to the size and health of the newborn, who is 5 weeks premature, but I suspect the couple is just waiting to file a report until they complete the peer-review process at People: Neonatology.

Photodisc

Thin kin 

Have you heard the maxim, “What doesn’t kill you makes you scarred for life?” Neither have I, probably because it’s not all that catchy. And yet, as we learn more about the long-term health effects of childhood trauma, it seems to apply. Now we hear that children who are bullied by their siblings suffer just as much if not more psychological trauma than do those who are victimized by their peers. And all along I had hoped it was character building.

To me, the biggest surprise in the randomized telephone survey of 3,599 families was that only 32% of children interviewed reported being assaulted, insulted, or intimidated by a sibling in the past year. In my household of five children, I feel lucky if they spend 32% of the time being pleasant to each other. The researchers, led by Corinna Jenkins Tucker, Ph.D., of the department of family studies at the University of New Hampshire in Durham, asked things like whether a child’s sibling had taken away their property or intentionally broken or ruined something the responder owned, a question that could not  possibly have been thought up by an only child.

The team also asked about participants’ experiences of nonsibling assault, property victimization, psychological victimization, child maltreatment, sexual victimization, school and Internet victimization, and witnessing family and community violence, all just to make sure that siblings didn’t get wrongly blamed for psychological damage. (They just didn’t want to hear, “But I swear, it wasn’t me!”) The results were compelling, causing me to lay down some new rules around our house, specifically that none of the kids may speak, touch each other, take each other’s stuff, or make eye contact until the youngest is old enough to pay for his own mental health coverage.

Unlike

Do you especially hate those people on Facebook who seem to want to put all their friends to some moral test? “I know only some of you will be brave enough to do this, but if you really think world hunger is bad, you’ll repost this picture of a sad puppy.” There are few moral absolutes, but I think 99% of us can agree that certain things are undesirable, for example, dog-fighting, slavery, and child abuse. (If you disagree, please don’t Friend me on Facebook.) The question is, short of reposting someone’s picture in social media, what can we really do about it?

I can’t speak to dogs or slavery, but when it comes to doctors trying to detect and prevent child abuse, it seems we can’t do as much we’d hoped, at least according to a new analysis from the U.S. Preventive Services Task Force. More specifically, the study looks at interventions for children who do not yet show signs of child abuse -- if the USPSTF started evaluating treatments rather than screening tools, it would be called the Cochrane Collaborative and would have to adopt a pretentious British accent.

So far, no question, exam finding, or counseling has proven effective at detecting and preventing child abuse, but while the literature review was comprehensive, they’ve only begun to evaluate leaked documents from the National Security Agency. If the NSA can thwart dozens of terrorist attacks as they claim, perhaps they know how to stop kids from being terrorized in their own homes? Of course, the USPSTF also hasn’t tested the power of the sad puppy photo...

Using some restraint

Do you ever think you’re speaking clearly only to find that you must have been mumbling? According to my kids I always swallow my words when I try to say, “Turn off the TV.” This sort of phenomenon might explain why, in a new review of car safety from the Journal of the Academy of Orthopedic Surgeons, only 42%  of parents with 4- to 6-year-old children were following recommendations for appropriate car restraints for their children. A mere 46% of parents of children  in this age group reported ever hearing that their kids should be properly restrained.

These statistics are only disturbing if you oppose child injury and death, which any of my Facebook friends can tell you I do. I think, however, that I have a solution that would get the booster seat message out to 99% of the population and also buff the image of at least one borderline celebrity. When Kim Kardashian finally releases the first photos of her baby to the public, the infant should be wearing a stylish designer onesie emblazoned with the words, “Keep all children in booster seats until they are 8 years of age or 58 inches tall.” How jealous would that make Beyoncé?!

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.

Have you ever found yourself supporting a cause you really believed in, but then getting turned off when someone else took it, well, a little too far? Because that’s where I am with breastmilk-flavored lollipops. The good news is that the confections include no actual human milk. (Can we all agree that this is indeed good news?) “But,” I hear you asking, “how do they know they got the taste right?”

According to interviews with Jason Darling (his real name), the Austin-based founder of Lollyphile, a handful of breastfeeding mothers, “kept sharing their breast milk with our flavor specialists until we were able to candify it.” Which means that, yes, somewhere in Texas, there is at least one food chemist sporting a very special milk mustache. He is also enjoying temporary protection from ear infections.

Ingram Publishing

New faithful

Whenever I cover a report on parental vaccine resistance, naturally, my first question is, “How can I make this subject even more controversial?” Fortunately, Dr. Aamer Imdad of the State University of New York Upstate Medical University in Syracuse answered that question in this month’s Pediatrics: Add religion. Dr. Imdad and his team tracked the startling growth in religious exemptions to vaccines in the state of New York from 2000 to 2011, and all I can say is, “Holy whooping cough!”

The researchers examined rates of religious vaccine exemptions granted by schools in each county. The rates nearly doubled from 0.23% in 2000 to 0.45% in 2011. This trend begs a question: Since the major Western faiths all support immunization, what religion is so successfully recruiting converts in New York State? Is Breaking Amish just that big a hit? Or is there a flowering of new antivaccine congregations? Our Lady of Perpetual Pertussis? Temple Beth Tetanus? The Al-Influenza Center?

This is not just a question about how many angels can fit upon the tip of a needle without getting vaccinated. The authors go on to demonstrate that in counties in which the vaccine exemption rate exceeded 1%, whooping cough rates increased dramatically, among both unvaccinated and vaccinated children. These data further confirm that high immunization rates protect not just the herd, but also the flock.

Drinking problem

Does it seem to you like sugar-sweetened beverages are the new tobacco? I can totally envision a day in the future when my grandchildren ask, “Grandpa, is it true that people used to drink sodas...on purpose? Didn’t you know how dangerous they were? And why is the turn signal in our hover-car still on?”

It’s grown increasingly clear that sugared beverages are among the main contributors to the obesity epidemic, but last week, the Australians published a study demonstrating that sodas also worsen teens’ cardiac risk factors, even when those kids are not overweight. Further analysis linked soda consumption to global warming, nuclear arms proliferation, and the mysterious disappearance of Jimmy Hoffa in 1975.

Why, then, do we continue to give our children this poisonous-yet-oh-so-refreshing swill? A study from Sweden lays the blame on television. I have to say, I don’t imagine Swedish kids spending hours huddled on their starkly modernist sofas staring at their flat-screens, but I don’t know what else I think they’re doing, crafting inexpensive yet gorgeously designed flat-packed bookshelves? At any rate, for every hour of television that 1,733 Swedish 2- to 9-year-old children watched, they increased their sugared beverage consumption by 50%, even when their parents claimed to discourage it. This is proof of what I’ve always said: To combat heart disease worldwide, we must stop Nordic children from watching television. If only we’d known in 1975.

Prone to error

I’m wrong all the time. I know, because I live with teenagers. But it seems every time I open a medical journal, I’m finding something new I’ve messed up. Since when did peer-reviewed journals start talking to my kids? Most recently two physical therapists at the University of Alberta in Edmonton, Canada, looked to see if we need to revise our 4-month motor milestones since, as everyone knows, the shift from prone to supine infant sleep position 20 years ago has led to a delay in the average age at which infants learn to roll from front to back. Spoiler alert: We don’t. Because it hasn’t.

Modern infants, put to sleep safely on their backs, start rolling about the same time as their peers born before 1992, with the advantage that they’re less likely to suffer sudden infant death syndrome. Progress is a beautiful thing, at least until it results in a questionably flavored lollipop.

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.

Have you ever found yourself supporting a cause you really believed in, but then getting turned off when someone else took it, well, a little too far? Because that’s where I am with breastmilk-flavored lollipops. The good news is that the confections include no actual human milk. (Can we all agree that this is indeed good news?) “But,” I hear you asking, “how do they know they got the taste right?”

According to interviews with Jason Darling (his real name), the Austin-based founder of Lollyphile, a handful of breastfeeding mothers, “kept sharing their breast milk with our flavor specialists until we were able to candify it.” Which means that, yes, somewhere in Texas, there is at least one food chemist sporting a very special milk mustache. He is also enjoying temporary protection from ear infections.

Ingram Publishing

New faithful

Whenever I cover a report on parental vaccine resistance, naturally, my first question is, “How can I make this subject even more controversial?” Fortunately, Dr. Aamer Imdad of the State University of New York Upstate Medical University in Syracuse answered that question in this month’s Pediatrics: Add religion. Dr. Imdad and his team tracked the startling growth in religious exemptions to vaccines in the state of New York from 2000 to 2011, and all I can say is, “Holy whooping cough!”

The researchers examined rates of religious vaccine exemptions granted by schools in each county. The rates nearly doubled from 0.23% in 2000 to 0.45% in 2011. This trend begs a question: Since the major Western faiths all support immunization, what religion is so successfully recruiting converts in New York State? Is Breaking Amish just that big a hit? Or is there a flowering of new antivaccine congregations? Our Lady of Perpetual Pertussis? Temple Beth Tetanus? The Al-Influenza Center?

This is not just a question about how many angels can fit upon the tip of a needle without getting vaccinated. The authors go on to demonstrate that in counties in which the vaccine exemption rate exceeded 1%, whooping cough rates increased dramatically, among both unvaccinated and vaccinated children. These data further confirm that high immunization rates protect not just the herd, but also the flock.

Drinking problem

Does it seem to you like sugar-sweetened beverages are the new tobacco? I can totally envision a day in the future when my grandchildren ask, “Grandpa, is it true that people used to drink sodas...on purpose? Didn’t you know how dangerous they were? And why is the turn signal in our hover-car still on?”

It’s grown increasingly clear that sugared beverages are among the main contributors to the obesity epidemic, but last week, the Australians published a study demonstrating that sodas also worsen teens’ cardiac risk factors, even when those kids are not overweight. Further analysis linked soda consumption to global warming, nuclear arms proliferation, and the mysterious disappearance of Jimmy Hoffa in 1975.

Why, then, do we continue to give our children this poisonous-yet-oh-so-refreshing swill? A study from Sweden lays the blame on television. I have to say, I don’t imagine Swedish kids spending hours huddled on their starkly modernist sofas staring at their flat-screens, but I don’t know what else I think they’re doing, crafting inexpensive yet gorgeously designed flat-packed bookshelves? At any rate, for every hour of television that 1,733 Swedish 2- to 9-year-old children watched, they increased their sugared beverage consumption by 50%, even when their parents claimed to discourage it. This is proof of what I’ve always said: To combat heart disease worldwide, we must stop Nordic children from watching television. If only we’d known in 1975.

Prone to error

I’m wrong all the time. I know, because I live with teenagers. But it seems every time I open a medical journal, I’m finding something new I’ve messed up. Since when did peer-reviewed journals start talking to my kids? Most recently two physical therapists at the University of Alberta in Edmonton, Canada, looked to see if we need to revise our 4-month motor milestones since, as everyone knows, the shift from prone to supine infant sleep position 20 years ago has led to a delay in the average age at which infants learn to roll from front to back. Spoiler alert: We don’t. Because it hasn’t.

Modern infants, put to sleep safely on their backs, start rolling about the same time as their peers born before 1992, with the advantage that they’re less likely to suffer sudden infant death syndrome. Progress is a beautiful thing, at least until it results in a questionably flavored lollipop.

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.

Have you ever found yourself supporting a cause you really believed in, but then getting turned off when someone else took it, well, a little too far? Because that’s where I am with breastmilk-flavored lollipops. The good news is that the confections include no actual human milk. (Can we all agree that this is indeed good news?) “But,” I hear you asking, “how do they know they got the taste right?”

According to interviews with Jason Darling (his real name), the Austin-based founder of Lollyphile, a handful of breastfeeding mothers, “kept sharing their breast milk with our flavor specialists until we were able to candify it.” Which means that, yes, somewhere in Texas, there is at least one food chemist sporting a very special milk mustache. He is also enjoying temporary protection from ear infections.

Ingram Publishing

New faithful

Whenever I cover a report on parental vaccine resistance, naturally, my first question is, “How can I make this subject even more controversial?” Fortunately, Dr. Aamer Imdad of the State University of New York Upstate Medical University in Syracuse answered that question in this month’s Pediatrics: Add religion. Dr. Imdad and his team tracked the startling growth in religious exemptions to vaccines in the state of New York from 2000 to 2011, and all I can say is, “Holy whooping cough!”

The researchers examined rates of religious vaccine exemptions granted by schools in each county. The rates nearly doubled from 0.23% in 2000 to 0.45% in 2011. This trend begs a question: Since the major Western faiths all support immunization, what religion is so successfully recruiting converts in New York State? Is Breaking Amish just that big a hit? Or is there a flowering of new antivaccine congregations? Our Lady of Perpetual Pertussis? Temple Beth Tetanus? The Al-Influenza Center?

This is not just a question about how many angels can fit upon the tip of a needle without getting vaccinated. The authors go on to demonstrate that in counties in which the vaccine exemption rate exceeded 1%, whooping cough rates increased dramatically, among both unvaccinated and vaccinated children. These data further confirm that high immunization rates protect not just the herd, but also the flock.

Drinking problem

Does it seem to you like sugar-sweetened beverages are the new tobacco? I can totally envision a day in the future when my grandchildren ask, “Grandpa, is it true that people used to drink sodas...on purpose? Didn’t you know how dangerous they were? And why is the turn signal in our hover-car still on?”

It’s grown increasingly clear that sugared beverages are among the main contributors to the obesity epidemic, but last week, the Australians published a study demonstrating that sodas also worsen teens’ cardiac risk factors, even when those kids are not overweight. Further analysis linked soda consumption to global warming, nuclear arms proliferation, and the mysterious disappearance of Jimmy Hoffa in 1975.

Why, then, do we continue to give our children this poisonous-yet-oh-so-refreshing swill? A study from Sweden lays the blame on television. I have to say, I don’t imagine Swedish kids spending hours huddled on their starkly modernist sofas staring at their flat-screens, but I don’t know what else I think they’re doing, crafting inexpensive yet gorgeously designed flat-packed bookshelves? At any rate, for every hour of television that 1,733 Swedish 2- to 9-year-old children watched, they increased their sugared beverage consumption by 50%, even when their parents claimed to discourage it. This is proof of what I’ve always said: To combat heart disease worldwide, we must stop Nordic children from watching television. If only we’d known in 1975.

Prone to error

I’m wrong all the time. I know, because I live with teenagers. But it seems every time I open a medical journal, I’m finding something new I’ve messed up. Since when did peer-reviewed journals start talking to my kids? Most recently two physical therapists at the University of Alberta in Edmonton, Canada, looked to see if we need to revise our 4-month motor milestones since, as everyone knows, the shift from prone to supine infant sleep position 20 years ago has led to a delay in the average age at which infants learn to roll from front to back. Spoiler alert: We don’t. Because it hasn’t.

Modern infants, put to sleep safely on their backs, start rolling about the same time as their peers born before 1992, with the advantage that they’re less likely to suffer sudden infant death syndrome. Progress is a beautiful thing, at least until it results in a questionably flavored lollipop.

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 made record producer Jamal Rashid think that 19-year-old pop superstar Justin Bieber was emotionally ready to care for a monkey? Rashid, answering the perennial question, “What the heck do you give Justin Bieber?” was inspired in March to surprise the singer on his 19th birthday with a young capuchin, a breed of monkey known to be more loyal than Selena Gomez.

The card apparently did not include papers that would allow the pet to legally accompany Bieber to Germany, where authorities confiscated the creature, expressing alarm that the juvenile capuchin, like many of Bieber’s fans, had been removed from its mother far too early. The monkey, named Mally, is now preparing to join the only colony of white-headed capuchins in Germany, at the Serengeti-Park in Hodenhagen. Sources close to Bieber report that for his 20th birthday, he would prefer a pet rock.

Digital Vision

A very useful engine

How do we know we’re really good for anything? I mean around the house I can tell, because it appears that if I weren’t there, my kids would leave every single dish in the sink and then start eating off the floor. But what about all those well-child exams we do in our offices? Based on their budget proposals, it appears my state legislators don’t think poor children need access to a medical home. Could they be right? I knew I should have gone into accounting!

Thankfully, Dr. Jeffrey O. Tom of the Kaiser Permanente Center for Health Research in Honolulu just published a study evaluating whether well-child exams are worth at least as much as the Puffs consumed while toddlers wait for the pediatrician. The team reviewed the health records of 20,065 children between the ages of 2 months and 3.5 years to see if attending wellness exams actually contributes to children’s health or whether the sole purpose is to distribute cheap foreign treasure-box toys evenly among the population.

He asked a question so simple that even a state legislator could understand it: Do kids who go to their well-child exams get hospitalized less often for preventable causes? Admit it: Right now you’re at least a teeny bit worried the answer is “no.” But we can all breathe a sigh of relief, because the answer is “yes,” with a positive dose-response curve, even! Now that we know pediatricians actually do keep children from winding up in the hospital, the next pressing research question is, “Can we demonstrate a dose-response curve between the strength of medical evidence and the decisions of state government bodies?” About that one, I’m more than a teeny bit worried.

Rocky Mountain low

I have to admit I have mixed feelings about the legalization of medical marijuana. I mean, it has legitimate uses for the relief of suffering, but at the same time, marijuana is not a benign substance, causing impaired judgment and concentration, poor driving, and the Harold and Kumar movies. Even worse, since Colorado legalized the drug, kids can no longer look forward to nibbling Grandma’s special cookies.

In a widely publicized study, Dr. George Sam Wang of the Rocky Mountain Poison and Drug Center in Denver profiled the remarkable increase in children’s emergency department visits for cannabis poisoning that followed Colorado’s legalization of marijuana on Sept. 30, 2009. Since decriminalization, 14 children were treated for marijuana toxicity at a single Colorado hospital, with 2 being admitted to the intensive care unit. The youngest was 8 months old, presumably because 7-month-olds can’t finger feed.

The marijuana frequently came from grandparents’ stashes, usually in the form of cannabis-laced cookies, brownies, sodas, or candies. Now I’ve heard of unforeseen consequences, but, really, did no one see this coming? Were they on drugs? Oh, yeah, right. Medical marijuana providers, chastened by the study, have sworn to address the problem by switching to cannabis-infused brussels sprouts.

The brand played on

Do you ever go out of your way when drinking a beverage to turn it in just such a way that the brand logo is perfectly visible to someone watching you? Yeah, me neither, but in movies, it seems to happen all the time: “This time, they messed with the wrong guy, a maverick cop with nothing to lose, and hey, what brand of cola is that? Suddenly, I feel thirsty.” This phenomenon is not a coincidence, but a result of paid product placement, and since the master tobacco settlement in 1998, you’ll notice the brand of cigarettes is always hidden, usually behind a really big gun.

No such legal restrictions apply to alcohol, however, and according a new study in JAMA Pediatrics, the incidence of alcohol brand placement in movies has increased steadily between 1996 and 2009, including in movies intended for kids as young as 13. What floors me is that the researchers actually watched the top 100 movies in each of those years, carefully monitoring for alcohol and cigarette brand placements. Fortunately for them, Harold and Kumar lost out in 2004 to such gems as Anacondas: The Hunt for the Blood Orchid. They also missed 2011’s Justin Bieber documentary, Never Say Never, but hopefully they’ll catch the 2013 sequel, Dude, Where’s My Monkey?

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 made record producer Jamal Rashid think that 19-year-old pop superstar Justin Bieber was emotionally ready to care for a monkey? Rashid, answering the perennial question, “What the heck do you give Justin Bieber?” was inspired in March to surprise the singer on his 19th birthday with a young capuchin, a breed of monkey known to be more loyal than Selena Gomez.

The card apparently did not include papers that would allow the pet to legally accompany Bieber to Germany, where authorities confiscated the creature, expressing alarm that the juvenile capuchin, like many of Bieber’s fans, had been removed from its mother far too early. The monkey, named Mally, is now preparing to join the only colony of white-headed capuchins in Germany, at the Serengeti-Park in Hodenhagen. Sources close to Bieber report that for his 20th birthday, he would prefer a pet rock.

Digital Vision

A very useful engine

How do we know we’re really good for anything? I mean around the house I can tell, because it appears that if I weren’t there, my kids would leave every single dish in the sink and then start eating off the floor. But what about all those well-child exams we do in our offices? Based on their budget proposals, it appears my state legislators don’t think poor children need access to a medical home. Could they be right? I knew I should have gone into accounting!

Thankfully, Dr. Jeffrey O. Tom of the Kaiser Permanente Center for Health Research in Honolulu just published a study evaluating whether well-child exams are worth at least as much as the Puffs consumed while toddlers wait for the pediatrician. The team reviewed the health records of 20,065 children between the ages of 2 months and 3.5 years to see if attending wellness exams actually contributes to children’s health or whether the sole purpose is to distribute cheap foreign treasure-box toys evenly among the population.

He asked a question so simple that even a state legislator could understand it: Do kids who go to their well-child exams get hospitalized less often for preventable causes? Admit it: Right now you’re at least a teeny bit worried the answer is “no.” But we can all breathe a sigh of relief, because the answer is “yes,” with a positive dose-response curve, even! Now that we know pediatricians actually do keep children from winding up in the hospital, the next pressing research question is, “Can we demonstrate a dose-response curve between the strength of medical evidence and the decisions of state government bodies?” About that one, I’m more than a teeny bit worried.

Rocky Mountain low

I have to admit I have mixed feelings about the legalization of medical marijuana. I mean, it has legitimate uses for the relief of suffering, but at the same time, marijuana is not a benign substance, causing impaired judgment and concentration, poor driving, and the Harold and Kumar movies. Even worse, since Colorado legalized the drug, kids can no longer look forward to nibbling Grandma’s special cookies.

In a widely publicized study, Dr. George Sam Wang of the Rocky Mountain Poison and Drug Center in Denver profiled the remarkable increase in children’s emergency department visits for cannabis poisoning that followed Colorado’s legalization of marijuana on Sept. 30, 2009. Since decriminalization, 14 children were treated for marijuana toxicity at a single Colorado hospital, with 2 being admitted to the intensive care unit. The youngest was 8 months old, presumably because 7-month-olds can’t finger feed.

The marijuana frequently came from grandparents’ stashes, usually in the form of cannabis-laced cookies, brownies, sodas, or candies. Now I’ve heard of unforeseen consequences, but, really, did no one see this coming? Were they on drugs? Oh, yeah, right. Medical marijuana providers, chastened by the study, have sworn to address the problem by switching to cannabis-infused brussels sprouts.

The brand played on

Do you ever go out of your way when drinking a beverage to turn it in just such a way that the brand logo is perfectly visible to someone watching you? Yeah, me neither, but in movies, it seems to happen all the time: “This time, they messed with the wrong guy, a maverick cop with nothing to lose, and hey, what brand of cola is that? Suddenly, I feel thirsty.” This phenomenon is not a coincidence, but a result of paid product placement, and since the master tobacco settlement in 1998, you’ll notice the brand of cigarettes is always hidden, usually behind a really big gun.

No such legal restrictions apply to alcohol, however, and according a new study in JAMA Pediatrics, the incidence of alcohol brand placement in movies has increased steadily between 1996 and 2009, including in movies intended for kids as young as 13. What floors me is that the researchers actually watched the top 100 movies in each of those years, carefully monitoring for alcohol and cigarette brand placements. Fortunately for them, Harold and Kumar lost out in 2004 to such gems as Anacondas: The Hunt for the Blood Orchid. They also missed 2011’s Justin Bieber documentary, Never Say Never, but hopefully they’ll catch the 2013 sequel, Dude, Where’s My Monkey?

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 made record producer Jamal Rashid think that 19-year-old pop superstar Justin Bieber was emotionally ready to care for a monkey? Rashid, answering the perennial question, “What the heck do you give Justin Bieber?” was inspired in March to surprise the singer on his 19th birthday with a young capuchin, a breed of monkey known to be more loyal than Selena Gomez.

The card apparently did not include papers that would allow the pet to legally accompany Bieber to Germany, where authorities confiscated the creature, expressing alarm that the juvenile capuchin, like many of Bieber’s fans, had been removed from its mother far too early. The monkey, named Mally, is now preparing to join the only colony of white-headed capuchins in Germany, at the Serengeti-Park in Hodenhagen. Sources close to Bieber report that for his 20th birthday, he would prefer a pet rock.

Digital Vision

A very useful engine

How do we know we’re really good for anything? I mean around the house I can tell, because it appears that if I weren’t there, my kids would leave every single dish in the sink and then start eating off the floor. But what about all those well-child exams we do in our offices? Based on their budget proposals, it appears my state legislators don’t think poor children need access to a medical home. Could they be right? I knew I should have gone into accounting!

Thankfully, Dr. Jeffrey O. Tom of the Kaiser Permanente Center for Health Research in Honolulu just published a study evaluating whether well-child exams are worth at least as much as the Puffs consumed while toddlers wait for the pediatrician. The team reviewed the health records of 20,065 children between the ages of 2 months and 3.5 years to see if attending wellness exams actually contributes to children’s health or whether the sole purpose is to distribute cheap foreign treasure-box toys evenly among the population.

He asked a question so simple that even a state legislator could understand it: Do kids who go to their well-child exams get hospitalized less often for preventable causes? Admit it: Right now you’re at least a teeny bit worried the answer is “no.” But we can all breathe a sigh of relief, because the answer is “yes,” with a positive dose-response curve, even! Now that we know pediatricians actually do keep children from winding up in the hospital, the next pressing research question is, “Can we demonstrate a dose-response curve between the strength of medical evidence and the decisions of state government bodies?” About that one, I’m more than a teeny bit worried.

Rocky Mountain low

I have to admit I have mixed feelings about the legalization of medical marijuana. I mean, it has legitimate uses for the relief of suffering, but at the same time, marijuana is not a benign substance, causing impaired judgment and concentration, poor driving, and the Harold and Kumar movies. Even worse, since Colorado legalized the drug, kids can no longer look forward to nibbling Grandma’s special cookies.

In a widely publicized study, Dr. George Sam Wang of the Rocky Mountain Poison and Drug Center in Denver profiled the remarkable increase in children’s emergency department visits for cannabis poisoning that followed Colorado’s legalization of marijuana on Sept. 30, 2009. Since decriminalization, 14 children were treated for marijuana toxicity at a single Colorado hospital, with 2 being admitted to the intensive care unit. The youngest was 8 months old, presumably because 7-month-olds can’t finger feed.

The marijuana frequently came from grandparents’ stashes, usually in the form of cannabis-laced cookies, brownies, sodas, or candies. Now I’ve heard of unforeseen consequences, but, really, did no one see this coming? Were they on drugs? Oh, yeah, right. Medical marijuana providers, chastened by the study, have sworn to address the problem by switching to cannabis-infused brussels sprouts.

The brand played on

Do you ever go out of your way when drinking a beverage to turn it in just such a way that the brand logo is perfectly visible to someone watching you? Yeah, me neither, but in movies, it seems to happen all the time: “This time, they messed with the wrong guy, a maverick cop with nothing to lose, and hey, what brand of cola is that? Suddenly, I feel thirsty.” This phenomenon is not a coincidence, but a result of paid product placement, and since the master tobacco settlement in 1998, you’ll notice the brand of cigarettes is always hidden, usually behind a really big gun.

No such legal restrictions apply to alcohol, however, and according a new study in JAMA Pediatrics, the incidence of alcohol brand placement in movies has increased steadily between 1996 and 2009, including in movies intended for kids as young as 13. What floors me is that the researchers actually watched the top 100 movies in each of those years, carefully monitoring for alcohol and cigarette brand placements. Fortunately for them, Harold and Kumar lost out in 2004 to such gems as Anacondas: The Hunt for the Blood Orchid. They also missed 2011’s Justin Bieber documentary, Never Say Never, but hopefully they’ll catch the 2013 sequel, Dude, Where’s My Monkey?

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’re a young celebrity, how do you know you’re in trouble? Take Amanda Bynes, for example. My children watched the comedic actress grow up on TV, and they’ve internalized her strong antidrug message: “Don’t worry, Dad,” they say, “we don’t want to end up like Amanda Bynes!”

Maybe you know when you allegedly toss a bong out the window of your Manhattan apartment as the police are knocking at the door? Or is it when you’re accused of saying mean things about the singer Rihanna, and people seem to care? No, I’d have to say it’s when Courtney Love is trying to perform an intervention on you via Twitter. I’m not sure how much good advice Love has to offer on keeping the celebrity life simple and substance free, but I’m guessing 140 characters is more than enough room to contain it.

Stockbyte

Tough to stomach

Can we share a secret, just you, me, and the Internet? Sometimes we dread evaluating abdominal pain, don’t we? Best-case scenario, it’s something fixable like constipation, and we flush with pride. Rarely we pick up an appendicitis, and then we want to call our old medical school professor and crow, “See, I can too make a diagnosis with just a basic history and physical exam, so long as my hunch is backed up by a stat contrast CT of the abdomen and pelvis!” But more often we ask all sorts of questions, poke around in places mentionable and unmentionable, order a bunch of labs and x-rays, and end up feeling about as useful as a washed-up celebrity providing life coaching on Twitter.

Now a group of Dutch researchers has quantified exactly how often we fail to treat pediatric abdominal pain, which I find surprising, because somehow my image of the Netherlands doesn’t include children kvetching about tummy aches (presumably because those wooden shoes distract from pain anywhere else). The researchers looked at 305 children aged 4-17 years who presented to their doctors’ offices with abdominal pain. Nearly 79% had or developed Chronic Abdominal Pain (CAP), which is the medical term for “beats the heck outta me!”

The diagnosis of CAP is defined and codified by the Rome III Criteria, which are not nearly as sexy as they sound. The criteria classify abdominal pain without a detectable organic cause as either functional dyspepsia, irritable bowel syndrome, abdominal migraine, or functional abdominal pain. (I don’t recall the specific distinctions between these diagnoses, but if it will jog my memory, I’m perfectly willing to go to Italy.) One year after diagnosis, around half the kids in the study still had abdominal pain bad enough to impair their daily functioning. In conclusion the researchers felt this prognosis was not gouda, er, good.

Pillow top

Humans fail notoriously when it comes to judging risks. If we were better at it, no one would be content to wait an hour in an airport security line in order to fly safely to a place where they forget to use enough sunscreen. According to a new meta-analysis from the British Medical Journal, if we were really good at judging risk, none of us would ever co-sleep with our young infants.

The study came from Robert Carpenter at the Department of Medical Statistics at the London School of Hygiene and Tropical Medicine, a place whose name makes me think of washing coconuts in antibacterial soap. Carpenter’s team looked at 1,472 infants who had died of sudden infant death syndrome (SIDS) and 4,679 matched controls. His rather clever idea was to control for two risk factors for SIDS, parental smoking and formula use, by counting only breastfed babies with nonsmoking parents.  Unfortunately the authors were unable to completely control for drinking, drug use, and whether parents slept on Swedish memory foam.

SIDS deaths increased from 8 per 100,000 infants among non-co-sleeping babies to 23 per 100,000 when babies slept with their parents. As a doctor I find a nearly threefold increase in risk of death concerning, but my guess is that proponents of “attachment parenting” will point out that for every 100,000 co-sleeping infants 99,977 survive. As for the 15 excess fatalities? You can't prove it wasn't that memory foam.

Gym Shorts

I’m sure some kid in some school somewhere enjoys physical education. For me it was mainly a chance to educate my classmates on how to identify a full-blown asthma attack. And yet, I’m kind of loving PE now, as it may be one of the keys to stopping the epidemic of pediatric obesity. That, and I’ve been practicing dodge ball for the last 35 years, just waiting for it come up again.

An analysis in the Journal of Health Economics found that just one extra hour a week of PE class has the power to reduce childhood obesity by nearly 5%. You know what this means: we can eliminate childhood obesity altogether if kids would just spend 20 hours a week in gym class! And since other studies have demonstrated that time spent in PE may improve kids’ academic performance and behavior in school, we could easily have the smartest, best-disciplined, skinniest, smelliest students the world has ever seen. And why just limit it to school kids? Why not wayward celebrities? Amanda Bynes is already apparently a ringer at the Bong Toss, and I’ve heard she’s training for the Perp Walk, hoping to beat the prior record, held by Courtney Love.

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’re a young celebrity, how do you know you’re in trouble? Take Amanda Bynes, for example. My children watched the comedic actress grow up on TV, and they’ve internalized her strong antidrug message: “Don’t worry, Dad,” they say, “we don’t want to end up like Amanda Bynes!”

Maybe you know when you allegedly toss a bong out the window of your Manhattan apartment as the police are knocking at the door? Or is it when you’re accused of saying mean things about the singer Rihanna, and people seem to care? No, I’d have to say it’s when Courtney Love is trying to perform an intervention on you via Twitter. I’m not sure how much good advice Love has to offer on keeping the celebrity life simple and substance free, but I’m guessing 140 characters is more than enough room to contain it.

Stockbyte

Tough to stomach

Can we share a secret, just you, me, and the Internet? Sometimes we dread evaluating abdominal pain, don’t we? Best-case scenario, it’s something fixable like constipation, and we flush with pride. Rarely we pick up an appendicitis, and then we want to call our old medical school professor and crow, “See, I can too make a diagnosis with just a basic history and physical exam, so long as my hunch is backed up by a stat contrast CT of the abdomen and pelvis!” But more often we ask all sorts of questions, poke around in places mentionable and unmentionable, order a bunch of labs and x-rays, and end up feeling about as useful as a washed-up celebrity providing life coaching on Twitter.

Now a group of Dutch researchers has quantified exactly how often we fail to treat pediatric abdominal pain, which I find surprising, because somehow my image of the Netherlands doesn’t include children kvetching about tummy aches (presumably because those wooden shoes distract from pain anywhere else). The researchers looked at 305 children aged 4-17 years who presented to their doctors’ offices with abdominal pain. Nearly 79% had or developed Chronic Abdominal Pain (CAP), which is the medical term for “beats the heck outta me!”

The diagnosis of CAP is defined and codified by the Rome III Criteria, which are not nearly as sexy as they sound. The criteria classify abdominal pain without a detectable organic cause as either functional dyspepsia, irritable bowel syndrome, abdominal migraine, or functional abdominal pain. (I don’t recall the specific distinctions between these diagnoses, but if it will jog my memory, I’m perfectly willing to go to Italy.) One year after diagnosis, around half the kids in the study still had abdominal pain bad enough to impair their daily functioning. In conclusion the researchers felt this prognosis was not gouda, er, good.

Pillow top

Humans fail notoriously when it comes to judging risks. If we were better at it, no one would be content to wait an hour in an airport security line in order to fly safely to a place where they forget to use enough sunscreen. According to a new meta-analysis from the British Medical Journal, if we were really good at judging risk, none of us would ever co-sleep with our young infants.

The study came from Robert Carpenter at the Department of Medical Statistics at the London School of Hygiene and Tropical Medicine, a place whose name makes me think of washing coconuts in antibacterial soap. Carpenter’s team looked at 1,472 infants who had died of sudden infant death syndrome (SIDS) and 4,679 matched controls. His rather clever idea was to control for two risk factors for SIDS, parental smoking and formula use, by counting only breastfed babies with nonsmoking parents.  Unfortunately the authors were unable to completely control for drinking, drug use, and whether parents slept on Swedish memory foam.

SIDS deaths increased from 8 per 100,000 infants among non-co-sleeping babies to 23 per 100,000 when babies slept with their parents. As a doctor I find a nearly threefold increase in risk of death concerning, but my guess is that proponents of “attachment parenting” will point out that for every 100,000 co-sleeping infants 99,977 survive. As for the 15 excess fatalities? You can't prove it wasn't that memory foam.

Gym Shorts

I’m sure some kid in some school somewhere enjoys physical education. For me it was mainly a chance to educate my classmates on how to identify a full-blown asthma attack. And yet, I’m kind of loving PE now, as it may be one of the keys to stopping the epidemic of pediatric obesity. That, and I’ve been practicing dodge ball for the last 35 years, just waiting for it come up again.

An analysis in the Journal of Health Economics found that just one extra hour a week of PE class has the power to reduce childhood obesity by nearly 5%. You know what this means: we can eliminate childhood obesity altogether if kids would just spend 20 hours a week in gym class! And since other studies have demonstrated that time spent in PE may improve kids’ academic performance and behavior in school, we could easily have the smartest, best-disciplined, skinniest, smelliest students the world has ever seen. And why just limit it to school kids? Why not wayward celebrities? Amanda Bynes is already apparently a ringer at the Bong Toss, and I’ve heard she’s training for the Perp Walk, hoping to beat the prior record, held by Courtney Love.

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’re a young celebrity, how do you know you’re in trouble? Take Amanda Bynes, for example. My children watched the comedic actress grow up on TV, and they’ve internalized her strong antidrug message: “Don’t worry, Dad,” they say, “we don’t want to end up like Amanda Bynes!”

Maybe you know when you allegedly toss a bong out the window of your Manhattan apartment as the police are knocking at the door? Or is it when you’re accused of saying mean things about the singer Rihanna, and people seem to care? No, I’d have to say it’s when Courtney Love is trying to perform an intervention on you via Twitter. I’m not sure how much good advice Love has to offer on keeping the celebrity life simple and substance free, but I’m guessing 140 characters is more than enough room to contain it.

Stockbyte

Tough to stomach

Can we share a secret, just you, me, and the Internet? Sometimes we dread evaluating abdominal pain, don’t we? Best-case scenario, it’s something fixable like constipation, and we flush with pride. Rarely we pick up an appendicitis, and then we want to call our old medical school professor and crow, “See, I can too make a diagnosis with just a basic history and physical exam, so long as my hunch is backed up by a stat contrast CT of the abdomen and pelvis!” But more often we ask all sorts of questions, poke around in places mentionable and unmentionable, order a bunch of labs and x-rays, and end up feeling about as useful as a washed-up celebrity providing life coaching on Twitter.

Now a group of Dutch researchers has quantified exactly how often we fail to treat pediatric abdominal pain, which I find surprising, because somehow my image of the Netherlands doesn’t include children kvetching about tummy aches (presumably because those wooden shoes distract from pain anywhere else). The researchers looked at 305 children aged 4-17 years who presented to their doctors’ offices with abdominal pain. Nearly 79% had or developed Chronic Abdominal Pain (CAP), which is the medical term for “beats the heck outta me!”

The diagnosis of CAP is defined and codified by the Rome III Criteria, which are not nearly as sexy as they sound. The criteria classify abdominal pain without a detectable organic cause as either functional dyspepsia, irritable bowel syndrome, abdominal migraine, or functional abdominal pain. (I don’t recall the specific distinctions between these diagnoses, but if it will jog my memory, I’m perfectly willing to go to Italy.) One year after diagnosis, around half the kids in the study still had abdominal pain bad enough to impair their daily functioning. In conclusion the researchers felt this prognosis was not gouda, er, good.

Pillow top

Humans fail notoriously when it comes to judging risks. If we were better at it, no one would be content to wait an hour in an airport security line in order to fly safely to a place where they forget to use enough sunscreen. According to a new meta-analysis from the British Medical Journal, if we were really good at judging risk, none of us would ever co-sleep with our young infants.

The study came from Robert Carpenter at the Department of Medical Statistics at the London School of Hygiene and Tropical Medicine, a place whose name makes me think of washing coconuts in antibacterial soap. Carpenter’s team looked at 1,472 infants who had died of sudden infant death syndrome (SIDS) and 4,679 matched controls. His rather clever idea was to control for two risk factors for SIDS, parental smoking and formula use, by counting only breastfed babies with nonsmoking parents.  Unfortunately the authors were unable to completely control for drinking, drug use, and whether parents slept on Swedish memory foam.

SIDS deaths increased from 8 per 100,000 infants among non-co-sleeping babies to 23 per 100,000 when babies slept with their parents. As a doctor I find a nearly threefold increase in risk of death concerning, but my guess is that proponents of “attachment parenting” will point out that for every 100,000 co-sleeping infants 99,977 survive. As for the 15 excess fatalities? You can't prove it wasn't that memory foam.

Gym Shorts

I’m sure some kid in some school somewhere enjoys physical education. For me it was mainly a chance to educate my classmates on how to identify a full-blown asthma attack. And yet, I’m kind of loving PE now, as it may be one of the keys to stopping the epidemic of pediatric obesity. That, and I’ve been practicing dodge ball for the last 35 years, just waiting for it come up again.

An analysis in the Journal of Health Economics found that just one extra hour a week of PE class has the power to reduce childhood obesity by nearly 5%. You know what this means: we can eliminate childhood obesity altogether if kids would just spend 20 hours a week in gym class! And since other studies have demonstrated that time spent in PE may improve kids’ academic performance and behavior in school, we could easily have the smartest, best-disciplined, skinniest, smelliest students the world has ever seen. And why just limit it to school kids? Why not wayward celebrities? Amanda Bynes is already apparently a ringer at the Bong Toss, and I’ve heard she’s training for the Perp Walk, hoping to beat the prior record, held by Courtney Love.

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.