10.07.07
Pediatric (Blog) Grand Rounds: October 7th, 2007
I’m pleased to be hosting this edition of Pediatric Grand Rounds at Dr. Ben’s Blog.
I’ll start at the newborn end of the spectrum with a fascinating item from Tales from the Clinical Lab. This post reports a study characterizing the evolution of infant’s gut microbiota from birth to one year, with comparisons of stool microbiota from mothers, fathers, siblings, and with mother’s vaginal and breast milk microbiota. This fills a long-speculated-on hole in our knowledge about how newborns with sterile guts evolve into adults with their particular microbial ecologies. The issue of gut microbiota is beginning to look germane to more and more issues, with possible relevance to obesity and to kidney stones, just for two examples.
Moving on to obesity: Walter at Highlight Health reports on the issue of TV viewing and childhood obesity. Several studies he describes have examined the relationship between food advertising that chlldren see and their food intake. Fully half the commercials during childrens’ programming on TV are for food, and of those almost all are for foods of poor nutritional value. Sounds like there are some fairly simple interventions parents can undertake to reduce the risk of their children becoming obese–a heartening conclusion.
Also on the nutritional front is a heartrending post from Crystal of I Must Admit describing her emotions and experiences as the mother of a very ill newborn who was unable to ever breastfeed due to an inborn error of metabolism. While it may seem small next to the illness itself, for any mother who wants to breastfeed and who can’t, there’s a real grieving process. It’s very important for those of us working in health care to hear about these experiences from patients.
Continuing with the nutritional theme is an analysis of the state of the art concerning food coloring and preservatives and their putative relationship with hyperactivity in children. Sandy Szwarc, a nurse who has become a policy advisor on nutritional issues, was prompted to write by a recent study published in the Lancet purporting to prove an association between food additives and hyperactive behavior. This has been a controversial issue for decades, and unfortunately, as Sandy points out, the current study is unlikely to settle the issue.
In another post, Sandy also offers a detailed debunking of the spin mainstream media put on the report on US life expectancy recently released by the National Center for Health Statistics. She again demonstrates that the devil is in the details, and that without a careful reading of the primary data, you can’t make sense of the anyone’s interpretation of the data.
From the sublime….to Dr Rob, whose Musings of a Distractible Mind often provides a belly laugh with his wonderfully way of looking at the world, a post about the classic situation of the pacifier falling on the floor. Many have probably heard the maxim about decreasing parental anxiety as the number of children increase. When your first child’s pacifier falls on the floor, you boil it before letting them suck on it again. With your second child, you wash it off in the sink before returning it to the child. With your third child, you blow on it or lick it yourself to clean it, and with your fourth, you just pick it up off the floor and hand it back to them.
Dr. Rob’s answer to the real question, by the way, is that parent saliva contains hazardous materials for babies and that therefore using your own mouth to clean the pacifier is not smart. I’m not sure I completely agree with him. If the parent isn’t sick, the major hazard I am aware of is the transfer of strep mutans, the bacteria responsible for tooth decay, which is usually transmitted within households.
Dr Mike at Pediacast offers audio material for parents in the form of a podcast. His latest offering is on alopecia, or hair loss. This problem, which might seem trivial at first blush, can actually have a pretty profound psychological impact for a child.
My wonderful colleague Dr Gwenn has written about how important it is to let go your teens become responsible gradually, maintaining some control and supervision out with them. This is vital for their safety. It’s quite a delicate balance, and as the parent of several teenagers myself I very much understand what a balancing act it is.
The last three submissions for this edition of Pediatric Grand Rounds are on a topic near and dear to my own heart: immunization safety. Three astute bloggers have commented on the latest study failing to find an association between thimerosal (the mercury-containing preservative that was in most vaccines until about 7 years ago) and various adverse effects.
Dr Steven Novella of NeurologicaBlog offers this, Orac of Respectful Insolence says this, and Dr Steve Parker (one of my favorite attendings from my days as a resident!) has this to say.
Unfortunately, the idea of negative effects of thimerosal (which was, a priori, a reasonable hypothesis) continues to burn despite study after study after study refuting the purported associations. These three well-articulated essays hopefully will do just a bit more to help dispel the myth.
That’s it for this edition of Pediatric Grand Rounds. Tara Smith at Aetiology will be hosting the next edition. Submit your entries to her, or to Clark Bartram who runs Pediatric Grand Rounds.