Archive for the ‘Newborns & Infants’ CategoryEarly Childhood Obesity Intervention Is a MustWednesday, April 28th, 2010Summary:
To be effective, any campaign against childhood obesity must include intervention strategies to combat obesity in preschool children, say researchers at the University of California San Francisco in a report published in the New England Journal of Medicine.
When childhood obesity is in the news, it’s often discussed in tandem with changes needed to school lunch programs. First Lady Michelle Obama’s Let’s Move campaign focuses a lot of attention on making school lunches healthier. A group of retired military veterans recently took up the school lunch cause, as well, because they have found many children graduating high school are too fat to qualify for military service. TV chef Jamie Oliver’s Food Revolution series focused on the issue, as well.
They’re not wrong. School lunches must be made healthier.
But to be effective, any campaign against childhood obesity must also address the needs of preschoolers, say researchers at the University of California San Francisco in a report published in the New England Journal of Medicine. [link: http://healthcarereform.nejm.org/?p=3321] The report was written by Dr. Janet M. Wojcicki and Dr. Melvin B. Heyman.
By the age of two, about one-third of all children in the U.S. are overweight or obese. This is not cute childhood chubbiness; it’s excess weight that causes real harm to their little bodies. Dr. Wojcicki and Dr. Heyman discovered markers in three-year-olds that have been linked to heart disease later in life.
What Parents Can Do for Infants
First, mom should not smoke while she’s pregnant, period. Ironically, although smoking is linked to low birth weight in babies, the bad habit also influences the body’s ability to regulate weight later in life. So an underweight infant can become an overweight toddler.
Second, mothers should follow their doctors’ recommendations when it comes to breast feeding. Shorter-than-recommended breastfeeding has been linked to childhood obesity, as well as many other health concerns.
Third, parents should establish a routine that allows the baby to get plenty of sleep. Lack of sleep also hurts the body’s ability to regulate weight. This is true from infancy through adulthood.
Whenever possible, an infant should be allowed to sleep in quiet surroundings. In other words, parents should not rely on the fact that their baby is sleeping in the car or at the ball game and say that the baby gets plenty of sleep. At loud sounds, deep sleep is frequently interrupted, even if the baby’s eyes don’t completely open. Deep, uninterrupted sleep is the goal.
What Parents Can Do for Toddlers
Parents of small children should turn off the TV and the computer until after the children are in bed. Even if the children aren’t watching the TV or playing on the computer, these machines deprive the child of the parent’s attention. Parents need to make a commitment to unplug from the world for at least a couple of hours each evening.
Instead of mindlessly watching TV or chatting online with their friends, parents can play with their children. Play is exercise, and this activity can help a child to maintain a healthy weight. This time together will also cement the bond between parent and child, in addition to helping the child develop great social skills.
Another step parents can take is to abolish unhealthy snacks from the house. These snacks are hard for adults to resist, impossible for toddlers. If, instead of stocking the pantry with potato chips and sugary cereal, parents only kept on hand fruit, vegetables, cheese, and other healthy snacks, children wouldn’t have the option to fill their bodies with junk.
It is undoubtedly true that school lunches must be made healthier. However, the problem of childhood obesity is evident long before children reach school age. That means that parents must take charge of their child’s diet right from the start.
When childhood obesity is in the news, it’s often discussed in tandem with changes needed to school lunch programs. First Lady Michelle Obama’s Let’s Move campaign focuses a lot of attention on making school lunches healthier. A group of retired military veterans recently took up the school lunch cause, as well, because they have found many children graduating high school are too fat to qualify for military service. TV chef Jamie Oliver’s Food Revolution series focused on the issue, as well. They’re not wrong. School lunches must be made healthier. But to be effective, any campaign against childhood obesity must also address the needs of preschoolers, say researchers at the University of California San Francisco in a report published in the New England Journal of Medicine. The report was written by Dr. Janet M. Wojcicki and Dr. Melvin B. Heyman. By the age of two, about one-third of all children in the U.S. are overweight or obese. This is not cute childhood chubbiness; it’s excess weight that causes real harm to their little bodies. Dr. Wojcicki and Dr. Heyman discovered markers in three-year-olds that have been linked to heart disease later in life. What Parents Can Do for Infants to Prevent an Overweight ToddlersFirst, mom should not smoke while she’s pregnant, period. Ironically, although smoking is linked to low birth weight in babies, the bad habit also influences the body’s ability to regulate weight later in life. So an underweight infant can become an overweight toddler. Second, mothers should follow their doctors’ recommendations when it comes to breast feeding. Shorter-than-recommended breastfeeding has been linked to childhood obesity, as well as many other health concerns. Third, parents should establish a routine that allows the baby to get plenty of sleep. Lack of sleep also hurts the body’s ability to regulate weight. This is true from infancy through adulthood. Whenever possible, an infant should be allowed to sleep in quiet surroundings. In other words, parents should not rely on the fact that their baby is sleeping in the car or at the ball game and say that the baby gets plenty of sleep. At loud sounds, deep sleep is frequently interrupted, even if the baby’s eyes don’t completely open. Deep, uninterrupted sleep is the goal. What Parents Can Do to Encourage Healthy Habits ToddlersParents of small children should turn off the TV and the computer until after the children are in bed. Even if the children aren’t watching the TV or playing on the computer, these machines deprive the child of the parent’s attention. Parents need to make a commitment to unplug from the world for at least a couple of hours each evening. Instead of mindlessly watching TV or chatting online with their friends, parents can play with their children. Play is exercise, and this activity can help a child to maintain a healthy weight. This time together will also cement the bond between parent and child, in addition to helping the child develop great social skills. Another step parents can take is to abolish unhealthy snacks from the house. These snacks are hard for adults to resist, impossible for toddlers. If, instead of stocking the pantry with potato chips and sugary cereal, parents only kept on hand fruit, vegetables, cheese, and other healthy snacks, children wouldn’t have the option to fill their bodies with junk. It is undoubtedly true that school lunches must be made healthier. However, the problem of childhood obesity is evident long before children reach school age. That means that parents must take charge of their child’s diet right from the start. Posted in Healthy Eating, Newborns & Infants | 2 Comments » Dr. William Foege: An Inspirational Talk at The Shilling Lecture SeriesFriday, March 12th, 2010Another reality check was the information about contributions made by vaccine and drug manufacturers to situations of need. Merck donated $ 250 million to the treatment of River Blindness in Africa. He also mentioned how, at one point, the incidence of HIV positive births at this particular hospital he visited in Africa was 40 %, and how just nine years later it had decreased to 4 %, thanks to medications and technology donated to the area.
At the end of the lecture a few students where invited to ask questions to Dr. Foege. One of them asked a very intelligent one: “Is there a disease or ailment in the world today for which there is no sponsorship”? The good news seems to be that for most of the current threats existing in our world there is concern, investigation and help. He mentioned poverty, social conflicts, unemployment, etc, as examples of unsponsored issues menacing our communities. I am going to add one more; an epidemic threatening the health of children across national borders: the obesity epidemic.
One day we’ll have sponsored programs and international cooperation aiding in the decline of childhood obesity.
From this pages you will hear all about it when it happens. For now I will continue trying to advice my patients, bringing awareness and help, one family at the time.
Thank you Natalie for inviting me to attend this lecture.
Marta Katalenas M.D.
Biography
Dr. William Foege was director of the U.S. Center for Disease Control and became Chief of the CDC Smallpox Eradication Program in the 1970’s. In 1984 he was part of the Task Force for Child Survival, a working group for the World Health Organization, INICEF, The World Bank, the United Nations Development Program and the Rockefeller Foundation. He was Executive Director of he Carter Center, Fellow for Health Policy and Executive Director of Global 2000, Executive Director of he Task Force for Children Survival and Development, Presidential Distinguished Professor of International Health at the Rollins School of Public Health at Emory University and Senior Medical Advisor for the Bill & Melinda Gates Foundation. He is the author of over 120 professional publications and recipient of many awards; he holds honorary degrees from numerous institutions and was named a Fellow of the London School of Tropical Medicine and Hygiene. He attended Pacific Lutheran University, received his medical degree from the University of Washington and his master’s degree in public health form Harvard University.
Dr. Forge is an epidemiologist who worked on the successful campaign to eradicate smallpox in the 1970’s. The smallpox virus killed more than 300 million people during the 20th Century. When the vaccine first became available, it met with the familiar limitations encountered when epidemiologist try to create a plan to best utilize the resources available. One of the limitations in any plan is the restricted quantity of vaccine available to face such a devastating disease, when compared to the population susceptible to the illness. Dr. Foege created a strategy of “surveillance and containment”, by which experts were able to identify focuses of disease and heavily vaccinate individuals around the focus. He made the analogy of a fire starting in a house. Firefighters must extinguish the existing fire, but by pouring water into the houses around the index case, they can assure the fire is not going anywhere, being able to better control the spread. The same tactic was utilized in the eradication of smallpox with very successful results: the disease was first contained and by 1977 the last case was reported in Somalia. The patient survived the illness, but the virus was dead. It had nowhere to go and was eliminated from the face of earth. What an accomplishment! It is estimated that more than 120 million lives where saved by the vaccine. I get inspired when I meet people like Dr. Foege, and I hope the students of Southwestern University recognized a good example to follow. He encouraged them to participate in the making of history by writing their own individual chapter, to invest in life and to be ambitious with their dreams. He invited them to shake the world, to wake up every morning with a goal in mind. Science is about people, Dr. Foege said. It is about making existence better for others by improving quality of life. There is more work to be done. Young students today have an open book to write as he reminded us about the 200,000 children who die every week from vaccine-preventable illnesses. He mentioned the Tsunami a few years ago, and the terrible earthquake devastating Haiti and Chile. About 200,000 people died in Indonesia during the tsunami and about the same number in Haiti. The whole world was moved by those disasters; cooperation and aid arrived from all around the globe and presidents joined the efforts to help the victims. The same number of children die every week from vaccine preventable diseases in the world; that information created a lump in my throat at the end of the lecture, as it really touched home. I see children in my practice everyday and I didn’t realize we still have so much work to do. Another reality check was the information about contributions made by vaccine and drug manufacturers to situations of need. Merck donated $ 250 million to the treatment of River Blindness in Africa. He also mentioned how, at one point, the incidence of HIV positive births at this particular hospital he visited in Africa was 40 %, and how just nine years later it had decreased to 4 %, thanks to medications and technology donated to the area. At the end of the lecture a few students where invited to ask Dr. Foege questions. One asked a very intelligent question: “Is there a disease or ailment in the world today for which there is no sponsorship”? The good news seems to be that for most of the current threats existing in our world there is concern, investigation and help. He mentioned poverty, social conflicts, unemployment, etc, as examples of unsponsored issues menacing our communities. I am going to add one more; an epidemic threatening the health of children across national borders: the obesity epidemic. One day we’ll have sponsored programs and international cooperation aiding in the decline of childhood obesity. From this blog you will hear all about it when it happens. For now I will continue advising my patients, bringing awareness and help, one family at the time. Thank you Natalie for inviting me to attend this lecture. Marta Katalenas M.D. Biography of Dr. William Foege Dr. William Foege was director of the U.S. Center for Disease Control and became Chief of the CDC Smallpox Eradication Program in the 1970’s. In 1984 he was part of the Task Force for Child Survival, a working group for the World Health Organization, INICEF, The World Bank, the United Nations Development Program and the Rockefeller Foundation. He was Executive Director of he Carter Center, Fellow for Health Policy and Executive Director of Global 2000, Executive Director of he Task Force for Children Survival and Development, Presidential Distinguished Professor of International Health at the Rollins School of Public Health at Emory University and Senior Medical Advisor for the Bill & Melinda Gates Foundation. He is the author of over 120 professional publications and recipient of many awards; he holds honorary degrees from numerous institutions and was named a Fellow of the London School of Tropical Medicine and Hygiene. He attended Pacific Lutheran University, received his medical degree from the University of Washington and his master’s degree in public health form Harvard University. Posted in Newborns & Infants, News & Events | 1 Comment » Pertussis Outbreak in Williamson County ContinuesTuesday, December 1st, 2009
It is a childhood disease and we all got immunized when we received the DTP vaccine, which stands for Diphtheria, Tetanus and Pertussis. But over the last few years those who look at national statistics for a living realized that the incidence of Whooping Cough in adolescents and beyond was increasing at a rate that was not acceptable. The Center for Disease Control then issued a recommendation for adults and children over the age of ten to receive a booster dose of the Whooping Cough vaccine. Here is how it is done: your adolescent or preadolescent child (over 10 years old) is going to be given a booster of Tetanus combined with Pertussis; the vaccine is called TdaP. The big letters indicate the main antigens present in the vaccine, Tetanus and Pertussis. The “d” refers to a small amount of diphtheria antigen that is present only to enhance the recognition by our immune system of the other two antigens, and the “a” (in case you are interested) refers to the presence in the vaccine of the “acellular” type of pertussis antigen. Back a couple of decades ago, the Pertussis vaccine had side effects such as very high fevers, irritability, etc. This lead to the development of the current “acelular” Pertussis vaccine, which enables the vaccine to stimulate the immune system without making us sick. If you are an adult you probably know you should receive a booster of Tetanus every 10 years. Tetanus is an almost-always fatal disease, and one for which there is no herd immunity. (Note to self: explain what “herd immunity” is). That is, no matter how many people you get immunized and protected, we are still going to see cases since the bacillus lives in the soil and it is not transmitted from person to person. So, you need your tetanus booster every 10 years, right? Next time you see your doctor, ask about the status of your tetanus protection. If you are due to receive a booster, ask to be given the TdaP. You don’t need to receive this combination every 10 years, just once is enough. Then you can continue with your regular tetanus-only vaccine every 10 years. By now you may still be wondering how this Pertussis business is affecting you. Well, it is not a pleasant set of symptoms when you get Whooping Cough; they last for a long time and the disease is very contagious. It may start like a cold, with runny nose and cough, fever and sneezing. After a couple of weeks the cough gets worse, occurring in very strong fits lasting six or more weeks. Children usually have fits of cough followed by a “whooping” sound as they try to catch their breath. The cough is often worse at night. If you are in contact with small children and babies, your chances of passing the disease to them are very high. Babies suffer greatly when infected with whooping cough; the cough may get so bad that it keeps them from eating, sleeping and breathing. Many end up admitted to the Intensive Care Unit, especially when it affects premature babies. So, the protection of the vaccine goes beyond you, like it is the case for the majority of the vaccines. Here are some case scenarios to help you clarify what choices you have to protect yourself and others around you.Q - I am a 50-year-old grandmother of a cute one-month old baby boy. Do I need to get immunized against Pertussis (Whooping Cough)?
A- Yes. In order to protect your grandson it would be advisable for every member of the family, in immediate contact with the baby, to receive a TdaP booster. Remember, babies start their immunizations at about 2 months of age and Pertussis is one of them. But they don’t mount a protective immunity until they go through the primary series of 3 doses, ending after 6 months of age. Q - My two-month-old premature grandson is coming home after spending his first two months of life in the Neonatal ICU. He got his first set of shots in the hospital and one of them includes Pertussis. Is he protected during this winter Pertussis outbreak?
A- Because this baby is premature his immune system is not as developed and he needs special care and consideration. It is good that the immunizations have been started, but we must add the effect of “cocooning” the baby in order to protect from serious infections. One of the protective measures to take is to make sure all adults and children in contact with the baby are up to date with immunizations, including the TdaP for those older than 10 years of age, as explained above. Breast-feeding, vitamin supplementation and day care avoidance are other protective measures when dealing with a premature infant. Q - I am 25 years old and pregnant. I had my last Tetanus booster 5 years ago but I don’t think it included Pertussis. Should I get immunized again? A - The TdaP vaccine is not indicated during pregnancy. It is not that it is unsafe to receive it; we simply don’t have enough data to make that recommendation. But you can make sure your husband and those who are going to be in contact with your newborn are immunized. Right after you have the baby you can ask your doctor to give you the TdaP vaccine, even if you had a Tetanus booster 5 years ago. The added protection provided by the Pertussis part of the vaccine is good for your baby. If you are planning on breastfeeding, you are going to make antibodies as a response to the vaccine and you are going to pass them through your breast milk to the baby. We can’t measure the extent of that protection, but it is a real one. Q - I am a 16 year-old High School student. The nurse informed the students and parents about a case of Whooping Cough in the school. I received a Tetanus booster 6 years ago, but it did not include the Whooping Cough. Should I get immunized?
A - Yes. The Tetanus protection is still good, but you are at risk for contracting whooping cough, especially now that you have a case in your school. Those in direct contact with patients suffering from Pertussis get antibiotic prophylaxis, but your doctor or the school nurse will advise you if you need to start taking antibiotics. The best long-term protection you can have right now comes from the TdaP vaccine. Even if your Tetanus part is up to date, it is advisable and safe to get the combination vaccine that includes Whooping Cough. I hope this explanation and case-scenarios is helpful to you all. I would appreciate your comments. Marta Katalenas M.D. Posted in Health Alerts, Newborns & Infants | No Comments » Getting Your Baby to Sleep Through the NightThursday, September 17th, 2009
Sleeping is a natural phenomenon and a need for human beings. We don’t know why we need to sleep, but it has to do with a restoration of energy and recharge time for all the cells in our body. We simply can’t go without sleep, and sleep deprivation constitutes a form of torture. No wonder it is so important to create a rhythm for the newborn to follow, that synchronizes with the day-and-night circadian rhythm of the rest of the population. It all has to do with the presence of sunlight during the day and the absence of sunlight during the night. Our body produces certain hormones that keep us awake and active during the hours when the sun is out in the sky and different hormones at sunset, which prepare the body for a night of rest. A newborn is not yet exposed to the routine of hormonal changes induced by the sun, since inside the mother there is no change in light exposure. Actually, there is no light exposure at all. Therefore, the newborn starts to learn the difference between day and night when he or she is born. It is important to create a noticeable difference between day and night from day 1 of life, to start the learning process. It usually takes about 6 weeks for the newborn to show some consistent behavior. The sooner you start, the sooner you will enjoy a full night of rest. What is a parent to do? Keep your newborn baby exposed to daylight during the day by keeping her in a room with plenty of light. If the weather is cloudy and the rooms of the house seem dark, turn on the light during the day. The baby needs to be exposed to light during the day, even when she is taking naps. Newborns need to sleep 16 to 20 hours/day; you’re going to see lots of naps during the first few weeks of life. Let the baby sleep whenever she feels like it; just make sure there is light in the room. In the evening, after the sun goes down, make sure the baby remains in the dark for the rest of the night. I advise the parents of my patients to give the baby a bath between 8 and 9 PM. Bath time will eventually mark the transition between day and night, and provides relaxation in preparation for sleep. You don’t need to use soap everyday, if you’re worried about the drying effects of soap on the baby’s skin. Just give the baby a quick bath with warm water. Keep the baby in the dark for the rest of the night, in such a way that if he wakes up for feedings, he is fed and changed in the dark. You may use a dim night-light if you need to, or turn on the hall light outside of the room if necessary. Another milestone to accomplish during the first 6 weeks of life is to train the baby to sleep on his own, without holding or rocking. During the first days of life, your baby is used to close contact and having pressure all over her body. For this reason, she is going to enjoy been held or swaddled for comfort. Eventually babies get used to the new environment and start pushing swaddling blankets away. When you baby is ready, allow her to practice how to fall asleep without holding her in your arms. Simply put her down in her crib or basinet and allow her to switch from awake to asleep. It takes about 6 weeks of daily light and darkness routine for the baby to get the rhythm. Most babies start some kind of regular night schedule at around 4-6 weeks of life, where they consistently wake up at around midnight and 3 AM for feedings. They usually have an early morning feeding, between 6 -7 AM that is going to persist for the rest of the learning process. At about 6-8 weeks of age, your baby will start skipping feedings at night. He may skip the midnight feeding or the 3 AM feeding. You will hear the baby waking up at those times, and you are going to hear your baby cooing and making noises, but he’ll go back to sleep by himself, until the next feeding. Always wait a few minutes to see if your baby is going to go back to sleep or needs a feeding in the middle of the night. Eventually, between 8-10 weeks, your baby will be able to go to bed between 8-9 PM, after his bath and feeding routine, and sleep until 6-7 in the morning. If you still keep the baby in your room, you will be aware of the two middle-of-the-night awakenings, but your baby will be able to go back to sleep without a feeding when he/she is ready. This is a good time to move the crib to another room. Like many other aspects of life, sleeping is a natural behavior but requires some consistency in creating the right circumstances to make it happen the right way. Keep your consistency and it will pay off with a night of rest for the whole family. Good night! Posted in Newborns & Infants | No Comments » |
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Summary: To be effective, any campaign against childhood obesity must include intervention strategies to combat obesity in preschool children, say researchers at the University of California San Francisco in a report published in the New England Journal of Medicine.
Talk about gifted people and inspirational speakers! Yesterday I attended the 2010 Shilling Lecture at Southwestern University in Georgetown, where Dr. William Foege gave a superb speech to students and other attendees; his talk was moving and inspiring.
You’ve probably heard it in the news. There is a Pertussis (Whooping Cough) outbreak in Williamson County and, I am sure, in other areas of the country. Whooping cough is a childhood disease, right? If you are an adult you may be thinking “who cares, it is not going to affect me anymore!” or “I was immunized as a child, I am protected”. Wrong and wrong again.
Getting a baby to sleep through the night is a dream of sleepy parents of newborns everywhere. It is easier than is sounds if you follow the right steps.