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Pediatric

One of the Worst Parenting Mistakes

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No matter how physically active a child is, time spent in front of the computer or television screen is associated with psychological problems.
CLICK & SEE
In other words, children can’t make up for TV time by spending extra hours exercising.

The findings also suggest that the way children spend their sedentary time, in addition to how much time they spend being sedentary in the first place, matters for their mental health.

According to Live Science:
“… [R]esearchers asked 1,013 British 10- and 11-year-olds how much time each day they spent in front of a computer or TV. The children also wore accelerometers around their waists for a week to track their physical activity and sedentary time …

The study found that … more than two hours a day in front of a TV or computer was associated with more emotional and behavioral difficulties.”
Sources:
Live Science October 11, 2010

Pediatrics October 11, 2010 [Epub ahead of print]

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Featured

Study Finds Many Children in U.S. Potentially Misdiagnosed With ADHD

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About  1 million children in the United States have potentially been misdiagnosed with attention deficit hyperactivity disorder (ADHD) — simply because they are the youngest, and therefore the most immature, in their kindergarten class.

These children are significantly more likely to be prescribed behavior-modifying drugs such as Ritalin.  Such inappropriate treatment is particularly troubling because of the unknown impacts of long-term stimulant use on children’s health.

According to Science Daily:

“It also wastes an estimated $320 million-$500 million a year on unnecessary medication — some $80 million-$90 million of it paid by Medicaid”.

Resources:
Science Daily August 18, 2010
Journal of Health Economics June 17, 2010 [Epub ahead of print]

Categories
News on Health & Science

Toolkit Helps Parents Recognize a Child’s Risk of Obesity

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Some simple interventions used by pediatricians were enough to change a parent’s perspective about a child’s being overweight or obese, and change the parent’s behaviors at home to reduce those risks.
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Researchers confirmed previous reports that parents of overweight or obese children do not recognize their child’s weight problem. But this time, by arming pediatricians with a “toolkit,” an easily used chart and a series of questions and suggestions, the researchers addressed several problems.

“Doctors often don’t have time to discuss overweight; they don’t have the tools to do it; and many aren’t confident that they’re going to make a difference in their patients’ lives,” said Eliana Perrin, lead author of the study.

“Also, parents don’t recognize weight problems or don’t know how to make things better, and even if they do, there are often barriers to healthier eating or more activity for these families,” says Perrin.

As First Lady Michelle Obama‘s “Let’s Move!” campaign aims to reduce childhood obesity – almost one-third of young people are overweight – two leading questions are how to affect that change and if it can be successful.

Perrin’s study is likely the first evidence that a parent’s assessment of their child’s weight can be changed. Her study also showed improved dietary behaviors in children and reduced time playing video games or watching television, called “screen time.”

“We found something we can do to help stem the obesity epidemic,” says Perrin, whose previous research in childhood obesity has shown that using a body mass index, or BMI, chart color-coded like a traffic light helps parents understand the often confounding measurement.

Perrin’s research group trained pediatric resident physicians on how to use the color-coded BMI chart and a revision of a questionnaire called “Starting the Conversation,” originally designed by Alice Ammerman, a co-author on the study. The STC gives health care providers a snapshot of potential red flags to help counsel patients as well as tips to implement change.

Parents were asked about their children’s weight status and discussions about weight in the doctor’s office. The Starting the Conversation form used in this study was revised by Perrin and asked parents about non-healthy eating habits – frequency of sugary snacks, sugar-sweetened beverages and eating out at restaurants, as well as activity and screen time. It also asked about the parent’s readiness to change. The pediatrics residents were instructed to show parents their children’s weight status in a color-coded BMI chart and were taught to use the parents’ responses to the questionnaire to engage the parents in discussions about healthier eating behaviors and activities.

Researchers enrolled 115 children ages 4 to 12 who were covered by Medicaid or the State Health Insurance Program and repeated the Starting the Conversation questionnaire as well as questions about weight status at one-month and three-month follow-up appointments.

The study showed the most significant improvement in dietary changes among children who were overweight. At follow up, they were more likely than healthy-weight children to drink lower-fat milk and showed the largest reduction in the frequency of eating out. But overall, children improved fruit and vegetable consumption, decreased sweetened beverages and unhealthy snacks, drank lower-fat milk more and reduced screen time.

In the initial visit, all of the parents of healthy-weight children accurately perceived their child’s weight. However, only 57 percent of overweight children’s parents did so at baseline. That improved significantly to 74 percent at three month follow up.

BMI was measured and tracked and a few children became more overweight, while more reached healthier weights but no significant improvements in weight status were noted in this short study, Perrin says. “The research has to be replicated and expanded, and it must determine if improvements in parental perception of children’s weight motivates families to improve behavior and, ultimately, leads to healthier weight over time,” she says.

“Everyone’s talking about BMI and we have a lot of studies to show that parents do not see their overweight children as overweight. That often does not sink in with parents,” Perrin says. “This is the first time we’ve seen a changed perspective from parents. We hope that parents who know their children are overweight will be empowered to help them achieve healthier lifestyles that can last a lifetime.”

Source: Elements4Health

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Healthy Tips

Exercise for Kids — Tips for Parents

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Here are some tips on getting your child fit from U.S. News & World Report:
click & see
Encourage a little bit at a time. Minutes spent playing kickball can add up over the course of a day.

Advocate for well-maintained, safe sidewalks and bike paths in your neighborhood.  Volunteer to supervise the use of school facilities after hours. Children are more likely to want to play outside if it’s safe.

Practice what you preach. It’s not hard to find activities the whole family can do together.

Don’t underestimate the value of some video games. So-called “active-play” video games can encourage regular exercise.

Don’t let other activities or physical disabilities limit your child. All children need exercise every day.

Resources:
*U.S. News & World Report June 2, 2010
*2010 Shape of the Nation Report: Status of Physical Education in the USA (PDF)

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Pediatric

When to Start Solid Food to Babies

It is always confusing to know when to give baby solid food. When a mom notices her baby is hungrier than usual, the mom usually asks the pediatrician, “When can my baby begin eating solid foods?” Baby will know, just pay attention to the signs. Mom just has to watch and listen.When you begin feeding your baby solid foods you want to progress in a way that sets baby up for healthy eating habits. You are not only putting food into your baby’s tummy, you are introducing lifelong attitudes about nutrition. Consider for a moment that during the first year or two you will spend more time feeding your baby than in any other interaction. You both might as well enjoy it.

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WAIT 6 REASONS:-
Gone are the days when pressured mothers stuffed globs of cereal into the tight mouths of reluctant six-week-olds. Nowadays parents feed their baby on the timetable that is developmentally and nutritionally correct — as determined by their baby. Don’t be in a rush to start solids. Here are some good reasons for waiting.

1. Baby’s intestines need to mature. The intestines are the body’s filtering system, screening out potentially harmful substances and letting in healthy nutrients. In the early months, this filtering system is immature. Between four and seven months a baby’s intestinal lining goes through a developmental growth spurt called closure, meaning the intestinal lining becomes more selective about what to let through. To prevent potentially-allergenic foods from entering the bloodstream, the maturing intestines secrete IgA , a protein immunoglobulin that acts like a protective paint, coating the intestines and preventing the passage of harmful allergens. In the early months, infant IgA production is low (although there is lots of IgA in human milk), and it is easier for potentially-allergenic food molecules to enter the baby’s system. Once food molecules are in the blood, the immune system may produce antibodies to that food, creating a food allergy . By six to seven months of age the intestines are more mature and able to filter out more of the offending allergens. This is why it’s particularly important to delay solids if there is a family history of food allergy, and especially to delay the introduction of foods to which other family members are allergic.

2. Young babies have a tongue-thrust reflex . In the first four months the tongue thrust reflex protects the infant against choking. When any unusual substance is placed on the tongue, it automatically protrudes outward rather than back. Between four and six months this reflex gradually diminishes, giving the glob of cereal a fighting chance of making it from the tongue to the tummy. Not only is the mouth-end of baby’s digestive tract not ready for early solids, neither is the lower end.

3. Baby’s swallowing mechanism is immature.
Another reason not to rush solids is that the tongue and the swallowing mechanisms may not yet be ready to work together. Give a spoonful of food to an infant less than four months, and she will move it around randomly in her mouth, pushing some of it back into the pharynx where it is swallowed, some of it into the large spaces between the cheeks and gums, and some forward between the lips and out onto her chin. Between four and six months of age, most infants develop the ability to move the food from the front of the mouth to the back instead of letting it wallow around in the mouth and get spit out. Prior to four months of age, a baby’s swallowing mechanism is designed to work with sucking, but not with chewing.

4. Baby needs to be able to sit up. In the early months, babies associate feeding with cuddling. Feeding is an intimate interaction, and babies often associate the feeding ritual with falling asleep in arms or at the breast. The change from a soft, warm breast to a cold, hard spoon may not be welcomed with an open mouth. Feeding solid foods is a less intimate and more mechanical way of delivering food. It requires baby to sit up in a highchair – a skill which most babies develop between five and seven months. Holding a breastfed baby in the usual breastfeeding position may not be the best way to start introducing solids, as your baby expects to be breastfed and clicks into a “what’s wrong with this picture?” mode of food rejection.

5. Young infants are not equipped to chew. Teeth seldom appear until six or seven months, giving further evidence that the young infant is designed to suck rather than to chew. In the pre-teething stage, between four and six months, babies tend to drool, and the drool that you are always wiping off baby’s face is rich in enzymes, which will help digest the solid foods that are soon to come.

6. Older babies like to imitate caregivers
. Around six months of age, babies like to imitate what they see. They see you spear a veggie and enjoy chewing it. They want to grab a fork and do likewise.

Like all children there are growth spurts, babies too! There are times when they are hungrier but this isn’t the sign they need solid food. Just pay attention and is if this is a consistent behavior and more than a growth spurt. If you decide it is more than just a “hungry day” it may be baby is ready for solids. If this is the case, please remember they need breast milk and formula still!

Baby’s nutrients mostly come from breast milk or formula. It is their main source of nutrients and they still require it through out the first year of their life. Theoretically, babies can begin solid foods between four and six months of age. This is not a hard and fast rule however, so if baby hasn’t begun to exhibited signs of being ready, don’t push. Each baby is different. Here are just a few of the signs that might signal baby is ready to begin solid foods, again don’t pressure or push your child.

*Adequate Neck Control
The first thing a baby has to have is neck control. If they look like a bobble head doll, they are not ready for solid food.your baby will be able to sit upright and keep the head in position for a long time.   Your baby will sit safely when you have the proper support.

If a baby has a wobbly head they are not able to swallow anything thicker than milk and to eat solid food they must be able to swallow food thicker than milk. If a baby eats solids too soon without the proper control needed they could choke.

*Reflux and Chewing
All babies’ naturally push things out of their mouth; it is natural for babies when feeding with a bottle or nipple to push things out of their mouth. It’s just the way for baby’s to prevent themselves from choking. When the reflux kicks in they begin to stop pushing nipple or bottle from their mouths.

The “extrusion reflex” cease: Your baby will no longer use his tongue out of his mouth milk or formula.

Shall be seen chewing movements. The tongue and mouth of babies is developed while your digestive system, like their teeth.

Your baby has a good appetite.
Before a baby can actually eat they need to learn to chew and this takes place when they can push the back of their mouth where it heads south to the stomach courtesy of that swallowing reflux. It’s just a matter of time. The chewing motion is a good sign that baby is ready to eat solid food. You can’t make it happen; it comes when your baby is developmentally ready.

*Weight Gain:Weight gain your baby will be significantly noticeable.
When the weight of your baby has doubled, they could be ready for foods. A rule of thumb many doctors give mothers. This alone is not a sure sign, but when it is combined with other indicators, the solid food stage is close at hand. Pay close attention and ask your pediatrician.

* Curious about the food they eat as adults.

*Individuality
Each baby is different
. If your baby is close to six months of age and not eating solids, be patient. Breast milk and formula is adequate and there is not hurry or rush. Eating more breast milk or formula will not harm your baby. When it is time for solid foods your baby will let you know. Continue to watch for the signals and pay attention to your baby’s cues.

Starting your baby on solid foods is the beginning of lifelong eating habits that contribute to your baby’s overall health. Here are general guidelines that can help you start your baby out on the right track to a healthy life. Starting baby solid foods and feeding schedule too early can cause your baby to develop food allergies.
But this is also not very true in all cases but one must start very slowly after 3to 4 months minimum one’s baby otherwise fit for it.

Resources:
http://organicbabyproducts101.com/starting-baby-food/
http://hubpages.com/hub/When-to-start-Solid-foods-for-baby-and-Baby-Feeding-Schedule
http://www.nordoniapreschoolparents.com/guide-to-the-baby-feeding-starting-solid-foods.htm

http://www.askdrsears.com/html/3/T032000.asp

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