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Hello, and welcome to Parenting News Online! I originally started this website in order to bring you, a parent, newsworthy articles about parenting, health, nutrition, and coping skills. What it has morphed into is a collection of articles based on new medical research related to kids. And I hope you enjoy paging through the articles as much as I enjoy writing them.

But I do need some help from you. I would ask you to submit ideas for topics on the form below. Otherwise I’ll just keep writing about whatever tickles my fancy. And that’s not really the point. Please take a second and tell me what you want to know, and I’ll do my best to bring it to you.

And thank you again for coming!

Ed





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Vaccinating mothers who breastfeed

English: SAN DIEGO (Aug. 27, 2011) Hospital Co...

We all cringe when we have to hear an infant down the hall get one or several vaccinations. It would be wonderful if vaccinating the breastfeeding mother in the first week or so after delivery would provide adequate protection for the baby without having to put the baby through those shots. In addition, the first vaccines for tetanus, diphtheria, and pertussis (whooping cough) are typically not even given until 2 months of age, so that babies don’t have immunity from those diseases. Finally, often it is the mother herself who is carrying the pertussis bacteria and infects the infant. If we immunized the mother during the early postpartum time period, would the baby be any better off?


In this study performed in Houston, physicians started following a recommendation by the Center for Disease Control and Prevention to administer the TdaP (tetanus, diphtheria, and acellular pertussis) vaccine to mothers just before hospital discharge from January 2008 through May 2009. The then identified 514 infants with pertussis and determined which of them had or had not been in the group whose moms had received the TdaP. After all of the analysis was done, the vaccination program in the moms did not work.

The conclusion of the study was that breast milk alone was not sufficient to protect babies from these vaccine-preventable illnesses. Efforts to reduce pertussis infections in children still require vaccination of the infant as well as any household contacts of people with pertussis.

The following is the author's description of t...

Photo credit: Wikipedia

 

Reference: Catagnini LA, et al. Impact of Maternal Postpartum Tetanus and Diphtheria Toxoids and Acellular Pertussis Immunization on Infant Pertussis Infection. Clin Infect Dis. (2012) 54 (1): 78-84.

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Stem Cells for Cystic Fibrosis

Young patient with cystic fibrosis

Young patient with cystic fibrosis

From Wikipedia:

Cystic fibrosis (CF) is a genetic disorder that affects mostly the lungs but also the pancreas, liver, kidneys and intestine. Long-term issues include difficulty breathing and coughing up sputum as a result of frequent lung infections. Other symptoms include sinus infections, poor growth, fatty stool, clubbing of the fingers and toes, and infertility in males among others. Different people may have different degrees of symptoms. It is caused by the presence of mutations in both copies of the gene for the protein cystic fibrosis transmembrane conductance regulator. CFTR is involved in production of sweat, digestive fluids, and mucus. When CFTR is not functional, secretions which are usually thin instead become thick. The condition is diagnosed by a sweat test and genetic testing. There is no cure for cystic fibrosis.





Or is there? These researchers used stem cells to target the genetic abnormality in the CFTR, and it worked! They were able to correct the CFTR gene mutation in cells derived from cystic fibrosis patients. This is incredibly exciting, since CF is a devastating disease for those kids and adult who have it. If this genetic problem could be corrected, it would dramatically change their quality of life not to mention their length of life (current life expectancy is between 37 and 50 years of age).


 


Go, Texas researchers, go!
Reference: Crane, Ana M., et al. “Targeted Correction and Restored Function of the CFTR Gene in Cystic Fibrosis Induced Pluripotent Stem Cells.” Stem cell reports 4.4 (2015): 569-577.

Picnics Bring Community Together

picnic
It’s Memorial Day weekend here in the US, a holiday usually marked by planting gardens and going for picnics. The community picnic has been criticized by some people saying that it segregates entire groups: men vs. women, whites vs. blacks, kids vs. grown-ups. And yet people have been having community picnics for years and years, so it must not be too malicious.



Well believe it or not, someone actually did a population-based sociologic study on a particular picnic in Tennessee to see if picnics were inherently segregating. The author used an ethnographic model and interviews of participants to gather data. The conclusion was that picnics were not, in fact, inherently bad and in fact promoted the sense of community and breaking of barriers.


 


So good news, moms and dad: it turns out that taking your kids to a picnic is in fact a good thing, both for them and for you. Be sure to bring bug repellent and sun screen! And your camera….
Reference: Bradley, Kristen A. A Tennessee Irish Picnic: Foodways and Complex Community Dynamics. University of Louisiana at Lafayette, 2014.

Lyme disease and Autism?

Autism

 

I came across a fascinating article that proposes that there is an association between Lyme disease and autism. These authors examined blood tests from kids with a diagnosis of autism to see if there were markers suggestive of Lyme disease. They surveyed parents of 48 kids with the diagnosis of Autism Spectrum Disorders (ASD) and asked if their kids had had any episodes of fever, fatigue, rashes, or joint pains prior to the diagnosis of autism. They tested these kids for serological markers of Lyme disease. Most of the kids tested positive. A few of the kids had improvement in their ASD after treatment with antibiotics.



This is very interesting, but there are a lot of problems with the study. First this was an online survey, and online surveys frequently have a select group of respondents who are looking desperately for an answer. It is not typically a random sample of the population. They rely on the parents’ recollection of symptoms, and asked the parents if their kids had been tested for Lyme disease in the past and if so did it turn out negative. Again, lots of opportunities for bias. They report on “anecdotal evidence” of improvement after antibiotics, which is like saying “I knew this one guy once who…”. Not scientific.


 

Even with these problems, nonetheless many of these ASD patients tested positive for Lyme disease. The study may not be the best quality, but it does make you think. And I guess that’s the idea of publishing medical reports: getting  people to think. What do you think?

Reference: Kuhn, Mason, and Robert Bransfield. “Divergent opinions of proper Lyme disease diagnosis and implications for children co-morbid with autism spectrum disorder.” Medical hypotheses 83.3 (2014): 321-325.

When Can Kids Have Gluten?

Gluten-free

One of the many problems that parents face is that there is so much information out there. Some of that information is really good, while a lot of it just isn’t. Getting advice from your favorite tabloid magazine, your next door neighbor, or your sister-in-law is risky, since you don’t really know if they know what they’re talking about. One example of this is the idea that giving gluten to babies will cause them to have celiac disease.



Celiac disease is one of the many names for an intolerance of gluten in the diet. Gluten is a protein in wheat that gives bread its structure, gives pasta is chewiness, and basically helps hold wheat products together. About 1% of people are allergic to this protein, though, and can have problems like diarrhea, gassiness, and eczema. Celiac disease is also called gluten enteropathy. Many people tell young parents that, if they give their baby or toddler anything with gluten in it that child will go on to develop celiac disease. Well these authors challenged that idea in an excellent article this month in the AAP News.

They reviewed the recent literature and had this to say about two recent studies looking at the relationship between Celiac Disease (CD) and breastfeeding::

Results from two recent European studies indicate that it is very unlikely that the timing of gluten introduction into the diet makes a difference on the incidence of CD. The studies also call into question any relationship between CD and breastfeeding.

I think this is great news. You can lose the idea that you did anything wrong by introducing gluten “too early”. You can tell your neighbors to calm down. You can breastfeed your baby even if you have a piece of bread. It’s genetics, not diet, that sets people up for CD. So go ahead, give them spaghetti!


 

Reference: Greer, Frank R., and Sarah Jane Schwarzenberg. “Does timing of gluten introduction with or without breastfeeding prevent celiac disease?.” AAP News36.1 (2015): 1-1.

Juvenile Fibromyalgia?

Child painWell here’s one I’ll bet you never heard of! At least I hadn’t. Juvenile fibromyalgia. Fibromyalgia is a poorly understood condition that affects about 2-8% of the population with females outnumbering males by about 9 to 1. It apparently can be seen in kids as well, and this paper shows that the diagnosis is often delayed because we just don’t think about it.



This was a paper done out of Kaiser Permanente in Fontana, CA. They implemented a new questionnaire called the SORE scoresheet to screen for undiagnosed fibromyalgia. In only 4 months of use they found 22 kids with juvenile fibromyalgia syndrome. The whole purpose of the paper was to test out this new scoresheet, not so much as to tell us how to treat it. I guess it also points out that this new condition is probably more common than we thought.


 


We still don’t know exactly what fibromyalgia is, why it affects certain people and not others, why it’s worse in some than others, why women seem to have it more than men, how best to treat it, what the natural history of the disease is, and so on. Particularly for our kids it would be nice to know if it will eventually go away. It seems that one of the biggest problems facing those who have fibromyalgia is that a lot of it goes unreported and untreated. Maybe a screening tool like this can help for our kids.

Reference: McLeod, Judith D. “Juvenile fibromyalgia syndrome and improved recognition by pediatric primary care providers.” Journal of Pediatric Health Care 28.2 (2014): e9-e18.

Depression and inflammation

Sad kid
Readers of this website (both of you) know that I have a fascination with the relationship between inflammation and depression. It just makes sense to me that people who are chronically ill are more likely to be depressed, and people with chronic depression are more likely to be ill. Many studies have shown excellent results treating depression with anti-inflammatory medications like Celebrex® and naproxen. Other studies have shown that Zoloft® is a pretty decent anti-inflammatory medicine.



These researchers set out to examine blood markers of inflammation in patients with hepatitis C and depression. They compared the results to a similar group of people without hepatitis C. They found that people with hepatitis C have sky-high markers of inflammation and a higher incidence of depression. Surprisingly, the control group patients, some of whom happened to be depressed, had similar profiles. These scientists were able to identify specific blood profiles that seem to be associated with depression, information that may provide more specific targets for treatment down the road.


 

One interesting side note is that this helps to “medical-ize” depression. It helps us to understand it as an illness rather than just an attitude. We can see it as a condition that should be covered by insurance like any chronic disease, and prescription costs for treatment should be similarly covered. Insurances shouldn’t look at this as “six sessions with a social worker and a pat on the back”. There is so much interplay between depression and systemic illnesses, and clearly treating one helps the other. We have a long ways to go before we understand all of this, but we’re learning fast!

Reference: Huckans, M., Fuller, B. E., Olavarria, H., Sasaki, A. W., Chang, M., Flora, K. D., Kolessar, M., Kriz, D., Anderson, J. R., Vandenbark, A. A. and Loftis, J. M. (2013), Multi-analyte profile analysis of plasma immune proteins: altered expression of peripheral immune factors is associated with neuropsychiatric symptom severity in adults with and without chronic hepatitis C virus infection. Brain and Behavior. doi: 10.1002/brb3.200

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