Tag Archives: Infant

Pollution and birth weight

Beijing in January

Beijing in January

What with continuing air pollution woes in such diverse locales as Beijing and Salt Lake City,  a study released last week in Environmental Health Perspectives–which found a direct relationship between particulate air pollution and low birth weight in term babies–couldn’t be more timely.

The study’s authors compiled data on more than 3 million births in nine countries and found a 10-15% increased risk of low birth weight in the most polluted locations.

This isn’t just about turning out slightly less pudgy newborns. The consequences of low birth weight are far-reaching, even multi-generational. Low birth weight babies are more likely to develop chronic health conditions as they grow up, like heart disease, hypertension, and diabetes–just the sort of health problems that make for high-risk pregnancies a generation down the road.

In other words, today’s low birth weight baby girl is more likely to one day produce an unhealthy baby of her own. It’s a cycle that’s tough to break once it starts, and this study is more food for thought as world leaders (hopefully) get serious about addressing climate issues.

(Photo credit: jaaron)

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Filed under Environment/Toxins, Maternal-child health, Newborns

Early antibiotics and obesity?

An English study of more than 11,000 children has turned up an association between early antibiotic use (that is, antibiotics given to babies less than 6 months of age) and later obesity.  Interestingly, the study did not find that antibiotics given to children between the ages of 6 and 14 months increased the risk of obesity, and the effect of antibiotics on children aged 15-23 months was inconsistent.

Why would the antibiotic-obesity association be found primarily in younger babies? The authors speculate that an altered gut microbiota may be the culprit.

The germs that make up the gut microbiota (GM) are acquired at birth and shortly afterwards. By a few months of age the “core” GM is more or less set for life. An altered GM has long been associated with obesity in older children and adults (see more extended discussions in my posts here and here)–it would make sense that antibiotics given in this sensitive period of GM development would have greater impact than later on, when the GM is more stable.

The added risk of obesity from early antibiotic administration is small for any individual baby,  the study’s authors stress, but even small increases spread over an entire population can have significant public health implications.

Still, sometimes babies need antibiotics. Studies like this one highlight the unintended (but real) consequences of the overuse of a sometimes life-saving tool.

***(Photo credit: Seattleye)

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Filed under Infectious diseases, Obesity

Breastfeeding in the U.S. (Part 2): How are we doing?

Making progress…

First the good news: More American babies are breastfeeding every year.

According to the Centers for Disease Control and Prevention, which just released its Breastfeeding Report Card 2012:

– 76.9% of infants start out life breastfeeding

– 47.2% were at least partially breastfed at 6 months (versus 34.2% in 2000)

– 25.5% were at least partially breastfed at their first birthday (versus 15.7% in 2000)

The statistics for exclusive breastfeeding show a similar encouraging trend:

– 36% of babies were exclusively breastfed through 3 months of age (vs. 30.5% in 2000)

– 16.3% were exclusively breastfed through 6 months (vs. 11.3 in 2000).

The bad news, such as it is, is that as a nation we have a long way to go. Ideally, all babies would be exclusively breastfed until at least 6 months of age, and we’re far from that ideal.

The percentage of exclusively breastfed babies in the 2012 report card does come close to the CDC’s Healthy People 2010 goals: 40% of babies exclusively breastfed at 3 months, and 17% at 6 months. But still…that means the majority of American babies aren’t enjoying breastfeeding’s many benefits.

The CDC has set more ambitious and hopefully achievable breastfeeding goals in Healthy People 2020:

2020 Target:

1) Ever breastfed: 81.9% (2012 report card: 76.9%)

2) Any breastfeeding:

At 6 months: 60.6% (2012: 47.2%)

At 1 year: 34.1% (2012: 25.5%)

3) Exclusive breastfeeding:

Through 3 months: 46.2% (2012: 36%)

Through 6 months: 25.5% (2012: 16.6%)

Next we’ll look at state-by-state breastfeeding data. Not surprisingly, there are some significant differences…

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Filed under Breastfeeding, Maternal-child health

FAQs: Is Vitamin D necessary for breastfed babies? (Part 1)

This is the first in a series of frequently asked questions I hear from parents in my practice. If you have an FAQ about children’s health, send it along!

Vitamin D: A buffness requirement

Is vitamin D supplementation really necessary for breastfed babies?

Vitamin D supplementation for breastfed newborns is a hot topic. Though it’s strongly recommended by the American Academy of Pediatrics, many parents understandably question the need for it. After all, isn’t breast milk nature’s perfect food? Aren’t we undermining breastfeeding promotion by saying mother’s milk is deficient in something? And, hey…if this is such a problem, how did the human race manage to get by without vitamin drops all these eons??

Let’s look at the issue from a number of angles and see what the fuss is all about. I’ll start with a basic Q & A and then go into more detail in future posts.

1) What is vitamin D?

Vitamin D is a steroid hormone. It belongs to the same chemical family as cholesterol, testosterone and estrogen, among many other compounds.

2) What does vitamin D do?

It was originally thought to only play a role in bone health, by helping the body absorb calcium. In recent years, though, vitamin D has been shown to play an important role in immune system functioning, both by heightening the body’s responses to invading bacteria and preventing the immune system from attacking normal tissues.

3) Where do we get vitamin D?

There are two major sources: sunlight and diet. Sunlight is the more efficient way to get vitamin D.

The good stuff

4) What happens if we don’t get enough?

Historically, the connection between lack of sunshine and rickets–soft, deformed bones–was made in the 19th century. (Pelvic bones shrunken and deformed by rickets were the cause of many deaths in childbirth in those days.) Later, a lack of vitamin D was identified as the cause of rickets. Osteoporosis, especially in women, also results from inadequate vitamin D. Recently, as vitamin D’s immune system role has become clearer, a lack of vitamin D has also been linked to a number of serious chronic conditions, such as Type 1 diabetes, systemic lupus erythematosis, and multiple sclerosis.

5) Why is there so much vitamin D deficiency these days?

It’s mainly due to decreased sun exposure and poor diet.

6) So why are breastfed babies at risk for vitamin D deficiency?

Many pregnant or lactating women don’t have enough vitamin D for their own bodies, let alone enough to build up their babies’ supply. A mother’s problem soon becomes her baby’s problem, too.

More to come…

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Filed under Nutrition, Science

Alison Gopnik on babies and “lantern consciousness”

Learning about baby brains

If you’re a fan of TED talks, here’s a short, interesting one by Alison Gopnik. She’s a professor of psychology at UC Berkeley and the author of popular books on how babies learn–most recently The Philosophical Baby (2009), which I reviewed for the San Francisco Chronicle. Her books make for fascinating reading, if you find babies as fascinating as I do.

In the Ted talk and in her book Gopnik describes infants and toddlers as having a “lantern consciousness” with which they explore their world. They take in everything around them–like a lantern casting light in all directions–without doing much editing. That maddening tendency to flit from thing to thing may drive parents nuts, but it’s purposeful flitting–it’s how they eventually make sense of everything, from social encounters to the physics of walking. (There’s a very cute video in the talk of a four-year old trying to figure out how to make a block light up–if nothing else, check that out.)

By comparison, Gopnik describes adults as having “spotlight consciousness”–we’re really good at zeroing in on the task at hand, at the expense of missing out on a lot of interesting things going on around us. We do occasionally flip into “lantern” mode, like when we travel to a new place and explore the differences between there and home (if we have time to just wander, that is). But most of the time we burrow into our familiar routines, focused on schedules and deadlines and racing through our chosen mazes. Too bad for us!

I like her description of what it’s like to be a lantern-conscious baby:

Pass the espresso!

“It’s like being in love in Paris for the first time after you’ve had three double espressos.”

Think of that image the next time you watch a baby hard at work, figuring out the world.

(And thanks to Erin Duckhorn for passing along the TED link!)

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Filed under Development, Science

Are colic and migraines related?

No fun at all...

Now this is interesting!

In a study of 154 new mothers with colicky babies, University of California San Francisco researchers discovered that mothers with a history of migraine headaches were two and a half times more likely to have a colicky baby than those who had no migraine history.

It’s too early to tell, of course, but the UCSF team speculates that colic may turn out to be an early symptom of migraines in some babies, similar to other childhood “periodic pain syndromes” like abdominal migraines.

Abdominal migraines are weird things. They’re characterized by sudden, sometimes severe abdominal pain that can be accompanied by nausea, vomiting and headache. But sometimes it’s just abdominal pain by itself, and it can be disabling. Since there’s no test to diagnose it, kids with abdominal migraines typically go through a whole battery of labs before their pediatricians decide that’s what it must be. Other serious conditions have to be ruled out first.

Now compare that with a classic description of colic, courtesy of Dr. Wilfrid Sheldon, from his 1936 edition of Diseases of Infancy and Childhood:

“A typical attack of intestinal colic begins suddenly, the infant screaming and drawing up his thighs on his abdomen, which becomes tense and rigid. Vomiting may ensue. Each attack lasts two or three minutes and passes gradually… Nervous infants, or those born of nervous parents, are at risk of convulsing.”

Sounds pretty similar, eh?

I can’t tell you how many colicky babies I’ve seen over the years (none of whom have convulsed, despite Dr. Sheldon’s concerns), and how many distraught parents I’ve helped get through what can seem like the longest few weeks in their lives. Historically, parents have used everything from charms and herbs to “soothers” containing morphine and marijuana–Dr. Sheldon’s favorite remedy included belladonna and opium. Many, many babies died in the old days from side effects of colic treatments.

Next up for the UCSF team is to follow the babies in the study as they grow and see how many end up with migraines. If their findings pan out, this could lead to new understanding, and new treatment, for an age-old scourge.

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Filed under Colic

Finger foods help prevent obesity

Filthy, yes. Fat, no.

Here’s something I’ve always felt made sense: Babies allowed to wean themselves to finger foods when they’re ready are less likely to become obese than those who continue to be exclusively spoon-fed. The simple explanation: it’s easier to learn to quit eating when you’re full if you’re the one controlling the feeding. In my experience the finger feeding phase arrives between 6 and 12 months, right at the age babies start fighting spoon feedings. (They must be reading the studies!)

Fear of choking is the concern I hear most often from parents leery of letting their babies finger feed themselves. But think of the foods typically offered as finger foods: cereal puffs, cheese, soft-cooked peas and carrots, and such. These are nearly impossible to choke on, since they quickly stick to saliva (and hair, and eyelashes, and nostrils, etc.). I challenge you – put a Cheerio in your mouth and try, try to inhale it and choke on it. You can’t, and neither can your baby.

The dangerous foods are slippery ones. Every year the leading causes of choking deaths from food are hot-dog chunks (with the skin all the way around) and whole grapes. (This usually happens to toddlers, who can grab food for themselves, and not infants, who eat what they’re given.) This is because the skin or peel makes it easy for the food object to slide to the back of the throat and block the windpipe.

Keep in mind, too, that choking and gagging are actually two very different things. Choking occurs when a solid object blocks the flow of air through the windpipe. Gagging moves food forward and away from the windpipe, and so actually protects babies from choking. It’s a good idea to take an infant CPR course so you’ll know the difference and be prepared in case of a real emergency. Most local hospitals and Red Cross chapters offer such classes.

Still, if your baby gags easily, go easy on the finger foods until a bit later. You want mealtime to be positive, and as we all have experienced at one time or another, gagging is not a pleasant sensation. The easy-gagger phase will pass in time.

In the meantime, on to finger feeding (and a jumbo under-the-high-chair ‘splat mat’!)


Filed under Natural childbirth, Newborns, School