Tag Archives: American Academy of Pediatrics

SIDS… Sudden Infant Death Syndrome

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NOTEWORTHY WEDNESDAY!

Every now and then I write about SIDS (Sudden Infant Death Syndrome).

It is frightening for parents to even think about this happening but there are American Academy of Pediatrics‘ recommendations to follow to lessen the risk of SIDS .

SIDS is considered by some professionals to be a disease. Here is what  Norman Lewak, Clinical Professor of Pediatrics at UCSF …  had to say:

SIDS is a real disease. The “Triple Risk Model for SIDS is described in the Technical Report that accompanies the Policy Statement on-line edition only. Thanks to the work of Hannah Kinney of Boston Childrens, we know that SIDS infants have lesions in the respiratory center of the brainstem. This is the first risk pre-exiting respiratory center lesion. The second risk is the vulnerable developmental age, peaking at 2-4 months, in which CNS respiratory control changes. The third risk is an “environmental trigger“–an environmental event that blocks continued respiratory activity.This trigger appears to many of us to be deep sleep brought on by increased comfort from increased warmth. Prone sleep has been proven to increase warmth. The pacifier effect is most likely caused by an increase in activity, thus a lighter sleep.http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284/reply#content-block

Some AAP recommendations to prevent SIDS are:

  • supine sleeping position
  • a firm sleep surface
  • breastfeeding
  • room sharing without bed sharing
  • consider using a pacifier which leads to a lighter sleep
  • avoid soft bedding
  • avoid overheating of the room where baby sleeps
  • avoid exposure tobacco smoke, alcohol and illicit drugs

According to recent information, SIDS  a disease which can be triggered by other environmental factors such as sleeping on soft surfaces, or stomach sleeping. These situations can set off a reaction whereby an infant ceases breathing due to an abnormal increase in his/her CO2 level. SIDS is not “suffocation”.

Every parent-to-be should be given information about SIDS prior to delivery and any questions should be answered by nurses or pediatricians early in the newborn period.

It is easier to follow sleeping guidelines when they are explained and make sense as to why they are important and how they can make a difference in the prevention of SIDS. Of course unfortunately, there are never any guarantees but parents can do their best with the knowledge that they have to prevent a tragedy.

There is so much to being a parent … children are precious… we are their protectors…just as we use car seats to protect them in the car we should protect them when we put them to sleep.

SIDS is down, but back-sleeping is just part of the message – USATODAY.com.

Replies to SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment.

SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment.

http://pediatrics.aappublications.org/content/128/5/e1341.full

Related posts:

Safe Sleep for Your Baby

SIDS…Sudden Infant Death Syndrome

Sudden Infant Death Syndrome (SIDS)

Sudden Infant Death…Most Common on New Year’s 

Baby’s First Year …Feeding and Nutrition

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NOTEWORTHY WEDNESDAY!

Lately, I have been writing a fair amount about childhood and obesity.

This is a problem that begins early in a child’s life.

Back in the day, there was a saying,“a fat little baby was a healthy baby”. We know so much more today about weight and health to realize how far that statement is from the truth.

I am not suggesting monitoring a baby’s feedings and dietary habits as we would our own adult intake of fat and carbs. But regular visits to the pediatrician during the first year of a child’s life will help track his/her growth and development related to his/her nutritional intake .  Discussions about feeding schedules such as when and what solid foods to introduce  can help parents along the way so that formula or breast milk still remain the major source of nutrition during baby’s first year.

For the first 6 months breast milk or formula is normally the sole nutrition for your child and it remains the major source of nutrition for a child’s first year of life.
Clearly monitoring your child’s growth and development along with your pediatrician will determine whether your child is getting sufficient nutrition.

HealthyChildren.org – Feeding & Nutrition.

I came across an interesting study from the American Academy of Pediatrics of a group of infants and their transition to a variety of foods during their first year.

We found dramatic transitions in dietary consumption that occurred among infants during their first year. The transition from a diet of virtually nothing but breast milk, infant formula, or both to a varied diet of foods from all food groups began for most infants at ∼4 to 5 months of age and continued throughout their first 12 months. Infant cereal was usually the first food other than milk or formula given to infants and remained the most common supplementary food until infants were ∼8 months of age. Fruits and vegetables were introduced at a median age of 5 to 6 months, and meats were introduced at a median age of ∼8 months. By 1 year of age, more than half of the infants were consuming a diet that included not only cereals, fruits, vegetables, meats, and milk products but also foods high in sugar or fat but low in nutrient density.

In this study, we identified several infant feeding practices of concern, including substantial formula supplementation in the hospital, early introduction of solid foods, late introduction of meats, and feeding of high-fat/high-sugar foods to infants. Because of their frequent contact with infants and their parents, clinicians have a unique opportunity to advise new parents about recommended infant feeding practices. By being aware of these infant feeding recommendations and communicating them to parents, clinicians can help start children on the road to a healthy lifestyle.

http://pediatrics.aappublications.org/content/122/Supplement_2/S36.full

Even though I was a Masters educated Maternal and Child nurse when I brought home my first daughter, I did not have a clue as to how to increase her formula beyond the first week of her life. Thankfully, Jackson Memorial Hospital in Miami had given me a “mimeographed” booklet about feeding during the first year of a baby’s life. I kept that dogeared booklet very close at hand since I dared not rely on my own mother or extended family…at the time, they seemed as clueless as I was.

During a recent Google search I located an excellent resource for infant feeding from Lucile Packard Children’s Hospital at Stanford, Palo Alto, CA  “Feeding Guide of the First Year”. 

The guide divides the first year into two parts (4 to 8 months) and (9 to 12 months) and then subdivides these ages. It also provides a complete list of food items as well as measured amounts. Baby’s tiny stomach cannot hold that much solid food and breast milk or formula will still be his main source of nutrition.

  • breast milk or formula provides you baby all the nutrients that are needed to grow
  • your any is not physically developed enough to eat solid food from a spoon
  • starting your baby on solid food too early increases the chance that he/she may develop a good allergy
  • feeding your baby solid food too early may lead to overfeeding and being overweight.

The first year of life is a year of unbelievably rapid growth and development…a baby needs the proper nutrition to keep up with all the physical changes that are taking place.

More growth occurs during this period of life than any other time in your child’s life.

Amazing isn’t it?

Breastfeeding Is Health, Not Lifestyle Choice …

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THURSDAY, March 1, 2012 MedPage Today — Every infant should begin life with six months of exclusive breastfeeding, followed by another six months or longer with other foods gradually added to the childs diet, according to an updated policy statement from the American Academy of Pediatrics.

These statistics are stunning…take a look at the link below:

via Breastfeeding Is Health, Not Lifestyle Choice – Pregnancy 101 – EverydayHealth.com.

TODAY: Breastfeed at Target …

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NOTEWORTHY WEDNESDAY!

Breastfeeding is a natural way to feed babies…

it is a healthy way to feed babies…

for some moms it is an easy transition after delivery and for other moms it is difficult and takes time and patience to get into a rhythm with their babies.

Whatever the case…moms should be encouraged to breast feed and be able to breast feed anywhere.

That apparently was not the experience of a Texas mom who was “harassed” by Target employees when she chose to breast feed in an aisle at a Target store. She was asked to go to a fitting room to breast feed.

Now, my personal choice would not be to sit down in an aisle at Target to breastfeed but a fitting room would not necessarily have been my choice either. Perhaps, a table in their food court would have been more my style.

Now…today, moms have organized through Facebook and are scheduled to “nurse-in” at selected Targets this morning.

What will be the outcome of such a protest?

I am sure there will be some who are “appalled” that moms would do such a thing.

It is time to support breastfeeding moms…the research is in and the American Academy of Pediatrics has made their statements.

Even if you do not support a “nurse-in” it is time to give the thumbs up to those moms who do and it is time to let Target and others like them know that customer service is more than a counter in the front of the store.

Safe Sleep for Your Baby

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NOTEWORTHY WEDNESDAY1

This week I have seen this PSA (Public Service Announcement) and three media discussions associated with it. The consensus of what I have read  and heard is that this PSA is inappropriate and uses “shock” value to relate an important message to parents concerning “co-sleeping“.

Do we really need this type of photo to make a statement against co-sleeping?

What do you think?

Well, I visited Milwaukee‘s website and found some helpful “safe sleep” resources and information related to infant deaths in Milwaukee.

It is my opinion that Milwaukee is trying desperately to reduce infant mortality but are they trying too hard? Will they lose the attention of the very group that they are aiming to help educate with this poster.

The City has had a Safe Sleep Sabbath this past October 11th, where churches participated in a safe sleep for baby program to educate parents about the danger of not putting baby to sleep in an appropriate environment but more importantly it provided information about what was appropriate and safe for infants.

Safe Sleep Sabbath – Sunday, October 9, 2011 Act now to overcome one major problem that is killing our babies: infant sleep death. Infant mortality: The number of infants who die before their first birthday.

Okay …great…now what what else could be done to decrease infant mortality due to poor and unsafe sleeping conditions?

Since we know that in Milwaukee, SES  (socio-economic status) is also related to infant mortality it might be helpful to have culturally sensitive educational materials and discussions about safe sleep for infants.

It would also be advantageous if this discussion did not confuse co-sleeping with unsafe sleep environments for babies.

Let’s keep the discussion going but in a more positive format.

Social workers are doing what they can in Milwaukee as evidenced in this piece from the Sentinel.

Lets here it for  education…education…education…rather than scare tactics and scapegoating “co-sleeping”.

This is a very multifaceted problem that needs to be combatted with a multifaceted action plan.

 

In Milwaukee around 20% of infant mortality is attributable to a combination of Sudden Infant Death Syndrome (SIDS),  and Sudden Unexplained Death in infancy (SUDI).  Of these deaths the majority die in an unsafe sleep environment.

The City of Milwaukee Health Department strongly advises parents NOT to share a bed with their infant. This is based on an American Academy of Pediatrics 2011 Policy Statement which states that the risk of SIDS has been shown to be reduced when the infant sleeps in the same room as the mother, but the AAP recommends that infants not share a bed with parents or anyone else, due to increased risk.

Co-Sleeping Defined

The term “co-sleeping” can be confusing, as it is used both to refer to sharing a bed and sharing a room. To clarify the distinction, many pediatric experts now refer to “bed-sharing” (referring to a infant who is sleeping in the same bed, couch, or other surface where parents or others are sleeping), and “room-sharing” (referring to a infant who is sleeping in the parents’ room, but in their own crib or bassinet).

Safe Sleep Guidelines

Parents should:

  • Put baby to sleep on their back. Babies who sleep on their backs are safer.
  • Provide a separate but nearby sleeping environment, meaning: babies should share a room with their parents, but not a bed. The risk of SIDS is reduced when the infant sleeps in the same room as the mother.
  • Never put a baby to sleep on a couch or a chair. A crib, bassinette or cradle that conforms to the safety standards is recommended.
  • Make sure that the only item in the crib is a mattress, covered by a tight-fitting sheet. No bumper pads, blankets or toys.
  • Never lay a baby down on or next to a pillow.  Pillows are extremely dangerous for infants as they can cause suffocation.
  • Do not ever use infant sleep positioners.  The FDA says there have been 12 known deaths associated with these products. 
  • Dress the baby in a one-piece sleeper to keep them warm in winter.
  • Keep the room at a temperature that is comfortable for the whole family. But the house should not be too warm.
  • Never smoke in a house where an infant or child lives.

The American Academy of Pediatrics Task Force has found that rates of bed-sharing are increasing, especially as we encourage breastfeeding. But the conclusion of the task force is that bed-sharing, as practiced in the US and other Western countries is more hazardous than the infant sleeping on a separate sleep surface. It is recommended that infants not share a bed with adults.  Infants may be brought into bed for nursing or comforting, but should be returned to their own safe space to sleep when the parent is ready to return to sleep.

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AAP NEWS RELEASE – HALLOWEEN SAFETY TIPS

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NOTEWORTHY WEDNESDAY TUESDAY!

Halloween is one of my favorite holidays…I love the costumes,candy and I especially love the “little ones” coming to the door dressed up.

For the safety of  the kids…the American Academy has issued safety tips for the holiday.

I like to review them to make sure I remember all the tricks that can make a happy holiday a real horror!

AAP NEWS RELEASE – HALLOWEEN SAFETY TIPS.

Gummy Bears…new way for teens to consume Alcohol…

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Underage drinking…I have written about this in the past and just saw this new way for teens to get drunk with Gummy Bears and Gummy Worms…

Just in time for Halloween…

I hope this helps to open up a conversation between you and your children about alcohol use and responsible drinking.

“Hard” Gummy Bears are not for kids…

One of the scariest things about raising teens is the possibility that they might be influenced to drink. You can warn them of the dangers and consequences until you’re blue in the face, but sometimes, peer pressure gets the best of them. The American Academy of Pediatrics found that more than four million adolescents drink alcohol in any month

via Underage Alcohol Usage: Soaking Gummy Bears In Alcohol Is Newest Trend For Teens.

KELOLAND.com Video.

Related Posts:

http://parentingintheloop.wordpress.com/2011/03/16/teenagers-and-alcohol/

http://parentingintheloop.wordpress.com/2011/09/28/other-teens-drink-and-use-marijuana-but-my-kids-dont-do-you-say-this/

http://parentingintheloop.wordpress.com/2011/04/06/alcohol-awareness-month/

Congenital heart disease screening for newborns….

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NOTEWORTHY WEDNESDAY!

There is a new recommendation from the American Academy of Pediatrics and the American College of Cardiology Foundation and the American Heart Association which calls for screening of all newborns for congenital heart defects.

Before newborns leave the hospital, they should receive a simple, pain-free test to check for signs of congenital heart disease, one of the most common types of birth defects, according to a recommendation by a federal advisory panel.

via Congenital heart disease screening recommended for newborns – latimes.com.

A congenital heart defect can be detected early but often goes undetected because newborns can appear normal in the first few days after delivery. The reason these newborns look normal is that fetal circulation may still be functioning somewhat and thus they do not turn ‘blue’ or have a signs of distress until after they are at home.

This is pretty scary stuff for parents. A simple pulse oximetry test can look at the oxygen in the baby blood. It is non-invasive and requires putting an electrode on the newborn’s toe. Although there may be many false positives with this test it can give an indication of whether the newborn is in any kind of distress which is not evident by listening to his/her heart sounds or by looking at his appearance which may indeed be pink and healthy looking.

The question here is what to do if the pulse oximetry is positive indicating that there may be a problem. This has not yet been worked out thoroughly. The newborns that have a positive pulse oximetry may be sent for further testing such as a cardiac ultrasound. Not all hospitals are capable of newborn follow-up so the baby may have to be sent to another hospital for these tests. Parents will be upset and anxious until the results are in…but it is a small price to pay to avoid a possible life threatening cardiac event in the newborn period.

I am not sure what the protocol will be concerning these new recommendations but each hospital will more than likely develop their own response.

Parents need to be aware of these recommendations and the reasons for them so that they can advocate for their newborns and make sure that their precious little ones get checked out thoroughly.

World Breastfeeding Week…

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This is “World Breastfeeding Week”…we know that breastfeeding is “Best for Babes” but not every mother feels that she can adequately breast feed and not every woman wants to breast feed. This being said there are many ways we can encourage women to breast feed and do so successfully.

The following article talks about ways that hospitals can encourage a new mother to breast feed. Many good points are made here…but ultimately the mom will be taking her newborn home after a very short stay in the hospital and the home atmosphere and home support will be the true test of success.

What we need is a “doula” of breastfeeding…a compassionate, educated, non-judgemental mom who is willing to help mother and baby get established in their breastfeeding routine together. This is not an easy task. There is no room for a fanatical breast feeding “doula” who imparts her successful breastfeeding stories and inadvertently guilt to the new breastfeeding mom. This relationship in my opinion can make or break a breastfeeding experience.

Hospitals can only do so much and since hospital experiences are so short  for the new mom in many cases, it is my belief  that for many reasons  hospitals will never provide the support that is needed  for success in breastfeeding.

A new mother’s ability to continue  breastfeeding is influenced by what she  experiences and how much support she receives during the first hours and days after birth. Breast milk is “the perfect nutrition,” says Frieden. It provides antibodies to help newborns ward off illness until the immune system can produce their own, which doesn’t happen until the infant is 6 months old.  Mom’s milk also provides important hormones that help baby regulate how much it needs to eat. Plus, studies have shown that breastfeeding reduces diarrhea, ear infections and bacterial meningitis, as well as cutting the risk of sudden infant death syndrome, diabetes and asthma, according to the American Academy of Pediatrics.

The CDC report says breastfeeding for nine months reduces a baby’s odds of becoming overweight by more than 30%. For babies to get all of these benefits, the AAP recommends that infants should be fed only breast milk for the first six months of life and moms should continue to nurse while they start introducing solid foods until the baby is at least a year old, longer if mom and baby still want to.

In response to this report, the American Hospital Association tells CNN: “Breastfeeding is a personal choice and hospitals will follow the wishes of the mother, be it to breastfeed or bottle feed. There are numerous reaso

ns for the results and those include that hospitals can’t always accommodate a single room for maternity care and some mothers choose to send their babies to the nursery.”

There are of course other ways to help mothers continue to breastfeed. One came earlier this week, when the Department of Health and Human Services adopted recommendations from the Institute of Medicine, which will require insurance companies to pay for breastfeeding support, supplies and counseling, without any cost to the insured (aside from her regular insurance premiums of course), starting in August 2012.

via Hospitals need to do more to help moms breastfeed – The Chart – CNN.com Blogs.

“Best for Babes” is a wonderful organization which is totally on the right track in trying to assist the breastfeeding mom and baby. We need more involvement like this in order to promote successful breastfeeding. Here is the mission of “Best for Babes” for those of you who are not familiar with this organization.

The amazing health, economic and environmental benefits of exclusive breastfeeding for six months or more are well-established.  Moms know this — they want to breastfeed. But sadly, very few of those who start or plan to start make it past the first few days — they struggle and suffer unnecessarily and give up, understandably, long before they intended to.  Too often, it’s not their fault!  They are being set up to fail by the very people and places that are supposed to help them — by the Booby Traps– the many cultural and institutional barriers that prevent them from achieving their personal feeding goals.

BFB’s mission is to help turn this situation around by bringing the power and influence of a consumer-driven, celebrity and corporate-backed, mainstream independent nonprofit –the Mother of All Causes –to bear on this issue;  to help create permanent  culture change that embraces, celebrates and supports breastfeeding and moms!  As a nonprofit foundation, we serve and complement the heroic, long-term efforts of the existing breastfeeding community and we lend added value by being able to harness and leverage the collective power of celebrities, corporations, foundations, the public sector, advertising, the medical community and the media.

March of Dimes takes stand….

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I was so excited when I read this letter from the President of the March of Dimes to Ther-Rx regarding Makena.

As a maternal-child nurse and clinical social worker I know from experience how important it is for patients to be able to have access to important medications like Makena. I am so pleased to see the March of Dimes take such a pro-active response to the current situation concerning the affordability of Makena and its availability to the patients that need it.

Thank you March of Dimes!

March of Dimes demands action:

“A letter from Dr. Jennifer Howse, March of Dimes President, to Greg Divis, President Ther-Rx Corporation regarding Makena.

March 23, 2011

Greg Divis, President

Ther-Rx Corporation

One Corporate Woods

Bridgeton, MO 63044

Dear Mr. Divis:

Thank you for your letter of March 17th.  I am pleased to learn that you are ‘listening carefully to stakeholder concerns about list price, patient access, and cost to payers’.  Thank you for considering additional steps to ensure that Makena is available to all eligible women, and for  convening stakeholders from the March of Dimes, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the Society for Maternal Fetal Medicine next week.

In advance of that meeting, I want to go on the record that March of Dimes expects Ther-Rx to come to the table  with substantive commitments including:

1) A significant reduction in the list price of Makena.

2) Adjustments to the patient assistance program to ensure adequate coverage of all patients, insured, uninsured and underinsured.

3) A method for reporting on a regular basis to stakeholders on the patient assistance program to ensure that it is meeting needs in a timely and adequate way.

4) A justification or rationale for your pricing based on your investment in the product, savings to the health care system, or other appropriate methodology, which you are prepared to make public.

Without these elements, I do not believe that Makena can succeed in the current marketplace environment, and as a result, at -risk women will be denied access to a safe and effective treatment to reduce preterm delivery.  Therefore if you are unable to make a clear commit-ment to significantly address the above issues at the meeting, the March of Dimes will need to pursue alternative strategies for ensuring that this proven intervention to prevent preterm birth is made available to all medically eligible pregnant women, and we will step away from our longstanding and productive corporate relationship with Ther-RX.  Thank you for your consideration of this critical matter.

Sincerely,

Jennifer L. Howse, PhD

President

Tags: 17p, Makena, Ther-Rx

via News Moms Need » Blog Archive » MOD demands prompt action.