Date: March 19th 2004

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BABY 411 NEWS UPDATE: March 2004
The free eNewsletter for the readers of BABY 411
http://www.Baby411.com
March 2004
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In this email:
1. TOP STORY: New ear infection treatment guidelines
2. Obesity and soft drinks
3. Chickenpox outbreak in vaccinated children
4. Do moms confide in their pediatrician?
5. MMR and autism study refuted

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Here’s what is new in healthcare for your baby:

1. TOP STORY: New ear infection treatment guidelines


The American Academy of Pediatrics and American Academy of Family Physicians released their much-speculated revised treatment guidelines for ear infections this month. For the complete recommendations, go to www.aap.org. Why the change you ask? Antibiotic resistant bacteria are on the rise. The only way to have effective antibiotics to fight bacterial infections when we need them is to avoid using them when we don’t. Up to 80% of ear infections will clear WITHOUT antibiotics.

Infants under six months of age with acute middle ear infections will still get treated with antibiotics. These little ones are more likely to have complications related to ear infections and get sicker more quickly.

Children ages 6 months to 2 years of age with clear cut ear infections will also still be treated with antibiotics. When the diagnosis is questionable though, medical providers may opt to ‘wait and see’ how a child is doing in 2-3 days before prescribing an antibiotic. In the past, the mantra was, “When in doubt, treat.” The new mantra will be, “When in doubt, wait and see.”

Children 2 years to 12 years with clear cut ear infections who are not in severe pain and lack a high fever may be sent home without an antibiotic with a follow-up plan in place in the next 2-3 days. If there is no improvement in a child’s symptoms or exam, then antibiotics are in order.

The guidelines leave it up to the medical provider to implement a treatment plan based on each individual patient. Some doctors may opt to send a parent home with a safety-net prescription to fill if the child’s symptoms are not improving. Others may prefer to see the patient back in the office in a couple of days to reevaluate the child, or have the parent follow-up by phone.

Okay, I know what is running through your mind. While these guidelines are helping mankind, what do you do with you own child who is screaming all night with an earache? The guidelines also address this question. A study compared kids who were treated with antibiotics for ear infections and those who weren’t. Whether kids got antibiotics or not, 60% had less pain within 24 hours of their complaints- the antibiotics themselves do not provide pain relief in the first 24 hours.

Bottom line: If your child is crying in pain, he won’t be sent home without an antibiotic. The guidelines are attempting to limit antibiotic use in kids with mild to moderate symptoms and avoid use when the diagnosis itself is questionable (not all ear infections are so black and white).

Look for more information about ear infections and treatment in our special section in Baby 411.

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2. Obesity and soft drinks-

We have all heard about the obesity epidemic affecting our country. One study has shown a 60% increased risk of obesity by drinking just one can of soda a day. (A12 oz can contains 150 calories and 10 teaspoons of sugar). The American Academy of Pediatrics has numerous recommendations, including that soft drinks and fruit flavored drinks should not be sold in elementary schools. One issue is that schools benefit from contracts with soft drink manufacturers-to the tune of $200 million nationwide. Bottom line: Encourage your school to require soft drink manufacturers to sell 100% fruit juice, milk, and water in vending machines and create a nutrition advisory panel if your school doesn’t have one.

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3. Chickenpox outbreak in vaccinated children-

A recent study looked at an outbreak of chickenpox infection at an elementary school in Oregon where 97% of the students were vaccinated against the disease. The study found that children who had been vaccinated more than 5 years prior to the outbreak were more likely to catch the illness. Vaccine effectiveness was about 72% in complete protection from disease. The kids who ended up with the infection had very mild cases (less than 50 pox) as compared to unvaccinated kids who routinely get about 350 pox lesions.
Bottom line: Chickenpox vaccine is given to kids under 12 years of age only once. A booster dose may be recommended in the future if we continue to see outbreaks. The good news is that even if the vaccine is not 100%, kids still are protected from serious infection.


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4. Do moms confide in their pediatrician?

A study released this month looked at mothers of young children and whether or not they felt comfortable discussing their ‘emotional health’ with their pediatrician. Although pediatricians could be a resource for help, many moms reported that admitting parenting stress would be admitting failure. They relied on lactation groups, postpartum groups, playgroups, and the Internet as sources of support. Yet, over 50% of pediatricians feel it is their responsibility to recognize postpartum depression.

One mom in the study said it best,” The pediatrician has a wonderful opportunity to treat the entire family for the benefit of the child.”

Bottom line: Most pediatricians feel that their job description includes making sure that moms are doing okay with life. Test the waters next time you visit your child’s doctor-you might be pleasantly surprised.

5. MMR and autism study refuted-

A study published in 1998 by the journal Lancet was recently refuted. The “Wakefield Study” looked at the possibility of the combination of Measles, Mumps, and Rubella vaccine causing autism. Ten of the 13 investigators in the original study have refuted the findings based on significantly more data that has been evaluated. It also appears that Dr. Wakefield recruited research subjects who were involved in lawsuits against vaccine companies. Dr. Wakefield has now hit the U.S. soil, opening up autism centers across the country.


That’s the news from here!

Denise Fields
Ari Brown, MD
Co-authors, BABY 411

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Think of it as the ultimate FAQ for new moms and dads! Check it out Baby 411 here: http://www.Baby411.com





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