Date: July 6th 2004

Baby 411 E-News July 2004: New jaundice rules, cough medicines, swimmer’s ear, early signs of autism, peanut allergies

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BABY 411 NEWS UPDATE: July 2004
The free eNewsletter for the readers of BABY 411
http://www.Baby411.com
July 2004
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In this newsletter:

1. AAP revises guidelines to prevent brain damage in newborns
2. Do cough medicines help sick kids sleep?
3. Swimmer’s ear prevention
4. Early signs of autism
5. Good news for kids with peanut allergy

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1. AMERICAN ACADEMY OF PEDIATRICS REVISES POLICY STATEMENT FOR MANAGING JAUNDICED NEWBORNS

A rare, but preventable form of brain damage (see ‘kernicterus’ in Baby 411) is caused by the collection of body garbage (‘bilirubin’) in the brain. Newborns are at risk for this problem because they eat poorly in the first 5 days of life and thus, do not eliminate it effectively in their poop.

About 60% of the 4 million babies born in the U.S annually will experience some yellowing of the skin (jaundice) shortly after birth. Only a small fraction of those babies are at risk of brain damage, but they all need to be followed more closely so none are missed. Levels of jaundice start to rise just as most newborns are going home from the hospital at 48 hours of life. The levels usually peak between 3-5 days of life.

Certain factors put some babies at higher risk: prematurity, blood type (if mom is O and baby is A or B), birth trauma (head bruises), Asian or Mediterranean ancestry, or history of a sibling with jaundice. Additionally, breastfeeding may also be a risk factor if the newborn is not feeding at least 8 times a day or there is a delay in mother’s milk coming in.

Because of the increased number of newborns that are breastfed, and that brain damage is almost always preventable with close monitoring, the AAP has modified its policy statement to reflect this.
The recommendations are:

1. Screen all babies thoroughly for the risk of severe jaundice.
2. Improve education and breastfeeding support for parents while they are in the hospital.
3. Breastfeed at least 8 times per day.
4. Routinely schedule an appointment with the baby’s medical provider at 3-5 days of life. (even if that means an appointment on a weekend)

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2. DO COUGH MEDICINES HELP SICK KIDS SLEEP?

A study published in the July issue of the journal, Pediatrics, looked at 100 children who took over-the-counter cough medicines and whether they slept better or not. The verdict: the kids who took the cough medicine did not sleep any better than those who were medication-free (and neither did their parents).

The bottom line: Since kids do about the same with or without cough medicine, you might want to re-think using these products.

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3. SWIMMER’S EAR PREVENTION

With summer upon us, many children visit their pediatrician for swimmer’s ear. This is an infection of the skin that lines the external ear canal. It’s different that the middle ear infections that occur behind the eardrum after children have had a cold.

Swimmer’s ear is caused by water that sits in the ear canal after a day of diving, swimming under water, and playing too much Marco Polo. A bacteria that loves water grows in that stagnant water and makes the skin get swollen and red. Needless to say, infants and toddlers are at low risk of getting swimmer’s ear. But if you have an older child who fits this description, there is an easy way to prevent it.

After your child has finished swimming, place 2 drops of rubbing alcohol and 2 drops of vinegar in each ear. This dries out the water and changes the pH of the skin so the bacteria cannot grow.

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4. EARLY SIGNS OF AUTISM

With autism in the news, many parents have concerns about their own child’s development. A checklist (called CHAT) is available for pediatricians to administer for toddlers 18 months of age to serve as a screening tool. Signs of autism develop before this age, but become more apparent in this age group.

Early signs of autism include poor nonverbal communication skills. By one year of age, many children ‘point and grunt’ to express what they want. Autistic children often do not use their finger to indicate a desired object. Autistic children may also have difficulty changing the focus of attention from one activity to the next.

In the toddler age group, autistic children have difficulty with ‘symbolic’ or imaginary play. For instance, they will not pretend to feed a doll or serve food to a parent. Language delays also become more obvious when these children do not start to learn new words.

Children who fail the CHAT screening test should get further testing. There are also other medical causes that need to be ruled out for children who fail the screening test.

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5. GOOD NEWS FOR PEANUT ALLERGIC KIDS

Several studies have looked at kids with peanut allergies recently. One study showed that over 90% of children with severe peanut allergies would not have an ‘anaphylactic’ reaction after having skin contact with peanut butter. This has been a concern for allergic kids when they reach school age and are constantly exposed to another child’s PB & J sandwich in the lunchroom. But remember, it’s always important to have an Epi-pen available for an emergency.

More good news: A new medication is in the works for peanut allergic kids. It is called a ‘monoclonal antibody’ and it would decrease a person’s sensitivity to peanuts. People who eat a trace amount of peanut and have a serious reaction might be able to handle up to 9 peanuts without a problem with this medication.

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That’s the news from here! Thanks for reading Baby 411!

Ari Brown, M.D. & Denise Fields, authors
BABY 411
Web: www.Baby411.com