UK watchdog issues new guidance on treating jaundice in babies

The UK watchdog NICE has issued new, stricter guidance on how medical professionals should better diagnose and treat jaundice in babies.

New guidance issued by the National Institute of Health and Clinical Excellence suggests that newborns suspected of having jaundice should receive blood tests within two hours of birth to verify the condition.

Doctors, nurses and midwives have traditionally gauged babies for jaundice by visually checking the color of the skin and eyes. Jaundice, a condition typically caused by an undeveloped liver, is associated with yellow skin and whites of the eyes. The yellowing is a result of the liver not being able to process bilirubin, a byproduct of broken down red blood cells.

“Clinical recognition of the severity of the jaundice can be difficult, especially in babies with darker skin tones, and uncertainty currently exists about when and how to treat it,” said Dr. Fergus Macbeth, the director of the Centre for Clinical Practice at NICE, in a press release.

This new guideline aims to address this by helping midwives, health visitors and pediatricians, amongst others, recognise and treat neonatal jaundice to prevent problems like kernicterus,” added Macbeth.

While most instances of jaundice are little to worry about, complications do occur, sometimes in the form of kernicterus, a neurological condition linked to cerebral palsy, hearing loss and deficiencies in the eyes and teeth.

“The majority of babies will develop jaundice in their first week of life, and it will be generally harmless in most cases,” said Macbeth.

“Although the condition does have the potential to become serious, it can usually be easily treated with timely and appropriate medical care. This guideline will ensure that happens.”

Dr. Janet Rennie, the chair of the Guideline Development Group and a consultant neurologist at University College Hospital London, agreed that the new guidelines were required.

“These recommendations should ensure that babies who have factors associated with an increased likelihood of developing significant jaundice are identified earlier so they receive prompt effective and appropriate treatment, directed at preventing permanent damage,” said Rennie.

The full guidance document can be found on the NICE Web site.

         

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Study: educational videos don’t help babies learn vocabulary

A recent study has added to the evidence that educational videos aren’t helpful for babies trying to acquire new vocabulary.

Many companies creating media directed at infants have claimed that infants can learn vocabulary through the media. Those claims have largely been unsubstantiated until recently.

A new study out of the University of California-Riverside that infants likely don’t learn new vocabulary by watching educational DVDs and in fact may be hindered by such activity.

The research team examined 96 toddlers between the ages of 12 months and 25 months, giving a Baby Wordsworth DVD (part of Disney’s Baby Einstein collection) to the parents of half the babies while the other half received no special educational material. The parents who received the 35-minute video were told to have their babies watch it in the attempt to learn 30 English words highlighted by the video.

The study lasted six weeks, and all babies were brought to the laboratory every two weeks. They were all tested on their vocabulary, specifically focusing on the vocabulary of the video.

The researchers found no evidence that the DVD had helped the babies learn the vocabulary.

“Apart from the gains in word knowledge we would expect from developing children, there was no evidence that children learned words specifically highlighted in a DVD focused on teaching children those words,” wrote the study authors.

Though the researchers didn’t find any significant difference in cognitive ability scores between the two groups, they did notice something curious. They found that the lower the age of the child that first watched the DVD, the lower the language-related test score.

Time journalist Alice Park speculates that overstimulation of the brain by the video may be one possible culprit. Past research suggests that young children are better off learning from a live speaker who both engages with them and repeats vocabulary, especially while look at the specific object.

Park also suggests that the simple act of replacing parental interaction time with a DVD decreases the opportunities for the young child to learn.

“Given that infant-directed media have become nearly ubiquitous aspects of many infants’ lives, future research should continue to examine whether and how parents can use these DVDs effectively to teach their young children,” said lead author Dr. Rebekah Richert.

However, Richert noted that completely removing the media may not be completely realistic. She told Time, “[Parents] can use them to sometimes teach children, but they should be aware that without being involved themselves, children aren’t likely to learn.”

The study appears online in the March issue of the Archives of Pediatrics and Adolescent Medicine.

         

Motor skill development in babies linked to learning

The motor skill development of babies has been linked to learning and behavior issues by a major British study.

New research has found that it may be beneficial to monitor the development of motor skills in babies in order to identify those children that may require learning assistance later in childhood.

The Millennium Cohort Study, conducted by the Institute of Education at the University of London, found that young children who didn’t reach key milestones in their motor skill development by year one typically had learning and behavioral problems at age five.

“We found that delay in gross and fine motor development in a child’s first year, which affects about one in 10 children, was significantly associated with delayed cognitive development at age five,” the study authors said.

“Delay in gross motor development also has a significant impact on the child’s behavioral adjustment at five. This additional finding confirms the importance of screening for developmental delay before the first birthday.”

The study focused on 14,853 children born in the U.K. between 2000 and 2001 and conducted research until they reached the age of five. Numerous picture, spatial reasoning and vocabulary tests were used to access cognitive development in the five year olds and the results were compared to previous years. The psychological characteristics of the mother were also gauged to help paint a better picture of the relationship between the mother and her child.

On average, those children that had difficulties with fine motor skill assessment at nine months were five points behind in cognitive ability tests at age five, compared to those that didn’t have problems with their motor skills.

An additional gap was found between those children who were raised in persistent poverty and those that never received “means-tested” benefits. There was an average difference of 11 points on cognitive ability tests between the two demographic groups.

Through the research, the team discovered that there were certain steps a mother could take to help reduce the risk of cognitive delays.

For example, researchers found that those children who were consistently read to at the age of three demonstrated stronger ability on a wide range of subjects at age five. They also discovered that in poorer families, a strong mother-child relationship significantly benefited the child’s cognitive and behavioral development.

The study was commissioned by the Economic and Social Research Council, the U.K.’s leading agency for funding and training in the economic and social sciences.

         

UK doctors and nurses issued warning about antibiotics for babies

UK doctors and nurses are being warned about the dangers of adverse reactions to babies that receive powerful antibiotic treatments.

The National Patient Safety Agency and the Royal College of Paediatrics and Child Health have drawn up new guidelines meant to aid doctors and nurses in the U.K. with decisions regarding antibiotics for babies.

Gentamicin, an antibiotic used to treat bacterial infections typically caused by Gram-negative bacteria, was reported to have caused 507 cases of harm or potential harm in babies last year. This caused the NPSA to write up new guidelines for the use of gentamicin.

The NPSA’s Jenny Mooney said, “Frontline services should adopt this latest Patient Safety Alert to ensure high standards of care are taken in the prescribing, administrating and monitoring of this drug.”

While the drug was reported to have caused little to no harm to in 483 of the cases, 23 cases of moderate harm occurred from its use as well as one severe case. Issues involving the drug included giving the drug at the wrong time of day, prescribing the wrong dosage and failing to monitor blood levels.

The new guidelines call for all hospitals to have a clear protocol on dosage levels and blood level monitoring in order to combat potential side effects like kidney and hearing damage.

Baby charity Bliss welcomed the news by the NPSA, with chief executive Andy Cole telling the Telegraph: “We welcome the recommendations … for the administration of the antibiotic gentamicin and are delighted that these crucial issues in neonatal care have been addressed by the NPSA.”

“It is imperative that all drugs are given as safely as possible to sick babies to ensure that adverse reactions are minimized. It is important that parents are informed about the possible risks of any course of treatment for their baby and that they are able to discuss and properly assess the clinical options presented to them.”

“Ensuring the baby’s best interest is paramount,” he added.

         

Could bacon and eggs boost brain development in a mother’s unborn child?

New research suggests a link between eating foods like bacon and eggs and the brain development of a mother’s unborn child.

Foods like bacon, eggs, liver and wheatgerm contain a nutrient that is essential to the development of a healthy brain according to new research out of the University of North Carolina.

Dr. Steven Zeisel, Dr. Mihai G Mehedint and a team of other researchers focused on the nutrient choline and its effects on fetal brain development in mice. Using a group of pregnant mice, the team randomly split them up into two groups, one that received a normal diet and the other a diet without choline. Both groups received the diets after 11 days of pregnancy.

After 17 days of pregnancy, researchers looked at an area of the fetal brains called the hippocampus, responsible for long-term memory and spatial navigation. They found that in the developing brains of baby rats that didn’t receive choline in the diet, a particular protein was missing. This missing protein essentially caused the switches in the hippocampus to turn off, telling that region of the brain to not develop nerve cells.

“Our study in mice indicates that the diet of a pregnant mother, especially choline in that diet, can change the epigenetic switches that control brain development in the fetus,” said Dr. Zeisel. “Understanding more about how diet modifies our genes could be very important for assuring optimal development.”

The researchers cautioned that the research doesn’t automatically apply to humans. Additionally, as intelligence tests were not applied on the mice later, no conclusion could be drawn about the effects of a choline-light diet on intelligence. But the results give the team further incentive to move to the human brain and determine how diets low in choline may affect human brain development.

So while it’s generally known that choline, a nutrient found in bacon and eggs, is useful, more research is needed in humans before doctors can recommend a modified bacon and egg diet to future mothers. Expectant mothers who consume a healthy balanced diet are likely to receive enough choline in their diet. But it also doesn’t mean a hearty breakfast is completely unhealthy.

“We may never be able to call bacon a health food, but the emerging field of epigenetics is already making us rethink those things we consider unhealthy,” said Dr. Gerald Weissmann, editor of the journal Federation Of The American Societies For Experimental Biology. The research was published in the January edition of the journal.

         

New research shows breast milk not nearly as important as originally thought

New research out of Norway finds that the association between breast milk and baby health is not as strong as originally thought.

The general medical consensus over the last few decades has been that a breastfeeding baby is healthier than a bottle-fed baby. However, researchers at the Norwegian University of Science and Technology (NTNU) say that correlation isn’t necessarily true.

The research team, based out of NTNU’s Department of Cancer Research and Molecular Medicine, focused on the data and results of over fifty international medical studies performed to find relationships between baby health and breastfeeding.

After a thorough analysis, the team found little correlation between babies that were breastfed and their future health. Rather, they found that the prevalence of male hormones (known as androgens) in the bodies of pregnant women had a direct impact on how much those women breastfed after giving birth.

“Pregnant women who have higher levels of androgens breastfeed less,” said head researcher, Dr. Sven M. Carlsen. “Probably, this is a direct effect of hormones that simply limit nursing ability by reducing milk production in the breast.”

Dr. Carlsen and his team have been researching how hormones affect pregnant women and their babies for years. During that time, the researchers have compiled a list of risk factors that likely affect a woman’s ability to breastfeed. Women who are obese, smoke, or suffer from the hormonal disorder polycystic ovary syndrome have been shown to breastfeed less. And they all have higher levels of male hormone in their body while pregnant.

“It’s thus not the woman’s will to breastfeed,” said Dr. Carlsen. “Women who had more testosterone in their bodies during pregnancy feel the effects of a hormone that limits breastfeeding. That is clearly why it is not as easy to breastfeed.”

The researchers began to see patterns in the data, and they drew the conclusion that the placenta is more relevant to a baby’s health than breastfeeding.

Carlsen explained that during a normal pregnancy, hormones from the fetus are sent to the placenta, where they are converted into testosterone and estrogen. This conversion requires significant energy, and if there isn’t enough energy available to convert testosterone into estrogen, an overabundance of male hormone is free to affect both mother and child.

In the mother’s case, this extra male hormone reduces the growth of glandular tissue in the breast and in turn reduces the breast’s ability to create milk. In the child’s case, the extra testosterone may lead to an increased risk of obesity, diabetes and, in the case of girls, polycystic ovary syndrome.

“We find it very interesting that almost all of the factors previously shown to be associated with breastfeeding can be explained by changes in testosterone levels in the mother during pregnancy,” said Dr. Carlsen.

“There are many good reasons to breastfeed. But concern for the child’s health is not one of them. There is no reason why women who are struggling to breastfeed should have to go around feeling guilty, or think that they are giving their child a poor start in life if they can’t nurse. Baby formula is as good as breast milk.”

The research is published in January’s edition of the journal Acta Obstestricia and Gynecologia Scandinavica.

         

New research suggests breast milk can be stored safely for at least 4 days

A small research project focused on storing breast milk has found that it may have a longer shelf life than originally thought.

Dr. Richard Schanler and Dr. Meredith Slutzah, of Schneider Children’s Hospital in New York, had questions regarding the storage of breast milk. The duo knew there were concerns about bacteria growth but wanted to also test the overall integrity and nutritional quality of stored breast milk.

They set out on a small research project to test their theories. They recruited scientists at Schneider’s and Yeshiva University’s Albert Einstein College of Medicine to collect, store and test the breast milk of 36 mothers.

Those mothers waited until about a month after giving birth to use a breast pump to collect milk for the team. The milk was then refrigerated at 39 degrees F and tested at 24-hour intervals for four days.

Researchers tested acidity, bacteria levels and prevalence of beneficial proteins and fatty acids in the milk, finding little to no degradation of quality over the four-day period.

Dr. Schanler said that strict regulations at Schneider’s prevented long-term storage of breast milk at the hospital. “We didn’t like to store it longer than 48 hours and that prompted us to do this study, and we found there really weren’t many changes (in the integrity of the breast milk) up to 96 hours,” he said.

Dr. Schanler hopes that their research will shift the opinion of hospital staff towards longer-term storage. Additionally, he emphasized that the results may be useful for working mothers who may have difficulty finding time to feed their infant.

The research, published in January’s Journal of Pediatrics, suggests maintaining human breast milk in glass containers or plastic containers free of bisphenol A. The researchers suggested a storage temperature of 39 degrees F or slightly cooler with placement of the containers near the back of the refrigerator.

Schanler cautioned that freezing breast milk isn’t recommended as key infection-fighting cells are destroyed, cells that protect against bacterial colonization. Additionally, vital nutrients may be lost with the freezing process.

         

Online survey finds 1 in 6 British children have speech problems

Nearly 1 in 6 British children have difficulties learning to speak according to a new online survey.

Internet-based market research firm YouGov released the results of its survey of 1,015 parents in England, revealing speech difficulties in one out of every six children.

The survey, given in December, focused on children under eight from different populations. It found that 22 percent of boys faced difficulties with speaking and understanding others’ speech, compared to 13 percent of girls.

Additionally, the survey, commissioned and published by England’s new Communication Champion Jean Gross, found that some three-year-old children were unable to speak a word.

“Our ability to communicate is fundamental and underpins everything else. Learning to talk is one of the most important skills a child can master in the 21st century,” said Gross, appointed to the newly-formed position of Communication Champion in October 2009.

“The proportion of children who have difficulty learning to talk and understand speech is high, particularly among boys,” she added.

Through the survey, boys were found to be twice as likely as girls to exhibit major speech difficulties. Additionally, nearly a quarter of all children with speech difficulties didn’t receive help of any kind for their impairment.

“It is essential that all children get the help they need from skilled professionals as early as possible. The lack of this is cause for great concern because the results of this poll shows that parents place learning to talk and listen as a top priority for their children, whatever their social class, and do a great deal to help them learn to communicate.”

Many children receive help with speech difficulties from a teacher or staff at a nursery. But the survey suggested that many parents didn’t know who they could turn to for help despite ranking the ability to talk, listen and comprehend as being most important.

As part of her duties as Communication Champion, Gross will head a committee to plan and organize a “National Year” in 2011 with a strong focus on the need to better children’s communications skills.

         

Father plays important role in future health of baby

A father’s lifestyle and age likely play an important role in the future health of his child.

When it comes to pregnancy, women get all the press. After all, they carry most of the burden, right? Media constantly tells pregnant women to avoid certain foods, keep certain habits and maintain certain routines.

But should the father be relegated to the sidelines? While most of the attention is focused on what the woman can do better her chances for a healthier child, most media gives little focus to the father’s lifestyle. Yet there have been many research studies performed on males, their habits, and how those habits influence the health of their children.

In a June 2009 article titled “Throw of the dice”, the magazine Cosmos addressed this issue. Emma Young, a science writer for the magazine, interviewed numerous experts and collected research that shows a father’s age at conception and his lifestyle before conception may have an impact on the health of his future child. That it hasn’t received as much attention is surprising.

Young talked to Dr. Cynthia Daniels, a professor of political science at Rutgers University. “It’s a function of gender bias that we haven’t focused more attention on the role of men in healthy pregnancy outcomes,” Dr. Daniels told Young. “We continue to see reproduction as the exclusive responsibility of women — and we’re reluctant to recognize men’s responsibilities as well.”

But men do have a responsibility, at least according to research studies. Young goes on to detail many instances of research that show men’s age and what they expose themselves to have impacts on children’s future health.

For example, Young points out research that finds that fathers aged 40 and older are twice as likely to have a child with schizophrenia as fathers under the age of 30. She points out that it’s not just one research study, but several carefully controlled studies. She also notes that Swedish researchers found that bipolar disorder was 1.37 times more likely in children born to a father aged 55 or older, compared to young fathers in their early twenties.

As for non-age related issues, Young highlights studies on alcohol, cigarette smoke, drugs and pesticides. For example, sperm abnormalities caused by a father’s heavy alcohol consumption may pass on birth defects to a child. Children may be heavier than normal if their fathers began smoking at an early age. Men who are exposed to pesticides frequently may go on to have children with increased cancer risks.

Later in the interview, Dr. Daniels tells Young: “If I were a young woman planning my family, I would consider not only the age of my partner, but also his possible exposures to workplace and environmental toxins, excessive use of drugs and alcohol, and cigarette smoking. And I would be quite angry that we as a society haven’t paid more attention to this possible risk of harm.”

Dr. Daniels’ opinion may be strong, but it still rings true. In a modern world where women are the primary focus of children’s futures, men’s roles in the development of a child shouldn’t be forgotten. Additionally, it should be noted that our environment affects our health and our genetics. Regardless of gender, what we put into our bodies and how we age affect our ability to procreate effectively. Man and woman are in the procreation business together, and the lifestyle and age of each plays an important in that business.

For Emma Young’s full article in Cosmos, you can find it here.

         

Negotiations break down in swine flu jab program for children under five

Negotiations between the government and general practitioners have broken down regarding a proposed plan to vaccinate children under five for the swine flu.

Children between six months and five years of age in Ireland, Scotland, the U.K., and Wales were expected to be able to receive the swine flu jab beginning in mid-December.

However, due to discrepancies in how GPs would be able to make time in their schedules without losing income, the negotiations broke down on Tuesday. The Daily Telegraph reports that demands by ministers for GPs to see patients within a 48-hour time period were too strong. GPs feared that income penalties would be too high when missing the 48-hour window.

Dr. Laurence Buckman, Chairman of the British Medical Association’s General Practitioner’s Committee, told the Telegraph: “We sincerely wanted to be able to reach a national agreement with the U.K. governments about a process for vaccinating the under fives against swine flu. Unfortunately this has not been possible because the government would not support adequate measures to help free up staff time.”

“At the busiest time of the year for general practice, with surgeries already dealing with the additional work of vaccinating the first wave of at-risk groups, we felt this was vital in order to ensure this next phase could be carried out quickly.”

“We appreciate that parents of young children might be worried when they hear that there will be no national framework and want to assure them that this does not mean their children will not be vaccinated.”

Dr. Dean Marshall, representing Scotland’s GP’s Committee, explained that the decision made by GPs was based on the 48-hour rule and its “unfair” constraints.

“If I am being monitored on access, then my access isn’t going to be as good if I have got an extra 700 appointments for children,” Dr Marshall told The Scotsman.

“So it wasn’t about us doing it or not. It wasn’t about more money. It was about how we were going to fit that in, in addition to everything else we are doing at the busiest time of the year. It seems slightly unfair to be monitored on access, which could result in defunding my practice at a time when I am prioritizing access for children.”

Dr. Brian Dunn, Chairman of the British Medical Association’s Northern Ireland GP’s Committee, confirmed that time was an issue, telling the Belfast Telegraph, “The government would not support adequate measures to help free up staff time to deliver this phase of the H1N1 vaccination program in what is the busiest time of the year for general practice.”

Due to the breakdown, negotiations will be needed on a more local level. Local NHS offices are expected to begin working with GPs in their regions to come to an agreement.

Representing the Welsh GP’s Committee, Dr David Bailey told Wales Online: “I hope that NHS boards and local medical committees work together to reach agreement swiftly on local deals that provide the much needed flexibility that practices require in order to cope with their current workload as well as delivering the vaccination program.”

It’s not clear at this time if a universal agreement will be reached between GPs and the governments. Many GPs have already made a good-faith effort to fit more children requiring the vaccination into their schedules despite existing time constraints.

         

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