In the Car: Rear Face as Long as Possible

In the Car:  

Rear Face as Long as Possible

The American Academy of Pediatrics has just issued a new guideline:  keep your infant facing backwards until age 2, unless they outgrow their rear-facing car seat.

As doctors, we spend a lot of time and energy thinking and responding to illnesses, but for Americans ages 1-50 years old, injuries are the #1 cause of death, far more likely to cause harm and fatality than any illness or condition.  That makes injuries the very #1 cause of death and harm in childhood, after one year of age!

One of the main causes of death and harm from injury is the car.  We are used to cars, nearly everyone has been in one, so we tend to forget just how dangerous they really are.  Cars are far more safe now than many years ago, but still remain the most dangerous part of our lives.

Perhaps the greatest step forward in reducing the chance of death or injury has been the invention of the seat and shoulder belt.  Wearing it saves lives, lots of them.  Cars, however, are sold to adults, not kids, so their safety belts only fit people who are taller than 4 foot 9 inches.  If you are shorter than that, at any age, you need some sort of adapter to have the seat and shoulder belts actually fit, that is, actually work.

Until this month, the recommendation for children from birth to 1st birthday was to be in an infant car seat, facing backwards, until both 1 year old AND 20 pounds.

A study from 2007 recently showed that the benefit of facing backwards should be extended another year.

http://www.ncbi.nlm.nih.gov/pubmed?term=henary%20B%2C%20Sherwood%20CP

This study found that for children ages 1-2, the risk of serious injury was indeed reduced if they were facing backwards.  I have reviewed this study and find that the evidence is compelling.

Therefore, we at Advanced Pediatrics support the AAP recommendation and urge all families to have their children, when in a car, be in a rear-facing car seat to age 2, unless they cannot obtain a car seat that can fit their child up to that age.  In which, case the child should advance to the larger seat prior to age 2.

Dr. Arthur Lavin

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

A Curious Finding Suggests Immunizations May Prevent Some Cancers

A Curious Finding Suggests 

Immunizations May Prevent Some Cancers

A well-respected team of researchers from one of the nation's leading medical centers, the Houston Medical Center, has published a strong association that suggests that childhood immunization may decrease the risk of developing childhood cancer, in particular childhood leukemia, brain tumors, and lymphoma.

http://www.jpeds.com/article/S0022-3476(10)01048-6/abstract

This rather remarkable claim at this point is simply an observation.   The authors report that if you look at thousands and thousands of children across Texas who did and did not develop these cancers, a pattern emerges in which those who received immunizations were less likely to develop the most common forms of childhood cancer.  The overall reduction in the childhood cancers studied was 20% and for some immunizations the level of prevention went as high as nearly 40%.  A curious linkage between chickenpox and brain tumors was found as well, where getting the varicella (chickenpox) vaccine or the actual disease decreased the chance of developing brain tumors.

No one knows for sure what the cause of this observation is.  We are not even sure if the observation will yield a real cause-link between getting immunizations and less cancer in childhood or whether something else related to getting immunized is the explanation.  The authors did a very good job of eliminating other possible causes such as parental education, social status, smoking, age, and many other possible influences.

If this observation stands up to further scrutiny, it will advance the compelling emergence of the very curious "hygiene hypothesis."  This concept emerged from the fact that allergies are raging across the developed world.  In the 1960's only about 0.1% of men in Finland had any sort of allergic disease (eczema, hay fever, asthma).  Now about 11% do.  One explanation being put forward is that as the modern world has reduced the burden of infectious diseases, the immune system has switched from killing deadly germs to attacking harmless substances like dust, pollen, and milk.  There is actually a growing body of proof to support this idea.  We can measure the level of dirt that kids on farms eat, and the more dirt they eat, the less allergy they develop, and at no cost, they have no more actual infections, just more exposure to a wider variety of germs.

The idea flies directly in the face of the fear of germs and also against the widely held belief that a newborn's immune system is a delicate thing that best not be perturbed.   The hygiene hypothesis boldly states that the developing immune system needs a good fight to properly mature, and failing that it will take matters into its own hands and start picking fights that cause the child to have allergies.

Now, the researchers in Houston have added more fuel to this intriguing idea, by observing that perturbing the immune system with shots may actually help it prevent childhood cancer.  Again, this is not an observation that has any explanation proven yet.  But in these days of grave concern over the impact of immunizing children against many illnesses, I felt it was urgent that families know that it may turn out that immunizing their children will do far more than protect them against dangerous infections, it may help their immune system protect them against cancer.

Please also note that this research received no support from any drug company and had no other conflict of interest as well.

Bottom Line

A trustworthy group of researchers from one of country's leading medical centers has found an association between having your child fully immunized and a 20-40% drop in the chance of developing childhood leukemia, brain tumor, and lymphoma.

If this finding holds up, the entire concept that the newborn immune system is fragile system that must be kept at peace will be shattered and a more realistic vision of a baby's immune system will emerge- it must be used to work well.

Dr. Arthur Lavin

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

A Reminder that Fever is Harmless

A Reminder that Fever is Harmless

Advanced Pediatrics was very pleased to be contacted by a reporter from Suite 101.com to discuss the recent American Academy of Pediatrics (AAP) campaign to remind families that fever is not a harmful symptom.

Suite 101.com is rated as one of the top 10 blog spots and receives 28 million hits a month, so we were especially pleased that we could get our message out to over 300 million people a year.

Here is our interview, we hope you find it informative and helpful.

http://www.suite101.com/content/american-academy-of-pediatrics-launches-fever-phobia-campaign-a357897

Our key points are:

• Fever remains a fearsome symptom for two key reasons:

1. For most of human history, infections were the number one cause of death in childhood, causing as many as one in four children to pass.
2. Even today, fever makes everyone feel terrible.

• Fever today should no longer create fear for two key reasons:

1. In the US and the rest of the developed world, death from infection is now very, very rare in childhood.  Fever no longer indicates a likely hazard.
2. Fever, although uncomforrable, is not dangerous.  Everyone gets fevers, everyone.  With almost no exceptions, fever itself causes no actual harm.

• More important to be concerned about than fever are signs of serious infection:  Stiff neck, trouble getting air in and out of the chest, severe pain, worrisome rashes.

Dr. Arthur Lavin

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

FDA to take up to 500 cold medicines off the market

Image via WikipediaFDA to take up to 500 cold medicines off the market

The FDA announced on March 1, 2011 that it would now investigate over 500 cold and cough medications, and that for any that do not work, the manufacturer would have 90 days to stop making it and 180 days to stop shipping it, according to a report in the Washington Post FDA today.  http://voices.washingtonpost.com/checkup/2011/03/fda_cracks_down_on_unapproved.html

A list of drugs that will be investigated can be seen at http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/SelectedEnforcementActionsonUnapprovedDrugs/ucm238675.htm#cough

This development continues a clear trend that we have been communicating to families since 1985, now over 

25 years ago- that the cold and cough remedies simply do not work, and that no good reason exists to give your child a medicine that does not work.

As these drugs come under increasing scrutiny, we look forward to two steps being taken:

1.  That all families stop using the cold and cough remedies currently on the market.

2.   That scientists find interventions that really do help people who have colds and coughs.

Dr. Arthur Lavin

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*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.