What they found is that babies who were exclusively fed breast milk for at least three months had a lower BMI than babies who were given mainly formula. The introduction of solid food before six months didn’t seem to matter, and if a mother supplemented a little bit with formula while in the hospital, that didn’t matter as long as she established exclusive breastfeeding afterwards.
What did matter, interestingly, is how the breast milk was delivered to the baby. Mothers who exclusively fed at the breast had babies with lower BMIs than baby’s who received expressed breast milk in a bottle. Regardless of how they got the breast milk, breastfed babies had lower BMI than formula-fed babies.
The fear is that with legalization comes the idea that marijuana is safe to use and could even help women control nausea from morning sickness.
The Academy made these recommendations to its members:
Inform adolescents and women of reproductive age about the lack of definitive research. Counsel about concerns regarding potential adverse effects of THC exposure, including passive smoke, on pregnant women and fetal, infant and child development. Include marijuana when discussing the need to abstain from tobacco, alcohol and other drugs during pregnancy.
Counsel pregnant women who are using marijuana or other cannabinoid-containing products to treat a medical condition, nausea and vomiting during pregnancy — or who are identified during screening as using marijuana — about the lack of safety data and the possible adverse effects of THC on the developing fetus.
Explain that even where marijuana is legal, pregnant women can be subject to child welfare investigations if they have a positive marijuana screen result.
Note that data are insufficient to assess the effects on infants who are exposed to maternal marijuana while breastfeeding. Inform women of the potential risk of exposure during lactation and encourage them to abstain from using any marijuana products while breastfeeding.
Encourage women who never have used marijuana to remain abstinent while pregnant and breastfeeding.
Work with state/local health departments if legalization of marijuana has occurred or is being considered to help with constructive, nonpunitive policy and education for families.
The Centers for Disease Control and Prevention released its 2018 Breastfeeding Report Card. How is the U.S. and Texas doing when it comes to reaching the Healthy People 2020 goals that were established in 2010 by this committee that has representatives from the U.S. Department of Health and Human Services, the U.S. Department of Agriculture and U.S. Department of Education.
In many areas, we’re meeting those goals. 83.2 percent of infants in the U.S. have been breastfed at least once. (the goal was 81.9 percent). We’ve also more than met the proportion of infants who are breastfed at a year (35.9 percent are); and the percentage at three months (46.9 percent are). The six-month mark we didn’t quite hit the mark in infants who are breast fed (57.6 percent vs. the goal of 60.6 percent) or those that are exclusively breastfed at that time (24.9 percent vs. the goal of 25.5 percent). We also didn’t do as well as hoped in the percentage of infants given formula before 2 days old (17.2 percent instead of 14.2 percent).
What can you do to encourage a new mom to breastfeed?
Make sure she checks out what kind of support she’ll receive at her hospital when it comes to lactation consulting. Hint: It’s usually 3 a.m. when you need a consultant. Babies feed just great from 9 a.m. to 5 p.m.
She can also ask the hospital what percentage of their infants are given formula vs. babies that are exclusively breastfed while there.
Feed her. Bring her healthy meals and plenty of water.
Offer to take care of her other child, help around the house or hold the baby while she takes a nap.
If she’s a work colleague, link her to another mom who has been pumping at work, who can help her make the transition back to work easier.
“We’re recommending that doctors write a prescription for play, because it’s so important,” said pediatrician Michael Yogman, the lead author of the report in a press release. “Play with parents and peers is fundamentally important for developing a suite of 21st century skills, including social, emotional, language and cognitive skills, all needed by the next generation in an economically competitive world that requires collaboration and innovation. The benefits of play cannot really be overstated in terms of mitigating stress, improving academic skills and helping to build the safe, stable and nurturing relationships that buffer against toxic stress and build social-emotional resilience.”
What the study and others like it note is that children are playing less.
Here are some stats this study offers:
Children’s playtime has decreased by 25 percent from 1981 to 1997, and we bet that if someone did a current study, it would be even less.
About 30 percent of kindergarten children don’t have recess and instead have more academic lessons, says research from Advances in Life Course Research.
In a study of 8,950 preschool children and parents, only 51 percent of those children went outside to walk or play once a day with a parent.
Part of what has happened is that academics have replaced play at a very young age, and parents don’t know how to play with their children or they are fearful about safety concerns to let their children play.
It enhances brain structure and function and promotes that executive function, the study says
When kids play, stress is reduced and kids learn to regulate their stress. One of the things the study found was that preschool children who were anxious about going to school were twice as relieved of their stress when they were able to play with their teacher of fellow students for 15 minutes instead of listening to a story. Kids with disruptive behaviors were also less stressed and disruptive when a teacher played with them one-on-one.
Children who played as preschoolers had a better advantage when it came to paying attention and behaving appropriately in the classroom.
Of course, the study also looked at play in rats and changes in the brain structure of the rats who played and the rats who weren’t allowed to play. “Rats that were raised in experimental toy-filled cages had bigger brains and thicker cerebral cortices and completed mazes more quickly.”
And in kids, the study notes that “Children who were in active play for 1 hour per day were better able to think creatively and multitask.”
Play also helps our children be physically active, be socially aware, learn self-regulation skills, language development, imagination and more.
So, parents, get out there and play with your children. Yes, you can put the phone down and they can put down that tablet or gaming device. Also, make sure that your child’s school still has elements of play such as outdoor time or recess.
Zach Theatre is starting a new class for parents and young children to play together called Wee Play. It will be showcased at the open house on Saturday at it’s 1510 Toomey Road location and on Sept. 1 at its 12129 RM 620 N. location.
Have a backpack and binder cleaning out party regularly. Consider doing it whenever we have a school holiday or at the start of a new grading period.
Establish positive communication with teachers, parents. Read the regular emails and notes your child’s teachers sends. Ask questions but not in an accusatory way.
Look for ways you can help teachers. Does that teacher need help copying papers or cutting things for an upcoming project? Ask how you can help, even if you can’t be at school during daytime hours.
Attend as many school activities as possible. If you can, chaperone a field trip. Come to games and performances. Be that embarrassing fan in the stand cheering for your kid, just don’t undermine the coach or director.
Give teachers praise. Like something that the teacher did for your child or the rest of the class? Parents and students always can drop teachers a handwritten note or an email. ‘Thank you” goes a long way. Think about nominating a particularly great teacher for an award.
Get to know the staff at your school. The principal and vice-principals, the secretaries, the counselors all can be good allies to have.
If you’ve thought school nursing was just about taking temperatures and handing out bandages, a few hours at “Kids First” workshop at University of Texas School of Nursing proves you wrong pretty quickly.
During the course of two days last week, about 300 nurses from districts around Central Texas learned about the latest in managing diseases like ADHD, diabetes and mental health disorders, how to recognize child abuse, and how to recognize signs of stress and sleep deprivation in students. They also brushed up on skills such as catheterization, cleaning gastrostomy tubes, changing tracheal tubes and how to recognize abnormal heart and lung sounds and ear infections.
While school nurses cannot diagnose anything, they might be the first medical professional to see warning signs of life-threatening or chronic illnesses, and they also might be called on to help manage some of the care during the school day.
Some of the nurses who attended “Kids First” were regularly having to do things like catheterization or GT tubes because of the kids who are in their schools, others had never had a kid on their campus with those needs and welcomed the refresher lessons.
Deanne Hemmenway, CD Fulkes Middle School in Round Rock Independent School District, who regularly has done catheterization on a student, says it’s all about creating privacy and a trust factor, as it would be for any student she sees.
She’s been a school nurse for 20 years and knows that what comes into her office definitely depends on the time of year. There’s flu season, and allergy seasons, there’s also football season, volleyball season and track season. She also sees a lot of asthma and diabetes management come in as well as scrapes and falls. She’s called ambulances for football paralysis, severe asthma and falls down the staircase.
Sometimes the nurse’s office is where kids take a breather in the sanctuary of a quiet space and a nurse with an empathetic ear.
“Every day I have a handful of kids that don’t want to go to class,” Hemmenway says. Sometimes it’s a test they are trying to avoid. Other times there is more going on, like avoiding peers or family struggles.
The nurses office, she says, is like a mini emergency room or clinic, in the variety of things that come in.
“You never know what is going to happen day to day,” says Joanne Johnson, a nurse at Ridgeview Middle School in Round Rock ISD.
What has changed is some of the things that are coming nurses’ offices weren’t decades ago. Mental health crises, particularly depression and anxiety, and problems with stress management come into the office more frequently, says Violet Filley, who has been a nurse for 23 years and works with sixth-graders to 12th-graders at Round Rock Opportunity Center.
How can parents best work with their school nurses? We asked some nurses at the training what information they’d like parents to be given them and how parents can be better partners in their child’s care.
Make sure your contact information is updated online (if your district has an online emergency contact form) and also by paper (if they don’t have the online form or the power goes out).
Make sure your child knows your phone number and the phone number of a few more people to call in an emergency. It’s not enough to have it in their phone. Their phone might not be charged at that moment.
Take the nurse’s call when she calls you and have a plan on what to do if your child needs to go home. Have a backup person who can pick up your child if you’re not available and make sure that your backup person is on the emergency contact form.
Know that a school nurse cannot diagnose. They can make a suggestion of what they think might be going on, but you have to take your child to a doctor to receive a diagnosis and treatment. The school nurse also is not your primary care clinic. However, sometimes school nurses might notice things that a teacher or parent has not, and often, they know what ick is going around.
Follow the 24-hour fever-free rule to return to school. Our nurses understand that parents have to work, but giving a kid Tylenol or Advil to get the fever down, doesn’t qualify as being 24-hours fever-free. It has to be 24-hours fever-free with no assistance. This is for your child’s safety as well as other children’s to stop the spread of disease. Remember last year’s flu season in which some districts had classrooms with very few kids in them? Let’s try to avoid that this year.
For very young kids, put a clean pair of pants and underwear in their backpack and keep it there all year. Make sure your child and your child’s teacher knows where those clothes are.Nurses often have to send kids home or find clothes in the lost-and-found or try to clean up kids after an accident.
Share medical information with the nurse. They want to know if your child has a chronic illness, what medication your child is on and how much, what food or other allergies your child has and what to do if she has an attack, and what mental health diagnoses your child might have. If you think the teacher or the counselor has this information, don’t assume it’s filtering down to the nurse. It can be beneficial to sign a records sharing request for your child’s doctor’s office to send over medical information.
Let the nurse know if there has been flu, strep or other communicable diseases. The school districts’ health departments are required to share numbers with the state and even the Centers for Disease Control and Prevention. Those numbers start with the school nurse and can help establish a pattern of where and how quickly a virus is moving.
Share the 504 plan or individualized education plan with the nurse. The teachers, counselors and administration might know it, but the nurse also should be informed, especially if it’s for behavior, physical health or mental health. They want to know what works with your child. They also want to know if the behavior that has caused your child to go to the nurse is normal for them. If your child regularly has panic attacks, that’s helpful for the nurse to be able to rule that out if your child comes in with shortness of breath.
Let the nurse know about a long-term medical condition that might mean homebound services will be needed. Sometimes the school nurse gets tasked in getting assignments for kids who can’t attend school.
Have the right paperwork for giving a child medication. If your child needs to take medicine while at school, most districts won’t let you just give the kid the pill bottle. There will be paperwork involved that comes from your doctor if it’s prescribed or from you if it’s an over-the-counter. Each district has its own set of guidelines. Ask your nurse what you need to provide and know that she can’t give your child anything if the paperwork is not filled out properly.
Realize that kids are different at school than at home. Sometimes kids will have stomachaches and headaches at school and be fine at home or the opposite can be true. It depends on how your child is wired. Recognize that what the nurse sees might not be the same symptoms you see regularly.
Understand that the nurse might not need to call you. Most districts have protocols for calling parents if there is a fever or head injury. If there’s an injury that seems to be fixed with a bandage or if the kid just needs a break, the nurse might not call you. Sometimes nurses who know families well have more information about whether or not you’re the kind of parent who wants a call at every visit to the nurse’s office or not. If you are that parent, let the nurse know that you’d like a call. Realize that the nurse’s time is valuable (usually there’s only one of her for hundreds or even thousands of children). She might not be able to call you that moment. A good reason that you might want a call is if you’re trying to establish a pattern to your child’s symptoms or if you’re trying out a new medication and need data if it’s working.
When in doubt, overshare information. Often the school nurse is the last to know, but the first to see your child in an emergency.
46th in midwives and obstetrician/gynecologists per capita
36th in pediatricians and family doctors per capita
37th in parental leave policy
29th in hospital Cesarean-delivery charges
28th in hospital vaginal-delivery charges
19th in infant mortality rate
28th in low birth weight
10th in annual cost of early child care
26th in child-care centers per capita
What does all this mean to Texas moms? It means that they might have to travel farther to see a midwife or OB/GYN or go to a pediatrician or family doctor than people in other states.
The Economist also came up with another interesting statistic: delivering a baby in the U.S. costs about $10,808, part of the total of about $30,000 for before and after birth care. Most people with insurance pay about $3,000 in hospital delivery costs after insurance. Many women in Europe have birth and delivery available for free by their country’s medical care system. Then if they want an upgrade of a private room in a luxury hospital, they might pay an additional fee. Duchess Kate spent about $8,900 for her private room in the St. Mary’s Hospital in London.
The study looked at more than 24,000 children of more than 16,000 nurses enrolled in the Nurses Health Study II in the 1990s. The researchers specifically looked at children who were not obese before age 9 and where they were at age 14.
What they found was that 5.3 percent of those children became obese in those five years. The risk of becoming obese was lower in children whose mothers had a body mass index between 18.5 and and 24.9, engaged in at least 150 minutes a week of moderate to vigorous physical activity, did not smoke and consumed alcohol in moderation.
Here’s the big takeaway: Children of mothers who had those markers of health had a 75 percent less chance of becoming overweight than the children whose mothers did not.
Those researchers found that it wasn’t just about the children’s healthy lifestyle, it was about the mothers’ as well.
Dr. Kelly Thorstad, a pediatrician at St. David’s Children’s Hospital and Lone Star Pediatrics, says that what this study shows is it’s not just about genetics. While genetics is a factor, it’s also about lifestyle and creating an environment of healthy habits.
“I think children learn what they live,” she says. “Having parents that have a healthy lifestyle that have a healthy weight … it will be good for the family.”
Some of the things she recommends families start doing are:
Control how much TV kids and parents are watching, and no TV in the bedrooms.
Have family meal times together to share those healthy habits.
Avoid fried food. Instead of counting calories, worry about the amount of fat.
Focus on serving size. We have trouble remembering what a healthy serving is, especially at restaurants. “Look at your plate,” she says. “Cut everything in half and that would be a normal serving size.”
Get good protein throughout the day, but especially at breakfast. Think boiled eggs, a protein bar without a lot of sugar, whole-grain cereal with milk or, better yet, yogurt with fruit and some whole-grain cereal on top.
Trade chips and cookies for fruits and vegetables as a snack after school and on the weekends.
Control what you bring into the house. If you don’t bring in junk food, it’s not available for eating, at least when they are at home.
Thorstad, of course, would like families to do all of these things, but if they can only do one thing, cutting out sugary drinks would be her choice.
Thorstad often has to have conversations with parents when their children’s weight is not at a healthy level. She says she always asks them if it would be OK to talk about weight.
The Austin Diaper Bank would be happy to have your donation. Right now, they particularly need size 5 and size 6, but they’ll take any size diapers and they’ll take ones for adults, too.
“While diaper donations slow during the summer, the need does not,” said Holly McDaniel, executive director of the Austin Diaper Bank, in a press release. “If we can’t replenish some of our supplies, some of our neighbors in Central Texas may not get the diapers they need to keep babies or other family members clean, dry and healthy during these hot months.”
Don’t get caught missing a vaccine or without your paperwork. Find your children’s shot records and make sure they are in compliance with the 2018-2019 school vaccination schedule:
Diphtheria/Tetanus/Pertussis: four or five doses depending on which version your kid got.
Polio: four or three doses
Measles, Mumps and Rubella: two doses
Hepatitis B: three doses
Varicella: two doses
Hepatitus A: two doses
All of the above, plus
Diphtheria/Tetanus/Pertussis: three doses of the primary series plus a booster within the last five years
Meningococcal: one dose
Eighth- throught 12-graders
All of the above, but if the diptheria/tetanus/pertussis shot has not been given in the last 10 years, a booster is needed.
The Centers for Disease Control and Prevention also recommends these vaccines for the 11-year-old or 12-year-old check up:
Human papillomavirus (HPV) vaccine helps protect against HPV infections that cause cancer. For kids age 9-14, it’s two doses, one six months to a year after the first. For kids 15 or older, it’s three doses, the second one to two months after the first; the third, six months after the first.
Quadrivalent meningococcal conjugate vaccine
Quadrivalent meningococcal conjugate vaccine protects against some of the bacteria that can cause infections of the lining of the brain and spinal cord (meningitis) and bloodstream infections (bacteremia or septicemia). These illnesses can be very serious, even fatal. It recommends one dose at 11.
Tdap vaccine provides a booster to continue protection from childhood against three serious diseases: tetanus, diphtheria, and pertussis (also called whooping cough).
Preteens and teens should get a flu vaccine every year, by the end of October if possible. It is very important for preteens and teens with chronic health conditions like asthma or diabetes to get the flu shot, but the flu can be serious for even healthy kids.
Think your child doesn’t need to be vaccinated. Dr. Don Murphey, an infectious disease specialist at Dell Children’s Medical Center of Central Texas, who has been treating infectious disease in Texas children for almost a quarter of a century, explained to us last school why vaccines are so important.
Last year he saw seen mumps cases, like the ones at UT, come into Dell Children’s. Last year by August, Texas had more than 200 cases. “Before 2000, we had almost no cases of mumps,” he says.
He’s also seen in recent years more measles, whooping cough, pneumococcal meningitis and Haemophilus influenzae type b meningitis.
What’s going on here?
We’re seeing what doctors have been seeing in Europe, especially France and the United Kingdom, but on a smaller scale, Murphey says. The rates of mumps and measles in particular skyrocketed there after “The Lancet” medical journal published a 1998 study by Dr. Andrew Wakefield that it later had to retract. Wakefield lost his license because of it.
Wakefield’s study found a link to autism from the measles-mumps-rubella vaccine. Multiple studies including those funded by plantiff’s lawyers who were looking for a link found no-such link. What happens, though, is that the MMR vaccine is given around the same time — about 12 months to 15 months — as when many kids with autism start to show signs.
Yet, the misinformation and the fear of vaccines persisted. Parents in Europe stopped vaccinating and Europe no longer had the “herd” immunity that happens when at least 90 percent to 95 percent of the population are vaccinated against a disease.
Diseases like measles and mumps that we just didn’t see are happening again. We rely on the herd immunity to protect us. You see these vaccines are not fool-proof, and they have waning effects. In the case of the students at UT, even if college students have been vaccinated as children but are exposed to mumps now, they might not be fully immune and get it.
Murphey says the mumps vaccine we use “is a very safe one. It doesn’t cause any meningitis,” he says. “It works great for herd immunity, but it doesn’t work if you’re exposed.”
If you do get mumps, it isn’t the worst thing most of the time. You get a fever, you feel bad for a few days, he says. Boys can also get an infection in their testes and girls in their ovaries. What is scary is that mumps can lead to meningitis and deafness.
While mumps is not a terrible disease, we could avoid the whole thing, if people who can get immunized do get immunized, he says.
For parents who are considering or are using an alternative vaccine schedule and delaying vaccines, Murphey encourages them not to. “Alternative schedules have never been shown to be any safer,” he says.
By delaying vaccines, you’re not protecting the most vulnerable population, who can get the most sick from these disease — infants and small children. They end up in the hospital or worse.
“You want to start protecting those kids as soon as possible,” Murphey says.
Vaccinate, please, if not for your own child, but for the other children.