Parenting Solved

The Vast Colic Conspiracy

This week marks the release of Colic Solved. For those unfamiliar with Colic Solved, it discusses the fuzzy nature of the colic “diagnosis” and addresses the miserable baby in the context of what we know about why babies scream. Despite the controversy that it may generate, Colic Solved will hopefully serve as a valuable resource for the parents of babies suffering with acid reflux and milk protein allergy.

I’m excited to be partnering with Babies R Us in a seminar tour for expectant and new parents. My Colic Solved seminar offers practical information to help new parents understand the basics of nutrition and digestive health in their infant. Over the next couple of months I’ll be offering the seminar at stores in Atlanta, San Diego, LA, Denver, Seattle, Dallas, Austin, and San Antonio. It’s been well received in the Houston area over the past year and this success will hopefully translate nationally. It’s is free and open to anyone interested in understanding how to keep their baby’s digestive system happy and healthy. I’ll post a schedule in the side column in the next few days.

You can find the Colic Solved wherever fine books are sold.

Havidol - When More is Not Enough

I have to admit that when I initially read about Havidol I thought that I may be suffering from from dysphoric social attention consumption deficit anxiety disorder. Then I discovered it was a parody. If you’re looking to have a little fun, check it out.

Just more backhanded evidence that we’re suffering from an epidemic of diagnoses.

Via Dr. Wes

Screaming Baby Robots Avert Teen Pregnancy

The latest tool for reining in teen pregnancy is a colic robot. The computerized bundle of misery known as Baby Think it Over burps, screams, and carries on just like a real baby with reflux esophagitis or milk protein allergy. And living just one night with BTIO seems to put the kibosh on teen mojo. It was apparently modeled after the natural prophylactic effect observed in exhausted parents. I was shocked to Google this – Lots of teen programs have this infantile terminator in use. Genius.

The Baby Think it Over is manufactured by Realityworks, Inc.

Can Probiotics Treat Colic?

It’s a timeless question when it comes to the miserable baby: Is it the brain or the gut? Recent indications are that the gut and its many bacterial inhabitants may hold a clue.

A study published last month in the journal Pediatrics looked at the use of probiotics in the treatment of unexplained irritability in breast fed infants. Researchers treated one group of miserable babies with the probiotic Lactobacillus reuteri and another group with simethicone, the active ingredient in most infant gas drops. 95% of the group treated with the probiotics were noted to respond with significantly less crying within 7 days. Only 7% of the simethicone group showed a similar response.

So what is it about probiotics that could potentially make some miserable babies at ease? Inflammation can trigger painful dysmotility or spasm of the intestinal tract. The well-known anti-inflammatory properties of probiotics could be countering the allergic effects of proteins encountered by these babies. It’s possible that a natural imbalance of intestinal flora could explain the misery of some babies. And L. reuteri has been shown to inhibit visceral pain which may explain why babies may feel better but doesn’t explain why they were in pain to begin with. All of this, of course, may be irrelevant to a mother working on 4 hours of sleep.

Irrespective of why the babies in this study felt better, the results are thought provoking and leave us with as many questions as answers. Structuring studies that deal with slippery topics like colic is tricky business. More placebo-controlled studies will help define the role of probiotics in treating screaming babies.

L. reuteri is available in infant drops through Biogaia, a Swedish biotechnology interest that produces probiotics for companies manufacturing functional foods.

Twigs, Berries and The Newberry Medal

There’s a crisis brewing in children’s literature. It seems the Susan Patron, the 2007 recipient of the prestigious Newberry Medal, chose to use the word scrotum on the first page of her award winning book, The Higher Power of Lucky. Librarians are taking sides and the story even made the front page of this morning’s New York Times. I didn’t give the matter a lot of thought until I read further along and learned of the author’s penchant for the word’s musical, aesthetic qualities.

The word is just so delicious. The sound of the word to Lucky is so evocative. It’s one of those words that’s so interesting because of the sound of the word.

As a pediatrician-father of a school-aged boy I’m not averse to discussing the details of anatomy. I'll risk my reputation, however, and come down on the side that scrotum probably doesn’t belong in vernacular of most children. Delicious or not.

For more coverage of both sides of this check out Librarian.net

Peter Pan's Diarrhea

When the CDC disclosed the recent outbreak of Peter Pan associated salmonella, the calls to my office began no sooner than the sponsored ads for legal representation on Google. It’s remarkable that despite the availability of unlimited online information on the subject, there are times that mothers still want to hear from me. It’s just as remarkable that at other times parents are willing to disregard my opinion for that of a chat room stranger. Strange days indeed.

Bilirubin Neurosis

More and more the Wall Street Journal is becoming a forum for hot child health issues of the day. This morning the front page tells the story of one child who suffered from a rare complication of newborn jaundice called kernicterus. Kernicterus occurs early in life when excessively elevated bilirubin in the blood damages the developing brain. While the exact incidence of kernicterus is unknown, some experts suggest that the incidence may approach 75 cases per year in the United States. Sue Sheridan, the child’s mother, has embarked on a national campaign to prevent kernicterus and this morning’s feature details her mission.

For the uninformed, one might take away from the passionate efforts of Ms. Sheridan that “one simple test” is all it takes to prevent anything bad from happening to a baby. In truth, the appropriate management of jaundice in the newborn must involve the careful consideration of a number of variables including a baby’s age, perinatal history, what they’re feeding, bilirubin level, rate of change, and blood type to name but a few. Jaundice in the newborn always warrants attention but management isn't always straightforward.

While my heart goes out to Ms. Sheridan and her son, the WSJ feature resurrects the timeless debate of when, how far, and at what cost we should take public health measures to identify rare problems. No system for early identification of preventable disease is perfect but a good pediatrician’s judgment likely remains the best means of identifying and treating jaundice in babies.

And by the way, no one rides the main stream media for free. It seems the kernicterus-prevention media campaign has been funded, in part, by none other bilirubin-testing device maker Respironics, Inc.

Why You Can't Tickle Yourself

Ever wonder why you can unmercifully tickle your two-year-old but not yourself? This question was posed to Sarah-Jayne Blakemore, at the Institute of Cognitive Neuroscience at University College in London and answered in Scientific American.

The answer lies at the back of the brain in an area called the cerebellum, which is involved in monitoring movements. Our studies at University College London have shown that the cerebellum can predict sensations when your own movement causes them but not when someone else does. When you try to tickle yourself, the cerebellum predicts the sensation and this prediction is used to cancel the response of other brain areas to the tickle.

This is absolutely fascinating for me. As someone makes a living examining bellies, I’ve found that asking a child to put their hand on top of my hand as I palpate markedly diminishes the tickle response. I saw an old pediatrician do this some years ago and picked up on it. Now I know why it works.

And by the way, when the doctor is examining your child, never comment that she’s ticklish. Suggestion, I’ve found, is a very powerful trigger in this case.

Via Shelley at Retrospectacle.

Breasts in Boys Linked to Lavender and Tea Tree Oil

While medical journals have never had the sensational flair of grocery store tabloids, all that may be changing.

The New England Journal of Medicine this week reports that the lavender and tea tree oils found in soaps and body lotions can produce enlarged breasts in boys. The report discusses gynecomastia, or breast enlargement, in three boys ages four, seven and ten years that was reversed when they stopped using the products containing these oils. Subsequent laboratory studies conducted at the National Institute of Environmental Health in North Carolina found that the lavender oil and tea tree oil mimic the action of the female hormone estrogen and block the hormones responsible for inhibiting breast development in men. The effects on girls and women are unknown.

The pediatric endocrinologists reporting this fascinating case series suggest that such effects in other children are dependent upon poorly defined factors including oil concentration; duration, quantity, and frequency of use; and a child’s genetic makeup. This is concerning given that these oils are appearing more commonly in commercial products such as shampoos, hair gels, soaps and lotions.

I’m shocked that this hasn’t hit the media in full force.

Soy Formula - Not a Good Choice for the Allergic Baby

Soy formula is not the formula of choice for babies with milk protein allergy. Studies looking at this problem have shown that up to 50% of infants who react to cow’s milk protein will also react to soy protein. So if your baby has true signs of milk protein allergy, you’re playing the odds by switching to soy. A casein hydrolysate formula such as Nutramigen or Alimentum are considered the first line formulas of choice for the milk allergic baby.