Parenting Solved

It's Final - Autism Not Associated with Thimerosal

Alert the media (and Jenny McCarthy), here’s another study showing that mercury-based preservatives in vaccines aren’t responsible for autism. The study published in this month’s Archives of General Psychiatry found that despite removal of thimerosal the prevalence of autism was unchanged between 1995 and 2007. Hopefully this will close the door on the Big Pharma witch hunt of the 20th century that undermined both the healthy and the afflicted.

And on the subject of autism, a study recently published in the journal Pediatrics found that children with autism spectrum disorder tend to be less irritable when febrile. Interesting stuff. The study is unable to answer why this is the case although in their discussion the authors offer a number of potential mechanisms for the observed behavior. Temperature related changes in nerve conduction and the neurological effects of fever associated compounds in the body topped the list.

While not a deal breaker, it’s studies such as these that offer small, incremental additions to the puzzle that’s autism.

Are Doctors Missing Reflux in Children?

According to a study presented at the annual meeting of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition last month, researchers from Loyola University Medical Center found that nearly one third of parents reported visiting three doctors before receiving a correct diagnosis of gastroesophageal reflux for their child.

And among toddlers and preschoolers in the study, more than 50% experienced a 3 month delay from the time of symptom presentation to diagnosis. 22% of children in this age group experienced a delay in diagnosis of greater than 18 months.

While these stats are concerning, they should come as no surprise for some parents who have sought attention for reflux disease. As pediatric GERD awareness remains in its infancy, vigilance is what drove the caregivers in this study to seek care for their kids.

Look for this compelling study to reach peer reviewed publication soon.

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.

Ear Tubes May Not Improve Development

A study in today’s New England Journal of Medicine reports that the early placement of ear tubes does little to improve language, speech or development in otherwise normal children with persistent ear fluid. The study brings closure to nearly four decades during which it was believed that persistent middle ear fluid early in life was associated with developmental problems. Tympanostomy, or the placement of tubes into the eardrum to drain the middle ear, is the second most frequently performed surgical procedure after circumcision.

While children with persistent middle ear fluid need to be followed closely for hearing problems, this study offers some relief for the parents of otherwise normally developing children who want to ride it out. My guess, however, is that ear tubes will remain as wildly popular as in years past.

Teens Surf Google to Lose Weight

Web sites that promote anorexia and bulimia are becoming more popular.

Researchers in the journal Pediatrics this month investigated the awareness and usage of “pro-eating disorder” websites among adolescents and parents. Results showed pro-eating disorder site usage was common among adolescents with eating disorders, yet parents had little knowledge of this. While visiting pro-eating disorder sites, 96 percent of the respondents reported learning new weight loss or purging techniques. Of the sites investigated in the study, “most share similar content, including "thinspiration" (images of thin and cachectic women), poetry, weight-loss advice, methods for avoiding detection by family and health care providers, forums, merchandise, and links to other, related sites.” The study discusses pro-recovery sites which also appear to be commonly used.

This is interesting. Before I went to medical school I worked on a adolescent psychiatric unit that treated children with anorexia nervosa. Back then the tricks of losing weight were passed along quietly in the girl's room. Social networks were limited a girl’s immediate environment. Now it seems, Google’s the limit.

IVF Babies Less Healthy

As the father of an IVF baby I found this interesting. A study published in Pediatrics this month finds that IVF children have more health problems than other children. The Finnish study looked at children conceived through IVF born over a 3 year period between 1996 and 1999 and followed them until 2003. They were compared to other children not conceived through IVF.

Overall, IVF children were noted to have higher mortality rates, greater numbers of hospitalizations, and increased risk of behavioral problems, cerebral palsy, and infections. The risk of cerebral palsy didn’t appear to apply to single IVF babies.

So why would IVF children be less healthy? The authors note that their poor health could be the result of infertility itself, varying health behavior during pregnancy, and preterm labor which is more common in mothers requiring high-tech treatments like IVF.

While this isn’t the first study to showcase the outcomes of in vitro babies, it’s a sobering reminder. For potentially childless couples the benefits probably still outweigh the potential risks.

Promising New Lice Therapy

Hot air may represent a safe and effective way to eliminate head lice according to a study published in Pediatrics this month. Researchers at the University of Utah used six different methods of delivering hot air to the scalp as a means of eliminating eggs and hatched lice. While all 6 methods were effective at eliminating head lice, the custom built Lousebuster resulted in 100% elimination of eggs and 80% mortality of hatched lice. Nearly all subjects were cured of their infestation at one week follow up. The authors conclude that a 30-minute application of hot air represents a safe and effective means of treating lice.

The study was supported by the National Pediculosis Association which represents the interests of those afflicted with nits. Their claim to fame: The patent protected lice comb, the Licemeister, which was featured on CSI. Check out the clip showcasing the Licemeister’s 5 minutes of fame.

Pictured is the Lousebuster in action on a premed student. Despite a striking resemblance to the wildly popular Flowbee Vacuum Haircut System of the early 1990's, the authors suggest that the Lousebuster will have its greatest use in institutional settings.