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Parenting, Pediatrics, Public Health

Study shows cavities have become the most common childhood disease

Study shows cavities have become the most common childhood disease

Kids mouthA Washington Post blog entry published earlier this week reports that cavities are the most common childhood chronic disease in the United States. Fifty-nine percent of kids between the ages of twelve and nineteen have at least one cavity, according to a recent Pediatrics paper, and the American Academy of Pediatrics in turn issued new recommendations advising parents to start brushing children’s teeth with fluoride as soon as the teeth appear. The study refers to cavities in young children as a “silent epidemic” that disproportionately affects poor, young and minority populations.

From the article:

“We’re still seeing a lot of cavities in very young children,” said Rebecca Slayton, a pediatric dentist and member of the executive committee of the academy’s section on oral health.  “Various national surveys show that we are making progress in some age groups, but in the younger age groups we are not.”

Some of the problem stems from poor and immigrant children lacking dental care, but even among parents with the resources to get their children to dentists, there is a lack of awareness that baby teeth need the same care as permanent ones. And infants, of course, can’t complain about tooth pain.

Whether it’s a lack awareness or lack of resources that is preventing parents from addressing tooth health, the article makes clear that regular dental hygiene for children is an important part of their overall health.

Previously: Side effects of childhood vaccines are extremely rare, new study finds, “Mountain Dew mouth” rots teeth, costs taxpayers 
Photo By: Emran Kassin

Autism, Parenting

Growing up with an autistic sibling: “My sister has a little cup”

Growing up with an autistic sibling: "My sister has a little cup"

It was the photo that first draw my attention: the big sister and little sister, with their bed-head hair and pink-and-purple pajamas, hugging each other happily. It was like a scene straight out of my house, and I’m a sucker for stories about sisters – so I began reading. The Huffington Post piece was, indeed about two close, loving little siblings – but, more specifically, about the writer-mom’s concerns over how her youngest daughter’s autism has affected her daughter Phaedra.

Neither of my girls has autism, but Janel Mills is such a gifted writer (and her older daughter, with her maternal, sensitive ways, reminded me so much of mine) that it wasn’t difficult to feel what it would be like in this mother’s shoes. And this portion of the story, with Mills’ beautiful, simple description of what was going on in her younger daughter’s mind, brought me to tears:

One day, as we were driving to my mom’s house, Bella started having a full-blast, take-it-to-eleven, screeching meltdown because she dropped a toy somewhere in the car and neither she nor I could reach it. Phaedra hates the car meltdowns most of all because she can’t go anywhere to escape them. Listening to Bella melt down hurts her physically (the screams are LOUD) and emotionally (she’s a sensitive soul). When we finally pulled into my mom’s driveway and I got Bella her toy, Phaedra asked me with a shaky voice why Bella reacted the way she did. I must have heard this or read this somewhere, because there’s no way I was this clever on the spot, but this is what I told her:

“Everyone has a cup in their head. We pour all of our feelings, like happy, sad, mad, scared, anything, into that cup. Most people have regular-size cups. When you pour out your feelings into your cup, you have more than enough room for them. Bella has a cup, too, but her cup is little. When she pours her feelings out, her little cup can’t hold all of them, and it overflows. Does that make sense, honey?”

Apparently it did, because she uses this story to explain to others how Bella is different. She shares it with teachers, friends, basically anyone who will stand still and listen to her talk about her family.

“My sister Bella has a little cup.”

Previously: “No, I’m not ready yet”: A sister’s translation for her brother with autism and A mother’s story on what she learned from her autistic son

Applied Biotechnology, Parenting, Pediatrics, Research, Sleep, Stanford News, Technology

Biodesign fellows take on night terrors in children

Biodesign fellows take on night terrors in children

baby on bed

Standing in the Clark Center’s grand courtyard, gazing upward at scientists ascending an outdoor staircase and traversing the exterior corridors on the top two floors, one senses that big ideas take shape here. But how?

Prototyping, say Andy Rink, MD, and Varun Boriah, MS, who spent the last year as Biodesign fellows. Part of Stanford’s Bio-X community, the Biodesign Program trains researchers, clinicians and engineers to be medical-technology innovators during its year-long fellowship. Fellows learn the Biodesign Process, which could be likened to design thinking for health care. On teams of two or four, the fellows identify a substantial health-care need and generate ideas to solve it using medical-device innovation.

Though most Biodesign projects take root after fellows complete a “clinical immersion” shadowing health-care workers in a hospital to observe problems, Rink found his inspiration when visiting family and waking up to a 3-year-old relative’s screams from recurring night terrors. The problem was not so much that it affected the child – pediatricians may advise that children will likely outgrow the condition – but that it affected the parents, Rink saw.  The parent’s lost sleep and anxiety over their child’s well being had huge effects on their quality of life. (In some cases, these are so severe that Xanax and Valium may be prescribed to the children as a last-ditch effort.) What if a treatment could be found that involved no medication and no parental intervention, offering everyone a solid night’s sleep?

The physician and engineer are working with School of Medicine sleep researchers Christian Guilleminault, MD, professor of psychiatry and behavioral sciences, and Shannon Sullivan, MD, clinical assistant professor of psychiatry and behavioral sciences, on a clinical method to treat night terrors in children. In a first-floor room of the Clark Center, they’re protoyping an under-mattress device that senses how deeply a child is sleeping and is able to prevent the nightly episodes from occurring, creating a healthier sleep cycle for the children.  This relieves the parent’s anxiety, and helps the entire family sleep better.

Faculty and students from more than 40 departments across Stanford’s campus, including the schools of medicine, business, law, engineering and humanities and sciences, play a role in Biodesign, as do experts from outside the university. Fellows work closely with the Institute of Design at Stanford, attending – and then teaching – the school’s d.bootcamp. They also have access to the d.school’s facilities and consult regularly with their faculty. Some of the d.school’s methods – focusing on big problems, encouraging radical collaboration, prototyping early and user-testing before focusing on functionality – guide the trajectory of Biodesign projects.

Physicians who are Biodesign fellows often work outside their specialty, and engineers bring a mix of academic and industry experience to the design table. While faculty mentors may simply provide advice to fellows, Guilleminault and Sullivan have become invested in the course of the research as lead investigators on the study. For their involvement, they were both honored with the Biodesign Specialty Team Mentorship Award.

Fellow Boriah noted that medical-device innovation is moving from products like catheters to systems such as health IT, mobile health and software. A former CEO and co-founder of a wearable patient blood-diagnostics device, he said the Biodesign program has provided valuable “access to clinical reality.” Rink, a surgical resident at Northwestern University, said that as a fellow, he’s been “exposed to a side you don’t see in a hospital.”

The researchers are currently recruiting participants ages 2-12 for their study. Rink and Boriah are also working with the Stanford-supported StartX to see their project into the next stage of development.

Previously: Sleep, baby, sleep: Infants’ sleep difficulties could signal future problemsStudying pediatric sleep disorders an “integral part” of the future of sleep medicine and At Med School 101, teens learn that it’s “so cool to be a doctor” 
Photo by MissMayoi

Cancer, Parenting, Pediatrics, Public Health, Research

Study shows number of American teens using sunscreen is declining

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Despite an increase in cases of melanoma, the most dangerous type of skin cancer, growing percentage of high school students get a failing grade when it comes to using sunscreen. HealthDay reports:

The number of U.S. teens using sunscreen dropped nearly 12 percent in the last decade, a new report shows.

During that same time period, the number of teens using indoor tanning beds barely decreased. Both indoor tanning and failure to use sunscreen increase the risk of skin cancers, including deadly melanomas, the researchers noted.

“Unfortunately, we found a decrease in the overall percentage of teens who reported wearing sunscreen, from 67.7 percent in 2001 to 56.1 percent in 2011,” said lead researcher Corey Basch, an associate professor in the department of public health at William Paterson University in Wayne, N.J.

“Using sun-protective behaviors like applying sunscreen and avoiding intentional exposure to tanning devices will be key [to lowering cancer risk],” she added.

Use of indoor tanning devices by white girls decreased only slightly, from 37 percent in 2009 to 29 percent in 2011, she said.

Study authors say more research is need to understand why teens aren’t following national guidelines regarding sun protection.

Previously: Melanoma rates exceed rates of lung cancer in some areas, Beat the heat – and protect your skin from the sun, Working to protect athletes from sun dangers and Stanford study: Young men more likely to succumb to melanoma
Photo by Alex Liivet

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Obesity, Parenting, Pediatrics, Research, Sleep

Study shows poor sleep habits as a teenager can “stack the deck against you for obesity later in life”

Study shows poor sleep habits as a teenager can "stack the deck against you for obesity later in life"

11386276_c148dfd9bd_zNew research examining the effect of sleeplessness on weight gain in teenagers over time offers strong evidence that inadequate sleep may increase the risk of obesity.

In the study, researchers at Columbia University and the University of North Carolina pored over health information from the the National Longitudinal Study of Adolescent Health on more than 10,000 Americans ages 16 and 21. In addition, details about individuals’ height, weight and sleep habits were collected during home visits in 1995 and 2001.  According to a release, results showed:

Nearly one-fifth of the 16-year-olds reported getting less than six hours of sleep. This group was 20 percent more likely to be obese by age 21, compared to their peers who got more than eight hours of sleep. While lack of physical activity and time spent watching television contributed to obesity, they did not account for the relationship between sleeplessness and obesity.

“Lack of sleep in your teenage years can stack the deck against you for obesity later in life,” says [Columbia researcher Shakira Suglia, ScD]. “Once you’re an obese adult, it is much harder to lose weight and keep it off. And the longer you are obese, the greater your risk for health problems like heart disease, diabetes, and cancer.”

“The message for parents is to make sure their teenagers get more than eight hours a night,” adds Suglia. “A good night’s sleep does more than help them stay alert in school. It helps them grow into healthy adults.”

Previously: Want teens to eat healthy? Make sure they get a good night’s sleepProlonged fatigue and mood disorders among teensMore evidence linking sleep deprivation and obesityStudy shows link between lack of sleep and obesity in teen boys and Study shows lack of sleep during adolescence may have “lasting consequences” on the brain
Photo by Adrian Sampson

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Neuroscience, Parenting, Pediatrics

Can musical training help close the achievement gap between high and low-income children?

Can musical training help close the achievement gap between high and low-income children?

scope Music and kids

Drawing data from hundreds of students from low-income urban communities, a recent study offers new insights into understanding the academic gap between children from varying socioeconomic backgrounds and demonstrates the impact of musical training in helping low-income youth improve their language and reading comprehension skills.

The research (.pdf) was presented at the American Psychological Association’s annual convention and involved elementary and high school-aged students who participated in two separate projects measuring neural responses along with language and cognitive evaluations over a two-year period. Younger participants were part of Los Angeles-based nonprofit Harmony Project and older subjects attended three public high schools in Chicago. As explained in a press release:

[Researchers] studied children beginning when they were in first and second grade. Half participated in musical training and the other half were randomly selected from the program’s lengthy waiting list and received no musical training during the first year of the study. Children who had no musical training had diminished reading scores while Harmony Project participants’ reading scores remained unchanged over the same time span.

Over two years, half of the [Chicago] students participated in either band or choir during each school day while the other half were enrolled in Junior Reserve Officer’s Training Corps classes, which teaches character education, achievement, wellness, leadership and diversity. All participants had comparable reading ability and IQs at the start of the study. The researchers recorded the children’s brain waves as they listened to a repeated syllable against soft background sound, which made it harder for the brain to process. The researchers repeated measures after one year and again at the two-year mark. They found music students’ neural responses had strengthened while the JROTC students’ responses had remained the same. Interestingly, the differences in the music students’ brain waves in response to sounds as described above occurred after two years but not at one year, which showed that these programs cannot be used as quick fixes, [Northwestern neurobiologist Nina Kraus, PhD] said. This is the strongest evidence to date that public school music education in lower-income students can lead to better sound processing in the brain when compared to other types of enrichment education, she added.

“Research has shown that there are differences in the brains of children raised in impoverished environments that affect their ability to learn,” Kraus further explained in the release. “While more affluent students do better in school than children from lower income backgrounds, we are finding that musical training can alter the nervous system to create a better learner and help offset this academic gap.”

Previously: Pump up the bass, not the volume, to feel more powerful, Denver rappers’ music motivates kids (of all ages) to eat better and Brains of different people listening to the same piece of music actually respond in the same way.
Photo By: CherryPoint

From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.

Neuroscience, Parenting, Pediatrics, Research

Can’t remember being a baby? Rapid growth of new neurons in young brains may explain why

Can't remember being a baby? Rapid growth of new neurons in young brains may explain why

baby_073014A close friend once told me that one of her favorite aspects about being a parent is that she could experience what it was like to be a baby and toddler. “As adults, we have no recollection of what it was like to be that young,” she said. “Watching my son grow up offers me a window into that part of my life.”

The inability to remember memories in early childhood is known as “infantile amnesia”. Few adults can remember events in their lifetime that occurred before the age of three. A past study shows that these memories tend to fade away around the age of seven.

But why can’t we remember our days as a crawling, toddling, babbling youngster? Recent research suggests the answer many have to do with how quickly the brain develops during this stage in our lives. According to a Scientific American article published earlier this week:

In a new experiment, the scientists manipulated the rate at which hippocampal neurons grew in young and adult mice. The hippocampus is the region in the brain that records autobiographical events. The young mice with slowed neuron growth had better long-term memory. Conversely, the older mice with increased rates of neuron formation had memory loss.

Based on these results, published in May in the journal Science, [neuroscientists Paul Frankland, PhD, and Sheena Josselyn, PhD] think that rapid neuron growth during early childhood disrupts the brain circuitry that stores old memories, making them inaccessible. Young children also have an underdeveloped prefrontal cortex, another region of the brain that encodes memories, so infantile amnesia may be a combination of these two factors.

Previously: Study finds age at which early-childhood memories fade and Individuals’ extraordinary talent to never forget could offer insights into memory
Photo by D Sharon Pruitt

Parenting, Pediatrics, Pregnancy

Losing Jules: Breaking the silence around stillbirth

My birthday is coming, and I’m dreading it. I can’t celebrate; I’d like to go to bed and wake up twenty-four hours later. It’s not because I’m a year older. It’s because it’s the anniversary of the death of my second child, Jules.

My experience is nothing unique. Death anniversaries haunt most people: the anniversary of the death of a parent; the anniversary of a friend’s suicide, the day a father or husband died in battle. My nightmare began on the morning of my birthday, three years ago. I was beginning my 38th week of pregnancy, and I felt great. All signs pointed to a normal, healthy baby. I woke up early the morning of July 30 and my water broke. With great excitement, I grabbed my overnight bag and headed to the hospital with my husband and my (then) 4 1/2 year old son, Miles.

Although I’m not religious, I baptized Jules with my tears and told him how much I loved him. Then I did the hardest thing I’ve ever had to do in my life: I put him down, and I left.

We checked into the obstetric intake bay, and the nurse began to hook me up to a fetal monitor. She couldn’t get it to work and remarked that it must be malfunctioning. She brought in another monitor, and she couldn’t pick up the baby’s heartbeat on that one either. Then she brought in an MD with an ultrasound. I looked at the image of my beautiful son on the screen. There was no pulsing heart in his rib cage. He was dead.

I went into the kind of shock that people describe as “a bad movie.” Everything slowed down and became tunnel-like. I felt removed from the situation, almost observing the scene from a distance as the staff wheeled me to a room at the end of the maternity ward to deliver my stillborn child. I remember the rose a nurse placed on the outside of the door to mark that this room was different. She closed the door when the sounds of newborns drifted down the hall to my room. She was extremely compassionate and held me through some of my labor pains. I asked for Pitocin to speed the birth, and Jules was born quickly. His death was ruled a cord accident.

Jules was so beautiful, so perfect and so still that at first I was afraid to hold him. The staff wrapped him in a hospital blanket and put him in the baby gurney. A pediatrician came to give him a newborn exam with a mix of horror and grief on his face. Cautiously, I picked Jules up and held him and rocked him for a very long time. I desperately didn’t want to leave him there, and I desperately wanted to hold my living son, Miles, who was at a friend’s house. Although I’m not religious, I baptized Jules with my tears and told him how much I loved him. Then I did the hardest thing I’ve ever had to do in my life: I put him down, and I left.

My husband and I went through a special kind of hell in the weeks and months that followed. My milk came in, and I had to bind my swollen breasts and ice them for days. I couldn’t sleep, and when I did, I had nightmares. Worst of all, we had to explain to our son Miles that baby Jules was not coming home from the hospital. Sweet Miles began our healing when he thought about this for a few moments, and said, “So, Jules is now a twinkle in Papa’s eye.”

The community wrapped its arms around our family. Our house filled with flowers, and we had more food than we knew what to do with. What surprised me the most was how many women reached out to me to share their own stories of stillbirth. In the first 24 hours after we got home, our neighbors came over to talk to us about their baby dying in-utero near term. Over the course of the next few months, I spoke to many women who had lost babies, mainly by stillbirth, but not exclusively. I had no idea that in this age of medical advancement 1 in every 167 babies in the United States is stillborn (.pdf). Just over half a percent (.6 percent) doesn’t sound like a lot – until it’s you. Statistically, this has probably happened to someone you know, but they probably don’t talk about it. I know of three people – either in my circle or once removed – who have had stillbirths since mine.

I describe the initial weeks after Jules’ death in military terms: It felt like our family took a direct hit. Over time, I became skilled in answering people when they asked, “So, how’s your baby?” Those questions lasted for a year and a half. I sought counseling with health professionals who had experienced stillbirth or infant death. I’m not Jewish, but I went to talk to a Rabbi. She helped me to understand a beautiful philosophy: that we owe it to the dead to try and live well and fully. I’m still here, and I shouldn’t squander my time. It’s not always easy, especially when someone asks, “So, you have just the one?” But I work hard to live well and fully every day, especially on the anniversary of what would have been a joint birthday for Jules and me.

Polly Stryker works as a producer and editor at KQED Radio, an NPR affiliate in San Francisco, where she lives with her family. She is writing a book called “Losing Jules” for her son, Miles.

Previously: A call to “break the silence of stillbirth”
Image of Jules’ footprints in featured entry box courtesy of Polly Stryker

Humor, Parenting, Science

A humorous look at how a background in science can help with parenting

A humorous look at how a background in science can help with parenting

Scientist-moms out there might enjoy this playful (tongue-in-cheek) Huffington Post essay on how having a science degree made the writer a better parent. I had to chuckle at Sarah Gilbert’s list of how she’s found uses for the sciences in her day-to-day life:

Physics: Knowing that my house will return to complete disorder immediately after I clean it, because entropy.

Biology: Knowing everything my baby ate by the contents of her diaper, because scat identification.

Neuro-psychology: Knowing that my toddler freaking out over sandwich crusts is just a phase, because frontal lobe development.

Statistics: Knowing that the chance of having a baby brother is 50/50 no matter what my mother-in-law thinks, because mutually exclusive events.

Astronomy: Knowing that the woman judging me by my yogurt-spattered shirt isn’t the only thing in the universe, because cosmology.

Parenting, Sleep, Women's Health

What other cultures can teach us about managing postpartum sleep deprivation

What other cultures can teach us about managing postpartum sleep deprivation

New_mom_072114Prior to becoming a mom, I felt fully confident that caring for a newborn would be less demanding than, or at least equal to, the physically grueling trainings from my college soccer days or my sleepless year of graduate school. But I soon learned that both of these experiences paled in comparison to the exhaustion I encountered after the arrival of my 8-pound-plus bundle of joy. So I was interested to read a recent Huffington Post blog entry from the Stanford Center for Sleep Sciences and Medicine examining how mothers in other countries cope with postpartum sleep deprivation.

In the entry, Mara Cvejic, MD, a neurologist at the University of Florida and former sleep medicine fellow at Stanford, notes that although sleep deprivation can profoundly affect cognitive function and mood, the brain of a postpartum mom is actually growing. She writes:

… despite all the formidable evidence of sleep deprivation in the everyday person, the scientific evidence of what happens to the postpartum brain is positively astounding — it thrives. A study published by the National Institutes of Health in 2010 actually shows that a mother’s brain grows from just 2-4 weeks to 3-4 months post delivery without any significant learning activities. The gray matter of the parietal lobe, pre-frontal cortex, hypothalamus, substantia nigra, and amygdala all form new connections and enlarge to a small degree. The imaging study confirms what animal studies have shown in the past — that these brain regions responsible for complex emotional judgment and decision-making actually bulk up with use. Rationale to the study shows that mothers who have positive interactions with their offspring — soothing, nurturing, feeding, and caring for them — are performing a mental exercise of sorts. Their learned coping skills in the face of novel child-rearing actually muscularize their brain.

She goes on to outline how new moms from Bulgaria to Sweden, and everywhere in between, turn to “hammocks, spa treatments, hired help, warm foods, arctic cradles, and cardboard” to cope with a lack of sleep. Personally, I’m in favor of Americans adopting this Malaysian tradition:

Food and warmth are also a focus of the Malaysian confinement of pantang. Steeped in the belief that the women’s life force is her fertile womb, she undergoes a 44-day period of internment to focus on relaxation, hot stone massage, lulur (full body exfoliation), herbal baths, and hot compresses. Typically a bidan, what can only be described as a live-in midwife and nanny combined, is hired to attend on the new mother. This is sometimes a family member, such as her mother or mother-in-law.

Previously: The high price of interrupted sleep on your health, What are the consequences of sleep deprivation? and Study: Parents may not be as sleep-deprived as they think
Photo by sean dreilinger

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