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Obesity, Parenting, Pediatrics, Research

Feeding practices and activity patterns for babies vary with families’ race and ethnicity, study shows

Feeding practices and activity patterns for babies vary with families' race and ethnicity, study shows

4361756526_774638516a_zWhen and how does childhood obesity begin? The question is a big challenge for researchers, who have observed that more than a quarter of US children aged 2 to 5 are now obese. That’s worrying because of links between obesity, heart disease and diabetes.

To help find answers, a new study is following babies and their parents from age 2 months to 2 years, tracking the babies’ growth and the families’ habits around feeding and activity for their little ones. Researchers at four centers around the country have recruited more than 800 baby-parent pairs to participate. The subjects are ethnically diverse and come mostly from low-income households, with 86 percent receiving Medicaid.

Today in Pediatrics, the scientists report the first findings from the project, an analysis of baseline data collected when the babies were 2 months old. The researchers found striking differences in feeding practices and activity patterns along racial and ethnic lines, suggesting that perhaps future efforts to prevent childhood obesity should be culturally tailored for different groups. Stanford’s Lee Sanders, MD, is one of the authors of the new paper, though none of the data was collected at Stanford.

Among the findings, Hispanic parents were more likely to encourage babies to finish a bottle and reported less tummy time than white parents; black parents were more likely to put babies to bed with a bottle, prop a bottle in front of a baby with a blanket (instead of holding it as the baby ate), and reported more TV watching for their babies than white parents. The differences persisted after the data was adjusted for possible confounding factors such as family income. It’s not clear whether all of these behaviors will be connected to higher obesity rates, but later reports from the same study will give more information about that.

In the study’s discussion, the researchers write:

If these behaviors are truly “obesogenic,” however, families from all races and ethnicities studied need early counseling, and the findings here also underscore the likely need for culturally sensitive health behavior counseling during early infancy. Particularly actionable are the specific behaviors that may be most sensitive to culturally adapted interventions: (1) infant exposure to television and other visual media; (2) breastfeeding initiation and exclusivity; and (3) encouraging infants to finish bottles.

Previously: Childhood obesity a risk for imminent heart problems, research shows, Sugar intake, diabetes and kids: Q&A with a pediatric obesity expert and Nutrition and fitness programs help East Palo Alto turn the tide on childhood obesity
Photo by dogs & music

Parenting, Patient Care, Pediatrics, Stanford News

Children’s hospital volunteers snuggle infants to soothe tiny patients and reassure their parents

Children's hospital volunteers snuggle infants to soothe tiny patients and reassure their parents

Calling all cuddlers! As previously written about here and in the most recent  Stanford Medicine Newsletter, volunteers Pat Rice and Claire Fitzgerald have been holding and soothing infants at Lucile Packard Children’s Hospital Stanford for 16 years, providing comfort both to the tiny patients and their parents. Rice and Fitzgerald, Ronald Cohen, MD, and sweet babies were featured on ABC’s World News with Diane Sawyer in the segment above.

Previously: Paying kindness forward through infant-cuddling“I opened the doors:” A look back at two special babies and Neonatologist celebrates 50 years of preemie care

In the News, Parenting, Pediatrics, Sleep

Study: Baby sound machines may be too loud for little ears

Study: Baby sound machines may be too loud for little ears

DSC_0293Sound machines that help babies sleep more soundly are a staple on many new parents’  baby registries (I had a little sheep that mimicked the sounds of rainfall and ocean waves). Well, as you may have read about elsewhere today, a new study published in the journal Pediatrics finds those soothing sounds may actually do more harm than good. Researchers from the Hospital for Sick Children in Toronto have found that infant sleep machines can reach sound levels that are hazardous to infant hearing and development. Writer Michelle Healy outlines their findings in an article in USA Today:

When set to their maximum volume:

– All 14 sleep machines [studied] exceeded 50 decibels at 30 cm and 100 cm, the current recommended noise limit for infants in hospital nurseries.

– All but one machine exceeded that recommended noise limit even when placed across the room, 200 centimeters away.

–Three machines produced outputs greater than 85 decibels when placed 30 cm away. If played continuously, as recommended on several parenting websites, infants would be exposed to sound pressure levels that exceed the occupational noise limits for an 8-hour period endorsed by the National Institute for Occupational Safety and Health and the Canadian Centre for Occupational Health and Safety.

It’s important to note that the researchers only tested the maximum output levels produced by the sound machines, and not their direct effect on infants. But Nanci Yuan, MD, tells Healy that the study does raise some important concerns:

​Parents “can feel desperate and want to try anything” when a baby has difficulty sleeping, says Nanci Yuan, pulmonologist and sleep medicine specialist at Lucile Packard Children’s Hospital Stanford.

But this research highlights the potential for a previously “unknown harm that can occur,” Yuan says. “We’re getting more and more concerned about issues related to sound and noise and hearing-loss in children because it’s progressive.”

Photo by Margarita Gallardo

Parenting, Patient Care, Pediatrics, Stanford News

One family’s story caring for their children with type 1 diabetes

One family's story caring for their children with type 1 diabetes

diabetesFamily members may share a set of values, a sense of humor, or various personality traits. And sometimes members of a family have a health condition in common. The recent Stanford Medicine Newsletter features a San Jose, Calif. family with five children – two of whom have type 1 diabetes and a third who has been identified as likely to develop it in the next two years. The Bergh family receives care for their children at Lucile Packard Children’s Hospital Stanford.

From the piece:

Roughly 5 percent of families who have one child with diabetes will have a second child with the disease, but it’s unusual to have three, according to Bruce Buckingham, MD, professor of pediatric endocrinology at Lucile Packard Children’s Hospital Stanford and the School of Medicine.

Buckingham, who treats the Bergh children, assessed everyone in the family for the disease by testing for antibodies that can generally predict when a child is going to develop diabetes. Four months after Maleki got his diagnosis, Marae tested positive for the antibodies. She did not get the disease for five more years, but by then Tierra Bergh [the mom] knew what to do. After noticing that Marae was drinking and urinating excessively one weekend, she used her son’s glucose meter to test Marae’s glucose levels and immediately called Buckingham.

“I was devastated,” she recalled, “but Dr. Buckingham was very calm. He said, ‘You already know how to take care of a child with diabetes.’”

Previously: A tale of two Shelbys: The true story of two diabetes patients at Lucile Packard Children’s Hospital and Tips for parents on recognizing and responding to type 1 diabetes
Photo courtesy of Bergh family

 

Parenting, Stanford News, Videos

Stanford patient celebrates son’s first birthday with help of her care team

Stanford patient celebrates son's first birthday with help of her care team

This touching video is a must-watch. The piece focuses on a young mom whose serious illness has kept her hospitalized for more than a month. When the patient’s care team learned of her son’s first birthday, they sprang into action and threw the little boy a party right then and there – ensuring that his mom wouldn’t miss this most important milestone.

“Some patients tug at your heart,” Hirut Truneh, the unit’s patient care manager, told Stanford Hospital’s Sara Wykes, who produced the video alongside Todd Holland. The video certainly tugged at mine.

Mental Health, Parenting, Pediatrics, Public Health

Doctors advised to screen for depression and test cholesterol during well-child visits

Doctors advised to screen for depression and test cholesterol during well-child visits

Child_depressionHow old should children be before their doctors start annual depression screenings? According to revised guidelines from the American Academy of Pediatrics, the suggested age is 11. The national physician group also suggests pediatricians check middle school-age children’s cholesterol levels, test 16 to 18-year-olds for HIV, and not perform pap smears in girls younger than 21.

As reported in a Health Day story:

The changes attempt to address several pressing health issues affecting U.S. families today. The nation’s obesity epidemic means that children are developing high cholesterol levels — a risk factor for heart disease — at earlier ages. And depression is linked to higher risk for teen suicides and murder.

“One in five kids will, at some point in time, meet the criteria for depression,” said [Joseph Hagan, MD, co-editor of the guidelines and] a professor in pediatrics at the University of Vermont College of Medicine.

The article continues with explanations for specific changes. A full version of the updated guidelines was published yesterday in the journal Pediatrics.

Previously: Lucile Packard Children’s Hospital partners with high schools on student mental health programs and The link between teen depression and suicide
Photo by D. Sharon Pruitt

Parenting, Pediatrics, Research, Stanford News

Want to boost your child’s language skills? Talk directly to him (or her) from an early age

Want to boost your child's language skills? Talk directly to him (or her) from an early age

13499-fernald_newsIn a past entry published on Scope, my colleague Holly MacCormick spoke with Anne Fernald, PhD, an associate professor of psychology at Stanford, about her research showing that the amount of time parents spend speaking directly to their toddler can make an significant difference in the child’s language proficiency and vocabulary.

To further explore the link between children’s language skills and how often their caregivers talk directly to them, Fernald and colleagues launched a parent-education intervention study with low-income Spanish-speaking mothers in East San Jose. A recent Stanford Report story offers more details about the program and researchers’ preliminary findings:

This new program, called ¡Habla conmigo! (Talk with Me!), teaches Latina mothers how they can support their infants’ early brain development and helps them learn new strategies for engaging verbally with their children. Although they have data from only 32 families so far, the preliminary results are promising. Mothers in the ¡Habla conmigo! program are communicating more and using higher quality language with their 18-month-olds compared to mothers in a control group.

“What’s most exciting,” said Fernald, “is that by 24 months the children of more engaged moms are developing bigger vocabularies and processing spoken language more efficiently. Our goal is to help parents understand that by starting in infancy, they can play a role in changing their children’s life trajectories.”

Previously: Talk to her (or him): Study shows adult talk to preemies aids development, Stanford study shows importance of parents talking directly to their toddler and Study shows brain scans could help identify dyslexia in children before they start to read
Photo by Alan Bailey/Shutterstock

Cancer, Dermatology, Parenting, Pediatrics, Research

Want teens to apply sunscreen regularly? Appeal to their vanity

tanning_021314When it comes to encouraging teenagers to take measures to reduce their risk of skin cancer, new research suggests parents and health educators should emphasize how ultraviolet light causes wrinkles and other signs of premature aging.

In the study, researchers recruited high-school students and randomly assigned them to two groups. One set of participants watched a health-based video that highlighted skin-cancer risks, while the other group viewed a video focusing on the cosmetic changes due to ultraviolet light. Students completed questionnaires demonstrating their knowledge about ultraviolet light and use of sun-protective behaviors before and after watching the videos. According to a University of Colorado Cancer Center release:

… despite knowing the skin cancer risk from ultraviolet exposure, the group that had watched the health-based video showed no statistically significant increase in their sun-protective behaviors. On the other hand, the group that had been shown the appearance-based video reported a dramatic increase in the use of sunscreen.

“For teenagers, telling them [ultraviolet] exposure will lead to skin cancer is not as effective as we would hope. If our endgame is to modify their behavior, we need to tailor our message in the right way and in this case the right way is by highlighting consequences to appearance rather than health. It’s important to address now – if we can help them start this behavior when younger, it can affect skin cancer risk when older,” [says study co-author April Armstrong, MD.]

Previously: Beat the heat – and protect your skin from the sun, As summer heats up take steps to protect your skin, How ultraviolet radiation changes the protective functions of human skin, Medical experts question the safety of spray-on tanning products and The importance of sunscreen in preventing skin cancer
Photo by David van der Mark

Neuroscience, Parenting, Pediatrics, Research

Talk to her (or him): Study shows adult talk to preemies aids development

Talk to her (or him): Study shows adult talk to preemies aids development

preemie sleeping

When my little niece was born at 25 weeks’ gestation, she lived in a clear plastic incubator for the first several months out of the womb. Walled off in her own world, she grew and stabilized her health seemingly by the force of her own strong will, which still powers her as a 6-year-old. Unlike healthy full-term babies who can be snuggled, sung to and incorporated into the fold of a family’s daily life, preemies in the NICU may have less direct contact with their parents and other loved ones initially. But a recent study (subscription required) published in the journal Pediatrics has found that when adults spent more time talking to premature infants in the NICU, those babies score better on development tests at ages 7 and 18 months corrected age (actual age in weeks minus weeks premature).

Reuters Health article reports:

For the new study, the researchers recruited families of 36 babies that were medically stable but born before 32 weeks of pregnancy and kept in the NICU.

….

The babies in the study wore vests equipped with devices that record and analyze the conversations and background noises near the baby over 16 hours. The recordings were taken at 32 and 36 weeks of gestational age.

Overall, the babies were exposed to more talking at 36 weeks than at 32 weeks, but the actual amount of talk each baby was exposed to during the study periods varied from 144 words to over 26,000 words.

The study found an increased amount of parent talk in the NICU was linked to higher language and thinking scores when the babies were older. “I think we should pay attention to it, and try to understand it a little bit better and figure out what the causal mechanisms are,” Heidi Feldman, MD, PhD, a Lucile Packard Children’s Hospital Stanford physician who was not involved in the study, said of the findings.

Previously: The year in the life of a preemie – and his parentsUsing the iPad to connect ill newborns, parents and The emotional struggles of parents of preemies
Photo by singingbeagle

Behavioral Science, Nutrition, Parenting, Pediatrics, Public Health, Research

Fruit-filled Manga comics may increase kids’ consumption of healthy food

Fruit-filled Manga comics may increase kids' consumption of healthy food

kidsfruitMore than a decade into adulthood, I’m still drawn in to the worlds created by sugar-cereal commercials. Hypnotized by the swirling pattern of Cinnamon Toast Crunch and captivated by the magic of Lucky Charms, I can see how actual kids’ eating behavior could be influenced by cartoon messaging.

So I was interested to read about a pilot study in New York City public school children that examined how reading comics featuring healthy food could have an effect on snack choice.

Science 2.0 reports:

It comprised 57 youth, approximately 11 years of age, nearly 90% of whom were either Black/African American or Hispanic and 54% were female. The school districts in the study had greater percentages of students eligible for free lunch (79 and 96%, respectively) compared to the citywide average of 66%.

After reading either a Manga comic, titled “Fight for Your Right to Fruit,” or a non-health-related newsletter, children were given the choice between a healthy snack (oranges, grapes, apples, strawberries) or an energy-dense snack (cookies, potato chips, nacho chips, and cheese-filled crackers). 61% of children in the comic group chose a healthy snack after reading, opposed to just 35% of the control group.

Regarding the choice of Manga, a Japanese comic form featuring detailed artwork and storytelling, the study notes:

The Transportation-Imagery Model (TIM) explains how Manga comics may contribute to changes in health-related beliefs and behaviors. According to the TIM, persuasion of a story’s messages occurs because an individual is “transported” or immersed into the narrative world.15 The TIM also suggests that images are most impactful when they are embedded in a story, rather than provided in isolation.15 Thus, visual images relevant to the story’s messages, such as those incorporated in Manga comics, may further influence attitudes and beliefs.

The authors write, “Results suggest Manga comics may be a useful format to promote healthy snack selection in urban minority youth.” (Side note: Writing about this pilot study made me want to eat mangoes.)

The research was published in the Journal of Nutrition Education and Behavior.

Previously: Depictions of obesity in children’s moviesNo bribery necessary: Children eat more vegetables when they understand how food affects their bodies, Talking to kids about junk food ads, Health experts to Nickelodeon: Please stop promoting unhealthy food to our kids and Researchers find cartoons really do make food taste better (or so kids think)
Photo by North Charleston

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