Reduced Eye-Patching for Lazy Eye Less Stressful, Just as Effective

Wearing an eye patch for two hours a day instead of six works just as well at improving eyesight in children with lazy eye (amblyopia), according to a new study. This research, appearing in May’s Archives of Opthalmology, is good news for families with children suffering from the most common cause of visual impairment in childhood.

In the study, children under the age of 7 were put in two groups. The first received two hours of daily eye patching and the second, six hours. After four months, the rate of improvement for both groups was the same. All children performed one hour of “near” work – coloring, reading, tracing, etc. – while wearing the patch. The near work was an important part of the prescribed treatment. The researchers, however, say they are uncertain whether there would be the same amount of improvement without the daily near work.

"Prior to these results, many children with amblyopia had to wear an eye patch during school hours," says Dr. Paul A. Sieving, director of the National Eye Institute, a branch of the National Institutes of Health and the organization that sponsored the study. "For these children, the accompanying social and psychological stigma was very real. Many were stared at and teased by other children, which made them feel different. Now, children can look forward to attending school without the patch. This will make them feel better about themselves."

Amblyopia usually begins in infancy or childhood and is characterized by poor vision in an otherwise healthy eye. The brain learns to favor the other eye for reasons such as crossed or wandering eyes or a significant difference in nearsightedness or farsightedness between the two eyes. (5-27-03)

Food Fight: Mealtime Struggles

Do you have trouble getting your little one to eat what you give them? If so, you’re not alone.

A study commissioned by the Captain Birds Eye company investigated the eating habits of children in the United Kingdom. The research shows that children aren’t afraid to voice their opinions at mealtimes, and that many of them use refusal of foods as a way to assert their independence.

The study reveals that more than 60 percent of children are reluctant to try new foods. More than a third will only eat a few kinds of foods, and that same number will not eat their dinner at night because they are too full from snacks.

Parents themselves may be hindering their child’s blossoming taste buds. More than 90 percent of parents say their children won’t eat any vegetables without being coaxed, according to the study. But getting upset, providing an alternative or offering a bribe of dessert or other favored foods may help fuel the child’s negative attitude toward the meal.

Attitudes toward food are learned early in childhood, explains Dr. Pat Spungin, child psychologist. “When mums offer a sweet or pudding for eating nutritious food they are inadvertently reinforcing the idea that these foods are not very pleasant because they have to be bribed to eat them," says Dr. Spungin. "In turn, mums place the power back in the hands of the child by resorting to these tactics, so invariably mothers are rewarding fussiness.”

Children can be one of two types of eaters – adventurous or cautious – expert nutritionist, Fiona Hunter, has discovered from an analysis of 100 children’s mealtime diaries. Adventurous eaters are more likely to try unusual foods, such as mangoes or curry. However, 90 percent of the children analyzed fall into the cautious eater category. These children had more of a tendency to choose unhealthy foods over more healthy ones.

So what can you do if your child is a cautious eater and you don’t want to use bribery to get him or her to eat what you serve? Get creative. Some methods other parents have tried to get their kids to eat new or healthy foods include using recipes that disguise vegetables or insisting that their child’s favorite hero or celebrity would eat the food. (5-20-03)

Your Home: A Danger Zone for Children

Researchers of two new studies at the Cincinnati Children's Hospital Medical Center have found that home is the most common location for children to be injured in the United States and that most injuries resulting in a trip to the emergency room for children and adolescents occur at home. It also shows that residential injuries are a leading cause of death for this age group, especially for African Americans.

This study, presented at the Pediatric Academic Societies annual meeting, found the following:

• Between 1985 and 1997, almost 3,000 children and preteens died each year as a result of unintentional injury at home.
• Between 1993 and 1999, children and adolescents under age 20 made four million trips to emergency rooms in the United States.
• Almost one in 10 emergency room visits for a residential injury was for a moderate or severe injury.

Dr. Lanphear’s study shows that nearly 70 percent of deaths in children and adolescents in the United States between 1985 and 1997 were the result of unintentional home injuries. African American children had a death rate that was twice as high as that of white children. Deaths were due, in descending order, to burns or fires, submersions or suffocations, poisonings and falls.

The study also shows that injury rates were greatest for children under 5 and for boys.

The second study found that residential injuries cause nearly 15 percent of all children’s and adolescents’ trips to the emergency room and almost 40 percent of unintentional injury visits between 1993 and 1999. The study shows that falls caused the most home injuries.

"Children's health is inextricably linked with housing," says Dr. Bruce Lanphear, director of the Children's Environmental Health Center at Cincinnati Children's. "Unfortunately, despite evidence that residential exposures have a dramatic impact on children's health, housing is largely ignored as a public health problem. Our research is aimed at making housing and the environment safe for children." (5-20-03)

Wheezing and Daycare Attendance

A study in the American Thoracic Society’s May 2003 American Journal of Respiratory and Critical Care Medicine found that daycare attendance in the first year of life is associated with an increase in wheezing in the first six years of life among children born to mothers who suffer from asthma. Recurrent wheezing at age 6 was defined in the study as two or more episodes of wheezing during the previous year.

Seven associates out of Brigham and Women’s Hospital in Boston, Mass., studied 453 children birth to 6 years old who had a parent with a history of hay fever, allergies or asthma. The infants were recruited for the study between September 1994 and August 1996. The researchers gathered their information through telephone questionnaires conducted with the primary caregivers of the infants.

The researchers found that the relationship between daycare attendance in the first year of life and wheezing in the first six years of life is significantly greater if a child’s mother has asthma. Children without a maternal history of asthma who attend daycare in early life show a decreased risk of wheezing and asthma by age 6. There was no significant finding for children with a paternal history of asthma.

"To our knowledge, this is the first study to show maternal history may influence the relation between daycare attendance in early life and childhood asthma," says Dr. Juan Celedón, one of the authors of the study.

Previous studies in this area have shown protective effects of daycare attendance in the development of asthma in young children. But the researchers of this study claim that the increased risk of respiratory tract infections in children is one reason for the earlier, contradictory findings. (5-13-03)

Homeopathy Not Effective in Treating Asthma

Does homeopathy really work? Not to help children who have asthma, according to a new study in the journal Thorax.

Researchers studied more than 90 children ages 5 to 15 who had mild to moderate asthma, which was treated in the usual way with reliever or preventer inhalers. Classically trained homeopaths, who had been in practice for at least 10 years, also provided homeopathic remedies for the children in up to six sessions over the course of a year. Half the children were given dummy remedies (placebo) instead of homeopathy. Neither the children nor the practitioners knew who would receive which remedy.

Researchers found no evidence that homeopathy had any measurable impact on quality of life. The severity of symptoms lessened among children taking homeopathic remedies, but not to any extent that was significantly greater than placebo.

Homeopathic remedies are used by an estimated 15 percent of children with asthma in the United Kingdom, according to the authors. (5-6-03)

Treating Gastroesophageal Reflux Disease May Reduce Need for Asthma Medications in Children

Children who suffer from both asthma and gastroesophageal reflux disease (GERD) may require fewer asthma medications after receiving anti-GERD treatment, says a study published in the April issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP). The study found that medically or surgically treating GERD in children with asthma reduced the need for total asthma medications by more than half.

The study, conducted at West Jefferson Medical Center, is the first of its kind to evaluate the effect of anti-GERD treatment using acid suppressing drugs called proton pump inhibitors (PPIs) on the requirement for asthma medications in older children with persistent moderate asthma.

During 12 months of observation, all patients in the study (ages 5 to 11) with GERD receiving anti- GERD treatment showed a more than 50 percent reduction in total asthma medications used, and specifically, a more than 50 percent reduction in bronchodilator use. In addition, 89 percent of patients with GERD required no treatment with inhaled corticosteroids, and no patients required use of leukotriene antagonists during the final six months of observation. Patients receiving no anti-GERD treatment showed no change in the use of total asthma medications.

"Children with persistent asthma often take the maximum amount of medications to maintain their asthma, yet they still end up in the emergency room on a regular basis," says Dr. Vikram Khoshoo, pediatric gastroenterologist at West Jefferson Medical Center, New Orleans, La "With anti-GERD treatments such as PPIs, we may help to lighten our patients' asthma regimens and eventually reduce the number of emergency room visits and school days missed." (4-29-03)

Take a Break From the Tube During TV-Turnoff Week

Are your kids too tuned into the tube? Or for that matter – are you? If so, take a break during the annual TV-Turnoff Week 2003 (April 21-27), sponsored by nonprofit group, TV-Turnoff Network. The organization encourages children and adults to watch much less television in order to promote healthier lives and communities.

According to TV-Turnoff Network, a recent a recent Harris poll found more than 90 percent of Americans admit they have soft addictions – seemingly harmless habits like over-eating, compulsive shopping, watching too much TV or surfing the Internet for hours that take our time, zap our energy and keep us from creating a more meaningful life. The poll also found that more than a third said they watch too much TV, and more than half reported too much TV watching in children.

Soft addiction expert Judith Wright has teamed up with TV-Turnoff Week 2003 to encourage millions of children and adults to take a seven-day break from the television and rediscover that life can be more fun, rewarding and even relaxing when we do more and watch less. For many, the Week will become the springboard to making lasting change in their lives: watching less television, choosing what they watch more selectively and engaging in more screen-free activities.

"Families of school-age children that limit TV time report that their children achieve higher grades and social success," says Wright. "They also experience more family closeness, greater creativity and more interactive play at all levels of family involvement." Wright is the author of There Must Be More Than This: Finding More Life, Love, and Meaning By Overcoming Your Soft Addictions (Broadway, 2003).

During TV-Turnoff Week 2002 an estimated 6.4 million people took part in the event in more than 16,000 organized Turnoffs. The lengthy list of supporting organizations for 2003 includes a number of major groups, including the American Academy of Pediatrics, American Medical Association, National Education Association, Boys and Girls Clubs of America and many others.

For more information, log on to www.tvturnoff.org or www.theremustbemore.com. (4-22-03)

Parents Not as Likely to Discuss Children's Anxiety With Doctor

A new study finds that parents are less likely to talk with their family doctor about social anxiety disorders in their children than other issues such as attention deficit-hyperactivity disorder or depression.

The study, presented at the Anxiety Disorders Association of America's 23rd annual meeting, looked at 190 families with children between the ages of 8 to 17.

Researchers found that less than a third of parents who had a child with social anxiety disorder had discussed their child's symptoms with a pediatrician. In contrast, 67 percent parents of children with attention deficit-hyperactivity disorder and half of parents of children with major depression had disclosed these issues with their pediatricians.

"Despite the signs of social anxiety disorder, many children remain undiagnosed for reasons including lack of communication between parent and pediatrician, time constraints of primary care visits, discomfort discussing psychosocial concerns and limited recognition of anxiety problems," says Denise A. Chavira, PhD, department of psychiatry at University of California at San Diego. "Recognizing and providing appropriate treatment recommendations for social anxiety disorders during primary care visits can have important short- and long-term implications."

Social anxiety disorder is particularly prevalent and debilitating in adolescence. Adolescents with social anxiety disorder have few friends, demonstrate disturbances in school function, experience difficulties with intimate relationships and report elevated alcohol use. Research suggests significant stability of this disorder into adulthood, as well as long-term negative consequences including increased risk for suicide attempts, alcohol abuse, difficulty working, incomplete educational attainment and depression.

The Anxiety Disorders Association of America (ADAA) is the only national, non-profit membership organization dedicated to informing the public, health care professionals and legislators that anxiety disorders are real, serious and treatable. The ADAA promotes the early diagnosis, treatment and cure of anxiety disorders and is committed to improving the lives of the people who suffer from them. (4-15-03)

Single Parenthood Increases Risk of Hospitalization, Early Death in Parents, Children

A new study has found that being a single parent increases the risk of hospitalization and early death in mothers, fathers and children.

For a dissertation at Umeå University in Sweden, a researcher traced illness and mortality among about 700,000 mothers and fathers and nearly a million children during the 1990s.

The results indicate that single parenthood entails greater risks of serious ill health (requiring hospital care) and early mortality among mothers, fathers and children. Single mothers showed greater risks when compared with cohabitating mothers. Single fathers, with custody of their children, also had heightened mortality risks, but it was above all single fathers who did not live with their children and single men without children who showed the highest mortality risks.

The greatest rise in risk among both men and women was found in cases of mental illness, suicide and substance abuse. Growing up in a single-parent household seems to mean more than twice the risk of mental illness, suicide/attempted suicide and substance abuse, according to the study, and it was also associated with a lower level of education as an adult.

The researcher attributes some of the increased risk to the fact that single parents have poorer economic and social conditions on average and that a greater share of people with weak health are included in the group. (4-8-03)

Warm Weather May Mean More Emergency Room Trips

Warm, sunny weather drives up the numbers of children requiring emergency care finds a study in Emergency Medicine Journal.

In a study of a children's hospital in Scotland over three months, researchers found that warm, sunny weather consistently drove up the numbers of children requiring emergency care for injuries all three months. Weekends, public and school holidays made no difference.

On average, the authors noted that attendances for emergency treatment were 30 percent higher between April and September than in the winter months. In the winter, medical conditions tended to predominate. (4-01-03)

Secondhand Smoke Linked to Childhood Cavities

Here's another reason not to smoke in front of your children – secondhand smoke may cause cavities, according to a new study.

The study, which appears in the March 12 issue of the Journal of the American Medical Association, surveyed more than 3500 children ages 4 to 11 who had had both dental examinations and a serum cotinine – a byproduct of nicotine – level measurement.

Researchers found that an elevated cotinine level was significantly associated with both decayed primary teeth and those that had fillings.

The authors concluded that there is an association between environmental tobacco smoke and risk of cavities among children. Reduction of passive smoking is important not only for the prevention of many medical problems, but also for the promotion of children's dental health, they say. (3-25-03)

CDC Activates Emergency Operations in Response to New Pneumonia-like Illness

In response to reports of increasing numbers of cases of an atypical pneumonia that the World Health Organization (WHO) has called Severe Acute Respiratory Syndrome (SARS), the Centers for Disease Control and Prevention (CDC) activated its emergency operations center on Friday, March 14.

As of March 19, WHO has received reports of 264 patients from 11 countries with suspected and probable SARS. Areas with reported local transmission include Hong Kong and Guangdong province, China; Hanoi, Vietnam and Singapore. More limited transmission has been reported in Taipei, Taiwan and Toronto, Canada. Eleven cases have been reported in the United States. The initial cases reported in Singapore, Taiwan and Toronto were among people who all had traveled to China.

Among patients reported worldwide as of March 19, the disease has been characterized by rapid onset of high fever, myalgia, chills, rigor and sore throat, followed by shortness of breath, cough and radiographic evidence of pneumonia. Of the 264 suspected and probable cases reported by WHO, nine (3 percent) people have died.

CDC has been working with the World Health Organization (WHO) since late February to investigate and confirm outbreaks of this severe form of pneumonia in Vietnam, Hong Kong and parts of China.

"The emergence of two clusters of this illness on the North American continent indicates the potential for travelers who have been in the affected areas of Southeast Asia to have been exposed to this serious syndrome," says Dr. Julie L. Gerberding, CDC director. "The World Health Organization has been leading a global effort, in which CDC is participating, to understand the cause of this illness and how to prevent its spread. We do know that it may progress rapidly and can be fatal. Therefore, we are instituting measures aimed at identifying potential cases among travelers returning to the United States and protecting the people with whom they may come into contact."

The WHO issued a global alert about the outbreak on March 12, cautioning that the severe respiratory illness may spread to hospital staff. (3-25-03)

Hospital Offers Tips for Helping Kids Cope With War

Now that war in underway, how can you help your children cope? The staff at Linden Oaks Hospital at Edward in Naperville, Ill., offer the following suggestions:

• Monitor the television! While adults may understandably want ongoing, up-to-date information, children need to be protected from an onslaught of graphic and violent images.
• Give children honest information at their level of understanding.
• Allow them to "lead" the conversation rather than overwhelm them with details.
• Get help for yourself! Your child will sense and feel your anxiety. Be conscious of your own reactions and try not to burden your child with your own shock, anger, fear or grief. Be aware of forcing or wanting a certain response from your child.
• Listen! Don't judge, don't criticize and don't minimize.
• Assure children that they and your family are safe.
• Be available for your children. Play with them while encouraging them to share their thoughts. Remember that children may not discuss issues in the same manner as adults – often, their deepest feelings are revealed during play.
• Fear is OK – it is a normal reaction in these circumstances.
• Some may not immediately show fears/emotions, and this, too, is normal. Children often deal with significant emotions on a bit-by-bit basis. It may take several days or weeks for children to process their reactions. Stay tuned in.
• Mobilize outside support: church, family, friends, schools and community groups.
• Do your best to maintain a normal routine.
• Be careful not to project strong political, ideological, racial or cultural feelings onto children. Reserve these topics for adults.
• Be prepared to answer "Why?" Respond in a manner that allows for discussion and attends to fear and anxiety about the future.
• Understand and remember that we are all Americans and we must help our children not to focus any blame on our neighbors.

Linden Oaks Hospital at Edward provides a wide range of inpatient, outpatient and partial hospitalization behavioral health services including support for depression, chemical dependency, eating disorders, self injury, anxiety disorders and more.(3-25-03)

Design of New Thermometer Helps Kids, Seniors Take Temperature

Have trouble getting your child’s temperature? A new thermometer could help make the task a little easier.

MEDport, LLC and Timex Licensing Corporation recently unveiled the first in a new series of digital oral fever thermometers – the Timex Accu-Curve Thermometer – developed by three Rhode Island moms.

The Timex Accu-Curve Thermometer features a curved design, which allows the thermometer's temperature-taking tip to comfortably rest on the 'hot spot' under the tongue, the best place for recording a person's body temperature. The thermometer's body, which houses the electronics, is properly balanced so the thermometer's weight doesn't push up and move the thermometer around in the mouth. The result is a quick, accurate, more enjoyable and measurably better temperature-taking experience, according to the company.

"Listening to and working with moms, we have found a safer, better way, using a superior and smart ergonomic design,” says Jeff Jacober, chairman of MEDport LLC. “Our design incorporates other beneficial features such as a large, easy-to-read display and Indiglo® nightlight, which allows a person to take a temperature at night without having to turn on a light."

Jacober also says that the Timex Accu-Curve is an ideal thermometer for seniors who may also have difficulty using traditional straight thermometers. "For someone like my dad who has Parkinson's and has a hard time keeping the tip of the thermometer in the right place, the Accu-Curve is a perfect solution," he says.

For more information, log on to www.medportllc.com. (3-18-03)

Window Cords Pose Hazards to Toddlers as Well as Babies

While many parents and caregivers know about the potential dangers window cords can pose to infants, many are unaware that toddlers and young children also can be at risk.

Since 2000, nearly 40 percent of window-cord strangulations reported to the U.S. Consumer Product Safety Commission have involved children between the ages of 3 and 6. While cord hazards involving infants are almost always due to placement of a crib or playpen near a window, toddlers frequently become entangled in window cords while climbing furniture to look out a window.

"Toddlers are naturally active and curious, which is why it is so important to restrict access to windows and to make sure window cords are secured up and away from reach," says Carolynn Jennings, deputy director with the Window Covering Safety Council (WCSC). Since 1995, the Council has provided consumers with free window cord safety repair kits through their toll-free hotline at 1-800-506-4636.

Jennings says parents should adhere to the following safety rules to eliminate or severely reduce a toddler's access to windows and cords:

• Move all furniture, cribs and climbable items as far away from windows as possible, preferably against another wall.
• Secure all pull-cords out of reach by using a cleat or permanent tie-down device.
• Install cord stops on horizontal blinds and miniblinds to prevent inner-cord access.
• Eliminate looped pull-cords on older (pre-1995) mini-blinds and shades by cutting the loop and attaching safety tassels to the pull-cord ends.

Parents can find additional information and illustrations of window cord hazards and appropriate methods of safety repair at www.windowcoverings.org. (3-11-03)

Online Workshop Educates Parents on Preventing Infections, Preparing for Bioterrorism

A new online workshop teaches Americans of every age how to prevent infections in all areas of life, from homes, businesses and classrooms to what to do if a bioterrorist strikes.

The Parents of Kids with Infectious Diseases (PKIDs) workshop is filled with vivid graphics, amazing facts and fun activities for any age. It is a train-the-trainer program offered free of charge to the nation's classrooms, employers, parents and coaches.

The workshop focuses on the following areas:

• Why viruses and bacteria are so good at making us so sick.
• How to prevent infections through standard precautions and immunizations.
• Beware the blood: Fun ways to teach children standard precautions.
• Make your own alcohol disinfectant handrub.
• Why do state governments mandate immunizations?
• How to prepare for a bioterrorist strike.
• How to keep athletes of all ages safe from bloodborne and other infections.
• Why the infected are stigmatized and what protections civil rights laws provide.

"The workshop is designed so anyone can use it to teach others about infectious disease – no teaching certificate is required!" says Trish Parnell, executive director of PKIDs, a national nonprofit organization that supports families touched by infectious diseases and educates the public about disease prevention. "Each section provides a detailed instructional text plus great hands-on learning activities for use in homes, schools and businesses."

The materials were developed in cooperation with leading physicians and public health educators to create an accurate and user-friendly program that is free to the public.

PKIDs' Infectious Disease Workshop can be downloaded or printed for free at www.pkids.org/idw.htm or it can be purchased on CD-ROM for $30 plus shipping and handling by calling 360-695-0293 or e-mailing pkids@pkids.org. (3-11-03)

Would Your Child Touch a Gun?

Parents' beliefs about how their children would react to finding a gun may impact whether – and how – they address gun safety issues reports a new study in the February issue of Pediatrics.

According to the study, "'They're Too Smart for That': Predicting What Children Would Do in the Presence of Guns," researchers found that 87 percent of parents surveyed – regardless of gun ownership, geography, race, gender, education level, income or child age – believed that their children would not touch a gun they found.

The researchers specifically investigated how parents reasoned about their children's actions. They concluded that physicians and others who address gun safety topics should think about the issue not only in terms of what the parents believe about guns, but also in terms of what they believe about their child's developmental level and impulse control. (3-4-03)

Many Emergency Room Trips Due to the Common Cold

Parents who are misinformed about the cause and treatments of colds may be more likely to take their children to the emergency room, reports a new study in the February issue of Pediatrics.

The study found colds accounted for 1.6 million emergency room visits in 1998, even though most colds are viral and do not require medical intervention.

Researchers suggest that educating parents about the inappropriate use of antibiotics for treating colds may reduce unnecessary ER visits. (2-25-03)

Restraint Use Rises to Record High Level for Infants and Toddlers

A new survey from the U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) reports good news: More children are being restrained during travel than ever before.

An NHTSA survey found that an estimated 99 percent of infants under age 1 are now restrained during travel, up 4 percentage points from 2000. Fully 94 percent of toddlers are now restrained, a 3 percentage point gain over two years ago. Eighty-three percent of children ages 4 to 7 are restrained, with no past data available for this age group.

“Children are the most vulnerable passengers riding on America’s roadways. It is extremely good news that more of them are now safely secured,” says Dr. Jeffrey W. Runge, NHTSA administrator.

However, Dr. Runge indicated serious concern about other findings from the survey, which shows that many young children continue to ride in the front seat. An estimated 15 percent of infants under age 1 now ride in a front seating position; 10 percent of toddlers ages 1 to 3 ride in the front; and 29 percent of youngsters ages 4 to 7 do so.

Besides indicating increasing restraint use among infants and toddlers, the latest national survey reached these key findings:

• The link between restraint use of drivers and their child passengers remains strong. More than 90 percent of belted drivers also restrain the children traveling in their vehicles. Approximately 70 percent of unbelted drivers restrain their child passengers.
• Male drivers are restraining their children more often than they did two years ago, bringing them to near parity with female drivers. The 2000 survey indicated a 7-percentage-point disparity between men and women. That gap has now been narrowed to about 1 percentage point.
• Parents appear to be more aware of the need for appropriate restraint use based on the age and size of their children. The latest survey indicates lower incidence of “premature graduation” in the use of restraint systems. Premature graduation involves transitioning children to the next stage of restraint system use before they are ready in terms of age or size. For example, infants are placed in forward-facing seats too soon, or children are moved from a child safety seat directly to an adult safety belt too soon, bypassing the booster-seat stage. (2-18-03)

Help Your Child Avoid Cavities

Cavities may be the most common childhood disease, but with a little help from parents, children can avoid them says a new report in the journal General Dentistry.

Cavities, an infectious disease caused by acid-forming bacteria found in dental plaque, destroys the tooth's structure. Young children, ages 1 through 6, are more susceptible to develop cavities because their primary teeth have thinner, weaker enamel and are a prime target for plaque. Primary teeth also have more spaces between teeth where food is more likely to linger, which creates a breeding ground for cavity-causing bacteria.

"Learning about proper oral care should be just as much of a priority as prenatal care. Parents-to-be should take the initiative and ask health care professionals about a baby's oral health," says Shahrbanoo Fadavi, DDS, MS.

How can parents help their children keep cavities at bay?

1. Add more fluoride to children's daily intake. Fluoride strengthens young teeth and can be obtained through toothpaste, fluoridated water, rinses and professional application. Not only does fluoride prevent the development of cavities, it also repairs the early stages of tooth decay (before cavity formation). Therefore, tooth decay is reduced throughout the child's life and so is the cost of dental treatment.

2. Eat a healthy, balanced diet and limit sugar intake. "Promote fruits and vegetables in the household, and remove foods with processed sugars and add teeth-cleaning foods like apples, carrots and celery," says Manuel Cordero, DDS, MAGD, spokesperson for the Academy of General Dentistry. However, be selective on what you serve.

In addition, limit or eliminate sugary drinks and snacks; the best alternative drink is water. "After eating, these sugary carbohydrates lead to 20 minutes of acid production in the mouth which is the crucial time when cavities form," says Cordero. Replace sweet treats with fruits, and buy sugar-free chewing gum that contains xylitol and sorbitol. Limit intake of carbonated drinks, and use a straw with drinks to prevent sugar contact with teeth.

3. Help implement a dental education program within the school and/or community. Make dental and health education a priority within the school system. Children spend most of their waking hours at school and are easily influenced by others, which can form bad habits. Parents should speak with teachers and school administrators about producing dental and health based programs or workshops that will teach kids about practicing good oral hygiene and nutrition.

"Parents can also teach kids good dental care through imitation. Let your children watch you brush your teeth and then take time to show them how to do it," says Dr. Cordero.

4. Prevent baby bottle tooth decay by becoming aware of nursing patterns. Baby bottle tooth decay is caused by the frequent and long-term exposure of a child's teeth to liquids containing sugars. Among these liquids are milk, formula, fruit juice, sodas and other sweetened drinks. The sugars in these liquids pool around the infant's teeth and gums, feeding the bacteria that cause plaque. Every time a child consumes a sugary liquid, acid attacks the teeth and gums. After numerous attacks, tooth decay can begin.

Never allow children to fall asleep with a bottle containing milk, formula, juice or other sweetened liquids. Clean and massage the baby's gums to help establish healthy teeth and to aid in teething. Wrap a moistened gauze square or washcloth around the finger and gently massage the gums and gingival tissues. This should be done once a day.

5. Children should visit a dentist within six months of the eruption of the first tooth. Parents often wait much longer than this for their child's first dental visit. However the American Academy of Pediatric Dentistry and the Academy of General Dentistry recommend children visit a dentist within six months after the first tooth erupts and no later than 12 months of age. During the first visit, parents will learn more about the proper oral care and hygiene measures that is necessary for healthy, young teeth. (2-11-03)

New Award-winning Segment to Join Teletubbies Program on PBS

Are Tinky Winky, Dipsy, Laa-Laa and Po household names in your home? If so, you'll be happy to learn – or at least your kids will – there's a new addition to the popular Teletubbies TV show on PBS.

Teletubbies Everywhere, a new 10-minute segment which starts off the show, features the Teletubbies characters in a simple, graphic setting and introduces first concepts such as numbers, shapes, colors and opposites with clarity and humor at a pace very young children enjoy. Created by international filmmakers, each live-action segment provides an entertaining and innovative new way for American preschoolers to discover the lives, languages, music and customs of children from a variety of cultures and countries.

"Children everywhere will love 'Everywhere'," says David Levine, vice president of corporate and business affairs at Ragdoll, the creator of Teletubbies. "'Everywhere' looks and feels wonderfully different from the original Teletubbies show and will add immensely to the enjoyment of children who already watch the Teletubbies everyday."

Teletubbies Everywhere recently received a BAFTA Award (British Emmy). (2-04-03)

Government to Test Drugs Prescribed to Kids, But Not Yet Tested in Kids

The U.S. Department of Health and Human Services (HHS) has announced that 12 commonly-prescribed drugs will be tested for use in children beginning this year.

Once a drug has been approved for a particular use, physicians may prescribe it for other uses as they deem necessary. Many commonly-available drugs, although approved for use in adults, have never been tested specifically for use in children. The 12 drugs on the list are currently prescribed for children, but their safety and effectiveness has been established only in adults.

The drugs include:

• Azithromycin – an antibiotic used to treat many different types of bacterial infections.
• Baclofen – a muscle relaxant used to relieve the spasms, cramping and tightness of muscles caused by medical problems such as multiple sclerosis or certain injuries to the spine.
• Bumetanide – used to reduce the swelling and fluid retention caused by various medical problems, including heart or liver disease. It also is used to treat high blood pressure. It causes the kidneys to get rid of unneeded water and salt from the body into the urine.
• Dobutamine – a heart-stimulating drug.
• Dopamine – used to treat Parkinson's disease and schizophrenia.
• Furosemide – used to treat swelling and water retention.
• Heparin – decreases the clotting ability of the blood and helps prevent harmful clots from forming in the blood vessels.
• Lithium – treatment for bipolar disorder (extreme mood changes from depression or anger to elation).
• Lorazepam – treatment for anxiety.
• Rifampin – used in combination with other medications to treat tuberculosis and to treat carriers of meningitis-causing bacteria.
• Sodium nitroprusside – a treatment for high blood pressure.
• Spironolactone – a treatment for high blood pressure.

Each drug will undergo about two years of testing, followed by evaluation of test results by the FDA. The testing is called for in the Best Pharmaceuticals for Children Act (BPCA), which was signed into law by President Bush last year. The law provides for HHS agencies to sponsor pediatric tests of certain drugs already approved for marketing but never tested specifically for their effects in children. (1-28-03)

Advice to Slow Down Does Not Help Kids Who Stutter

"Slow down and relax!"

A new survey shows that this is exactly what most adults tell children who stutter, but leading experts say that strategy can aggravate the problem.

A national survey of 1,000 adults by the Stuttering Foundation found that nearly 90 percent said “slow down and relax” is exactly what they would tell a child who began to stutter. Yet such simplistic advice won’t help stop stuttering and may actually frustrate a child who stutters, say experts at the Stuttering Foundation, a nonprofit organization dedicated to the prevention and improved treatment of stuttering.

“Parents should realize that the way they react to stuttering plays an important role in the child’s speech development,” says Lisa Scott Trautman, Ph.D., assistant professor of speech-language pathology at The Florida State University. “If a child senses frustration and impatience when he speaks, his concerns about talking will increase.”

So what are parents to do?

• Remain calm if you hear your child stutter.
• Give the child your attention and listen carefully, allowing him to complete his sentence without interruption.
• Talk in a slow, relaxed way yourself; this will be more effective than any criticism or advice to "try it again slowly."
• Convey that you are listening to what your child says, not how she says it. This will build confidence and likely increase fluency.

For many young children, positive attitudes and reactions of parents and other family members are an effective way to encourage normal fluency. However, if stuttering lasts longer than six months or if it seems fairly severe or worsens, an evaluation by a speech therapist is recommended. The success rate is very high when children begin therapy between the ages of 2 and 5 years old.

For more information and a list of local resources, log on to the Stuttering Foundation Web site at www.stutteringhelp.org or call 1-800-992-9392. (1-21-03)

Some Toys Create Risk of Suffocation

Did you know toys can not only pose a choking hazard to children but some can also cause them to suffocate by creating a suction?

A new study appearing in the January issue of Pediatrics looked at data from the U.S. Consumer Product Safety Commission between January 1983 and March 2000 and found that eight children between the ages of 3 and 4 died from such suffocation. Nine children of the same age survived because of parental intervention.

In all of the cases, a child placed a hollow, hemispherical toy or object over the nose and mouth causing a suction effect and upper airway obstruction.

The study recommends product design changes that would limit surface contact between a child's face and a toy or object's perimeter and lower the chance of forming a seal. Ventilation holes could also help prevent suffocation. The study also recommends parent and practitioner education on such hazards. (1-21-03)

Nip Head Lice in the Bud

Sometimes parents get more than they bargained for when they travel to visit friends and relatives over the holidays. Head lice, an unfortunate part of raising children today, may have returned home along with the happy memories and yellow credit card slips.

The National Pediculosis Association (NPA) reminds parents to screen for head lice and their eggs (nits) before their children return to the classroom or to childcare after the holiday vacation. Getting lice "out of your hair" is not so difficult if families are prepared with accurate information and effective tools.

The NPA encourages routine screening, early detection and removal of lice and nits to minimize disruption, save money and, most importantly, protect against unnecessary and direct exposure to potentially harmful chemicals, many of which have no benefit because of lice resistance.

The NPA urges a manual and non-chemical approach using the LiceMeister®, comb especially for children who have other medical problems or mothers who may be pregnant or nursing.

Free educational downloads and a limited free offer for the NPA's "Critter Card" to help parents accurately identify head lice and nits are available at www.headlice.org. (1-14-03)

More Children Receiving Health Insurance

The number of children receiving health insurance is continuing to increase according to a new report from the Centers for Disease Control and Prevention (CDC).

The CDC conducts an annual survey tracking health insurance and other health indicators for Americans.

The report found that the percent of American children with health insurance continued to increase in the first half of 2002, meaning that a half million more children are now covered by insurance than in the previous year. The improvement comes as more children rely on public coverage for their health care, including the State Children's Health Insurance Program (SCHIP) created in 1997.

SCHIP is designed to help children without health insurance, many of whom come from working families with incomes too high to qualify for Medicaid but too low to afford private health insurance. There were 4.6 million children enrolled in SCHIP at some point during fiscal year 2001, the most recent year for which complete state data is available.

Overall, just more than 14 percent of the population was without health insurance coverage in the first half of 2002, about the same as in 2001, and down from about 15 percent in 1997.

Working-age adults were more likely than seniors or children to lack health insurance coverage, with 18.5 percent of those aged 18 to 64 without coverage. In early 2002, about one in three Hispanics lacked health insurance, a far greater percent than the non-Hispanic black population (16.4 percent) and non-Hispanic whites at 10.5 percent.

The complete report is available at www.cdc.gov/nchs. (1-14-03)

Report Offers Latest Numbers on Assisted Reproductive Technology

According to a new report from the Centers for Disease Control and Prevention (CDC), more than 35,000 babies were born as a result of assisted reproductive technology (ART) procedures in 2000, with in-vitro fertilization (IVF) the most common infertility treatment.

The CDC's sixth annual ART report summarizes national trends and provides information on success rates from more than 380 fertility clinics around the country.

Overall, about one in four ART cycles resulted in the birth of a baby for women who used their own (fresh) eggs. This is a slight increase in the success rate from the previous year.

The report also found that the age of the woman is one of the most important factors in determining whether she will have a live birth by using her own eggs. Overall, a third of the ART procedures started in 2000 among women younger than 35 resulted in live births. This percentage decreased to 27 percent among women aged 35 to 37, 18 percent among women aged 38 to 40, 10 percent among women 41 to 42 and 4 percent among women older than 42.

Thirty-five percent of all ART deliveries were multiple births, compared with less than 3 percent for the general population. This is because multiple embryos are often transferred to increase the likelihood of a live pregnancy. Multiple births are associated with greater risk, both to the babies – including prematurity, low birthweight, neonatal death and lifelong disability – and to the mothers, including Cesarean section and hemorrhage.

The full report is available on the Web at www.cdc.gov/nccdphp/drh/art.htm. (1-14-03)

Government Issues Warning on Car Seats

The U.S. Department of Transportation’s National Highway Traffic Safety Administration (NHTSA) recently warned consumers to watch out for problems with child seats equipped with recessed buckles built into the seat between the child’s legs.

NHTSA said the buckles in these seats can easily collect particles of food, drink, dirt, sand or other material that may interfere with the buckle. The consumer may have difficulty latching and unlatching dirty buckles. In some cases the material may cause a “false latch” if the user mistakenly believes that the buckle is securely latched when it is not.

To ensure that the child is securely fastened in the child seat, the user should always check that the buckle is fully latched every time the seat is used. The user does this by (1) inserting the latch plate fully into the buckle; (2) listening for a click and (3) tugging firmly on the harness webbing to make sure the buckle is latched.

Consumers should be sure to inspect the car seat regularly for food or debris down in the buckle area. If the buckle becomes difficult to operate or fails to latch even after it is cleaned, NHTSA recommends that the consumer contact the child seat manufacturer and the safety agency’s toll-free Auto Safety Hotline, 1-888-327-4236, to report the problems. If the buckle does not latch properly even after it is cleaned, the seat should not be used. (01-14-03)

Caffeine Likely to Affect Your Child's Sleep

Is your child like trying to wake the dead in the morning? If so, you might want to check their consumption of caffeine, say researchers at the Children's Nutrition Research Center (CNRC) at Texas Medical Center in Houston

"The stimulating effect of caffeine can last up to three to four hours after consumption," says Dr. Janice Stuff, a CNRC nutrition researcher. "As a result, kids who reach for caffeine-containing beverages in the evening can have trouble falling and staying asleep at night, which can make it harder to get them up in the morning."

Caffeine is a mild stimulant considered safe in moderate amounts, according to the CNRC. For older teens and adults, a moderate amount is 200 milligrams per day, or about two 6-ounce cups of coffee. For younger children, experts suggest keeping caffeine levels below 50 milligrams a day, or the amount found in one 12-ounce soda.

To help children improve their beverage choices and sleep, Dr. Stuff offers the following strategies:

• Opt for decaffeinated or caffeine-free versions of soft drinks, coffees and teas. Also, don't forget that beverages like milk, water and fruit juice are part of a healthy diet.
• Downsize soft-drink, tea and coffee purchases.
• Watch the time. Avoid consuming caffeine-containing foods, medications and beverages within four hours of bedtime.
• Check the label. Although two products may seem identical, one may be caffeine-free while the other is not. Also, keep in mind that some citrus-flavored soft drinks contain more caffeine than colas. Caffeine is also a common ingredient in some over-the-counter medications.
• To learn more about caffeine, visit http://ific.org/pdf/CaffeineIFICReview.pdf.
• To find out the caffeine content of common foods, beverages and medications, visit www.cspinet.org/new/cafchart.htm.

Children With Sleep Apnea Have Smaller Airways

Children with sleep apnea have smaller airways, reports a new study in the January issue of the American Journal of Respiratory and Critical Care Medicine.

Researchers at Children's Hospital of Philadelphia examined of the upper airways in 20 children whose age averaged 3.7 years and who had obstructive sleep apnea (OSA) and in 20 children who did not. The investigators used MRI to visualize and accurately measure the upper airway, various soft tissues and the skeleton comprising this area.

They found that the size of the airway in the children with OSA was significantly smaller in comparison with the control group.

OSA results from a blockage in the throat or upper airway. The researchers say that complete obstruction during air intake may be more likely where narrowing in the airway occurs and high negative pressures are developed.

In sleep apnea, a sleeping individual repeatedly stops breathing long enough to decrease the amount of oxygen in the blood and brain and to increase carbon dioxide. After more than 10 seconds, the person awakens very briefly and resumes breathing. According to the authors, OSA in children is a common disorder and may affect as many as 2 percent of younger persons. (1-07-03)

Restricting Unhealthy Foods May Cause Young Girls to Overindulge

A new study shows that restricting what your daughter eats may not help her develop better eating habits and in fact may backfire and cause her to overindulge.

Dr. Jennifer Fisher of the Children's Nutrition Research Center (CNRC) at Texas Medical Center in Houston monitored the eating habits of nearly 200 5-year-old girls over a two-year period to see what and how much of several tempting snack foods they would consume right after eating a full meal and were no longer hungry.

She found that the tendency of young girls to over-indulge in snack foods when not hungry increased when their parents were in the habit of tightly controlling what their daughters ate.

"Kids, just like adults, don't like to be told what they can't do," says Dr. Fisher.

The study also revealed that those who tended to consume the most snacks when not hungry were more than four times as likely to be overweight at both 5 and 7 years of age.

According to Dr. Fisher, the study suggests that a less restrictive approach that includes palatable, energy-dense foods as part of a well-varied diet could help young girls stay in touch with their own fullness cues and maintain a healthy view of their own eating. However, she also stresses that this does not mean that parents should let kids eat whatever and whenever they wish. (12-24-02)

Help for Vegan Parents

How can you raise your child to be a vegan in a non-vegan world? A new book published by VegFamily magazine will help vegan parents do just that.

Raising Vegan Children in a Non-Vegan World by Erin Pavlina, editor of VegFamily, offers advice on transitioning children to a vegan lifestyle, health and nutrition concerns, selecting veg-friendly schools and daycare centers, how to handle social situations, traveling advice, how to instill in children compassion for animals and the environment, as well as 32 kid-friendly recipes.

For more information or to purchase the book, visit www.VegFamily.com. (12-24-02)

Choose Safe Toys to Avoid Injuries This Christmas

What is your child getting from Santa this year? Prevent Blindness Ohio, a nonprofit organization dedicated to preventing blindness and preserving sight, reminds you to choose your gifts wisely to avoid having your child become an emergency room statistic.

In 2001, close to 10,000 children under the age of 14 were treated in U.S. hospital emergency rooms for eye injuries caused by toys and sporting equipment, according to Prevent Blindness Ohio. The total number of general toy-related injuries is much higher with an estimated 247,000 toy-related injuries in 2001, according to the organization.

These injuries can result from accidents (such as a child tripping over a toy that is left out), unintended misuse of the toy or an inherent flaw in the toy's design or material.

Prevent Blindness Ohio offers the following tips to make your holidays safer for your children:

1. Inspect toys for safe construction. Products given to young children should be made of durable plastic or wood with no sharp edges or points.
2. Toys should be able to withstand impact. Avoid purchasing toys with small parts for young children. Young children tend to put items in their mouths, increasing their risk of choking.
3. Check your children's toys regularly for broken parts. Throw broken toys out immediately if they cannot be safely repaired. Older children often alter their toys and misuse them, making them unsafe. It is better to be vigilant, even with older children, so that serious eye injuries can be prevented.
4. Read the instructions and suggested age level on the packaging. Assess whether the item is appropriate for the child's ability and age. Age labeling is provided not just for developmental reasons, but for safety reasons as well.
5. Avoid toys that shoot projectiles, such as toy guns. They contribute to a large number of serious eye injuries and can rob children of their sight. Last year, there were close to 2,000 eye injuries in children under the age of 14 caused by toy weapons, BB guns, slingshots and other propelled toys.
6. Look for the symbol ASTM F963. This indicates the product meets the national safety standards set by the American Society for Testing and Materials (ASTM).
7. Make recommendations to family members and friends about gifts that you feel are appropriate for your child.
8. Remain aware of recalled products. Large toy retailers post regular notices of recalled toys usually at the front of the store. Take recalled products back to the store where they were purchased for a full refund. For further information on toy and product recalls, visit the U.S. Product Safety Commission Web site at www.cpsc.gov.

For a free fact sheet on tips for choosing toys and the most dangerous toys to children's eyes, call 1-800-301-2020. (12-17-02)

Acupuncture May Help Relieve Pain and Nausea in Children

Acupuncture can be beneficial for children suffering chronic pain or nausea, according to an article published in the December issue of Contemporary Pediatrics.

Dr. Kathi Kemper, a pediatrician at Brenner Children's Hospital in Winston-Salem, N.C., says acupuncture may be used as an additional therapy for children who experience chronic, recurrent or severe pain such as migraine, severe chronic abdominal pain and pain associated with cancer and nausea.

"Several studies have shown that acupuncture is effective in the treatment of headaches in pediatric patients," says Dr. Kemper. "Acupuncture is safe and effective. For patients who have no interest in taking additional medications or who are already receiving maximal medical treatment and want help with symptoms, acupuncture is a viable alternative."

For nausea, she recommends a combination of professionally-administered acupuncture and over-the-counter acupuncture wristbands. She says patients often prefer acupuncture because its side effects include a greater sense of well-being, enhanced alertness and reduced pain.

Acupuncture is the most familiar of the several therapies that make up traditional Chinese medicine. Traditional Chinese medicine views disease as an imbalance or lack of harmony in the body and prescribes therapies as a way to restore that balance and harmony, according to Dr. Kemper.

Although many children's hospitals, including Brenner Children's Hospital, do not currently offer acupuncture services, Dr. Kemper says she hopes that as more acupuncturists become available in more mainstream clinical settings and as insurance plans are encouraged to cover the treatment, pediatric access will grow. (12-17-02)

New Scans Help Kids Avoid Unnecessary Appendectomies

Some appendectomies may be unnecessary, and two types of scans can help doctors determine whether or not your child truly needs the surgery, according to new research in the December issue of Pediatrics.

Researchers looked at more than 1,300 children who were hospitalized with suspected appendicitis and found that ultrasonography (US) and computed tomography (CT) scans helped rule out appendicitis among the children who were difficult to diagnose. The children then avoided unnecessary appendectomies.

In addition, the scans revealed true appendicitis more quickly, reducing the risk of a perforated or "burst" appendix. Both perforation and negative appendectomy rates significantly declined in children after the protocol using US and CT was implemented. (12-10-02)

High Quality Daycare Offers Lifetime of Benefits

High quality childcare pays, according to a new analysis of data from a long-running research project at the FPG Child Development Institute at the University of North Carolina at Chapel Hill.

Researchers found that for every dollar spent on high-quality early education programs, taxpayers can expect four dollars in benefits. "These programs not only lead to greater academic success, they boost lifetime earnings for participants and their mothers," says Steven Barnett, co-author of the report and director of the National Institute of Early Education Research at Rutgers University.

Researchers did a benefit-cost analysis of the Abecedarian Early Childhood Intervention Project, which began in the 1970s at FPG. They found:

• Children in high-quality programs are projected to make roughly $143,000 more over their lifetimes than those who didn't take part in the program.
• Mothers of children who were enrolled can also expect greater earnings – about $133,000 more over their lifetimes.
• School districts can expect to save more than $11,000 per child because participants are less likely to require special or remedial education.
• Results suggest a possible impact on smoking. Participants were less likely to smoke (39 percent vs. 55 percent in the control group), resulting in health benefits and longer lives, for a total benefit of $164,000 per person.
• The children of participants are projected to earn nearly $48,000 more throughout their lifetimes.

Researchers at UNC began the Abecedarian Project with 57 infants from low-income families who were randomly assigned to a high-quality childcare program at FPG. Another 54 infants were in a control group that did not attend the same program, although some did attend other childcare centers. The project included small class sizes, well-trained and well-compensated teachers and a strong curriculum.

Researchers have followed the participants, who are now young adults, and found that they were more likely to perform well on intelligence tests, pursue higher education and delay parenting than those who did not take part in the program. (12-10-02)

Bottle-feeding Before Bedtime Linked to Asthma, Wheezing

Feeding your baby by bottle in his bed or crib before he goes to sleep could cause him to wheeze and have asthma as a toddler and child.

Researchers followed nearly 450 children from birth through age 5 to examine the relationship between bottle-feeding in the bed or crib before sleep time in the first year of life and wheezing and asthma in the first five years of life. Researchers found that that such bottle-feeding was a risk factor for asthma and recurrent wheezing at 5 years of age and wheezing between the ages of 1 and 5.

Each of the children in the study had at least one parent with a history of allergies or asthma.

The researchers concluded that avoiding large-volume liquid meals in the bed or crib before sleep time and perhaps avoiding placing a baby on his or her back immediately after bottle-feeding may reduce wheezing in early childhood.

The study appears in the December issue of Pediatrics. (12-03-02)

Parents Uninformed About Dangers of Hepatitis A

Do you know the facts about hepatitis A? A new survey by the American Liver Foundation (ALF) found that many parents do not know how hepatitis A affects the body, how severe the disease can be or how it is transmitted.

According to the ALF, parents need to be educated about hepatitis A because the highest incidence of cases occurs among children under 10.

Hepatitis A, an infection of the liver, is spread via the fecal-oral route, through close personal contact or through the ingestion of contaminated water or food. Symptoms of the disease can be debilitating and include fever, fatigue, loss of appetite, nausea, abdominal discomfort, jaundice and dark urine.

Infected individuals can unknowingly infect others up to two weeks prior to feeling ill themselves. On average, people miss about 30 days of work when they are infected with the virus that causes hepatitis A. Up to 22 percent of adult hepatitis A patients require hospitalization and more than 100 people in this country die every year from consequences of the disease.

Even though infected children may not always display symptoms of the disease, they serve as a “reservoir” for the virus, easily passing it to adults who can develop severe symptoms, liver disease and even death in rare cases.

Although the hepatitis A vaccine is available for children over 2, awareness of the vaccine is also very low.

Part of the confusion stems from a misunderstanding between the different types of hepatitis. The survey results indicate that hepatitis A has the lowest awareness by parents as compared to hepatitis B or hepatitis C.

"There has been a large public focus on hepatitis B and hepatitis C, but people need to be educated about hepatitis A. They need to know that it is a highly infectious liver disease contracted via the fecal-oral route,” says Dr. Philip Rosenthal, professor of pediatrics and surgery at the University of California.

For additional information about hepatitis A or other forms of viral hepatitis and liver disease, contact the ALF at 1-888-4HEP-ABC or visit www.liverfoundation.org. (11-26-02)

Strokes in Children Have Myriad Causes

A new study finds that childhood stroke can be caused by a number of things beyond the obvious causes such as cardiac disease, iron deficiency anemia and coagulation disorders.

In the study appearing in the Annals of Neurology, British researchers reviewed the cases of 212 stroke patients who averaged 5 years of age. About half had previously been diagnosed with conditions ranging from congenital heart disease to sickle cell disease.

Among the previously healthy group, 23 had recently suffered trauma to the head or neck and 68 had had chickenpox. These numbers were significantly greater than among the symptomatic patients.

In contrast to some previous studies, completely unexplained stroke was rare if patients were evaluated in detail, say researchers, recommending that all children who suffer stroke should have comprehensive evaluations even if the cause of the stroke is thought to be obvious. (11-26-02)

Tomboys May Be Born, Not Made

Do you have a tomboy in your family? New research shows they were likely born that way.

In a study appearing in the November/December issue of Child Development, researchers measured the levels of testosterone in more than 13,000 pregnant women and then evaluated the behavior of their children at age 3 1/2.