Archive for category News

Baby chokes after dummy breaks

The failure of a popular brand of baby dummy in Australia has sparked safety fears on both sides of the Tasman.

A baby boy choked on a Happy Baby brand dummy after the teat came off.

The company has not recalled the dummies; instead it has asked for the broken one to be returned for tests.

It has also warned customers not to over-sterilise their dummies, which it says will cause them to deteriorate faster than normal.

http://tvnz.co.nz/world-news/baby-chokes-after-dummy-breaks-3662052

Baby-bottle health risks

Parents are being warned against buying baby bottles made with a chemical linked to cancers and other health problems.

Bisphenol A, or BPA, is a synthetic substance added to plastics to make them tougher. It is common in many hard, clear plastic baby’s bottles and containers for adult drinks.

The warning comes in the wake of new research by the University of Auckland’s Liggins Institute. A team led by Professor Murray Mitchell published findings this week showing that even low levels of BPA can be passed by pregnant mothers to their foetus through the placenta.

Mitchell said international research has linked the substance to breast and prostate cancer, hyperactivity, erectile dysfunction and other health issues.

He said it was crucial pregnant mothers drank from BPA-free bottles and urged parents to use glass, disposable bottles or BPA-free bottles for babies.

Mitchell is calling for a complete ban on BPA, which is outlawed in Denmark, Canada and three US states.

Six of the biggest baby-bottle manufacturers in the US, including Disney, have stopped using it and scientists are lobbying for a ban in Britain.

Mitchell said he advised a New Zealand Health Ministry sub-committee last year to outlaw the chemical. He claims officials said they were “overloaded” by a list of environmental contaminants to evaluate.

“If the Canadian Government has moved you would wonder why the New Zealand Government seems to be silent on the issue,” he said.

Mitchell, whose research has been published in the American Journal of Obstetrics and Gynecology, said manufacturers were not required to say if their products contained BPA.

His study was carried out on women’s placentas and revealed a foetus could be “completely exposed” to the chemical and was unable to “deal with the compounds”.

Glass, disposable and BPA-free alternatives to hard, plastic bottles are available, but can be more expensive.

The website babyuniverse.co.nz sells glass bottles for $7.99 and BPA-free plastic bottles for $23.99, compared to $3.79 for a basic, hard-plastic Baby’s Best alternative at The Warehouse.

Mitchell said he bought disposable bottles for his son and advised others to do the same.

The ministries of health and consumer affairs referred questions about BPA to the New Zealand Food Safety Authority.

An authority spokesman said they welcomed new research, but took into account all the evidence available when making decisions.

Other international studies had found that expected levels of exposure to BPA did not pose a risk to consumers, whatever their age.

Parents pay for peace of mind

Tim and Helen Hills didn’t mind spending extra money on a BPA-free bottle for their 10-month-old daughter, Beth.

The Wellington couple bought an Avent bottle for several times the price of a basic, hard-plastic alternative, after researching the health risks linked to the substance.

Tim, a 30-year-old banker, said he and Helen, a 28-year-old sleep psychologist, paid more “so we would feel comfortable – it’s a security blanket”.

He said they were like many Kiwi parents who would rather buy the “healthier, greener” option, just in case.

He said many retailers appearedto have high-quality bottles on their shelves – probably for the higher profit margins, but also for well-informed consumers who wanted the best for their babies.

And if there was concern over BPA he hoped the Government or Plunket would advocate for a ban on the sale of such products.


rachel.grunwell@hos.co.nz

Painkillers overdose toddlers need new livers

Mon 28th June 2010

Two children in the past three months have required liver transplants after being given painkillers, prompting medics to call for a review of over-the-counter medicine.

Both of the children had overdosed on paracetamol. One of them is a two-year-old from Wellington.

Now a group of Capital & Coast District Health Board clinicians is calling for a review of the way drugs – including those on supermarket shelves – are dispensed.

They point to an increase in addiction to codeine-based drugs, which have been used in scores of suicide attempts.

The National Poisons Centre lists paracetamol as the most common substance in the poisoning of children under five, accounting for about 65 per cent of its calls. In the past five years the centre has been alerted to 1814 children under seven accidentally taking paracetamol, 389 of them needing medical help.

There were 617 notifications of children accidentally taking ibuprofen, with 97 requiring medical help, and 731 notifications of children accidentally taking aspirin, of whom 122 needed medical help.

A spokeswoman said it was not clear how many of those products were bought over the counter and how many were prescribed.

Children took accidental overdoses when they were given the wrong dose unintentionally or found drugs and took them.

Starship hospital child health director Richard Aickin said the cases were rare, but would have life-long ramifications for the children, aged between two and three.

He would not reveal details of the two recent transplant cases, other than that they resulted from paracetamol overdoses.

Dosing children too regularly or giving too much in single doses were the usual causes of the problem, he said. “It’s quite difficult for them to take enough by themselves to cause serious problems.”

An overdose of paracetamol could cause irreversible liver damage, vomiting, stomach pain, loss of consciousness and bleeding. Symptoms were the same for adults and children. “It’s just a total shutdown in body chemistry.”

He called for paracetamol to be sold only in small bottles, as opposed to the one-litre bottles available in pharmacies. All medicines should be sold in child-proof packaging unless otherwise requested, he said.

Geoff Robinson, a Capital & Coast chief medical officer and detoxification unit physician, suspected many New Zealanders, young and old, were severely damaging themselves with over-the-counter drugs such as ibuprofen, aspirin and paracetamol.

National Poisons Centre figures showed ibuprofen had been used in many intentional overdoses, he said. It could cause ulcers, while aspirin could cause bleeding in the stomach if used in excessive doses.

Dr Robinson is one of a group of Wellington physicians who last week published a report pointing to a trend of codeine addiction from over-the-counter medicines. These drugs included easily accessible products such as Nurofen Plus and Panadeine Plus.

The report, in the New Zealand Medical Journal, calls for a review of how commonly used over-the-counter drugs are sold.

STEPS TO KEEP YOUR FAMILY SAFE

- Stick to the instructions on packaging, and always check instructions on different products – not all paracetamol is the same strength. Some pharmacies provide a free service of weighing your child to determine the correct dosage.

- Keep medicine in childproof packaging.

- Keep medicine out of sight and reach of children, preferably in a locked cabinet.

- Check ingredients in other medications – other products can contain paracetamol which could lead to an accidental overdose.

- Don’t bulk buy. Choosing smaller containers can minimise the risk of an overdose.Don’t think you’re safe if you don’t have symptoms straight away – people can overdose through a build-up of paracetamol if they continually take a higher dose.

- If in doubt, ask your doctor or pharmacist for advice.

Source: Starship hospital, National Poisons Centre

Disclaimer

Content provided on this site is forInterest/educational purposes only and should not be construed to be medical advice, diagnosis or treatment. At all times you should consult your medical specialist.

As neonatal weight increases, so do the risks of adverse obstetric outcomes

February 5, 2010 — As neonatal weight increases, so do the risks of adverse obstetric outcomes — including uterine rupture — in women giving birth vaginally after a prior cesarean delivery, new research suggests.

In light of this finding, the authors conclude that “estimated fetal weight should be included in the decision-making process for all women contemplating a trial of labor after cesarean delivery.”

Prior research has linked fetal macrosomia with various adverse obstetric outcomes, including emergency cesarean delivery, perineal laceration, first and second stages of labor dystocia, and shoulder dystocia, according to the report in the February issue of Obstetrics & Gynecology. Few trials, however, have examined these outcomes in women undergoing vaginal birth after cesarean delivery.

To investigate, Dr. Emmanuel Bujold, from Universite Laval, Quebec, Canada, and colleagues reviewed the medical records of all women who underwent a trial of labor following a prior low transverse cesarean delivery at Sainte-Justine Hospital from 1987 to 2004.

The women were divided into categories based on their infants’ birth weights. The reference group, designated group 1, had infants weighing less than 3500 g. Groups 2 and 3 had infants weighing 3500 to 3999 and 4000 g or more, respectively.

Of the 2586 women who were seen during the study period, 1519 (59%) were in group 1, 798 (31%) in group 2, and 269 (10%) in group 3, the researchers report.

Birth weight was directly linked to the rate of failed trial of labor. For group 1, the rate was 19%, whereas for groups 2 and 3, the rates climbed to 28% and 38%, respectively (p < 0.01).

Likewise, the authors found direct correlations between birth weight and the rates of uterine rupture (0.9%, 1.8%, and 2.6% for groups 1, 2, and 3, p < 0.05), shoulder dystocia (0.3%, 1.6%, and 7.8%, p < 0.01), and third- and fourth-degree perineal laceration (5%, 7%, and 12%, p < 0.01).

After accounting for potential confounders, a birth weight of 4000 g or more was associated with more than twofold increased risks of uterine rupture (OR, 2.62), failed trial of labor (OR, 2.47), and third- and fourth-degree perineal laceration (OR, 2.64). For shoulder dystocia, a particularly elevated risk was seen: OR, 25.13.

“Current recommendations of the American College of Obstetricians and Gynecologists and the Society of Obstetricians and Gynecologists of Canada state that fetal macrosomia should not be a contraindication for a trial of labor although it is associated with a lower likelihood of successful vaginal birth after cesarean delivery,” Dr. Bujold’s team notes.

“Based on our data,” they continue, “we believe that women with a previous cesarean delivery and an estimated fetal weight of 4000 g or more should be informed about their higher risks of uterine rupture and other adverse outcomes. Such women with no previous vaginal delivery should be told about the high risk…of uterine rupture.”

Obstet Gynecol. 2010;115:338-343. Abstract

Reuters Health Information 2010. © 2010 Reuters Ltd.

Pregnancy stress ‘passed to baby’

Image of a baby

The researchers looked at the stress hormone cortisol

Children whose mothers were overly stressed during pregnancy may themselves be more vulnerable to anxiety as a result, research suggests.High levels of stress hormone may cross the placenta and affect the baby in the womb in a way that carries long-term implications, UK scientists believe.

A Bristol University team found anxiety in late pregnancy was linked to higher cortisol levels in children aged 10.

The work in Biological Psychiatry tallies with earlier animal findings.

Stress effects

Past studies have shown stress in animals during pregnancy affects the body’s stress response system – the hypothalamic-pituitary-adrenal (HPA) axis which controls stress hormone levels, including cortisol.

But scientists have not been able to show that it also affects humans in the same way.

US psychologist Dr Thomas O’Connor, from the University of Rochester in New York, working with UK colleagues from Bristol University and Imperial College London, studied 74 children aged 10.

They analysed saliva samples first thing in the morning and three times a day on three consecutive school days to monitor levels of stress hormones.

The children’s mothers had completed questionnaires 10 years previously, when they were expecting, about any stress or anxiety they were experiencing during their pregnancy.

Alleviating anxiety

The researchers looked back at this data to compare the results with those of the saliva tests.

The children with high levels of cortisol in their saliva tended to be born to the mothers who reported the most stress during their pregnancy.

Dr O’Connor said: “These results provide the strongest evidence to date that prenatal stress is associated with longer term impact on the HPA axis in children.

Antenatal classes can help allay fears women might have about pregnancy, the birth and the health of the baby
Gillian Fletcher of the National Childbirth Trust

“Several human studies of children and adults suggest that elevated basal levels of cortisol are associated with psychological risk…notably depression and anxiety.

“Our findings point to a possible mechanism by which prenatal stress or anxiety may predict these disturbances in early adolescence, and possibly into adulthood.”

However, he said much more work was needed to check that this was the case.

He also pointed out that it was not clear whether high cortisol itself could cause psychological disturbance. Some psychiatric disorders have been linked with low rather than high cortisol levels.

Other factors, such as the personality of the child and the environment they are living in, may play a part in childhood stress too.

Gillian Fletcher of the National Childbirth Trust said: “It’s certainly something we need to look at in more detail.

“We don’t want to make women who are pregnant more anxious than they already are by saying stress could have long term implications for the growing child.”

She said there were many things pregnant women could do to alleviate stress and anxiety.

“Antenatal classes can help allay fears women might have about pregnancy, the birth and the health of the baby.

“They can also teach a women about stress and relaxation and taking life more slowly can help. It’s trying to find a balance.”

Hormones ‘govern ability to breastfeed’

Breastfeeding baby

Breastfeeding has been linked to many benefits for babies

Mothers who find breastfeeding so hard that they give up should not blame themselves, researchers say.

A Norwegian study concludes that difficulty feeding a newborn may be down to higher levels of the male hormone testosterone during pregnancy.

Having reviewed all of the available evidence, researchers also cast doubt on the health benefits of breast milk over formula.

The work features in Acta Obstetricia and Gynacologica Scandinavica.

The team from the Norwegian University of Science and Technology followed 180 pregnant women.

These included those at risk of delivering a small baby – births which are known to be influenced by higher levels of the male sex hormone testosterone.

A mother should do what makes her happy
Professor Sven Carlsen
Norwegian University of Science and Technology

After taking into account other factors such as age, education and smoking, they still found a clear relationship between low rates of breastfeeding at three and six months and higher levels of testosterone.

There are many reasons why a mother might have high levels of this male hormone in her womb during pregnancy as the placenta – an engine of hormone production – kicks into action.

The team suggest that the hormone may impact negatively on the development of glandular tissue in the breast, in turn affecting her ability to feed her baby.

Lead researcher Professor Sven Carlsen said: “Basically a mother who finds she has difficulty shouldn’t feel guilty – it probably is just the way it is, and her baby will not suffer for being fed formula milk.

“A mother should do what makes her happy.”

Benefits ‘exaggerated’

He argues that it is the hormone balance in the womb which explains both a mother’s ability to breastfeed and any apparent health benefits of a baby who is breastfed – rather than the breast milk itself.

Last year Professor Carlsen’s team reviewed 50 international studies on the relationship between breastfeeding and health.

Based on this work he concludes the benefits of breast over formula milk may have been exaggerated.

“These health differences are really not so significant in any event.

“When you look at the epidemiological studies and try to strip away the other factors, it is really hard to find any substantial benefits among children who were breastfed as babies.”

The government recognises that breastfeeding is the best form of nutrition for infants
Department of Health

Professor Ashley Grossman of the Centre for Endocrinology at Barts in London said the suggestion that male hormones may influence the ability to feed was an interesting one.

“There may be all sorts of biological factors which affect a woman’s ability to breastfeed, and when women are always being told to go away and try harder it’s important to stress some simply cannot.

“We are learning more and more about how the environment of the womb may influence a child’s future development – this is really where it’s all happening, and it has a much greater impact than whether or not a child is breastfed or not.”

The Department of Health recommends that all babies be exclusively breastfeed for the first six months.

A spokesman said: “The government recognises that breastfeeding is the best form of nutrition for infants.

“It gives health benefits for both the baby and the mother – even after they are no longer breastfeeding.

“It protects against stomach bugs and chest infections, provides perfect nutrition for the first six months and reduces the likelihood of becoming obese in later childhood.”

BBC News

C-Sections ‘do not affect how long a mum breastfeeds’

Breastfeeding baby

White mothers stop breastfeeding sooner than women from ethnic minorities

Having a Caesarean or instrumental birth does not appear to impact upon how long a mother breastfeeds, British research suggests.

A study of 2,000 mothers who received breastfeeding support also found little association with how soon after birth the baby was put to the breast.

What did have an impact was ethnicity, and the number of previous births, the study in BMC Pediatrics reported.

White mothers were 70% more likely to stop than non-White contemporaries.

The Department of Health recommends exclusive breastfeeding for the first six months of a baby’s life, but the majority of UK mothers have abandoned it altogether by this point – giving the country one of the lowest breastfeeding rates in Europe.

There have been a series of measures aimed at increasing prevalence, from better support to a ban on any promotion of infant milks.

This latest study, conducted by the University of Manchester and East Lancashire Primary Care Trust, followed more than 2,000 mothers who all received breastfeeding help from the same peer support group, to enable a fair comparison of other factors.

Bucking the trend

On average these supported mothers were giving some breastmilk for 21 weeks, and half of them for more than 27 weeks, markedly higher than the national average. But there were differences between sub-groups.

What is really exciting about this research is the rates of breastfeeding – both exclusive and mixed – that have been achieved among all groups
Professor Mary Renfrew, infant feeding expert

White women tended to stop a number of weeks before non-white, with mothers of black and Indian ethnic origin breastfeeding the longest, closely followed by Pakistani.

But the relative economic status of the women made no difference, with the poorest as likely to continue or abandon breastfeeding as the wealthiest, nor did it matter whether the mothers were married.

Having an instrumental or Caesarean birth had no statistically significant impact on the duration of breastfeeding, contrary to some suggestions that a “non-natural” birth, possibly as a result of the analgesics used, may hamper feeding.

Also babies who were put to the breast within an hour of being born – as recommended by the World Health Organisation – were not breastfed any longer than those with whom breastfeeding was initiated within 48 hours.

Previous deliveries

The study did however find that the number of babies a mother had previously delivered impacted upon breastfeeding duration, with women having their third or fourth baby more likely to continue than those having their first.

The study’s authors noted that while breastfeeding support was clearly important in mitigating a number of obstacles to prolonged feeding, there were other factors at play.

Dr Gabriel Agboado of East Lancashire PCT said: “The results suggest that infant feeding practices associated with maternal ethnicity and previous experience of having children may be more difficult to influence by peer support interventions.

“Peer support programs, particularly those in multi-ethnic settings, will need to identify the needs of their various client groups in order to appropriately support them to breastfeed longer”.

Professor Mary Renfrew, who researches infant feeding practices, said: “We know that rates are higher among ethnic minority groups and that previous experience of breastfeeding has an effect on whether the mother does it again, and the study confirms this.

“But what is really exciting about this research is the rates of breastfeeding – both exclusive and mixed – that have been achieved among all groups. They are doing something right in this area, and it does seem to point to peer support, although there may be other factors involved.

“Tailored support is recommended for all mothers, but some places have been much more pro-active on this front than others. When people say you simply cannot get breastfeeding rates up, it’s clear there are policies which can have an effect.”

Sue Ashmore, head of Unicef’s UK Baby Friendly Initiative said: “evidence shows that women are more likely to breastfeed if they are supported by someone who believes they can do it. This is the point of peer support programs.

“In the UK peer support work is varied, and therefore the results are varied. It is vital that robust monitoring and evaluation processes are in place so that strengths and weaknesses can be identified and addressed; this would lead to a more successful peer support programs nationwide.”

BBC News

Blood pressure harm from smoke ‘may explain cot death’

Blood pressure harm from smoke ‘may explain cot death’

Pregnant woman smoking

It’s thought a third of cot deaths could be avoided by quitting smoking

Smoke exposure during pregnancy damages a baby’s blood pressure control, which may explain why such babies’ risk of cot death is higher, say experts.

Maternal smoking remains one of the biggest risk factors for cot death.

A team at Sweden’s Karolinksa Institute found smoke-exposed babies had abnormal surges in blood pressure, even when sleeping undisturbed in their cots.

These surges put extra demand on the heart, making it pump faster and harder, the journal Hypertension says.

The study suggests damage to the circulation may be a factor in sudden infant death syndrome (SIDS), although it set out to look at the effects of smoking on the newborn rather than cot death per se.

We have known for some time that there is a cardiovascular element to sudden infant death
Lead researcher Dr Gary Cohen

Dr Gary Cohen and his team studied 36 newborn babies – 17 of whom had mothers who smoked during the pregnancy.

When they examined the babies they found the ones that had been exposed to cigarette smoke showed abnormal heart rate and blood pressure responses.

And these abnormal responses got worse throughout their first year of life.

Dramatically different

At one week of age the smoke-exposed babies showed abnormally large blood pressure rises as they were lifted up from lying down.

By the age of one, the same babies appeared to have adapted to this and now showed abnormally low blood pressure responses to the same posture change.

The hypothesis presented here is highly plausible and agrees with work from other research groups
Professor George Haycock
Foundation for the Study of Infant Deaths adviser

Usually, when a person stands the heart rate increases and the blood vessels tighten, raising blood pressure slightly, to keep up the blood flow to the heart and brain.

Dr Cohen said: “Babies of smokers have evidence of persistent problems in blood pressure regulation that start at birth and get worse over time.

“This study reveals for the first time that early life exposure to tobacco can lead to long-lasting reprogramming of the infant blood pressure control mechanism.”

He said this might explain why babies of women who smoke are at increased risk of cot death.

“We have known for some time that there is a cardiovascular element to sudden infant death.

“It’s not just breathing, but blood pressure control and heart rate control.

“This is another piece of the jigsaw.”

He plans to continue to study the babies as they grow up to see if the damage is lasting and whether it leads to problems, such as high blood pressure, in later life.

Professor George Haycock, scientific adviser for the Foundation for the Study of Infant Deaths (FSID), said: “The hypothesis presented here is highly plausible and agrees with work from other research groups.

“FSID’s top piece of advice remains, cut smoking in pregnancy – fathers too, and don’t let anyone smoke in the same room as your baby.”

Experts say a third of cot deaths could be avoided if mothers-to-be did not smoke.

Janet Fyle, Professional Policy Advisor at the Royal College of Midwives, said: “These findings support what we know; that smoking during pregnancy can harm the developing foetus.

“The RCM would urge pregnant women who smoke to seek advice and support from their midwife about stopping smoking, for the benefit of their own long-term health.

“This would also benefit the health of their child.”

Friends rally for sick baby Degen

What started as a happy family reunion in Minnesota to show off the new baby has turned into a heart-wrenching bedside vigil for Palmerston North parents Sarah and Edan Meyer.

Five-month-old Degen has spent a month in intensive care in Cincinnati Children’s Hospital fighting liver cancer, and the family’s plans are on hold.

The couple’s first child showed signs of constipation and a distended tummy last month while visiting his grandparents, and after a biopsy confirmed a cancerous tumour, he was rushed to Cincinnati on September 16.

About 40 per cent of his liver had to be surgically removed, and he has now begun a 28-week course of chemotherapy.

The couple’s friend back in Palmerston North, Nicola Reid, is turning her worry into action, organising fundraising to help the family through the devastating change of fortune.

“Our babies were born on the same day, we had the same midwife. Our Micah is just lovely, and Degen is so sick. He should be sitting up and gurgling, just crying about cutting teeth.”

Mrs Reid said it was a comfort, at least, to know that Degen was in one of the best places in the world to get the best chance of successful treatment. Early CT scans have shown some improvements.

At this stage nobody knows how long the Meyers will stay in Cincinnati, or whether they will be able to continue Degen’s treatment back in New Zealand at some stage.

“But what we’re hoping to do is to keep up the mortgage payments, and keep paying their bills back here for as long as they need.”

Mr Meyer, a diesel mechanic, is on extended leave from his work in Palmerston North. His mother, Jill, flew to Cincinnati to offer her support with help from the Rongotea Lions Club.

Degen’s other grandparents, Leroy and Sylvia Thorstad, live in Minnesota and have stayed close by their grandson through the ordeal.

“We would hope that the more people that know about this poor wee boy, the more people can send healing thoughts and prayers to the team in Ohio,” said Mrs Reid.

There will be a benefit evening to support the family on December 1 at the Convention Centre featuring Wellington fashion stylist Lisa O’Neil, with an auction and raffle to follow.

“Already we have felt the community’s reaction to the Meyers’ plight and it is humbling; people and businesses are being incredibly generous.”

Anyone who wants to help can contact Mrs Reid on 355 2634 or email kelly@midwife4u.co.nz