By Genevra Pittman
Reuters

When there was a shortage of a drug used to prevent IV-related infections in kids, the frequency of those infections increased almost ten-fold at one Michigan hospital, a new study shows.

Known as ethanol lock therapy, the preventive drug is given to kids with bowel problems who require an IV feeding line because their intestines don't absorb enough nutrients.

Those children are at higher risk of infection to begin with because their gut bacteria don't have as much practice killing off germs, researchers said.

Luitpold Pharmaceuticals, then the sole supplier of ethanol, or dehydrated alcohol, voluntarily stopped manufacturing the drug between April and September, 2011 after scrutiny of pharmaceutical facilities by the U.S. Food and Drug Administration.

The details of the production halt were not made public.

Up until early 2011, kids being treated at C.S. Mott Children's Hospital in Ann Arbor were given daily ethanol lock therapy in their catheters to prevent infection. But with the shortage, that was cut back to weekly prophylaxis for most young patients.

The new study, published this week in Pediatrics, covers eight children ranging in age from 22 months to 18 years who'd been diagnosed with necrotizing enterocolitis or other intestinal conditions requiring an IV line.

When ethanol was readily available, there was an average of one catheter-related infection per child every four years.

But when the dosing frequency dropped, seven of the eight children developed catheter-related infections in just a few months. Six of them needed to be hospitalized as a result and spent more than two weeks in the hospital, on average. Treating them cost over $100,000 per patient, and two of the youths ended up in the intensive care unit.

"We definitely had concerns that rationing (ethanol) or decreasing the amount of time we used it could lead to an increase in infection," said lead author Dr. Matthew Ralls, from Mott and the University of Michigan Medical School.

But the researchers said the spike in infections was far greater than what they'd expected.

"We had basically a complete failure in prophylaxis," Ralls told Reuters Health. "We reverted back to the numbers from before we even used ethanol."

He said he and his colleagues hope that in the future, the FDA can come to an agreement with companies that are the sole producers of important drugs to only shut down some of their production facilities at any given time, for example.

"This had a profound effect on these kids," Ralls said. "Some of the complications were pretty devastating for some of these children."

A press officer at the FDA said the agency hadn't reviewed the new study.

But, Sarah Clark-Lynn told Reuters Health in an email, "the FDA is working hard with pharmaceutical companies to prevent and resolve drug shortages. Drug shortages (are) a top priority issue for the FDA and we are working hard to help assure that patients in the United States have access to the high quality medications they need."

She added that another company, Akorn Pharmaceuticals, is now manufacturing ethanol lock therapy. "We do not anticipate any further shortage issues at this time for this drug," she said.

Luitpold did not respond to a request for comment.

By MyHealthNewsDaily

Parents who let their young children climb into bed with them during the night may decrease their child's risk of obesity, a new study from Denmark suggests.

In the study, children who never entered their parents' bed during the night were three times more likely to be overweight compared with children who got into their parents' bed every night.

The findings are contrary to what might have been expected: obesity is associated with poor sleep quality, and kids who climb into bed with mom and dad are clearly waking up during the night, the researchers said.

However, parents who let their kids enter their beds at night may be giving their children a greater sense of emotional support, which may protect against obesity, the researchers said. In contrast, some children who are not allowed to enter their parents' bed at night may feel rejected, and such negative feelings may increase the risk of obesity, they said.

Dr. Nanna Olsen, of the Institute of Preventive Medicine at Copenhagen University Hospitals, and colleagues analyzed information from 645 children ages 2 to 6 who were predisposed to obesity because they had a high birth weight, their mothers were overweight before pregnancy or their families had a low income.

For about 500 of the children, information was available on whether the child entered the parents' bed at night, and if so, how often. In addition, researchers had information on the children's body mass index (BMI).

The study was presented today (May 9) at the European Congress on Obesity in Lyon, France.

 

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Karen Rowan
MyHealthNewsDaily

The best way for parents to reduce the amount of soft drinks their young children drink is to not serve it with meals, a new study suggests.

The findings from researchers in Belgium showed that children from higher-income families drank less than half — about 42 percent — as much soda as children from lower-income families. However, the vast majority of the difference between the income groups could be explained by three parenting practices: not offering soda at mealtimes, not letting kids drink soda whenever they want, and not keeping soda in the house, according to the study.

"Parents have a great influence through the food they make available and accessible to the child, their own nutritional behavior and by child-feeding practices," the researchers wrote in their study, published online April 1 in the journal Appetite.

Reducing the amount of soda kids drink is important, the researchers say, because sugary beverages have been linked with obesity and Type 2 diabetes.

What works, what doesn't
Researchers based their findings on questionnaires completed by 1,639 parents of children ages 2  to 7.

The practice of not offering soda at mealtimes explained about half of the difference in soda consumption seen between the high- and low-income families, according to the study. Not letting kids drink soda whenever they want explained about a third of the difference, and not having soda in the home explained 16 percent of the difference, according to the study.

"It makes sense that the home environment and home 'policies' or limits related to soft drinks will have the biggest impact," on soda consumption, said Kate Dickin, a nutritional science research at Cornell University who was not involved in the study. "Our behavior is very strongly influenced by our environments," Dickin said.

The study also revealed that telling children of this age that soda is unhealthy, and refraining from drinking soft drinks in front of them, are unlikely to make a difference.

"Although modeling and explaining why foods are unhealthy can be important, not having any soda in the house or on the table is clearly the most effective way to prevent consumption," Dickin said. If the soda is right there, it’s a lot harder to for parents — especially tired, stressed or distracted parents — to say "no," she said.

The study was limited in that it was conducted with a specific group of parents, and relied on their reports of their own behaviors and how much soda their kids drank.

How to make healthy choices appealing to kids
Dickin said it's helpful when parents understand how to create a home environment that offers kids healthy choices.

"Young kids respond well to simple ways to make a healthy beverage seem special — a pretty cup, a citrus slice, or a drinking straw. Healthy eating is enjoyable and can be presented that way — to parents and to children," she said. "Framing it in terms of restriction and deprivation gets us nowhere."

Dickin said that by looking only at soft drink consumption, the study might have missed part of the picture of what kids are drinking. "Replacing soda with other sugar-sweetened beverages doesn’t help, so it would have been useful to know about all sweetened drinks."

Still, "it’s great to have more evidence of the importance of shaping the home environment as a means for parents to influence child behaviors," Dickin said. Cornell offers an education program for lower-income families focused on learning to make healthier choices.

"We hear back from a lot of parents that these approaches are really effective," Dickin said.

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By Rachel Rettner
MyHealthNewsDaily

Children under age 2 should avoid watching TV as much as possible, according to a new policy statement from the nation's largest group of pediatricians, who suggest the tots should play instead.

The idea that TV programs are beneficial to the learning of children this young has not been proved, the American Academy of Pediatrics says. In addition, TV viewing may lead to sleep problems and a delayed use of speech in young kids, recent research suggests.

Even merely having the TV on in the background may be less than optimal for a child's development, the AAP says. Background television may distract from playtime activities that benefit children's learning. And it may distract parents, preventing them from speaking and interacting with their kids, the AAP says.

However, the recommendations run counter to what most parents actually do. About 90 percent of parents say their kids younger than 2 watch some type of media, according to a 2007 study. By the age of 3, nearly one-third of kids have a TV in their bedrooms.

As a compromise, parents should come up with a strategy to manage TV viewing in their young children, the AAP says. Ideally, when kids younger than 2 watch TV, their parents should watch it with them.

The new policy statement was released today (Oct. 18) here at the AAP National Conference & Exhibition. The policy statement specifically addresses the viewing of TV programs and does not comment on the potential benefits or risks of using phone applications, video games or other programs a child may encounter on a screen.

Young kids and TV

The AAP first released guidelines on media use by young kids in 1999, concluding that media use by kids under 2 should be discouraged. Since then, a lot more research has been done on the subject. The AAP reviewed this research for its new policy statement and essentially came to the same conclusion.

That's not to say that kids can't benefit from TV. Children older than 2 can improve their language and social skills by watching TV, some studies have shown.

However, in order to gain a benefit from a TV program, kids need to be able to understand and pay attention to it. Young kids may lack the mental ability to comprehend what they are watching. In fact, two studies have found that, for kids 2 and under, watching programs such as “Sesame Street” may have a negative impact on language development, the AAP says. 

"There's a great developmental digital divide," Dr. Ari Brown, a pediatrician in Austin, Texas, and lead author of the new policy statement, said at a news conference. Studies show that children under 1¹/² years old have the same reaction to a TV program regardless of whether it's going forward or backward, Brown said. In contrast, older children prefer to watch the program forward.

All in all, instead of spending time in front of the TV, young kids are likely better off spending that time engaged in unstructured play, which promotes creative thinking, problem solving and reasoning skills.

Setting limits

If parents choose to let their young kids watch TV, they should set limits, the AAP says. They should also avoid placing a TV in the child's bedroom

Parent should be aware TV programs may affect their child's development, even if the child cannot understand the program. They should turn the TV off if no one is watching it and try to watch their adult programs when the kids are not around, Brown said.

If parents cannot play with their kids directly, even having the children play with toys by themselves can be beneficial, the AAP says.

The AAP also recommends further research in this area to examine the long-term effects of early TV viewing on toddlers’ development.

The new policy statement will be published in the November issue of the journal Pediatrics.

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