Here is my recent article, published in The Huffington Post about breastfeeding.
http://www.huffingtonpost.com/jay-gordon/gisele-bundchen-nutrition_b_675130.html
A lively discussion is taking place at the bottom of the page over there.
Gisele Bundchen, Nutrition Expert?
Yes!
In a recent magazine article, Ms. Bundchen was quoted saying that breastfeeding should be the legal norm for all babies for the first six months of life.
Of course, this generated a storm of protest about “feeding choices” and whether or not we should listen to someone with her lack of credentials. Lost in the fabricated drama and controversy is the fact the we mustlisten if her advice and high profile can save babies’ lives. I’m sure that this one famous mother’s words will be heard and heeded by more mothers than we pediatricians can possibly reach. (Ms. Bundchen’s statement that post partum weight loss is faster because of breastfeeding is very much in line with current medical literature and will certainly appeal to most new mothers.)
It’s easy to misinterpret a forceful metaphorical statement about “chemical food”–infant formula–and the crucial lifesaving value of breastfeeding for six months. And, that’s exactly what pundits did to turn this into an “us against them” issue. “How dare she . . . ”
While it is tragic that a supermodel-mom dispenses better advice than many doctors and most governmental agencies, it’s impossible to misinterpret what the World Health Organization says about these artificial (chemical) feeding options:
The protection, promotion and support of breastfeeding rank among the most effective interventions to improve child survival. It is estimated that high coverage of optimal breastfeeding practices could avert 13 percent of the 10.6 million deaths of children under five years occurring globally every year. Exclusive breastfeeding in the first six months of life is particularly beneficial, and infants who are not breastfed in the first month of life may be as much as 25 times more likely to die than infants who are exclusively breastfed.”…
There is a common misconception that in emergencies, many mothers can no longer breastfeed adequately due to stress or inadequate nutrition, and hence the need to provide infant formula and other milk products. Stress can temporarily interfere with the flow of breast milk; however, it is not likely to inhibit breast-milk production, provided mothers and infants remain together and are adequately supported to initiate and continue breastfeeding. Mothers who lack food or who are malnourished can still breastfeed adequately, hence extra fluids and foods for them will help to protect their health and well-being.
If supplies of infant formula and/or powdered milks are widely available, mothers who might otherwise breastfeed might needlessly start giving artificial feeds. This exposes many infants and young children to increased risk of disease and death, especially from diarrhea when clean water is scarce. The use of feeding bottles only adds further to the risk of infection as they are difficult to clean properly.”
Moreover, not breastfeeding has been found to double the risk of SIDS (Sudden Infant Death Syndrome)
Read just one sentence above aloud:
“Infants who are not breastfed in the first month of life may be as much as 25 times more likely to die than infants who are exclusively breastfed.”
No parent in America is allowed to let their infant travel in a car in the “second best” way possible: Car seats are the law in all 50 states. A breastfeeding law will not be passed soon, but there is a moral, ethical and medical imperative to get this nutrition information to mothers and families any way we can. Hyperbole is easy to ridicule but, in this case, the hyperbole will prevent the deaths of many, many babies worldwide.
The World Health Organization estimates that one-and-a-half million babies die from lack of breast milk each year. 1,500,000.
If Gisele Bundchen’s magazine interview, comments and the resultant furor cause more mothers in developing nations to breastfeed, thousands and perhaps tens of thousands of babies will be alive a year, two years or five years from now who might otherwise have succumbed to diseases caused or fatally exacerbated by lack of mother’s milk.
I certainly wish that this legal proposal/metaphor had been issued by the government, health insurers or the American Academy of Pediatrics. In lieu of those recommendations, the very intelligent suggestion of a really smart mom will have to do.
Avoid foods that contain any of the following ingredients:
- artificial butter flavor
- butter, butter fat, buttermilk
- casein
- caseinates (ammonia, calcium, magnesium, potassium, sodium)
- cheese
- cottage cheese
- curds
- custard
- half and half
- hydrolysates (casein, milk protein, protein, whey, whey protein)
- lactalbumin, lactalbumin phosphate
- lactoglobulin
- lactose
- milk (derivative, protein, solids, malted, condensed, evaporated, dry, whole, low fat, non fat, skim)
- nougat
- pudding
- rennet casein
- sour cream, sour cream solids
- sour milk solids
- whey (delactosed, demineralized, protein concentrate)
- yogurt
Ingredients that MAY indicate the presence of milk protein:
- brown sugar flavoring
- caramel flavoring
- chocolate
- high protein flour
- margarine
- natural flavoring
- Simplesse
- A “D” on a product label next to a “K” or circled “U” may indicate the presence of milk protein.
Links
I see a lot of moms in my office who would like to lose weight and get back into shape faster. Most of them are either being too hard on themselves or someone who should be supporting their wonderful mothering is being to hard on them.
Nursing babies “cost” about 1000 calories per day so breastfeeding is one of the most efficient ways to make sure that the extra fat and water added during pregnancy are transferred to the rightful owner.
Nursing moms, and almost everyone else, need about 1800 calories/day to “get by” and much less than that is not healthy. Here are a few tips for getting into shape safely and a little bit faster:
- Eat healthy foods. (All together now, “duh.”) This really is overlooked, though. Emphasize nutrient-rich foods which are not “calorically dense.” Avoid greasy snack foods and so-called healthy foods like cheese and whole milk. Eat more fruits, grains, pastas and beans and avoid red meat and salads laden with dressing.
- Try to build some outdoor activity into your day. (“In my spare time and with my spare energy??) Somehow. Walk with your baby every day and try to get a jogging stroller added to your wish list. Slings make carrying your baby more efficient and burn more calories. In my experience, even moms who really didn’t have the time and energy to exercise a little, feel just great when they somehow do it.
- Drink more water. Avoid soda and juice. These are truly empty calories.
- Combining 100 to 200 fewer calories per day of higher fat foods (that’s just a couple spoonfuls of dressing or a piece of cheese) with 20 to 40 minutes of a good walk with your baby (200 calories out) will lead to exactly the weight loss and conditioning you want. Add in a little formal or informal yoga and stretching and you’ll get there even sooner.
- Above all, be nicer to yourself. This is not a contest nor a sprint. You are an extraordinarily important and extraordinarily busy person: a Mother. Get into shape at a pace that suits you, not the rest of the world.
I see most of the couples in my practice prior to their delivery. I like to do a prenatal discussion fairly early but most people come in during the last month or two of pregnancy. One reason I’d like to talk earlier is to discuss the best pregnancy diet. There is excellent medical and common sense evidence that the best nutrition during pregnancy gives the best outcome. Specifically, moms with any family history of allergies should avoid dairy products. There is not much disagreement in the medical literature about the benefits of a dairy-free diet to the developing fetus. Allergies are increased by prenatal exposure to this allergenic protein. Whatever you do, avoid the outdated advice to increase your milk intake during your pregnancy.
Avoid alcohol and other noxious chemicals. We know that medium to large amounts of wine, beer or liquor can seriously damage a baby and produce Fetal Alcohol Syndrome. It’s now recognized that lesser amounts of alcohol at critical stages of pregnancy lead to “Fetal Alcohol Effect.” If we know this, why would you drink at all during pregnancy?
The warning signs in super markets about swordfish telling pregnant women to limit the number of servings per month would lead me to a similar conclusion: Why eat any mercury-containing fish at all?
Stay active, eat as well as you can focusing on meals with lots of fruits, veggies, reasonable amounts of healthy protein, avoid alcohol, decrease or eliminate dairy products to have the healthiest pregnancy and the healthiest baby.
California declared a pertussis (whooping cough) epidemic this week. The California Department of Public Health reports 910 confirmed cases, including the death of five infants since the beginning of the year. The Department of Public Health is urging all families to vaccinate against this disease.
Whooping cough, also known as pertussis, is a bacterial respiratory tract infection. It begins looking like most other upper respiratory illnesses:
There may be nothing more than a runny nose and sneezing, often with little or no fever. The first coughs can look like a common cold. After 1-2 weeks, this may progress to a stage characterized by bursts of numerous rapid coughs (paroxysms, a “machine gun” cough) followed by a loud “whooping” inhalation, which gives Bordetella Pertussis the alternative name of “whooping cough.” That “whoop,” however is not an invariable part of the illness. A final recovery stage with coughing may last weeks or months. It’s a nasty illness which the Chinese call the “100 day cough” and their number is not far off. In most cases, whooping cough is a truly miserable cough that can ruin a family’s summer plans and mean a lot of missed days of work and school. In very rare cases, it can lead to much more serious conditions. The risk is highest for infants in the first six weeks of life who can get very sick and even die from it.
At the present time, I’m aware of two families in my practice who I believe have pertussis. I have no laboratory confirmation and in neither case has anyone in the family required hospital care.
The media and many official medical organizations get the discussion of “epidemics” wrong as often as they get it right and when they finally have something to talk about in the press it’s hard to sort out the truth. Before you read any further, have a look at this New York Times article about the whooping cough “epidemic that wasn’t.”
This time, unlike the H1N1 “pandemic” scare, the avian flu hype, the measles epidemic of 132 cases, the Jewish mumps scare and the West Nile Virus fear posters at every trail head, the pertussis outbreak information might be real and might be a reason to consider getting your child vaccinated. Whooping cough is not easy to diagnose with lab tests and doctors and parents often must rely on their clinical impression the cough and the pattern of disease spread. According to the official website of Children’s Hospital of Philadelphia, an article reviewed by Dr, Paul Offit estimates that there are between “600,000 to 900,000″ cases of pertussis each year in adults and adolescents alone. This stands at odds with official data from the CDC which puts that number at 5000-10,000. This type of disparity makes the discussion of pertussis outbreaks and vaccination just a little more difficult.
I think the DTaP vaccine is the shot with the best risk/benefit ratio and it’s the vaccine I use the most often in my office week. The official schedule includes far too many shots for six-week-old babies. A lot of harm and confusion could be alleviated by vaccinating later and not giving five or six vaccines at the same time.
This “acellular” vaccine does not contain mercury (almost no vaccines still do) and has been in use for nearly fifteen years in the United States and for quite a few years before that in other countries.
DTaP vaccine prevents whooping cough and may even prevent illness or lessen the severity of illness after the first vaccine. The routine schedule includes three doses in the first six months of life, a fourth at eighteen months of age, a fifth at age five years and booster doses of a new adolescent/adult vaccine. I don’t think your babies under a year of age should be given any vaccines, including this one. The CDC and most doctors, including my colleagues in this office, disagree.
Erythromycin, Zithromax and similar antibiotics can shorten the contagious phase of pertussis and can stop the spread of the illness in a family or a school. Our office has DTaP vaccine for infants and young children and another for older children, adolescents and adults. I do not recommend this vaccine for infants unless there are unusual risk factors in a baby’s life. Again, the vast majority of experts disagree, and I understand the need for public health considerations and preservation of herd immunity but still would rather vaccinate only after 12-24 months of age and feel comfortable, in most cases, giving no vaccine at all.
Ultimately this is a parents’ decision. Do not expect the media to let up on this issue in the near future.
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Tylenol Recall Update
Since the April recall, Children’s Tylenol, Benadryl, Motrin and other McNeil Pharmaceutical products are still unavailable for purchase. The latest report says we should not expect a return of these products until 2011. You can receive updates from the makers of Tylenol on their website. In the meantime, I recommend generic brands of diphenhydramine (Benadryl) for allergies and generic acetaminophen and ibuprofen for fever control when you need it.
Here is a resource to help you determine the proper amount of acetaminophen to give your child.
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Jay Gordon, MD, FAAP
I spent Saturday at an incredible conference in Chicago. Any thoughts I ever had about wavering in my support of Andrew Wakefield have dissolved.
Jay
Last night, PBS aired a show called “The Vaccine War.” I was interviewed at great length and in great depth about vaccines and my point of view and expressed my ambivalence about the polarization of this issue and the need for more calm reasoned discussion about the number one question that new parents have. I told Kate McMahon, the co-producer of the show, that there was a large group of doctors and others who cannot be dismissed with the facile label “anti-vaccine” because we still give vaccines and see a place for them in the practice of medicine, but we do not agree with the current vaccine schedule nor the number of vaccines children receive all at one time.
A few days ago, Ms.McMahon emailed me to tell me that the decision had been made to omit my interview from the show. There would not be one word from me. She didn’t tell me that she had also omitted 100% of Dr. Robert Sears’ interview. And that any other comments from physicians supporting the parents on the show in their ambivalence about vaccines or their decision to refuse all vaccines would also be omitted.
She left this as a show with many doctors commenting very negatively, very frighteningly and often disdainfully and dismissively about vaccine “hesitation” as they called it.
Below is my email response to Kate McMahon.
Dear Kate,
The “Frontline” show was disgraceful. You didn’t even have the courtesy to put my interview or any part of the two hours we spent taping on your web site.
You created a pseudo-documentary with a preconceived set of conclusions: “Irresponsible moms against science” was an easy takeaway from the show.
Did you happen to notice that Vanessa, the child critically ill with pertussis, was not intubated nor on a respirator in the ER? She had nasal “prongs” delivering oxygen. I’m sorry for her parents’ anxiety and very happy that she was cured of pertussis. But to use anecdotal reports like this as science is irresponsible and merely served the needs of the doctor you wanted to feature.
No one pursued Dr. Offit’s response about becoming rich from the vaccine he invented. He was allowed to slide right by that question without any follow up. Dr. Paul Offit did not go into vaccine research to get rich. He is a scientist motivated by his desire to help children. But his profiting tens of millions of dollars from the creation of this vaccine and the pursuit of sales of this and other vaccines is definitely not what he says it is. His many millions “don’t matter” he says. And you let it go.
Jenny McCarthy resumed being a “former Playboy” person and was not acknowledged as a successful author, actress and mother exploring every possible avenue to treating her own son and the children of tens of thousands of other families.
I trusted you by giving you two or three hours of my time for an interview and multiple background discussions. I expressed my heartfelt reservations about both vaccines and the polarizing of this issue into “pro-vaccine” and “anti-vaccine” camps. I told you that there was at least a third “camp.” There are many doctors and even more parents who would like a more judicious approach to immunization. Give vaccines later, slower and with an individualized approach as we do in every other area of medicine.
What did you create instead?
“The Vaccine War.”
A war. Not a discussion or a disagreement over facts and opinions, but a war. This show was unintelligent, dangerous and completely lacking in the balance that you promised me–and your viewers–when you produced and advertised this piece of biased unscientific journalism. “Tabloid journalism” I believe is the epithet often used. Even a good tabloid journalist could see through the screed you’ve presented.
You interviewed me, you spent hours with Dr. Robert Sears of the deservedly-illustrious Sears family and you spoke to other doctors who support parents in their desire to find out what went wrong and why it’s going wrong and what we might do to prevent this true epidemic.
Not a measles epidemic, not whooping cough. Autism. An epidemic caused by environmental triggers acting on genetic predisposition. The science is there and the evidence of harm is there. Proof will come over the next decade. The National Children’s Study will, perhaps by accident, become a prospective look at many children with and without vaccines. But we don’t have time to wait for the results of this twenty-one year research study: We know that certain pesticides cause cancer and we know that flame retardants in children’s pajamas are dangerous. We are cleaning up our air and water slowly and parents know which paint to buy and which to leave on the shelves when they paint their babies’ bedrooms.
The information parents and doctors don’t have is contained in the huge question mark about the number of vaccines, the way we vaccinate and the dramatic increase in autism, ADD/ADHD, childhood depression and more. We pretend to have proof of harm or proof of no harm when what we really have is a large series of very important unanswered questions.
In case you were wondering, as I practice pediatrics every day of my career, I base nothing I do on Dr. Wakefield’s research or on Jenny McCarthy’s opinions. I respect what they both have done and respectfully disagree with them at times. I don’t think that Dr. Wakefield’s study proved anything except that we need to look harder at his hypothesis. I don’t think that Jenny McCarthy has all the answers to treating or preventing autism, but there are tens of thousands of parents who have long needed her strong high-profile voice to draw attention to their families’ needs: Most families with autism get inadequate reimbursement for their huge annual expenses and very little respect from the insurance industry, the government or the medical community. Jenny has demanded that a brighter light be shone on their circumstances, their frustration and their needs.
I base everything I do on my reading of CDC and World Health Organization statistics about disease incidence in the United States and elsewhere. I base everything I do on having spent the past thirty years in pediatric practice watching tens of thousands of children get vaccines, not get vaccines and the differences I see.
Vaccines change children.
Most experts would argue that the changes are unequivocally good. My experience and three decades of observation and study tell me otherwise. Vaccines are neither all good–as this biased, miserable PBS treacle would have you believe–nor all bad as the strident anti-vaccine camp argues.
You say the decisions to edit 100% of my interview from your show (and omit my comments from your website) “were purely based on what’s best for the show, not personal or political, and the others who didn’t make it came from both sides of the vaccine debate.” You are not telling the truth. You had a point to prove and removed material from your show which made the narrative balanced. “Distraught, confused moms against important, well-spoken calm doctors” was your narrative with a deep sure voice to, literally, narrate the entire artifice.
You should be ashamed of yourself, Kate. You knew what you put on the air was slanted and you cheated the viewers out of an opportunity for education and information. You cheated me out of hours of time, betrayed my trust and then you wasted an hour of PBS airtime. Shame on you.
The way vaccines are manufactured and administered right now in 2010 makes vaccines and their ingredients part of the group of toxins which have led to a huge increase in childhood diseases including autism. Your show made parents’ decisions harder and did nothing except regurgitate old news.
Parents and children deserve far better from PBS.
Dr. Jay discusses the Healthy School Lunch Program 2010 on ABC’s Good Morning America Health.
I have seen more children and adults with influenza-like illness: 104 degree fevers, muscle soreness, sore throat and negative tests for strep, than in any summer I can remember. I haven’t used the “flu swab” to test anybody, but I’m sure that many if not most of these sick people had Swine Flu. They all felt miserable, and they are all feeling just fine now.
Preventing outbreaks of this “novel H1N1″ influenza may be a mistake of huge proportions. Yes, sadly, there will be fatalities among the 6 billion citizens of the planet. Tens of millions of cases of any illness will lead to morbidity and mortality, but this is completely (tragically) unavoidable. The consequences of not acquiring immunity this time around, however, could be really terrible and far outweigh a mass prevention program.
Here’s my rationale for not using Tamiflu: If (if, if, if) this virus circles the globe as the rather innocent influenza it now appears to be, but mutates and returns as a very virulent form of influenza, it will be quite wonderful and life-saving to have formed antibodies against its 2009 version. These antibodies may be far from 100% protective, but they will help. This is incredibly important but being ignored in the interest of expediency.
In 1918, it appears that influenza A (an H1N1, by the way) did this globe-trotting mutation and killed millions. The times and state of medical care are not comparable, but a milder parallel occurrence is possible. Perhaps this happens every 100 years or so, perhaps every three million.
Whenever possible, we should form antibodies against viruses at the right stage of their existence and at the right stage of our lives (For example, chickenpox in childhood and EBV/mono in early childhood. There are many other examples.) Getting many viral illnesses confers lifetime immunity, and very few vaccines do.
Tamiflu is a very powerful drug with little proven efficacy against this bug, and with its major side effect being tummy upset. I’m not using it at all. Psychiatric side effects are also possible.
I also won’t be giving the flu shot to the kids and parents in my practice unless there are extraordinary risk factors. I anticipate giving none at all this year. I doubt that there will be any really large problems with the vaccine, but I also doubt any really large benefits. As I said, I think that this year’s version of this particular H1N1 is as “mild” as it will ever be and that getting sick with it this year will be good rather than bad. The chances that a new “flu shot” will be overwhelmingly effective are small.
I consider this, and most seasonal and novel influenza A vaccines, as “experimental” vaccines; they’ve only been tested on thousands of people for a period of weeks and then they’ll be given to hundreds of millions of people. Not really the greatest science when we’re in that much of a hurry. Yes, one can measure antibodies against a certain bacterium or virus in the blood and it may be associated with someone not getting sick, but there are very few illnesses common enough or enough ethics committees willing enough to do the right tests. That is, give 1000 people the real vaccine and 1000 placebo shots, expose all of them to the disease and see who gets sick. Seriously. I know it sounds terrible.
This is, obviously, a difficult public discussion because it touches on the concept of benefits and risks, again, of morbidity and mortality. Few public officials have the courage or inclination to present all facets of this difficult decision. I give vaccines to my patients every single day, but I always err on the side of caution. Implying that this is a dangerous new shot is not scientifically or statistically correct and represents hyperbole and even dishonesty on the part of the so-called “anti-vaccine” camp.
It sure isn’t “sexy” to suggest handwashing, good nutrition, hydration, extra sleep and so on. It’s not conventional to suggest astragalus, echinacea, elderberry and vitamin C. Adequate vitamin D levels are crucial, too.
I just think that giving this new H1N1 vaccine is not the cautious nor best thing to do.
Best,
Jay Gordon, MD, FAAP
Well, that wasn’t April’s only storm. An April Fool’s joke I posted to a private group of a few thousand doctors, lactation experts and other medical experts triggered alarm in the halls of my club, The American Academy of Pediatrics.
Interestingly, the AAP may actually have dramatically increased integrity under Dr. David Tayloe, our new president, but someone else violated the first rule of publicity: Don’t complain when some one makes you look a lot better than you really are. Even if he does it on April First!!
Dr. Susan E.Burger is one of the world’s foremost experts on international nutrition and epidemiology who shared with me her submission to the New York Times. The Times did not publish this excellent article and I asked her permission to post it here. Thank you very much, Dr. Burger
By ROBERT F. KENNEDY JR.
In June 2000, a group of top government scientists and health officials gathered for a meeting at the isolated Simpsonwood conference center in Norcross, Georgia. Convened by the Centers for Disease Control and Prevention, the meeting was held at this Methodist retreat center, nestled in wooded farmland next to the Chattahoochee River, to ensure complete secrecy. The agency had issued no public announcement of the session — only private invitations to fifty-two attendees. There were high-level officials from the CDC and the Food and Drug Administration, the top vaccine specialist from the World Health Organization in Geneva and representatives of every major vaccine manufacturer, including GlaxoSmithKline, Merck, Wyeth and Aventis Pasteur. All of the scientific data under discussion, CDC officials repeatedly reminded the participants, was strictly “embargoed.” There would be no making photocopies of documents, no taking papers with them when they left.
The federal officials and industry representatives had assembled to discuss a disturbing new study that raised alarming questions about the safety of a host of common childhood vaccines administered to infants and young children. According to a CDC epidemiologist named Tom Verstraeten, who had analyzed the agency’s massive database containing the medical records of 100,000 children, a mercury-based preservative in the vaccines — thimerosal — appeared to be responsible for a dramatic increase in autism and a host of other neurological disorders among children. “I was actually stunned by what I saw,” Verstraeten told those assembled at Simpsonwood, citing the staggering number of earlier studies that indicate a link between thimerosal and speech delays, attention-deficit disorder, hyperactivity and autism. Since 1991, when the CDC and the FDA had recommended that three additional vaccines laced with the preservative be given to extremely young infants — in one case, within hours of birth — the estimated number of cases of autism had increased fifteenfold, from one in every 2,500 children to one in 166 children.
By Katie Allison Granju
November 3rd, 2003 was a big day for Alabama emergency room pediatrician, Dr. Carden Johnston. On that date last month, he was installed as the new President of the 66,000 member American Academy of Pediatrics (AAP) at the prestigious organization’s annual meeting in New Orleans. It was also the date that he sparked what has emerged as a major ethical controversy by inadvertently pulling back the curtains on the powerful influence that a particular corporate interest appears to have in shaping AAP policy and action.
“I have to admit that I never imagined that my presidency would start off with such a bang,” Dr. Johnston says, acknowledging the debate now taking place within his organization.
By Dee Negron
The allergen in poison ivy is a substance called urushiol. What urushiol does, to people who are allergic to it, is bind with the skin cells and produce a rash. In order to treat a reaction to the poison ivy what you essentially need to do is “neutralize” the urushiol.
There are several herbs, when applied topically, that can do this. Jewelweed is one of the best. You can also combine this with any herb that contains a significant amount of saponins such as Soapwort, Horse Chestnut, Licorice, or Rose Leaves. Please remember that these are for topical use only as saponins shouldn’t be taken internally while pregnant or nursing, but are perfectly safe when used externally. Some things to help control the itching are aloe vera or plantain. Also, cool baths with powdered colloidal oatmeal can be extremely soothing.
Attention Deficit Disorder (ADD) or Attention Deficit Disorder with Hyperactivity (ADHD) affects millions of children and their families. Currently accepted statistics say that as many as 10% of the school-aged population have ADHD and perhaps another 20% have symptoms of the disorder suggestive of ADHD. Boys are diagnosed three times more often than girls and 30-50% of these children will continue to manifest these symptoms and problems in adulthood.
It’s no wonder that the pharmaceutical industry has made a huge effort to market drugs for ADHD and that a large and intelligent backlash has developed against the widespread use of these powerful chemicals.
I have been a pediatrician for twenty years and for fifteen of those years I completely disdained the use of Ritalin and the other psychopharmaceuticals for ADHD kids. I was probably wrong to “throw out the baby with the bath water.” Denying that a small percentage of children receiving Ritalin actually benefited from the drug was not fair to them. We don’t know enough about brain chemistry to completely understand ADHD, but we do know the impact of untreated ADHD on children: a much more difficult childhood and adolescence with school and social problems which can be nonstop.
I now try “everything else” before resorting to prescription medication, but I no longer rule out that possibility.
Deficiency in central nervous system dopamine probably causes many, if not most, of the problems associated with ADHD. Nutritional problems can cause or exacerbate this deficiency: supplemental tyrosine, B vitamins, vitamin C and copper have all shown a positive influence on improving the school performance of children with ADHD. These can all be combined with conventional therapy with no adverse interactions. Ritalin and similar drugs act by directly increasing brain dopamine levels.
Before I consider anything else, I try to persuade the family to put their child and themselves on an excellent diet. The standard American diet filled with sugar, artificial sweeteners, colors, preservatives, saturated fats, low levels of vitamins and minerals, and too much protein is not good for brain health or health in general. Mainstream medical journals have debated this topic for decades and most medical practitioners don’t like to consider nutritional alternatives in the treatment of any disease because it takes too long to discuss it with their patients.
I recommend whole foods as the backbone of the nutritional regimen. As obvious as this sounds, most children get the bulk of their food in an over-processed form. Whole grain cereals and breads and lots of fresh fruit and vegetables and beans and pasta make for meals which interest children and adults. Counsel your patients to avoid sugar!! Reading labels closely will show parents just how many artificial additives have worked their way into kids’ daily diets. Many chemicals mimic brain neurotransmitters and even conventionally published research admits that sugar has a negative impact on the behavior of ADHD children. Processed cereals and high-fructose corn syrup sweetened drinks add huge amounts of sugar to a child’s day. Even regular unsweetened apple juice in the quantities some children like can be a large source of extra sugar.
There are many alternative remedies which can be used to treat children with ADHD and learning disorders. We must help the families in our practices find these and guide them in their usage.
Ginkgo Biloba dilates blood vessels and improves circulation to the brain. Researchers have shown it’s utility in Alzheimer’s Disease.
Variations are to be expected, and are in no way to be considered a defect.
– Hang tag from Madras shirt
Statistics reflect this confusion. Depending on who you read, some experts say we have about eight hundred-thousand learning disabled children in the country. Others put the figure as high as eight million.
In 1963, when “learning disabilities” were first described, we found very few students with the problem and thought the problem was rare.
Some take a very conservative view and say that 30 – 50% of us will outgrow it, but a growing body of experts think we just learn to cope with it. There’s a certain brain development that takes place at puberty that sometimes makes ADD much easier to live with. I think the jury’s still out but my guess that most of learn to live with it, not outgrow it.
There are herbs that may drastically alter your feeling of well-being. These may be something you’d like to consider before resorting to medications.
For anxiety, a mix of Kava and Siberian Ginseng is good.
For depression, Gingko Biloba or Borage. There has been a good amount of success with a combination of the two as well.
Keep in mind when combining herbs to treat one symptom or illness to use a proportional dosage. (i.e., two herbs would be half dosage of each, three herbs would be one-third dosage, etc.)
Here is a link that goes into homeopathic remedies for depression. The info given is on postpartum depression simply because all of these are safe while nursing. They are all used to treat general depression as well, so they’re not specific for use for PPD.
Homeopathic Remedies for Postpartum Depression – MotherNature.com Health Encyclopedia
The usual speech applies here. When looking into using herbal or homeopathic remedies, make sure you’re getting them from a good health food store. Avoid commercial places like GNC. Get out the yellow pages and look under health food stores, then call around until you find one with a certified herbalist on staff. This is the store you want to go to.
Exercise should not be forgotten when dealing with depression. It has been shown that regular exercise is the best remedy for depression. There have been patients who’ve suffered repeated bouts of depression who have been able to go off meds completely after starting and maintaining a regular exercise program.
For painful joint problems, a combination of glucosamine and chondroitin has shown positive results in many.
The dosage for regenerating cartilage is 1500 mg of glucosamine a day and 1200 mg of chondroitin a day. Take this dosage until you start feeling a relief from the pain. Then drop down to 1000mg of glucosamine and 800 mg of chondroitin until pain disappears. From that point on, take a daily dose of 500 mg glucosamine and 400 mg chondroitin daily to prevent future degeneration.
Patients using glucosamine for osteoarthritis should take 1500 mg per day. It can take up to 4 – 8 weeks to relieve pain. Therefore, continuing on a NSAID during this time period may be necessary.
Patients with type II diabetes should monitor their blood sugar carefully due to concerns that glucosamine might increase insulin resistance.
In considering which supplements will assist you best with joint pain, it may be helpful to know that the absorption rate for chondroitin is 0 to 8% while the glucosamine sulfate is 98%. Glucosamine sulfate is the best source. It is possible to get the relief you are looking are with glucosamine alone.
By Dee Negron
Here are some natural treatments for colds that can be used in children and are also safe while nursing. When using herbs with children you can usually find a product made specifically for infants and children. If you can’t here’s how to determine the dosage. You take the child’s weight and divide it by 150. The resulting fraction is the portion of the adult dose to administer.
The first thing you’ll want to do is boost your body’s immune system. Echinacea, 2 capsules 3 times per day, and Colloidal Silver are great immune system boosters. You may also want to boost your intake of vitamin C, up to 500mg 4 times per day, and eat foods with plenty of fresh garlic.
Anise and Mullein, in tea form and taken as needed, are both natural expectorants. Elderberry, 10ml 2 times per day, is the best antiviral product on the market, natural or otherwise. It is most effective in fighting the flu virus, but is also very effective against cold viruses.
Aromatherapy can be a great tool as well. Lavender and Clary Sage in your bath are what you’ll want to use. Lavender works to relax muscles and can help soothe coughs and Clary Sage helps alleviate the grumpiness that tends to accompany colds. What you’ll need to look for is an essential oil. It is the oils of these plants that work, so something that merely contains a fragrance is going to be useless. Then what you do is take some unscented liquid soap and add five drops Clary Sage oil and ten drops Lavender oil and use your finger to mix the oil with the soap. This emulsifies the oils so that they mix with your bath water.
Ear infections can be viral or bacterial. It seems logical to assume that the majority of them–like all kids’ infections–are viral and therefore completely non-responsive to antibiotics. The medical literature is just loaded with controversy about ear infections and that controversy includes the basic idea that ear infections may not need antibiotics at all!
I think that many infections, including otitis media (middle ear infections) respond faster or better to antibiotic treatment but I also think that the negative impact of those medicines is underestimated by doctors and patients alike. Everything from yeast overgrowth in the intestines, oral thrush, vaginal or diaper area yeast infections to diarrhea result from antibiotics. Additionally, some people have allergic reactions to these medicines. Perhaps the most underestimated problem is the breeding of bacteria which are resistant to the very drugs we count on to kill them.
1. Always feed your baby at the first sign of hunger and not by the clock or a schedule.
2. Don’t be thrown by growth spurts. They are normal and short lived. The only accurate way to gauge how much the baby is taking in is by counting wet and dirty diapers.
3. Buy yourself a tube of Lansinoh.
4. Get through the first 2 to 3 weeks. After that it is SO much easier!!
5. Have phone numbers of breastfeeding-friendly people to help you.
6. Remember that your breasts are never truly empty of milk. You make milk as your baby nurses.
7. Always let the baby end the feeding himself. That way, he will get all of the hindmilk he needs.
8. If you feel discouraged or like throwing in the towel, read this list or 101 Reasons to Breastfeed. It has always helped me and I could never quit after being reminded of why I was breastfeeding.
9. Check to see if you have inverted or flat nipples while pregnant, because you can start correcting them before the baby is born.
10. The first few days till milk comes in, colostrum is really all a baby needs. Nurse often on each side (every 90 minutes) to make sure baby gets enough colostrum and to ensure milk will come in soon.
When a mom is new to breastfeeding, the idea of nursing in public can be somewhat daunting. She may have already been exposed to a less-than-supportive attitude from friends or family regarding breastfeeding. Let’s face it, at least in American society, you will find more uninformed opinions on breastfeeding than you will find opinions that it is the normal and natural way to feed your child. That offers little comfort when confronted with new territory… Nursing In Public (NIP).
The mothers from the Breastfeeding and Breastfeeding Support boards on AOL have contributed some things that they found helpful when they were new to NIP. We hope that it will provide you with tips for making the transition to NIP an easier one for you.
Most of all, remember, that nursing your baby is completely normal and natural to do, regardless of where you are when your baby is hungry. It’s how our bodies were designed to nurture our precious children. It’s just that some folks haven’t figured that out yet. Set a good example for another new mom that may be watching you and just nurse your baby.
- Cherri
Breastfeeding is an incomparable emotional experience for mothers and babies. Scientific support keeps getting stronger because solid medical research articles keep affirming the overwhelming nutritional and immunological superiority of human milk for human babies
I have always enjoyed scanning medical databases for new breastfeeding articles but this collection was gathered by Ginna Wall, MN, IBCLC and Jon Ahrendsen, MD, FAAFP who have given their kind permission for its presentation here.
For a frank discussion with your dentist, skip right to the dental caries articles. Families with premies need to look hard at the RSV research and the NEC articles among others. Neonatologists need them, too.
The brain grows better with breastmilk as has been shown over and over again in research about IQ, motor development and vision.
The articles about decreased incidence of malignancy and diabetes are worth a read in their entirety when you have a chance to get to MEDLINE or Pubmed.
By Cheryl Taylor, CBE
Infections of the breast present themselves typically in two manners. Mastitis is a bacterial infection in the breast, typically involving a considerable quantity of mammary tissue. A plugged duct is an individual duct that is blocked, swollen and often presents as a hard knot in the breast. A plugged duct can lead to mastitis, but the two are not always presented together. The treatment for both includes many of the same measures. The differentiation is often seen in the level of a fever and length it sustains. If a woman is familiar with the symptoms of either, and begins treatment immediately upon noticing the first symptoms, it can almost always be resolved before antibiotics are necessary. I encourage all breastfeeding moms to become familiar with the symptoms, so as to be in a position to catch the first signs and avert a long and painful battle.
By Cheryl Taylor, CBE
If there is a rule that would help moms survive growth spurts with a smile, it would have to be, “Don’t Watch The Clock!” Don’t watch the clock for how long baby has been nursing. Don’t watch the clock for how long it’s been since baby last wanted to nurse. Don’t watch the clock for how many times you’ve been awakened that night to nurse.
Growth spurts happen. They happen with all nursing dyads. Some babies protest more about them and others seem to sail through them with the greatest of ease. Some books will tell you they happen at so many weeks or months. They may tend to, but the truth is, they can happen anytime.
By Cheryl Taylor, CBE
I hear from moms regularly that are planning on using both breastfeeding and bottle feeding. Some of them are well informed about the many dangers of formula and have a pump ready to use to provide expressed breastmilk. Some are not, and the first place we begin is with a lesson on the many inadequacies of infant formulas. For the ones that do know that breastmilk only is the goal, but want their husbands to “bond” with the baby, our lesson begins with all the many, many ways in which fathers can interact with their babies without using a bottle.
Regardless of what is being put in the bottle, there are several areas of impact that remain the same.
By Cheryl Taylor, CBE
Thrush is a yeast infection that can present itself in your baby’s mouth or on your nipples. When thrush is in either of these locations, you may also find the yeast deep in the breast tissue, vaginally or on your baby’s diaper area. When the yeast infection presents itself, it may be in all or one of these locations.
By Cheryl Taylor, CBE
When in the course of a happy breastfeeding relationship you notice a supply change, it can cause momentary panic. The first course of action should be to assess a few basic things. Are you resting enough? Getting a good night’s sleep? Taking a nap if necessary? Are you drinking at least 64 ounces of water a day? Are you eating a good, healthy diet? These are some of the basics of a nursing relationship that have to be maintained to the very best of your ability. Our bodies aren’t necessarily so forgiving of being pushed to the limit when we’re nursing. They tend to give us a clear signal. One of those ways is with a dip in supply. Listen to your body and take some action.
By Dee Negron
Many pregnant and nursing moms want to stay as far away from synthetic medications as possible. As a result, they look into using herbs and other natural remedies as an alternative. Herbs can be a wonderful alternative and many are very helpful. The problem arises when the assumption is made that just because herbs are natural, they are 100% safe. This simply isn’t true. Herbs can be very powerful, some are potentially dangerous, and all should be taken while under the supervision of your doctor or a certified herbalist.
One of the herbs nursing women ask about most frequently is ginseng. Many new mothers find themselves stressed out and fatigued. They start to look for anything that will help them get through the next harried day and sleepless night. Ginseng seems to be the answer. However, most forms of ginseng are unsafe for nursing mothers.
By Cheryl Taylor, CBE
If breastfeeding is going to be combined with working, there are some things to consider that will give you greater success. A working mom can provide breastmilk for her baby without having to resort to the use of ABM (artificial baby milk). She has many balls in the air and every trick that makes any aspect of pumping a bit easier is worth consideration. Whether you’re planning on returning to work, or you’ve hit a bump in the road, I hope you’ll find a tip here that will make life easier and the milk flow.
By Cheryl Taylor, CBE
The identification of a strike, versus weaning, is simple. Weaning is something that happens gradually over several weeks or months with baby or child dropping a single nursing at a time. A strike is something that happens abruptly. Baby or child is nursing several times a day and suddenly stops completely. Sometimes it is impossible to ascertain the cause of a strike, but the solution is the same regardless of the cause.
- The gastrointestinal (GI) tract of a normal fetus is sterile.
- The type of delivery has an effect on the development of the intestinal microbiota.
* Vaginally born infants are colonized with their mother’s bacteria.
* Cesarean born infants’ initial exposure is more likely to environmental microbes from the air, other infants, and the nursing staff which serves as vectors for transfer.
- Babies at highest risk of colonization by undesirable microbes or when transfer from maternal sources cannot occur are cesarean-delivered babies, preterm infants, full term infants requiring intensive care, or infants separated from their mother.
- Breastfed and formula-fed infants have different gut flora.
* Breastfed babies have a lower gut pH (acidic environment) of approximately 5.1-5.4 throughout the first six weeks that is dominated by bifidobacteria with reduced pathogenic (disease-causing) microbes such as E coli, bacteroides, clostridia, and streptococci o babies fed formula have a high gut pH of approximately 5.9-7.3 with a
variety of putrefactive bacterial species.
* In infants fed breast milk and formula supplements the mean pH is approximately 5.7-6.0 during the first four weeks, falling to 5.45 by the sixth week.
* When formula supplements are given to breastfed babies during the first seven days of life, the production of a strongly acidic environment is delayed and its full potential may never be reached.
* Breastfed infants who receive supplements develop gut flora and behavior like formula-fed infants.
- The neonatal GI tract undergoes rapid growth and maturational change following birth.
* Infants have a functionally immature and immuno-naive gut at birth.
* Tight junctions of the GI mucosa take many weeks to mature and close the gut to whole proteins and pathogens.
* Open junctions and immaturity play a role in the acquisition of NEC, diarrheal disease, and allergy.
* sIgA from colostrum and breast milk coats the gut, passively providing immunity during the time of reduced neonatal gut immune function.
* Mothers’ sIgA is antigen specific. The antibodies are targeted against pathogens in the baby’s immediate surroundings.
* The mother synthesizes antibodies when she ingests, inhales, or otherwise comes in contact with a disease-causing microbe.
* These antibodies ignore useful bacteria normally found in the gut and ward off disease without causing inflammation.
- Infant formula should not be given to a breastfed baby before gut closure occurs.
* Once dietary supplementation begins, the bacterial profile of breastfed infants resembles that of formula-fed infants in which bifidobacteria are no longer dominant and the development of obligate anaerobic bacterial populations occurs. (Mackie, Sghir, Gaskins, 1999)
* Relatively small amounts of formula supplementation of breastfed infants (one supplement per 24 hours) will result in shifts from a breastfed to a formula-fed gut flora pattern. (Bullen, Tearle, Stewart, 1977)
* The introduction of solid food to the breastfed infant causes a major perturbation in the gut ecosystem, with a rapid rise in the number of enterobacteria and enterococci, followed by a progressive colonization by bacteroides, clostridia, and anaerobic streptococci. (Stark & Lee, 1982)
* With the introduction of supplementary formula, the gut flora in a breastfed baby becomes almost indistinguishable from normal adult flora within 24 hours. (Gerstley, Howell, Nagel, 1932)
* If breast milk were again given exclusively, it would take 2-4 weeks for the intestinal environment to return again to a state favoring the grampositive flora. (Brown & Bosworth, 1922; Gerstley, Howell, Nagel, 1932)
- In susceptible families, breastfed babies can be sensitized to cow’s milk protein by the giving of just one bottle, (inadvertent supplementation, unnecessary supplementation, or planned supplements), in the newborn nursery during the first
three days of life. (Host, Husby, Osterballe, 1988; Host, 1991)
* Infants at high risk of developing atopic disease has been calculated at 37% if one parent has atopic disease, 62-85% if both parents are affected and dependant on whether the parents have similar or dissimilar clinical disease, and those infants showing elevated levels of IgE in cord blood irrespective of family history. (Chandra, 2000)
* In breastfed infants at risk, hypoallergenic formulas can be used to supplement breastfeeding; solid foods should not be introduced until 6 months of age, dairy products delayed until 1 year of age, and the mother should consider eliminating peanuts, tree nuts, cow’s milk, eggs, and fish from her diet. (AAP, 2000)
- In susceptible families, early exposure to cow’s milk proteins can increase the risk of the infant or child developing insulin dependent diabetes mellitus. (IDDM) (Mayer et al, 1988; Karjalainen, et al, 1992)
* The avoidance of cow’s milk protein for the first several months of life may reduce the later development of IDDM or delay its onset in susceptible individuals. (AAP, 1994)
* Sensitization and development of immune memory to cow’s milk protein is the initial step in the etiology of IDDM. (Kostraba, et al, 1993)
- Sensitization can occur with very early exposure to cow’s milk before gut cellular tight junction closure.
- Sensitization can occur with exposure to cow’s milk during an infection-caused gastrointestinal alteration when the mucosal barrier is compromised allowing antigens to cross and initiate immune reactions.
- Sensitization can occur if the presence of cow’s milk protein in the gut damages the mucosal barrier, inflames the gut, destroys binding components of cellular junctions, or other early insult with cow’s milk protein leads to sensitization. (Savilahti, et al, 1993)
References
American Academy of Pediatrics, Work Group on Cow’s Milk Protein and Diabetes Mellitus. Infant feeding practices and their possible relationship to the etiology of diabetes mellitus. Pediatrics 1994; 94:752-754
American Academy of Pediatrics, Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics 2000; 106:346-349
Brown EW, Bosworth AW. Studies of infant feeding VI. A bacteriological study of the feces and the food of normal babies receiving breast milk. Am J Dis Child 1922; 23:243
Bullen CL, Tearle PV, Stewart MG. The effect of humanized milks and supplemented breast feeding on the faecal flora of infants. J Med Microbiol 1977; 10:403-413
Chandra RK. Food allergy and nutrition in early life: implications for later health. Proc Nutr Soc 2000; 59:273-277
Gerstley JR, Howell KM, Nagel BR. Some factors influencing the fecal flora of infants. Am J Dis Child 1932; 43:555
Host A, Husby S, Osterballe O. A prospective study of cow’s milk allergy in exclusively breastfed infants. Acta Paediatr Scand 1988; 77:663-670
Host A. Importance of the first meal on the development of cow’s milk allergy and intolerance. Allergy Proc 1991; 10:227-232
Karjalainen J, Martin JM, Knip M, et al. A bovine albumin peptide as a possible trigger of
insulin-dependent diabetes mellitus. N Engl J Med 1992; 327:302-307
Kostraba JN, Cruickshanks KJ, Lawler-Heavner J, et al. Early exposure to cow’s milk and solid foods in infancy, genetic predisposition, and risk of IDDM. Diabetes 1993; 42:288-295
Mackie RI, Sghir A, Gaskins HR. Developmental microbial ecology of the neonatal
gastrointestinal tract. Am J Clin Nutr 1999; 69(Suppl):1035S-1045S
Mayer EJ, Hamman RF, Gay EC, et al. Reduced risk of IDDM among breastfed children. The Colorado IDDM Registry. Diabetes 1988; 37:1625-1632
Savilahti E, Tuomilehto J, Saukkonen TT, et al. Increased levels of cow’s milk and blactoglobulin antibodies in young children with newly diagnosed IDDM. Diabetes Care 1993; 16:984-989
Stark PL, Lee A. The microbial ecology of the large bowel of breastfed and formula-fed infants during the first year of life. J Med Microbiol 1982; 15:189-203
By Cheryl Taylor White, CBE
There are times when a nursing mom needs to take certain medications. Many physicians are simply not well educated on medications and the safety of taking them while breastfeeding. They may give information that is inaccurate and/or recommend that a mom wean to take a medication. Breastfeeding is so very vital to an infant’s health and development and should be guarded more vigilantly by our medical community. There truly is a small number of medications that are contraindicated for breastfeeding.
Dr. Thomas Hale is the leading expert on breastfeeding and medications. If you have been prescribed a medication and been instructed to wean to take it, take the time to get the accurate information on that medication and how it pertains to nursing. Your proactive manner of handling this could be what saves your breastfeeding relationship!
I remember sitting in my new pediatrician’s office, when I eight months pregnant, discussing what his views were on well child visits. As we sat and chatted I was sure I had found the perfect pediatrician for my first baby.
As we were getting up to leave, he handed me a packet. He called it “propaganda”. He said as we walked down the hall, “Read this packet of propaganda on the adverse effects of vaccines, but don’t worry…the risk of anything happening is very slim.” So with that we said goodbye and I tucked the packet away. How I wish I could go back to that day and ask all the questions I now know to ask!
A few weeks later my son was born a healthy little boy and immediately started his immunization schedule at his first appointment. I dutifully took him every two months and received the battery of vaccinations. At that time we didn’t think anything of the fact that he wasn’t interested in toys like other kids or that he didn’t babble or smile much. He seemed to learn these things at a slower rate, but then would lose the skills he had gained. As a Special Education teacher, I knew in my heart that something was very wrong with my little boy. My pediatrician was reassuring and tried to calm my fears, but something inside me just ached. At twelve months I requested an evaluation for my son and at fifteen months he was evaluated by a Speech Therapist. I remember her coming to me in the waiting room and in front of the rest of families she said, “There is something very wrong with your child. I suspect it is a form of autism. You need to call for a full evaluation.” With that she walked away and my life crumbled and has forever changed. Read the rest of this entry »
Infants born prematurely literally start life a little bit behind. Their lungs may not be well enough developed to absorb oxygen and discharge carbon dioxide. Their intestinal tracts may not absorb food well and their central nervous systems may not allow them to maintain temperature stability.
Occasionally they may need extra oxygen by tube, nasal prongs or even need a respirator. Intravenous calories can nourish and sustain the most vulnerable preemies and a gradual transition from tube feeding to breast or bottle will let the stomach and intestines mature without risking harm.
Even babies born a week or two early can have “respiratory distress syndrome of prematurity”–or RDS as it’s called–but this is much more likely under 34-35 weeks gestation (5-6 weeks early.) If premature delivery is anticipated and can’t be stopped, an obstetrician will give the mother-to-be an injection of steroids to speed up lung maturation. This relatively simple and apparently harmless medication has saved countless babies’ lives and kept others from prolonged hospitalizations. Your doctor may not have a lot of time to explain this fully to you when it’s needed on an emergency basis but please know that it works and is safe.
Below I answer frequently-asked questions about the impact of prematurity on infant survival, development, vaccination decisions, and family dynamics. Read the rest of this entry »
Most babies are born in hospitals and hospitals function best on routines. They’ll explain that “routinely we take your baby to the nursery for a bath and an exam and Dad can go along.” Tell them that this is your one and only special baby and that the “routine baby” must be next door. The baby’s not dirty and doesn’t need a bath. If they need to know what he weighs, the scale has wheels and his temp can be taken under his arm in your arms.
Babies born prematurely or with any problems or instability are a completely different issue and you’ll be happy you’ve chosen an OB you trust, a pediatrician attentive to your baby and a hospital which can handle the problems or prematurity.
But, most babies are born at or near term (37-41 weeks) and need no extra attention from the nursery and don’t need to be separated from their moms and dads. Talk to your doctors and the nursery about this before you go into labor. It’s a much tougher discussion at 6 or 7 centimeters dilation.
Meningitis is a terrible disease caused by viruses or bacteria which inflame the membranes surrounding the spinal cord. Viral meningitis is a much milder illness but bacterial meningitis can cause permanent damage and, very rarely, death.
Meningitis is also one of the best headline-grabbing diseases. The new (January 2001) recommendation by the American Academy of Pediatrics to vaccinate all college students living in dorms with meningococcal vaccine will cause many parents to bring their soon-to-be graduates to the doctor because the disease rate is “almost five times greater in dorm students than in the general population.” Meningococcus is one of many organisms which can cause meningitis. Read the rest of this entry »
There seems to be a great deal of confusion about vaccinations and the requirements for school entrance. Actually, this is very simple: Many states’ laws require that children receive the recommended immunizations prior to school entry or that parents sign a waiver stating that all or some of the vaccines have not been given because of medical, personal or religious reasons.
I have had firsthand experience and dozens of episodes reported to me of school officials attempting to convince parents that there something wrong with their signing the waiver. Parents have been coerced and threatened over and over again, particularly about the hepatitis B vaccination being absolutely required for entry to kindergarten, sixth or seventh grade. This is not true and represents a serious violation of the letter and the spirit of the laws of the state. This vaccine, along with any and all others, can be waived and refused. School entry may not be denied by either public nor private schools.
I recommend vaccines, gave most of them to my daughter and to the children of my friends, and still support the absolute right of parents to make decisions regarding vaccinations.
Vaccinations never used to be the least bit controversial. Or, if they were, I wasn’t aware of the controversy. Now I spend a very large portion of every day discussing the eight or nine different vaccinations given to children in the first years of life and there is no end in sight — no end to the discussions and no apparent end to the number of new vaccines which will become available over the next few years.
If I were to be invited to participate in a consultation about public health or global vaccine policy, I would readily state that vaccines do much more good than harm.
In my office I am consulted about one child at a time. I tell the parents that I believe that each vaccine deserves a risk/benefit analysis with each individual child. Families which travel extensively are certainly more likely to be exposed to diseases nearly extinct in America. Breastfeeding babies in healthy families whose vacations are less than exotic are less likely to be anywhere near someone with polio, diphtheria or measles.
I have listened to many different points of view about vaccination and am very tired of hearing people “shout” about the issue. Calm, reasoned discussions will give parents the information they need to make informed choices about vaccines.
One simple fact: 99% of doctors favor vaccinating every child and teenager with available vaccines at all the appropriate ages. Only a very small number of doctors and other authorities favor any other point of view, be it delaying vaccines or not giving some or all of the shots.
The first shot offered to your baby is a hepatitis B vaccination which some doctors still choose to give in the hospital within the first 48 hours of life. Hepatitis B is a potentially “permanent” illness which can lead to chronic liver inflammation, damage and eventually liver cancer. The vaccine has helped reduce the incidence of hepatitis B in America by 90%. The disease is contracted through high risk behavior: intravenous drug use or sexual contact but some authorities say that more mundane activities such as sharing a toothbrush or razor can transmit the virus. I prefer to give this vaccine much later in life when I give it. A small minority of vaccine experts argue that the hepatitis has adverse consequences which lead to autoimmune diseases like multiple sclerosis and diabetes. Although they have gathered data supporting their position, the vast majority of experts refute this idea and support universal vaccination against hepatitis B.
At the six week or two month appointment, the DPaT, IPV, HIB, Prevnar and second HBV are routinely given. These initials stand for, respectively, diphtheria/acellular pertussis/tetanus, inactivated polio vaccine, hemophilus influenza B, and the newer pneumococcus vaccine. In large measure because of vaccination policies, none of these illnesses are common in America. We see an average of one case per year of diphtheria per year in the entire country and 60 to 70 cases of tetanus. There are still thousands of cases of pertussis (whooping cough), most of which do not get diagnosed and which cause rare hospitalizations and even rarer fatalities. Whooping cough can be fatal in children under six weeks of age (1 out of 200 cases in the midst of an epidemic) and in virtually no other cases.
Tetanus is very rare and occurs mostly in older adults and others with compromised immune systems. The problem I have faced with children who do not have complete tetanus immunity is that I cannot answer the question, “Could this wound cause tetanus? What are the chances?” The honest answer is that a healthy immune system can almost always defeat the clostridia tetani bacterium. Almost always. I have no percentage nor great answer for people who have fewer than three shots or whose immunity is “out of date.” I am quite certain that very few children would contract tetanus even if they were unvaccinated, but I have no proof. I worry, parents worry and the only answer is to get a “tetanus immune globulin” injection to create instant immunity. After a bad wound, there is no certainty of protection with just one shot or even with a second tetanus (or DPaT) injection.
Wild polio has not been in America since 1979. There is presently no wild polio in the Western Hemisphere and it has been obliterated from the Pacific Rim. Most cases of polio are in smaller villages in Africa and in countries in Asia. There have not been recorded cases of immigrants to the USA bringing in polio for decades. Over the past two decades, there have been sporadic outbreaks in Jamaica, the Netherlands, Israel and elsewhere when a person emigrated from another country and found a susceptible group of unvaccinated people. The Netherlands outbreak was among a group of Amish. Many docs and grandparents, and some parents remember the polio epidemic of the 1950s. There is a lot of scientific support and a huge amount of emotional support for continuing to vaccinate thoroughly against this illness even though it no longer exists in America. The elimination of the oral polio immunization, which was a “live” vaccine, has also eliminated vaccine-associated polio in the U.S. Other countries still use this vaccine and it works extremely well. The risk was small, but the IPV doesn’t carry even that tiny chance of transmitting polio from a vaccinee to a susceptible adult or child.
Hemophilus influenza B used to be the major cause of meningitis under two years of age and now that type of meningitis has been almost completely eliminated from pediatric practice. This is a true testimony to the effectiveness of this shot. It is also a strong argument for initiating the risk/benefit analysis I mentioned. Again, a very small minority of vaccine researchers have concluded that the HIB vaccine is another cause of autoimmune problems. There have even been research articles in mainstream medical journals supporting this point of view. And, again, the vast majority (99% or more) of physicians and experts do not believe that the risk outweighs the benefits. Besides meningitis, this bacteria can cause epiglottitis and other “invasive” infections. I have not seen a case of HIB disease in quite a few years.
The Prevnar vaccine is too new for me to recommend. The number of cases of Pneumococcal ear infections which could be prevented is very small and the number of cases of meningitis prevented is also small. I have no quarrel with doctors who recommend the shot or with parents who choose to get it. I have very strong objections to advertising this immunization to the general public on television. I don’t think enough information can be disseminated in 60 seconds.
The second HBV continues the buildup of antibodies against hepatitis B.
(The other commonly mentioned hepatitides are hep A and hep C. Hepatitis A is not a permanent disease but can ruin an adult’s vacation and even lead to hospitalization. The vaccine must be considered seriously by travelers. Hepatitis C is deadly and we have no vaccine for this or the other most-commonly discussed sexually transmitted killer, HIV.)
DPaT, HIB and IPV booster doses are given at the 4 month check up and then another DPaT and HIB at the six month visit. Most experts do not give a third IPV until the 18 month visit. The DPaT is given again at 18 months as is the HIB. A third HBV is given at 18 months of age although this timing may vary.
At one year of age, a child is to receive the measles/mumps/rubella vaccine. The MMR has received more notoriety in the past year or two than all the other shots combined. Research in England and elsewhere tied the shot to an increase in intestinal problems linked with autism. As I have mentioned over and over again above, the vast majority of experts discount these findings and feel that the benefits of the triple shot outweigh the risk. They remind us that, even though America is in the third year during which we will have fewer than 100 cases of measles reported, in India, there are an average of 1,000,000 deaths each year. Most of these deaths are in children. Rubella is dangerous to a fetus at certain stages of pregnancy and mumps can decrease fertility in men who catch the disease. I evaluate this vaccine and discuss it on a case by case basis in my office.
Vaccinating college students against meningococcal meningitis has become official policy on many campuses. If we vaccinate every single college student against this terrible disease, it has been estimated that we would prevent a half dozen cases of the disease each year. If the vaccine has any risk associated (none has been proved) this benefit is not great enough in my opinion.
In a public venue such as this, or on a TV show or in a national newsmagazine, I don’t think enough of a dialogue or evaluation can take place. For that reason, I would rather attempt to give information and let parents expand their knowledge with reading and talking. I do not vaccinate all of my patients and I don’t feel that these partially vaccinated or unvaccinated children are at high risk. I think that if national vaccine policy shifts away from universal vaccination, outbreaks could occur.
The questions surrounding the issue of vaccination are the hardest questions I face each day in my office. Vaccines work and opponents of immunizations who try to convince you that they don’t are not being honest.
I am very much opposed to the routine vaccination schedule in the U.S. There are too many vaccines given too early in a child’s life and not enough information given to parents.
Vaccines have side effects. Some rare severe problems, some common minor problems and constant speculation about hidden problems. Vaccine proponents who deny side effects are not being honest with you, either.
My strongest recommendation to you and anyone else considering alternatives to the standard vaccine regimen is to become very well informed and discuss these issues long and hard with your doctor. A doc who won’t hold these discussions is too busy and you may need to move on to another.
Inflammation and swelling at the site of injection are common and can last for days. Large or very tender swelling may represent a small abscess and has to be seen by your doctor.
Fevers and flu-like symptoms are also not rare and almost never last too long. Severe lethargy or a high fever mandate a phone call to the doctor.
Rashes occur with many shots and usually can just be observed for a little while unless they cause you to worry.
Seizures or “collapse syndromes” are quite rare and require immediate medical attention.
I personally would prefer to start vaccines after the first 6-12 months of life even though I know that this would slow the development of immunity to whooping cough which may come back any year.
“I no longer give or recommend the MMR vaccine. I think that the risks exceed the benefits. Obviously, discuss this with your doctor but please know that the CDC declared rubella officially eradicated in the U.S. in 2005, measles remains a rare disease in America (30-40 cases/year) and mumps is also not very common.
Mumps can cause decreased fertility in teenage boys who get the illness and suffer testicular infection, but this is a very rare occurrence.
All three of these viruses continue to be associated with severe life-threatening complications in other countries, but the vaccine—including the “split” vaccines—enough risk to outweigh the benefit for healthy North American or European children.”
Editor@People.com
Your article (“Desperate Measures” People, 9/27/04) mentions that the flu shot contains about the same amount of mercury as 2.5 ounces of albacore tuna. Rarely, if ever do we intentionally inject tuna into six month old babies. I cannot imagine that Dr. Cody Meissner, the physician quoted immediately following that phrase “signed on” to this comparison. No intelligent person would.
This year’s flu shot contain 25 micrograms of mercury. This is 250 times the Environmental Protection Agency’s recommended daily limit of 0.1 micrograms/day and violates the spirit if not the letter of the FDA’s mercury guidelines, too.
There may be many people at risk of influenza complications who should receive the flu shot but pregnant women should not and neither should small babies. The risks outweigh the benefits.
Very solid medical studies support the concept that mercury and other toxins can trigger autism, diabetes and other illnesses in susceptible children. It is completely incorrect to imply that these substances have been proven to “cause” autism but equally inaccurate reasoning to claim that we’ve proven that they do not.
You quote Dr. Gary Freed commenting on his caring for a child who died of measles complications. We have fewer than 50 cases of measles each year in the USA and doctors should help parents decide if the possible risks exceed the possible benefits for each individual child. We have not had a measles death in America for some years. He may have seen this happen, but it was a while ago.
Zealots who deny that the tremendous decrease in measles, polio and other illnesses is not owed to vaccination are as lacking in intellectual honesty as the experts who try to scare parents into vaccinating rather than presenting an honest presentation of the facts.
There are good reasons to vaccinate but there may be other good reasons for parents to refuse certain vaccines.
Jay Gordon, MD, FAAP, IBCLC
drjaygordon.com
I have often asked parents not to bring poop samples into my office. While there is a lot of information to be gleaned from studying full diapers, I think I can do most stool analysis on the phone or online unless an emergency situation occurs.
There is a wide variety of color and consistency of bowel movements. In my glamorous job as a pediatrician, I discuss this hot topic every day.
A change of pattern can throw the most confident mom for a loop and can even confuse an experienced pediatrician. Babies have blood in their stool fairly often and it virtually never is the sign of serious illness, but I pay a lot of attention to this because it alarms parents and requires that a reason be found.
We shouldn’t be any more surprised to see a variety of bowel movements in our babies than we would in anyone of any other age. In breastfed babies, the mom’s diet can affect the color or consistency of a baby’s stools, particularly if the baby is showing an allergic reaction to a certain food or food group.
Sticky, tar-like and green or black
This is meconium. The first stools of a newborn will be this consistency and color. It is what is present inside the bowels of a newborn upon birth and will clear itself out within the first couple of days and represents the “byproducts” of building an entire human being for nine months.
Greenish or Yellow/Brown, grainy or seedy
This is the transition between meconium and a regular breastfed stool and begins as mom’s milk is coming in on the second, third or fourth day of life. There may be three stools each day, ten, or even twenty. Occasionally, even a baby in the first week of life will skip a day and have no bowel movements at all. Call your doctor to discuss this even though it is normal. This does not require a dietary change or supplementation of a breastfed baby.
Light yellow to bright green, loose/runny, curdy, lumpy, seedy, creamy, mustard-like
These are normal breastfed stools. The consistency, frequency and color vary from day to day. My wife described the smell as “curried yogurt”. Opinions on this odor description differ widely.
Frequent Watery Stool often “Greener” than usual
How can you spot diarrhea in a baby who has loose frequent stools every day? This type of poop is “diarrhea” in a breastfed baby. It can be due to a virus, a bowel infection, stress, anxiety or a food intolerance.
Hard, pellet – like, presence of blood or mucous
This is constipation in a breastfed baby and is so very rare that I cannot recall ever seeing it in a baby who is receiving breastmilk as a sole source of nutrition, as are most babies in the first six months. It could be related to a food allergy. Formula fed babies get constipated much more often and may even have harder bigger stools like older kids and adults. Getting these stools softer is a balancing act of great proportions.
Black stools often accompanied by constipation
This is the result of iron supplementation. Iron fortified infant foods and infant vitamins can cause constipation. A healthy breastfed baby does not need iron supplementation. The iron in breastmilk is much more bioavailable than any other form.
Red streaked stools
This usually comes from bleeding in the lower intestine or rectum. Most often it is caused by rectal fissures which are tiny “cuts” around the circumference of the anus. This can be a reaction to dairy in mom’s diet. Elimination of all dairy is the first line of defense in this situation. I have seen countless babies who had blood in their poop which resolved when mom stopped all dairy products and returned with even a small amount of milk or cheese. Other dietary changes may be needed for breastfeeding moms. Formula fed babies lose blood from the lower intestine when they drink cow milk formula and some have the same losses on soy formula. Occasionally, this “micro-hemorrhaging” can become visible as blood streaking on the surface of the stool. Persistent or increasing blood in the stool or blood mixed with mucus (described as “currant jelly” stool in the texts) requires an immediate call to your doctor.
Green, frothy stools
This can be a result of a hindmilk/foremilk imbalance. A true imbalance is rare. It is often seen accompanying a forceful letdown. Lactation consultants will help moms find a nursing pattern which works to combat this problem. If letdown it too forceful in the early weeks, the solution can be to allow milk to leak into a cloth diaper during letdown, then latch baby back on. Feeding two to three times off the same side may also show improvement. Caution should be used with same side feeding as it can decrease supply.
Green, mucousy stool
This can be a result of a virus. Often the only sign we see of a virus is in the green stool. This is evidence of malabsorption in the intestines. Watch for how many days and with what consistency it is occurring. With a virus, it will run its course over a few days and begin to improve.
Another cause of malabsorption in the intestines can be teething. The profuse saliva of a teething baby can cause irritation in the intestines interfering with proper absorption. When babies teethe, we can see lots of drooling. Large quantities of saliva is swallowed which can irritate the intestines causing runny, acidic stools. This can also cause a rash in the diaper area.
There is something important to point out regarding frequency of stooling in an exclusively breastfed baby. Many parents are concerned when after the early weeks where they may have been seeing a little bowel movement in almost every diaper, they suddenly begin to see days go by without any. This is perfectly normal. There is a great range of frequency of bowel movements with exclusively breastfed infants, ranging from a couple of times a day to several days. There are completely healthy nursing babies that have a bowel movement once a week, once every ten days, or even a few that go a bit longer. If your baby is healthy, developing well, nursing well and the consistency of the bowel movement when it does make its appearance is soft or loose, then do not be concerned. It is not constipation if it arrives in soft form. Constipation would arrive in pellets and hard formed pieces.
In summary, stools in breastfeeding babies are predictably green, brown, yellow or orange. It is runny and has curds almost every time. It changes color with viruses, may have a small amount of blood (call your doc) and may come once a day and even taper off to once a week or more after a few weeks of age. Formula feeding babies may show a little trickier set of changes involving constipation and diarrhea. This is just one small reason to strongly recommend and support breastfeeding your baby.
Fluoride was a teeth damaging natural water pollutant way before it was a cavity-fighting water supply additive. New research questions the safety and efficacy of fluoride and fluoridation.
Dentists wondered why, in the early 1900′s, in pockets of the Southwest USA, many residents’ teeth were permanently stained yellow, brown or black, some just had white blotches, some were crumbling. They called it “Colorado Brown Stain.” The culprit – high levels of tasteless, odorless fluoride in drinking water, from 2 – 13 parts per million (ppm), which also irrigated crops the locals ate.
These ugly, sometimes deformed, teeth were unusually cavity-free. Since fluoride stained teeth, dentists assumed fluoride also prevented decay. “Colorado Brown Stain” became known by the more scientific term, dental fluorosis. Unfortunately, dentists overlooked what’s obvious today, even to a layperson. They failed to factor in the calcium, magnesium and other teeth strengthening minerals also in the water supply.
During an era when doubting government was anti-American, when public health heroes of the day were idealists who believed they were saviors of their people, fluoridation began in the late 1940′s. One part per million fluoride added to “fluoride deficient” water supplies, reduced decay by 70% without unwanted fluorosis public health officials promised. Holding the paternalist values of their time, they believed mothers couldn’t be trusted to give their children their daily fluoride dose in pill form so they prescribed it into the drinking water. Children up to nine years old would benefit, they told us. Fluoride incorporated into their developing teeth to erupt with a shield against decay as long as they consumed 1 milligram fluoride daily via approximately one quart of 1 ppm fluoridated water.
Children, who didn’t live in fluoridated communities, were (and still are) prescribed fluoride supplements – a drug marketed before safety testing was required by the Food and Drug Administration.
At its inception, fluoridation, or these supplements, was virtually children’s only fluoride source. Now over 62% of US water supplies are fluoridated and so are the foods and beverages grown, bottled and manufactured with that water. There’s a glut of fluoridated dental products on the market, both over-the-counter and by prescription. Fluoridated pesticide residues remain on foods, medicines contain fluoride, and air is polluted by fluoride from industry.
Instead of bringing tooth decay rates down to that enjoyed by early Southwesterners who ate produce from their own gardens, children’s dental fluorosis rates have steeply increased. Yet, tooth decay is still a major problem for malnourished or poorly nourished Americans.
New research proves old-time dentists’ premise was wrong. Fluoride’s possible benefits, if any, are topical. So there’s no good reason to swallow fluoride or put it into the water supply.
The old dogma is beginning to unravel. British researchers report in the British Medical Journal that fluoridation studies are flawed. A Canadian Government report found fluoridation does more harm than good. A US National Institutes of Health Panel found most tooth decay studies, including hundreds on fluoride, scientifically invalid. Even UNICEF, the organization that protects children, reports, “more and more scientists are now seriously questioning the benefits of fluoride, even in small amounts.”
What’s more unbelievable is that the chemicals most used to fluoridate drinking water are silicofluorides, contaminated waste product of industry, that were never safety tested on humans or animals. Meanwhile we are conducting a massive toxicological experiment. Our children are the test subjects
Silicofluorides are linked with children’s increased lead absorption. Studies link fluoride chemicals to bone fractures, lowered IQ, thyroid dysfunction, cancer, allergies and more.
And the American Dental Association is working on a new and improved cavity fighter, even better than fluoride – calcium and phosphate – the minerals they overlooked in the early 1900′s.
- Fluoride Action Network
- Fluoride: Protected Pollutant or Panacea?
- The Fluoride Stop
- Take Action
- Pennsylvania Environmental Network
- Fluoride Journal
- Preventive Dental Health Association
- Gary Null, PhD
- Citizens for Health
- Fluorosis Education Resources, David Kennedy, DDS
- Suite 101 – Fluoridation
- New York State Coalition Opposed to Fluoridation
- UNICEF, Water, Environment & Sanitation – Fluoride In Water: An Overview
- After 50 Years, Fluoride Supplements have Never been Approved by the FDA
Carol S. Kopf is a freelance health writer who has written for many publications, including Reuters Health, WebMD.com, Onhealth.com, and Newsday. She has a BS in Biology and a master’s in Science and Environmental Reporting. As President of the Levittown Safe Water Association, she spearheaded a campaign that ended 29 years of fluoridation in her town in 1983. Carol can be reached via email at caru@earthlink.net.
“Ten year old, Gradon got some nasty news from his dentist and it wasn’t a cavity,” reports CBC-TV. “I saw this yellow stuff and thought it was my toothpaste and kept trying to wash it off; but it wouldn’t come off,” says Gradon.
Those patches are fluorosis, a condition that shocks many parents because of the cause — too much fluoride. “It was even a bigger surprise to his pediatric dentist — he’s Gradon’s father,” said the Canadian broadcaster. (1)
“We don’t really know how much fluoride it takes to cause fluorosis; and it’s not something we really knew much about ten years ago,” said the Canadian dentist in 1998.
Dental fluorosis is growing in prevalence and severity in American children (2) and can range from mild, white spotted teeth to moderate and severe fluorosis — yellow, brown or black and sometimes pitted and crumbling teeth.
American children are over-fluoridated. It’s hard to believe that dentists themselves are undereducated about fluoride and its adverse effects, but they are.
Some dentists and pediatricians wrongly prescribe fluoride supplements to children who live in fluoridated communities. Further, the Center for Disease Control (CDC) teaches dentists that fluoride supplements and fluoride treatments by dentists are only advisable for those with a high risk for tooth decay (3), although doctors usually prescribe supplements based on water fluoridation status, age and fluoride treatments based on insurance carriers’ willingness to pay. The only scientifically-valid predictor of future cavities is present tooth decay.
Fluoride treatments may be a money-maker for dentists, but there’s no proof it benefits children at low risk for tooth decay. (4)
Fluoride’s alleged beneficial effects are topical, not systemic as once believed. Scientists discovered that fluoride supplements discolor teeth but don’t reduce tooth decay. (5)
That is why mainstream dental groups such as the Canadian Dental Association, the Western Australia Health Department’s Dental Service and the German Scientific Dental Association stopped recommending routine fluoride supplementation, unlike the American Dental Association who still recommends supplements, not based on patient need, scientific evidence or CDC guidelines, but on water fluoridation status and age.
And to add insult to injury, fluoride supplements have never been approved or safety tested by the FDA (U.S. Food and Drug Administration), having been “grandfathered” in, (already being sold) before the law to test drugs was passed (6).
In the early 1900’s, Americans drinking naturally calcium-fluoridated water supplies displayed cavity-free but discolored teeth. Fluoride, the tooth staining culprit, was assumed the cavity preventer, also. But researchers overlooked calcium, magnesium and other teeth-building components in the water supplies.
Those early studies are dismissed as flawed. (7) But, still not ready to give up on fluoride, dentists claim fluoride must work topically. However, no well-done studies exist comparing cavity rates between similar populations of fluoride users vs. non-users.
Neither a nutrient nor essential to health, fluoride is simply used as a drug to treat tooth decay. Unlike vitamin and mineral supplements discouraged in favor of a balanced diet, fluoride supplements are promoted by the medical establishment and mandated into water supplies, even though slightly more than recommended leads to adverse effects such as dental fluorosis. Three to four times “optimal” can actually cause tooth decay. (8)
In larger amounts, fluoride is lethal. But some dentists are painfully unaware of this, too.
In order to convince California legislators to vote for fluoridation, a dentist swallowed a whole vial of fluoride tablets in front of them and then said, “Hey, guess what? I’m still alive.” (9)
Swallowing too many fluoride pills killed children. (10) Another child died after swallowing instead of expectorating his dentist’s fluoride treatment. The dentist didn’t think it was toxic. (11) People have become sickened and died because water engineers or machinery malfunction injected excess fluoride into water supplies. (12)
Warnings on the back of fluoridated toothpaste tubes and boxes are there because ingestion of the whole tube’s contents can be lethal to a small child. (10)
Over 65% of America is fluoridated, and virtually all Americans consume too much fluoride in their foods, beverages and dental products. With dental fluorosis increasing, one would expect tooth decay would be obliterated.
Instead tooth decay rates climb. (13)
The only virtual sure thing that’s linked to extensive cavities is poverty, which is also linked to poor nutrition, high rates of infant mortality, higher cancer death rates, and most other health disorders. Unlike nutrients which have deficiency health consequences, fluoride deficiency has no health consequences.
Dentist Weston Price discovered in the 1920s and ‘30s that “primitive” populations around the world who followed their traditional nature-based diets enjoyed decay-free teeth, while those that turned to the “civilized” diet of processed, sugar-laden foods had many missing and decayed teeth. (14)
There are ways to help prevent tooth decay in children. The American Dental Association (ADA) states, “Pregnant women can help ensure their children get a good start on their oral health by focusing on staying healthy, including a proper diet, because teeth begin developing between the third and sixth month of pregnancy.” (15)
Breastmilk is the healthiest choice for a young child’s overall development. It also has anti-cariogenic properties and is an important factor in keeping teeth healthy. Breastmilk contains bacteria fighting cells and enzymes, which may help destroy the germs that cause tooth decay. (16) (17)
As children begin eating solid foods, continuing to provide a well balanced diet, rich in fresh fruits and vegetables, is beneficial to good dental health.
References:
(1) CBC News, December 1998, http://cbc.ca/cgi-bin/templates/view.cgi?category=Sci-Tech&story=/news/1998/12/29/fluoride981229
(2)”Prevalence and trends in enamel fluorosis in the United States from the 1930s to the 1980s.” by Beltran-Aguilar, et al, Journal of the American Dental Association, February 2002
(3) “Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States” August 27, 2001, CDC
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm
(4)”Preventive dentistry: practitioners’ recommendations for low-risk patients compared with scientific evidence and practice guidelines,” Am J Prev Med Feb 2000 , by Frame et al http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&
db=PubMed&list_uids=10698247&dopt=Abstract
(5) “The case for eliminating the use of the dietary fluoride supplements for young children,” J Public Health Dentistry 1999 Fall by BA Burt
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&
db=PubMed&list_uids=10682335&dopt=Abstract
(6) Letter from New Jersey Representative Kelly to FDAhttp://www.citizens.org/Food_water_safety/Fluoridation/Materials/
web_pages/letter%20_%20to_FDA.htm and confirmed by Crystal Wyand, spokesperson, FDA’s Center for Drug Evaluation and Research, e-mail correspondence.
(7) “More Rigorous Studies Needed to Advance Emerging Dental Caries Diagnostic and Management Strategies, Says NIH Consensus Panel,” NIH News Release, March 28, 2001http://consensus.nih.gov/news/releases/115_release.htm and British Medical Journal (B.M.J.), October 7, 2000,McDonagh, et al
(8) “Dentistry, Dental Practice and the Community,” by Burt and Eklund.
(9) Journal of the California Dental Association, January 1997, “The Fluoride Victory,” by Joanne Boyd
(10) “The Metabolism and Toxicity of Fluoride,” by Gary Whitford and
http://pmeiers.bei.t-online.de/burton.htm
(11) http://pmeiers.bei.t-online.de/kennerly.htm
(12) “Acute fluoride poisoning from a public water system,” New England Journal of Medicine, Jan 1994, Gessner et al,
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd
=Retrieve&db=PubMed&list_uids=8259189&dopt=Abstract
and http://www.fluoridealert.org/leaks-spills.htm
(13) “Health Journal: As kids’ cavities rise, some dentists advocate using tooth sealants,”Wall Street Journal, Tara Parker-Pope, March 8, 2002http://www.sfgate.com/cgi-bin/article.cgi?file=/news/archive/
2002/03/08/financial1058EST0079.DTL
(14) “Nutrition and physical Degeneration,” by Weston A. Price D.D.S.
(15) http://www.ada.org/public/media/newsrel/0202/nr-01.html
ADA News Releases
February 2002
Good Oral Health Begins in the Womb
(16) Loesche WJ, “Nutrition and dental decay in infants.” Am J Clin Nutr 41; 423-435, 1985
(17) Lucas, A, Cole T, “Is Breast Feeding a Likely Cause of Dental Caries in young Children?” Journal of American Dental Assoc., 1979; 98:21-23
Infections cause a variety of responses from the body and elevated temperature is one of the most noticeable. Children’s temperatures seem to rise faster and higher than a n adult’s does.
Fevers help to fight infections because white blood cells move faster and kill viruses and bacteria better at 102 degrees than they do at 98.6. Additionally, many germs have a limited range of viability and do not grow as well when the temperature is higher.
The problem is that most children do not eat, drink or sleep very well when they have high fevers. They are also not easy to assess medically at 102 either. To a parent or a doctor, a child with a high temp looks pretty bad even when the illness causing the fever is “just a cold.”
There are two reasons to bring down the temperature:
- To make a child more comfortable so they have an easier time staying hydrated and getting a little more rest.
- To be able to observe a child with a lower temperature and realize that it was a large fever and a small underlying illness making them look a lot worse than they really are.
In adults, the height of the fever often correlates well with the severity of the illness. In children, this is not always the case: a two-year-old can develop a 105 fever with a viral cold or could be sick with pneumonia but only have a 100.8 temp. Bringing the temp down on that first child will give you a fairly normal child for an hour or so but bringing the temp down for the kid with pneumonia or some other more significant illness won’t do anywhere near as much to make them feel a lot better.
I recommend long lukewarm tub baths as the best way to lower temperatures when you need to. Also, make sure to “unwrap” your baby or child to allow heat to radiate out from the body rather than being trapped underneath heavy clothing or blankets. This is much more important than many parents realize.
Most doctors also recommend Tylenol type drugs or Advil/Motrin type anti-inflammatory medicine. Some families also rely on a homeopathic medicine like belladonna. More natural approaches favor not bringing down the fever at all but just working for good hydration and comfort while allowing the immune system’s natural mechanisms (including fever) to work on the infection. This is not a bad course of action but a lot of parents I know are not very comfortable watching their child’s temp go up and stay up. If this is the way you feel, try lowering the temperature at least once to reassure yourself and your doctor that under this big fever is a small illness.
Aspirin must never be used in childhood or teenage years because of the statistical association with Reye’s syndrome, a potentially fatal liver disorder.
A word about febrile seizures: From about 18 months through age five years or slightly later, about 1 out of 50 children will have a convulsion with the fever. This is an innocent occurrence about 99.99% of the time but one of the most frightening things you’ll ever see. Remain as calm as you can, call your doctor right away, and do not put anything into your child’s mouth. Hold them upright and slightly tilted forward so that they have an easier time with secretion or vomit. The seizure will last 1-3 minutes (it will feel like an hour) and then your child will sleep or act very lethargic. Immediate medical evaluation is needed for at least the first of these seizures. Over half the kids go on to have a second convulsion with a fever but virtually none of them develop epilepsy or other complications. Call your doctor. Most families also call 911 and this is not a bad idea except that transporting your two-year-old by ambulance to the nearest hospital may put you in an ER inexperienced or over reactive to sick kids. Over reaction may be better than a laissez-faire approach by far, but it is not the best way.
To summarize: fever is natural, helps end the infection faster but may need lowering for the child’s comfort or the parents’ reassurance.
Ear infections are the pediatric problem which produces the most visits to the doctor’s office.
Most of these visits, with healthy, growing babies and children, are not needed at all. When I look in the ear with my otoscope, I am looking through the external canal to the ear drum which lies at the end of the canal and transmits sound vibration to the bones and fluid of the middle ear.
The bones of the middle ear are “lubricated” by a mucus-like fluid which then drains from the middle ear into the Eustachian Tube and into the throat. In adults and older kids, this is a nearly vertical drainage tube but in babies and younger kids, it’s nearly horizontal. As you might guess, horizontal drainage of middle ear fluid can be easily slowed or stopped if the mucus gets thicker or if the tube gets inflamed and narrowed.
This leads to a “stagnant puddle of water” in the middle ear which is prone to thickening and/or infection with viruses or bacteria. The fluid accumulates and, lacking the normal drainage through the Eustachian tube into the throat, causes pressure on the ear drum which hurts and shows visible inflammation when I look at it.
When viruses and/or bacteria manage to grow in the fluid, “acute otitis media” can be diagnosed. The traditional treatment with antibiotics has been shown to be quite ineffective and, as a matter of fact, not anymore effective than doing nothing at all during the first three to four days. Most experts now recommend pain control only during the first days of an ear infection, although I think thatsafe alternative care (homeopathy, ear drops, hot compresses, vitamin C, elderberry or echinacea) will improve the healing course.
Please understand that very small babies with fevers and obvious ear pain or children with special conditions and underlying problems deserve a visit to the doctor and your doc may want to use medicine right away even thought antibiotics don’t work as well as we have claimed for decades. The advice here is mainly for healthy full term babies and children whose main problem is fever and ear pain. For most illnesses like this, I tell parents that the best way to evaluate a sick child is from a few feet away when the fever’s down. Most kids will “bounce back” for a little while. They smile a little, play a little and are obviously not very sick.
Ear infections occasionally cause the ear drum to perforate which is in some ways analogous to a pimple popping: The infection may go away and the pain is gone. The ear drum heals and sometimes the fluid reaccumulates but often the infection is gone. The drainage and occasional blood from the ear looks frightening and your doctor may want to have a look. Don’t put drops in a draining ear without first talking to your doctor.
As an ear infection heals, the drum may not look 100 percent normal for weeks or months. The current recommendation is to tolerate the appearance of increased fluid behind the drum for 60 to 90 days.
Ear tubes have very little benefit in the long term and don’t even preserve hearing the way we pediatricians once believed. I have seen them seem to help a lot in the short term when the “ventilation” of the middle ear (a hole poked in the ear drum and kept open by a tiny tube for a year or so) led to a lot less pain, fewer doctor’s visits and less missed school and fun. However, tubes, for the most part, are not worth it.
Treat ear infections with pain control, “watchful waiting” and a call to the doctor when you are uncomfortable.
Croup is a terrifying illness for parents–and kids–to suffer through. In the middle of the night, your child may sit up in bed gasping for air, often coughing like a barking seal. These symptoms are so unsettling that panic is usually the first reaction. However, most of the problems associated with croup can be safely and easily treated at home.
Croup is a viral infection that causes a swelling in the larynx (voice box), trachea (windpipe), and other airways leading to the lungs, making breathing noisy and difficult. The swelling is not visible in the tonsils and cannot be heard when a doctor listens to the lungs with a stethoscope, so you won’t know your child has it until he or she wakes up with the distinctive barking seal cough.
Most common in the fall and winter in children under four, the swelling is also accompanied by increased secretions in the air passageways that become dried out. The dried, thick secretions in turn block the respiratory tract and make breathing even more difficult. Children outgrow croup as the airway passages enlarge; it is unusual after age seven.
The best treatment for this swelling and narrowing of the respiratory tract is cool, moist air. The best way to get this “dose” is by driving towards or along the beach or another body of water with the windows rolled down. Dress warmly, including a hat, and take a late night ride for 20-40 minutes and your child will probably experience almost instant relief from the frightening sounding cough. As these dried, hard secretions are dissolved and the air can again pass freely into the lungs, the child’s discomfort will subside.
You may be thinking about your mother’s admonition that “You’ll catch your death of cold” if you go outside late at night, especially with your precious baby in your arms. Well, forget the idea that you’ll catch a cold from the brisk night air. That idea is a myth–you cannot catch pneumonia or any other illness from cold air. Colds, flu and pneumonia are spread by viruses which like to stay nice and warm… and in humans.
Another option is to steam up your bathroom to create a moist, soothing environment. Close all the doors and windows and run a warm shower to create steam, but avoid really hot water as it may scald the child. To avoid slipping while holding your child, do not stand in the shower. Remember too, that steam rises, so do not set the child on the floor, but hold him or her upright in your lap. Usually after ten minutes you’ll see improvement, but continue comforting the child.
You can also purchase a cool mist humidifier and place it in the child’s room for several nights. Position the humidifier as close to the bed as possible so the moist air can make its way to the child’s airway passages.
Croup is a “self-limited” viral illness, meaning you have to let it run its course. Unfortunately the second night is often worse than the first. There may be a few more scary nights of the barking cough, but continue with the car rides or steam treatments to relieve symptoms. The illness then changes into a long, mucousy cold which can last for another week or more. The fever rarely rises above 102 or 103 degrees and can be treated with anti-fever medications, long lukewarm baths, and light clothes to allow the body to cool itself.
Take your child to the emergency room if he or she:
- shows no improvement in breathing with either of these mist therapies after 30 minutes;
- cannot talk because of lack of breath;
- has difficulty swallowing, drools, and breathes with chin jutting out and mouth open, this could be a rare infection called epiglottitis;
- struggles when inhaling or appears to be in severe respiratory distress.
Many of my patients refuse neonatal eye care. They do this after having read information on their own and discussing the issue at length with me during a prenatal visit in my office.
This is a controversial issue and the vast majority of doctors and experts recommend giving the treatment shortly after birth. Nonetheless, there is research to suggest that this routine may not be necessary.
Obviously, this represents a minority point of view both in the hospital and in the pediatric community in general.
I have added my own emphasis to these articles.
Pediatrics 1993 Dec;92(6):755-60
Randomized trial of silver nitrate, erythromycin, and no eye prophylaxis for the prevention of conjunctivitis among newborns not at risk for gonococcal ophthalmitis. Eye Prophylaxis Study Group.
Bell TA, Grayston JT, Krohn MA, Kronmal RA
Department of Biostatistics, University of Washington, Seattle 98195.
OBJECTIVE. To compare the efficacy of commonly used forms of eye prophylaxis for newborns with no prophylaxis in the prevention of nongonococcal conjunctivitis. DESIGN. Randomized doubly masked clinical trial. SETTING. University of Washington Hospital and affiliated clinics, Seattle, between 1985 and 1990. SUBJECTS. The medical records of 8499 women were evaluated for possible participation; 2577 were eligible. Of the 758 enrolled, the infants of 630 were evaluable. INTERVENTION. Comparison of silver nitrate, erythromycin, and no eye prophylaxis given at birth for the prevention of conjunctivitis. MAIN OUTCOME MEASURES. Conjunctivitis during the first 60 days of life and nasolacrimal duct patency in the first 2 days of life. RESULTS. The frequency of impatent tear ducts at the 30- to 48-hour examination did not differ significantly by prophylaxis group. Among the 630 infants randomized and observed, 109 (17%) developed mild conjunctivitis. Sixty-nine (63%) of the cases appeared during the first 2 weeks of life. After 2 months of observation, infants allocated to silver nitrate eye prophylaxis at birth had a 39% lower rate of conjunctivitis (hazard ratio = 0.61, 95% confidence interval = 0.39 to 0.97), and those allocated to erythromycin had a 31% lower rate of conjunctivitis (hazard ratio = 0.69, 95% confidence interval = 0.44 to 1.07), than did those allocated to no prophylaxis. CONCLUSION. Silver nitrate eye prophylaxis caused no sustained deleterious effects and even provided some benefit to infants born to women without Neisseria gonorrhoeae. However, the effect was modest and against microorganisms of low virulence. The results suggest that parentalchoice of a prophylaxis agent including no prophylaxis is reasonable for women receiving prenatal care and who are screened for sexually transmitted diseases during pregnancy.
Pediatr Infect Dis J 1992 Dec;11(12):1026-30
Prophylaxis of ophthalmia neonatorum: comparison of silver nitrate, tetracycline, erythromycin and no prophylaxis.
Chen JY
Department of Pediatrics, Chung Shan Medical and Dental College Hospital, Taichung, Taiwan, Republic of China.
From November, 1989, to October, 1991, 4544 neonates were born at our hospital. Neonatal ocular prophylaxis immediately after birth was used with 1% tetracycline ophthalmic ointment in 1156 neonates, 0.5% erythromycin ophthalmic ointment in 1163 neonates and 1% silver nitrate drops in 1082 neonates. No prophylaxis for neonatal conjunctivitis was given to 1143 neonates. A total of 302 infants (6.7%) developed conjunctivitis during the first 4 weeks of life. Between December, 1991, and January, 1992, 425 neonates were born at our hospital and all were given 0.5% erythromycin ophthalmic ointment twice in the first 24 hours after birth for ocular prophylaxis. Thirty-one (7.3%) infants developed conjunctivitis during the neonatal period. The incidence rates of neonatal chlamydial conjunctivitis in the tetracycline, erythromycin, silver nitrate, no prophylaxis and erythromycin twice groups were 1.3, 1.5, 1.7, 1.6 and 1.4%, respectively. We conclude that neonatal ocular prophylaxis with erythromycin (one or two doses) or tetracycline or silver nitrate does not significantly reduce the incidence of neonatal chlamydial conjunctivitis compared with that in those given no prophylaxis.
5: Am J Epidemiol 1993 Sep 1;138(5):326-32
The bacterial etiology of conjunctivitis in early infancy. Eye Prophylaxis Study Group.
Krohn MA, Hillier SL, Bell TA, Kronmal RA, Grayston JT
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle.
The authors conducted this study to determine the etiologic agents of conjunctivitis in early infancy. From 1985 to 1990, 630 infants enrolled in a randomized, controlled, double-masked study of eye prophylaxis were observed for 60 days after delivery for signs of conjunctivitis. The following isolates were categorized as pathogens: Haemophilus influenzae, Streptococcus pneumoniae, Neisseria cinerea, Klebsiella pneumoniae, and Chlamydia trachomatis. Using conditional logistic regression for analysis of 97 infant pairs, the authors identified isolates categorized as pathogens almost exclusively among cases (odds ratio (OR) = 18.0, 95% confidence interval (CI) 2.3-128). Among the microorganisms which have not usually been regarded as pathogens in the etiology of infant conjunctivitis, Streptococcus mitis was the only microorganism associated with an increased risk of conjunctivitis (OR = 5.3, 95% CI 1.8-15.0).The findings concerning the species of bacteria most often associated with conjunctivitis, as well as the finding that method of delivery is unimportant, suggest that bacteria were transmitted to the infants’ eyes after birth and not from the birth canal.
14: Pediatr Infect Dis J 1989 Aug;8(8):491-5
Failure of erythromycin ointment for postnatal ocular prophylaxis of chlamydial conjunctivitis.
Black-Payne C, Bocchini JA Jr, Cedotal C
Department of Pediatrics, Louisiana State University School of Medicine, Shreveport 71130.
Chlamydia trachomatis is the most common pathogen associated with conjunctivitis during early infancy in the United States. During a 13-month interval at our medical center 4834 infants were born, 311 of whom (6.4%) had conjunctival specimens tested for chlamydial antigen before the age of 12 weeks. In 44 (14% of all tested infants, 0.9% of live births) chlamydial antigen was present. Because the rate of asymptomatic maternal chlamydial endocervical colonization is estimated to be 26% at our institution (previous prospective study), we calculated a minimal failure rate for erythromycin ocular prophylaxis of from 7 to 19.5%. A subsequent case-control study revealed that mothers of infants with chlamydial conjunctivitis were more likely to be primiparous (P = 0.03) and experience longer duration of rupture of membranes before delivery (P = 0.046). We conclude that a substantial percentage of infants exposed to Chlamydia develop chlamydial conjunctivitis despite receiving erythromycin ocular prophylaxis.
It sounds simple doesn’t it? Yet I have seen so many moms whose babies have looked healthy, nursed well, met developmental milestones one right after the other and have lost all confidence in breastfeeding due to someone telling them that their baby’s weight was not on the charts. This someone was looking at the scale and charts, rather than the baby.
In the first 24 to 72 hours after birth babies tend to lose about 3-10% of their birth weight and then regain that weight over the next 2 to 3 weeks. If a mother receives lots of IV fluids during labor, the baby could be born “heavier” because of the increased water. The somewhat higher weight could be measured if a baby were weighed right before it peed for the first time. The difference of this extra fluid retention might only be a few ounces, but some parents are told to be concerned when, at their baby’s two week checkup, the baby is a few ounces under birth weight.
Another common problem at early checkups is a baby that is not gaining what the practitioner considers to be “normal weight gain.” There is not general agreement on normal weight gain and the range in texts are from 4 to 8 ounces a week. Some babies are genetically destined to be a lot smaller or larger than others. As I mentioned in the first paragraph: Easy concept, isn’t it?
If you have been told that weight gain is not acceptable, look hard at this list of questions:
- Is your baby eager to nurse?
- Is your baby peeing and pooping well?
- Is your baby’s urine either clear or very pale yellow?
- Are your baby’s eyes bright and alert?
- Is your baby’s skin a healthy color and texture?
- Is your baby moving its arms and legs vigorously?
- Are baby’s nails growing?
- Is your baby meeting developmental milestones?
- Is your baby’s overall disposition happy and playful?
- Yes, your baby sleeps a lot, but when your baby is awake does he have periods of being very alert?
If you have answered yes to the above questions, you may want to progress on to two important questions which the “charts” seem to ignore.
- How tall is mom?
- How tall is dad?
If someone were to ask you what weight a 33 year old man should be, you would laugh. The range of possibilities varies according to height, bone structure, ethnicity and many other factors. Yet babies are expected to fit onto charts distributed throughout the country with no regard to genetics, feeding choice or almost anything else.
There can be nursing problems that can cause slow weight gain; an inadequate “latch-on” is probably the only common breastfeeding problem in the first weeks. This is an easily remedied problem with the right help. In the best of circumstances, breastfeeding should be assessed within the first day or two after birth by a skilled lactation expert. Good hospitals have these LC’s and IBCLC’s on staff and, if not, please line up a consultation within the first 12 hours of life. Your pediatrician can help you with this. If not, call La Leche League and ask them whom they recommend in your area. This is a crucial step in becoming a parent and must not be skipped.
If there are nursing problems, the first answer should never be supplementation but must be to find the best advice and help available. Find quality help in person if possible and online if needed. There is nothing better than having an experienced breastfeeding expert watch you and your baby and give you the help and encouragement and support you need and deserve.
Too many mothers and babies lose the breastfeeding experience and the lifesaving and illness preventing benefits because we doctors are trained to look harder at the scale than we are at the baby.
A few notable examples:
- Baby, birth weight: 9 lbs. 12 oz.
Weight 36 hours after delivery: 9 lbs. 2 oz.
I have seen mothers encouraged to supplement because “they have no milk, the baby is hungry and losing weight.” The baby looks good and is nursing every 1 to 3 hours and mom’s nipples are not getting sore. There is no need to do anything but nurse often, switch breasts every 5 minutes or so and wait another day or two for the milk to come in. A thirsty baby nurses strongly and is in no danger. A baby given water or formula might not nurse so strongly and mom’s confidence (and milk supply) will suffer for it. This mom only needs the support of an expert who can be sure that she knows how to latch her baby on to the breast.
- Same baby, two week checkup: 9 lbs. 6 oz
Forgetting that this represents a 4 oz. weight gain from the 36 hour weight, some docs might recommend supplementation. Again, watch breastfeeding and if everything is going well, don’t worry. A dry, jaundiced baby with darker yellow urine is a different case and needs more help with nursing. This baby still should not get formula. Make sure mom is drinking enough water, nursing often without a set schedule (every 1 to 3 hours) and make very sure that she gets help latching her baby on, especially if she has sore nipples.
- Same baby, six month checkup: 15 lbs.
Lactation consultation had been successful in the early weeks thanks to mom having found a supportive, smart doctor and being determined to succeed at feeding her baby the best. This big baby (9 lbs. 12 oz. at birth, remember?) had weighed 13 pounds at her four month visit and now weighs 15 pounds. The doctor is paying attention and sees that Mom is 5′ 3″ and Dad is 5′ 9″ and slender. He looks at the charts second and the baby first and isn’t concerned about the baby dropping from a very high percentile at birth to a lower one and then to a lower one still.
I think I’ll conclude this scenario with this happy ending.
In summary, babies who are nursing, peeing clear urine and wetting diapers well in the first weeks of life are almost always all right. I cannot recall seeing a baby for whom slow weight gain in the first 2 to 6 weeks was the only sign of a problem.
Older babies, 2 to 12 months of age, grow at varying rates. Weight gain should not be used as a major criterion of good health. Developmental milestones and interaction with parents and others are more important. Do not be persuaded to supplement a baby who is doing well. Get help with breastfeeding and use other things besides weight to guide you.
Red blood cells break down at a somewhat higher rate in newborns and some of the breakdown products have colors. Bilirubin is yellow and often gives a yellow tinge to the babies eyes and skin. The liver is responsible for excreting these metabolic “wastes” and it’s somewhat slower to do so in the first days and weeks of life. As a result, jaundice (also called hyperbilirubinemia or just “hyperbili”) is much more visible.
In extreme situations, hyperbili can stain the brain and damage it or make babies sleepy, lethargic and prone to under eating and dehydration. Severe infections often have jaundice as their first sign. These are rare problems but it is dangerous to ignore the possibilities.
In the vast, vast majority of healthy full term babies, mild jaundice is normal and harmless. Breastfeeding babies get more jaundiced than formula fed babies and there are some researchers who think this represents an advantage because bilirubin is a “bacteriostatic” chemical. That is, it inhibits the growth of infectious bacteria.
Jaundice itself may not be a problem but increased jaundice may indicate poor breastfeeding. This is a problem and this is one of the reasons that the “knee jerk” reaction to jaundice is so dangerous. Instead of just attempting to change the baby’s color from slightly yellow (or quite yellow) we should be looking much harder at the reason for the increased bilirubin. Lactation consultation is usually much more valuable than bilirubin tests and bili lights.
PLEASE REMEMBER, this information is strictly applicable to healthy full term babies; preemies and sick kids must be cared for differently and this is beyond the scope of this brief discussion.
Jaundice may continue and even increase through the first week or two and if a baby is doing well, milk is in, nipples are not sore, jaundice is rarely a problem. If a baby continues to lose weight and jaundice is increasing, lactation help is needed and closer medical observation is crucial.
It is almost never correct to interrupt breastfeeding nor to supplement babies with mild to moderate jaundice. The disease entity called “Breast Milk Jaundice” is rare and possibly involves a chemical in breastmilk which inhibits the metabolism of bilirubin. This jaundice is longer and more yellow and almost always harmless. Some experts advocate breastfeeding interruption for a day to help make the diagnosis in a baby with jaundice beyond week two or three. Many experts do not recommend this and instead will wait if the baby’s clinical appearance is reassuring.
Jaundice is a normal condition of babies in the first week of life. Healthy full term babies who are nursing well, urinating and looking good do not need intervention. Supplementing with water makes this worse and supplementing with formula is not necessary and interferes with breastfeeding success and good health.
More information:
Contrary to what you often will hear about how bilirubin levels increasing in a newborn is not a good thing, there is new research which is showing the importance of the presence of bilirubin.
Bilirubin has the ability to function as an antioxidant in the brain, scavenging free radicals and protecting the brain against oxidative damage.
“When women breastfeed, the babies have higher levels of bilirubin and are healthier. Babies with higher bilirubin levels are more disease-resistant,” said Dr. Sylvain Dore of Johns Hopkins School of Medicine, Baltimore, Maryland. “Bilirubin also protects against retinopathy in premature babies.”
Dr. Dore has done research on the neuroprotective effect of bilirubin in the hippocampus. His studies have indicated that low concentrations of bilirubin decreased oxygen-radical mediated injury, suggesting that bilirubin could act as an antioxidant.
Dore further experimented on cultured neurons showing that bilirubin protects against oxidative stress. The enzyme hemeoxygenase is responsible for making bilirubin. In these experiments researchers prevented bilirubin synthesis by eliminating the gene for hemeoxygenase and found, as a result, twice the level of stroke damage in mice.
There is also some belief amongst medical professionals that bilirubin is a bacteriostatic compound which acts to slow or eliminate bacterial growth and therefore give an advantage to babies with higher levels of jaundice. This theory would contribute to the fewer infections in breastfed babies, whose bili counts often descend at a slower rate.
These studies shed new light on the way in which bilirubin in a newborn should be viewed. There is no reason to overreact to bili counts ranging up to low 20′s as long as the mother is frequently nursing (every 60 – 90 minutes during the mother’s waking hours and no more than two stretches of four hours maximum at night), baby is wetting and the counts have begun to slow in ascension or have begun their descent.
Mother must be diligent at following a pattern of frequent nursing until jaundice is gone, even if it includes having to wake the baby, because jaundice tends to make a baby sleepy.
In August 2000, the American Academy of Pediatrics issued an official statement about allergenic proteins in a mother’s diet appearing in her breastmilk and creating problems for her baby. They stopped far short of talking about excellent research showing that cow’s milk in the diet of a pregnant or breastfeeding woman creates even more problems than we ever thought for her nursing baby.
Breastfeeding moms get lots of advice about the food they should be eating while nursing their babies. I try to discuss this with the mom- and dad-to-be when we meet during a prenatal appointment. I often wish I could talk to more women before they become pregnant to discuss anti-allergy measures and other topics.
Please don’t misunderstand the incredible superiority of human milk for human babies. Infants who receive formula have more intestinal problems by far than infants who drink breastmilk. Uninformed medical practitioners have actually told mothers that their babies were “allergic to their breastmilk.” Nothing could be further from the truth.
Babies can be allergic to protein fragments from mom’s diet which end up in the milk, but if they are sensitive to those proteins, they would be much more affected by an artificial baby milk made entirely of non-human protein. Even so called “hypoallergenic” formulas are rarely any better. They are made of proteins broken down into smaller fragments to provoke less of a reaction. They are still allergenic and don’t solve the problem for many babies.
Common Symptoms of a Reaction to Dairy
- Green, runny stool
- Blood tinged stool
- Skin rashes
- Chronic nasal stuffiness
- Vomiting
- Diarrhea
- Excessive abdominal discomfort
- Cramping
- Coughing
- Mimic of GER (gastroesophageal reflux) symptoms
- Heartburn
- Spitting up
- Gassiness
- Constipation
Gassiness
Babies are gassy. That is an immutable fact caused by the need to double or triple one’s weight in a year. Try doing that yourself and see if you don’t spend a little time gassy.
I have seen the gassiest babies get better when moms removed dairy products from their diets.
Some babies seem to cry much more than others and their parents describe them as “writhing in pain.” Changing the nursing pattern helps some newborns and older babies if overactive milk ejection reflex (OMER) or a hindmilk/foremilk imbalance is the cause, but many more babies are helped when mom changes the way she eats. My list of allergens begins with cow’s milk and continues with eggs, peanuts, wheat and citrus. The most important change a mom can make is to stop drinking milk and eating things made with milk.
Blood in Stools
Babies with blood in their stool often stop having blood when moms stop drinking milk and eating other dairy products.
Cow’s milk protein irritates the intestinal lining and virtually always causes what’s called “microhemorrhaging.” Sometimes this bleeding is quite visible and helps alert parents to the need for mom to change her diet. Blood in the stool can be frightening but is rarely dangerous. It has a few other causes such as viral irritation, but the most common reason I have seen it is dairy allergy.
Eczema
Eczema lessens and often goes away completely when breastfeeding moms become dairy-free.
Skin rashes occur frequently in newborns and babies. The most common, worrisome, persistent problem is an allergic rash called eczema. Dermatologists and allergists describe eczema as not a “rash that itches, but an itch that rashes.” That is the first thing that happens and the first thing the parents may notice: increased irritability and “face rubbing” by their baby. They may also see a red rash which becomes more and more “angry” looking and eventually gets scaly and even bloody. Superficial skin infections can follow and be difficult to treat.
Dairy elimination is crucial. Long before you use cortisone cream, stop all dairy. Stop peanuts and eggs, too.
Constipation
Babies who are constipated often improve when dairy is eliminated from mom’s diet. Older children may also get relief from constipation with complete dairy elimination. In older children, studies have shown that some bedwetting may also be cured by dairy elimination. The allergic reaction to the offending protein in milk is exhibited in a variety of ways that affect the bowels and urinary tract. If your child is suffering from problems in these areas, dietary restriction should most certainly be considered prior to doing further testing or using medications.
Changing a breastfeeding mom’s diet or changing the diet of an older child eating solid foods will often lessen medical problems dramatically.
Cold Symptoms
Babies who have constant runny noses often get better when moms stop all dairy. Cow’s milk allergies may look just like “hay fever” at any age: stuffiness, cough, runny nose that seems to persist for weeks and weeks.
Older kids with ear infections often stop having ear infections when dairy is removed from their diets.
This has been a key intervention in my practice. I have cared for hundreds of kids who have taken ten or even twenty courses of antibiotics and even steroids. They were able to cancel scheduled ear surgery because they got better when they stopped drinking milk and eating cheese. The ear infections just plain stopped for many of the children and for others they decreased to manageable childhood illnesses rather than being a constant source of pain, school absences and incapacity.
Read more at: http://www.notmilk.com/mucus.html
GER (Reflux)
Before a baby gets evaluated for GER (gastroesophageal reflux), breastfeeding moms must eliminate all dairy from their diets. To some, this seems like a drastic step. It is far less drastic or invasive than the tests and medications for GER in babies.
When eliminating dairy and watching for a reduction of GER symptoms, patience is a key. The offending protein can take a few weeks to be completely undetectable in breastmilk. Many will see improvement within days, because the levels begin to decrease as a diet devoid of dairy is consumed. It is not unusual to see little change until two or three weeks after eliminating dairy.
The almost miraculous improvement in hundreds of troubled babies in 22 years of practice might be the strongest evidence, albeit anecdotal evidence, that I bring to the table. Does this work 100% of the time? No, nothing works 100% of the time, but dairy elimination is the single-most important advice I give to dozens of people each and every week.
Casein and B-lactoglobulin
The two proteins that trigger the biggest allergic response are casein and b-lactoglobulin. If your baby doesn’t get as much relief as you had hoped just from dairy elimination, read labels carefully. Soy cheese and many other foods that we expect to be dairy protein-free are really not. Even diaper creams may contain casein.
Read more at: http://www.drjaygordon.com/nutrition/dangerousfood/dairy
Increased exposure to allergens like dairy allergens can even lead to fatal reactions. Fortunately, the “minor” symptoms almost always go on for a long time before major reactions in almost all babies, children and adults.
Lactose Intolerance
The major “sugar” in cow’s milk is lactose and some people confuse lactose intolerance and cow’s milk protein allergy. Lactose intolerance evolves gradually after about age 7 or 8 years and is particularly common in those of Asian, Native Alaskan and African decent. Gassiness and bloating after drinking milk, eating cheese or ice cream occur in many people. Some choose to ignore it, others limit dairy and still others just use supplemental lactase (an enzyme) to lessen their symptoms.
Viral stomach flu can create temporary lactose intolerance.
We adults are clearly not meant to drink cow’s milk and the number of children adversely affected by dairy protein and dairy sugars is underestimated in mainstream nutrition books.
A very informative article in August 2000 issue of “Discover Magazine” features a discussion with T. Colin Campbell, an ex-dairy farmer now a Cornell University nutritional biochemist:
“The bottom line for Campbell is simple: ‘It’s unnatural to drink milk.’ Most adults in Asia and Africa, along with many in southern Europe and Latin America, have trouble digesting lactose, the main sugar in the milk of both humans and cows. Some suffer from bloating, cramps, or diarrhea if they try. A 1978 population survey, compiled by geographer Frederick J. Simoons of the University of California at Davis, suggests that it was only because of a genetic aberration that milk became a food staple in northern Europe and North America. Nature normally programs the young for weaning before they reach adulthood by turning down production in early childhood of the enzyme that breaks down lactose. But a gene mutation inherited by people of northern European descent prevents the production of this enzyme from being turned down. As a result, the majority of Americans can drink milk all their lives.”
This excellent, short article also talks about osteoporosis as it relates to dairy consumption: Countries with the highest dairy intake have the highest incidence of osteoporosis. This striking fact seems at odds with everything we think we “know” about calcium and nutrition. Osteoporosis is related more to calcium excretion due to salt and protein intake than to calcium deficiency in the diet. The entire article and the attached graphics are well worth a look.
Read more at: http://www.discover.com/aug_00/featmilk.html
Other Medical Experts on Dairy
Hundreds of medical articles and many books have been written about the problems with milk products in humans. The authors are physicians of great standing in the medical community. The late Frank Oski MD was head of the Department of Pediatrics at Johns Hopkins University and the editor of the Yearbook of Pediatrics. The late Dr. Benjamin Spock was the most famous and most influential physician of the past 100 years and many other doctors have participated in trying to bring dairy’s shortcomings to the attention of doctors and patients alike.
Dr. John McDougall often cites milk’s problems alphabetically:
Allergies (dairy is the leading cause of allergies in adults and children) and continuing with a discussion of . . .
Anemia. Again milk products are the number one cause of this problem because they cause blood loss and also interfere with iron absorption. Additionally, kids who drink lots of milk feel very full and often have no “room” for healthier iron-containing foods. Dr. Oski wrote many articles about milk’s role in causing anemia in America’s children.
Arthritis is the third on Dr. McDougall’s list and he documents published studies from the British Medical Journal, the Journal of Arthritis and Rheumatology and other major medical journals. The mechanism of action involves antibody/antigen particles which lead to inflamed joints.
Atherosclerosis, or heart and blood vessel disease, make the third “A” on the list. Milk is the number one source of saturated fat in most diets. A further problem involves the antibodies formed against milk attacking the delicate lining of arteries.
Blood loss, constipation, and diabetes follow in alphabetical order. The medical evidence strongly points to early exposure to cow’s milk leading to an increase in Type 1 diabetes. I have seen constipation clear up in a matter of days when parents remove dairy products from their child’s diet and the intestinal blood loss from drinking milk (or exposure to milk protein through breast milk) is an accepted medical fact.
Read more at: http://www.ffl.org/html/milk_facts.html
Talking to patients about dairy products is a lot easier than it used to be because the “problems with milk” are better known than just a few years ago. Still, it’s hard to combat the $400,000,000 annual advertising budget available to the purveyors of dairy products. Milk does not “do a body good” nor build strong bones. It is a traditional food which has become a lazy staple of the American diet.
Children (and their parents) get healthier when they have fewer dairy products and are healthiest when they have none.
When I’m talking to older kids about making dairy a smaller part of their diets, I tell them that it’s kind of like an old Seinfeld joke: “Hey, look at those large animals in the field! Let’s go squeeze those things underneath them and then drink whatever comes out. Then, let’s take whatever’s left over, put it aside for a year or so and . . . eat it!” The kids respond with a hearty “eeeeew!” Even adults get it sometimes.
I am a pediatrician in private practice and am therefore consulted about one child at a time rather than about the effects of vaccines on an entire population. This creates a problem for me each day because I am not certain that the benefits of vaccinating a healthy American child outweigh the risks.
I don’t believe that vaccines are “poisonous” or that the tremendous increase in the incidence of autism is directly and solely linked to the “MMR” or mercury in the shots. I do think that there are adverse impacts on a child’s immune system and central nervous system from some immunizations and the preservatives in the solutions, but I don’t agree that we have figured everything out. Nor do I agree with the vaccine opponents who continue to shout at us all about the shots “not even working” and harming everyone who gets them.
The Institute of Medicine reported last year and Dr. Neal Halsey stated (in the Journal of the American Medical Association in November of 1999) that there are enough questions about mercury’s toxicity to warrant eliminating this metal from shots “as soon as possible” to use the IOM’s words. Other constituents of vaccines have not received the same scrutiny but may also have at least minimal side effects that could be cumulative in a 10-pound baby receiving four separate inoculations on the same day.
While there is a huge amount of scientific research to support the fact that vaccines protect against illness, there is very little science supporting the way we give vaccines in America and many other countries. Many children receive the Hepatitis B vaccine within hours of birth and then six weeks later receive another Hep B shot along with a DPT, Hemophilus Influenza B (HIB) Polio vaccine and the newest recommended shot, the Prevnar vaccine. The timing of four or five shots with seven components and a multitude of preservatives and “inert” ingredients is very possibly the wrong thing to do. Two months later this same regimen is repeated and 3 or 4 shots are also given at the six-month visit. The one-year checkup is the time for the measles/mumps/rubella combination vaccine and the chickenpox shot.
Many countries begin vaccines later and slower and I strongly believe we should do the same things. The expedient and economically superior method, which we use now, doesn’t serve our babies well.
I would like to summarize my point of view by making it clear, once again, that very few responsible experts have reservations about the way we give vaccines. I do.
I also don’t like the financial ties that vaccine researchers have to the manufacturers because some of these same experts help make the official decisions about which shots will be approved and/or required.
The diseases against which we vaccinate used to be much more common (and still are in some other countries) but we are now down to an average of one case of diphtheria (the “D” of the DPT) per year in the U.S., a few thousand cases of Pertussis (“P”) and 30 or so cases of Tetanus each year.
We have not had a case of “wild” polio in America since 1979 and the entire Western Hemisphere has been free of the disease for some years.
HIB bacteria used to be the most common bacterial cause of meningitis in young children. Meningitis is a dangerous, potentially fatal infection of the lining of the brain and spinal cord. This vaccine is extremely effective and has eliminated over 95% of this illness. I personally have not seen a case if HIB meningitis in at least 7 or 8 years, maybe more. This shot was a godsend but some scientists and others now think that the vaccine may cause “autoimmune” problems — the immune system mistakenly attacks one’s own body — such as diabetes. This is very much a minority point of view but some data have been gathered which support this possibility.
The Prevnar vaccine was invented to protect higher-risk individuals from a particular group of dangerous bacteria. It was never intended to be, and is not very effect as, an “ear infection” shot. The diseases that it prevents are extremely rare.
The MMR vaccine merits an entire page of its own. Virtually no reputable American authority agrees with the research of Dr. Andrew Wakefield who tied the vaccine to intestinal infection that might lead to autism. But there is enough evidence that these “live-virus” vaccines may not be as safe as we thought to convince me that we need much more study before we can stop looking. The idea of separating these vaccines strikes me as having no advantage.
Chickenpox is a relatively benign disease in childhood and a potentially dangerous disease in adult years. Doctors may have forgotten that this is not a new vaccine but a shot invented in the 1970s to protect children on chemotherapy or high dose steroids for asthma and other illnesses. These very high-risk kids could get severe complications from varicella (chickenpox) but normal kids get immunity from the illness which might actually have been better than that acquired from the shot. My take on this shot is to try to get your child natural chickenpox for 4 or 5 years and then get the shot later if you’re not successful.
The Hepatitis A vaccine may become part of the California State law next year and very few pediatricians would have supported that some years ago. While Hep A might ruin an adult’s vacation (“food handlers’ hepatitis”) this viral illness passes virtually unnoticed in children. This is in marked contrast to the great danger and possible permanence of Hepatitis B and Hep C. The Hep B shot works very well but may have autoimmune complications (again, this belief is held by only a very small minority of physicians) and should be given after careful evaluation of the risks and benefits to the child. There is no Hepatitis C vaccine yet. Hepatitis B and C are diseases transmitted through high-risk behavior involving sex and intravenous drugs.
Smallpox and Anthrax vaccines are not available now and neither is as safe nor effective as it needs to be. These diseases have gotten far more “press” than they deserve at the present time.
Perhaps the most frequently asked questions involve coming in contact with ill people while our families travel and the possibility of immigrants or visitors from other countries bringing rare illnesses to the U.S. “Possible but highly unlikely,” is the short answer with a full discussion beyond the scope of this short article. A family planning a two-year sojourn to Africa or Asia or Eastern Europe needs a completely different discussion of vaccination. There are no diseases in Europe that will threaten an unvaccinated child any more than in the USA. Again, this is beyond the scope of this present discussion.
In my office, with families I know well, I believe that the main idea I convey is that we should vaccinate later and slower. One shot at a visit starting later in the first year and perhaps in the second year of life. I have many families in my practice who have chosen to give their children no vaccines.
My one request is that you thoroughly discuss with your physician all of the benefits and risks of vaccines with an absence of the usual scare tactics we doctors sometimes use.
Based on the findings of Britain’s General Medical Council, the journal had no choice but to retract the twelve-year-old research and I agree with their retraction. At the very least, the study was far too small, and-as I’ve said repeatedly-had too many methodological flaws, to be used as proof of anything at all.
Neither “The Lancet” nor Britain’s General Medical Council have stated that there is not a connection between vaccines in autism, just that they deem this particular piece of research unethical and incorrect.
This prestigious journal is now forced to cover their own embarrassment at having done virtually no rigorous due diligence of Dr. Wakefield’s methodology, data gathering and conclusions before they published the paper in 1998.
The New York Times reported this week that the World Health Organization raised the Swine Flu alert level to phase 5, one level below all-out global pandemic. “All countries should immediately activate their pandemic preparedness plans,” warns Dr. Margaret Chan, director general of the W.H.O.
Phase 5 hasn’t been declared since the Avian Influenza in 2005.
This should make you feel better, unless you or someone you know came down with the Avian Flu.
Read the rest of this entry »
“With all due respect to Dr. Gordon’s article and his opinion posted [on Peachhead2] I would love to hear [another] doctor’s opinion about the H1N1. I talked to a neurologist last week and he mentioned to me the concern being young children and the possibility of being hooked up to a respirator.”
It is exactly this kind of absurd, exaggerated rhetoric (not from our Peachheader, but from the doctor she’s quoting) that is creating anxiety and fear and making it harder to make an informed intelligent decision.
The possibility of your healthy child “being hooked to a respirator” because of Swine Flu is incredibly small. To imply otherwise is an unintelligent scare tactic.
I’m still seeing one or two children each day with Swine Flu symptoms and can reassure you that the government and the media are engaging in scare tactics rather than presenting the facts.
No lengthy newsletter to read today. Just a couple important medical articles. One from the lay press and one from a serious medical journal.
Please invest 15-20 minutes reading these two articles in full. I’ve given brief summaries of some of their information below.
One article is from a well-respected periodical and the other is from the most respected medical journal (BMJ) in the world and the Cochrane Collaboration which is the “gold standard” in medical information.
We’re a month into the school year and it’s the time of year when it seems our kids are spending more days sick than well.
Please don’t be fooled into thinking that this winter is so different from previous winters.
Swine Flu does not pose a realistic risk to your family: There will be millions of cases reported and rare fatalities highly publicized.
Some of us will get high fevers and have to miss school and work for a few days and 99.9999% of us will remain completely unaffected after the flu season except that those who contract Swine Flu this year will be protected if it gets meaner and more virulent in coming years as expected.
Just wash your hands.
Every year, hundreds of viruses pass through the pediatric and adult community. Many of the bugs are disruptive and keep kids out of school and adults away from work. Some of the viruses have unique signs and symptoms, but most just cause amorphous aches, sneezing, coughing or intestinal upset.
Influenza viruses, especially new ones, trigger more news stories and can be made to seem much more frightening and dangerous than they really are. Government agencies and media don’t supply statistical context and make it sound like you’ve got a “fifty-fifty” chance of contracting this new virus. They then make it sound like a lot of people who get this influenza end up in the hospital and may die. Statistically, nothing could be further from the truth: The chance that the new virus is really dangerous is small. The chance that you’ll get it is much, much smaller, and the possibility that you or a family member will be harmed by the virus is so slim that the news should be on page twenty, not page one.
Swine Flu is a virus for which there is no vaccine, little to no threat to your family, and there are undoubtedly tens of thousands of harmless undiagnosed cases throughout the world. The news stories are probably taking a hundred questionable respiratory deaths in Mexico and guessing.
There actually is a very, very small chance that this virus could cause severe illness and whenever this occurs hospitalization and even fatalities are reported. The likelihood of a pandemic is miniscule, but newspapers, government agencies and the manufacturers of pharmaceuticals do their best work and make their biggest sales when people are scared.
Broadcast media get major sponsorship from the pharmaceutical industry and do not always present the “other side” of the story. Tamiflu is recommended for treatment and prevention of this influenza virus. Local pharmacies are already running low on Tamiflu.
Connect these dots.
http://uk.reuters.com/article/governmentFilingsNews/ idUKN2445216420090424
http://www.snopes.com/politics/medical/tamiflu.asp
http://www.reuters.com/article/domesticNews/idUSTRE53O17O20090425
The usual boring admonitions apply: wash your hands, stay well-rested and well-hydrated. You do not need to buy Tamiflu. It is an effective antiviral drug but has possible side effects.
http://health.howstuffworks.com/health-illness/treatment/medicine/ medications/tamiflu-psych.htm
As far as our office prescribing Tamiflu, we would rather not, but we will if you insist. I promise you that I personally am purchasing none for my family and would recommend the same to you.
Jay N. Gordon, MD, FAAP
Dr. Rahul Parikh’s article entitled, “Parents, Don’t Be Immune to Vaccine Truths” should not have been published by the Los Angeles Times. He begins by painting a grim picture of a child in Mumbai who survives a case of tetanus. Instead of attempting to educate parents, his stated aim, he attempts to frighten them.
We should have long ago moved beyond trying to scare parents into vaccinating and also moved beyond trying to frighten parents into believing that every child getting a vaccine might end up with autism.
But the middle part of his exposition is devoted to a patient of mine and he commits ethics and HIPAA violations so egregious that the Medical Board must take him to task.
The article that appeared in the Los Angeles Times 3/29/09 has generated a lot of discussion, and I was asked to respond.
Unvaccinated children do not pose a threat to vaccinated children or their families.
We all have a responsibility to keep each other’s children safe. Choosing to not vaccinate or choosing an alternative vaccine schedule could be considered a rift in that contract. Medically, scientifically and statistically speaking, it is not. Honest people might disagree.
I have been a pediatrician for thirty years and have watched children receive all scheduled vaccines, some of the vaccines or receive no vaccines at all. I have seen every one of the illnesses against which we vaccinate. Since the early 1980s, I believe I’ve only seen once case of bacterial meningitis in a child and one other case in a teenager. The rarity of this terrible disease means that it makes the news whenever a case occurs but denying that childhood meningitis still exists is dishonest. Equally dishonest is implying that it is a large threat to any of our children. I see kids with pertussis every year. I see children misdiagnosed with whooping cough far more often. Two years ago, the New York Times took note of this phenomenon.
2009 marks the thirty year anniversary of the last case of “wild polio” in the United States. Subsequent cases were caused by the oral polio vaccine which is no longer used in this country.
http://www.polioeradication.org/casecount.asp (WHO/CDC supported site)
Rubella is no longer an “American” disease.
http://www.cdc.gov/od/oc/media/pressrel/r050321.htm (CDC Press Conference)
I recently read an article, written in 2009 which chastised non-vaccinating parents because there had been 131 cases of measles in the U.S. in the first half of 2008 alone. And how many cases were there in the whole year? 134. The usual number? 62. Disingenuous reporting. An extra 72 cases of measles among 300,000,000 Americans made the papers every day or two for months and the LA Times writers dredge up the child who caught measles on a Swiss vacation one more time.
Yes, as mentioned, measles and other viruses can cause encephalitis. It’s very, very rare. Implying otherwise could scare parents.
And, no, the law does not allow us to know which children have not received vaccines any more than it allows other invasions of privacy.
I have received hundreds of emails from people all over the country and the world reaching out to me and asking me to listen to them about vaccine issues and injuries because it seems that no one else will. I have permission from a mother to forward email she sent to me-with a picture-of her four month old daughter who received four vaccines and died shortly thereafter. I have dozens and dozens of similar emails and dozens of face-to-face encounters in my office with parents coming to me after what they considered to be vaccine damage to their children. I will not forward that email. It creates a different kind of fear that also doesn’t serve the dialogue well.
I think that these possibly injured children and families represent one end of the bell shaped curve and that scary stories about meningitis in Minnesota (the first there in 18 years) represent the other end. (I do feel that the former end of the curve is far fuller than the latter but no proof exists. None.)
The LA Times stories were “fear-based” just as my forwarding these emails would have been.
The University of Michigan Law Review recently invited me to write a journal article about vaccines and tort law.
I sum up my law review presentation to parents every winter by telling them that the only way to avoid childhood illnesses is “reverse isolation” of your illness-free child. If you go to a two-year-old’s birthday party during the winter months . . . You will probably get sick.
Peripherally, let’s all remember that it took fifty years or more, thousands of court cases and a lot of money to finally prove the connection between cigarettes and cancer. The three court cases showing no connection between vaccines and autism should make no headlines and should be an impetus to honest investigative journalism.
We have increased the number of vaccines and the combinations of vaccines given to babies and children. Adequate testing has not been done. I have seen a huge rise in the number of children with autism. Neither I nor any other doctors are hundreds of percent better at diagnosing this spectrum of developmental delay than ten or twenty years ago. The dramatic rise in the number of cases of autism spectrum disorders is attributable to something other than “reclassification” or better diagnosis.
While waiting for scientific proof, we have to tolerate families’ completely legal and scientific desire to have or not have their children given vaccines according to the current schedule.
JNG MD, FAAP
