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Health Tip
Baby teeth usually begin to appear between 5 months and 7 months of age. Infants may continue to get baby teeth until they are about 2 1/2 years old.

The Lucile Packard Children’s Hospital offers a list of common symptoms of teething, and some warning signs that something may be wrong.

Normal signs:

* Additional drooling.
* Frequent chewing or sucking on the fist or fingers.
* Swelling or puffiness of the gums.
* Being unusually fussy.

Unusual symptoms:

* While some discomfort is normal, teething shouldn’t cause your baby to have a high fever.
* Teething also shouldn’t cause cold-like symptoms or diarrhea.
By HealthDay

Children treated for hypothyroidism aren’t likely to drop pounds with treatment for the condition says a new study in the Journal of Pediatrics. The study is the first to examine the link between hypothyroidism treatment and weight loss in pediatric patients.

“Parents of overweight children often desire a ‘quick fix’ for the problem and request thyroid tests, but, unfortunately, screening for hypothyroidism is not the answer," said the study’s lead author, Dr. Jefferson P. Lomenick, an assistant professor at the University of Kentucky College of Medicine Department of Pediatrics’ Division of Pediatric Endocrinology. "Most experts agree thyroid function tests are generally unnecessary in an overweight child if he/she has normal linear growth and no other symptoms of hypothyroidism. The results of our study support this.”

The study followed 68 children with acquired hypothyroidism treated in the pediatric endocrinology clinic at Kentucky Children’s Hospital from 1995 to 2006. Most of the subjects had severe cases of hypothyroidism. Researchers found treatment with levo-thyroxine, which normalized the children’s thyroid levels, did not lower weight or BMI from baseline to any time point measured, either short-term or long-term.

"These findings were true for the group as a whole, as well as those children who were overweight," Lomenick said. "In fact, the entire group of 68 subjects actually gained 2.4 pounds by the first follow up visit despite their treatment. We did find that about a third of the children experienced weight loss by the second visit. However, these subjects had extremely severe cases of hypothyroidism, far worse than the children who did not lose weight, and they didn’t lose that much, only about five pounds.”

Lomenick said he is not surprised by these findings. "Although this is the first study in children to address this issue, there have been a few reports in adults which show similar results."

Although hypothyroidism is commonly believed to cause weight gain, Lomenick said the disease has been given a bad reputation.

“Long-standing hypothyroidism causes accumulation of a proteinaceous fluid in the subcutaneous tissues called myxedema," said Lomenick. "The amount of adipose, or fatty tissue, is not really altered with hypothyroidism. Replacement of thyroid hormone causes this fluid, which only amounts to a few pounds, to dissipate over a few weeks. Most cases of hypothyroidism are actually discovered long before myxedema even develops, which is why the majority of people experience little, if any, weight loss after treatment. The effect of hypothyroidism on weight has been vastly blown out of proportion to reality.”

The study, "Effect of Levo-Thyroxine Treatment on Weight and Body Mass Index in Children with Acquired Hypothyroidism," was co-authored by Dr. W. Jackson Smith, associate professor of pediatrics and chief of pediatric endocrinology at UK, and Maysa El-Sayyid, a medical student at UK.

Elementary schools can have a significant impact on low-income students’ consumption of fruits and vegetables by providing a lunch salad bar, according to a recent UCLA study. The findings, published in the December issue of the international journal Public Health Nutrition, show that the frequency of students’ fruit and vegetable consumption increased significantly—from 2.97 to 4.09 times daily—after a salad bar was introduced. In addition, students’ mean daily intake of energy, cholesterol, saturated fat and total fat declined considerably.

“One of the major contributing factors to the high rate of overweight children in the United States is that they do not consume the daily recommended servings of fruits and vegetables,” said lead author Dr. Wendy Slusser, assistant professor of pediatrics at Mattel Children’s Hospital UCLA and the UCLA School of Public Health. “Increasing the availability and accessibility to healthy foods is one way to improve children’s diets. In turn, this sets up opportunities for kids to have repeated exposure to healthy food and positively impact their choices.”

The UCLA pilot study was conducted at three Los Angeles Unified School District elementary schools participating in the salad bar program and the U.S. Department of Agriculture’s reimbursable lunch program. Study participants included 337 children in grades 2 through 5. Children were interviewed using a 24-hour food-recall questionnaire, both before and after the salad bar intervention—in 1998 and 2000, respectively.

The study was offered in conjunction with a nutritional education component, including a school assembly to teach children about the proper etiquette of serving themselves salad and picking a well-balanced lunch, as well as an artwork project and visits to farmers markets or a farm. The salad bar program was developed together by LAUSD Food Services and Occidental College in Los Angeles.

“The results are clear—if we provide fresh fruits and vegetables in kid-friendly ways, we will increase consumption,” said school board member Marlene Canter. “I am excited to see that our efforts to find new and creative ways to improve our students’ nutrition and help reduce obesity are working.”

Since the study, the LAUSD school board voted positively on a 2003 obesity-prevention motion that includes recommending fruit and vegetable bars as a modification of the hot lunch program.

An important source of nutrition, fruits and vegetables help with weight management and can also be beneficial in reducing the risk of certain cancers, heart disease, stroke and Type 2 diabetes. Eating a variety of fruits and vegetables can improve health by increasing amounts of vitamin C, phytonutrients, potassium and fiber in the body and displacing energy-dense fatty foods.

The U.S.D.A. has reported that only 36.4 percent of U.S. children between the ages of 2 and 19 eat the recommended three to five servings of vegetables per day, and only 26 percent eat the two to four recommended daily servings of fruit.

“The salad bar program showed us that children will indeed eat more fruits and vegetables if offered in an appetizing and accessible manner,” Slusser said. “Future studies should evaluate parent education with school lunch menu changes, as well as why boys are less likely to eat from the salad bar at lunch than girls.”

The study was funded by the Joseph Drown Foundation and the Center for Advanced Studies in Nutrition and Social Marketing at the University of California, Davis.

Source: University of California

Research findings from the University of Michigan C.S. Mott Children’s Hospital indicate that kids who don’t get enough sleep may be at increased risk of being overweight. A study researching the connection between length of sleep and weigh for third and sixth grade children showed that kids who got less than 9 hours sleep per day were at greater risk of being overweight—regardless of their gender, race, socioeconomic status, or home environment quality.

The study showed that sixth graders short on sleep were more likely to be overweight. Third graders who got fewer hours of sleep—regardless of their BMI—were more likely to become overweight in sixth grade. The findings of this study appear in the November issue of the journal Pediatrics.

“Many children aren’t getting enough sleep, and that lack of sleep may not only be making them moody or preventing them from being alert and ready to learn at school, it may also be leading to a higher risk of being overweight,” says study lead author Julie C. Lumeng, M.D., assistant research scientist at the U-M Center for Human Growth and Development. “This study suggests that an increased risk for overweight is yet another potential consequence of short sleep duration, providing an additional reason to ensure that children are receiving adequate sleep, primarily through enforcing an age-appropriate bed time.”

Data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development on reported sleep problems, sleep duration and BMI for 785 elementary school children, aged 9 to 12, was reviewed . 50% were male, 81% were white, 18% were overeight in the sixth grade. The overweight sixth grade lids slept fewer hours than those were not overweight, with boys in the majority of overweight sixth grade children.

“Even more important,” Lumeng says, “is emerging research that shows a connection between sleep disruption and the hormones that regulate fat storage, appetite and glucose metabolism. Short sleep duration alters carbohydrate metabolism, and leads to impaired glucose tolerance, which can affect a person’s weight. Circadian rhythms, too, affect the body’s leptin, glucose and insulin levels.”

So weight gain may not be a result of sleep’s effect on behavior, notes Dr. Lumeng, but rather sleep’s effect on hormone secretion in the body, specifically leptin and grehlin.

The National Sleep Foundation recommends these basic daily sleep requirements for children, adolescents, pre-teens and teens:

• Preschoolers: 11-13 hours
• Elementary school students: 10-12 hours
• Pre-teens: 9 - 11 hours
• Teens: 8 ½ - 9 hours

In addition to Lumeng, co-authors from the U-M Center for Human Growth and Development are Deepak Somashekar, B.S., and Niko Kaciroti, Ph.D.; Danielle Appugliese, MPH, with the Data Coordinating Center, Boston University; and Robert F. Corwyn, Ph.D., and Robert H. Bradley, Ph.D., with the Center for Applied Studies in Education, University of Arkansas.

The study was supported by the American Heart Association Fellow-to-Faculty Transition Award, and the American Heart Association Midwest Affiliate Grant-in-Aid.

Reference: Pediatrics,

Children are being exposed to peanuts and exhibiting signs of life-threatening peanut allergies at much earlier ages, according to a new study from researchers at Duke University Medical Center, who caution parents and care-givers to be alert to the trend. As many as 12 million Americans suffer from food allergies, including milk, soy, eggs, wheat, tree nuts, fish and shellfish, according to the American Academy of Allergy Asthma and Immunology. About 1.8 million Americans are allergic to peanuts, and studies show the incidence of peanut allergy in children has doubled in the past decade.

The study, which appears in the current issue of the journal Pediatrics, looked at a group of children born during or after 2000 and compared them to a group of children born between 1995 and 1997. The younger group reported exposure to peanuts at 12 months, and reported their first adverse reaction at 14 months. That’s in contrast to a decade ago, when first exposure was documented at 22 months, and first adverse reactions occurred at 24 months.

“This should be a wake-up call to all parents of young children,” says Wesley Burks, MD, chief of pediatric allergy and immunology at Duke University Medical Center, and the study’s senior author. “Kids are being exposed to peanuts and having allergic reactions much earlier than they did five or 10 years ago.”

“There’s a valid reason to delay introduction to products containing peanuts,” adds Todd D. Green, MD, the study’s lead author and assistant professor of pediatrics at Children’s Hospital of Pittsburgh. Green was a postdoctoral fellow at Duke where the research was conducted before joining Children’s Hospital. “When kids are older, it can be easier to manage bad reactions. They can tell you right away if their mouths feel funny. For that reason alone, it’s worth delaying exposing your child to a peanut product, especially if a child is at high risk.”

“More research needs to be done to determine why peanut allergy in children is increasing and, most importantly, how to stop this increase,” says Anne Munoz-Furlong, director of the Food Allergy and Anaphylaxis Network in Fairfax, VA. “Peanut allergy is life-long and causes the majority of severe or fatal allergic reactions from foods, particularly in teens.”

As many as one-third of patients allergic to peanuts have severe reactions that can be near-fatal and sometimes fatal. More specifically, about 200 deaths occur each year due to food-induced anaphylaxis, usually involving peanuts or tree nuts, Burks says.

Current medical studies suggest that strict avoidance of peanuts and peanut products in allergy-prone families is the only way to avoid an allergic reaction. The American Academy of Pediatrics recommends that children avoid peanuts for the first three years of life if immediate family members have food allergies.

In the study, patients with a family history or exhibited evidence of sensitivities to foods other than peanuts showed signs of peanut allergies at earlier ages.

Furlong says this is because “most parents are not aware of the AAP recommendations until after their child is diagnosed with peanut allergy.”

Burks and colleagues question whether the earlier signs of exposure are a result of the increased prevalence of peanut allergies, and their next steps are aimed at pinpointing why the exposure levels are rising.

At the same time, they are looking at whether early introduction of peanut products actually promotes tolerance, or could potentially prevent peanut allergies in some patients. A study currently under way at Duke is investigating whether ingesting small amounts of offending foods including peanuts, eggs and milk might desensitize children prone to food allergies, helping their immune system mount an appropriate response.

Source: Duke University Medical Center

Weight gain between a woman’s first and second pregnancies can cause complications during pregnancy and delivery — even for women not considered medically overweight, a new study found.While previous studies had noted an association between weight gain and pregnancy complications, this new research is the best evidence thus far for a cause-and-effect relationship, the researchers said.”We are contributing evidence to strengthen the argument for causality,” said Dr. Eduardo Villamor, assistant professor of international nutrition at the Harvard School of Public Health and lead author of the study, which was published in the Sept. 30 issue of The Lancet. “As far as we could humanly show, the evidence is pretty robust,” he said.The practical implications are clear. “Being of normal weight and trying to lose weight between pregnancies would be very helpful,” added Dr. Ellen Landsberger, assistant professor of obstetrics and gynecology and women’s health at Albert Einstein College of Medicine in New York City, who also has a degree in nutrition.Paradoxically, another new study found that women who had regularly exercised for four or more hours a week in the previous nine years or less were 40 percent less likely to have a live birth after their first cycle of in-vitro fertilization, compared to women who didn’t exercise.The study also found that regular exercisers were twice as likely to have an implantation failure or pregnancy loss after undergoing in-vitro fertilization (IVF). Cardiovascular exercise, in particular, was associated with a 30 percent lower likelihood of successful live birth compared with women who didn’t exercise. It was unclear why this was the case, although hormones certainly could be involved, the authors theorized.This study, by researchers at Brigham and Women’s Hospital in Boston, was published in the October issue of the journal Obstetrics & Gynecology.Overweight and obesity have become one of the world’s greatest public-health challenges. In the United States in 1999-2000, 28 percent of women aged 20 to 39 were obese, up from only 9 percent in 1960-62.And some relationship, whether causal or not, between overweight and obesity and pregnancy complications has long been suspected.For the new study, investigators from Harvard and Sweden took advantage of Sweden’s excellent health records, studying more than 150,000 Swedish women with first and second births between 1992 and 2001.Body mass index (BMI, a ratio of weight to height) was calculated at the first prenatal visit of each pregnancy. The difference in BMI was then correlated with complications during second pregnancies, including preeclampsia (hypertension), gestational diabetes, gestational hypertension and Caesarean delivery as well as stillbirth and large-for-gestational-age birth.A gain of one to two BMI units increased the risk of gestational diabetes, gestational hypertension or large-for-gestational age birth an average of 20 percent to 40 percent. A gain of three or more BMI units resulted in a 63 percent greater chance of stillbirth compared to a gain of less than one BMI unit. It also had a greater effect on all other complications, the researchers found.Even modest amounts of weight gain in normal-sized women caused problems. If a 5-foot-5-inch woman weighting 139 pounds (a BMI of 23, considered normal) gained 6.6 pounds — or one BMI unit — between the two pregnancies, her average risk of gestational diabetes increased more than 30 percent. A gain of 12.2 pounds (two BMI units) increased the risk 100 percent.”One of the key findings of our study is that we found that weight gain between pregnancies increased the risk of these complications even in women who had never been obese or overweight,” Villamor said.”It appears it is not necessary for women to become overweight or obese, a few kilos might carry a risk,” he continued. “One message could be that women should not gain any weight. They should try to go back to their pre-pregnant weight and should not gain any weight after the first pregnancy. Obviously, overweight and obese women should try to reduce their weight and that’s likely accompanied by other health benefits.”