Buying Breast Milk Online, Sport Stars, Fake Ids – PediaCast 271

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Join Dr Mike in the PediaCast Studio for more news parents can use. This week’s topics include buying breast milk online, learning about germs… while visiting farms, bad influence from sport stars, MMR & febrile seizures, and fake ID use among college students.

Topics

  • Buying Breast Milk Online

  • Germs & Farms

  • When Sport Stars are a Bad Influence

  • Measles Vaccine & Seizures

  • Fake IDs & College Students

Links

 

Transcription

Announce 1: This is PediaCast.

[Music]

Announce 2: Welcome to PediaCast, a pediatric podcast for parents. And now direct from the campus of Nationwide Children's here is your host Dr. Mike.

Dr. Mike Patrick: Hello everyone and welcome once again to PediaCast, it is a pediatric podcast for moms and dads. This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital, we're in Columbus, Ohio. It is November 6, 2013, this is episode 271, we're calling this one buying breast milk online, sport stars, and fake ID's. I want to welcome everyone to the show, we have a news parents can use addition to the program lined up for you this week.

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It's been a few weeks since we've done one of this and for the newcomers in the crowd here's the gist. I take a fairly recent journal article that relates to pediatric medicine and or parenting, deconstruct the science, report the findings and put a practical spin on the information which you can use in everyday parenting. Certain studies may affect more view than others but I do try to include a wide range of ages. For instance in this episode we have content aimed parents with babies and parents of college students. Some of the news item are a bit more useful than others, some way include just because they're kind of fun, some of the stories highlight research here at Nationwide Children's Hospital like one of the five new stories that I'm covering this week. But this isn't about promoting our research we have other channels that do that. We do it when it's warranted, but it's more about providing useful information and education for you, the parent.

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In that spirit what are we covering today? Buying human breast milk online from strangers, and I have to say honestly I was completely naive about this growing trend, moms buying breast milk from strangers online. Turns out they do and it's a potentially dangerous practice, we'll get into the specific dangers and talk about safer alternatives. And then learning about germs while visiting a farm, the best learning is fun learning and learning in contacts. British students are doing quite a bit of learning about micro-biology and infectious disease while out on the country side enjoying the sights, sounds, and smells down on the farm. I'll let you know if they're up to and we'll provide American educators and students with the way to get in on the fun, it's kind of a cool topic.

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Bad influence of sport stars, you know in many cases professional athletes are heroes, we look up to them and considering how much money they make for the privilege of being looked up to, you think they would make better decisions on what to endorse and what not to endorse, but alas their final decision often comes down to the almighty dollar and so it's up to us parents to help our children navigate the endorsements. Some more details on how to do that coming your way. Measles containing vaccines associated with fever and seizures, those two things are associated, measles containing vaccines can cause fever which can result in febrile seizure, it's a fact, should parents be worried? It is the benefits of the vaccine justify the risk? Should measles vaccines be avoided or delayed because of this risk? You probably know my answers to these questions because you know I'm for vaccine. But let's take an evidenced based look at the facts so you can decide for yourselves.

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And finally fake ID's in college students, you know the story, you might have done it yourself, but you might be surprised just how wide spread fake ID uses among under aged college students, and you might also be surprised at the risks involved. They are not anything to laugh about or shrug off and after hearing the story you may want to ask your college age children some pointed questions and maybe it's worthwhile to have some frank discussions with your high schoolers as well, lot's coming your way this week.

Before we get started a few reminders, it is November the Holidays are just around the corner and as you know every gift matters during the holidays. And here at Nationwide Children's Hospital we rely on your gifts and our effort to advance ground breaking pediatric research, and to provide the best pediatric care on the face of the planet. Please consider helping us out as we help kids from across the United States and around the world. Many of you gave to Nationwide Children's last year, thank you for that, we do appreciate your trust and your support.

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And this year as the gift giving season approaches I would simply ask that you consider including Nationwide Children's in your charitable giving this holiday season. It's an easy thing to do, just head over to the show notes for this episode at pediacast.org, it's episode 271 and click on the every gift matters link, you can also call us toll free at 1855-885-5437 and I'll include that phone number in the show notes for you as well, again over at pediacast.org show notes for episode 271. Another reminder, PediaCast is on iHeart Radio Talk it's easy to find us there, just head over to iheart.com or download the iHeart radio app for iPhone or android and search for PediaCast. You'll find our latest full length shows as well as the new way to consumer material PediaBytes our shorter, single topic segments and you can incorporate these into your daily polls and iHeart radio will knit them together with other talks show segments from other shows once you chose and I can even infuse your local news, traffic, and weather.

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If you aren't up for all these customization yourself, maybe you just don't have time to search through iHeart radio's library of talk shows but you would like a pre-fabricated talk show station geared toward moms and dads, we have something for you as well. You can find PediaCast on Mom's Sippy Cup and The Parent Hood, both available on iHeart Radio Talk. Mom's Sippy Cup is a collection of entertainment, health, and family shows and The Parent Hood features parenting, health, and financial programs. It's a whole new way to interact with PediaCast and your other favorite talk show programs, again over at iheart.com and through the iHeart Radio app for iPhone and android. Finally I want to remind you that PediaCast is your show, if you have a topic you'd like us to talk about or you have a question for me, it's easy to get in touch, just head over to pediacast.org and click on the contact link.

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I want to remind you the information presented in every episode of PediaCast is for general educational purposes only, we do not diagnose medical conditions or formulate treatment plans for specific individuals. If you do have a concern about your child's health make sure to call your doctor and arrange a face to face interview and hands on physical examination. Your use of this audio program is subject to the PediaCast terms of use agreement which you can find at pediacast.org. Let's take a quick break and I will be back with News Parents Can Use right after this.

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Dr. Mike Patrick: We are back and the first new story is one that surprised me. Results from a study led by researchers here at Nationwide Children's Hospital found more than three-quarters of breast milk samples purchased over the internet contain bacteria that can cause illness and frequently exhibit signs of poor collection, sub-optimal storage, and less than ideal shipping practices. What surprised me was not the fact that there would be increased bacteria, and poor collection, and sub -optimal storage, and less than ideal shipping practices that's not what surprised me. What surprised me is that people are actually doing this and buying breast milk over the internet, to some degree it's our own fault, we've said breast milk is best and now people are resorting to buying other people's breast milk which is not a good idea. The study published in the November issue of the journal Pediatrics is the first to examine the safety of selling breast milk to others over the internet, a trend that has become more frequent in the past several years.

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It is unknown exactly how common purchasing breast milk online is, but an earlier study cited 13,000 postings placed on US milk sharing web sites in 2011. The research team from the Center for Bio-Behavioral Health at the Research Institute at Nationwide Children's Hospital purchased breast milk listed for sale on public web sites and then analysed it in the lab. The research was completed in collaboration with Cincinnati Children's Hospital Medical Center in the Ohio State University. Dr. Sarah Keim principal investigator on the project says," We were surprised so many samples had such high bacterial counts and even fecal contamination in the milk, most likely from poor hand hygiene. We were also surprised a few samples contained salmonella, other harmful bacteria may have come from the use of either unclean containers or unsanitary breast milk pump parts." ; Individuals posted classified ads on web sites describing the breast milk they wanted to sell or why they were seeking breast milk.

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Researchers responded to ads from sellers who did not ask for information about the infant receiving milk and who did not require phone call before a transaction was made. They analyse a 101 samples bought online and compared the findings to 20 samples obtained from a certified milk bank. In the US, 12 non-profit milk banks follow the human milk banking association of North America guidelines and they provide pasteurized milk from carefully screened donors for fragile and sick infants. Because the milk banks pasteurize their milk, harmful bacteria are killed before the milk reaches an infant unlike breast milk purchased online. Even before pasteurization the milk bank samples were less likely to contain several types of bacteria and had lower bacterial growth in many instances. Shipping practices also play the role in the levels of bacteria in the milk purchased online, the longer the shipping time the more contaminated the milk. Nineteen percent of sellers did not include dry ice or an alternative cooling method, and the temperature when the milk arrives was outside the recommended range for storage.

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Researchers found particularly high levels of one or more types of bacteria in 17% of the samples. Information provided by sellers in their classified ads online such as "I eat an organic diet" or "great quality" had no direct implication on the safety of the actual breast milk. However sellers often did include information about the use of hygienic milk handling or storage practices that they screen for diseases transmissible by the milk, or that they limited or abstain from legal or illegal drugs. Often they included that information but there's no way to prove whether it was true or not, in many other instances they did not include any of that information. Dr. Keim says, "Major milk sharing websites post a lot of guidance about milk collections, storage, shipping and provider screening, however results from this study showed sellers do not often follow this advice because hygiene and shipping practices were often compromised….

0:12:07.9

"Based on our research it is not safe to buy breast milk online and the Food and Drug Administration recommends against sharing milk obtained in that way. Recipients are not able to determine for sure if the milk has been tampered with, or contains harmful drugs or pharmaceuticals, or for information the provider supplied about their health was truthful." ; According to Dr. Keim, "it is difficult to know if a particular infant would be sickened by consuming any given bottle of milk but the types of bacteria found in the online samples contain a bacteria that could cause illnesses known to be linked to contaminated breast milk. Milk banks are a safer alternative for breast milk for sick babies if the mother cannot provide her own milk, why? Because donors receive proper instructions and the milk is pasteurized limiting the risk of bacterial illness. Human breast milk is preferred over infant formula for pre-mature and sick babies because it can help strengthen the immune system and has been shown to protect against severe illnesses like necrotizing enterocolitis, a potentially deadly condition affecting thousands of pre-mature and sick infants each year….

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Dr. Keim said, "Women who have extra milk should consider donating it to a breast milk bank where the milk can be handled properly and they will ensure it goes to a baby who badly needs it rather than selling it for profit online. Milk sold online and contaminated with bacteria that cause illness can be particularly harmful for pre-mature infants are those with weakened immune systems who are already particularly susceptible to infection." ; Dr. Keim Says, "Our research results may not apply to situations where milk is shared among friends or relatives or donated rather than sold. The potential risks of those situations are less well understood. Moms pumping for their own children should sanitize the parts of the breast pump that come into contact with the milk, use clean containers and wash their hands before pumping and handling the milk. Also keep milk cold and feed it to your baby as soon as possible." ; She says, "Our goal is to identify infant feeding practices that optimize child of maternal health in addition to lactation consultants who are available at hospitals and clinics, there are community based lactation consultants and peer support organizations where women can help each other."

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"We will continue to study breast feeding in the context of contemporary society since where and how infants are fed is rapidly changing." ; There you have it and I almost feel that this should be obvious to those in the PediaCast audience without me having to explicitly say so, but the bottom line here is, don't buy human breast milk over the internet. Honestly, I never in my life imagine needing to say these words, don't buy human breast milk over the internet, it's not a good idea, you don't know where it's coming from, you don't know who it's coming from, you don't know what's in it, you don't even know for sure that it's human milk. Certified milk banks are a safe alternative for pre-mature and sick babies whose doctors' recommend donor milk and certified milk banks need donor milk for these pre-mature and sick babies.

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If your infants' doctor recommends donor human breast milk or if you wish to donate human breast milk, then you should get in touch with a certified human breast milk bank and you can get in touch with a certified human breast milk bank through the Human Milk Banking Association of North America. And to make it simple to touch base with them, I'll provide a link in the show notes for this episode 271 over at pediacast.org. If you have a healthy baby at home and your own breast milk is not an option, don't buy human breast milk online. Put this through your risk-benefit filter, infant formula or breast milk from a stranger that you bought online that get shipped through the mail. Infant formula should come out of your filter, not breast milk from a stranger on the internet. If a breast milk from a stranger comes out of your filter I'd say get a new risk-benefit filter because yours my friend sounds defective.

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Our next new story comes from across the pond. A study by Public Health England has found that the use of interactive lesson plans in a farm setting significantly improves students' knowledge of germs and the importance of hand hygiene in reducing the risk of infectious disease. In fact 80% of the children correctly answered all questions about microbes and disease following the farm intervention. The study recently published in the science journal Plus One used an interactive lesson plan devised by e-Bug, it's a European wide educational resource for junior and senior students which is available free for teachers at the e-Bug website, I'll include the link in the show notes for this episode 271 over at pediacast.org.

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Researchers say, "School visits to farms are a positive educational experience but do post a level of risk of infection form a number of micro-organisms including e. coli, salmonella, and campylobacter which are found in animal poop and on surfaces around the farm…. A total of 210 children between the ages of 9 and 11 took part, they came from rural locations and small towns across England. The Lesson lasted between one to two hours and covered three topics, introduction to microbes, hand hygiene, and farm hygiene. Teachers used a true-false and I don't know questionnaire before and after the farm visit to assess how the children's knowledge developed. Dr. Meredith Hawking, lead author of the research says, "The positive results from our study show how this interactive lessons can be very beneficial in teaching behaviors to reduce risk of acquiring infections. This is particularly important within the farm setting as some childhood behavior such as nail biting, sucking thumbs, and eating on the go give more opportunity to ingest harmful bacteria. We also saw that children had a high level of knowledge that they should wash their hands after contact with an animal but not all of them knew to do this consistently by building on a child's knowledge and awareness of what could be harmful."

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"We can hopefully encourage them to adopt positive habits and behaviors. We were therefore encourage schools to use the e-Bug farm activity and an associated farm visit." ; That just sounds fun, and why should the British kids be the only ones to learn about germs while visiting a farm? I'd like to go on that trip, teachers out there in the audience make room in your lesson plans, visit the e-Bug website and check out the learning about microbes on a farm curriculum, your students will appreciate it and they'll learn something too which is always important, I'll put a link to that in the show notes for episode 271 at pediacast.org. Professional athletes are often paid large amounts of money to endorse commercial products, but the majority of the food and beverage brands endorsed by professional athletes are for unhealthy products like sports beverages, soft drinks, and fast food.

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That's according to a new study by the Rudd Center for Food Policy and Obesity at Yale University and published in the November 2013 issue of the journal Pediatrics. Researchers analyse data collected in 2010 from the AdScope advertisement data base which reveal that teenagers between the ages of 12 and 17 viewed the most television food ads endorsed by athletes. Previous research by public health advocates had criticized the use of athlete endorsements in food marketing campaigns for often promoting unhealthy food and sending mixed messages to youth about health. But this is the first study to examine the extent and reach of such marketing. Researchers selected 100 professional athletes to study based on business week's 2010 power 100 report which ranked athletes according to their endorsement value and prominence in their sport. Information about each athlete's endorsement was gathered from the power 100 list in AdScope.

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Researchers then sorted the endorsement into categories, food and beverage, automotive, consumer goods, service providers, entertainment, finance, communications and office supplies, sporting goods and apparel, retail, airline, and other. For the food and beverage group the nutritional quality of the foods featured in athlete endorsement advertising was assessed along with the marketing data. Of the 512 brands associated with these athletes, food and beverage brands were the 2nd largest category of endorsements behind sporting goods. Marie Bragg, a doctor of Canada at Yale and lead author of the project says, "We found that Lebron James of the NBA, Peyton Manning of the NFL, and Serena Williams of Tennis Fame had more food and beverage endorsement than any of the other athletes examined, most of the athletes who endorse food and beverages were from the NBA followed by the NFL and Major League Baseball. Sports beverages were the largest individual category of athlete endorsements, followed by soft drinks and fast food….

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"Ninety three percent of the 46 beverages endorsed by professional athletes received all of their calories from added sugars. Food and beverage advertisements associated with professional athletes had far reaching exposure with ads appearing nationally on television, the internet, radio, newspapers, and magazines. As Bragg says, "The promotion of energy dense, nutrient poor products by some of the world's most physically fit and well know athletes is an ironic combination that sends mixed messages about diet and health." ; That was well said, because these guys and gals, they're not consuming these stuff at least not on a regular basis. I don't follow Lebron James around and find out what he's putting into his body, but I have a feeling that it's not the same stuff that he's advertising. I could be wrong about that, I don't want Lebron James' lawyers knocking on my door saying, "You don't know what he drinks," you're right, I don't know what he drinks but I do know this, I know that it's not healthy for your kids to consume all the things that these folks are saying that they're consuming and that they want your kids to consume that stuff because their endorsement checks depend on it.

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If they are not increasing sales, they're not going to get paid. Miss Bragg also asserts that professional athletes should be aware of the health value of the products they're endorsing and should use their status and celebrity to promote healthy messages to youth. Ultimately it's up to us moms and dads to put the truth into prospective for our kids, is this stuff really healthy? It just might knock that sport star off his pedestal for your kid when you say, "He's not making good choices," something that has parents have to do. Children receiving measles containing vaccines at 12 to 15 months of age have a lower increase risk of fever and seizures than those who received them at 16 to 23 months of age, that's according to a new Kaiser Permanente study published in Gemma Pediatrics. The Centers for Disease Control and Prevention recommend a two dose series of measles containing vaccine with the first dose administered at 12 to 15 months of age, and the second dose at four to six years of age.

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The Kaiser Permanente study found that receiving the first dose by 15 months provides a benefit to children. Dr. Ali Rowhani-Rahbari, lead author of the study and an assistant professor of epidemiology at the University of Washington says, "We found that the magnitude of increased risk of fever and seizures following immunization with measles containing vaccine depends on age. While measles containing vaccine administered at 12 to 15 months of age are associated with the small risk of fever and seizures following immunization, delayed administration at 16 to 23 months of age results in a greater risk of these adverse events. Previous studies have shown that measles containing vaccines administered to children 12 to 23 months of age are associated with an increased risk of febrile seizures one to two weeks following immunization….

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"This is the period of time during which the vaccine virus replication is at its peak, potentially causing fever and the resulting fever may cause some children to experience a seizure…. Dr. Matthew Daley, a pediatrician and senior investigator at Kaiser Permanente Colorado's Institute for Health Research says, "Kaiser Permanente's guidelines for measles containing vaccines are in line with the CDC's recommendations. The study's findings reinforce for parents that these vaccines are safer when children receive them at 12 to 15 months of age…. Senior author and co-director of Kaiser Permanente vaccine Study Center, Dr. Nicola Klein adds a bit of perspective, "While femoral seizures are the most common neurological adverse events following immunization with measles containing vaccines, the risk is small regardless of age…. He adds, "Medically attended febrile seizures following immunization with measles containing vaccines are not common events. Concern parents should understand that the risk for febrile seizure after any measles containing vaccine is low, less than one febrile seizure per 1000 injections….

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Using data from the vaccine safety data link, a collaborative effort of the Centers for Disease Control and Prevention and Nine Managed Care Organizations, Kaiser Permanente researchers evaluated the potentially modifying effect of age on the risk of fever and seizures following immunization with any of the measles containing vaccines. Researchers evaluated the records of 840,348 children 12 to 23 months of age who would've received a measles containing vaccine between January 2001 and December 2011. Following immunization with any measles containing vaccine, the incidents of fever and seizures during days 7 to 10 post injection was significantly greater than any other time during the 42 day post injection monitoring period. The patterns for the incidence of fever and seizures were different during the period of observation. The incidents of fever steadily decline from 12 months to 23 months of age while the incidence of seizures was highest among children in the 16 to 18 month range.

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The relative risk of fever and seizures during the 7 to 10 day post injection interval was significantly greater among children 16 to 23 months of age than among children 12 to 15 months of age, and the risk of seizures attributable to the vaccine during the 7 to 10 day post injection interval was significantly greater among children 16 to 23 months of age than among children 12 to 15 months of age. The authors conclude that while the overall risk of febrile seizures associated with a measles containing vaccine is low, the risk is lower when the injection is given at 12 to 15 months of age compared to 16 to 23 months of age. What is the point of this research? Because who cares if a child has a vaccine related fever and an associated febrile seizure?

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One of the quotes from one of the authors was to say, "Our research shows that it's safer to give kids the vaccine at 12 to 15 months of age because they're less likely to have a fever and a febrile seizure." ; But is a fever and a febrile seizure a safety event? We've talked about febrile seizures many times on this podcast and we have established that except in the case of very rare complex febrile seizures which probably aren't febrile seizures at all, it's probably for most of these kids with complex ones the beginning of their epilepsy. The run of the mill febrile seizure, they aren't dangerous and when you get a measles containing vaccine, you're injected with an attenuated form of a live virus, that means they take the live measles virus and they've engineered it so that it's not as infectious but it still stimulates the immune system and in fact that provides very good immunity against measles which is an important thing because a 158,000 unvaccinated children around the world die from measles infection each year.

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We want the vaccine to work, we wanted to provide immunity, and as the immune system is faked out by thinking you have a full blown measles invasion when it's just an attenuated virus, your immune system goes to work so you're protected if and when the real deal comes along. In the process of faking out your immune system, you might get a fever that's a by-product of the immune system in action. The fever is a bit uncomfortable, it's inconvenient, but it's not dangerous and it's not nearly as uncomfortable and inconvenient as getting the real deal measles infection. Your child might have a febrile seizure associated with the fever because they can have a febrile seizure associated with any fever. Again, it's inconvenient, it's scary when you see it but it's not even close to being as dangerous as a real deal measles infection.

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A febrile seizure is small price to pay for protection against the potentially deadly virus and in my mind the benefit of measles protection outweighs the risk of a febrile seizure. I want my kid to get the vaccine when it will provide optimal immunity regardless of the risk of a febrile seizure. There are those who would say that if more kids get febrile seizures associated with the vaccine, then it's going to scare more parents and more kids will go unvaccinated. But I say, let's not make decisions based on parental fear, let's educate parents so they won't be afraid if a febrile seizure occurs, let's educate them before the febrile seizure occurs before it even has a chance to happen, let's tell them that this is a possibility so they can understand and be prepared for that remote possibility. All the while understanding that the benefit of the vaccine justifies this risk. Give the measles containing vaccine at the optimal time for immunity which right now at least happens to correspond with the interval with less risk of febrile seizure 12 to 15 months of age.

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I suppose we can use a star advantage when guiding parents who want to delay immunization, we can say, "OK you can wait but the risk of seizure is going to be higher", but I wouldn't do that because then we're the one stooping to scare tactics, let's just tell the truth. Educate and advocate for the vaccine to be given when it works best which right now is believed to be the 12 to 15 month window. I say right now because there is another study published in the November issue of the journal Pediatrics which shows better immunity when the first dose of measles containing vaccine is given 15 months or older rather than the 12 to 15 month range. This study had a relatively small sample size and a limited population in Quebec, Canada but it is possible that recommendations can potentially change in the future if more studies verify these findings. Recommendations which would move a measles containing vaccine to a time when febrile seizures are little more likely and so education about febrile seizures would become even more important.

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If you like to know more about the second study that I mention, the one that showed delaying measles containing vaccine until 15 months or older that, that might provide better immunity, I'll put a link to that one in the show notes for this episode 271 over at pediacast.org. I have one more new story for you today, the use of fake ID"s by youth to buy alcohol is a slippery slope toward alcohol use disorders. According to a study from researchers at the University of Maryland, and the State University of New York Buffalo, and published in the journal Alcoholism, Clinical and Experimental Research. According to this researchers, the majority of underage youth admitted to using false identification to buy alcohol, in fact almost two-thirds of the underage college students surveyed admitted to using false ID's to obtain alcohol.

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The use of these false ID's appears to contribute to the development of alcohol use disorders by facilitating more frequent drinking. While underage students tend to drink less frequently than their older college peers, they are more likely to engage in high risk drinking behaviors and at risk for developing alcohol use disorders. Dr. Amelia Arria associate professor of Behavioral and Community Health and director of the Center on Young Adult Health and Development at the University Of Maryland School Of Public Health says, "Alcohol use is extremely prevalent among underage youth in the United States, despite minimum legal drinking age laws and opposes health and safety risks. Alcohol is easy for most youth to obtain and false ID's are one of the factors contributing to alcohol's easy accessibility." ; She adds, "False ID use seems to be related to high risk drinking in at least two major ways. First, heavy drinkers are more likely to obtain and use a false ID, and second, false ID use increases how much and how often a student drinks….

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"In our sample we found a clear pathway for more frequent false ID use to more frequent drinking which leads to a greater risk for developing alcohol dependence even after adjusting for several risk factors for alcohol use disorders. Thus we believe false ID use contributes to high risk drinking patterns because it increases the accessibility of alcohol and makes it easier for students to drink more frequently…. Dr. Arria and her colleagues recruited 1015 college students, 529 females and 486 males who had drink alcohol at least once in their lives by their first year in college. Each student participated in an annual assessment during their first four years of college which included questions about the use of false ID's and alcohol consumption. Researchers also examine several other factors that might increase risk for an alcohol use disorder, things like demographics such as sex, race, living situation, religiosity and socio-economic status. Individual characteristics such as childhood conduct problems, sensation seeking, and age first drink. High school behaviors such as high school drinking frequency and drug use.

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Family factors such as parental monitoring, and parental alcohol problems, and perception of peer drinking norms. Dr. Arria says, "First we found that 66.1% of the college students use false ID's. On an average we estimated that they use false ID's 24.1% of the times that they drink before turning 21 years of age. Second, we demonstrated that false ID use led to increases in drinking frequency and amount consumed. Third, we showed while false ID use wasn't directly related to the risk of developing an alcohol use disorder, it did indirectly predict increases an alcohol use disorder risk overtime through its contribution to increases in drinking frequency. Lastly, the study identified several predictors of false ID use frequency such as younger age at first drink of alcohol, greater levels of alcohol and drug involvement during high school, higher levels of sensation seeking, Greek life involvement, and living off campus….

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Dr. Jennifer Reid, an associate professor in the Department of Psychology at the State University of New York at Buffalo says, "I think some of the most important findings to come out of this study have to do with how wide spread this problem is. I was surprised that almost two-thirds of the students use false ID's. That'll be interesting to see if this reflects something specific to this university or region in Dr. Arria study, or if the use of false ID's is as ubiquitous across campuses in the United States or beyond college campuses." ; Dr. Arria adds, "It' difficult to say whether this findings would also apply to non-college attending young adults since their environment is different from those of college students. However it seems like the factors that predict false ID use might be similar regardless of college attendance. Future research can help confirm whether our findings could be applied to non-college attending youth and to evaluate whether or not interventions to reduce false ID use is effective for both students and non-students….

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Regardless of the status of college attendants, Dr. Arria says, "Interventions targeted at youth and policies that enforce sanctions against false ID use are needed. Reducing the use of false ID's needs to be a priority for policy makers in order to help reduce excessive drinking among college students…. Other research has suggested that effective measures include heightened enforcement of sanctions against individuals who manufacture and sell false ID's confiscation of false ID's by alcohol retailers, bars and clubs, and the use of ID checking machines in establishments that are restricted to persons who are of legal drinking age. Sanctions for individuals caught using false ID's could include their confiscation, fines, and citations. Most importantly high risk drinkers should be directed toward effective interventions that can help them change their behavior. Ultimately this will promote their health, safety, and long term success. Parental awareness and involvement in this issue is also important. Dr. Reid points out, "Just knowing how commonly used a false ID's is suggest that this among other things is something that parent should monitoring, and also talking with their kids about….

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"Parental monitoring and communication haven't shown the buffer against problem drinking outcomes in young adults, and this is another area where parents might be encouraged to engage in these practices…. Dr. Arria adds, "It's important to know that have your drinking patterns seems to be both a predictor and an outcome of false ID use. In other words, false ID's might be adding fuel to the fire among students who are already high risk drinkers…. Dr. Reid says, "One of the big implications I see of this work pertains to drunk driving. Underage drinking often takes place in bars and clubs, while some underage drinkers have a designated driver, or taking public transportation, or walk in some cases. It's probably reasonable to assume that many others are not. In future research, it'll be interesting to look at the extent to which the use of false ID's is linked to driving under the influence…. There you have it moms and dads, two-thirds of your underage college students may be using fake ID's to buy and consume alcohol, and their illegal use of alcohol may contribute to a lifetime of problems.

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Is your child one who uses a fake ID? You should make it your business to know. Many of you are footing the bill for college and you'll be called upon to foot future problems if your son or daughter becomes alcohol dependent. That wraps up our News Parents Can Use, I'll be back to wrap up the show with the final word right after this.

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Dr. Mike Patrick: Our final word this week comes from a listener, I did this a couple of weeks ago and I'm going to do it again. This final word comes from Beth in Chesapeake, Virginia. A little bit of background on this, the final word that I let a listener share a couple of weeks ago. It was a listener, her name is Lee and she wanted to voice some encouragement and support from others who wish to breast feed, try their hardest to breast feed but for one reason or another it doesn't work out and they switch over to infant formula. Beth has a comment in response to Lee, she says, "Dr. Mike I wanted to let Lee know that her words mimic my own and I was thankful for her well worded letter. I know what it's like being a mom who wants to breast feed but just can't. I have two kids ages 12 and eight and could not breast feed either one. The first go round I made it three weeks sub-supplementing formula when my one-eighth of an ounce just didn't fill my son up, pumping and more pumping and nothing changed. When I was pregnant with my second child, I researched everything so I would be ready when she was born….

0:40:00.8

"Nurse, pump, repeat was my life and my output was even less, at three weeks I threw in the towel. Past forward six years and I'm bringing a meal to a friend who had just had her baby, I was there at the end of week two and she was exhausted and crying, and her baby was crying and exhausted. This too was her second baby and second time with no milk. I assured her that she was not alone and pointed to my two healthy, smart, well-adjusted kids and said it was OK to switch to formula, food is better than starvation. It was funny in that moment we were a shamed sisterhood who bonded over our lack of milk, I think it help us both know we were not alone. Now my husband and I often joke about how thankful we are that I couldn't breast feed because if I had, then the kids will be smarter than us by now. It helps lighten the burden I felt of not being able to provide the food my kids needed and deserved. Thank you for letting Lee speak to all those women in the same boat, Beth."

Dr. Mike Patrick: Thank you for chiming in Beth. I do want to point something out here, breast feeding can be difficult, there's no question about that and there are those like Lee and Beth who give it a try and It doesn't work out. I'm sure many of you are in the same boat or someone who is in that boat, while breast feeding doesn't always work out and should not be a source of guilt, here's and important piece of advice, before giving up get some help. Put your pride aside, talk to your pediatrician or your Ob/gyn and they can provide advice and resources to get you through the difficulties. As Lee and Beth point out, sometimes our best efforts fail and we must move on, toss the guilt aside, resist the urge to buy breast milk online from strangers, and supplement or switch over to infant formula. But like Lee and Beth don't go down without a fight, breast milk is best and if you can provide it even though it's difficult you should.

0:42:05.5

But Lee and Beth's point are good ones if you've tried your honest best and you've sought help and that help has not worked, it is time to move on, and that's my final word. One more request before we go, as you head into the holiday season you're going to see lots of family that you don't visit with every day and they'll have kids and points of discussion will arise regarding the health of those kids and this will be great opportunity for you to spread the word about PediaCast. We all know that trustworthy, evidence based child health resources are hard to find, the best place is your pediatricians' office, but one of the next best place is right here on PediaCast. Be sure to warn your family and friends to be careful with emotion driven discussion boards, fly by night blog posts, and run of the mill web sites. Sure there's a mountain of every possible opinion out there.

0:43:01.4

If you want to believe something you're going to find the place of support online, you're going to find others who believe what you believe and they're going to make you feel all warm and fuzzy inside, but what's the truth? What should you really believe as you make those day in and day out parenting decisions? We want PediaCast to be one of your trusted sources to find out and we want more parents to know about our program. With the holidays upon us you can help us do that, please consider paying forward as those who came before you did. You found PediaCast in some fashion, maybe from friends or family last year during a holiday gathering, maybe it was a shared post on Facebook, or review on iTunes, or maybe your pediatrician told you about the program. I'd simply ask that you do as they did and just help us spread the word about the program. I do want to thank all of you for taking a time out of your day to make PediaCast a part of it. Don't forget PediaCast and our single topic short format programs PediaBytes are both available on iHeart Radio Talk which you'll find on the web at iheart.com and in the iHeart radio app for mobile devices, iOS and android.

0:44:12.0

Reviews and comments on iHeart Radio and in iTunes, that's one of the ways that you can help spread the word and those would be most helpful. Links, mentions, shares, re-tweets, re-pens all those things on Facebook, Twitter, Google Plus, and Pinterest because we are in all of those bases. Please share and share a like and let others know about the program both online and offline during your holiday gatherings this year. Also be sure to tell your child's doctor about the program if you haven't done so already when you go in for the next well check-up, or sick office visit, or ADHD re-check, medicine re-check. Be sure to let the office staff know about PediaCast so they can spread the word to their other patients. We do have posters available under the resources tab at pediacast.org.

0:44:57.2

One more time, the way to get in touch is to head to pediacast.org and click on the contact link, I read each and every comment that comes through there, if you do have a topic that you'd like us to talk about, if you have a comment that you would like considered for our final word segment, or if you just have a question you'd like to ask, just head over to pediacast.org and click on the contact link. We do have a connect with the pediatrics specialists from Nationwide Children's, that's for referrals and appointments. If you just want to get in touch with our hospital, maybe you want to see one of our specialist who manage your child's health problem or for a second opinion, just an easy way to get in touch and you'll find that in the show notes as well. Until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involve with your kids, so long everybody.

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0:45:59.5

Announce 2: This program is a production of Nationwide Children's, thank you for listening. We'll see you next time on PediaCast.

0:46:06.9 

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