PediaCast 157 * Smoke Alarms, Depressed Dads, Poop Uckies

Welcome to another pediacast with Dr. Mike!  Today he will be discussing smoke alarms, depressed fathers, how anesthesia may be linked to learning problems, and anger in young boys.  Dr. MIke will also answer listener questions dealing with the social implications of not watching TV, toddler beds, poop uckies, and the accuracy of Googling health information.  

Topics

  • Home Smoke Alarms
  • Depressed Fathers
  • Anesthesia Linked To Learning Problems
  • Dealing With Emotions in Young Boys
  • Social Implications of No TV
  • Transitioning From Crib to Toddler Bed
  • Poop Uckies
  • Googling Health Information

Links

Transcript

Announcer 1: This is PediaCast.

[Music]

Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from Birdhouse Studios, here is your host, Dr. Mike!

Dr. Mike Patrick: Hello, everyone, and welcome to PediaCast. It is episode 157, 1-5-7, for March16th, 2011. We're calling this one Smoke Alarms, Depressed Dads, and Poop Uckies.

01:00

so what exactly is poop uckies? Well, you have to wait and we'll get to that, one of our listeners wrote in with a question about that eerie topic, so we'll get there. This is usually the part in the show when we have a little light heart adventure, you know,talk about what's going on in life and in the world. But you know, there's really not a lot of light things to talk about today.

My heart is heavy and I'm sure that many of you feel the same way just with what's happening in Japan. After the 9.0 earthquake and a devastating tsunami, and now the nuclear crisis that's unfolding. It's just a one, two, three slam that's horrible, and it's very difficult to look at the pictures and not think about the people who are affected.

I mean, it's one thing to see pictures of destruction and you see this nuclear power plants, and the smoke, and the radiation, and just the horrid devastation that this is causing.

02:08

And we have to keep in mind that there's kids there too. And just as all of- most of you have kids at home or take care of kids as a provider in one way or another. There are hundreds of thousands of children who are in these conditions right now as we speak.

And it's just troubling. So I thought instead of talking about anything that really doesn't matter at this point, we probably ought to just take a couple of minutes here, about a minute and a half and just pray and reflect and really sort of as one big collective audience, just put our thoughts toward the folks in Japan. So let's do that.

[Music]

04:00

Dr. Mike Patrick: All right. I know it's hard to sometimes be serious with that upbeat music, but this is really, really a devastating situation and just my personal prayers and like I said I think our collective prayers really go out to the people in Japan and the families, and the children,, and just everyone who is affected by this. And also the folks in charge and the rescue operations.

We just really pray and hope for safety for all those involved. So really here at PediaCast our hearts go out to all of you in Japan right now. All right. Well, we're going to talk about today in our news segment we're going to talk about home smoke alarms, also depressed fathers, anesthesia is linked to learning problems, maybe, we're going to discuss that.

Dealing with emotions in young boys especially like anger and really intense emotions, how do you deal with that in young boys to prevent problems down the road. Then we have some listener questions, the social implications of not watching TV.

05:01

We hear about the bad things that TV can do to you, for you and the question becomes well, OK, so we take TV away, are there social implications of that? And then we're going to talk about transitioning from kids to toddler beds, and then poop uckies. I told you it would get to that. And then finally we're going to do a research round up, Googling health information, how accurate?

What kind of information comes up in the first few pages of Google search results, so we'll talk about those things. Don't forget if you like to get a hold of us here at PediaCast, it's very easy to do just go to pediacast.org. We have a brand new redesigned website for you and you just click the contact link, and you'll be able to get in touch with me.

You can also email pediacast@gmail.com, or call the voice line at 347-404-KIDS, that's 347-404-5437. I want to remind you that the information presented in PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, call your doctor and arrange a face to face interview and hands on physical examination.

06:12

Also your use of this audio program is subject to the PediaCast terms of use agreement which you can find at pediacast.org. And with that in mind, we will be back with our 'News Parents can Use', right after this short break.

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Dr. Mike Patrick: Our News Parents Can Use is brought to you in conjunction with news partner Medical News Today, the largest independent health and medical news website. You can visit them online at medicalnewstoday.com.

07:05

In Australian study to determine the likelihood of school aged children waking up to their home smoke alarm, found that 78% of children slept through a smoke alarm sounding for 30 seconds. The outcomes of the study are published in the journal Fire and Materials. Home smoke detectors have been relied on since the 1960s, and have been known to save lives in domestic fires.

The study result show, children are most at risk of not waking up to the sound of their home's smoke detector. Though related studies have been conducted in the past, the sample size used in this study has been the largest to date. In order to gather data for the study, parents of 123 children were asked to trigger their smoke alarms for 30 seconds after their child or children have been asleep for one to three hours.

Sixty boys and 63 girls were included in the study and the average age of the kids was 8.82 years. The group was split into two age group, so that the younger group would be prepubescent and this is because plasma melatonin levels dropped with puberty onset, and the melatonin hormone is known to be sleep inducing.

08:08

About 70% of the participants were aged five to 10 and 30% from 11 to 15. Parents reported whether or not their children woke using a research website, and the results showed that 78% of the children slept through the alarm. Of the small number of children who did wake up, only half recognized the sound as a smoke alarm, and only half of those children knew they should evacuate. The data collected also showed younger children (five to ten years old) were significantly more at risk, with 87% sleeping through the alarm, compared to 56% of 11-15 year olds.

"Parents should not rely on their children waking up to the smoke alarm in the event of a fire and should not assume that they will immediately evacuate if they do wake up to a fire," says Dr. Dorothy Bruck, lead author of the study at Victoria University in Melbourne, Australia.

"In summary, home safety plans should not assume children will wake up to an alarm. This data suggests fire safety training needs more emphasis on the need for children to evacuate the home in the event of an alarm sounding."

09:09

Each of your bedrooms at home including your children's bedroom should have a working smoke alarm and of course they should be in other locations as well. With regard to the this study, it definitely want the alarms in the bedroom, of course you want fresh batteries, make sure you change those at least twice a year.

Test the devices frequently and do a middle of the night test to see if your alarm wakes your child. You could even try to get one spouse asleep and just wake up one and do it, and see if your spouse wakes up. And it's not a bad idea for families to have a middle of the night fire drills. And you might have to experiment with different detectors to see which one is going to wake everybody up the best.

All right. We're going to move on. 41% of depressed fathers were found have spanked their child compared to 13% of non-depressed dads, that's according to researchers from the University of Michigan in Ann Arbor and published in the journal Pediatrics.

10:04

Dr. R. Neal Davis, and team gathered information on 1,746 dads with 1-year-old children from the Fragile Families and Child Wellbeing Study. Positive parenting behavior includes playing games, reading stories, and singing songs with a child at least 3 days in a typical week.

Negative parenting behaviors include spanking. They used the World Health Organization Composite International Diagnostic Interview Short Form -the form may be short, but the name isn't, to assess depression in fathers.

They found that approximately 7% of all dads were suffering from depression. They also found that a father with depression is considerably less likely to read to his child. On the other hand, they report that depressed and non-depressed dads were just as likely to play games, sing or talk to their children. The researchers believe these activities are more routinely performed by fathers than reading.

77% of fathers with depression said they had talked to their child's pediatrician during the previous twelve months. Therefore, doctor's visits might be an ideal opportunity to talk about specific parenting behaviors (to screen for depression) and refer dads for appropriate therapy.

11:14

The only problem with that recommendation I see is there's already precious little time during health well check up exams. Now I'm not saying it's not important to figure out if dads were suffering from depression, I'm just saying, it's not always practical because there are so many other things to cover and most pediatricians out there, schedules are pretty jam-packed and you got to get through all the health information.

You know, the growth charts, the physical exam, and all the anticipatory guidance. So sometimes it's hard to fit those things in. Now, I know if you're going to criticize a recommendation or say that recommendation doesn't really go far enough, or isn't practical, you want to take the time to give a better idea, right?

So I say, we need a campaign to place daddy depression checklist above the urinals in restaurants, in sports and entertainment venues.

12:06

Now you laugh, but you also know that it would work. It's a place that dads would definitely take the time and you could just have a little checklist of the symptoms of depression and then a contact phone number for local resources to get help.

And moms out there, is dad depressed? If so, help him get help. He'll be a better husband and a better father. And if you want to know all the signs of daddy depression, there will be a link in the Show notes at pediacast.org to WebMD's Depression Guide, so that will be waiting for you there in the Show notes for episode 157 at pediacast.org.

An estimated four million children receive anesthesia every year, not just for surgery but for diagnostic procedures like MRI and CAT scans, but little is known about their effect on the developing brain. A growing body of data from studies in animals suggests that under certain circumstances, prolonged anesthesia could adversely affect neurologic, cognitive, and social development of neonates and young children.

13:09

Now, anesthesia is both necessary and helpful however, and too little can even be harmful for kids. A landmark study published in the early 1990s found that a newborn's chance of surviving a heart operation improved dramatically if he was given deep rather than light anesthesia. So the stress of pain, it turns out, makes surgery riskier.

Well, this week a federal panel met to evaluate growing concerns about whether anesthesia in young children, used in millions of surgical procedures, can in some cases lead to cognitive problems or learning disabilities. Dr. Bob Rappaport, the Food and Drug Administration's director of the division of anesthesia and analgesic products wrote in a related article this week:

"These drugs can cause cognitive disturbances in juvenile animals. We don't know what this means for children at this time. That's exactly why it's so critical that we get all of the necessary information."

14:00

Studies in rodents and monkeys have shown that exposure to anesthesia at a very young age, roughly corresponding to under age 4 in humans, is associated with brain cell death. And a new study, by the FDA's National Center for Toxicology Research, found that exposing 5-day-old rhesus monkeys to 24 hours of anesthesia resulted in poor performance on tests of memory, attention and learning. OK. Most children aren't getting that much anesthesia at a time, but we'll keep listening.

Dr. Randall Flick, associate professor of anesthesiology and pediatrics at the Mayo Clinic comments: "You don't have to be a rocket scientist to say, 'Geez, if this happens in monkeys, then there's a high probability that something like this occurs in humans.' Or at least in humans who are getting 24 hours of anesthesia.

"In one 2003 study, scientists found that a combination of three anesthetic drugs given to seven-day-old rats resulted in brain-cell death at a critical time in brain development. And rats that received the medications had persistent learning and memory problems.

15:01

That study and others got the attention of pediatric anesthesiologists and neurologists and prompted the Food and Drug Administration to organize a meeting in 2007 to discuss the research. At that time, FDA scientists stressed that there was no evidence that anesthesia caused problems in children, but they called on the anesthesia community to continue to study the medications.

In a special report published last year, FDA researchers said anesthesiologists should "attempt to minimize exposure to potentially offending drugs when possible, to consider alternative therapies as may be available, and to remain vigilant as new information is developed."

To galvanize research, the F.D.A. has formed a public-private partnership with the International Anesthesia Research Society. Dr. Nancy Glass, a pediatric anesthesiologist at Texas Children's Hospital and president-elect of the Society for Pediatric Anesthesia concludes: "We're all concerned. We don't believe there is data yet that says to us either that we should change our technique or that we should frighten parents about allowing us to anesthetize their children for unnecessary surgery."

16:03

The word here of course is necessary. But what about maybe necessary procedures, or probably not necessary procedures? What about tonsil surgery, and ear tubes? Well the evidence is not completely in, but there's a good chance there is a relationship that exist between anesthesia, cell death, and thinking problems. So that's a point to consider when you're running through your list of pros and cons for any anesthesia requiring procedure.

The way you react to your two-year-old's temper tantrums or clinginess may lead to anxiety, withdrawal and behavior problems down the road, and the effect is more pronounced if the child is a boy who often displays anger and social fearfulness. That's according to a new University of Illinois study to be published in the May issue of the journal Social Development.

"Young children, especially boys, may need their parents' help working through angry or fearful emotions. If you punish toddlers for their anger and frustration or act as if their fears are silly or shameful, they may internalize those negative emotions, and that may lead to behavior problems as they get older," so says Nancy McElwain, a University of Illinois associate professor of human development.

17:10

McElwain and lead author Jennifer Engle examined data gleaned from observations of 107 children who were part of a larger study of children's social and emotional development and parent-child relationships.

When the children were 33 months old, mothers and fathers were asked how often their child had displayed anger or social fearfulness in the last month. The parents were also asked how they would respond to the child's negative emotions in several hypothetical situations.

Engle says, "We investigated two types of parental reactions to children's negative emotions. One type of reaction was to minimize their child's emotions; for example, a parent might say, 'Stop behaving like a baby.' Another type of reaction was punishing the child for these emotions. A parent might send the child to his room for crying or being upset, or take away a toy or a privilege."

18:00

When children reached 39 months, parents answered questionnaires about their child's current behavior problems. Moms and dads who were apt to punish their kids for their fears and frustrations were more likely to have children who were anxious and withdrawn at the time of the second assessment. And the effect was especially pronounced for boys who had been identified as having a high incidence of negative emotions at 33 months. "When parents punish their toddlers for becoming angry or scared, children learn to hide their emotions instead of showing them. These children may become increasingly anxious when they have these feelings because they know they'll face negative consequences."

The researchers are intrigued with the finding that little boys were especially affected when they're not supported during times of fear or frustration. "In our culture, boys are discouraged from expressing their emotions. If you add parental punishment to these cultural expectations, the outcome for boys who often experience negative emotions may be especially detrimental."

According to the researchers, parents play an important role in helping children learn how to regulate and express their emotions. This study, which gathered responses from both mothers and fathers, adds to a growing body of work that suggests that both parents are important in this process.

19:11

Engle sums up, "When children are upset, it's better if you can talk with them and help them work through their emotions rather than sending them to their room to work through their feelings on their own. Young children, especially little boys who are prone to feeling negative emotions intensely, need your comfort and support when their emotions threaten to overwhelm them."

So it pretty much speaks for itself. So if you have a little boy at home really give that some careful consideration. All right. Well that wraps up our News Parents Can Use for this week. And we'll be back to answer your questions, right after this.

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20:12

Dr. Mike Patrick: All right. We are back with our listener's segment and first up is Meg in Harrison, Ohio. She says, "Thank you for your hard work and for giving me tremendous information that I may well have never found out about from other sources. You're doing a great service for parents and for doctors by providing unbiased information.

As the daughter of a doctor, the famous words, "Let me see the study and evidence about what you just told me", set with me from the mouth of my father. I appreciate when doctors and other professionals present information in its whole. I love listening to your podcast while my little ones are napping and I'm working out. Thanks for the thanks, Meg.

Next up, social implications of no TV. This comes from Gem, it's such a glowing name, in Colorado. And Gem says, "Hi, Dr. Mike. I'm so glad you're back and now able to do regular podcast shows.

21:01

My toddler will be turning two soon, and I've been thinking about how we'll deal TV in our house. In general I believe the less TV the better, however will being unfamiliar with popular shows be a handicap when my son starts developing friendships with other children. Have there been any studies looking at the social implications for children that don't watch the same TV shows their friend do? Thanks for the information, Gem."

I agree with your statement Gem, the less TV, the better. It's better to read, and play, and do puzzles, and games than watch TV. And there are plenty of studies showing this to be the case. There are studies that have linked TV watching in kids to obesity, poor diet, decreased physical activity, earlier initiation of sexual activity, drug and alcohol use, and delayed literacy.

Now, in terms of study showing negative consequences of not watching TV, I've never come across one of these and I did a quick literature search to see if anything interesting popped up, and it didn't.

22:02

So without studies to back me up on this, where do I stand? Well, in terms of socialization, social situations on television especially children's programming and other programming as well.

Those social situations on television are not in my opinion reflective of social situations your child will likely encounter, unless he lives in a pineapple under the sea or on a luxury hotel, goes to school on a cruise ship, or lives in a household of wizards, right?

Now, will your child suffer because he can't talk a certain show around your school's proverbial water cooler? Probably not. All right. Most certainly not. Here's an opportunity to turn the conversation to his or latest read, whether it's Eric Carle "The Magic Tree house", Encyclopedia Brown, Harry Potter, or the latest Maximum Ride installment. How about bringing up sports or music, or any of the hundreds of non-TV related discussion possibilities.

23:00

Maybe your child will be the instigating force driving down the TV time of his classmates. So there's an interesting concept, less TV goes viral in the elementary schools. Of course I maintained that a little bit of TV is OK if you'd like, as long as the show is appropriate for your child's age and as long as it's practiced with a generous, generous dose of moderation. In the end I like the way Gem puts it to less TV, the better.

All right. Moving on to April in San Rafael, California. April says, "My son is almost 28-months-old and he just learned how to climb out of his crib. Yeah, that's not good. I'm wondering if I should get a crib tent and keep him in his crib a little while longer or shall I try to transition from the crib to a big boy bed.

I know it probably depends on your child, but do you have any advice on when is a good time for transitioning from crib to bed? We live in a small apartment and I have a fear of him wandering in the night or early in the morning and getting into things he shouldn't.

Just an FYI, my house was pretty baby proof until the smart little guy realized he could push a chair next to the counter or anything really, and now it's a whole new world to him. He can get into literally everything

24:10

Is locking his door or putting up a gate in his doorway cool? What do you think, Dr. Mike? Thanks for your help and your podcast. Thanks for your question April. Let's tackle this point by point. The age you should transition from crib to bed is not set in stone.

You should be using an up- -to-date crib with all the current safety guidelines and no current recalls on the crib, and there should be nothing in the crib including pillows, bumpers, comforters, stuffed animals -nothing that your child can climb on and go over the rail.

Now, once your child is big enough to climb out without anything to stand on, then it's definitely time for the transition from a crib to a bed. Now let me back up, you should really make the transition just prior to his or her new ability to climb out.

25:00

You want to beat him to that milestone so he doesn't fall out. Now the next question is flat on the floor toddler bed or a regular bed?Now again there's no fast rules on this, but if you have an active kid who is going to be a jumper, I'd probably go around as possible. What about crib tents?

You know, I'm not a big fan of these. They can be safe when they're used properly and it's your preference if that's your preference fine, I'm not going to argue with you, but caged zoo animals come to mind, and getting your child out in an emergency can become a possible issue. So I'm not a big fan of crib tents and in terms of when you transition from crib to bed is really going to be different from one kid to another.

Now once you make the transition and you go from a crib to a bed, what do you do with the room? What you basically want to toddler proof the room like crazy. You're going to use outlet covers, you're going to make sure there's nothing chokable, you're going to clear out all of the toys and make sure there's nothing to climb on.

26:04

You're basically going to make the entire room into a crib with pretty much nothing in it. You can get the toys and the books out when you need them, and you're going to read and play, but you want to put everything away when they're put to sleep and you're using the bedroom now as a crib.

You also want to be careful what's in closets, in drawers that they can open. I really get down on your hands and knees and view the room from their view looking for any and all dangers. Baby gate with an open door is fine as long as it's installed properly and your child can't climb out, although many kids who would be able to climb the side of the crib would likely be able to scale a baby gate as well, so closed door is probably best.

I'd have a monitor in the room so you could hear and/or see exactly what's going on. If you don't want to lock the door you could use a child proof door handle on the inside, the kind you have to squeeze a certain way in order to get it open. So that's my take on your plan April.

And gates and locked doors aren't cruel, although again you kind of sort of be careful about how you're locking a door because in an emergency you'd want to be able to get in there right away and not be fiddling around with trying to get the door open.

27:13

But allowing your child to fall out of the crib or confining him to a room with safety dangers or allowing her to roam the house at night, that is cruel. All right. So finally in our listener's segment, poop uckies, now again, yup you heard me right.

This one comes from Renee in Green Bay, Wisconsin. She says, "Dr. Mike, I'm a fan of your podcast. Thanks for all the great information that you make available to your listeners. My daughter just turned 16-months-old and up until two or three weeks ago, she loved taking a bath. She would run in and quickly disrobe and just jump in.

She had a couple of accidents in the tub. In some wash, she was diaper free waiting to go in. It was our mistake because the first time we didn't really know what to do. So we scooped it out and showed her where it goes and flushed it down.

28:03

This happened about three times in a row and we tried to be very calm about it and delayed her bath time so we knew she wouldn't go in the tub. Anyway, it's about three weeks later and now she's afraid of the bath because any little speck of dirt or hair, she thinks is uckie and will immediately start crying and nervously marching saying, "Uckie all done. Uckie all done."

It's to the point she doesn't sit down or enjoy bath time like she used to. What can we do to turn this around? Is this the stage? I asked because she'll stop eating to have her hands wiped or she'll bring me fuzz that she finds in the carpet. Looking for some advice. Thank you."

Wow, Renee!I have to tell you, you just described my now 16-year-old daughter when she was 16-months-old. So I think you have a little OCD on your hands, but nothing that's took concerning. You already have some good stories for the future and you'll likely have many before it's all said and done. The dirty hands and carpet fuzz are no biggie, and in addition to those you're probably dealing with sock fuzz between the toes if she wants her socks on at all.

29:06

Car seat belt straps, or I should say car seat straps, she shouldn't be in a seatbelt. But car seat straps that are not sitting just right, you know if something's a little crooked or her coat or sweater something is bunched up under her straps you know, she's going to let you know about it.

For some kids you know, their toys have to be in a certain order, or the same beverage has to be in the same cup at the same time of day. Can you tell I've dealt with this personality type before and I'm sure there's plenty of moms out there right now nodding their head, nodding their collective heads in understanding.

So what do you do about the uckies in the tub? Well, first and this is going to seem a little obvious, and you hit on it and I'm just making this point for other parents who maybe going through the same sort of thing. You do want to make sure she goes to the potty just prior to bathing. So if you see her doing the stop, squat, and push dance, get the tub pre-rinsed, and start running the bath water, right?

30:03

Pre-rinse, so that there's no little specks and fuzzes that are going to the surface. You want a nice, clean tub, start running the bath water. And then ones she's naked, check her head to toe for fuzz especially between the toes, sock fuzz is probably the most common of all the fuzz species. But look at other cracks and crannies as well.

Now once she's in the tub, if you do get a floater, I would scoop it out, and if she goes into uckie mode, all you really have to do is distract her. Now I know that's easier said than done, although it gets easier as time goes by. But you want like a really special toy, something she'll really like that when she starts to get upset you're like, "Oh, hey! Look at this." You know really just take her mind completely off of the uckie.

So if it's something that looks really cool, that's made for the bath. Now of course then the next time she takes a bath she's going to ask for it and you know, you may have it there the first few times, but then if something does start to float, then she can get the toy.

31:05

If you get to the point where she needs to find something that's floating -I mean, you could put a little, well, save a little fuzz and put it in there and make it sort of a game like, "Ooh, there's the uckie', you know, and then you can scoop it out, and then she gets the cool toy. And then eventually she'll just get the cool toy, and then the uckies aren't as big of a deal.

I mean, you could also blow bubbles, you know, when she starts to do the uckie dance, something different that really grabs her attention that will take here mind off of the uckie dance. So blowing bubbles, or a little squirt of shampoo or liquid soap into the water to make the uckie all gone after you scooped it out.

It's all kind of creative, fun things that you can do. You got to be creative, you got to be persistent, and you don't want to give in to the uckie dance in order to extinguish its behavior. And pretty soon like I said, she'll be looking for floaters so she can fish them out and get whatever cool that they bring. All right. Well that's my 2 cents anyway which is probably only worth about a penny in this recession.

32:04

All right. That puts a wrap on our listener's segment for this week. We will be back and we're going to add to our Research Roundup, right after this.

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Dr. Mike Patrick: All right. We're going to head into our Research Roundup. Before we get started with that, I just wanted to mention and we've talked about this before, but I just wanted to put another plug in for it, and that is our Miracles At Play campaign, it's going on here at Nationwide Children's Hospital.

33:01

And it's really easy if you just go to miraclesatplay.org, we're basically trying to raise money that's being given by a private donor. And for every person who follow Nationwide Children's on Twitter or Facebook, or registers with their email address, for each person who does that, we get a dollar up to $100,000. And so we're trying to reach that 100,000 mark.

So if you haven't done that, would appreciate it. It's $1.00 for any of those things. And each and every of those things I should say. So if you do all three we get $3.00. So, it's pretty easy to do, just go to miraclesatplay.org and it helps to raise money for Nationwide Children's Hospital.

So you're not in our service area, why would you care? And the reason is because lots of research goes on here, and it's one of the largest children's hospitals in the country, in fact in world. We do treat kids all over who come in to see many of our sub specialist from all over the place.

34:05

So really you are supporting a very large pediatric institution that really is contributing to the health of kids everywhere. I also wanted to mention some of these, we would have done in the intro, but we wanted to take some time out to think about Japan.

Something else I've mentioned lately that I have it in the past and I'd like to start thinking about more. And that is now that we have Nationwide Children's Hospital on our side, to really talk to your pediatric provider whether that's a pediatrician or a family practice doctor, or a nurse practitioner and tell them about PediaCast.

You just let them know, we're evidence based medicine source of information for parents on pediatric topics. We're produced by Nationwide Children's Hospital. So it's a really good quality source of information that you can trust about child health topics. So just make sure you share our show with your providers so that they can share it with other patients.

35:05

They're more than welcome to make signs for the rooms or if you wanted to make a sign for the exam rooms at your doctor's office, that would be great. Soon we should have some downloadable material on the website that providers would be able to download, and print off and hang in examination rooms. That should be coming up in the next week or two.

All right. Let's move on a Googling health information. This is a study that comes out of Nottingham, UK. The authors are Paul Scullard, Clare Peacock, and Patrick Davies. and it was published in the archives of Disease in Childhood back in April of 2010.

So this is a one-year-old study, but it's a good one and really relevant to what we're doing here on PediaCast. So I thought it would be interesting for everyone to hear about. The question among the researchers was basically, "Among patients who access the internet for health information, how accurate is the information provided?

36:01

So for their methods, investigators used the Google search engine to get information and advice for five common pediatric questions. And they were five questions that each had a clear and distinct correct answer. So they could look and see, 'OK, the websites that we get back on Google are they giving us good information or not?"

So what were the five questions? Well, the first one; Is there a link between MMR and autism? Number two; Should an HIV-positive mother breastfeed? Number three; Should a mother with mastitis breastfeed? Mastitis is a breast infection. Should they breastfeed?

Number four; Should a baby sleep prone or supine? On their belly or their back? And Number five; What action should be taken for a baby with green vomit? So these were the questions with there's no question about what the answer is. There is a definite right answer and they just wanted to see if the search result revealed sites that provided the correct answer.

37:05

So for each of the five items, researchers basically assessed the first 100 websites that appeared and that include any Google advertised links as well. So the first 100 websites that appeared including the Google Ads, and they categorized them into seven types of websites, government, educational, news, company websites, interest groups, individual websites, and the sponsored links, so the Google Ads.

Now again there's 100 websites they looked at for each of these five questions. So all together we have 500 websites that we're looking at. So what were the results? Well, the correct answer was provided of the 500, 197 times. So the correct answer was only provided in 39% of cases. Now to be fair, the question was not actually answered on many of the sites. So if you do a question on what shall I do if my baby is vomiting green? It may not have an answer for you.

38:07

So the next thing they did was they basically threw out any websites that did not actually have an answer. So when you discount those, now we're up to 78% of the websites did give the correct answer. But you'll be surprised when we actually break down -that we actually break down the result here.

Instantly incorrect answers then were provided 11% of the time. OK. So, what about correct answer breakdown? So if you throw out all the websites that did not have an answer, and we're just going to look at "Did all of the remaining websites who gave an answer, give the right answer or an inappropriate answer?

And we'll do it by category and then we'll break it down by question. In terms of the government category, 100% of the time if the answer was there, it was correct.

39:04

So government websites were very reliable. So this is going to be you know, the CDC, the FDA, any national health service type websites for instance in the UK. So government websites are very reliable, 100% of the time if they answered the question, the question was answered correctly.

Educational websites, company websites, interest group websites, and individual websites those were all correct 80% of the time. 80% of the time they gave the correct answer if they gave an answer. OK. What about news websites?

Well, news websites were correct, gave the correct answer 55% of the time. So they only gave the correct answer 55% of the time. What about sponsored links? So the Google Ads if you click on those. Those gave the correct answer, you'll going to love this 0% of the time.

40:02

So never was there a correct answer given in any of the sponsored websites. I have found that pretty interesting, really. What about if you break it down now instead of by looking at the category if you break it down in terms of the actual question. So if you go back through and you're juts looking at the questions themselves, what percent of the time did you get a right answer for the question?

And the results are a little bit surprising as well. We're going to go in order of most to least. The mastitis, breastfeeding question was answered correctly 59% of the time. The MMR/autism question was correct 44% of the time. The infant sleep position question was correct 43% of the time. The HIV and breastfeeding question was correct only 35% of the time. And the what to do if your baby is vomiting green, that one was only correctly answered 17% of the time.

41:10

So the conclusion of the researchers was that the quality of medical advice provided by the internet is variable and physicians should strive to be the major source of healthcare information for their patients and should refer their patients to reliable internet sources.

So this study is of course near and dear to our hearts as of course we are committed to making PediaCast a trusted source of evidence based information. So again as we sort of eluded to before we went through this research study is make sure you just let your own doctors know about our program here at PediaCast. Just send them to pediacast.org.

And since we are committed to these goal of providing or being a trusted source of evidence based information, let's go ahead and answer the five questions. First; is there a link to MMR and autism?

42:01

And that answer is: No. There is not. And that is based on research. So if you looked at any research study that's been done, that is credible, and there's only one that was not credible, but there have been many subsequent studies which show that there is no link between MMR and autism, and of course that one study that did show it was a very, very flawed study with a low sample size, it was retracted by the journal who published it and it really was just bad science.

And subsequent studies have been done which have been well designed with large sample sizes and they have all shown that there is no link between MMR and autism, and it's not a big all in compassing conspiracy within the medical community to fudge the subsequent studies to make it appear as if there's not a link. There is no link.

43:00

OK. Should an HIV-positive mother breastfeed? This answer might surprise you. The answer is: Yes. But with the caveat they should also be taking anti retroviral drugs throughout the breastfeeding period -the baby should.

All right. Should a mother with mastitis or a breast infection breastfeed? The answer is: Yes. Should a baby sleep prone or supine? So on their belly or their back, you guys know the answer to this one. They should sleep supine or on their back. And so when can you put them on their belly?

The answer to that for me is you always put them on their back. If they are at the age where they're able to flip themselves over onto their belly, and flip themselves back, so in other words if they can move themselves from front to back, then you put them down on their back, let them do their thing.

You don't have to go in and flip them back on their back every time they go on their belly because if they're at the point where they can move in either direction, it's OK. And that's really not going to be until they're probably five or six months old that they're able to really do that. So, just always put them on their back.

44:10

The other thing with that is though again, we mentioned, don't put anything else in the crib so that your child doesn't climb up on those things and climb over the rail and fall. The other reason that they don't have anything in there is because if you do have a baby who's just starting to learn to flip themselves, you don't want them to get onto their belly, flip themselves from their back to their belly, and then have their head down in a pillow or a blanket, or a bumper, or stuffed animals or any of those things.

So that's another reason even in younger kids who are at risk for climbing up on stuff and falling over the crib rail. You also don't want things in younger baby's cribs, really you don't want anything in any crib's baby, but for the younger ages it's so that they don't get their head in and then suffocate on anything.

OK. And then finally; what action should be taken for a baby with green vomit?

45:03

And the answer to that is: Seek medical attention immediately. Call you pediatrician and if you can't get in touch with your doctor, immediately go to the emergency department or go to the emergency department. Do not pass go, do not collect your $200.

Infants who are vomiting green could have a bowel obstruction which can quickly become life threatening. All right. So that roundup our Research roundup, and we will be back, we're going to wrap up the show, right after this.

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46:06

Dr. Mike Patrick: All right. We're just here now, just basically to wrap up the show. We have not had interviews yet. I know you're saying, "Dr. Mike, you said you're going to Nationwide Children's Hospital, you got this new studio, where are the interviews?

And we're still having little technical difficulty with the whole interview process, but they shouldn't be too much longer. Another week or two and we'll break those out for you. Also I do want to thank several folks for helping us out with PediaCast.

The Nationwide Children's Hospital obviously, Medical News Today helping us out with the news segment, Vlad over at vladstudio.com,. Vlad is a artist in Russia. And he is the designer of our logo. And so if you would be so kind as to visit his site, vladstudio.com.

Also the folks at Wizard Media, would like to thanks them, and of course thanks to all of you for helping us out and listening, and spreading the word and telling PediaCast -telling all of your friends about PediaCast.

47:06

You know I feel little subdued today, and I really think we've actually gone through the material a little quicker that we usually do because I haven't been as chatty. But things going on in Japan are really frightening and bothersome. And this whole nuclear catastrophe that's sort of unfolding is really worrisome.

So I'm not trying to panic anyone and certainly not time to -if you're in the United States to run out and buy iodine tablets and all that business, but it's unless the surgeon general says you should.

I think the latest on the West Coast was might not be a bad idea, but we're not saying to do it. That protects against thyroid cancer by the way. So anyway, it's disturbing, it is very disturbing. And so our prayers and thoughts definitely go out to those in Japan.

48:04

All right. Reminders reviews on iTunes are ever so helpful. If you came across PediaCast because you were looking through iTunes, and you read the reviews, and thought,"Hey, I'll give this a try." If you wouldn't mind just contributing your own review would be ever so helpful.

Also if you have a blog, or you have a presence on Facebook, if you could mention PediaCast with a link that would be super fantastic. We are by the way, we are on Facebook and we also are on Twitter now.

So if you go to pediacast.org there is a link there to get you on our Facebook page and into our Twitter account as well. Of course we mentioned that tell your doctors, tell your providers about PediaCast and I want to remind you we also have an Android app that you can download from the android store that just helps you to stay in touch with PediaCast a little bit easier.

49:02

Don't forget if there is a question or a concern, or comment, or anything else that you would like to let us know, you can go to pediacast.org, and click on the contact link, you can get to us that way. Also email pediacast@gmail.com, or you can call the voice line at 347-404-KIDS, 347-404-K-I-D-S.

All right. And until next time which hopefully would be next week. This is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everybody!

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