Measles, Junk Food, Depression – PediaCast 403

Show Notes


  • This week we cover more news parents can use! Topics include screen-free week; the impact of motherly depression on her child’s IQ; liquid nicotine and e-cigarette safety; protecting children from junk food ads; and dangerous complications of ear infections. We’ll also ask the question: are measles still deadly? We hope you can join us!


  • Welcome to Screen-Free Week!
  • Mom’s Depression & Child’s IQ
  • Are Measles Still Deadly?
  • Dangers of Liquid Nicotine
  • Protecting Kids from Junk Food Ads
  • Dangerous Ear Infection Complications



Announcer 1: This is PediaCast.


Announcer 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's 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's Episode 403 for May 2nd, 2018. We're calling this one "Measles, Junk Food, and Depression". I want to welcome everyone to the program. 

We have another installment of News Parents Can Use for you this week. And in addition to the topics I mentioned in the title, so measles, junk food and depression, we're also going to cover liquid nicotine and e-cigarettes. Also, ear infection complications. 


So lots coming your way this week. I'll give you a little more information about each of these topics to help you determine if this is an episode of the program that pertains to you and your family. Or if your time is better served listening to a different episode of the program. 

By the way, that's why we do the sneak peeks in the show intro. You may have wondered about that. Why not just dive right into the news stories themselves? You know, the title is brief. It doesn't give you the context or the direction that we're heading with any particular topic. 

For instance, we could talk about depression for hours and hours. There's a lot of different things that we could say about depression. But in this case, we're going to explore how depression in mothers affects the IQs of their school-aged children and why knowing that association is important for your family. 

You can't really express that in an episode title. And I always find it frustrating when I listen to a podcast. All excited because a certain topic shows up in my feed, I see it in the podcast title. I listen, only to discover like 20 minutes in or so this wasn't the coverage I was expecting. Thank you very much, podcast producer, for wasting a little bit of my time. 


So because of that experience, I always like to give just a little context and direction right from the get-go so you can decide if you want to stick around or bail. I mean I'd love for you to stick around. But moms and dads are busy, and I want to respect your time. So, that's why we do it. 

So, there is one sneak peek for you. We'll get to the others in a moment. 

First though, it is Screen-Free Week which is brought to you by a host of organizations, including among many others, the American Academy of Pediatrics, the Childhood Obesity Foundation, The Emily Program, the National Association of Elementary School Principals, the National Association of School Nurses, the Outdoors Alliance for Kids, Parents Across America, Reach Out & Read, the Society for Developmental and Behavioral Pediatrics, Stop Marketing to Kids Coalition. And we have lots more to say about marketing to kids later in the program. But lots of organizations came together to make this week possible, over 100 in all. 


So, what is it, this Screen-Free Week? Well, it's simply a time to say let's be intentional and unplug from digital entertainment. Except from podcast, of course. No, not really, listen to what Screen-Free Week is and then, fine, unplug and listen to the rest of this podcast next week. I'm absolutely fine with that.

So let's be intentional. Unplug from digital entertainment and spend the resulting free time that we have doing other things. Things that many of us did as kids that we don't do so much anymore, like playing and reading and daydreaming, exploring, creating, connecting with our family and friends. Important stuff that has a tendency to fall by the wayside if we don't make time for it.


The folks who brought you this week have a website, And I'll put it in the Show Notes for this episode, 403, over at It's got all sorts of tips and hints and goodies to help you get through the week unplugged. And of course, you have to use a digital device to view the website. 

And the Screen-Free folks are quick to point out, you should still use your screen for work and school assignments. The point really is set some time aside for those other things this week. And if it's not this week, do it another week. Have your own Screen-Free Week whenever you're like and consider doing it on a regular basis. Maybe once a quarter, that feels like a good place to start.

And if your family finds itself enjoying the screen-free time which may surprise you, especially if you really strive to make it fun, maybe move to a screen-free week once a month. Again, details and lots of great ideas for that are available at 


This is also a good time to mention the Family Media Use Plan from the American Academy of Pediatrics. I'll put a link to that in the Show Notes to that site as well, again, the Show Notes for this episode, 403, over at 

We've talked about the Family Media Use Plan before on this program. It's a handy tool kit that can help your family plan out the right amount of screen time that fits in with your family's other priorities and commitments and activities in a healthy way.

So I'd encourage you to check that out as well. And again, links in the Show Notes, 403, over at 

All right, what else are we talking about today? I mentioned the impact of depression in mothers on the IQs of their school-aged children. We'll also consider measles, specifically at the incidents of measles in Europe. And this is important because there are lots more cases of measles in that part of the world. We'll explore the reason why. 

And we'll take a look at the death rate among children with measles in developed countries that are similar to the USA, but they're in Europe with healthcare systems on par with the American system. The question being, does measles still kill children in the modern area of medicine?


So, legitimate question to ask, is measles really still dangerous? Well, since there are lots more cases of measles in Europe, we can take a look and see how often death occurs in kids, identify who is most at risk and consider ways of preventing death, which is always a good thing to do.

And this is all applicable to the United States because we have seen pockets of measles outbreaks here in the recent past. And it would be useful to know what to expect, how to prepare should another measles outbreak strike here at home. 

And then we'll also going to cover liquid nicotine. Now, I'm going to warn you right off the bat that when my brain has the word liquid and then another word starts with N, nitrogen usually comes next. That's just what my brain goes to, liquid nitrogen, because as the general pediatrician, we use liquid nitrogen to freeze warts. And so, I'm use to saying that and as I was preparing for this show, I even kept typing liquid nitrogen.


So, I think I've got them all fixed in my brain. It's going to be liquid nicotine but if it's slip through and you hear liquid nitrogen, you'll know why now and just replace nitrogen with nicotine because we're talking about the stuff you put in e-cigarettes.

Young kids as it turns out are getting into it which is a problem because drinking liquid nicotine can be lethal for young kids. Probably drinking liquid nitrogen could, too. But in any case, we're not talking about liquid nitrogen, it's liquid nicotine. We know that it can be lethal, kids are getting into it. 

And we know that because the National Poison Centers keep track of why people call. So we have numbers and we have numbers of emergency department visits for liquid nicotine exposure. 


So, we'll describe the scope of the problem. We'll share some safety tips. And then we're going to explore junk foods ads aimed at children. Marketers spend a lot of time trying to figure out how to effectively lure our children into convincing their parents to spend lots of money on products that can ultimately cause their harm.

So, we'll discuss educating our kids in age-appropriate ways to recognize marketing for what it is. That can actually a fun and enlightening task with the goal of helping our children and ourselves make good decisions that protect our family's health and wellness regardless of the commercials we see on TV.

Then, we'll wind down with the brief discussion on ear infection complications, things to watch for when an ear infection strikes. All of that is coming your way very soon.

First though, one more item of business, if there's a topic you'd like me to discuss on the program, if you have a question for me, you want to point me in the direction of maybe news article that you've seen or even a journal article, easy thing to do. Just head over to, click on the Contact Page and ask away. Let us know what your thoughts are, and we'll try to get those on the show.


It's easy to get in touch again, just use that Contact link at

Also, I want to remind you, the information presented in this program 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, be sure to call your doctor and arrange a face-to-face interview and hands-on physical examination. 

Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at 

Let's take a quick break and I will be back with news parents can use, it's coming up right after this.


Dr. Mike Patrick: According to the Centers for Disease Control and Prevention, roughly 1 in 10 women in the United States will experience depression. Turns out the consequences of depression in mothers may extend to their children. This, according to researchers at the University of California San Diego School of Medicine, who say motherly depression can negatively affect a child's cognitive development up to the age of 16. 

Their findings, by the way, were published last month in the journal Child Development.

The researchers surveyed 900 healthy children and their mothers living in Santiago, Chile at five-year intervals from the child's infancy through age 16. They observed how affectionate and responsive mothers were to their children at each age period and recorded how often the mothers provided age-appropriate learning materials. The children were assessed on verbal cognitive skills using standardized IQ tests during each assessment. And finally, the mothers were screened for symptoms of depression.


Dr. Patricia East, who is a research scientist with the Department of Pediatrics at UC San Diego School of Medicine says, "We found that mothers who were highly depressed did not invest emotionally and were less likely to provide learning materials such as toys and books compared to mothers who were not depressed. This, in turn, impacted the child's IQ at ages 1, 5, 10 and 16. And the consistency and longevity of these results speak to the enduring effect that depression has on a mother's parenting and her child's development."

So, just how big was the difference?

The investigators report that on a scale from 1 to 19, the average verbal IQ for all children in the study at age 5 was 7.64. Children who had severely depressed mothers were found to have an average verbal IQ score of 7.30 compared to a score of 7.78 in children without depressed mothers.


Dr. East says, "Although seemingly small, differences in IQ from 7.78 down to 7.30 are actually highly meaningful in terms of a child's verbal skills and vocabulary. Our study results show the long term consequences that a child can experience due to chronic maternal depression."

Throughout the study period, at least half of the mothers were shown to be depressed at one point or another, based on a survey with questions like, "Are you sad?" and "Do you find yourself crying?"

Dr. East says, "For mothers in the study, there were many stressors in their lives. Most of the mothers, while literate, had only nine years of education, were not employed outside the home and often lived with extended family in small, crowded homes, factors that likely contributed to their depression." 

She adds, "Many mothers suffer from depression in the first six months after childbirth, but for some, depression lingers."


Investigators report their data suggest 20% of mothers who are severely depressed when their child turns one year of age remain depressed for a long time.

Dr. East puts a practical spin on the results of her team study. She says, "For healthcare providers, the results show that early identification, intervention and treatment of maternal depression are key. And providing resources to depressed moms will help them manage their symptoms in a productive way and ensure their children reach their full potential."

Study authors say future steps include further analyzing the data to see how mothers' depression affects children's own depression symptoms throughout childhood and adolescence, as well as how maternal depression affects their child's academic achievement and health, including their likelihood of being overweight or obese.

So, depression during motherhood, it's not a good thing as we think about our children's development, intellect and well-being. 


I think this makes sense to us at face value. I'm not sure how well this particular study extrapolates to other cultures. There's also no mention of whether the moms were seeking treatment for their depression, how well treatment, if any, was working? Or if treating the depression in turn will churn the children's IQ back toward normal for the group?

These are all important questions. And while the study itself is interesting, the take-home point really is this, let's think about depression in moms. Somebody has to be the mother's advocate here whether it's her partner, her family or her doctor. 

Somebody has to identify the presence of depression in moms because there's a good chance that depressed mom may not recognize the problem in herself. She may not see her feelings for what they are. And she may not seek help on her own to detriment of her own health and well-being, and health and well-being of her children, her partner, and the entire family unit.


And this is important because we know, and we've talked about it several times on this program, that untreated depression is associated with lots of things, not just the cognitive and intellectual ability of her children. So, if you know a mother and we all know lots of mothers, think about the possibility of depression. If you see something, say something. And then support that mom and lovingly guide her to the help she needs.

The vast majority of measles cases in Europe occur in unvaccinated children. And children younger than two years of age are at a higher risk of dying from measles compared with older kids. 

This according to research presented at the 28th European Congress of Clinical Microbiology in Infectious Diseases. Dr. Manuel Robertson, presenting author and scientist with European Center for Disease Prevention and Control, also known as ECDC in Stockholm, said his group analyzed data to support European States in reaching the recommended 95% two-dose vaccine coverage. 


The team also set out to determine any possible differences between society's youngest individuals and older populations when infected with the disease. Researchers examined all 37,365 cases of measles reported to ECDC from January 2013 through December 2017. 

Researchers found 81% of all reported cases for patients who were not vaccinated. Most of these cases were in Italy, Romania, Germany, the Netherlands, and the United Kingdom with each country reporting more than 5% of the total number of measles cases. 

These countries also had the most instances of measles that had been domestically acquired rather than imported from another country. 

The study also noted that 33% of the patients, so a third were hospitalized and 11% had pneumonia. Eighty-one percent of cases involved children who were two years old or older. Of the remaining 19%, 9% were one to two years old, and 10% were younger than one year of age.


The rate which children died from the disease highlighted the impact measles had on the youngest of kids. Researchers found that 1 in every 1,000 cases of measles resulted in death. 

So, let me say that again, 1 in every 1,000 cases in Europe, when we look at 37,000 cases, results in death. And the death occurred most frequently in the youngest of patients. One-year-olds with measles were six times more likely to die compared to children at two years of age and older. And infants younger than one year of age were seven times more likely to die compare with the older kids.

Investigators say their data should be communicated widely in an effort to tackle the resurgence of measles in Europe. The World Health Organizations had set goals for the elimination of measles in rubella. One of the main actions to achieve those goals is to maintain high rates of sustained immunizations.


So, three take-home points here. Number one, the question that's often raised as we think about childhood vaccines, are these diseases still dangerous? It's a good question. Some have said the MMR vaccine was developed at the time when the treatment of disease wasn't as sophisticated as it is today. So, do we really still need the vaccine? Why not just treat the disease when it occurs?

Well, measles is a viral disease. We don't really have a lot of good tools to treat viral disease other than supportive care, things like IV fluids and respiratory support. So, treatment for measles was never really all that sophisticated and still is not all that sophisticated. 

And as it turns out in Italy, Romania, Germany, The Netherlands and the United Kingdom where these are developed countries with sophisticated healthcare systems and yet, 1 in every 1,000 cases of measles resulted in death between 2013 and 2017. So, yes, measles is still a dangerous disease. 


Take-home point number two, vaccinated children are far less likely to die from measles compared to children who have not been vaccinated. So, measles vaccine is important. It can be life saving especially among the youngest of children.

And take-home point number three, the United States is not immune to this problem. We've seen it here, not to the scale of Europe, but in pockets of unvaccinated populations including Southern California, Amish communities here on Ohio and elsewhere. Measles can and does raise its ugly head, and children can and do die from the disease. And in fact, children younger than one year of age are most at risk. 

Now, unfortunately, they can have the vaccine until they reach 12 months of age. So, young babies rely on those around them having had the vaccine to protect them from this deadly disease. 

So, please vaccinate your children, protect them against measles. You'll not only protect your sons and daughters, you'll also be protecting the other kids, young babies, those with cancer, immune systems are not working properly. In other words, vaccinating healthy children not only protects them but also protects the most vulnerable kids in your community.


A new study published in the Journal Pediatrics and conducted by the Center for Injury Research and Policy in the Central Ohio Poison Center here at Nationwide Children's Hospital found more than 8,200 calls to US poisons centers regarding exposure to liquid nicotine and e-cigarettes among children younger than six years of age from January 2012 to April 2017. 

These averages to 129 calls each month and more than 4 poison center calls each day. Children younger than three years of age are accounted for most of the exposures at 84%. And ingestion, so drinking the product, was the most common method of exposure at 93%. 

More than one-third of children exposed to liquid nicotine were evaluated, treated and released, but 1.4% required admission to the hospital. Twenty-five percent of children exposed to liquid nicotine experience one more troubling symptoms. Severe complications were rare but they did occur to some unfortunate kids and they included coma, seizure, respiratory arrest, and cardiac arrest. 


Dr. Henry Spiller, study author and director of the Central Ohio Poison Center says, "These exposures are concerning because a very small amount of concentrated nicotine solution could easily deliver a lethal dose to a young child." 

Increased concern about the risks of liquid nicotine exposure have led to state and federal legislation requiring child-resistant packaging for liquid nicotine containers in recent years.

The annual rate of exposure to liquid nicotine and e-cigarettes increased by almost 1,400% from 2012 to 2015 and then decreased by about 20% from 2015 to 2016. 


The observed decline in exposures since January 2015 is thought to be due to legislation requiring child-resistant packaging and create a public awareness of the dangers of liquid nicotine and e-cigarette products to young children.

Dr. Gary Smith, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children's Hospital says, "Although the observed decrease in exposures is encouraging, the number of young children still being exposed to liquid nicotine is unacceptably high and additional regulation is needed."

The authors recommend adding flow restrictors to liquid nicotine refill bottles, similar to those use for children's fever medications to limit young children's ability to empty the contents of the bottle. They also recommend child-resistant chambers on e-cigarette devices to help prevent liquid nicotine exposures to young children.

Additionally, the volume and concentration of liquid nicotine in refill bottles should be limited to a sub-lethal dose for an average young child. This approach has been used for decades for products like children's Tylenol. 


And to decrease exposure among young children, the authors call on the US Food and Drug Administration to prohibit the use of flavors and attractive labeling for liquid nicotine, as was done in years past for cigarettes.

The research team offers additional safety tips for parents and child caregivers. 

Be sure to store e-cigarettes and refill products where children cannot see or reach them, like you would for other poisons. In a locked location is best. Do not store these products in a purse which children can easily access. 

Use e-cigarettes and refill them alone. Do not use these products around children. Kids want to imitate adults which means using e-cigarettes and refilling with the children nearby could wind up leading to dangerous exposures as the images, the smells, the colors are likely to attract your kids.

Refill, clean, and dispose on products safely. Wear rubber or latex gloves when handling liquid nicotine, clean up spills right away with paper towels. And get rid of the leftover liquid by pouring it into a bag of kitty litter or coffee grounds.


Put empty liquid nicotine containers, paper towels, and other waste into a sealed bag and throw it away in a location kids can't find and open. Once everything is in the trash, wash your hands.

Adults and households with children younger than six years of age should be counseled on quitting the vaping habit. However, if adults with young children continue to use e-cigarettes, they are strongly encouraged not to use or store e-cigarettes, liquid nicotine, and related products in the home. 

Be sure to save the National Poison helpline phone number. It's 1-800-222-1222 in your cellphone, and post it near your home phones. The number again for the National Poison helpline, 1-800-222-1222.



Dr. Mike Patrick: Junk food ads are shown more frequently on television at times when children are watching. This, according to new research funded by the Heart Foundation, conducted by investigators at the University of Adelaide in Australia and published in the Journal of Pediatrics and Child Health.

The study also found that children were exposed to twice as much unhealthy food advertising as ads for healthy options. Investigators found children view more than 800 junk food ads each year for 80 minutes of television watch each day. 

The research team built a special TV monitoring system, believed to be the first of its kind in the world, allowing them to capture an entire year's worth of television ads from an over-the-air and freely available television network in South Australia. 


Dr. Lisa Smithers, Associate Professor at the University of Adelaide and lead investigator for the project says, "This is the most robust data we've seen anywhere. It's the largest dataset ever used by health researchers for examining food advertising in Australia and probably the world. Most research in this area is based on only a few days of data and there are no Australian studies taking seasonality into account."

Thirty thousand hours of television containing more than 500 hours of food related commercials, which works out to almost 100,000 individual food ads, we're logged during 2016. 

The Australian Guide to Healthy Eating was used to group foods and beverages into healthy and unhealthy categories. Snack foods, crumb and battered meats, takeaway fast foods, and sugary drinks were among the most frequently advertised foods.


During typical peak viewing times for kids, the frequency and duration of unhealthy junk food ads was more than twice the frequency and duration of ads for healthy food. Across the year, junk food advertising peak at 71% of all food advertising in January and dropped to a low of 41% in August.

Dr. Smithers says, "Diet-related problems are the leading cause of disease in Australia and the World Health Organization has concluded that food marketing influences the types of food that children prefer to eat, the types of foods they ask their parents to provide, and ultimately, the types of food they consume."

Some countries and/or regions have implemented children's television advertising bans completely such as in Quebec, Canada. They also have junk food advertising bans in Norway. And requirements to publish healthy eating messages when unhealthy foods are advertising, that's required in France.


In Australia, all advertising during children's TV programs is covered by the Children's Television Standards. There are other codes developed by industry groups that aim to limit Australian children's exposure to unhealthy food advertising. However, these codes are voluntary. There's also no processes for routine, independent monitoring of children's exposure to food advertising.

Dr. Smithers adds, "Australian health, nutrition and policy experts all agree that reducing children's exposure to junk food ads is an important part of tackling obesity. And there is broad public support for stronger regulation of advertising to protect children."

She says, "I would love to see the results of our research play a role in protecting children from the effects of junk food advertising."

Investigators say, "Their specially designed TV monitoring system which uses a television tuner attached to a computer has the potential for use across all Australian markets, as well as internationally."

They say, "This is the kind of thing that would be fairly easy to set up to monitor change over time and to evaluate the impact of different policies."


For example, researchers are now using the system to look at food advertising during sporting events. 

Dr. Smithers says, "The advertising data collected for this project could have many more users and collection is ongoing." She says her team is also open to inquiries from other researchers regarding use of the data. 

Dr. John Kelly, CEO of the National Heart Foundation says, "The research findings are disturbing but he's proud the Heart Foundation is supporting this research with a 2015 Vanguard grant." He says, "As a charity and the largest non-government funder of heart disease research in Australia, the Heart Foundation is proud to invest in research to help all Australians have better heart health."

And he wishes to thank the foundation's generous donors who make important research such as this project happen.

So, this is an interesting study examining television advertising of junk food in Australia at times when children are most likely to be watching TV.


So, what do you think moms and dads? Here in America, would we find similar results? I think we would. Perhaps, junk food advertising is even worse here in the USA. If that were the case, I don't think any of us would be surprised because our democracy cringes when talks turn to anything other than industry written and self-imposed but never enforce rules of food marketing engagement with kids.

So, really it's up to us, moms and dads, right? It's up to us to be aware of the tricks that food marketers use to entice our children to convince us to buy their products for them. 

Please don't take the bait. Watch TV with your kids. And here's actually a fun activity. Okay, this really can be fun. When these commercials come on, with cartoon characters or sports stars or movie stars or fashion models, when any of these folks try to convince our children, or us for that matter, to buy a particular product, let's remind our kids often and in an age-appropriate way, that it's really about the money. 


We the people making lots of money for someone else, which gives us the chance to talk about capitalism with our kids which can actually be fun. And I recommend starting this conversation at a young age. Again, in an age-appropriate way because it doesn't take kids long to recognize the pattern, especially when you make it a game.

And then it's not long before they are the ones telling you or their young friends, "Hey, that's not right. They just want us to buy something. They don't really care if we eat it or not. They just want our money."

And the kids love that sort of game, especially if the baseline tone of your home has any degree of sarcasm in it, like it does in our house. But you do have to watch TV with them to have those age-appropriate conversations. 
Now, look, don't get me wrong. Capitalism in many ways has helped our country grow and prosper tremendously. There are lots of great, great things about capitalism including the current state of my retirement savings. 


But sneaky marketing tricks to entice children to crave and covet products that negatively impact their health and well-being and ultimately bring them harm, that's not one of them. It's okay to stand up to that trickery. And the earlier our children recognized it for what it is, the better equipped they will be to make healthy choices in the future.

While antibiotics have greatly reduced the dangers of ear infections, serious neurological complications including hearing loss, facial paralysis, meningitis and brain abscess still occur. This, according to a report written by doctors Michael Hutz, Dennis Moore and Andrew Hotaling, all ear, nose, and throat specialists for Loyola Medicine and published in the journal Current Neurology and Neuroscience Reports.

The authors say otitis media, which is the medical term for the common ear infection, occurs when a cold, allergy or upper respiratory infection leads to the accumulation of pus and mucus behind the eardrum, causing ear ache and swelling.


In developed countries, about 90% of children have at least one episode of otitis media before school age, usually between the ages of six months and four years. Today, secondary complications from otitis media occur in approximately one out of every 2,000 children in developed countries.

The potential seriousness of ear infections was first reported by the Greek physician Hippocrates in 460 BC when he said, "Acute pain of the ear with continued high fever is to be dreaded for the patient may become delirious and die."

The deadliest complication of otitis media is a brain abscess, an accumulation of pus in the brain due to an infection. The most common symptoms of brain abscess are headache, fever, nausea, vomiting, neurological deficits and altered consciousness.

With modern neurosurgical techniques, most brain abscesses can be suctioned or drained followed by IV antibiotics for six to eight weeks.


During the past 50 years, worldwide death from brain abscesses has decreased from 40% of all cases to 10% and the rate of full recovery has increased from 33% to 70%.

Other possible complications of the common ear infection include bacterial meningitis. Symptoms include severe headache, high fever, stiff neck, irritability, altered mental status and malaise. As the infection spreads, the patient develops more severe restlessness, delirium and confusion. Treatment is high-dose IV antibiotics for 7 to 21 days.

Acute mastoiditis is another possibility. This is an infection that affects the mastoid bone which is located behind the ear. It must be treated to prevent it from progressing to more serious complications like a brain abscess. Treatments include IV antibiotics and placement of a drainage tube.

Hearing loss is also possible. Permanent hearing loss is rare, occurring in about 2 out of every 10,000 children who have otitis media. Rare but it can happen.


And then, facial paralysis, prior to antibiotics, this debilitating complication occurred in about 2 of every 100 cases of otitis media. Since antibiotics, the rate has dropped to 1 in every 2,000 cases.

This is some good news with facial paralysis associated with ear infections. The good news is about 95% of those affected recover completely. However, there are more serious causes of facial paralysis. So, always treat it as an emergency and have your child seen right away if they have any paralysis of the face.

The authors say, "Antibiotic therapy has greatly reduced the frequency of these complications from otitis media. However, it is of vital importance to remain aware of the possibility of neurologic complications. It's important to recognize symptoms early, obtain prompt imaging and laboratory studies, and provide the proper multi-disciplinary referrals to guide management and reduce the severity of disease."


So I think this is an important public service announcement for parents because in this age of antibiotics stewardship, using antibiotics only when absolutely necessary, which is a good thing, in of itself. And then, there is also this idea of watching and waiting to treat ear infections especially in older kids. And with studies demonstrating an association between early antibiotic use and alterations in the gut microbiome and the possibility that this plays a role in the development of various allergic conditions including food allergies, season allergies, asthma, eczema. 

With all that in mind, and these are very important and worthwhile considerations, but my observation is that that's led many medical providers to be less aggressive in their diagnosis of otitis media or ear infections and its treatment with antibiotics.

There is a middle road here, I think. We don't want to overprescribe antibiotics but we don't want to under-prescribe them either. And we should all, doctors and parents alike, be on a lookout for neurological complications when our children are sick with the common ear infection.



Dr. Mike Patrick: All right, we are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. Really do appreciate that. 
Don't forget, you can find us in all sorts of places. We are in iTunes, the Apple podcast app, Google Play, iHeart Radio, Spotify, and most mobile podcast apps for iOS and Android. Even the apps for like Apple TV, you can find PediaCast there as well.


So, if there is a particular podcasting app that you'd like to use and you can't find PediaCast there, let me know. Just use the Contact Page over at and we'll try to get our content ahead to their lineup. 

Don't forget we also have a landing site, You'll find our entire archive of past episodes, all of our Show Notes, our transcripts, so if you'd want to read the content rather than listen to it. We also have our Terms of Use Agreement there, very important, and that Contact page so that you can ask questions and suggest topics.

We're also a part of the Parents On Demand Network at It's a collection of podcasts for moms and dads. That collection includes PediaCast, along with many others. There's a Parents On Demand Network mobile app which you can find in the App Store and Google Play. 

The network's also featured in iTunes so you can subscribe to each show easily. 


Speaking of those shows, you might want to check out one called the Empowered Mama podcast. And we try to highlight a different podcast each month from that network. And that's my recommendation for the month of May, the Empowered Mama podcast with the host Lisa Druxman. It's a weekly podcast aimed at helping moms achieve health and wellness.

Lots of great topics including staying on top of stress and finances, organizing your house, setting goals and priorities, planning your day, nurturing confidence and a positive attitude while tossing our worry and regret, all important things. Also relationship maintenance, and of course, a healthy eating, and hints and tips on choosing and sticking with an exercise plan. 

So, it's a great podcast, folks, very helpful for empowering mamas. And I do encourage you to check it out. I'll put a link to the Empowered Mama podcast in the Show Notes. You can also search for it in all places podcast. Again, Empowered Mama podcast.


Also, I would like to remind you that reviews of PediaCast wherever you listen to your podcast are extremely helpful. When you think about buying a product or using a service or going out to a restaurant, we use all sorts of types of review applications and sites in order to choose what we're going to buy, or do, or eat. 

So products on Amazon, we read a reviews. Angie's List can help us with services. Yelp is a great place to find reviews on restaurants. Even hotels and activities, you can use TripAdvisor, Rotten Tomatoes for checking out movies and TV shows. 

And it's important for podcast as well. So if you listen to PediaCast often, I would just ask, it's freely available for you, I would just ask that you just take a couple of minutes to write a quick review, wherever it is that you most listen to podcast. So you can help other parents make a determination of whether they want to check us out or not.


We are also on social media, on Facebook, Twitter, Google+, Pinterest and even LinkedIn. Simply search for PediaCast, you can find us there. 

And, of course, we really appreciate it when you tell others about the program face to face, your family, friends, neighbors, co-workers, babysitters, childcare workers, grandparents, anyone who has kids or takes care of kids and would benefit from listening to this program. That includes your child's teacher and, of course, his or her pediatric medical provider.

And while you have their ear and letting them know about this show so they can share it with their other families, let them know we have a podcast for them as well. PediaCast CME, the CME stands for Continuing Medical Education. That show is similar to this program. We do turn the science up a couple of notches and offer free Category 1 Continuing Medical Education Credit for those who listen. Shows and details are available at the landing site for that show,

PediaCastCME is also on iTunes, the Apple podcast app, Google Play, iHeart Radio, Spotify, and most mobile podcast apps. Simply search for PediaCast CME. 


All right, I want to thank all of you once again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids. So long, everyone. 


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

Leave a Reply

Your email address will not be published. Required fields are marked *